ABSTRACT
(1) Background: Incisional hernia (IH) is one of the most common complications following open abdominal surgery. There is scarce evidence on its real incidence following pancreatic surgery. The purpose of this study is to evaluate the incidence and the risk factors associated with IH development in patients undergoing pancreaticoduodenectomy (PD). (2) Methods: We retrospectively reviewed all patients undergoing PD between 2014 and 2020 at our centre. Data were extracted from a prospectively held database, including perioperative and long-term factors. We performed univariate and multivariate analysis to detect those factors potentially associated with IH development. (3) Results: The incidence of IH was 8.8% (19/213 patients). Median age was 67 (33-85) years. BMI was 24.9 (14-41) and 184 patients (86.4%) underwent PD for malignant disease. Median follow-up was 23 (6-111) months. Median time to IH development was 31 (13-89) months. Six (31.5%) patients required surgical repair. Following univariate and multivariate analysis, preoperative hypoalbuminemia (OR 3.4, 95% CI 1.24-9.16, p = 0.01) and BMI ≥ 30 kg/m2 (OR 2.6, 95% CI 1.06-8.14, p = 0.049) were the only factors independently associated with the development of IH. (4) Conclusions: The incidence of IH following PD was 8.8% in a tertiary care center. Preoperative hypoalbuminemia and obesity are independently associated with IH occurrence following PD.
Subject(s)
Hypoalbuminemia , Incisional Hernia , Humans , Aged , Pancreaticoduodenectomy/adverse effects , Tertiary Care Centers , Incisional Hernia/epidemiology , Incisional Hernia/etiology , Incidence , Retrospective Studies , Risk FactorsABSTRACT
The host response to biomaterials is a critical determinant of their success or failure in tissue-repair applications. Macrophages are among the first responders in the host response to biomaterials and have been shown to be predictors of downstream tissue remodeling events. Biomaterials composed of mammalian extracellular matrix (ECM) in particular have been shown to promote distinctive and constructive remodeling outcomes when compared to their synthetic counterparts, a property that has been largely attributed to their ability to modulate the host macrophage response. ECM bioscaffolds are prepared by decellularizing source tissues such as dermis and small intestinal submucosa. The differential ability of such scaffolds to influence macrophage behavior has not been determined. The present study determines the effects of ECM bioscaffolds derived from eight different source tissues upon macrophage surface marker expression, protein content, phagocytic capability, metabolism, and antimicrobial activity. The results show that macrophages exposed to small intestinal submucosa (SIS), urinary bladder matrix (UBM), brain ECM (bECM), esophageal ECM (eECM), and colonic ECM (coECM) express a predominant M2-like macrophage phenotype, which is pro-remodeling and anti-inflammatory (iNOS-/Fizz1+/CD206+). In contrast, macrophage exposure to dermal ECM resulted in a predominant M1-like, pro-inflammatory phenotype (iNOS+/Fizz1-/CD206-), whereas liver ECM (LECM) and skeletal muscle ECM (mECM) did not significantly change the expression of these markers. All solubilized ECM bioscaffold treatments resulted in an increased macrophage antimicrobial activity, but no differences were evident in macrophage phagocytic capabilities, and macrophage metabolism was decreased following exposure to UBM, bECM, mECM, coECM, and dECM. The present work could have important implications when considering the macrophage response following ECM implantation for site-appropriate tissue remodeling. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 138-147, 2017.
Subject(s)
Extracellular Matrix/chemistry , Macrophages/cytology , Macrophages/metabolism , Tissue Scaffolds/chemistry , Animals , Female , Mice , Organ SpecificityABSTRACT
Algunas veces las tareas de los ingenieros clínicos se han visto limitadas por la falta de información y conocimiento sobre la tecnología biomédica y su correspondiente proceso de gestión. Una solución para esto, se encuentra en el desarrollo de programas educativos a distancia a través de la Internet que ofrezan máxima accesibilidad a los usuarios. Esta metodología conocida como e-learning (aprendizaje virtual) es cada día más común y tienen gran acogida a nivel mundial. En el presente artículo se describe el proceso seguido por parte de las universidades CES, Vermont, Pontificia Católica del Perú y Escuela de Ingeniería de Antioquia, apoyados por la OMS-OPS, para el desarrollo del diplomado virtual: Gestión y Soporte de Equipo Médicos, así como su implementación, desarrollo, resultados y conclusiones.
Sometimes the tasks of clinical engineers have been limited by lacks of information and knowledge regarding biomedical technology and its corresponding management process. The development of distance education programs using the Internet to provide maximum accessibility to users could be a solution to this concern. This methodology known as e-learning has becoming increasingly common and well received worldwide. The present article describes the process followed by some universities: Vermont, CES, Escuela de Ingeniería de Antioquia and Pontificia Universidad Católica del Perú, supported by PAHEF, for the online course development, design, implementation and its results and conclusions.
Subject(s)
Biomedical Engineering , Education, Distance , Information Technology , Access to Information , MentoringABSTRACT
Los términos virtual y virtualidad se han convertido en elementos centrales de esta era denominada "La Sociedad de la Información". que no es más que la expresión de realidades y capacidades de los nuevos medios de comunicación permeados por los desarrollos tecnológicos logrados en la última década. La televisión, el almacenamiento de información, el video, sonido y textos, han podido agruparse en soportes de almacenamiento como CD o a través de señales que solo transmiten datos digitales
