Laparoscopic Thal versus laparoscopic Nissen fundoplication in children: Comparative study regarding outcome and patient satisfaction

Introduction Gastroesophageal reflux disease is a common condition in pediatric age group. Many surgeons believe that complete fundoplication provides better reflux control, yet it results in more dysphagia and gas-bloat symptoms. On the other hand, a partial wrap is reported to have fewer adverse effects but a higher failure rate in controlling reflux. Until now, there is no agreement and little evidence as to whether complete or partial  fundoplication is the optimal procedure in this age group.Patients and methods This is a prospective singleblinded randomized comparative study that included 30 patients who were admitted in the time period from May 2013 to May 2015 and were treated laparoscopically byeither Nissen or Thal fundoplication.Results Operative time (minutes) was significantly longer in the Thal group (186 ± 52) when compared with the Nissen group (150 ±48) (P =0.031). Intraoperative complications showed no significant difference when comparing the two groups. Although the incidence of postoperative dysphagia was statistically insignificant, the duration of dysphagia did  show significantly shorter duration in the Thal group (median: 6 days), when compared with the Nissen group (median: 17 days). There was no recurrence in the Thal group, whereas there was one recurrence in the Nissen group.Conclusion This study suggests that Thal fundoplication offers an effective alternative to Nissen fundoplication with apparently shorter duration of dysphagia and thus earlier return to the normal eating pattern. Level of evidence

Diffusion tensor magnetic resonance imaging in the gradingof liver fibrosis associated with congenital ductal plate malformations

Purpose: Liver biopsy is still the standard method for the diagnosis of ductal plate malformations (DPM). However, it is an invasive tool. Magnetic resonance imaging (MRI) has shown its accuracy in the diagnosis of this pathology. Herein, a study was conducted to elucidate the role of diffusion MRI parameters in predicting the degree of hepatic fibrosis. Material and methods: This prospective study included 29 patients with DPM and 20 healthy controls. Both groups underwent diffusion tensor magnetic resonance imaging (DT-MRI), and its parameters were compared between patients and controls, and then they were correlated with the degree of liver fibrosis in the patient group. Results: All patients with DPM, whatever its type, expressed a significantly lower hepatic apparent diffusion coefficient (ADC) compared to controls. However, fractional anisotropy (FA) showed no significant difference between them. The ADC value of 1.65 × 10-3 mm2/s had sensitivity and specificity of 82.1% and 90%, respectively, in differentiating DPM patients from healthy controls. It was evident that patients with higher fibrosis grades had significantly lower hepatic ADC, indicating a negative correlation between ADC and the grade of hepatic fibrosis; rs = -0.901, p < 0.001. Conclusions: DT-MRI showed good efficacy in the diagnosis of congenital DPM. Moreover, ADC could be applied to monitor the degree of liver fibrosis rather than the invasive liver biopsy. No significant correlation was noted between the FA and the grades of liver fibrosis

An integrated methodology for surface soil moisture estimating using remote sensing data approach

The present study aimed to propose an operational approach for estimating surface soil moisture from Moderate Resolution Imaging Spectroradiometer (MODIS) data by considering diverse environmental variables such as Normalized Difference Vegetation Index (NDVI), land surface temperature (Ts), evapotranspiration, topographic parameters (elevation and aspect) and soil texture (clay, loam and silt). A soil moisture index (SMI) derived from NDVI-Ts space is combined to all other variables, based on stepwise multiple regression, to develop a new SSMC model. Performance of this model was assessed using field-measured data of SSM. Accuracy was performed by the k-fold cross validation method, it showed a R2 (coefficients of determination) of 0.70, RMSE of 1.58% and unRMSE of 0.5%. In addition, the results of the developed model were compared with another soil moisture model SMM proposed in the irrigated perimeter of Tadla (Morocco), and revealed that the established model provided effectiveness results in the study areas

Cannulation rates and technical performance evaluation of commericially available single-use duodenoscopes for endoscopic retrograde cholangiopancreatography: A systematic review and meta-analysis

Background: Single use duodenoscopes were developed to reduce the risk of infection transmission from contaminated reusable duodenoscopes. To this end, we examined various biliary interventions using single use duodenoscopes in patients undergoing endoscopic retrograde cholangiopancreatography (ERCP). Methods: Medline, Embase, Scopus, and Cochrane databases were searched from inception through Aug 2022 to identify studies reporting on the performance of single use duodenoscopes for ERCP. Results: Seven articles were included in the final analysis that included 642 patients (318 males). The Exalt Model D duodenoscope was used in most cases (88.8%) followed by the aScope Duodeno (11.2%) for ERCP. Most ERCPs had a complexity grade of 2 (n&nbsp;=&nbsp;303) and 3 (n&nbsp;=&nbsp;198). The pooled cumulative rate of successful cannulation was 95% (95% Confidence Interval (CI): 93-96%, I2=0%, P&nbsp;=&nbsp;0.46). Sphincterotomy was successfully performed in all cases. The pooled cumulative rate of PEP was 2% (95% CI: 0.4-3.4%, I2=0%, P&nbsp;=&nbsp;0.80). The pooled cumulative rate of total adverse events was 7% (95% CI: 4-10%, I2=47%, P&nbsp;=&nbsp;0.08). Conclusions: The results of this systematic review and meta-analysis show that single use duodenoscopes are associated with high cannulation rates, technical performance, and safety profile

Wet- versus dry-suction techniques for EUS-FNA of solid lesions: A systematic review and meta-analysis

The optimal sampling techniques for EUS-FNA remain unclear and have not been standardized. To improve diagnostic accuracy, suction techniques for EUS-FNA have been developed and are widely used among endoscopists. The aim of this study was to compare wet-suction and dry-suction EUS-FNA techniques for sampling solid lesions. We performed a comprehensive literature search of major databases (from inception to June 2020) to identify prospective studies comparing wet-suction EUS-FNA and dry-suction EUS-FNA. Specimen adequacy, sample contamination, and histologic accuracy were assessed by pooling data using a random-effects model expressed in terms of odds ratio (OR) and 95% confidence interval (CI). Six studies including a total of 418 patients (365 wet suction vs. 377 dry suction) were included in our final analysis. The study included a total of 535 lesions (332 pancreatic lesions and 203 nonpancreatic lesions). The pooled odds of sample adequacy was 3.18 (CI: 1.82-5.54, P = 0.001) comparing wet- and dry-suction cohorts. The pooled odds of blood contamination was 1.18 (CI: 0.75-1.86, P = 0.1). The pooled rate for blood contamination was 58.33% (CI: 53.65%-62.90%) in the wet-suction cohort and 54.60% (CI 49.90%- 59.24%) in the dry-suction cohort (P = 0.256). The pooled odds of histological diagnosis was 3.68 (CI 0.82-16.42, P = 0.1). Very few adverse events were observed and did not have an impact on patient outcomes using either method. EUS-FNA using the wet-suction technique offers higher specimen quality through comparable rates of blood contamination and histological accuracy compared to dry-suction EUS-FNA

2021 GenZ Story Express Projects: Allan Hall

Every spring, Lynn University holds the Nuremberg Trials class and the GenZ Story Expression Workshop—which culminate in an event that has been treasured by students and the Boca Raton community for more than a decade. Both provide special opportunities for students to explore history with the people who survived it. In 2013, Lynn partnered with NEXT GENERATIONS, a Boca Raton-based organization that strives to preserve the legacy of those who perished and honor those who survived the Holocaust, to expand the class to the GenZ Story Expression Workshop. As part of the workshop, students hear from a survivor firsthand. Later, they create a story expression project through creative mediums such as art, poetry, music, film, theater, technology, blogs or social media. The purpose is for students to express what they have heard in a way to reach out to others who have not heard the survivor’s story and may not be familiar with the horrors of the Holocaust. Due to Covid-19 safety concerns, this year’s workshop was held on Zoom. Final projects are typically displayed at the Project Nuremberg Lawyers Luncheon at Temple Beth El in Boca Raton and at Lynn’s annual Celebration of the Arts. Since those events were cancelled, this iBook was created as a tribute to the Holocaust survivor.https://spiral.lynn.edu/genz-workshop/1001/thumbnail.jp