Mechanical bowel preparations not supported in elective colo-rectal surgeries with anastomosis: A retrospective study

ObjectiveTo analyze the risk and benefit of bowel preparations in elective colo-rectal surgery.BackgroundMechanical bowel preparations (MBPs) have been popularized in colo-rectal surgery since studies in the 1970s, but recent data has called their use into question and examined complication rates between patients with and without bowel preparations.MethodsA retrospective case-review was performed consisting of 1237 elective colo-rectal surgeries performed by two surgeons between 2008 and 2021. Patients received either a MBP, a mechanical bowel preparation with oral antibiotics (OAMBP), oral antibiotics alone (OA), or no bowel preparation; some patients across all categories received an enema.ResultsBowel preparations combined (MBP and OAMBP) totaled 436 patients and showed no statistically significant difference (P > .05) in primary outcomes of wound infection and anastomotic leak when compared to the 636 patients without a bowel preparation and 165 patients with OA. The analysis controlled for comorbidities and presence of enema. Of secondary outcomes, urinary tract infections (UTIs) were significantly more common in patients who received a bowel preparation (P = .047). All other outcomes showed no significant difference between groups, including complications on day of surgery; complications, readmission with and without surgery, and ileus formation within 30 days of surgery; sepsis; pneumonia; and length of stay (LOS). The presence of enemas did not have a statistically significant effect on outcomes.ConclusionsThis study’s data does not support the routine use of MBPs in elective colo-rectal surgery and draws into further question whether MBPs should remain standard of care

The epistemological presuppositions of communication

Thesis (Ph.D.)--Boston University, 194

An automated method for analysis of microcirculation videos for accurate assessment of tissue perfusion

Background Imaging of the human microcirculation in real-time has the potential to detect injuries and illnesses that disturb the microcirculation at earlier stages and may improve the efficacy of resuscitation. Despite advanced imaging techniques to monitor the microcirculation, there are currently no tools for the near real-time analysis of the videos produced by these imaging systems. An automated system tool that can extract microvasculature information and monitor changes in tissue perfusion quantitatively might be invaluable as a diagnostic and therapeutic endpoint for resuscitation. Methods The experimental algorithm automatically extracts microvascular network and quantitatively measures changes in the microcirculation. There are two main parts in the algorithm: video processing and vessel segmentation. Microcirculatory videos are first stabilized in a video processing step to remove motion artifacts. In the vessel segmentation process, the microvascular network is extracted using multiple level thresholding and pixel verification techniques. Threshold levels are selected using histogram information of a set of training video recordings. Pixel-by-pixel differences are calculated throughout the frames to identify active blood vessels and capillaries with flow. Results Sublingual microcirculatory videos are recorded from anesthetized swine at baseline and during hemorrhage using a hand-held Side-stream Dark Field (SDF) imaging device to track changes in the microvasculature during hemorrhage. Automatically segmented vessels in the recordings are analyzed visually and the functional capillary density (FCD) values calculated by the algorithm are compared for both health baseline and hemorrhagic conditions. These results were compared to independently made FCD measurements using a well-known semi-automated method. Results of the fully automated algorithm demonstrated a significant decrease of FCD values. Similar, but more variable FCD values were calculated using a commercially available software program requiring manual editing. Conclusions An entirely automated system for analyzing microcirculation videos to reduce human interaction and computation time is developed. The algorithm successfully stabilizes video recordings, segments blood vessels, identifies vessels without flow and calculates FCD in a fully automated process. The automated process provides an equal or better separation between healthy and hemorrhagic FCD values compared to currently available semi-automatic techniques. The proposed method shows promise for the quantitative measurement of changes occurring in microcirculation during injury

Alien Registration- Najarian, Sarkis (Madison, Somerset County)

https://digitalmaine.com/alien_docs/7015/thumbnail.jp

Parasitic copepods of the family Sphyridae with special reference to the internal anatomy of the redfish parasite, Sphyrion Lumpi (Krøer) 1837 Bassett-Smith, 1899

Thesis (M.A.)--Boston University, 1949. This item was digitized by the Internet Archive