Current trends regarding protective ileostomy after restorative proctocolectomy

AbstractThe decision to perform a protective ileostomy after ileoanal-pouch anastomosis is con- troversial, and most of the discussion is based on its advantages and disadvantages. Al- though a temporary intestinal diversion has been routinely indicated in most patients, this choice is also associated with complications. The present work aims to review the outcomes after restorative proctocolectomy with or without a protective ileostomy in the treatment of ulcerative colitis and polyposis syndromes. Most papers emphasize that di- version protects against anastomosis leaks; consequently, it may prevent pelvic sepsis and pouch failure. Otherwise, a defunctioning ileostomy may cause morbidity such as dehydra- tion, electrolyte imbalance, psychological problems, skin irritation, anastomosis strictures and intestinal obstruction, among others. There are those who believe that the omission of an ileostomy after the confection of ileal pouches should be reserved for selected patients, with quite acceptable results. The selection criteria should include surgeon, patient and procedure features to ensure a good outcome

Spin-orbit coupling effects in zinc-blende InSb and wurtzite InAs nanowires: Realistic calculations with multiband k.p method

A systematic numerical investigation of spin-orbit fields in the conduction bands of III-V semiconductor nanowires is performed. Zinc-blende (ZB) InSb nanowires are considered along [001], [011], and [111] directions, while wurtzite (WZ) InAs nanowires are studied along [0001] and [10 (1) over bar0] or [11 (2) over bar0] directions. Robust multiband k center dot p Hamiltonians are solved by using plane-wave expansions of real-space parameters. In all cases, the linear and cubic spin-orbit coupling parameters are extracted for nanowire widths from 30 to 100 nm. Typical spin-orbit energies are on the mu eV scale, except for WZ In As nanowires grown along [10 (1) over bar0] or [11 (2) over bar0], in which the spin-orbit energy is about meV, largely independent of the wire diameter. Significant spin-orbit coupling is obtained by applying a transverse electric field, causing the Rashba effect. For an electric field of about 4 mV/nm, the obtained spin-orbit energies are about 1 meV for both materials in all investigated growth directions. The most favorable system, in which the spin-orbit effects are maximal, are WZ InAs nanowires grown along [1010] or [11 (2) over bar0] since here spin-orbit energies are giant (meV) already in the absence of electric field. The least favorable are InAs WZ nanowires grown along [0001] since here even the electric field does not increase the spin-orbit energies beyond 0.1 meV. The presented results should be useful for investigations of optical orientation, spin transport, weak localization, and superconducting proximity effects in semiconductor nanowires

Preditores de bem-estar e qualidade de vida em homens submetidos à prostatectomia radical: estudo longitudinal

Objective: to identify socio-demographic, clinical and psychological predictors of well-being and quality of life in men who underwent radical prostatectomy, in a 360-day follow-up. Method: longitudinal study with 120 men who underwent radical prostatectomy. Questionnaires were used for characterization and clinical evaluation of the participant, as well as the instruments Visual Analog Scale for Pain, The Ways of Coping Questionnaire, Hospital Depression and Anxiety Scale, Satisfaction with Social Support Scale, Marital Satisfaction Scale, Subjective Well-Being Scale and Expanded Prostate Cancer Index. For data analysis, the linear mixed-effects model was used. Results: the socio-demographic factors age and race were not predictors of the dependent variables; time of surgery, problem-focused coping, and anxiety were predictors of subjective well-being; pain, anxiety and depression were negative predictors of quality of life; emotion-focused coping was a positive predictor. Marital dissatisfaction was a predictor of both variables. Conclusion: predictor variables found were different from the literature: desire for changes in marital relationship presented a positive association with quality of life and well-being; emotion-focused coping was a predictor of quality of life; and anxiety was a predictor of subjective well-being.Objetivo: identificar fatores preditores sociodemográficos, clínicos e psicológicos para o bem-estar e a qualidade de vida de homens submetidos à prostatectomia radical, em seguimento de 360 dias. Método: trata-se de um estudo longitudinal, com 120 homens submetidos à prostatectomia radical. Foram utilizados questionários para caracterização e avaliação clínica do participante, bem como os instrumentos Escala Visual Analógica de Dor, Inventário de Estratégias de Coping, Escala Hospitalar de Ansiedade e Depressão, Escala de Satisfação com o Suporte Social, Escala de Satisfação Conjugal, Escala de Bem-estar Subjetivo e o Expanded Prostate Cancer Index. Para análise dos dados, utilizou-se o modelo linear de efeitos mistos. Resultados: fatores sociodemográficos idade e raça não se mostraram preditores das variáveis dependentes; tempo de cirurgia, enfrentamento focado no problema e ansiedade foram preditores para bem-estar subjetivo; dor, ansiedade e depressão foram preditores negativos de qualidade de vida; estratégia de enfrentamento focado na emoção, positivo. A não satisfação conjugal foi preditora para ambas variáveis. Conclusões: foram identificados fatores preditores distintos da literatura: desejo de mudança nos níveis de satisfação conjugal apresentou relação positiva com qualidade de vida e bem-estar; modo de enfrentamento focado na emoção foi preditor de qualidade de vida; e ansiedade foi preditor de bem-estar subjetivo.Objetivo: identificar factores predictores sociodemográficos, clínicos y psicológicos para el bienestar y la calidad de vida de hombres sometidos a prostatectomía radical, en seguimiento de 360 días. Método: se trata de un estudio longitudinal, realizado entre 120 hombres sometidos a prostatectomía radical. Se utilizaron cuestionarios para caracterización y evaluación clínica del participante, así como los instrumentos Escala Visual Analógica de Dolor, Inventario de Estrategias de Afrontamiento, Escala Hospitalaria de Ansiedad y Depresión, Escala de Satisfacción con el Soporte Social, Escala de Satisfacción Marital, Escala de Bienestar Subjetivo y el Índice de Cáncer de Próstata Ampliado. Se utilizó el modelo lineal de efectos mixtos para el análisis de los datos. Resultados: los factores sociodemográficos tales como edad y raza no se mostraron predictores de las variables dependientes; tiempo de cirugía, enfrentamiento enfocado en el problema y en la ansiedad fueron predictores para el bienestar subjetivo; dolor, ansiedad y depresión fueron predictores negativos de calidad de vida; estrategia de enfrentamiento enfocado en la emoción, positivo. La no satisfacción marital fue predictora para ambas variables. Conclusiones: se identificaron factores predictores distintos de la literatura: el deseo de cambio en los niveles de satisfacción marital presentó una relación positiva con la calidad de vida y el bienestar; modo de enfrentamiento enfocado en la emoción fue predictor de calidad de vida; y ansiedad fue predictor de bienestar subjetivo

Medical rescuers’ occupational health during COVID-19 : contribution of coping and emotion regulation on burnout, trauma and post-traumatic growth

The COVID-19 pandemic places unique challenges to medical rescuers’ occupational health. Thus, it is crucial to assess its direct and indirect impacts on key psychological outcomes and adaptation strategies. This study aims to analyse the impact of this pandemic on medical rescuers’ coping and emotion regulation strategies, and their levels of work-related psychological outcomes, such as burnout, trauma and post-traumatic growth. Additionally, it aims to analyse the contribution of coping and emotion regulation strategies, employed to manage the COVID-19 pandemic, on burnout, trauma and post-traumatic growth. A sample of 111 medical rescuers answered the Brief Cope, Emotion Regulation Questionnaire, Oldenburg Burnout Inventory, Impact of Event Scale-Revised and Post-Traumatic Growth Inventory. Medical rescuers resorted moderately to coping and emotion regulation strategies, since the beginning of COVID-19. They presented moderate burnout and post-traumatic growth and low trauma. Coping presented a higher weight on burnout, trauma and post-traumatic growth, than emotion regulation. Expressive suppression and dysfunctional coping predicted burnout and trauma, and problem and emotion-focused coping predicted post-traumatic growth. Dysfunctional coping mediated and, thus, exacerbated the effect of expressive suppression on burnout and on trauma. Practitioners should pay closer attention to professionals with higher burnout and trauma. Occupational practices should focus on reducing dysfunctional coping and expressive suppression and promoting problem-focused coping.Resumo: A pandemia COVID-19 coloca desafios únicos à saúde ocupacional dos profissionais do pré-hospitalar. Assim, é fundamental avaliar o seu impacto psicológico, para sintomatologia direta ou indiretamente relacionada com a COVID-19. Pretende-se analisar o impacto desta pandemia nos outcomes psicológicos laborais, como burnout, trauma e crescimento pós-traumático, e nas estratégias de coping e regulação emocional. Pretende-se também analisar o contributo do coping e regulação emocional para estes outcomes. Uma amostra de 111 profissionais de emergência médica pré-hospitalar responderam ao Brief Cope, Emotion Regulation Questionnaire, Oldenburg Burnout Inventory, Impact of Event Scale-Revised e Post-Traumatic Growth Inventory. Os profissionais recorreram moderadamente a estratégias de coping e regulação emocional, desde o início da pandemia. Reportaram moderado burnout e crescimento pós-traumático e baixo trauma. O coping apresentou maior peso para os outcomes. A supressão emocional e o coping disfuncional contribuíram para o burnout e trauma, e coping problema e emoção contribuíram para o crescimento pós-traumático. O coping disfuncional mediou e exarcebou o efeito da supressão emocional no burnout e trauma. Assim, poderá ser dada especial atenção a profissionais com elevado burnout e trauma e as práticas poderão ser focadas na redução do coping disfuncional e supressão emocional, bem como na promoção do coping problema.info:eu-repo/semantics/publishedVersio

Single-port cholecystectomy in a patient with situs inversus totalis presenting with cholelithiasis: a case report

<p>Abstract</p> <p>Introduction</p> <p><it>Situs inversus totalis </it>(mirror image organs) is a rare condition and may affect the intra-abdominal viscera as well as the intrathoracic organs. Cholelithiasis is not more common in these conditions, but the diagnosis may be more difficult.</p> <p>Case presentation</p> <p>We present the case of a 59-year-old African woman with gallstones and <it>situs inversus totalis</it>. A single-port cholecystectomy was performed using a single trocar access device (SITRACC).</p> <p>Conclusions</p> <p>The procedure was uneventful, showing that this approach may be an option for this kind of surgery even in patients with <it>situs inversus totalis</it>.</p