Solid lipid nanoparticles affect microbial colonization and enzymatic activity throughout the decomposition of alder leaves in freshwater microcosms.

Solid lipid nanoparticles (SLNs) are used as carriers for drug delivery, and are high biocompatible and designed to endure in the host organism. Despite its current industrial production is low, many of these substances are available on the market, and much more are in the production pipeline. As a result, many of them will end in aquatic systems raising the question whether they can pose a risk to aquatic biota and the associated ecological processes. Microbial decomposers of plant litter, play a key role in forested streams being responsible for the energy flow between terrestrial and aquatic environments. Here, we investigated the effects of SLNs on alder leaf litter decomposition by aquatic microbes. Alder leaves were immersed in a stream of Northeast Portugal to allow microbial colonization before being exposed in microcosms of two types of SLNs at two concentrations for 42 days. Results showed that rates of leaf decomposition decreased with exposure to SLNs. Bacterial biomass was not inhibited by SLNs, and cultivable fungi densities remained constant (SLN-A) or increased (SLN-C) compared with control microcosms. The type and concentration of SLNs influenced differently the leaf colonization by fungi as well as fungal sporulation rate. These effects were accompanied by changes in the community extraenzymatic profile: the activities of alkaline phosphatase, acidic phosphatase, Naphthol-AS-BI-phosphohydrolase (P cycle) and lipases increased in the SLNs microcosms. This study provided the first evidence of the adverse effects of the release of SLNs to streams on leaf litter decomposition. Those effects seem to depend on the composition and concentration of SLNs, as well on the microbial target group, or enzyme. Thus, prior to massive industrial production of these nanomaterials, some measures should be taken to avoid environmental impact affecting the microbial communities responsible for detritus decomposition.

Reparación de la eventración mediante prótesis intraperitoneal composite (parietene composite®) de componente absorbible, encirugía mayor ambulatoria y corta estancia en un hospital de alta resolución / No disponible

Objetivo: La cirugía mayor ambulatoria (CMA) requiere procedimientos seguros, de corta duración y con resultados similares a los de la hospitalización convencional. El objetivo de nuestro estudio es valorar la factibilidad y calidad de la reparación de eventraciones mediante la inserción de una prótesis intraperitoneal en CMA. Material y método: A lo largo de 31 meses 74 pacientes fueron atendidos con el diagnóstico de eventración en nuestra unidad. De estos, 54 fueron operados mediante técnica de reparación con prótesis intraperitoneal (RPI) de Parietene o Parietex Composite® (Sofradim Production). La RPI se ha realizado en eventraciones con defecto músculo-aponeurótico mayor de 5 cm. Se valora el estado de salud postoperatorio al 5º día mediante escala analógico-visual y EuroQol-5D.Resultados: El índice de sustitución fue del 51% y la duración media de la intervención de 38 minutos. Se registraron cuatro infecciones y un hematoma de herida, una perforación puntiforme de intestino delgado y tres ingresos no programados. Cinco pacientes fueron programados para cirugía en régimen de corta estancia.A los 5 días los pacientes se ocupaban de su aseo personal y dos de los pacientes manifestaron dolor espontáneo leve. El seguimiento de 39 pacientes (15,7 meses) ha detectado 3 recidivas. Conclusiones: La RPI es una técnica rápida y segura, realizable en régimen de CMA (AU)

Objective: Ambulatory surgery requires safe procedures of short duration with results comparable to those of hospitalization. The aim of our study is to assess the feasibility and quality of the repair of incisional hernia by insertion of an intraperitoneal prosthesis(IPP) on an ambulatory basis. Method and material: Over 31 months we have operated on 74 patients with a diagnosis of incisional hernia. In 54, the IPP technique was used by insertion of a Parietene or Parietex Composite mesh (Sofradim Production). The IPP technique was chosen when the hernia defect was greater than 5 cm. The postoperative status was evaluated through a visual analogue scale and the test EuroQol-5D.Results: The substitution index was 51 %. The mean operative time was 38 minutes. Complications were: four wound infections, one hematoma, one pinpoint bowel perforation. Three patients had to be unexpectedly admitted to hospital and another five were scheduled as short stay surgery. On the fifth postoperative day, patients were able to self-care and two patients complained of mild pain. The follow-up of 39 patients (15.7 months) has detected three recurrences. Conclusion: The IPP technique is a rapid and safe method, feasible as day surgery (AU)

Anestesia local y sedoanalgesia para la colecistectomía transcilíndrica / No disponible

Introducción: La colecistectomía transcilíndrica (CTC) bajo anestesia local y sedoanalgesia (AL + S) se plantea como una alternativa a la colecistectomía la paroscópica en CMA. El objetivo del estudio es estimar los resultados obtenidos con este método. Material y método: A lo largo de 20 meses en el Hospital Siberia-Serena (Talarrubias, Badajoz) pacientes ASA I-III fueron programados para CTC bajo AL + S. El procedimiento se inicia con la monitorización del paciente y una infusión de midazolam y remifentanilo para obtener una sedación de 2-3 en la escala de Ramsay y/o un valor de BIS de 70 a 85 antes de la aplicación de la anestesia local. Para la anestesia del campo quirúrgico se utilizan 300-500 mg de mepivacaína al 1% en el borde costal, región epigástrica derecha, bloqueando los nervios intercostales VII-IX. Resultados: Ochenta y ocho de los 124 casos realizados fueron completados bajo AL + S. En los 36 casos restantes hubo que recurrir a la anestesia general (29 por dificultades técnicas relacionadas con la alteración de la anatomía, 4 por corpulencia excesiva y 3 por intolerancia al procedimiento).Conclusiones: Según nuestra observación en este grupo de pacientes, la técnica de CTC es susceptible de realizarse en 2/3 de pacientes bajo AL + S con alto grado de aceptación por parte de los pacientes y con la única selección de cumplir con los criterios de CMA (AU)

Introduction: Trans-cylindrical cholecystectomy (TC) underlocal anaesthesia plus sedation (LA + S) is proposed as an alternative to laparoscopic cholecystectomy for ambulatory surgery. The study objective was to estimate the results obtained using this method. Material and method: Over a 20 month period 124 cases of TC were operated on at the Hospital Siberia-Serena (Talarrubias,Badajoz) in patients ASA I-III. In 88 patients the procedure was performed under LA + S and in the remaining patients, undergeneral anesthesia. The procedure begins with the monitoring of the patient and an infusion of remifentanil and midazolam for sedation of 2-3 on the Ramsay scale and/or a BIS value of 70-85 before the application of local anesthesia. For surgical anesthesia 300-500 mg of 1% mepivacaine were administered at the costalmargin in the right epigastric region, blocking the intercostal nerves VII-IX. Results: Out of the 124 cases attempted, 88 were completed under LA + S. In the remaining 36 cases, general anaesthesia had to be resorted to (29 due to technical difficulties related to an alteration of the anatomy, excessive girth in four, and in three because of intolerance to the procedure). Conclusions: According to our observation in this group of patients, the technique of TC is likely to be completed in two thirds of patients under LA + S, with excellent acceptance by patients (AU)

Resultados globales sobre cirugía mayor ambulatoria y de corta estancia en un hospital de alta resolución / No disponible

Objetivo: Analizar la labor realizada sobre CMA y cirugía de corta estancia en la especialidad de cirugía general y del aparato digestivo en un hospital de alta resolución. Material y método: A lo largo de 26 meses se han realizado1.063 intervenciones (826 de CMA y 237 de cirugía menor) en157 sesiones operatorias, acompañadas de 2.381 primeras visitas y 2.024 sucesivas. La colelitiasis es tratada por colecistectomía transcilíndrica (CTC) bajo anestesia local y sedación (AL + S). La reparación herniaria es selectiva dependiendo del tipo de hernia, pero siempre con prótesis de polipropileno y AL + S; las eventraciones son tratadas con malla intraperitoneal de Parietex composite®. La ligadura elástica o hemorroidectomía, la esfinterotomía lateral interna (ELI) y la fistulotomía, responden de la patologíaperianal también bajo AL + S. La safenectomía del muslo para las varices y diversas resecciones de tejido mamario completan nuestro catálogo de procedimientos. Resultados: De 118 CTC, 104 se iniciaron bajo AL + S y 28 requirieron conversión a anestesia general; no hubo complicaciones destacables. De 298 reparaciones herniarias la técnica de Rives fue la más practicada (191 reparaciones). En 41 pacientes se realizó la inserción de una malla intraperitoneal para la reparación de la eventración. Se practicó hemorroidectomía en 31 pacientes76 y ligadura elástica en otros 19; ELI en 20 y fistulotomía en 23. A ocho pacientes se les practicó tumorectomía mamaria o mastectomía,a 17 safenectomía. Se practicaron además dos lobectomías tiroideas. Conclusión: La satisfacción de los pacientes ha sido elevada lo que atribuimos al hecho de realizar los procesos con el menor número posible de desplazamientos. La reducción de la lista de espera quirúrgica en nuestra área de salud ha sido notable (AU)

Objective: The goal of this presentation is to analyze ambulatory surgery and short stay surgery in the department of general and digestive tract surgery in a “high resolution” hospital. Material and method: Over 26 months we performed 1,063 operations (826 as ambulatory surgery and 237 as minorsurgery) in 157 operating theatre sessions, produced by 2,381 first visits and 2,024 postoperative visits. Cholelithiasis was treatedby transcylindrical cholecystectomy (CTC) under local anaesthesia and sedation (AL + S). Inguinal hernia repair was selective, depending on the type of hernia, but always with aprosthetic mesh of polypropylene (Prolene® 15 x 15 cm) (AL +S); incisional ventral hernias were treated with an intraperitonealmesh of Parietex composite®. Elastic band ligation or haemorrhoidectomy, lateral internal sphincterotomy (ELI) and fistulotomy were performed for anal pathology (AL + S). Safenectomy of the thigh in varicose veins and various mammary resections completed the procedures. Results: Of the 118 CTC, 104 began as AL + S and in 28they needed conversion to general anesthesia, without important complications. Of 298 hernia repairs, Rives's technique was the most employed (191 repairs). In 41 patients we carried out the insertion of an intraperitoneal mesh for the repair of an incisionalhernia. Haemorrhoidectomy was performed in 31 patients, elasticb and in 19; ELI in 20 and fistulotomy in 23. Eight patients underwent tumorectomy or mastectomy; 17, safenectomy and 2, thyroid lobectomies. Conclusion: Patient satisfaction was high and we believe thatit is the result of performing the whole procedure with a minimum number of displacements and minimum discomfort to the patient. The reduction of the waiting-list has been notable (AU)

Transcylindrical cholecystectomy under local anesthesia plus sedation. A pilot study.

BACKGROUND AND STUDY AIM: The practice of laparoscopic cholecystectomy under local anesthesia is almost anecdotal. For 15 years we have been using a "transcylindrical cholecystectomy" technique for the treatment of cholelithiasis, cholecystitis, and choledocholithiasis. The present study was undertaken to assess the feasibility of transcylindrical cholecystectomy under local anesthesia through a prospective and longitudinal efficacy study. PATIENTS AND METHODS: Transcylindrical cholecystectomy is performed gas-free through a single cylinder 3.8 cm in diameter and 10.0 cm in length. In 60 patients suffering from cholelithiasis (mean age 52.6 years, range 31-83 years; men/women 13/47; body mass index 29.6 kg/m(2), range 24-44 kg/m(2)), transcylindrical cholecystectomy was planned and started under local anesthesia. Patients were reviewed 5 days after surgery; pain was assessed using a visual analog scale (VAS) and procedure satisfaction was assessed following completion of a patient questionnaire. RESULTS: Surgery was satisfactorily completed through the cylinder in all patients. In 13 patients (21.7 %) local anesthesia was converted to general anesthesia due to technical difficulties in 11 patients (two related to patient body volume), respiratory depression in one patient, and poor patient tolerance in one patient. Postoperative complications were: wound infection (n = 1, 1.7 %), wound seromas (n = 2, 3.3 %), and nausea (n = 3, 5 %). After surgery, only three patients experienced pain at rest with VAS values of 0.5, 1.5, and 2.9, respectively. All but two patients were discharged from hospital on the day of surgery, and all patients were satisfied with the procedure. CONCLUSIONS: Transcylindrical cholecystectomy under local anesthesia is a feasible technique that builds on the benefits of laparoscopic cholecystectomy, and confers an economic advantage and improved safety for patients.

Parity violation constraints using cosmic microwave background polarization spectra from 2006 and 2007 observations by the QUaD polarimeter.

We constrain parity-violating interactions to the surface of last scattering using spectra from the QUaD experiment's second and third seasons of observations by searching for a possible systematic rotation of the polarization directions of cosmic microwave background photons. We measure the rotation angle due to such a possible "cosmological birefringence" to be 0.55 degrees +/-0.82 degrees (random) +/-0.5 degrees (systematic) using QUaD's 100 and 150 GHz temperature-curl and gradient-curl spectra over the spectra over the multipole range 200