Notes

Bone fragments microstructure as well as bone fragments nutrient denseness aren't systemically different inside Antarctic icefishes as well as associated Antarctic notothenioids.
To demonstrate different techniques, and detail the considerations for obtaining primary laparoscopic access in gynecologic surgery.

Video demonstration of the techniques with narrated discussion of each method.

The methods for primary entry in laparoscopy vary by location and technique [1,2]. There are inherent risks with any mode of primary entry, and the risks are also specific to each technique [3-6]. The choice for primary entry depends on the patient's anatomy, surgical history, pathology, and surgeon preference [1,2].

This video reviews considerations for choosing the safest entry point and tips for proper entry technique [4,7-10]. The entry sites reviewed include the umbilicus, left upper quadrant, right upper quadrant, and supraumbilical [11]. The entry technique can be either open (Hasson), closed (Veress), or by direct laparoscopic visualization [9,10,12-14].

No single laparoscopic entry technique is superior [3]. The safest and most successful entry method will vary by case characteristics and surgeon training.
No single laparoscopic entry technique is superior [3]. ReACp53 The safest and most successful entry method will vary by case characteristics and surgeon training.Areal bone mineral density (aBMD) has a low sensitivity to identify women at high fracture risk. The FRAX algorithm, by combining several clinical risk factors, might improve fracture prediction compared to aBMD alone. Several micro-architectural and biomechanical parameters which can be measured by high-resolution peripheral quantitative computed tomography (HR-pQCT) are associated with fracture risk. HR-pQCT in combination or not with finite element analysis (FEA) may be used to improve bone strength prediction. Our aim was to assess whether HR-pQCT measurements (densities, cortical and trabecular microarchitecture, biomechanical proprieties assessed by FEA) had an added value in predicting fractures in a subgroup of women belonging to the Belgian FRISBEE cohort. One hundred nineteen women who sustained a fracture (aged 60 to 85 years) during the initial follow-up of our cohort had a radius and tibia examination by HR-pQCT and were compared with controls matched for their FRAX score at baseline. We found th [1.08-2.03], p less then 0.05), cortical (OR = 1.40 [1.04-1.87], p less then 0.05) and trabecular (OR = 1.37 [1.01-1.85], p less then 0.05) densities or apparent modulus (OR = 1.49 [1.07-2.05], p less then 0.05) at the radius were associated with a significant increase of fracture risk. At the tibia, only the cortical density was significantly associated with the fracture risk (OR = 1.34 [1.02-2.76], p less then 0.05). These results confirm the interest of HR-pQCT measurements for the evaluation of fracture risk, also in women matched for their baseline FRAX score. They also highlight that UDR aBMD contains pertinent information.
Gender disparity remains prevalent in the field of academic surgery with an under-representation of women at senior leadership ranks. A wide variety of causes are reported to contribute to this gender-based discrimination but a current quantitative analysis in the US has significant importance. This cross-sectional study aims to document gender disparity in academic and leadership positions in surgery as well as its relationship with scholarly productivity.

The American Medical Association's Fellowship and Residency Electronic Interactive Database (FREIDA), was used to identify General Surgery programs. Each institution's website was used to identify its faculty's primary profiles for data collection. Individuals with an MD or DO, and an academic ranking of Professor, Associate Professor or Assistant Professor were included. Academic productivity was quantified by recording H-index, number of publications, number of citations, and years of active research of a physician. All statistical analysis was perfosupport, mentorship, and sponsorship for women are imperative to achieve overall parity in general surgery.
A significant gender-based disparity was found in leadership positions and academic ranks. Research productivity appeared to be integral for academic and leadership appointments. Institution-level measures that enhance support, mentorship, and sponsorship for women are imperative to achieve overall parity in general surgery.
Studies have reported that general anesthesia (GA), especially volatile agents were associated with higher cancer recurrence rate after cancer resection surgery. However, the effect of supplementary regional anesthesia (RA) in reducing the use of anesthetic agents on oncological outcomes remains unclear. The primary aim of this meta-analysis was to examine the effect of adjunctive use of RA on the cancer recurrence rate in adults undergoing cancer resection surgery.

MEDLINE, EMBASE and CENTRAL were systematically searched for randomized control trials (RCTs) from its inception until April 2020.

Six RCTs (n=3139 patients) were included. In comparison to the GA alone, our meta-analysis demonstrated no significant difference in the cancer recurrence rate in patients who received the adjunctive use of RA in the routine care of GA (3 studies, n=2380 patients; odds ratio 0.93, 95%CI 0.63-1.39, ρ=0.73, certainty of evidence=very low). Our review also showed no significant difference in cancer-related mortality (2 studies, n=545; odds ratio 1.20, 95%CI 0.83-1.74, ρ=0.33, certainty of evidence=low), all-cause mortality (3 studies, n=2653; odds ratio 0.98, 95%CI 0.69-1.39, ρ=0.89, certainty of evidence=low) and duration of cancer-free survival (2 studies, n=659; mean difference 0.00 years, 95%CI -0.25-0.25, ρ=1.00, certainty of evidence=high).

This meta-analysis concluded that the adjunctive use of RA in the routine care of GA did not reduce cancer recurrence rate in cancer resection surgery. However, this finding needs to be interpreted with caution due to low level of evidence, substantial heterogeneity and potential risk of bias across the included studies.

CRD42020171368.
CRD42020171368.
Good management of disposable and reusable supplies may improve surgical efficiency in the operating room (OR) and also corresponds to the best eco-responsible approach. The purpose of this study was to assess the impact of a clinical pharmacist's intervention in the OR on the non-compliant use of medical devices. We also assessed the economic impact of the pharmaceutical intervention.

We conducted a monocentric prospective study in the OR of a University hospital over one year. Three surgical specialties urologic, digestive and gynecologic were audited after a preparatory phase to optimize usage of medical devices used for surgeries. The supply costs concerning the three specialties were compared before and after the pharmacist intervention.

One hundred and fifty surgical procedures were audited in digestive (33.3%, n=50), gynecologic (32%, n=48) and urologic (34.7%, n=52) surgeries. With the pharmacist in OR, 51 procedures (34% CI95%[26.4%; 41.6%]) with a non-compliance concerning at least one medical device were found compared to the 50% rate without the pharmacist reported previously (P<.
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