Implementing preoperative Botulinum toxin A and progressive pneumoperitoneum through the use of an algorithm in giant ventral hernia repair

Background Repair of large ventral hernias with loss of domain can be facilitated by preoperative Botulinum toxin A (BTA) injections and preoperative progressive pneumoperitoneum (PPP). The aim of this study is to evaluate the outcomes of ventral hernioplasty using a standardized algorithm, including component separation techniques, preoperative BTA and PPP. Methods All patients between June 2014 and August 2018 with giant hernias (either primary or incisional) of more than 12 cm width were treated according to a previously developed standardized algorithm. Retrospective data analysis from a prospectively collected dataset was performed. The primary outcome was closure of the anterior fascia. Secondary outcomes included complications related to the preoperative treatment, postoperative complications, and recurrences. Results Twenty-three patients were included. Median age was 65 years (range 28-77) and median BMI was 31.4 (range 22.7-38.0 kg/m(2)). The median loss of domain was 29% (range 12-226%). For the primary and secondary endpoints, 22 patients were analyzed. Primary closure of the anterior fascia was possible in 82% of all patients. After a median follow-up of 19.5 months (range 10-60 months), 3 patients (14%) developed a hernia recurrence and 16 patients (73%) developed 23 surgical site occurrences, most of which were surgical site infections (54.5%). Conclusion Our algorithm using both anterior or posterior component separation, together with preoperative BTA injections and PPP, achieved an acceptable fascial closure rate. Further studies are needed to explore the individual potential of BTA injections and PPP, and to research whether these methods can prevent the need for component separation, as postoperative wound morbidity remains high in our study

Field assessment of guar gum stabilized microscale zerovalent iron particles for in-situ remediation of 1,1,1-trichloroethane

A pilot injection test with guar gum stabilized microscale zerovalent iron (mZVI) particles was performed at test site V (Belgium) where different chlorinated aliphatic hydrocarbons (CAHs) were present as pollutants in the subsurface. One hundred kilograms of 56 μm-diameter mZVI (~ 70 g/L) was suspended in 1.5 m3 of guar gum (~ 7 g/L) solution and injected into the test area. In order to deliver the guar gum stabilized mZVI slurry, one direct push bottom-up injection (Geoprobe) was performed with injections at 5 depths between 10.5 and 8.5 m bgs. The direct push technique was preferred above others (e.g. injection at low flow rate via screened wells) because of the limited hydraulic conductivity of the aquifer, and to the large size of the mZVI particles. A final heterogeneous distribution of the mZVI in the porous medium was observed explicable by preferential flow paths created during the high pressure injection. The maximum observed delivery distance was 2.5 m. A significant decrease in 1,1,1-TCA concentrations was observed in close vicinity of spots where the highest concentration of mZVI was observed. Carbon stable isotope analysis (CSIA) yielded information on the success of the abiotic degradation of 1,1,1-TCA and indicated a heterogeneous spatio-temporal pattern of degradation. Finally, the obtained results show that mZVI slurries stabilized by guar gum can be prepared at pilot scale and directly injected into low permeable aquifers, indicating a significant removal of 1,1,1-TCA

Protective Intestinal Effects of Pituitary Adenylate Cyclase Activating Polypeptide

Pituitary adenylate cyclase activating polypeptide (PACAP) is an endogenous neuropeptide widely distributed throughout the body, including the gastrointestinal tract. Several effects have been described in human and animal intestines. Among others, PACAP infl uences secretion of intestinal glands, blood fl ow, and smooth muscle contraction. PACAP is a well-known cytoprotective peptide with strong anti-apoptotic, anti-infl ammatory, and antioxidant effects. The present review gives an overview of the intestinal protective actions of this neuropeptide. Exogenous PACAP treatment was protective in a rat model of small bowel autotransplantation. Radioimmunoassay (RIA) analysis of the intestinal tissue showed that endogenous PACAP levels gradually decreased with longer-lasting ischemic periods, prevented by PACAP addition. PACAP counteracted deleterious effects of ischemia on oxidative stress markers and cytokines. Another series of experiments investigated the role of endogenous PACAP in intestines in PACAP knockout (KO) mice. Warm ischemia–reperfusion injury and cold preservation models showed that the lack of PACAP caused a higher vulnerability against ischemic periods. Changes were more severe in PACAP KO mice at all examined time points. This fi nding was supported by increased levels of oxidative stress markers and decreased expression of antioxidant molecules. PACAP was proven to be protective not only in ischemic but also in infl ammatory bowel diseases. A recent study showed that PACAP treatment prolonged survival of Toxoplasma gondii infected mice suffering from acute ileitis and was able to reduce the ileal expression of proinfl ammatory cytokines. We completed the present review with recent clinical results obtained in patients suffering from infl ammatory bowel diseases. It was found that PACAP levels were altered depending on the activity, type of the disease, and antibiotic therapy, suggesting its probable role in infl ammatory events of the intestine

7th Drug hypersensitivity meeting: part two

No abstract availabl

Surgical treatment of stage IV colorectal cancer with synchronous liver metastases: A systematic review and network meta-analysis

Until prospective comparative trials are available, the treatment approach in patients with stage IV CRC with SCRLM should be discussed in a multidisciplinary team and tailored to the oncological, technical, and clinical characteristics of each patient

Pilot Scale Injection of Guar Gum Stabilized Micro-sized Zero-valent iron via Hydro-fracturing

Within the FP7 AQUAREHAB project, injectable micro-sized zero-valent iron particles (mZVI) are being developed and evaluated for in-situ chemical reduction of Chlorinated Aliphatic Hydrocarbons (CAHs). mZVI particles have good reactive properties and a longer life-time than nano-sized particles (nZVI). In contrast to nZVI, mZVI suspensions need to be stabilised to prevent sedimentation in storage vessels and injection tubes. Here we report on a field scale injection of guar gum stabilized mZVI that was performed in November 2011 as a joined endeavor of several AQUAREHAB partners. At the test site (located in Belgium) a TCE and 1,1,1-TCA contamination is present at 4-11 m bgs. The aquifer has a relatively low permeability and the gradient is very small resulting in an estimated groundwater velocity of approximately 10 m per year. Different injection techniques and approaches were considered. Based on the site characteristics, the final pilot test was performed with direct push injection (Geoprobe) at 5 depths (1 location) at high pressure to induce fracturing. Multilevel monitoring wells were installed at different distance around the injection point, along with temperature sensors and devices specifically developed to detect magnetic particles via measurement of electromagnetic susceptibility. In total, 100 kg of mZVI was injected suspended in 1.5 m³ of guar gum (6 g/l) slurry. The objectives of the field test were: - To evaluate the preparation procedure and injectability of guar gum stabilized mZVI - To understand the pressure range developed during the injection - To test the applicability of the newly developed monitoring probes - To determine the vertical and horizontal distribution of mZVI particles in the subsurface after injection - To evaluate the reactivity of mZVI after the injection A short overview of the approach followed is described in this pape

Pilot Scale Injection of Guar Gum Stabilized Micro-sized Zero-valent iron via Hydro-fracturing

Within the FP7 AQUAREHAB project, injectable micro-sized zero-valent iron particles (mZVI) are being developed and evaluated for in-situ chemical reduction of Chlorinated Aliphatic Hydrocarbons (CAHs). mZVI particles have good reactive properties and a longer life-time than nano-sized particles (nZVI). In contrast to nZVI, mZVI suspensions need to be stabilised to prevent sedimentation in storage vessels and injection tubes. Here we report on a field scale injection of guar gum stabilized mZVI that was performed in November 2011 as a joined endeavor of several AQUAREHAB partners. At the test site (located in Belgium) a TCE and 1,1,1-TCA contamination is present at 4-11 m bgs. The aquifer has a relatively low permeability and the gradient is very small resulting in an estimated groundwater velocity of approximately 10 m per year. Different injection techniques and approaches were considered. Based on the site characteristics, the final pilot test was performed with direct push injection (Geoprobe) at 5 depths (1 location) at high pressure to induce fracturing. Multilevel monitoring wells were installed at different distance around the injection point, along with temperature sensors and devices specifically developed to detect magnetic particles via measurement of electromagnetic susceptibility. In total, 100 kg of mZVI was injected suspended in 1.5 m³ of guar gum (6 g/l) slurry. The objectives of the field test were: - To evaluate the preparation procedure and injectability of guar gum stabilized mZVI - To understand the pressure range developed during the injection - To test the applicability of the newly developed monitoring probes - To determine the vertical and horizontal distribution of mZVI particles in the subsurface after injection - To evaluate the reactivity of mZVI after the injection A short overview of the approach followed is described in this paper

Strategies to increase bioavailability and uptake of hydrocarbons

12 páginas.-- 50 referenciasThe biodegradation of hydrocarbons in the environment is often slow due to restricted bioavailability. Research performed during the last 20 years has shown possible pathways to increase the bioavailability of hydrocarbons without necessarily increasing the risk to the environment. Pollutant solubilization through (bio)surfactants, microbial transport, and attachment to pollutant interfaces can increase bioavailability, which translates into an enhancement of biodegradation rates. These strategies can not only be integrated into optimized bioremediation protocols that lead to lower decontamination endpoints in soils and sediments but also help to improve biodegradation in other environmental contexts, such as wastewater treatment and natural attenuation.This study was supported by the Spanish Ministry of Science and Innovation (CGL2013-44554-R and CGL2016-77497-R), the Andalusian Government (RNM 2337), and the European Commission (LIFE15 ENV/IT/000396).Peer reviewe