New and Simple Approach for Preventing Postoperative Peritoneal Adhesions: Do not Touch the Peritoneum without Viscous Liquid—A Multivariate Analysis

Background. Postoperative peritoneal adhesions (PPAs) are an unsolved and serious problem in abdominal surgery. Method. Viscous liquids of soybean oil, octyl methoxycinnamate, flax oil, aloe vera gel, and glycerol were used in five experiments, using the same methodology for each. Liquids were applied in the peritoneal cavity before and after mechanical peritoneal trauma. Results were evaluated by multivariate analysis. Results. Compared with the control group, macroscopic and microscopic adhesion values before (P < .001) and after (P < .05) application of viscous liquids significantly reduced PPAs. Values were significantly lower when liquids were applied before rather than after peritoneal trauma (P < .0001). Discussion. Viscous liquids injected into the peritoneal cavity before or after mechanical peritoneal trauma decrease PPA. Injection before trauma was more effective than after trauma. In surgical practice, PPA formation may be prevented or decreased by covering the peritoneal cavity with an appropriate viscous liquid before abdominal surgery

High-concentration compact agar gels from hydrothermal synthesis

3 páginas, 2 figuras, 1 tabla.-- et al.A simple hydrothermal method has been used to prepare for the first time high-concentration, microstructurally compact agar hydrogels (3–30 g agar per 100 ml H2O). These gels reach concentrations unachievable by conventional methods and overcome problems normally associated to them. They feature superior homogeneity, modified and controllable porosity, increased densities and higher strength, thus widening possible applications of this widely used biocompatible polysaccharide.Partial funding from the Spanish Ministry of Science and Innovation (MICINN) (CTQ2008-06779-C02-01).Peer reviewe

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Çocuklarda Gastroözefageal Reflünün Süt ve Daimi Diş Erozyonu ile İlişkisi: Literatür Derlemesi

&lt;p class="MsoNormal" style="text-align: justify; line-height: 13pt; margin: 0in 0in 3pt; tab-stops: 9.0pt; mso-layout-grid-align: none;"&gt;&lt;span style="font-size: 9pt;"&gt;&lt;span style="font-family: Times New Roman;"&gt;Gastroözefageal reflü, özafagusun en sık görülen hastalığı olması yanında çocukluklarda da sıklıkla görülebilmektedir. Mekanizması tam olarak anlaşılmasa da genetik, çevresel, anotomik, hormonal ve nörojenik olaylarla ilgili olduğu gösterilmiştir. Gastroözefageal&lt;span style="color: red;"&gt; &lt;/span&gt;reflü hastalarında uzun vadede beslenme sorunları, özafagitis, anemi, apne, aspirasyon pnömonisi ve yemek borusu daralması gibi sorunlarla karşılaşılabilir. Dişlerdeki erozyon ile regürjitasyon ya da kusma vakalarının ilişkisi birçok çalışmada belirtilmiştir. Özellikle küçük çocuklarda reflü kontrol mekanizmalarının gelişmemiş olması, Gastroözefageal reflünün süt dişlerindeki erozyonunu daha belirgin hale getirebilmektedir. Gastroözefageal reflü erken dönemde diş hekimi muayenesi ile saptanabilmekte, hastalığın erken dönemde teşhisi ile ilerlemesi önlenebilmektedir. Gastroözefageal reflülü çocuk hastaların dişlerindeki erozyon koruyucu önlemlerin alınması ve hastanın bilinçlendirilmesiyle önlenebilir hale gelebilmektedir.&lt;/span&gt;&lt;/span&gt;&lt;/p&gt