Red Wine Polyphenols and Vascular Function

Hippocrates, the father of modern medicine, said many centuries ago: “let food be your medicine.” Today, this quote still shows its value, amongst others by the !nding that red wine consumption attributes to a healthy life style, reducing the risk to develop cardiovascular diseases. Cardiovascular diseases are one of the leading causes of death in many economically developed countries as well as in emerging economies.1 It has become a global epidemic problem, with type 2 diabetes, hypertension and, obviously, aging as one of the major risk factors. Red wine might interfere with one or more of these factors, and thus contribute in the prevention of cardiovascular diseases

Duhamel versus transanal endorectal pull through (TERPT) for the surgical treatment of Hirschsprung’s disease

For the surgical treatment of Hirschsprung’s disease, several surgical techniques are used to resect the distal aganglionic colon. Two frequently used techniques are the Duhamel procedure and the transanal endorectal pull-through procedure. During the ‘8th Pediatric Colorectal Course’ in Nijmegen, November 2015, a workshop was organized to share experiences of both techniques by several experts in the field and to discuss (long term) outcomes. Specifically, the objective of the meeting was to discuss the main controversies in relation to the technical execution of both procedures in order to make an initial assessment of the limitations of available evidence for clinical decision-making and to formulate a set of preliminary recommendations for current clinical care and future research

Feasibility and repeatability of ultrasound-guided surface electroenterography to measure colonic slow wave motility in healthy adults

Surface electroenterography is a potential non-invasive alternative to current diagnostics of colonic motility disorders. However, electrode positioning in electroenterography is often based on general anatomy and may lack generalizability. Furthermore, the repeatability of electroenterography measurements is unknown. This study aimed to evaluate ultrasound-guided electrode positioning for electroenterography measurements and to determine the repeatability of those measurements. In ten healthy adults, two electroenterography procedures were performed, consisting of fasting, ultrasound-guided electrode localization and two 20-minute electroenterography recordings separated by a meal. The dominant frequency, the mean power density (magnitude of colonic motility) and the power percent difference (relative pre- to postprandial increase in magnitude) were determined. Repeatability was determined by Lin’s concordance correlation coefficient. The results demonstrated that the dominant frequency did not differ between pre- and postprandial recordings and was 3 cpm, characteristic of colonic motility. The mean power density increased between the pre- and postprandial measurements, with an average difference of over 200%. The repeatability of both the dominant frequency and power density was poor to moderate, whereas the correlation coefficient of the power percent difference was poor. Concluding, ultrasound-guided surface electroenterography seems able to measure the gastrocolic reflex, but the dissatisfactory repeatability necessitates optimization of the measurement protocol.</p

A Microsoft HoloLens Mixed Reality Surgical Simulator for Patient-Specific Hip Arthroplasty Training

Surgical simulation can offer novice surgeons an opportunity to practice skills outside the operating theatre in a safe controlled environment. According to literature evidence, nowadays there are very few training simulators available for Hip Arthroplasty (HA). In a previous study we have presented a physical simulator based on a lower torso phantom including a patient-specific hemi-pelvis replica embedded in a soft synthetic foam. This work explores the use of Microsoft HoloLens technology to enrich the physical patient-specific simulation with the implementation of wearable mixed reality functionalities. Our HA multimodal simulator based on mixed reality using the HoloLens is described by illustrating the overall system, and by summarizing the main phases of the design and development. Finally, we present a preliminary qualitative study with seven subjects (5 medical students, and 2 orthopedic surgeons) showing encouraging results that suggest the suitability of the HoloLens for the proposed application. However, further studies need to be conducted to perform a quantitative test of the registration accuracy of the virtual content, and to confirm qualitative results in a larger cohort of subjects

The use of curved vs. straight instruments in single port access surgery, on standardized box trainer tasks

BACKGROUND: Single-port access (SPA) surgery is a novel surgical technique to create nearly "scarless" surgery. SPA surgery appears to be safe and feasible, but the exposure and handling of tissue may not be optimal. Therefore, the performance of SPA surgery with different instruments used and conventional laparoscopy is compared. METHODS: Fifteen participants (>50 laparoscopic procedures) performed three basic tasks (translocation, clip & cut, and tissue dissection, based on the fundamentals of laparoscopic surgery) in the box trainer in laparoscopy and SPA settings with both (conventional) crossed and curved instruments. All participants completed a questionnaire, which asked their opinion on the use of instruments and preference. RESULTS: Translocation was performed significantly faster in both laparoscopy and SPA crossed than SPA curved (means, 130.3 and 137.7 vs. 170.7 sec; p < 0.001 and p = 0.005). The errors also were less in laparoscopy and SPA crossed (means, 0.9 and 1.2 vs. 1.6), but not significant. The time to complete the dissection was almost equal between laparoscopy and SPA curved settings, but took longer for SPA crossed, although not significantly (148.1 and 150.8 vs. 179.5 sec). The errors only differed significantly between laparoscopy and SPA crossed (means, 0.5 vs. 1.27; p = 0.044). Fourteen participants still favored conventional laparoscopy and one SPA curved. They also thought SPA curved was better than crossed (means, 3.6 vs. 2.47; p = 0.003) and that exposure is superior in curved (means, 3.4 vs. 2.27; p = 0.002). CONCLUSIONS: Although conventional laparoscopy may appear most effective for proper dissection and exposure of tissue, single-port access surgery shows potential. Especially in the tissue dissection task, there is no significant difference in time or errors between conventional laparoscopy and SPA surgery, using specially designed curved instruments. Although the participants favor conventional laparoscopy, this could evolve to a more accepting mind when SPA surgery becomes more available and used in the clinical setting