Compression pre-stapler firing and post-ignition wait during sleeve gastrectomy: a prospective randomized trial

ABSTRACT BACKGROUND: Insufficient research exists on the stapling technique in and duration of laparoscopic sleeve gastrectomy (LSG). OBJECTIVES: This study aimed to assess the clinical outcomes using a 30-second precompression and post-firing waiting time without extra support for the stapling line. DESIGN AND SETTINGS: Randomized controlled prospective study at a university hospital. METHODS: This study included 120 patients treated between January 2022 and February 2023. The patients were divided into the non-waiting group (T0) and waiting group (T1), each with 60 patients. Perioperative complications were analyzed using statistical tests. RESULTS: The waiting group (T1) showed a significant reduction in the number of intraoperative bleeding points requiring intervention compared with the non-waiting group (T0) (81 versus 134, P < 0.05). In T0, postoperative C-reactive protein (CRP) levels increased (P < 0.05) and hemoglobin levels decreased significantly (P <0.05). The study recorded 22 postoperative complications, accounting for 18.3% of all cases during the 30-day postoperative period. CONCLUSIONS: The study concluded that the 30 sec + 30 sec stapling technique reduces perioperative bleeding, length of stay, and serious complication rates and is practical and effective for LSG. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov with registration code NCT05703035; link: https://clinicaltrials.gov/ct2/show/NCT05703035.

An injectable hydrogel/staple fiber composite for sustained release of CA4P and doxorubicin for combined chemotherapy of xenografted breast tumor in mice / 南方医科大学学报

OBJECTIVE@#To prepare an injectable hydrogel/staple fiber composite loaded with combretastain A-4 disodium phosphate (CA4P) and doxorubicin (DOX) and evaluate its antitumor efficacy via intratumoral injection.@*METHODS@#DOX-loaded PELA staple fibers (FDOX) were prepared using electro-spinning and cryo-cutting, and the drug distribution on the surface of the fibers was observed using a fluorescence microscope, and the encapsulation efficiency and loading capacity of FDOX were determined with a fluorospectro photometer. The fibers were then dispersed in CA4P-loaded PLGA-PEG-PLGA tri-block polymer solution at room temperature to obtain the hydrogel/staple fiber composite (GCA4P/FDOX). The thermo-sensitivity of this composite was determined by a test tube inverting method. An ultraviolet spectrophotometer and a fluorospectrophotometer were used to detect the release profile of CA4P and DOX, respectively. We observed in vivo gel formation of the composite after subcutaneous injection in mice. The in vitro cytotoxicity of GCA4P/FDOX composite in MCF-7 and 4T1 cells was assessed using cell Counting Kit-8 (CCK-8) reagent. In a mouse model bearing breast tumor 4T1 cell xenograft, we evaluated the antitumor efficacy of the composite by monitoring tumor growth within 30 days after intratumoral injection of the composite. HE staining, immunohistochemistry for Ki67 and immunofluorescence (TUNEL) assay were used for pathological examination of the tumor tissues 21 days after the treatments.@*RESULTS@#The average length of FDOX was 4.0±1.3 μm, and its drug loading capacity was (2.69±0.35)% with an encapsulation efficiency of (89.70±0.12)%. DOX was well distributed on the surface of the fibers. When the temperature increased to 37 ℃, the composite rapidly solidified to form a gel in vitro. Drug release behavior test showed that CA4P was completely released from the composite in 5 days and 87% of DOX was released in 30 days. After subcutaneous injection, the composite solidified rapidly without degradation at 24 h after injection. After incubation with GCA4P/FDOX for 72 h, only 30.6% of MCF-7 cells and 28.9% of 4T1 cells were viable. In the tumor-bearing mice, the tumor volume was 771.9±76.9 mm3 in GCA4P/FDOX treatment group at 30 days. Pathological examination revealed obvious necrosis of the tumor tissues and tumor cell apoptosis induced by intratumoral injection of G4A4P/FDOX.@*CONCLUSION@#As an efficient dual drug delivery system, this hydrogel/staple fiber composite provides a new strategy for local combined chemotherapy of solid tumors.

Three decades of household food availability according to NOVA - Brazil, 1987-2018 / Três décadas da disponibilidade domiciliar de alimentos segundo a NOVA - Brasil, 1987-2018

ABSTRACT OBJECTIVE To evaluate the trend of household food acquisition according to the NOVA classification in Brazil between 1987-1988 and 2017-2018. METHODS We used household food acquisition data from five editions of the Pesquisas de Orçamentos Familiares (Household Budget Surveys), conducted by the Instituto Brasileiro de Geografia e Estatística (Brazilian Institute of Geography and Statistics), in the years 1987-1988, 1995-1996, 2002-2003, 2008-2009, and 2017-2018. All reported foods were categorized according to the NOVA classification. The household availability of food groups and subgroups was expressed through their share (%) in total calories, for all Brazilian families, by household situation (urban or rural), for each of the five geographic regions of the country, by fifths of the household income per capita distribution (2002-2003, 2008-2009 and 2017-2018 surveys), and for the 11 main urban regions of the country (1987-1988, 1995-1996, 2002-2003, 2008-2009 and 2017-2018 surveys). Linear regression models were used to assess the trend of increasing or decreasing food purchases. RESULTS The diet of the Brazilian population is still composed predominantly of foods in natura or minimally processed and processed culinary ingredients. However, our findings point to trends of increasing share of ultra-processed foods in the diet. This increase of 0.4 percentage points per year between 2002 and 2009 slowed down to 0.2 percentage points between 2008 and 2018. The consumption of ultra-processed food was higher among households with higher income, in the South and Southeast regions, in urban areas, and in metropolitan regions. CONCLUSION Our results indicate an increase in the share of ultra-processed foods in the diet of Brazilians. This is a worrisome scenario, since the consumption of such foods is associated with the development of diseases and the loss of nutritional quality of the diet.

RESUMO OBJETIVO Avaliar a tendência da aquisição domiciliar de alimentos de acordo com a classificação NOVA no Brasil entre 1987-1988 e 2017-2018. MÉTODOS Foram utilizados dados de aquisição domiciliar de alimentos provenientes de cinco edições da Pesquisas de Orçamentos Familiares, realizada pelo Instituto Brasileiro de Geografia e Estatística, nos anos 1987-1988, 1995-1996, 2002-2003, 2008-2009 e 2017-2018. Todos os alimentos reportados foram categorizados segundo a classificação NOVA. A disponibilidade domiciliar dos grupos e subgrupos de alimentos foi expressa por meio de sua participação (%) nas calorias totais, para o conjunto das famílias brasileiras, por situação do domicílio (urbana ou rural), para cada uma das cinco regiões geográficas do país, por quintos da distribuição de renda domiciliar per capita (inquéritos de 2002-2003, 2008-2009 e 2017-2018); e para as 11 principais regiões urbanas do país (inquéritos de 1987-1988, 1995-1996, 2002-2003, 2008-2009 e 2017-2018). Modelos de regressão linear foram utilizados para avaliar a tendência de aumento ou diminuição na aquisição dos alimentos. RESULTADOS A dieta da população brasileira ainda é composta predominantemente por alimentos in natura e minimamente processados e ingredientes culinários processados. No entanto, nossos achados apontam tendências de aumento da participação de alimentos ultraprocessados na dieta. Esse aumento que foi de 0,4 pontos percentuais ao ano na primeira porção do período estudado, entre 2002 e 2009, e desacelerou para 0,2 pontos percentuais entre 2008 e 2018. O consumo de alimentos ultraprocessados foi maior entres os domicílios de maior renda, nas regiões Sul e Sudeste, na área urbana, e nas regiões metropolitanas. CONCLUSÃO Os resultados do presente estudo apontam um aumento na participação de alimentos ultraprocessados na dieta dos brasileiros. Cenário preocupante, uma vez que o consumo de tais alimentos está associado ao desenvolvimento de doenças e à perda da qualidade nutricional da dieta.

Pesquisa de orçamentos familiares: tendência do consumo de alimentos tradicionais, 2002-2018 / Brazilian household survey: trend in traditional foods consumption, 2002-2018

Descrever a evolução de consumo de alimentos tradicionais e da cesta básica brasileira entre 2002 e 2018. Série temporal do consumo de alimentos tradicionais e da cesta básica brasileira com base nos dados das três últimas Pesquisas de Orçamentos Familiares. A tendência da aquisição alimentar domiciliar per capita anual dos alimentos foi analisada segundo os períodos estudados e as regiões brasileiras. Houve diminuição da aquisição alimentar domiciliar de todos os itens da cesta básica, exceto a manteiga (8,3%). As maiores reduções observadas foram: farinha de mandioca (-69,9%), farinha de trigo (-56,1%) e feijão (-52,3%). Na região Sul ocorreu a maior queda percentual de aquisição de feijão (-56,1%), e o Norte se destacou pela redução acentuada do consumo de carnes (-32,1%) e leites (-57,2%). A diminuição observada no consumo de alimentos tradicionais pode sinalizar possíveis prejuízos à saúde dos indivíduos e perda da identidade cultural alimentar brasileira.

The evolution of consumption of traditional foods and Brazilian basic food basket between 2002 and 2018 is described through a time series of consumption of traditional food and Brazilian basic food basket based on data from Brazilian household surveys. Trend of annual per capita household food acquisition of food was analyzed according to the studied periods and regions in Brazil. Results reveal there was a decrease in household food acquisition of all items in the basic food basket, except butter (8.3%). Greatest reduction rates comprised cassava flour (-69.9%), wheat flour (-56.1%) and beans (-52.3%). In the southern region highest percentage decrease rate comprised the acquisition of beans (-56.1%), whilst in the northern region a sharp reduction in meat (-32.1%) and milk consumption (-57.2%) may be underscored. Decrease in the consumption of traditional foods by the population may detect possible damage to the health of individuals and loss of the Brazilian food culture.

Most consumed foods in Brazil: evolution between 2008-2009 and 2017-2018 / Evolução dos alimentos mais consumidos no Brasil entre 2008-2009 e 2017-2018

ABSTRACT OBJECTIVE: To describe the evolution of food consumption by the Brazilian population in 2008-2009 to 2017-2018. METHODS: Data from the National Dietary Surveys of 2008-2009 and 2017-2018 were used. Both surveys estimated food consumption of two non-consecutive days of individuals aged 10 years or older. The first survey collected consumption data from 34,003 individuals through food records; the second, obtained data from 46,164 individuals, through 24-hour recalls. The twenty most frequently reported food groups in the two surveys were identified. The probability of consumption of each food group in the two surveys was estimated according to sex, age and income. This study presents the foods that had a change in the frequency of consumption of 5% or higher between the two surveys. The probability of consumption was corrected for intra-individual variability using the method developed by the National Cancer Institute. RESULTS: Rice, beans, coffee, bread, vegetables and beef remained the staple Brazilian diet, ranking as the six most consumed items in both surveys. Ultra-processed foods such as sweet/stuffed cookies, savory cookies, processed meats and carbonated drinks also remained among the 20 most consumed foods. Trend analyses showed, regardless of gender, age and income range, a decrease in the consumption of rice, beans, beef, bread, fruit, milk and dairy, processed meats and carbonated drinks, and an increase in the consumption of sandwiches. CONCLUSION: The Brazilian diet is still characterized by consumption of traditional foods, such as rice and beans, and by high frequency of consumption of ultra-processed foods, such as cookies and carbonated drinks. However, between the years of 2008-2009 and 20172018, there was a decrease in the consumption of rice, beans, beef, bread, fruit, milk and dairy, processed meats and carbonated drinks, but an increase in the consumption of sandwiches. The results show a decrease in quality in the Brazilian diet.

RESUMO OBJETIVO: Descrever a evolução do consumo alimentar da população brasileira de 2008-2009 a 2017-2018. MÉTODOS: Foram utilizados dados dos Inquéritos Nacionais de Alimentação de 2008-2009 e 2017-2018, que estimaram o consumo alimentar de dois dias não consecutivos de indivíduos com 10 anos ou mais de idade. O primeiro inquérito colheu dados de consumo de 34.003 indivíduos por meio de registro alimentar; o segundo, de 46.164 indivíduos, por meio de recordatório de 24 horas. Identificaram-se os 20 grupos de alimentos mais frequentemente referidos nos dois inquéritos. A probabilidade de consumo de cada um dos grupos de alimentos nos dois inquéritos foi estimada segundo sexo, idade e renda. No presente estudo, são apresentados os alimentos que tiveram mudança igual ou superior a 5% na frequência de consumo entre os dois inquéritos. A probabilidade de consumo foi corrigida para a variabilidade intraindividual, utilizando método desenvolvido pelo National Cancer Institute. RESULTADOS: Arroz, feijão, café, pães, hortaliças e carne bovina permaneceram como base da alimentação dos brasileiros, sendo os seis itens mais consumidos em ambos os inquéritos. Alimentos ultraprocessados, como biscoitos doces/recheados, biscoitos salgados, carnes processadas e refrigerantes, também se mantiveram entre os 20 alimentos mais consumidos. As análises de tendência evidenciaram, independentemente de sexo, idade e faixa de renda, a diminuição do consumo de arroz, feijão, carne bovina, pães, frutas, laticínios, carnes processadas e refrigerantes, e o aumento da ingestão de sanduíches. CONCLUSÃO: A dieta do brasileiro permanece caracterizada pelo consumo de alimentos tradicionais, como arroz e feijão, e pela frequência elevada de ingestão de alimentos ultraprocessados, como biscoitos e refrigerantes. No entanto, entre os anos de 2008-2009 e 2017-2018, observou-se redução no consumo de arroz, feijão, carne bovina, pães, frutas, laticínios, carnes processadas e refrigerantes, mas aumento no consumo de sanduíches. Os resultados sinalizam piora na qualidade da alimentação do brasileiro.

Prospective interventional study of staple line reinforcement and buttressing in laparoscopic sleeve gastrectomy

Background: Laparoscopic sleeve gastrectomy has gained increasing acceptance among bariatric surgeons and patients. The three main options for staple line reinforcement are over-sewing and buttressing with synthetic polymers or biologic tissue. The purpose of this study was to prospectively analyse the relative efficacy of gastric staple line reinforcement (SLR) by using over sewing as the method of reinforcement and comparing it with non-reinforcement laparoscopic sleeve gastrectomy (LSG) in 60 patients who were admitted in IGGMC Nagpur from May 2017 to November 2019.Methods: Obese patients with age 18-65 years, BMI 40 and above with-out co-morbidities and 35 and above with co-morbidities, and BMI below 60, with no malignancy, no hiatus hernia, no previous bariatric procedure were included. All patients underwent LSG after thorough evaluation. 30 patients had reinforced staple line, while 30 had simple staple line.Results: Total 60 patients were studied, 30 in each group. Intraoperative leak was seen in 1 patient each in both study groups. No bleeding was seen in reinforced LSG, while 3 patients had intraop bleeding in simple staple line group. 1 patient each of non-reinforced group had postop leak, postop bleeding and post op morbidity and mortality in 1 patient, while no postop leak or bleeding, morbidity or morality was seen in reinforced group.Conclusions:Reinforcement of staple line by over sewing in LSG resulted in significantly fewer surgical complications, lesser morbidity and no mortality compared to simple stapling of the gastric tube.

Foreign Body in Maxillary Deciduous First Molar – A Case Report

Introduction: Children have a tendency to explore andinteract with their external environment by placing andchewing objects in their mouth.Case report: This article reports a case of lodgement of astaple pin in a neglected decay in the left maxillary deciduousfirst molar in a six year old male patient. The child reportedof pain which was spontaneous and aggravated on chewing.An emergency extraction of the tooth involved was performedunder local anaesthesia.Conclusion: In conclusion, this article further stresses on theneed of periodic examination of the overall oral health status inchildren and perform necessary early preventive procedures.

Surgical staples and skin closure tape in primary total knee arthroplasty: A systematic review and meta-analysis / 中国组织工程研究

BACKGROUND: Skin closure with surgical staplers has been widely used in total knee arthroplasty. In recent years, a new kind of skin closure tape has also achieved good results in total knee arthroplasty. There is no clear report on which method of skin closure is better. OBJECTIVE: To statistically analyzed the effect of two skin closure techniques in total knee arthroplasty. METHODS: The two researchers independently searched the relevant literature in PubMed, Cochrane library, EMBASE, Chinese Biomedicine Database, China National Knowledge Infrastructure, Wanfang Data and the VIP Chinese Sci-tech Journal Database. The retrieval time was from inception to April 2019. The literature was screened and finally included in the study. RESULTS AND CONCLUSION: A total of four studies were included, both of which were the literature in English. (1) In terms of the primary index, the re-admission rate of skin closure tape (RR=0.68, 95%C/:0.49-0.95, P=0.03) could be reduced compared with the staple. However, there was no significant difference in the incidence of complications between the two (RR=0.85, 95%C/:0.27-2.64, P=0.77). (2) In the aspect of secondary indexes, skin closure tape could relieve pain, save time and cost, and have good cosmetic effect though there was no significant difference in the removal time of closed materials between the two. (3) Results indicated that according to the existing literature, compared with surgical staples, skin closure tape is a less painful skin closure method with fewer complications in total knee arthroplasty. Because of the limited sample size, more studies and longer follow-up time are needed to confirm this conclusion.

Design Optimization, Function Analysis and in vitro Experiments of an Electric Stapler for Minimally Invasive Surgery / 医用生物力学

Objective To develop a new type of electric stapler, so as to solve the problems of insufficient rotation angle, inconvenient operation and difficulty in controlling the pressing strength of existing products. Methods An electric stapler was designed and manufactured. The motion trajectory curve of the prototype was measured by using the three-coordinate imaging instrument to build functional test platform of the prototype, and the goodness of fit was used to evaluate consistency between the theoretical curve and the measured curve. The small intestine tissues of fresh pig were anastomosed at different bending angles of the front end, and the forming rate of the anastomotic stoma was measured. Results The goodness of fit between the test curve and the theoretical curve for both turning motion and shooting motion was ideal, while the goodness of fit between the test curve and the theoretical curve for pressing motion was not ideal when the turning joint was bent at 0°-30°, and was ideal when it was bent at 45°-60°. In performance test, the deformity rate of the nail was smaller than 1.14%, indicating that the bending angle had no significant impacts on the anastomotic effect. Conclusions The kinematics curves of shooting motion and turning motion are consistent with the theoretical curves. The pressing motion curves fluctuate at different bending angles, which will not affect the anastomotic effect, and the effect of the electric stapler meets the clinical requirements.

Tissue fusion technology versus suture and staple in porcine bowel anastomosis: an in vivo study

The aim of this study was to make a comparison between the tissue fusion technique and conventional methods for sealing bowel anastomosis. Eighteen female domestic pigs (Suidae, Sus) were used in our study. Tissue-fused anastomoses (LigaSure groups) were made in 13 animals (5 anastomoses per animal), which were subdivided into 4 groups according to different manufacturing settings: "LigaSure-L-1" and "LigaSure-L-2", with low energy output level with 1 or 2 device-activated tissue sealing times, and "LigaSure-M" and "LigaSure-H", with medium or high energy output level. As controls, automatically stapled (GIA group) and hand-sewn (suture group) anastomoses were utilized in 3 and 2 animals, respectively. There was no statistical difference in the overall leakage rate between the GIA group (6.7%) and the LigaSure groups (15%) (P=1.000). There was less proliferating epithelium covering the anastomosis gap in the LigaSure groups compared with the other two groups. The gap between the two extremities of muscular layers of the anastomosis in the LigaSure groups was filled with collagen fibers. More proliferating cell nuclear antigen (PCNA)-positive cells were found in the anastomoses of the LigaSure groups compared with the other two groups (P=0.010). Our results showed that the tissue fusion technology was a feasible and safe method for anastomoses.

Correlations and selection of parents to technological traits of upland cotton / Correlações e seleção de genitores para caracteres tecnológicos em algodoeiro herbáceo

ABSTRACT: Technological traits improvement of cotton fiber is a constant demand by textile industry. This research aimed to identify the potential of improved materials with high lint percentage to contribute with alleles that increase the lint percentage in Extra long staple fiber (ELS) upland cotton. Two contrasting materials for lint percentage (LP) and fiber length (FL) were used, one with long fiber and a low lint percentage (parent A) and another with high lint percentage and medium length (parent B). The following variables were evaluated: lint percentage (LP), upper half mean length (UHML), fiber uniformity (FU), fiber strength (FS), and elongation (EL). Diallel analysis was performed using the Griffing's Method 4 adapted to partial diallel. Additive effects were predominant over non-additive effects. The mean LP was higher when using parent B. The opposite occurred for UHML. A negative correlation was detected between LP and UHML, showing the difficulty of obtaining genetic gain for both traits at the same time.

RESUMO: O aprimoramento das características tecnológicas da fibra de algodão é uma demanda constante da indústria têxtil. Este trabalho teve como objetivo identificar o potencial de materiais melhorados com alta porcentagem de plumas para contribuir com alelos que aumentam a porcentagem de plumas com fibra extra longa (ELS) no algodão de terras altas. Dois materiais contrastantes para porcentagem de fibra (LP) e comprimento de fibra (FL) foram usados, um com fibra longa e uma baixa porcentagem de fibra (pai A) e outro com alta porcentagem de fibra e comprimento médio (pai B). As seguintes variáveis foram avaliadas: porcentagem de fibra (LP), comprimento médio da metade superior (UHML), uniformidade da fibra (FU), resistência da fibra (FS) e alongamento (EL). A análise dialélica foi realizada utilizando o Método 4 de Griffing adaptado para dialelo parcial. Os efeitos aditivos foram predominantes em relação aos efeitos não aditivos. O LP médio foi maior quando se usou o pai B. O oposto ocorreu para o UHML. Uma correlação negativa foi detectada entre LP e UHML, mostrando a dificuldade de obter ganho genético para ambas as características ao mesmo tempo.

Green Serum: Causes And Clinical Outcomes : A Case Report

AIM:Analyse the significance of green serum in a clinical laboratory METHADOLOGY: Serum sample of a 20year old male patient presenting to ER with complaints of altered sensorium since last 3 days and a history of fever and yellow discolouration of the eyes since last 5 days was received in the lab for evaluation. As per protocol sample was centrifuged and serum was obtained for evaluation in the Beckman Coulter AU480 autoanalyser. When observed the serum was found to be green in colour RESULT: The biochemistry report showed excessively elevated serum bilirubin ( 34 mg/dl) with predominance of unconjugated bilirubin. SGOT was 248U/Land SGPTlevels were found to be normal. Serum K+ of was 2.0 mmol/dl and elevated TLC were the other significant finding. CONCLUSION: Occurrence of green serum is a very rare phenomenon. Even though it is theoretically possible to find green serum in pregnancy or in long standing rheumatoid arthritis but actually it is very hard to find . In our institution several samples obtained both from the obstetrics & gynaecology department and orthopaedic for RA cases were found to be of normal straw colour. In the above mentioned patient in view of all the other causes being ruled out an assumption of partial biliverdin reductase deficiency could be made as it has been found to be associated in the setting of fulminant hepatic failure mainly caused by alcoholism. KEYWORD

Efficient regeneration and genetic transformation platform applicable to five Musa varieties

Background: Banana (Musa spp.) is an important staple food, economic crop, and nutritional fruit worldwide. Conventional breeding has been seriously hampered by their long generation time, polyploidy, and sterility of most cultivated varieties. Establishment of an efficient regeneration and transformation system for banana is critical to its genetic improvement and functional genomics. Results: In this study, a vigorous and repeatable transformation system for banana using direct organogenesis was developed. The greatest number of shoots per explant for all five Musa varieties was obtained using Murashige and Skoog medium supplemented with 8.9 µM benzylaminopurine and 9.1 µM thidiazuron. One immature male flower could regenerate 380­456, 310­372, 200­240, 130­156, and 100­130 well-developed shoots in only 240­270 d for Gongjiao, Red banana, Rose banana, Baxi, and Xinglongnaijiao, respectively. Longitudinal sections of buds were transformed through particle bombardment combined with Agrobacterium-mediated transformation using a promoterless ß-glucuronidase (GUS) reporter gene; the highest transformation efficiency was 9.81% in regenerated Gongjiao plantlets in an optimized selection medium. Transgenic plants were confirmed by a histochemical assay of GUS, polymerase chain reaction, and Southern blot. Conclusions: Our robust transformation platform successfully generated hundreds of transgenic plants. Such a platform will facilitate molecular breeding and functional genomics of banana.

Finite element modeling and analysis on end-to-end anastomosis of the large intestine / 医用生物力学

Objective To analyze the relationship of closed staple height with tissue damage and compression pressure, so as to provide theoretical references and guidance for the surgeon to choose the appropriate staple cartridge and height, as well as improve the safety of operation. Methods The finite element model of stapled colorectal end-to-end anastomosis was established based on analysis of staple-tissue interaction. Large intestine tissues with different wall thicknesses (1.0-1.5 mm) were compressed by closed staples with 4 different height to compare changes in stress distributions and average radial pressure. Results When the tissues were compressed by closed staple with height of 1.0, 1.1, 1.2 and 1.5 mm, respectively, the average radial stress of compressed tissues with wall thicknesses of 1.2, 1.3, 1.4, and 1.5 mm were 56.0, 58.6, 59.7 and 57.3 kPa, respectively, which was close to the optimal compression pressure. Stress concentrations were found in contact area of the staple and tissues，with the maximum stress being 2 783, 1 750, 1940 and 2 030 kPa, respectively. Conclusions Tissue damage cannot be completely avoided in anastomotic surgery, and stress concentration is generally located near contact region of the staple and tissues. The optimal closed staple height ranges in 50%-60% of the uncompressed tissue height.

Angular Deformity Correction by Asymmetrical Physeal Supression in Children / 대한정형외과학회잡지

Angular deformity of extremities in children and adolescents with residual growth is not a rare condition in orthopaedics. Asymmetrical physeal suppression or guided growth method, one of the surgical techniques for correction of angular deformity, is a method of inducing plastic deformation by application of constant external force to a growing bone. Internal fixation devices used for asymmetrical physeal suppression include staples, transphyseal screws, and tension band plates, most representatively the 8-plate. Temporary hemiepiphysiodesis using staples is reported to show a success rate of 60% to 80%. Epiphysiodesis using transphyseal screws has several advantages over staples or 8-plates; smaller skin incision, shorter operation time, no postoperative splint or cast, faster return to daily life. Advantages of 8-plates over staples or transphyseal plates include a longer moment arm, which enables better correction of angular deformity and less suppression of the growth of the nearby normal growth plate. Asymmetrical physeal suppression is a simple and effective surgical method in correcting angular deformity of extremities of children and adolescents. Each of three internal fixation devices discussed in the current article has strengths and weaknesses and superiority in terms of angular correction power and complication rate, however further study is needed. Therefore, the most appropriate device should be selected according to the condition of each patient.

Relationship between the Characteristics of Staplers and Malformation of Staples.

The “Type of Article” of this paper is “Letter to the Editor”. This paper discuses about: “Relationship between the Characteristics of Staplers and Malformation of Staples”. No formal abstract is available. Readers are requested to read the full article.

Reinforcement Material on the Intestinal Stump Staple Line-The Effect and Mechanism of Reinforcement.

Background: In gastrointestinal surgery, the quality of anastomosis is one of the most important factors influencing the postoperative course. The purpose of this study was to verify the effectiveness and the mechanism of one type of reinforcement material. Methods: We analyzed the effect of NeoveilⓇ on the rate of staple line failure. Fresh pig small bowel was used. NeoveilⓇ sheets were placed on the anvil alone, cartridge alone or both sides of the stapler. Groups were: A, without NeoveilⓇ; B, the cartridge and anvil; C, the cartridge alone; D, the anvil alone. The burst pressures were measured. Results: In group A, a leak occurred at the intestinal stump in 5 of 10 cases (As). In the other 5 cases, the mesenteric side burst before failure of the staple line (Am). In groups B, C, and D, the mesenteric side burst before failure of the staple line. The median leak pressure was 100±46 mm Hg in group A (As; 57±6, Am; 143±12). In the other groups, the leak pressures were approximately 140 mm Hg. In group As, the middle staple only exists on the edge of stump. In group Am, however, both sides of the 3-row staple line exist on the edge of stump. Conclusion: The burst pressure of the stump became the result of the bipolarization. The strength of the stump staple line is affected by the arrangement of the staples. NeoveilⓇ was effective in obtaining a stronger staple line.

Condições de vida e aquisição de gêneros alimentícios de crianças beneficiárias do programa bolsa família / Condiciones de vida y adquisición de alimentos para los niños beneficiarios del programa bolsa família / Living conditions and acquisition of foodstuffs for children benefiting from the bolsa família program

O Programa Bolsa Família (PBF) visa reduzir a pobreza, as desigualdades sociais e combater a fome entre as famílias pobres vitimadas pela desigualdade social, que não estão inseridas no mercado de trabalho por razões diversas. O objetivo do trabalho foi investigar a disponibilidade de alimentos e as condições de vida de crianças de dois a seis anos, beneficiárias do PBF, em um bairro no município de Guarapuava (PR). Tratou-se de um estudo tranversal analítico, com visita domiciliar a 33 crianças de dois a seis anos, beneficiadas pelo PBF. As crianças apresentaram vulnerabilidade social, evidenciada principalmente pela renda per capita. A aquisição mensal pela família de frutas, hortaliças e leites foi baixa, e a de doces foi alta. Portanto, é necessário avançar em medidas que permitam aos beneficiários sua liberdade de escolha em alimentação, mas articulá-las a outros programas de intervenção, gerando uma melhoria na qualidade de vida e bem-estar dessa população.

El Programa Bolsa Familia (PBF) es un Programa Federal que tiene como objetivo reducir la pobreza, la desigualdad social y el hambre en las familias pobres, víctimas de la desigualdad social, que no se insertan en el mercado laboral, por diversas razones. El objetivo de este estudio fue investigar la disponibilidad de alimentos y las condiciones de vida de los niños de 2-6 años de edad, beneficiadas por lo PBF, en Guarapuava-PR, Brasil. Se realizó un estudio analítico transversal con visitas domiciliarias a 33 niños de 2-6 años. Los niños están en vulnerabilidad social, evidenciado principalmente por el ingreso per cápita. La adquisición mensual por la familia de las frutas, verduras y leche era baja, y el caramelo era alto. Por lo tanto, sería necesario avanzar en medidas que permitan a los beneficiarios a su libertad de elección en los alimentos, pero vincularlos a otros programas de intervención, lo que genera una mejora en la calidad de vida y el bienestar de esta población.

The Programa Bolsa Família (PBF) aims to reduce poverty, social inequality and fight hunger among poor families victimized by social inequality, which are not inserted in the labor market for various reasons. The aim of this study was to investigate the food availability and life conditions of children from two to six years old, beneficiated by PBF, in Guarapuava (PR), Brazil. This was a cross-sectional analytical study with home visits to 33 children from two to six years old, beneficiated by PBF. It was showed social vulnerability, primarily evidenced by per capita income. The family monthly acquisition of fruits, vegetables and milk was low, and the candy one was high. Therefore, it is necessary to advance in measures to allow the beneficiaries their freedom of choice in food, but link them to other intervention programs, generating an improvement in quality of life and well-being for this population.

Evaluation of a biopsy technique of the epiphyseal plate radius of mules with angular deformity of surgical type: case study / Evaluación de una técnica de biopsia de la placa epifisaria del radio de mulares con deformidad angular de tipo quirúrgica: estudio de caso / Avaliação de uma técnica de biopsia da placa epifisária do rádio de muares com deformidade angular de tipo cirúrgico: estudo de caso

Background: eight mules with angular limb deformity (ALD) type carpus varus and carpus valgus were studied. Objetive: to evaluate a biopsy technique of the distal growth plate of the radius using a Jamshidi needle. Methods: thirteen limbs with ALD were biopsied immediately before undergoing corrective surgery. The site of biopsy depended on the severity of ALD and surgical technique. The samples were preserved and processed for histopathological study. Results: of all biopsies evaluated, only three were successfully obtained. Conclusions: the biopsy technique used was not efficient (23% success rate), however it allowed us to describe the physeal dysplasia in mules with ALD. Our findings agree with those previously described in horses.

Antecedentes: ocho mulares con deformidad angular (ALD) de tipo varus y valgus del carpo fueron estudiados. Objetivo: evaluar una técnica de biopsia para la placa de crecimiento distal del radio con la aguja Jamshidi. Métodos: se utilizaron 13 miembros con ALD; inmediatamente antes de la cirugía correctiva. El lugar de la biopsia varió con la severidad de la ALD y con la técnica quirúrgica. Las muestras fueron conservadas y tratadas para estudio histopatológico. Resultados: se obtuvieron solamente 3 muestras exitosas. Conclusiones: la técnica de biopsia utilizada fue poca eficiente (23%), pero permitió describir la presencia de displasia fisária en mulares con ALD. Los hallazgos coinciden con los descritos para equinos.

Antecedentes: oito muares com deformidade angular (ALD) de tipo varus e valgus do carpo foram estudados. Objetivo: avaliar uma técnica de biopsia para a placa de crescimento distal do rádio com a agulha de Jamshidi. Métodos: se utilizaram 13 membros com ALD, imediatamente antes da cirurgia corretiva. O lugar da biopsia dependeu da severidade de ALD e da técnica cirúrgica. As amostras foram conservadas e tratadas para estudo histopatológico. Resultados: três amostras foram obtidas com sucesso. Conclusões: a técnica de biópsia utilizada foi pouca eficiente (23%), mas permitiu descrever displasia fisária em ALD. Os achados concordam com os descritos em equinos.

Feeding Pattern and Health Challenges of Nigerian Primary School Children in a Southeastern Urban Centre.

Aims: To document the feeding pattern of public primary school children, with emphasis on the staple diet and skipped meals; and the influence of diet and certain maternal demographic characteristics on their health and nutritional status. Study Design: This was a cross sectional descriptive study. Place and Duration of Study: The study was done in Onitsha, Anambra state, South East Nigeria between September and December, 2010 Methodology: This was a cross sectional descriptive study with multistage sampling of 804 children aged 6 to 12years from 12 public primary schools in the area. Selection was based on the age and gender distribution in each school. Verbal and written explanation was given to the parents/care givers who were invited to the schools to respond to interviewer administered questionnaires. Information was obtained on the feeding pattern of their children and maternal demographic characteristics. The children of those who responded, thereafter, had their heights measured and were assessed for clinically obvious morbidities. Information obtained on the age of respondents was verified from the schools’ registers. Data entry and analyses were done using Microsoft Office Excel 2007 and Statistical Package for Social Sciences (SPSS) version 16. Results: There were 406 males and 398 females with a male to female ratio of 1.02:1. Their staple diet was cassava and rice. An average of 2.5% of the children skipped one meal daily. Breakfast, which was the only meal that had a significant effect on stunted growth, (F=24.177, p value=0.002) was skipped by 2.2% of the children on the day of Original Research Article British Journal of Medicine & Medical Research, 4(27): 4542-4552, 2014 4543 interview. Only 1 of the children had a fruit within 24hours of the data collection. Fourteen percent of these children were stunted and the predominant morbidity observed was dermatophytosis. Most of the mothers (82%) were engaged in petty trading and menial jobs with 23.8% of them spending less than 500naira (3USD) on daily feeding. Maternal education and occupation were significantly associated with stunting in the children; p<0.05. Conclusion: Provision of at least 1 free school meal, preferably breakfast, is advocated for children in public primary schools. This will help to improve the daily nutritional content of the meals of these children who are obviously from poor homes.