The Importance of Shared Decision Making in the Decision to Prevent a Parastomal Hernia With Prosthetic Mesh

Parastomal hernia; Prosthetic mesh; Shared decision makingHèrnia parastomal; Malla protèsica; Presa de decisions compartidaHernia paraestomal; Malla protésica; Toma de decisiones compartid

Evolution of the Thorpe and Ozmidov scales at the lower atmospheric and planetary boundary layer

Turbulence affects the dynamics of atmospheric processes by enhancing the transport of mass, heat, humidity and pollutants. The global objective of our work is to analyze some turbulent descriptors which reflect the mixing processes in the atmospheric boundary layer (ABL). In this paper we present results related to the Thorpe displacements dT, the maximum Thorpe displacement (dT)max, the Thorpe scale LT and the Ozmidov scale, LO, and their time evolution in the ABL during a day cycle. A tethered balloon was used to obtain vertical profiles of the atmospheric physical magnitudes up to 1000 m. We discuss their vertical and time variability, and also their relationships.Postprint (author’s final draft

Elective Recurrent Inguinal Hernia Repair: Value of an Abdominal Wall Surgery Unit

Inguinal hernia; Abdominal wall surgeryHernia inguinal; Cirugía de la pared abdominalHèrnia inguinal; Cirurgia de la paret abdominalBackground The aim of this study was to analyze the impact of an abdominal wall surgery unit on postoperative complications (within 90 days postoperatively), hernia recurrence and chronic postoperative inguinal pain after elective recurrent inguinal hernia repair. Methods We conducted a retrospective cohort study of all adult patients who underwent elective recurrent inguinal hernia repair between January 2010 and October 2021. Short- and long-term outcomes were compared between the group of patients operated on in the abdominal wall surgery unit and the group of patients operated on by other units not specialized in abdominal wall surgery. A logistic regression model was performed for hernia recurrence. Results A total of 250 patients underwent elective surgery for recurrent inguinal hernia during the study period. The patients in the abdominal wall surgery group were younger (P ≤ 0.001) and had fewer comorbidities (P ≤ 0.001). There were no differences between the groups in terms of complications. The patients in the abdominal wall surgery group presented fewer recurrences (15% vs. 3%; P = 0.001). Surgery performed by the abdominal wall surgery unit was related to fewer recurrences in the multivariate analysis (HR = 0.123; 95% CI = 0.21–0.725; P = 0.021). Conclusions Specialization in abdominal wall surgery seems to have a positive impact in terms of recurrence in recurrent inguinal hernia repair. The influence of comorbidities or type of surgery (i.e., outpatient surgery) require further study.Open Access Funding provided by Universitat Autonoma de Barcelona. This work did not receive external funding from any source other than the authors’ institution

An experimental setup for the research of turbulent plumes mixing

Se presenta un sencillo modelo de laboratorio para generar mezcla turbulenta entre dos fluidos miscibles que están en una situación inicial inestable en un campo gravitatorio. El proceso de mezcla se genera por medio de la evolución de un conjunto discreto de penachos turbulentos forzados. Se describe el modelo experimental, los instrumentos de laboratorio y la forma de proceder. También se describen algunas características de los instrumentos que pueden clasificarse utensilios para la generación de los flujos fluidos, instrumentos eléctricos y aparatos para el registro en video y la digitalización. Este modelo de laboratorio permite medir los perfiles de densidad y las alturas de las capas fluidas por medio de la técnica shadowgraph y la visualización directa de los flujos fluidos.Peer ReviewedPostprint (published version

Prioritization criteria of patients on scheduled waiting lists for abdominal wall hernia surgery: a cross-sectional study

Elective herniorrhaphy; Incisional hernia; Inguinal herniaHerniorrafia electiva; Hernia incisional; Hernia inguinalHerniorràfia electiva; Hèrnia incisional; Hèrnia inguinalPurpose: Long delays in waiting lists have a negative impact on the principles of equity and providing timely access to care. This study aimed to assess waiting lists for abdominal wall hernia repair (incisional ventral vs. inguinal hernia) to define explicit prioritization criteria. Methods: A cross-sectional single-center study was designed. Patients in the waiting list for incisional/ventral hernia (n = 42) and inguinal hernia (n = 50) repair were interviewed by phone and completed health-related quality of life (HRQoL) questionnaires (EQ-5D, COMI-hernia, HerQLes) as a measure of severity. Priority was measured as hernia complexity, patient frailty using the modified frailty index (mFI-11), and the consumption of analgesics for hernia. Results: The mean (SD) time on the waiting list was 5.5 (3.2) months (range 1-14). Complex hernia was present in 34.8% of the patients. HRQoL was moderately poor in patients with incisional/ventral hernia (mean HerQL score 66.1), whereas it was moderately good in patients with inguinal hernia (mean COMI-hernia score 3.40). The use of analgesics was higher in patients with incisional/ventral hernia as compared with those with inguinal hernia (1.48 [0.54] vs. 1.31 [0.51], P = 0.021). Worst values of mFI were associated with inguinal hernia as compared with incisional/ventral hernia (0.21 [0.14] vs. 0.12 [0.11]; P = 0.010). Conclusion: Explicit criteria for prioritization in the waiting lists may be the consumption of analgesics for patients with incisional/ventral hernia and frailty for patients with inguinal hernia. A reasonable approach seems to establish separate waiting lists for incisional/ventral hernia and inguinal hernia repair

Parastomal hernia prevention with permanent mesh in end colostomy: failure with late follow-up of cohorts in three randomized trials

Hernia; Mesh; ParastomalHèrnia; Malla; ParastomalHernia; Malla; ParaestomalPurpose Short-term results have been reported regarding parastomal hernia (PH) prevention with a permanent mesh. Long-term results are scarce. The objective was to assess the long-term PH occurrence after a prophylactic synthetic non-absorbable mesh. Methods Long-term data of three randomized controlled trials (RCTs) were collected. The primary outcome was the detection of PH based exclusively on a radiological diagnosis by computed tomography (CT) performed during the long-term follow-up. The Kaplan–Meier method was used for the comparison of time to diagnosis of PH according to the presence of mesh vs. no-mesh and the technique of mesh insertion: open retromuscular, laparoscopic keyhole, and laparoscopic modified Sugarbaker. Results We studied 121 patients (87 men, median age 70 years), 82 (67.8%) of which developed a PH. The median overall length of follow-up was 48.5 months [interquartile range (IQR) 14.4–104.9], with a median time until PH diagnosis of 17.7 months (IQR 9.3–49.0). The survival analysis did not show significant differences in the time to development of a PH according to the presence or absence of a prophylactic mesh neither in the overall study population (log-rank, P = 0.094) nor in the groups of each technique of mesh insertion, although according to the surgical technique, a higher reduction in the appearance of PH for the open retromuscular technique was found (log-rank, P = 0.001). Conclusion In the long-term follow-up placement of a non-absorbable synthetic prophylactic mesh in the context of an elective end colostomy does not seem effective for preventing PH

Processing and adsorption control in ZnO single nanowire photodetectors

ZnO single nanowire photodetectors have been measured in different ambient conditions in order to understand and control adsorption processes on the surface. A decrease in the conductivity has been observed as a function of time when the nanowires are exposed to air, due to adsorbed O2/H2O species at the nanowire surface. In order to have a device with stable characteristics in time, thermal desorption has been used to recover the original conductivity followed by PMMA coating of the exposed nanowire surface

Update of the international HerniaSurge guidelines for groin hernia management

International guidelines; Hernia managementDirectrices internacionales; Hernia inguinalDirectrius internacionals; Hèrnia inguinalBackground Groin hernia repair is one of the most common operations performed globally, with more than 20 million procedures per year. The last guidelines on groin hernia management were published in 2018 by the HerniaSurge Group. The aim of this project was to assess new evidence and update the guidelines. The guideline is intended for general and abdominal wall surgeons treating adult patients with groin hernias. Method A working group of 30 international groin hernia experts and all involved stakeholders was formed and examined all new literature on groin hernia management, available until April 2022. Articles were screened for eligibility and assessed according to GRADE methodologies. New evidence was included, and chapters were rewritten. Statements and recommendations were updated or newly formulated as necessary. Results Ten chapters of the original HerniaSurge inguinal hernia guidelines were updated. In total, 39 new statements and 32 recommendations were formulated (16 strong recommendations). A modified Delphi method was used to reach consensus on all statements and recommendations among the groin hernia experts and at the European Hernia Society meeting in Manchester on October 21, 2022. Conclusion The HerniaSurge Collaboration has updated the international guidelines for groin hernia management. The updated guidelines provide an overview of the best available evidence on groin hernia management and include evidence-based statements and recommendations for daily practice. Future guideline development will change according to emerging guideline methodology.The present guidelines were produced with the funding from European Hernia Society (EHS). The EHS provided funds to cover the budget of the process including online meetings with members and stakeholders. The executive board of the society did not interfere with the process of guidelines development

Assessment of elemental composition in commercial fish of the Bay of Cádiz, Southern Iberian Peninsula

The assessment of trace metal content in our fish diet is important due to the adverse effect on human health. Despite the increasing interest about the fish quality, little information is available for Southern Spain, a region characterized by high seafood intake. Nine species from the Bay of Cádiz with high commercial value were selected. Similar values were measured in the nine studied species for most of the elements, except for the macroelements Ca and S, and the microelements Fe, Mn and As, which showed significant differences among species. Metal Pollution Index (MPI) did not differ among species, and it was similar to those obtained for other Atlantic and Mediterranean locations. The values measured for the nine species were below the health limits provided by World, European and Spanish legislations, indicating that, in general terms, consumption of these species is safe in the study area.9 página

Susceptibility patterns and molecular identification of Trichosporon species

The physiological patterns, the sequence polymorphisms of the internal transcriber spacer (ITS), and intergenic spacer regions (IGS) of the rRNA genes and the antifungal susceptibility profile were evaluated for their ability to identify Trichosporon spp. and their specificity for the identification of 49 clinical isolates of Trichosporon spp. Morphological and biochemical methodologies were unable to differentiate among the Trichosporon species. ITS sequencing was also unable to differentiate several species. However, IGS1 sequencing unambiguously identified all Trichosporon isolates. Following the results of DNA-based identification, Trichosporon asahii was the species most frequently isolated from deep sites (15 of 25 strains; 60%). In the main, other Trichosporon species were recovered from cutaneous samples. The majority of T. asahii, T. faecale, and T. coremiiforme clinical isolates exhibited resistance in vitro to amphotericin B, with geometric mean (GM) MICs >4 mug/ml. The other species of Trichosporon did not show high MICs of amphotericin B, and GM MICs were <1 mug/ml. Azole agents were active in vitro against the majority of clinical strains. The most potent compound in vitro was voriconazole, with a GM MIC </=0.14 mug/ml. The sequencing of IGS correctly identified Trichosporon isolates; however, this technique is not available in many clinical laboratories, and strains should be dispatched to reference centers where these complex methods are available. Therefore, it seems to be more practical to perform antifungal susceptibility testing of all isolates belonging to Trichosporon spp., since correct identification could take several weeks, delaying the indication of an antifungal agent which exhibits activity against the infectious strain.S