Medicina
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Background and Objectives: This study aimed to determine the minimal effective dose of indocyanine green (ICG) required for accurately assessing colonic perfusion during laparoscopic colorectal surgery using a laser-assisted laparoscopic near-infrared (NIR) camera system. Materials and Methods: In 15 patients with colorectal cancer undergoing right hemicolectomy, the left branch of the middle colic artery was preserved, and ICG angiography was performed in the transverse colon. To determine the optimal ICG dose, experimental doses of 0.01, 0.02, 0.03, 0.04, and 0.05 mg of ICG per patient's body weight (kg) were administered intravenously in each group. ⋯ An acceptable AI-based perfusion pattern was 14.2% in Group 1, significantly lower than in Groups 2-5 (66.4-100%). Washout time was significantly faster with minimal doses compared with conventional doses (39.0 ± 15.8 s vs. 117.5 ± 4.9 s, respectively, p < 0.001). Conclusions: This study supports the use of minimal ICG doses, ranging from 0.02 to 0.05 mg/kg, to optimize repetitive ICG angiography using a laser-assisted laparoscopic NIR camera.
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Background and objectives: Laparoscopic cholecystectomy (LC) is the most commonly performed operation in general surgery in the Western World. Gallbladder surgery, although most of the time simple, always offers the possibility of unpleasant surprises. Despite progress, the incidence of common bile duct injury is 0.2-0.4%, causing devastating implications for the patient and the surgeon. ⋯ Anatomical schemata were formulated corresponding to the norm and four variations. Conclusions: The proposed cognitive anatomical schemata summarize simply what one can expect in terms of deviation from the norm. We believe that the synergy between the correct application of the CVS and the structured knowledge of the surgical anatomy in cholecystectomy helps the surgeon to handle non-typical structures safely and to complete the laparoscopic or open cholecystectomy without vascular-biliary injuries.
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In the original publication [...].
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Background and Objectives: The incidence of hip fractures is increasing, and there have been reports linking cold weather to a higher risk of fractures. This study aimed to evaluate clinical variables in hip fracture patients who may predispose them to such fractures under different temperatures. Materials and Methods: This is a cross-sectional study conducted at a single medical center, enrolling older adults (≥60 years) who had experienced a hip fracture. ⋯ This finding suggests that for older adults with a higher Charlson Comorbidity Index, hip fractures tend to occur at lower temperatures and vice versa. Conclusions: Comorbidities are the only clinical concern that predisposes older adults to hip fractures under colder temperatures. This epidemiological finding could guide future patient education and hip fracture prevention programs.
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Background and Objectives: Biofilm formation on cochlear implants (CIs) poses a major problem for surgeons, leading to a high incidence of explantation and revision surgery. Therefore, developing appropriate and cost-effective biofilm detection and prevention techniques is of the essence. In this systematic review, we sought to investigate the development of biofilm formation on CIs. ⋯ Conclusions: Biofilm formation in CIs is considered one of the most dreadful complications. There have been no specific guidelines for the treatment of those cases, with removal and/or replacement of the CI being the treatment of choice. Various experimental prevention methods provide promising antibiofilm activity both in vivo and in vitro.