Handgrip Strength and Phase Angle Predict Outcome After Bariatric Surgery.

BACKGROUND: The amount of postoperative weight loss after bariatric surgery varies interindividually. The quality of the pre- and postoperative body composition is an important predictor of success. The aim of this study was to investigate the role of preoperative handgrip strength and phase angle (PhA) as predictors of sustained postoperative weight loss in order to assess the influence of body composition on the postoperative outcome after bariatric surgery. METHOD: In a prospective cohort study, bioelectrical impedance and follow-up data of 198 patients after laparoscopic sleeve gastrectomy (SG; n = 68) and Roux-en-Y gastric bypass (GB; n = 130) were analyzed for a period of 36 months postoperatively. RESULTS: The mean preoperative handgrip strength (31.48 kg, SD 9.97) correlates significantly with the postoperative body composition up to 24 months after surgery. Preoperative PhA, gender, size, and body weight influenced postoperative weight loss significantly. A significant correlation between preoperative PhA (mean 6.18°, SD 0.89°) and total weight loss (%TWL) was observed up to 3 months after SG (r = 0.31444, p = 0.0218) and up to 12 months after GB (r = 0.19184, p = 0.0467). The optimum cutoff for the prediction of a response of less than 50% excess weight loss was a preoperative PhA of 6.0°. CONCLUSIONS: The preoperative handgrip strength confirmed its suitability for use as a predictor of postoperative body composition, whereas the preoperative PhA predicts postoperative weight loss after bariatric surgery. Further research is necessary to identify the role of these parameters for preconditioning.

Clinical, oncological, and functional outcomes of Da Vinci (Xi)-assisted versus conventional laparoscopic resection for rectal cancer: a prospective, controlled cohort study of 51 consecutive cases.

PURPOSE: Despite the increasing use of telemanipulators in colorectal surgery, an additional benefit in terms of improved perioperative results is not proven. The aim of the study was to compare clinical, oncological, and functional results of Da Vinci (Xi)-assisted versus conventional laparoscopic (low) anterior resection for rectal cancer. METHODS: Monocenter, prospective, controlled cohort study with a 12-month follow-up of bladder and sexual function using the validated questionnaires International Prostate Symptom Score, International Index of Erectile Function, and Female Sexual Function Index. RESULTS: Fifty-one patients were included (18, Da Vinci (Xi) assisted; 33, conventional laparoscopy). Conversion to an open approach was more common in the Da Vinci cohort (p = 0.012). In addition, surgery and resumption of a normal diet took longer in the robotic group (p = 0.005; p = 0.042). Surgical morbidity and oncological quality did not differ. There was no difference in most functional domains, except for worsened ability to orgasm (p = 0.047) and sexual satisfaction (p = 0.034) in women after conventional laparoscopy. Moreover, we found a higher rate of improved bladder function in the conventional laparoscopy group (p = 0.023) and less painful sexual intercourse among women in the robot-assisted group (p = 0.049). CONCLUSION: In contrast to the ROLARR trial, a higher conversion rate was found in the robotic cohort, which may in part be explained by a learning curve effect. Nevertheless, the Da Vinci-assisted approach showed favorable results regarding sexual function.

[PDCA cyclus and morbidity and mortality conference as a basic tool for reduction of wound infection in colorectal surgery]. / PDCA-Zyklus und Morbiditäts- und Mortalitätskonferenz als Basis der Wundinfektionsreduktion in der Kolorektalchirurgie.

BACKGROUND: Morbidity and mortality conferences (M + M) are used for the discussion of errors and thereby further education in surgery. However, it is not clear whether this kind of quality assurance has any influence on the results of surgery. MATERIAL AND METHODS: We investigated whether M + M as part of PDCA-cylce (plan, do, check, act) with prospectively collected quality data, fixing future goals using benchmarking data and defining a strategy to reach these goals can lead to an increase in quality. RESULTS: Using surveillance data n = 673 colorectal resections were analysed. Between 2003 and 2008 we found a wound infection rate of 5.6 %. Comparing 2003-2005 (period of strategy development using M + M) and 2006-2008 (period of strategy conversion) the frequency decreased from 7.8 % to 3.5 % (p = 0.012). Thereby the risk factors for wound infection (ASA, wound classification, duration of surgery and wound infection score) were not different. CONCLUSIONS: M + M as part of this PDCA cycle resulted in a clear increase in surgical quality.

[Synthesis of some thiourea derivatives and their influence on biological and genetic effects of gamma rays]. / Sintez nekotorykh proizvodnykh tiomocheviny i ikh vliianie na biologicheskoe i geneticheskoe vozdeistvie gamma-luchei.

The synthesis of the new radioprotective compounds ATB (I, 2-allylthioureidobenzoic acid), PTB (II, 2-phenylthioureidobenzoic acid), A-2-PTU (III, N-allyl-N'-2-pyridylthiourea), and P-2-PTU (IV, N-phenyl-N'-2-pyridylthiourea) and their influence on biological and genetic effects of gamma rays was studied. In result of investigations it must be noted that PTB displayed radioprotective effect as a result of which more plants in M1 germination and survive in M2 of the induced mutations is increased. The cytological analysis reveals that the studied substance (PTB) decreases chromosome aberration in meristem cells of pea roots almost twice as a result of postirradiation treatment. The effect of A-2-PTU in the experiments with peas greatly depends on the dose of irradiation, i.e., on the degree of damaging of the processes of cell restoration and the possibility of their partial restoration after the treatment with the protector. The results obtained suggest that chemical compounds of N,N'-disubstituted thiourea group (A-2-PTU and P-2-PTU) exert strong radioprotective effect in the experiments with peas. This is of great importance to modern radiobiology and radiation mutagenesis and also to protect hereditary structures against radiation.

Radioprotective effect of novel disubstituted thioureas on pea (Pisum sativum L.) development.

The review presents our research on the influence of novel thiourea compounds on the biological and genetic effect of gamma-rays using in vivo and in vitro systems of pea. Some novel disubstituted thioureas: o-allylthioureidobenzoic acid (ATB); o-phenylthioureidobenzoic acid (PTB); N-allyl-N'-2-pyridylthiourea (A-2-PTU); N-phenyl-N'-2-pyridylthiourea (P-2-PTU) and 1,4-allylthioureidosalicylic acid (ATUS) were examined. Pea (Pisum sativum L.) seeds from five varieties were used. Experiments in vivo and in vitro were carried under laboratory, greenhouse and field conditions. The data revealed the PTB radioprotective effect demonstrated by: reduction of chromosome aberrations by 2 folds; 50% increase of germinating and surviving plants in M1; twice higher frequency of induced mutations in M2 generation relative to irradiation without PTB treatment; decreasing the level of induced radiation suppression leading to favorable effect on the initial stem and root development of pea. ATB radioprotective effect was demonstrated in vitro by: 25-35% stimulation of organogenesis; by 20-50% increase in bud formation; by 25% stimulation of growth. The effect of A-2-PTU and P-2-PTU depended on the irradiation dose. The protective effect of A-2-PTU is more pronounced at lower irradiation dose, while the effect of P-2-PTU is more pronounced at higher irradiation dose. ATUS, opposite to the other compounds, revealed radiosensibilizing effect by: 16-27% increase in lethality caused by gamma-rays leading to lower number of germinating and surviving plants in M1; 50% decrease in the number of induced mutations in M2 generation; limiting the types of induced mutations at the higher irradiation dose. As a result of the experiments useful mutation forms were obtained, characterized with: earliness, lodging and disease resistance; higher productivity.

Survey of Trichinella spp. infection in pigs from commercial piggeries in Zimbabwe.

Trichinella spp. infection has never been reported among domestic pigs in Zimbabwe. Given that Trichinella spp. occurs in a sylvatic cycle in Zimbabwe and particularly in the light of the recent notification of the presence of the infection in farmed crocodiles, a survey was undertaken to evaluate the present epidemiological situation on commercial pig farms. Carcasses of 7,446 fattener pigs (average 11.7% [+/- 0.2%] of those slaughtered from each farm) were investigated by artificial digestion of pooled diaphragm muscle samples. These carcasses originated from 70 commercial piggeries and were selected by stratification on a farm basis from 63,602 pigs slaughtered during the survey period. No Trichinella spp. larvae were found in any of the 7,446 diaphragm muscle samples. The results demonstrated no evidence of Trichinella spp. infection within the pig population of the commercial piggeries in Zimbabwe.

Enhanced inhibition of plant virus replication by pyridylthiourea compounds complexed with metal ions.

Inhibition of potato virus X replication can be enhanced by complexation of N-allyl-N'-2-pyridyl-thiourea and of N-phenyl-N'-2-pyridyl-thiourea with Cu+, Zn2+ and Cd2+. The antiphytoviral activity of some complexes with pyridylthiourea can be further augmented by adding small quantities of 2,4-dioxohexahydro-1,3,5-triazine.

Ischaemic changes in human myocardial cells during cardioplegia: an ultrastructural morphometric study of patients with CIHD and aortic valve vitia.

Ultrastructural morphometric examinations of changes in myocardial cells of two groups of patients were carried out before and after cardioplegic ischaemia. The ACB group (aorto-coronary bypass) comprised patients suffering from chronic The ACB group (aorto-coronary bypass) comprised patients suffering from chronic ischaemic heart disease, whilst the AVR group (aortic valve replacement) consisted of patients suffering from combined aortic vitium. The morphometric stereological examinations of biopsy material revealed that the ultrastructural changes in heart muscle cells were different for the two groups. This fact suggests different adaptation mechanisms of the myocardial cells of the two groups. The changes observed involved i.a. mitochondria, which in the cardiomyocytes of the ACB group diminished in size and increased in quantity, whilst in the myocardial cells of the AVR group they increased in size and diminished in number. From this it can be inferred that in the ACB group biogenesis occurred, while in the AVR group a swelling or fusion of the mitochondria took place. The results obtained indicate that the hypertrophic myocardial cells of patients with chronic aortic valve disease have a worse state of preservation after cardioplegic ischaemia and after reperfusion than those of the patients suffering from chronic ischaemic heart disease, who seem to be better able to withstand cardioplegic ischaemia and hence also surgery.

Antirival activity of N-phenyl-N'-arylthiourea derivatives against some Rhinoviruses.

The effect of 12 derivatives of N-phenyl-N'-aryl- or alkylthiourea, inhibitors of human enteroviruses and foot-and-mouth disease virus, on reproduction of some rhinoviruses (H-17, B-632) in HeLa Bristol cells was studied. As screening methods both the multicylce growth test in roller tube cultures and two variants of plaque inhibition tests were employed. The compounds selected were tested in one-step growth cycle set-up. We established that N-phenyl-N'-4-hydroxyphenylthiourea (V-24) and N-phenyl-N'-2-carboxyphenylthiourea (V-17) have a distinct inhibitory effect on the growth of rhinovirus H-17, and N-phenyl-N'-2-hydroxy-5-nitrophenylthiourea (V-25) inhibited strongly the multiplication of rhinovirus B-632.