Laparoscopic management of suspicious adnexal masses

OBJECTIVE: Our aim was to evaluate the feasibility and applicability of operative laparoscopy in the management of adnexal masses that do not meet the standard serum CA 125 and ultrasonographic criteria for benignity. STUDY DESIGN: One hundred thirty-eight patients underwent operative laparoscopy for removal of suspicious adnexal masses. The CA 125 level was >35 mIU/ml in 39 of 138 (28%) patients; ultrasonographic findings were abnormal in 127 of 138 (92%); masses were >10 cm in 43 of 138 (32%) of patients. RESULTS: Malignancies were discovered in 14% (19/138) of patients. Eight percent (11/138) of the procedures were converted to laparotomy, six because of inability to dissect the mass laparoscopically and five for staging or debulking of carcinoma. Operative times ranged from 25 to 210 minutes, with a mean of 86. Three major complications were encountered-an enterotomy and a lacerated vena cava, both of which were repaired laparoscopically, and a small bowel herniation through a lateral port site that required reoperation. Hospital stays ranged from 0 to 11 days, with a mean of 1.5. In two patients with "apparent" stage I adnexal carcinomas recurrence was diagnosed 6 and 38 months after surgery. CONCLUSIONS: Laparoscopic management of suspicious adnexal masses is technically feasible, with a low rate of morbidity and a short hospital stay. Adnexal carcinomas can be identified and managed appropriately with staging and complete resection as indicated. (Am J Obstet Gynecol 1996;175:1451-9.)     

Total fluid intake and its determinants: cross-sectional surveys among adults in 13 countries worldwide

Purpose

To evaluate the total fluid intake from drinking water and beverages in adult populations from different countries and assess the percentage of individuals complying with the European Food Safety Agency (EFSA) adequate intake (AI) of water from fluids.

Methods

A total of 16,276 adults (7580 men and 8696 women) aged between 18 and 70 years (mean age 39.8 years) were randomly recruited from 13 different countries from three continents. Information about the total daily fluid intake (sum of drinking water and beverages) was collected using a 24-h fluid-specific record over seven consecutive days.

Results

Important differences in total fluid intake between countries were found; however, few differences between men and women were reported in most of the countries. Less than 50 % of the women and approximately 60 % of the men do not comply with the EFSA AI of water from fluids. Women were more than twice as likely as men to meet these AI (OR 2.15; 95 % CI 2.02–2.29). The odds of meeting the AI of water from fluids were lower in individuals over 50 years (OR 0.88; 95 % CI 0.80–0.96). Nine percent of the total population consumed less than half of the AI, 40.5 % between 50 and 100 %, and 50.5 % more than the AI.

Conclusions

There were considerable differences in total fluid intake between countries but not between genders. Only 40 % of men and 60 % of women comply with the EFSA AI of water from fluids. Men and elderly individuals had an increased risk of not complying with this reference value.

     

Total fluid intake of children and adolescents: cross-sectional surveys in 13 countries worldwide

Purpose

To describe total fluid intake (TFI) according to socio-demographic characteristics in children and adolescents worldwide.

Methods

Data of 3611 children (4–9 years) and 8109 adolescents (10–18 years) were retrieved from 13 cross-sectional surveys (47 % males). In three countries, school classes were randomly recruited with stratified cluster sampling design. In the other countries, participants were randomly recruited based on a quota method. TFI (drinking water and beverages of all kinds) was obtained with a fluid-specific record over 7 consecutive days. Adequacy was assessed by comparing TFI to 80 % of adequate intake (AI) for total water intake set by European Food Safety Authority. Data on height, weight and socio-economic level were collected in most countries.

Results

The mean (SD) TFI ranged from [1.32 (0.68)] to [1.35 (0.71)] L/day. Non-adherence to AIs for fluids ranged from 10 % (Uruguay) to >90 % (Belgium). Females were more likely to meet the AIs for fluids than males (4–9 years: 28 %, OR 0.72, p = 0.002; 10–18 years: 20 %, OR 0.80, p = 0.001), while adolescents were less likely to meet the AI than children (OR 1.645, p < 0.001 in males and OR 1.625, p < 0.001 in females).

Conclusions

A high proportion of children and adolescents are at risk of an inadequate fluid intake. This risk is especially high in males and adolescents when compared with females or children categories. This highlights water intake among young populations as an issue of global concern.

     

Selective oxidation of alcohols and sulfides via O2 using a Co(ii) salen complex catalyst immobilized on KCC-1: synthesis and kinetic study

The aim of this study was to immobilize a Co(ii) salen complex on KCC-1 as a catalyst that can be recovered (Co(ii) salen complex@KCC-1). Field-emission transmission electron microscopy, FT-IR spectroscopy, thermogravimetric analysis, elemental analysis, atomic absorption spectroscopy, and XRD were used to confirm the structure and chemical nature of Co(ii) salen complex@KCC-1. The oxidation efficiency was obtained for an extensive range of sulfides and alcohols using this sustainable catalyst, alongside O₂ as an oxygen source and isobutyraldehyde (IBA) as an oxygen acceptor, with superior selectivity and conversion for the relevant oxidation products (sulfoxides and ketones or aldehydes) under moderate conditions. The μ-oxo and peroxo groups on the ligands of the Co complex appeared to be responsible for the superior activity of the catalyst. Essential factors behind the oxidation of alcohol and sulfoxides were investigated, including the catalyst, solvent, and temperature. In this paper, molecular oxygen (O₂) was used as a green oxidant. Furthermore, kinetic studies were conducted, revealing a first-order reaction for the oxidation of both benzyl alcohol and sulfide. The reaction progressed at mild temperature, and the catalyst could be easily recovered and reused for numerous consecutive runs under the reaction conditions, without any substantial reduction in the functionality of the catalytic system.

The aim of this study was to immobilize a Co(ii) salen complex on KCC-1 as a catalyst that can be recovered (Co(ii) salen complex@KCC-1).     

Dendritic structured palladium complexes: magnetically retrievable,highly efficient heterogeneous nanocatalyst for Suzuki and Heck cross-coupling reactions

The recyclable nanomagnetic Pd-complex PAMAM G₀-Pd@γ-Fe₂O₃ is reported for catalytic C–C cross-coupling reactions of challenging substrates. Mainly, a great variety of aryl chlorides can be used as substrates for Suzuki–Miyaura and Mizoroki–Heck reactions under mild reaction conditions (60–90 °C) and low catalyst loading (<1 mol% Pd) in aqueous media. The presence of numerous polar groups in the polymer matrix increases the solubility of the catalyst in water, thus facilitating its operation in aqueous environments. The immobilization of the catalyst on the surface of a magnetic platform allows its effective recovery and reuse without significant loss of catalytic activity for at least six cycles with total leaching of <1% palladium metal, meeting the requirements for acceptable metal residues in the pharmaceutical industry.

The recyclable nanomagnetic Pd-complex PAMAM G₀-Pd@γ-Fe₂O₃ is reported for catalytic C–C cross-coupling reactions of challenging substrates.     

Experimentelle Untersuchungen zur Frage unterschiedlicher Gewebstemperaturen bei tiefer Hypothermie und Wiedererwärmung

Ohne Zusammenfassung a. G. Mit 6 Textabbildungen VortragenderG. Rücker.     

Specific detection of mycobacteria by the immunofluorescent technique.

Using an indirect immunofluorescent technique, M. bovis var. BCG can be differentiated from M. avium in pure culture. The test involves using an unlabeled antiserum prepared against B-24, a type specific antigen of M. bovis var. BCG. In the same system M. bovis could be differentiated from other pathogenic my cobacteria in tissue sections of naturally and experimentally infected animals.