Notes

Administration of Dexmedetomidine Doesn't Develop Long-Term Defensive Impact on Testicular Injury Article Testicular Ischemia-Reperfusion Harm.
Rheumatoid arthritis (RA) is a chronic, debilitating autoimmune disorder involving inflammation and progressive destruction of the joints, affecting up to 1% of the population. The majority of patients with RA have one or more comorbid conditions, the most common being cardiovascular disease, osteoporosis, and depression, the presence of which are associated with poorer clinical outcomes and lower health-related quality of life. RA pathogenesis is driven by a complex network of proinflammatory cells and cytokines, and of these, interleukin-6 (IL-6) plays a key role in the chronic inflammation associated with RA. Through cell signaling that can be initiated by both membrane-bound and soluble forms of its receptor, IL-6 acts both locally to promote joint inflammation and destruction, and in the circulation to mediate extra-articular manifestations of RA, including pain, fatigue, morning stiffness, anemia, and weight loss. This narrative review describes the role of IL-6 in the pathogenesis of RA, its comorbidities, and extra-articular systemic manifestations, and examines the effects of the IL-6 receptor inhibitors sarilumab and tocilizumab on clinical endpoints of RA, patient-reported outcomes, and common comorbidities and extra-articular manifestations.
Inflammation is an integral part of the pathogenesis of periodontitis and sleep disorders. The aim of the present study was to review systematically the current evidence relating to the association between periodontal diseases and non-apnea sleep disorder.

Systematic searches were performed in MEDLINE, PsycINFO, Cochrane library, Web of Science, and Scopus without any limitation. Following preliminary screening, the quality of the remaining selected papers was appraised using the Newcastle-Ottawa Scale. Due to substantial heterogeneity among the selected articles, main outcomes were reported in a qualitative manner.

Following screening and evaluation, a final set of 13 studies was selected for inclusion. These studies examined the association between periodontal disease and short sleep duration, long sleep duration, poor sleep quality, or non-specific sleep disorders. The majority (N= 12/13) reported an association or trend between one type of sleep abnormality and periodontal or gingival parameters.

Despite the respective limitations of the articles included in this systematic review, an association between periodontal diseases and sleep disturbances was apparent.

Adequate management of periodontal disease requires that a patient's lifestyle factors be taken into consideration in treatment planning. One such factor is sleep initiation and maintenance. An obvious association between sleep disturbances and periodontitis exists. Sleep disorders may induce systemic inflammation, which, in turn, could influence the development of periodontitis.
Adequate management of periodontal disease requires that a patient's lifestyle factors be taken into consideration in treatment planning. One such factor is sleep initiation and maintenance. An obvious association between sleep disturbances and periodontitis exists. Sleep disorders may induce systemic inflammation, which, in turn, could influence the development of periodontitis.An amendment to this paper has been published and can be accessed via the original article.
Surgical procedures that use insufflation carry a risk of gas embolism, which is considered relatively harmless because of the high solubility of carbon dioxide. However, an in vitro study suggested that valveless insufflation devices may entrain non-medical room air into the surgical cavity. Our aim was to verify if this occurs in actual surgical procedures.

The oxygen percentage in the pneumoperitoneum or pneumorectum/pneumopelvis of eight patients operated with use of the AirSeal® was continuously measured, to determine the percentage of air in the total volume of the surgical cavity.

Basal air percentage in the surgical cavity was 0-5%. During suctioning from the operative field air percentage increased to 45-65%.

The AirSeal® valveless insufflation device maintains optimal distension of the surgical cavity not only by insufflating carbon dioxide, but also by entraining room air, especially during suctioning from the operative field. This may theoretically lead to air embolism in patients operated on with this device.
The AirSeal® valveless insufflation device maintains optimal distension of the surgical cavity not only by insufflating carbon dioxide, but also by entraining room air, especially during suctioning from the operative field. This may theoretically lead to air embolism in patients operated on with this device.
The benefit of adding oral antibiotic prophylaxis (OA) to intravenous prophylaxis (IV) in elective colorectal surgery to prevent surgical site infection (SSI) and whether the benefit of OA requires a mechanical bowel cleansing (MBP) are assessed in a systematic review. Meta-analyses compare randomized trials of IV versus IV plus OA, both with MBP; OA versus IV plus OA, both again with MBP; OA plus IV in studies randomizing patients to MBP or no MBP; and IV versus IV plus OA in patients with no MBP.

MEDLINE, EMBASE, and the Cochrane Library were searched for eligible studies from 1965 to April 1, 2020. The outcome assessed was SSI, superficial and deep, but not organ space. For each included study, risk of bias was assessed using the Cochrane Risk of Bias tool version 1. For each comparison, meta-analysis was performed from data from eligible studies to obtain a summary effect and heterogeneity using RevMan. Sensitivity analyses were performed excluding studies of poor quality. Certainty of evidence was asst comparison shows in just two studies that as in the first meta-analysis, but in the absence of MBP, combined OA plus IV is also superior to IV alone.
Combined OA and IV is superior to either alone in preventing SSI. The certainty of evidence is such that further research is unlikely to alter this relationship when MBP is used. In randomized trials of MBP, OA plus IV shows no benefit from MBP versus no MBP. The last comparison shows in just two studies that as in the first meta-analysis, but in the absence of MBP, combined OA plus IV is also superior to IV alone.
The transanal total mesorectal excision (TaTME) approach for rectal cancer has been gaining popularity. Although TaTME requires specific training, the opportunity to obtain this training is limited. We developed the first dry simulator that includes some important structural landmarks to provide training that includes all the procedural steps of TaTME.

The model was structured based on a computed tomography scan data. The simulator mimics the rectum and surrounding key anatomical structures. All material components were made of polyvinyl alcohol and stained with various colors to easily identify these anatomical structures while undergoing the training.

Our simulator is compact in its size and can be easily packed, stacked, and stored. The materials mimic the real one and the model allows us to perform the entire step-by-step TaTME procedures with genuine clinical devices from the attachment of operative platform to the anastomosis. We have held the course 24 times to date, with more than 200 surgeons participating not only from domestic hospitals but also from other countries. The result of the satisfaction survey from 65 participants, which was rated from 0 to 10 points, was an average score of 8.6 (± 1.4) points.

We present the world's first TaTME simulator and believe that it will play an important role for the safe spread of TaTME surgery.
We present the world's first TaTME simulator and believe that it will play an important role for the safe spread of TaTME surgery.Textiles damage analysis is a very valuable tool in forensic investigations. However, to date, very little research has been carried out to understand the impact of bullet causing damages to clothing. According to the review of the most recent scientific papers, the frictional heating and crushing action of a bullet passing through synthetic fibres cause a unique transformation in their ends called mushroom-shaped morphology. In this study, the textile remains of six individuals executed during the first decade of the Chilean military dictatorship period (1973-1990) were analysed. The purpose was to examine their clothing in order to describe the fibre defects in the bullet holes. The fibres were directly observed using two different models of stereomicroscopy (MZ16A and EZ4D, Leica Microsystem Ltd., Wetzlar, Germany) and through a combination of transmitted, oblique and co-axial illumination (with Leica DFC500 Digital Camera), at × 230 and at a resolution of up to 840 Lp/mm. The mushroom-shaped morphology, along with rupturing of yarns, fibrillation or splitting of fibres, was observed in the bullet holes. Although the mushroom-shaped is a useful pattern for bullet hole identification in synthetic fibres, further research needs to be performed for developing a sounder interpretational framework of this type of forensic evidence.
The objective was to analyse the effect of thoracic morphology on pulmonary function in adolescent idiopathic scoliosis (AIS) to predict preoperative lung function.

A total of 170 consecutive preoperative patients (average age 15.1years) with Lenke 1 and 2 AIS underwent pulmonary function testing. Thirteen deformity parameters, including rib hump size, rib asymmetry, spinal intrusion and thoracic/lung dimensions in the sagittal and coronal plane, were measured on whole-spine radiographs. Lung function parameters were expressed as z-scores. Correlation and regression analysis of these parameters with lung function were performed.

Mean thoracic Cobb (MT) was 69.1°, and mean T5-T12 thoracic kyphosis (TK) was 21.8°. MT correlated significantly with FEV
and FVC (r
 = -0.40 and -0.38). TK correlated weakly with FEV
and FEV
/FVC (r
 = 0.23 and 0.25). FEV
and FVC were best predicted by the inverse apical vertebra body-rib ratio (AVBRr
, r
 = 0.46 and 0.42), rib hump depth index (RHDi, r
 = -0.52 and -0.50) and spinal intrusion ratio (SIr, r
 = -0.50 and -0.45). The kyphosis-lordosis index (KLi) correlated with FEV
/FVC (r
 = 0.29). Multivariate regression analysis of coronal and sagittal Cobb angles produced a model which explained 35% and 30% of the variance in FEV
and FVC, whilst a regression model consisting of AVBRr
and SIr was able to predict 54% and 48%.

AVBRr
, RHDi and SIr measured on posterior-anterior and lateral radiographs provide better estimations of lung function in preoperative AIS patients than Cobb measurements. KLi was an indicator of airway obstruction as measured by FEV
/FVC.
AVBRr-1, RHDi and SIr measured on posterior-anterior and lateral radiographs provide better estimations of lung function in preoperative AIS patients than Cobb measurements. KLi was an indicator of airway obstruction as measured by FEV1/FVC.
Sexual minority adults are at greater risk for cardiovascular disease (CVD) risk factors than heterosexual adults. There is a dearth of research identifying factors that are associated with CVD risk among sexual minorities. This study examined the associations between distal and proximal minority stressors and CVD risk. We also tested a sense of mastery as one mechanism that might explain the link between minority stressors and CVD risk.

Participants were 670 sexual minority adults (53.6% male; 76% White), ages 18 to 76years (M = 41.19, SD = 14.73), obtained from a non-probability sample. Using an online survey, participants self-reported family history of CVD risk, physiological conditions (diabetes mellitus, high cholesterol, hypertension), and health behaviors (e.g., tobacco use, diet, exercise) that confer or protect against CVD risk. A weighted CVD risk index was computed. Linear and logistic regressions were conducted to test the effects of minority stressors on the CVD risk index and its specific indicators and to examine mediation.
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