The Interpretation Of The Figure Of The Prophet Jonah By Michelangelo On The Ceiling Of The Sistine Chapel: Anatomical Urological Vision.

A detailed analysis in the iconography and pictorial appearance of the scene of the Prophet Jonah painted by the artist Michelangelo Buonarroti (1475-1564) on the ceiling of the Sistine Chapel between the years 1508 and 1512. Literature review on the Italian Renaissance period and the life of Michelangelo Buonarroti and analysis of historical aspects of the evolution of studies of human anatomy in this period and the works of the artist. A comparative analysis of the representation of the figure of the fish on the left thigh of Jonah with a cross section of penis shows a curious similarity. The pictorial and iconographic analysis reveals an intensity of light on the pubic area and the position of the prophet with the legs spread apart and left hand placed on this region. A tube-shaped cloth covers the region and the angel at the side seems to be looking at this anatomical region of Jonah. In fact, sets of iconographic and pictorial relate to the deciphered code. This description helps to confirm the relationship of the Renaissance art with the human anatomy; science has been much studied in this period. The design of a cross section of the penis is revealed with the two cavernous bodies with the septum between them and the spongy body. Considering the circumstances in which Michelangelo had painted, subjectivity was fundamental due to religious motivations added to the vigorous implications of a limited scientific knowledge typical of that era.38317-22; discussion 32

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

The interpretation of the figure of the prophet Jonah by Michelangelo on the ceiling of the sistine chapel: anatomical urological vision

Purpose: A detailed analysis in the iconography and pictorial appearance of the scene of the "Prophet Jonah" painted by the artist Michelangelo Buonarroti (1475-1564) on the ceiling of the Sistine Chapel between the years 1508 and 1512. Materials and Methods: Literature review on the Italian Renaissance period and the life of Michelangelo Buonarroti and analysis of historical aspects of the evolution of studies of human anatomy in this period and the works of the artist. Results: A comparative analysis of the representation of the figure of the fish on the left thigh of "Jonah" with a cross section of penis shows a curious similarity. The pictorial and iconographic analysis reveals an intensity of light on the pubic area and the position of the prophet with the legs spread apart and left hand placed on this region. A tube-shaped cloth covers the region and the angel at the side seems to be looking at this anatomical region of "Jonah". In fact, sets of iconographic and pictorial relate to the deciphered code. Conclusions: This description helps to confirm the relationship of the Renaissance art with the human anatomy; science has been much studied in this period. The design of a cross section of the penis is revealed with the two cavernous bodies with the septum between them and the spongy body. Considering the circumstances in which Michelangelo had painted, subjectivity was fundamental due to religious motivations added to the vigorous implications of a limited scientific knowledge typical of that era.38331732

A cost-effective technique for pure laparoscopic live donor nephrectomy

OBJECTIVE: Compare two different techniques for laparoscopic live donor nephrectomy (LDN), related to the operative costs and learning curve. MATERIALS AND METHODS: Between April/2000 and October/2003, 61 patients were submitted to LDN in 2 different reference centers in kidney transplantation. At center A (CA), 11 patients were operated by a pure transperitoneal approach, using Hem-O-LokÒ clips for the renal pedicle control and the specimens were retrieved manually, without using endobags. At center B (CB), 50 patients were also operated by a pure transperitoneal approach, but the renal pedicles were controlled with endo-GIA appliers and the specimens were retrieved using endobags. RESULTS: Operative time (231 &plusmn; 39 min vs. 179 &plusmn; 30 min; p < 0.000), warm ischemia time (5.85 &plusmn; 2.85 min vs. 3.84 &plusmn; 3.84 min; p = 0.002) and blood loss (214 &plusmn; 98 mL vs. 141 &plusmn; 82 mL; p = 0.02) were statistically better in CB, when compared to CA. Discharge time was similar in both centers. One major complication was observed in both centers, leading to an open conversion in CA (9.1%). One donor death occurred in CB (2%). Regarding the recipients, no statistical difference was observed in all parameters analyzed. There was an economy of US$1.440 in each procedure performed in CA, when compared to CB. CONCLUSIONS: Despite the learning curve, the technique adopted by CA, showed no deleterious results to the donors and recipients when compared with the CB. On the other hand, this technique was cheaper than the technique performed in the CB, representing an attractive alternative for LDN, mainly in developing centers