COVID-19 and the Global Impact on Colorectal Practice and Surgery

Background: The novel severe acute respiratory syndrome coronavirus 2 virus that emerged in December 2019 causing coronavirus disease 2019 (COVID-19) has led to the sudden national reorganization of health care systems and changes in the delivery of health care globally. The purpose of our study was to use a survey to assess the global effects of COVID-19 on colorectal practice and surgery. Materials and Methods: A panel of International Society of University Colon and Rectal Surgeons (ISUCRS) selected 22 questions, which were included in the questionnaire. The questionnaire was distributed electronically to ISUCRS fellows and other surgeons included in the ISUCRS database and was advertised on social media sites. The questionnaire remained open from April 16 to 28, 2020. Results: A total of 287 surgeons completed the survey. Of the 287 respondents, 90% were colorectal specialists or general surgeons with an interest in colorectal disease. COVID-19 had affected the practice of 96% of the surgeons, and 52% were now using telemedicine. Also, 66% reported that elective colorectal cancer surgery could proceed but with perioperative precautions. Of the 287 respondents, 19.5% reported that the use of personal protective equipment was the most important perioperative precaution. However, personal protective equipment was only provided by 9.1% of hospitals. In addition, 64% of surgeons were offering minimally invasive surgery. However, 44% reported that enough information was not available regarding the safety of the loss of intra-abdominal carbon dioxide gas during the COVID-19 pandemic. Finally, 61% of the surgeons were prepared to defer elective colorectal cancer surgery, with 29% willing to defer for ≤ 8 weeks. Conclusion: The results from our survey have demonstrated that, globally, COVID-19 has affected the ability of colorectal surgeons to offer care to their patients. We have also discussed suggestions for various practical adaptation strategies for use during the recovery period. We have presented the results of a survey used to assess the global impact of coronavirus disease 2019 (COVID-19) on the delivery of colorectal surgery. Despite accessible guidance information, our results have demonstrated that COVID-19 has significantly affected the ability of colorectal surgeons to offer care to patients. We have also discussed practical adaptation strategies for use during the recovery phase

Spinal infection: state of the art and management algorithm

Spinal infection is a rare pathology although a concerning rising incidence has been observed in recent years. This increase might reflect a progressively more susceptible population but also the availability of increased diagnostic accuracy. Yet, even with improved diagnosis tools and procedures, the delay in diagnosis remains an important issue. This review aims to highlight the importance of a methodological attitude towards accurate and prompt diagnosis using an algorithm to aid on spinal infection management. METHODS: Appropriate literature on spinal infection was selected using databases from the US National Library of Medicine and the National Institutes of Health. RESULTS: Literature reveals that histopathological analysis of infected tissues is a paramount for diagnosis and must be performed routinely. Antibiotic therapy is transversal to both conservative and surgical approaches and must be initiated after etiological diagnosis. Indications for surgical treatment include neurological deficits or sepsis, spine instability and/or deformity, presence of epidural abscess and upon failure of conservative treatment. CONCLUSIONS: A methodological assessment could lead to diagnosis effectiveness of spinal infection. Towards this, we present a management algorithm based on literature findings

Parâmetros hematológicos e bioquímicos da tilápia-do-Nilo (Oreochromis niloticus L.) sob estresse por exposição ao ar

No presente trabalho avaliaram-se os parâmetros hematológicos e bioquímicos de exemplares adultos de tilápias (Oreochromis niloticus) sob a influência do fator estresse fisiológico em animais submetidos à exposição ao ar durante a engorda em sistema raceway. Foram analisados o eritrograma, teor de hemoglobina, volume globular, o volume corpuscular médio (VCM), a hemoglobina corpuscular média (HCM), a concentração de hemoglobina corpuscular média (CHCM), o leucograma, contagem diferencial de leucócitos, o plaquetograma, a glicose, a proteína total, o colesterol, o triglicerídeo e os eletrólitos (cálcio, cloretos, sódio e potássio). Os resultados revelaram que houve uma homogeneidade de distribuição para hemácias, volume globular, hemoglobina, índices hemantimétricos, proteína total, glicose, colesterol, e íons séricos, indicados pelos valores relativamente baixos do coeficiente de variação. Houve correlação positiva somente para leucócitos totais, células de defesa orgânica (neutrófilos e linfócitos), glicose, colesterol, sódio e cálcio. Quanto ao leucograma, à medida que os animais foram expostos ao ar, o número de leucócitos diminuiu gradativamente (leucopenia), ocorrendo simultaneamente neutrofilia e linfopenia. O índice glicêmico constituiu um bom indicador de estresse fisiológico, devido à hiperglicemia (82,0±20,88mg/dL) demonstrada nos tratamentos. A exposição ao ar constituiu um fator de desequilíbrio na homeostase iônica, e na síntese de colesterol endógeno. Entretanto, o tempo de recuperação não ocasionou a completa reabilitação fisiológica frente ao desafio imposto

Two GTPase isoforms, Ypt31p and Ypt32p, are essential for Golgi function in yeast.

In eukaryotic cells, monomeric GTPases of the Ypt/Rab family function as regulators at defined steps of vesicular transport in exo- and endocytosis. Here we report on the isolation and characterization of two genes (YPT31 and YPT32) of the yeast Saccharomyces cerevisiae which encode members of the Ypt family exhibiting >80% sequence identity. Whereas the disruption of one of the two genes was phenotypically neutral, the disruption of both YPT31 and YPT32 led to lethality. Depletion of wild-type Ypt31p or of a short-lived ubiquitin-Ypt31p in a ypt32 null background led to a massive accumulation of Golgi-like membranes, an inhibition of invertase secretion and defects in vacuolar protein maturation. Similar alterations were observed in a conditional-lethal ypt31-1 mutant at 30 min after shift to the non-permissive temperature. According to subcellular fractionation, a significant part of Ypt31p appeared to be located in Golgi-enriched membrane fractions. In accordance with this, indirect immunofluorescence using affinity-purified anti-Ypt31p antibodies gave a punctate staining similar to that observed with Golgi-located proteins. From the phenotypic alterations observed in ypt31 and ypt32 mutants, it seems likely that the two GTPases are involved in intra-Golgi transport or in the formation of transport vesicles at the most distal Golgi compartment

Subclinical hypothyroidism, hyperhomocysteinemia and dyslipidemia: Investigating links with ischemic stroke in Turkish patients

PubMedID: 17588311Objectives: Hyperhomocysteinemia is a risk factor for ischemic stroke. Hypothyroidism may cause hyperhomocysteinemia. To date, no works have examined the association between hypothyroidism and hyperhomocysteinemia in ischemic stroke. We aimed to investigate the roles of hypothyroidism and hyperhomocysteinemia in ischemic stroke, and whether any relationship exists between hypothyroidism and hyperhomocysteinemia in ischemic stroke patients. Methods: The study included 249 ischemic stroke patients and 102 patients with no history of stroke. Patients were evaluated for conventional risk factors and levels of homocysteine, thyroid-stimulating hormone, vitamin B12 and folic acid. Results: Ten (4%) patients in the ischemic stroke group had subclinical hypothyroidism. We did not find any overt or subclinical hypothyroidism in the control group. Hypothyroidism was higher to a statistically significant degree in the ischemic stroke group (p<0.05). Both hyperhomocysteinemia and hypothyroidism were associated with ischemic stroke patients. However, no association was found between hyperhomocysteinemia and hypothyroidism. Ischemic stroke patients with hypothyroidism had lower levels of HDL cholesterol and levels of total cholesterol/HDL-C and LDL-C/HDL-C were higher than those of ischemic stroke patients without hypothyroidism. Discussion: Hypothyroidism is associated with ischemic stroke. Low HDL cholesterol, high total cholesterol/HDL-C and high LDL-C/HDL-C were associated in ischemic stroke patients with hypothyroidism. Hyperhomocysteinemia was not found to be associated with ischemic stroke patients with hypothyroidism. © 2007 W. S. Maney & Son Ltd

Rheological, Electrokinetic, and Morphological Characterization of Alginate-Bentonite Biocomposites

We prepared biocomposite gel dispersions involving sodium alginate (Na-Alg) and calcium bentonite (Ca-B) with various solid concentrations and characterized their rheological, electrokinetic, and morphological properties. The flow properties, such as the apparent and plastic viscosities, shear stress, and yield value point, changed with increasing clay dosage. The viscosities of the homogeneous dispersions were represented by the Herschel-Bulkley model. The zeta-potential results were examined in the light of different characterization methods (X-ray diffraction, Fourier transform infrared spectroscopy, and atomic force microscopy) to understand the interactions between the Na and Ca ions of the alginate biopolymer and bentonite clay. A plausible structural model for the alginate-bentonite composite gel, known as the egg-box model, is proposed. The presence of Ca ions in the Ca-B partially crosslinked Na-Alg may be regarded as an excellent example of a self-assembling process. (C) 2011 Wiley Periodicals, Inc. J Appl Polym Sci 122: 19-28, 201

Depression, LUTS and ED Relation in Elderly Men

Objectives: Depression unfortunately, remains an under-recognized and misdiagnosed condition, especially in the aging population. We aimed to research the relation of depression, LUTS and ED in elderly men. Methods: In this prospective study, 364 elder male patients were evaluated. For depression research in patients, Beck's Depression Index (BDI) was used. Lower urinary tract symptoms of patients were evaluated by International prostatic symptoms score (IPSS) examination form and Erection quality was evaluated with International Index of Erectile Function (IIEF 5-15) examination form. According to evaluation results, patients were assigned as Group 0: Mild LUTS and no ED (IPSS26), Group 1: Patients describing only moderate and severe LUTS, Group 2: Patients describing only ED (IIEF7 - IIEF<26). Results: A significant difference was observed between depression states of patients and their LUTS and IIEFs. Depression risk for the Group 3 was monitored to increase by 5.4 fold (p=0.012) according to the Group 0. Conclusions: ED, LUTS and depression are all common conditions that accompany aging and significantly negatively impact quality of life. So this patient group can be treated more successful by a multidisciplinary approach