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Energy vessel-sealing devices are being increasingly utilized to seal pulmonary artery (PA) branches during lobectomy. Heat from these devices can potentially injure surrounding tissues. We evaluated heat production from devices in a live animal model.
PA branches were sealed in pigs with 4 energy vessel-sealing devices 2 ultrasonic (US), 1 advanced bipolar or 1 mixed US and bipolar (mixed) device. Thermocouples were implanted in tissue surrounding the PA branch being sealed to measure tissue temperature. A thermal camera measured the sealing site and the temperatures of the instruments. Pathological analysis was performed on PA stumps to identify thermal damage.
A total of 37 PA branches were sealed in 4 pigs. Maximum tissue heat measured by the thermocouples for the 2 US, advanced bipolar and mixed devices was 42, 39, 42 and 46°C, respectively. The mean tissue temperatures at the site of the sealing measured with the thermal camera were 78, 75, 70 and 82°C (P = 0.834) and the mean instrument blade temperatures were 224, 195, 83 and 170°C (P = 0.000005) for the 2 US, advanced bipolar and mixed devices, respectively. The mean diameter of the region with tissue reaching 60°C or more measured with the thermal camera was between 4 and 6 mm for the 4 devices (P = 0.941). On pathological analysis, PA stumps had either thermal damage on the adventitia and external media (26/37) or transmural damage (11/37) at 1 mm from sealed site.
A 3-mm safety margin between the instrument blades and vital structures is recommended. Instrument blades can reach high temperatures that may cause tissue damage.
A 3-mm safety margin between the instrument blades and vital structures is recommended. Instrument blades can reach high temperatures that may cause tissue damage.
Weakness of the gluteus medius and the gluteus maximus is associated with a variety of musculoskeletal disorders. However, activation of synergist muscles that are not targeted should be considered when prescribing side-lying hip abduction (SHA) exercises. Log-rolling positions may affect hip abductors activity during SHA.
To determine the effects of log-rolling positions on the gluteus medius, the gluteus maximus, and the tensor fasciae latae activity during SHA in participants with gluteus medius weakness.
The effects of different log-rolling positions on hip abductor activity during SHA were analyzed by one-way repeated-measures analysis of variance.
University research laboratory.
Twenty-one participants with gluteus medius weakness were recruited.
Three types of SHA were performed SHA in the frontal plane with a neutral position (SHA-neutral), SHA in the frontal plane with an anterior log-rolling position (SHA-anterior rolling), and SHA in the frontal plane with a posterior log-rolling positiatae in participants with gluteus medius weakness.
SHA-anterior rolling may be an effective exercise to increase activation of the gluteus medius and the gluteus maximus while decreasing the tensor fasciae latae in participants with gluteus medius weakness.The long-term outcomes of robotic-assisted McKeown esophagectomy (RAME) compared to thoraco-laparoscopic McKeown esophagectomy (TLME) for the patients with esophageal squamous cell carcinoma (ESCC) remain unclear. The aim of this study was to compare the number of dissected lymph nodes and long-term survival between RAME and TLME using a propensity score-matched (PSM) analysis. A total of 721 patients undergoing minimally invasive McKeown esophagectomy at our department from February 2015 to October 2019 were analyzed, including 310 patients in RAME group and 411 in TLME group. The exact numbers of lymph nodes including those among thoracic and abdominal categories as well as those along the recurrent laryngeal nerve (RLN) were all recorded. PSM analysis was applied to generate matched pairs for further comparison. All patients with R0 resection were followed with a strict follow-up period which range from 1 to 56 months. The effect of lymphadenectomy was compared between all patients in unmatched and matchedilar long-term survival outcomes compared to TLME.
A secondary analysis was conducted of two separate datasets to observe the association between maternal age and interpregnancy interval (IPI).
The IPI in a middle-income country (Guatemala) was compared with that of a very-high-income country (USA) among women with two pregnancies.
A regression model found that with each increasing year of age, the IPI increases by 1.26months (p<0.001) in Guatemala. A regression model found that IPI decreased as women aged in the USA.
It is hypothesized that as countries progress in their development indices, women may delay childbearing, which may result in reduced IPI, as was the case in the USA compared with Guatemala in these datasets.
It is hypothesized that as countries progress in their development indices, women may delay childbearing, which may result in reduced IPI, as was the case in the USA compared with Guatemala in these datasets.
It is established that Alzheimer's disease (AD) patients experience sleep disruption. However, it remains unknown whether disruption in the quantity, quality or timing of sleep is a risk factor for the onset of AD.
We used the largest published genome-wide association studies of self-reported and accelerometer-measured sleep traits (chronotype, duration, fragmentation, insomnia, daytime napping and daytime sleepiness), and AD. Mendelian randomization (MR) was used to estimate the causal effect of self-reported and accelerometer-measured sleep parameters on AD risk.
Overall, there was little evidence to support a causal effect of sleep traits on AD risk. There was some suggestive evidence that self-reported daytime napping was associated with lower AD risk [odds ratio (OR) 0.70, 95% confidence interval (CI) 0.50-0.99). Some other sleep traits (accelerometer-measured 'eveningness' and sleep duration, and self-reported daytime sleepiness) had ORs of a similar magnitude to daytime napping, but were less precisely estimated.
Overall, we found very limited evidence to support a causal effect of sleep traits on AD risk. Our findings provide tentative evidence that daytime napping may reduce AD risk. Given that this is the first MR study of multiple self-report and objective sleep traits on AD risk, findings should be replicated using independent samples when such data become available.
Overall, we found very limited evidence to support a causal effect of sleep traits on AD risk. JH-X-119-01 in vivo Our findings provide tentative evidence that daytime napping may reduce AD risk. Given that this is the first MR study of multiple self-report and objective sleep traits on AD risk, findings should be replicated using independent samples when such data become available.
Read More: https://www.selleckchem.com/products/jh-x-119-01.html
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