The idea of reproducing himself with the use of a mechanical robot structure has been in man's imagination in the last 3000 years. However, the use of robots in medicine has only 30 years of history. The application of robots in surgery originates from the need of modern man to achieve two goals: the telepresence and the performance of repetitive and accurate tasks. The first "robot surgeon" used on a human patient was the PUMA 200 in 1985. In the 1990s, scientists developed the concept of "master-slave" robot, which consisted of a robot with remote manipulators controlled by a surgeon at a surgical workstation. Despite the lack of force and tactile feedback, technical advantages of robotic surgery, such as 3D vision, stable and magnified image, EndoWrist instruments, physiologic tremor filtering, and motion scaling, have been considered fundamental to overcome many of the limitations of the laparoscopic surgery. Since the approval of the da Vinci(®) robot by international agencies, American, European, and Asian surgeons have proved its factibility and safety for the performance of many different robot-assisted surgeries. Comparative studies of robotic and laparoscopic surgical procedures in general surgery have shown similar results with regard to perioperative, oncological, and functional outcomes. However, higher costs and lack of haptic feedback represent the major limitations of current robotic technology to become the standard technique of minimally invasive surgery worldwide. Therefore, the future of robotic surgery involves cost reduction, development of new platforms and technologies, creation and validation of curriculum and virtual simulators, and conduction of randomized clinical trials to determine the best applications of robotics.
This study shows that both nonablative fractional laser 1,340 nm and microneedling are comparable and effective in the treatment of atrophic acne scars. Microneedling is well tolerated, with fewer side effects and lower down time.
Anatomical features of the oral fissure and pharynx of rabbits make orotracheal intubation a difficult task with a high failure rate. We have developed a versatile technique for retrograde intubation of rabbits which consists of the following steps: (1) assessment of the trachea through a cervicotomy (2) insertion of a guidewire into its lumen, (3) delivery of the guide through the mouth, and (4) introduction of the orotracheal tube over the guide. This procedure was performed in 58 rabbits under pentobarbital anesthesia and resulted in successful orotracheal intubation in 56 animals. Awakening from anesthesia and extubation were uneventful. No complications related to this technique were observed during a follow-up period of 5–14 days. The described technique is a simple and safe method to access the airways of rabbits and can be useful in chronic experiments.
Background: Malnutrition is very prevalent in patients with gastric cancer and increases
the risk of morbidity and mortality. Adductor pollicis muscle thickness
(APMT) appears as an important objective, quick, inexpensive and noninvasive
measure to assess the muscle compartmentAim: To compare APMT and other nutritional assessment methods and to correlate
these methods with postoperative mortalityMethods: Forty-four patients, 29 men and 15 women, mean age of 63±10.2 and ranging
from 34-83 years, who underwent nine (20.5%) partial and 34 (77.3%) total
gastrectomies due to stomach cancer (stage II to IIIa) were preoperatively
assessed by Patient Generated Subjective Global Assessment (PG-SGA),
anthropometry and laboratorial profileResults: APMT better predicted death (p<0.001) on both, dominant and non-dominant
hand, and well correlated with albumin (p=0.039) and PG-SGA (p=0.007)Conclusion: APMT clearly allowed to determine malnutrition and to predict risk of death
in patients with gastric cancer.
Background: Programmed cell death (apoptosis) has been implicated in tumor development and may affect the metastatic potential of tumor cells. The role of bcl-2, a proto-oncogene that inhibits apoptosis, has been studied in several malignancies, including cutaneous melanoma (CM). The purpose of this study was to evaluate the immunohistochemical expression of bcl-2 in 35 regional lymph node, 28 subcutaneous and 17 visceral CM metastases, correlating the findings with patient survival.
Thirty-nine patients were studied, 85,6% female, average age 60,1 years (+/- 12,89). The average index of the fecal incontinence was of 9,30 (+/- 4,93). In the anorectal manometry 23 patients showed low pressure. The pressures were significantly higher among males. The nerve terminal motor latency and pudental nerve (neuropathy) time was greater in 14 patients (35,9%). The age and the time of pudental nerve terminal motor were significantly co related. The other co relations were not statistically significant.
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