The laparoscopic treatment of perforated duodenal ulcer in Romania – a multicentric study

Clinica Chirurgie 2, Timișoara, România, Clinica Chirurgie, Spitalul de Urgență, București, Al XI-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” din Republica Moldova și cea de-a XXXIII-a Reuniune a Chirurgilor din Moldova „Iacomi-Răzeșu” 27-30 septembrie 2011Aims. This retrospective study was evaluated the results of laparoscopic treatment of the perforated duodenal ulcer (PDU) in 6 Romanian centres with an important experience in laparoscopic surgery.Methods. Between 2000 and 2010, 221 patients (38 females and 183 men) aged from 18 to 78 years, were operated laparoscopicaly for PDU, by using 3 (66.0%), 4 (27%) or 5 (7.0%) trocars. Forty six (20.8%) of them had a weak, 143(64.7%) an important and 32(14.5%) a grave peritonitis. Procedures performed were: simple suture 84(38.1%) patients, suture with epiplonoplasty 135(61.1%) patients, only epiplonoplasty 1(0.4%) patients, excision with suture 1(0.4%) patients. All patients had abundant peritoneal cavity washing and tub drainage (1-3 tubs).Results. The interventions lasted between 30 and 120 min, with an average of 63 min. No mortality was reported. Postoperative oral nutrition began after 24 hours for 114(51.6%) patients and after intestinal transit has restarted for 107(48.4%) patients. The intestinal transit has restarted after 1-6 days (average 3.5 days), depending of the gravity of peritonitis. Complications were: parietal infections 3 (1.3%), duodenal fistula 1 (0.4%), abdominal abcesses 1(0.4%), digestive haemorrhage 1(0.4%) and duodenal stenosis 1 (0.4%). Hospitalization lasted between 2 and 13 days (average 5.5 days). In comparison with open techniques, patients had the same intravenous perfusions, less pain, less antibiotics, less dressings, less complications during postoperative evolution. Conclusion. Laparoscopic treatment of PDU is safe even in case of severe peritonitis, with faster patient’s recovery. with less complications and with less postoperative medical care than open procedures. Aims. This retrospective study was evaluated the results of laparoscopic treatment of the perforated duodenal ulcer (PDU) in 6 Romanian centres with an important experience in laparoscopic surgery.Methods. Between 2000 and 2010, 221 patients (38 females and 183 men) aged from 18 to 78 years, were operated laparoscopicaly for PDU, by using 3 (66.0%), 4 (27%) or 5 (7.0%) trocars. Forty six (20.8%) of them had a weak, 143(64.7%) an important and 32(14.5%) a grave peritonitis. Procedures performed were: simple suture 84(38.1%) patients, suture with epiplonoplasty 135(61.1%) patients, only epiplonoplasty 1(0.4%) patients, excision with suture 1(0.4%) patients. All patients had abundant peritoneal cavity washing and tub drainage (1-3 tubs). Results. The interventions lasted between 30 and 120 min, with an average of 63 min. No mortality was reported. Postoperative oral nutrition began after 24 hours for 114(51.6%) patients and after intestinal transit has restarted for 107(48.4%) patients. The intestinal transit has restarted after 1-6 days (average 3.5 days), depending of the gravity of peritonitis. Complications were: parietal infections 3 (1.3%), duodenal fistula 1 (0.4%), abdominal abcesses 1(0.4%), digestive haemorrhage 1(0.4%) and duodenal stenosis 1 (0.4%). Hospitalization lasted between 2 and 13 days (average 5.5 days). In comparison with open techniques, patients had the same intravenous perfusions, less pain, less antibiotics, less dressings, less complications during postoperative evolution. Conclusion. Laparoscopic treatment of PDU is safe even in case of severe peritonitis, with faster patient’s recovery. with less complications and with less postoperative medical care than open procedures

Intensive laparoscopic laparoscopic training in live tissues – 11 years of experience in Pius Branzeu center from timisoara, Romania

Surgical Clinic II , University of Medicine and Pharmacy Timisoara, Romania, Al XI-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” din Republica Moldova și cea de-a XXXIII-a Reuniune a Chirurgilor din Moldova „Iacomi-Răzeșu” 27-30 septembrie 2011Aims: To assess the effectiveness of intensive laparoscopic training on pigs during 10 years of training. Method: Between 2000 and 2010, 25 intensive (3 days) and 7 advanced (2 days) laparoscopic courses (gastric, biliary, colo-rectal and bariatric) on live tissue were organized, with 324 participants coming from 13 countries. This poster presents the effectiveness of the training of the 244 surgeons who followed the 3 days laparoscopy skills courses. At the beginning of the first day, during the training and at the end of each day the acquirement of the skills participants were evaluated. Three groups where studied: the first group with no experience in laparoscopic surgery; the second group with less than 10 laparoscopic cholecystectomy and the third group with more than 10 laparoscopic cholecystectomy. Results: The first group had a lot of difficulty and were able to acquire only less than 32% of the taught techniques, the second group performed better and acquired 62% of the taught techniques and the third group performed very well acquiring 95% of the taught techniques. Conclusion: Surgeons with no previous laparoscopic surgery experience take little benefit from these courses. They should be encouraged to acquire basic skills on trainer boxes or on virtual reality simulators before the training on pigs. Surgeons with very little experience in laparoscopic surgery acquire important skills, but the best benefit is taken by surgeons with some laparoscopic surgery experience

Laparoscopic treatment for perforated duodenal ulcer

Clinica de Chirurgie 2, UMF “Victor Babeș” Timișoara, Clinica de Chirurgie, UMF ”Carol Davila”, București, Clinica de Chirurgie 2, UMF ”Grigore T Popa”, Iași, Clinica de Chirurgie 2, Facultatea de Medicină, Universitatea ”Ovidius”, Constanța, Clinica de Chirurgie 2, Facultatea de Medicina, Sibiu, Clinica de Chirurgie 1, UMF ”Iuliu Hațieganu”, Cluj- Napoca, Departamentul de Chirurgie I, Facultatea de Medicină, UMF Craiova, România, Al XII-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” din Republica Moldova cu participare internațională 23-25 septembrie 2015Introducere: Acest studiu retrospectiv evaluează rezultatele tratamentului laparoscopic în ulcerul duodenal perforat și este realizat în 7 spitale cu experiență în chirurgia laparoscopica din România. Material și metode: Între anii 2006 și 2013, 297 pacienți (48 femei, 249 bărbați) cu vârste cuprinse între 18 și 77 ani au fost supuși intervenției chirurgicale laparoscopice pentru ulcer duodenal perforat, cu utilizarea a 3 (61%), 4 (29%) sau 5 (10%) trocare. Șaizeci și doi (21%) dintre pacienți au prezentat o formă ușoară, 190 (64,1%) au prezentat o formă moderată și 45 (14,9%) o formă severă de peritonită. Procedurile utilizate au fost: sutura simplă – 118 (39,8%) pacienți, sutura cu epiplonoplastie – 176 (59,5%), doar epiplonoplastie – 1 (0,3%) pacient, excizie și sutură – 1 (0,3%) pacient. Rezultate: Durata intervențiilor a fost între 30 și 120 minute, cu o medie de 65 minute. Mortalitatea a fost nulă. Complicații: infecții parietale – 3 (1%), fistule duodenale – 3 (1%), abcese abdominale – 2 (0,6%), hemoragii digestive – 1 (0,3%) și stenoza duodenală – 1 (0,3%). Durata medie de spitalizare – 5,5 zile. În comparație cu tehnica clasica, pacienții au necesitat mai puține analgetice și antibiotice, cu 80% mai puține pansamente și au avut cu 70% mai puține infecții parietale în evoluția postoperatorie. Concluzii: Tratamentul laparoscopic pentru ulcerul duodenal perforat, este recomandat chiar și în cazurile cu peritonită severă, evoluția postoperatorie fiind cu mai puține complicații și cu o recuperare mai rapidă fața de procedura clasică. Aceast abord poate fi considerat “standard de aur” în tratamentul ulcerului duodenal perforat.Introduction: This retrospective study evaluates results of the laparoscopic treatment of perforated duodenal ulcer obtained in 7 centers with experience in laparoscopic surgery from Romania. Material and methods: A total of 297 (48 women and 249 men) patients with perforated duodenal ulcer underwent laparoscopic intervention between 2006 and 2013, with ages 18 to 77 years. Three (61%), 4 (29%) or 5 (10%) trocars were used. In 62 patients (21%) was diagnosed mild form of peritonitis, in 190 (64.1%) – moderate and in 45 (14.9%) – severe peritonitis. Types of repair used in this study: simple suture – 118 (39.8%) patients, suture with omental patch – 176 (59.5%), only sutured omental patch – 1 (0.3%), excision and suture – 1 (0.3%) patient. Results: Operation time was between 30 and 120 min, with average of 65 min. Mortality rate was zero. Complications: parietal infections – 3 (1%), duodenal fistula – 3 (1%), intraabdominal abscesses – 2 (0.6%), digestive bleeding – 1 (0.3%) and duodenal stenosis – 1 (0.3%). Average length of hospital stay – 5.5 days. Patients treated using laparoscopic technique needed less analgesics, antibiotics, 80% less dressing procedures and had 70% less surgical site infections in comparison to traditional operation. Conclusions: Laparoscopic treatment of perforated duodenal ulcer can be recommended even for patients with severe peritonitis. This treatment is associated with fewer complications and more rapid recovery than traditional intervention. Laparoscopic repair can be considered “gold standard” in the treatment of perforated duodenal ulcer

Academic student satisfaction and perceived performance in the e-learning environment during the COVID-19 pandemic: Evidence across ten countries

The outbreak of the COVID-19 pandemic has dramatically shaped higher education and seen the distinct rise of e-learning as a compulsory element of the modern educational landscape. Accordingly, this study highlights the factors which have influenced how students perceive their academic performance during this emergency changeover to e-learning. The empirical analysis is performed on a sample of 10,092 higher education students from 10 countries across 4 continents during the pandemic’s first wave through an online survey. A structural equation model revealed the quality of e-learning was mainly derived from service quality, the teacher’s active role in the process of online education, and the overall system quality, while the students’ digital competencies and online interactions with their colleagues and teachers were considered to be slightly less important factors. The impact of e-learning quality on the students’ performance was strongly mediated by their satisfaction with e-learning. In general, the model gave quite consistent results across countries, gender, study fields, and levels of study. The findings provide a basis for policy recommendations to support decision-makers incorporate e-learning issues in the current and any new similar circumstances.info:eu-repo/semantics/publishedVersio

Oral microbe-host interactions: influence of β-glucans on gene expression of inflammatory cytokines and metabolome profile

Background: The aim of this study was to evaluate the effects of β-glucan on the expression of inflammatory mediators and metabolomic profile of oral cells [keratinocytes (OBA-9) and fibroblasts (HGF-1) in a dual-chamber model] infected by Aggregatibacter actinomycetemcomitans. The periodontopathogen was applied and allowed to cross the top layer of cells (OBA-9) to reach the bottom layer of cells (HGF-1) and induce the synthesis of immune factors and cytokines in the host cells. β-glucan (10 μg/mL or 20 μg/mL) were added, and the transcriptional factors and metabolites produced were quantified in the remaining cell layers and supernatant. Results: The relative expression of interleukin (IL)-1-α and IL-18 genes in HGF-1 decreased with 10 μg/mL or 20 μg/mL of β-glucan, where as the expression of PTGS-2 decreased only with 10 μg/mL. The expression of IL-1-α increased with 20 μg/mL and that of IL-18 increased with 10 μg/mL in OBA-9; the expression of BCL 2, EP 300, and PTGS-2 decreased with the higher dose of β-glucan. The production of the metabolite 4-aminobutyric acid presented lower concentrations under 20 μg/mL, whereas the concentrations of 2-deoxytetronic acid NIST and oxalic acid decreased at both concentrations used. Acetophenone, benzoic acid, and pinitol presented reduced concentrations only when treated with 10 μg/mL of β-glucan. Conclusions: Treatment with β-glucans positively modulated the immune response and production of metabolites