Goodbye Hartmann trial: a prospective, international, multicenter, observational study on the current use of a surgical procedure developed a century ago

Background: Literature suggests colonic resection and primary anastomosis (RPA) instead of Hartmann's procedure (HP) for the treatment of left-sided colonic emergencies. We aim to evaluate the surgical options globally used to treat patients with acute left-sided colonic emergencies and the factors that leading to the choice of treatment, comparing HP and RPA. Methods: This is a prospective, international, multicenter, observational study registered on ClinicalTrials.gov. A total 1215 patients with left-sided colonic emergencies who required surgery were included from 204 centers during the period of March 1, 2020, to May 31, 2020. with a 1-year follow-up. Results: 564 patients (43.1%) were females. The mean age was 65.9 ± 15.6 years. HP was performed in 697 (57.3%) patients and RPA in 384 (31.6%) cases. Complicated acute diverticulitis was the most common cause of left-sided colonic emergencies (40.2%), followed by colorectal malignancy (36.6%). Severe complications (Clavien-Dindo ≥ 3b) were higher in the HP group (P < 0.001). 30-day mortality was higher in HP patients (13.7%), especially in case of bowel perforation and diffused peritonitis. 1-year follow-up showed no differences on ostomy reversal rate between HP and RPA. (P = 0.127). A backward likelihood logistic regression model showed that RPA was preferred in younger patients, having low ASA score (≤ 3), in case of large bowel obstruction, absence of colonic ischemia, longer time from admission to surgery, operating early at the day working hours, by a surgeon who performed more than 50 colorectal resections. Conclusions: After 100 years since the first Hartmann's procedure, HP remains the most common treatment for left-sided colorectal emergencies. Treatment's choice depends on patient characteristics, the time of surgery and the experience of the surgeon. RPA should be considered as the gold standard for surgery, with HP being an exception

CULTIVAR RELEASE - BRS 335: A midseason high-yielding upland cotton cultivar for Northeast Brazilian savanna

Cotton cultivar BRS 335 is a midseason high-yield cultivar and has adaptation to the Northeast Brazilian savanna, yield stability, desirable resistance to main cotton diseases and good fiber quality. The cultivar BRS 335 meets growers’ demands for competitive lint yield as well as fulfilling industrial textile requirements

Design e ergonomia: aspectos tecnológicos

Nesta coletânea são apresentadas diferentes questões, métodos de abordagem e demandas para a aplicação da Ergonomia no Design. A evolução tecnológica observada nas últimas décadas proporcionou inúmeros benefícios para o aumento na qualidade de vida das pessoas, mas também resultou em vários problemas de interface tecnológica, os quais geram constrangimentos, acidentes, e frustração aos consumidores. Tais questões são analisadas no livro, no qual se destacam temas de grande atualidade, como por exemplo: o uso de equipamentos médico-hospitalares por indivíduos obesos e de cadeiras de rodas por indivíduos idosos; as avaliações ergonômicas de espaços e equipamentos escolares; as dificuldades de leitura em rótulos e bulas de embalagens; o uso de colete de proteção nas atividades policiais, de calçados femininos com salto alto ou da poltrona do motorista de ônibus urbano, entre outros. Os artigos relatam pesquisas desenvolvidas no Programa de Pós-graduação em Design da UNESP, Campus Bauru, e ressaltam a importância da aplicação da ergonomia no design de produtos e sistemas, com a finalidade de se desenvolver tecnologias para melhorar a qualidade de vida human