Medicina
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Dysbiosis of the gastrointestinal tract is the most common cause of disease in childhood and adulthood. The formation of the intestinal microbiome begins in utero, and composition modification during life depends mainly on various genetic, nutritional, and environmental factors. The main cause of intestinal dysbiosis is improper nutrition due to a short period of breastfeeding, insufficient intake of fresh fruits and vegetables, and/or consumption of a large amount of processed food. ⋯ Factors associated with high fiber in a plant-based diet promote increased insulin sensitivity. Insulin and insulin-like growth factor 1 (IGF-I) act as promoters of most normal and pre-neoplastic tissues. Conclusion: A plant-based diet high in fiber prevents disease by creating metabolites in the gut that reduce oxidative stress.
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Background and Objectives: Recent findings suggest that combining mechanical bowel preparation (MBP) and preoperative oral antibiotics (OAs) decreases the risk of incisional surgical site infections (iSSIs) in colorectal surgery; however, this finding remains controversial. This study examined the efficacy of OAs and MBP in colorectal surgery using propensity score matching (PSM). Materials and Methods: Between January 2015 and December 2020, 559 patients with colorectal tumors underwent MBP followed by colorectal surgery. ⋯ The incisional SSI rate was significantly lower in the OA group (n = 338) than in the non-OA group (1.61% vs. 5.07%; OR 3.4; 95% CI; 0.123-0.707; p = 0.0062). Conclusions: This study revealed that OAs with MBP markedly reduced SSI rates. OAs with MBP should be adopted in colorectal surgery.
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Background and objectives: Laparoscopic cholecystectomy (LC) is the most commonly performed operation in general surgery in the Western World. Gallbladder surgery, although most of the time simple, always offers the possibility of unpleasant surprises. Despite progress, the incidence of common bile duct injury is 0.2-0.4%, causing devastating implications for the patient and the surgeon. ⋯ Anatomical schemata were formulated corresponding to the norm and four variations. Conclusions: The proposed cognitive anatomical schemata summarize simply what one can expect in terms of deviation from the norm. We believe that the synergy between the correct application of the CVS and the structured knowledge of the surgical anatomy in cholecystectomy helps the surgeon to handle non-typical structures safely and to complete the laparoscopic or open cholecystectomy without vascular-biliary injuries.
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Background and Objectives: The incidence of hip fractures is increasing, and there have been reports linking cold weather to a higher risk of fractures. This study aimed to evaluate clinical variables in hip fracture patients who may predispose them to such fractures under different temperatures. Materials and Methods: This is a cross-sectional study conducted at a single medical center, enrolling older adults (≥60 years) who had experienced a hip fracture. ⋯ This finding suggests that for older adults with a higher Charlson Comorbidity Index, hip fractures tend to occur at lower temperatures and vice versa. Conclusions: Comorbidities are the only clinical concern that predisposes older adults to hip fractures under colder temperatures. This epidemiological finding could guide future patient education and hip fracture prevention programs.
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Background and Objectives: Biofilm formation on cochlear implants (CIs) poses a major problem for surgeons, leading to a high incidence of explantation and revision surgery. Therefore, developing appropriate and cost-effective biofilm detection and prevention techniques is of the essence. In this systematic review, we sought to investigate the development of biofilm formation on CIs. ⋯ Conclusions: Biofilm formation in CIs is considered one of the most dreadful complications. There have been no specific guidelines for the treatment of those cases, with removal and/or replacement of the CI being the treatment of choice. Various experimental prevention methods provide promising antibiofilm activity both in vivo and in vitro.