224 research outputs found
Minimally invasive laparoscopic and robot-assisted emergency treatment of strangulated giant hiatal hernias: report of five cases and literature review
Background
Giant hiatal hernia (GHH) is a condition where one-third of the stomach migrates into the thorax. Nowadays, laparoscopic treatment gives excellent postoperative outcomes. Strangulated GHH is rare, and its emergent repair is associated with significant morbidity and mortality rates. We report a series of five cases of strangulated GHH treated by a minimally invasive laparoscopic and robot-assisted approach, together with a systematic review of the literature.
Methods
During 10 years (December 2009–December 2019), 31 patients affected by GHH were treated by robot-assisted or conventional laparoscopic surgical approach. Among them, five cases were treated in an emergency setting. We performed a PubMed MEDLINE search about the minimally invasive emergent treatment of GHH, selecting 18 articles for review.
Results
The five cases were male patients with a mean age of 70 ± 18 years. All patients referred to the emergency service complaining of severe abdominal and thoracic pain, nausea and vomiting. CT scan and endoscopy were the main diagnostic tools. All patients showed stable hemodynamic conditions so that they could undergo a minimally invasive attempt. The surgical approach was robotic-assisted in three patients (60%) and laparoscopic in two (40%). Patients reported no complications or recurrences.
Conclusion
Reviewing current literature, no general recommendations are available about the emergent treatment of strangulated hiatal hernia. Acute mechanical outlet obstruction, ischemia of gastric wall or perforation and severe bleeding are the reasons for an emergent surgical indication. In stable conditions, a minimally invasive approach is often feasible. Moreover, the robot-assisted approach, allowing a stable 3D view and using articulated instruments, represents a reasonable option in challenging situations
The role of procalcitonin in reducing antibiotics across the surgical pathway
Procalcitonin (PCT) is widely considered as a highly sensitive biomarker of bacterial infection, offering general and
emergency surgeons a key tool in the management of surgical infections. A multidisciplinary task force of experts
met in Bologna, Italy, on April 4, 2019, to clarify the key issues in the use of PCT across the surgical pathway. The
panelists presented the statements developed for each of the main questions regarding the use of PCT across the
surgical pathway. An agreement on the statements was reached by the Delphi method, and this document reports
the executive summary of the final recommendations approved by the expert panel
A relationship between oxytocin and anxiety of romantic attachment
The formation of social bonding is fundamental for several animals, including humans, for its relevant and obvious impact upon reproduction and, thus, survival of the species. Recent data would suggest that oxytocin might be one of the mediators of this process. Given the paucity of data on the possible involvement of oxytocin in human attachment, the present study was aimed to explore the possible relationships between the plasma levels of this neuropeptide and romantic attachment in healthy subjects. Forty-five healthy subjects who volunteered for the study, were included in the study. The romantic attachment was assessed using the Italian version of the so-called "Experiences in Close Relationships" (ECR), a self-report questionnaire for measuring this parameter in adults. The results showed that attachment anxiety and oxytocin are positively linked in romantic attachment to a statistically significant degree (r = 0.30, p = 0.04), that is, the higher the oxytocin levels the higher the score on the anxiety scale of the ECR. The authors suggest the hypothesis that this link represents one of the biological processes resulting in those rewarding emotions related to romantic attachment
Second international spectroradiometer intercomparison: results and impact on PV device calibration
This paper describes the results of an intercomparison of spectroradiometers for measuring global normal incidence and direct normal incidence spectral irradiance in the visible and in the near infrared, together with an assessment of the impact these results may have on the calibration of the short circuit current (I-sc) of triple-junction photovoltaic devices and on the relevant spectral mismatch calculation. The intercomparison was conducted by six European scientific laboratories and a Japanese industrial partner. Seven spectroradiometer systems, for a total of 13 different instruments/channels using two different technologies and made by four different manufacturers were involved. This group of systems represents a good cross section of the instrumentation for solar spectrum measurements available to date. The instruments were calibrated by each partner prior to the intercomparison following their usual procedure and traceability route in order to verify the entire measurement and traceability chain. The difference in measured spectral irradiance showed to have an impact on the calibration of a set of Iso-Type cells varying from +/- 2% to +/- 14% for middle and bottom cell, respectively
Second international spectroradiometer intercomparison: preliminary results and impact on PV device calibration
This paper describes the preliminary results of an intercomparison of spectroradiometers for global (GNI) and direct normal incidence (DNI) irradiance in the visible (VIS) and near infrared (NIR) spectral regions together with an assessment of the impact these results may have on the calibration of triple-junction photovoltaic devices and on the relevant spectral mismatch calculation. The intercomparison was conducted by six European scientific laboratories and a Japanese industrial partner. Seven institutions and seven spectroradiometer systems, representing different technologies and manufacturers were involved, representing a good cross section of the todays available instrumentation for solar spectrum measurements
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