Portable Automated Oxygen Administration System for hypoxaemic patients.

Oxygen is a lifesaving medication that should be offered with an administration to a patient who suffers from oxygen deficiency to avoid toxic effects of excessive oxygen supplement as well as to minimize the exposure to hypoxaemia. This work aims to automate the process of administering oxygen delivery in order to extend the continuous oxygen administration process beyond the IC units, reduce the cost of oxygen administration in terms of well-trained health care providers and equipment, prolong the lifetime of oxygen supplement, and help in the process of weaning patient from oxygen. In this work, a prototype model for a Portable Automated Oxygen Delivery System that consists of two subsystems: an Oxygen Reader Subsystem and an Automated Adjustment Oxygen Delivery Subsystem, both communicating wirelessly, has been developed. The system promises significant benefits in improving the life quality of hypoxaemic patients as well as healthcare service for oxygen delivery administration.

Pomegranate and type 2 diabetes.

Over the last decade, various studies have linked pomegranate (Punica granatum Linn), a fruit native to the Middle East, with type 2 diabetes prevention and treatment. This review focuses on current laboratory and clinical research related to the effects of pomegranate fractions (peels, flowers, and seeds) and some of their active components on biochemical and metabolic variables associated with the pathologic markers of type 2 diabetes. This review systematically presents findings from cell culture and animal studies as well as clinical human research. One key mechanism by which pomegranate fractions affect the type 2 diabetic condition is by reducing oxidative stress and lipid peroxidation. This reduction may occur by directly neutralizing the generated reactive oxygen species, increasing certain antioxidant enzyme activities, inducing metal chelation activity, reducing resistin formation, and inhibiting or activating certain transcriptional factors, such as nuclear factor κB and peroxisome proliferator-activated receptor γ. Fasting blood glucose levels were decreased significantly by punicic acid, methanolic seed extract, and pomegranate peel extract. Known compounds in pomegranate, such as punicalagin and ellagic, gallic, oleanolic, ursolic, and uallic acids, have been identified as having anti-diabetic actions. Furthermore, the juice sugar fraction was found to have unique antioxidant polyphenols (tannins and anthocyanins), which could be beneficial to control conditions in type 2 diabetes. These findings provide evidence for the anti-diabetic activity of pomegranate fruit; however, before pomegranate or any of its extracts can be medically recommended for the management of type 2 diabetes, controlled, clinical studies, are needed.

A rare case of merkel cell carcinoma metastasis to the adrenal resected robotically.

INTRODUCTION: Merkel cell carcinoma (MCC) is an uncommon skin malignancy that has a high propensity for metastatic spread and there is no consensus regarding the optimal therapeutic approach. The relative roles of surgery, radiotherapy, and chemotherapy are still controversial. As the robotic approaches are gaining more popularity over the recent years, herein we report our result for MCC using robotics. METHODS: We herein describe a patient with MCC metastases to the left adrenal gland, which was resected robotically. The procedure was performed under general anesthesia using the robotic camera and 2 robotic working ports. RESULTS: A 59-year-old woman, who was diagnosed to have MCC of the left forearm 1 year ago with stage T2 N1 and removed by wide excision, underwent left robotic lateral transabdominal adrenalectomy because of MCC metastasis to the left adrenal gland. She was discharged home on postoperative day 2 uneventfully and is currently alive at 18 months with no evidence of recurrent disease on imaging studies. CONCLUSIONS: This case report demonstrates that minimally invasive adrenalectomy may be performed for isolated MCC metastasis.

Retroperitoneal masses mimicking adrenal tumors.

OBJECTIVE: To report 10 cases of neoplasms that were initially thought to be primarily adrenal-derived masses but were later confirmed as tumors of a different origin. METHODS: Between 2000 and 2011, a total of 229 patients underwent adrenalectomy at our institution. Of this overall group, 10 patients had retroperitoneal pathologic conditions mimicking adrenal tumors. Using an institutional review board-approved database, we reviewed the clinical, biochemical, and radiologic characteristics of these 10 patients. RESULTS: The study cohort consisted of 4 male and 6 female patients. The mean age of these 10 patients was 48 years. The pathologic conditions included schwannoma (n = 3), leiomyosarcoma (n = 2), and 1 each of metastatic angiosarcoma, metastatic granulosa cell tumor, retroperitoneal hematoma, perivascular epithelioid cell tumor, and bronchogenic cyst. The patient with angiosarcoma had elevated plasma and urine catecholamines and a positive metaiodobenzylguanidine scan, whereas the others had normal findings on biochemical work-up. A percutaneous biopsy was performed preoperatively in 2 patients. All patients, except the patient with hematoma, underwent abdominal exploration, which was laparoscopic in 5, open in 2, and robotic in 2. With exclusion of the patients with angiosarcoma and hematoma, resection was possible in all the remaining patients. CONCLUSION: In this report we describe our experience with retroperitoneal masses mimicking adrenal tumors. Increased awareness of these unusual pathologic conditions is important for appropriate clinical management of these tumors. The presentation of the patients and the surgical management of these individual pathologic entities are highlighted.