8 research outputs found

    A sustaining rod increases necrosis of loop ileostomies: a randomized controlled trial.

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    PURPOSE Defunctioning loop ileostomies (LI) are commonly used in colorectal surgery to reduce the potentially detrimental consequences of anastomotic leakages. However, stoma-related morbidity is high with up to 75% of patients having local complications. The aim of this study was to investigate the effect of a sustaining rod on the local complication rate. METHODS In this prospective, multi-center, randomized controlled trial, subjects were allocated to either a rod or a rod-less protocol (NCT00959738). The primary outcome was local morbidity as measured by a stoma specific morbidity score (SSMS) during the first 3 months postoperatively. RESULTS Between August 2008 and July 2014, a total of 122 patients were enrolled in the study, of which 78 (63.8%) completed the study [44 (56.4%) rod, 34 (43.6%) rod-less]. There was no significant difference in the SSMS between the two groups. The incidence of necrosis or partial necrosis, however, was significantly increased in the rod group: 13 (29.5%) vs. 1 (2.9%) in the rod-less group (p  26) was associated with an odds ratio of 5 (p < 0.01) for severe stoma complications. CONCLUSIONS A rod-less technique for loop ileostomies reduces the risk of stomal necrosis, with a high BMI being an independent risk factor for stomal complications

    Methanogens: Syntrophic Metabolism

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    Syntrophy is a mutualistic interaction in which two metabolically different types of microorganisms are linked by the need to keep metabolites exchanged between the two partners at low concentrations to make the overall metabolism of both organisms feasible. In most cases, the cooperation is based on the transfer of hydrogen, formate, or acetate from fermentative bacteria to methanogens to make the degradation of electron-rich substrates thermodynamically favorable. Syntrophic metabolism proceeds at very low Gibbs’ free energy changes, close to the minimum free energy change needed to conserve energy biologically, which is the energy needed to transport one proton across the cytoplasmic membrane. Pathways for syntrophic degradation of fatty acids predict the net synthesis of about one-third of an ATP per round of catabolism. Syntrophic metabolism entails critical oxidation-reduction reactions in which H2 or formate production would be thermodynamically unfavorable unless energy is invested. Molecular insights into the membrane processes involved in ion translocation and reverse electron transport revealed that syntrophs harbor multiple systems for reverse electron transfer. While much evidence supports the interspecies transfer of H2 and formate, other mechanisms of interspecies electron transfer exist including cysteine cycling and possibly direct interspecies electron transfer as electric current via conductive pili or (semi)conductive minerals

    Beneficial autoimmunity improves cancer prognosis

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    Über die (aseptische) Harnstauungsniere

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