ABSTRACT
Intestinal stomas significantly impact patients' quality of life. Stoma-related complications are common, but even without complications, patients are faced with new challenges in stoma management and daily activities. Preoperative patient education and stoma site marking, in conjunction with conscientious surgical stewardship, are key to patient satisfaction and successful operative outcomes.
ABSTRACT
OBJECTIVE: To describe the components of targeted nanotherapeutics and to review their applications in the treatment of surgical diseases. BACKGROUND: Targeted nanotherapeutic is a novel strategy for treating a variety of diseases and is an emerging technology that offers advantages over current treatment strategies. The nanoscale size, combined with the ability to surface functionalize the delivery vehicle to enable targeting and incorporate a therapeutic payload, provides a new and innovative therapeutic platform to treat surgical diseases that has yet to be fully realized in the surgical arena. METHODS: A comprehensive literature review of nanotherapeutics, targeting strategies, and their utility in treating surgical diseases is performed. RESULTS: Targeted nanotherapeutics have demonstrated safety and biocompatibility in treating surgical diseases. The ability to surface functionalize the nanoparticles affords a unique tailorability that enables targeting specificity and therapeutic payload delivery to treat a variety of surgical diseases. Moreover, the small size and targeting capabilities allow access to biological compartments, such as the blood-brain barrier, that have previously been difficult to treat. CONCLUSIONS: Targeted nanotherapeutics represent a novel therapeutic platform and have great potential to impact the treatment of surgical diseases.
Subject(s)
Drug Delivery Systems/trends , Nanotechnology/trends , Surgical Procedures, Operative , Animals , HumansABSTRACT
PURPOSE: The precise definition of the rectum is essential for localizing colorectal pathology, yet current definitions are nebulous. The objective of this study is to determine the anthropometric definition of common pelvic landmarks in relation to patient characteristics. METHODS: Seventy-one patients underwent open proctectomy with intra-operative measurements from the anal verge to various pelvic landmarks, and patient characteristics were evaluated. Analyses were performed using Spearman correlation and Wilcoxon rank sum. RESULTS: The mean landmark distance was dentate line = 1.7 cm (range 0.8-4.0 cm), puborectalis muscle = 4.2 cm (range 2.0-8.0 cm), anterior peritoneal reflection = 13.2 cm (range 8.5-21.0 cm), sacral promontory = 17.9 cm (range 13.0-26.0 cm), and confluence of the taenia = 25.5 cm (range 16.0-44.0 cm). Men had longer mean distances to the dentate line (p = 0.0003), puborectalis muscle (p = 0.03), and anterior peritoneal reflection (p = 0.02). Patient weight significantly correlated with distance to all landmarks except for the confluence of the taenia, which did not correlate with any patient factor. CONCLUSIONS: The location of common pelvic landmarks is highly variable. The use of predefined absolute measurements from the anal verge to localize rectal pathology is inaccurate and fails to account for patient variability.
Subject(s)
Anthropometry , Rectum/anatomy & histology , Body Height , Body Mass Index , Body Weight , Colonic Diseases/surgery , Female , Humans , Male , Middle Aged , Pelvis/anatomy & histology , Rectal Diseases/surgery , Rectum/surgery , Retrospective Studies , Sex FactorsSubject(s)
Receptors, LDL/genetics , Skin Diseases/genetics , Skin , Xanthomatosis/genetics , Animals , Animals, Genetically Modified , Biopsy , Disease Models, Animal , Female , Foam Cells/metabolism , Foam Cells/pathology , Genetic Predisposition to Disease , Male , Phenotype , Receptors, LDL/deficiency , Skin/metabolism , Skin/pathology , Skin Diseases/metabolism , Skin Diseases/pathology , Swine , Swine, Miniature , Xanthomatosis/metabolism , Xanthomatosis/pathologyABSTRACT
Gonadal hormones have been shown to modulate memory retention in female rats. The current experiments examine the role of testicular hormones in modulating the performance of male rats on two spatial water maze tasks. In the first study, castrated and intact rats were trained on the visible platform and hidden platform versions of the Morris water maze task. Castration did not affect performance on either version of this reference memory task with castrated and intact rats demonstrating similar performance both during acquisition and on post-training probe trials. In the second experiment, castrated and intact rats were tested on a delayed-matching-to-place version of the water maze. Rats received a series of trial pairs in the maze with a hidden platform located in the same pool location on the exposure and retention trials of each pair; between pairs of trials, however, the platform was repositioned to a novel pool location. The interval between trials was either 10- or 60-min and memory retention, taken as the difference between the pathlengths on the exposure and retention trials, declined as the interval increased. Relative to intact males, castrated males demonstrated impaired working memory retention at 60-min but not at 10-min retention intervals. This interval-dependent impairment in working memory retention was reversed by physiologic levels of testosterone replacement. These findings indicate that castration does not significantly affect acquisition or probe trial performance on a classic reference memory task but does impair spatial working memory retention, an effect that is reversed by exogenous testosterone.
