The interpretation of the figure of the prophet Jonah by Michelangelo on the ceiling of the sistine chapel : anatomical urological vision

A detailed analysis in the iconography and pictorial appearance of the scene of the "Prophet Jonah" painted by the artist Michelangelo Buonarroti (1475-1564) on the ceiling of the Sistine Chapel between the years 1508 and 1512. Literature review on the Italian Renaissance period and the life of Michelangelo Buonarroti and analysis of historical aspects of the evolution of studies of human anatomy in this period and the works of the artist. A comparative analysis of the representation of the figure of the fish on the left thigh of "Jonah" with a cross section of penis shows a curious similarity. The pictorial and iconographic analysis reveals an intensity of light on the pubic area and the position of the prophet with the legs spread apart and left hand placed on this region. A tube-shaped cloth covers the region and the angel at the side seems to be looking at this anatomical region of "Jonah". In fact, sets of iconographic and pictorial relate to the deciphered code. This description helps to confirm the relationship of the Renaissance art with the human anatomy; science has been much studied in this period. The design of a cross section of the penis is revealed with the two cavernous bodies with the septum between them and the spongy body. Considering the circumstances in which Michelangelo had painted, subjectivity was fundamental due to religious motivations added to the vigorous implications of a limited scientific knowledge typical of that era38

Adrenalectomia laparoscópica para o tratamento de metástase única de câncer de pulmão de células não-pequenas relato de quatro casos e revisão da literatura

Objetivo: o objetivo deste estudo é apresentar os resultados da adrenalectomia laparoscópica no tratamento de pacientes com metástase adrenal única de câncer pulmonar de células não-pequenas. Métodos: quatro pacientes diagnosticados com metástase adrenal única de câncer pulmonar de células não-pequenas foram submetidos à adrenalectomia laparoscópica transperitoneal. Resultados: o período de seguimento foi de cinco anos. Três pacientes evoluíram com recidiva do câncer e/ou metástase e faleceram, enquanto um foi considerado curado após cinco anos de seguimento. Conclusão: a utilização da laparoscopia é viável em casos de metástase adrenal única de câncer pulmonar de células não-pequenas. Entretanto, nossa experiência com esta doença é limitada em razão de sua raridade

Avaliação sensorial quantitativa da sensibilidade dentária com o uso de um dessensibilizante

O tratamento clareador se destaca por ser uma técnica conservadora, que pode proporcionar elevação da autoestima e melhorar o convívio social das pessoas. No entanto, pacientes expostos a essa terapia experimentam diferentes níveis de ocorrência e de intensidade de sensibilidade dentária. Essa sintomatologia é preocupante, pois tem sido apontada como o reflexo de uma eventual resposta pulpar frente ao tratamento realizado. Por outro lado, a presença de dor é desestimulante aos pacientes, prejudicando a evolução do tratamento e reduzindo o sentimento de satisfação. Apesar dessa importância, a maior parte dos estudos de sensibilidade dentária ainda emprega métodos subjetivos, dificultando a reprodutibilidade e interpretação dos resultados. Objetivo: nesse sentido, o presente artigo objetiva analisar a resposta neurossensorial proporcionada pela aplicação de estímulos térmicos gerados pelo equipamento TSA II (Medoc TSA II Neurosensory Analyzer, Israel), em um paciente submetido ao tratamento clareador, seguido pelo uso ou não uso de um dessensibilizante. Métodos: as análises foram realizadas antes do clareamento (AC), depois do clareamento (DC) e depois da aplicação ou não do dessensibilizante (DD) em cada hemiarcada estudada. Os dados foram submetidos ao teste t de Student, com nível de significância de 5%. Resultados: observou-se que o clareamento dentário alterou o limiar de sensação ao frio, provocando aumento da sensibilidade dentária, e que o uso do dessensibilizante foi efetivo. Conclusão: o uso de testes sensoriais quantitativos mostrou-se promissor para o estudo da sensibilidade dentária, podendo colaborar no estabelecimento de terapias seguras e confortáveis

Conversion of Eragrostis plana Nees leaves to activated carbon by microwave-assisted pyrolysis for the removal of organic emerging contaminants from aqueous solutions

Eragrostis plana Nees leaves, abundant lignocellulosic biomass, was used as carbon source for preparation of activated carbon, by using microwave-assisted pyrolysis and chemical activation. The novel activated carbon (MWEPN) was characterised by FTIR, CHN elemental analysis, Boehm’s titration method, TGA, SEM, N2 adsorption/desorption curves and pH of the point of zero charge (pHpzc). Afterwards, the adsorbent was successfully employed for adsorption of the two emerging contaminants (caffeine and 2-nitrophenol). The results indicated that MWEPN had a predominantly mesoporous structure with a high surface area of 1250 m2 g−1. FTIR analysis indicated the presence of carbonyl, hydroxyl and carboxylic groups on the surface of MWEPN. The Boehm analysis showed the existence of the high amount of acid moieties on the surface of activated carbon. Adsorption kinetic indicated that the system followed the Avrami fractional order at the optimal pH of 7. The equilibrium time was attained at 30 min. The Liu isotherm model better described the isothermal data. Based on the Liu isotherm, the maximum sorption capacities (Qmax) of caffeine and 2-nitrophenol adsorbed onto activated carbon at 25 °C were 235.5 and 255.8 mg g−1, respectively

Conversion of Eragrostis plana Nees leaves to activated carbon by microwave-assisted pyrolysis for the removal of organic emerging contaminants from aqueous solutions

Eragrostis plana Nees leaves, abundant lignocellulosic biomass, was used as carbon source for preparation of activated carbon, by using microwave-assisted pyrolysis and chemical activation. The novel activated carbon (MWEPN) was characterised by FTIR, CHN elemental analysis, Boehm’s titration method, TGA, SEM, N2 adsorption/desorption curves and pH of the point of zero charge (pHpzc). Afterwards, the adsorbent was successfully employed for adsorption of the two emerging contaminants (caffeine and 2-nitrophenol). The results indicated that MWEPN had a predominantly mesoporous structure with a high surface area of 1250 m2 g−1. FTIR analysis indicated the presence of carbonyl, hydroxyl and carboxylic groups on the surface of MWEPN. The Boehm analysis showed the existence of the high amount of acid moieties on the surface of activated carbon. Adsorption kinetic indicated that the system followed the Avrami fractional order at the optimal pH of 7. The equilibrium time was attained at 30 min. The Liu isotherm model better described the isothermal data. Based on the Liu isotherm, the maximum sorption capacities (Qmax) of caffeine and 2-nitrophenol adsorbed onto activated carbon at 25 °C were 235.5 and 255.8 mg g−1, respectively

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research