Robotic surgery: will it be evidence-based or just "toys for boys"?

The document attached has been archived with permission from the editor of the Medical Journal of Australia. An external link to the publisher’s copy is included.Guy J Madder

Was kann aus den Konversionen während der Einführung eines VATS-Lobektomie-Programms gelernt werden?

Combined sewer overflows contribute significantly to pathogen loads in surface water. Some chemical disinfectants such as chlorine have proved to reduce the levels of microorganisms even in complex matrices such as wastewater in combined sewer systems; however, some of them release toxic by-products into water bodies and increase costs of plant maintenance and repair. In this study, we determined if performic acid (PFA) disinfection units can be operated at decentralized treatment facilities and reduce bacteria, viruses, and protozoan parasites in combined sewer overflows (CSOs). The PFA dosing unit at the inflow of a CSO storage tank dosed a fixed flow volume into the inflowing stormwater and, thus, concentrations varied between approximately 12–24 mg l−1. The results showed a reduction of most hygienically relevant bacteria with mean removal efficiencies of 1.8 log10 for Aeromonas spp. and 3.1 log10 for E. coli. For viruses, however, reduction was only observed for somatic coliphages with 2.7 log10. In this setting, PFA does not seem to be suitable to remove e.g. protozoan parasites such as Giardia lamblia. In terms of operation, dosing the substance is uncritical in decentralized facilities, but the PFA needs too much time to react with pathogens after being dosed into the overflow of CSO storage tanks and before dilution with surface water in most facilities. © 2016 Elsevier Gmb