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Cirocchi R, Matteucci M, Randolph J, Duro F, Properzi L, Avenia S, Amato B, Iandoli R, Tebala G, Boselli C, Covarelli P, Sapienza P. Anatomical variants of the intercostobrachial nerve and its preservation during surgery, a systematic review and meta-analysis. World J Surg Oncol 2024; 22:92. [PMID: 38605346 PMCID: PMC11007944 DOI: 10.1186/s12957-024-03374-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 03/28/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND The anatomic variants of the intercostobrachial nerve (ICBN) represent a potential risk of injuries during surgical procedure such as axillary lymph node dissection and sentinel lymph node biopsy in breast cancer and melanoma patients. The aim of this systematic review and meta-analysis was to investigate the different origins and branching patterns of the intercostobrachial nerve also providing an analysis of the prevalence, through the analysis of the literature available up to September 2023. MATERIALS AND METHODS The protocol for this study was registered on PROSPERO (ID: CRD42023447932), an international prospective database for reviews. The PRISMA guideline was respected throughout the meta-analysis. A systematic literature search was performed using PubMed, Scopus and Web of Science. A search was performed in grey literature through google. RESULTS We included a total of 23 articles (1,883 patients). The prevalence of the ICBN in the axillae was 98.94%. No significant differences in prevalence were observed during the analysis of geographic subgroups or by study type (cadaveric dissections and in intraoperative dissections). Only five studies of the 23 studies reported prevalence of less than 100%. Overall, the PPE was 99.2% with 95% Cis of 98.5% and 99.7%. As expected from the near constant variance estimates, the heterogeneity was low, I2 = 44.3% (95% CI 8.9%-65.9%), Q = 39.48, p = .012. When disaggregated by evaluation type, the difference in PPEs between evaluation types was negligible. For cadaveric dissection, the PPE was 99.7% (95% CI 99.1%-100.0%) compared to 99.0% (95% CI 98.1%-99.7%). CONCLUSIONS The prevalence of ICBN variants was very high. The dissection of the ICBN during axillary lymph-node harvesting, increases the risk of sensory disturbance. The preservation of the ICBN does not modify the oncological radicality in axillary dissection for patients with cutaneous metastatic melanoma or breast cancer. Therefore, we recommend to operate on these patients in high volume center to reduce post-procedural pain and paresthesia associated with a lack of ICBN variants recognition.
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Affiliation(s)
- Roberto Cirocchi
- Department of Medicine and Surgery, University of Perugia, Perugia, 06132, Italy.
| | - Matteo Matteucci
- Department of Medicine and Surgery, University of Milan, Milan, 20122, Italy
| | - Justus Randolph
- Georgia Baptist College of Nursing, Mercer University, Atlanta, GA, 30341, USA
| | - Francesca Duro
- Department of Medicine and Surgery, University of Perugia, Perugia, 06132, Italy
| | - Luca Properzi
- Department of Medicine and Surgery, University of Perugia, Perugia, 06132, Italy
| | - Stefano Avenia
- Department of Medicine and Surgery, University of Perugia, Perugia, 06132, Italy
| | - Bruno Amato
- Department of Public Health, University of Naples "Federico II", Naples, 80131, Italy
| | - Ruggiero Iandoli
- Department of General Surgery, P.O Frangipane Ariano Irpino, Avellino, 83031, Italy
| | - Giovanni Tebala
- Department of Digestive and Emergency Surgery, AOSP of Terni, Terni, 05100, Italy
| | - Carlo Boselli
- Department of Medicine and Surgery, University of Perugia, Perugia, 06132, Italy
| | - Piero Covarelli
- Department of Medicine and Surgery, University of Perugia, Perugia, 06132, Italy
| | - Paolo Sapienza
- Department of Surgery, "Sapienza" University of Rome, Roma, 00161, Italy
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Anania G, Campagnaro A, Chiozza M, Randolph J, Resta G, Marino S, Pedon S, Agrusa A, Cuccurullo D, Cirocchi R. A SICE (Società Italiana di Chirurgia Endoscopica e Nuove Tecnologie) observational prospective multicenter study on anatomical variants of the superior mesenteric artery: intraoperative analysis during laparoscopic right hemicolectomy-CoDIG 2 database (ColonDx Italian Group). Updates Surg 2024:10.1007/s13304-024-01787-6. [PMID: 38526696 DOI: 10.1007/s13304-024-01787-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 02/12/2024] [Indexed: 03/27/2024]
Abstract
Colorectal cancer, the third most common cancer worldwide, affects 40-45% of patients on the right side. Surgery, especially minimally invasive methods such as laparoscopic and robotic procedures, is the preferred treatment. However, these techniques present technical complications. The anatomical complexity and variations in vessel branching patterns pose challenges, particularly for less experienced surgeons. The CoDIG 2 is a nationwide observational study involving 76 specialized Italian general surgery departments focused on colorectal surgery. The centres were directed to maintain their standard surgical and clinical practices. The aim of this study was to analyse the intraoperative vascular anatomy of Italian patients who underwent laparoscopic right colectomy and explore the ligature techniques used by Italian surgeons. Surgeons reported information about vascularization of the right colon for 616 patients and about surgical anatomy of RCA for 368 patients. Fifty-three patients (10.8%) showed no RCA intraoperatively. The right colic artery (RCA) was categorized according to the Yada classification (types 1-4) during evaluation, and intraoperative assessments revealed that Yada type 1 was the most common type (55.2%), while radiologic evaluations revealed a higher prevalence of type 2. Furthermore, compared with the superior mesenteric vein (SMV), the RCA is more often located anteriorly according to intraoperative and contrast-enhanced CT examination; 59.9% were found in the anterior position during intraoperative examination, while 40.1% were found in the same position on preoperative contrast-enhanced CT. Vascularization of the right colon, including missing branches, additional branches, shared trunks, and retro-superior courses of the mesenteric vein, exhibited notable variations. To understand vascular variations, a preoperative radiological study is necessary; although there was no concordance between the intraoperative and radiological evaluations, this is a limitation of preinterventional radiological evaluation (PII) because it is always needed for oncological staging. This approach is especially critical for inexperienced surgeons to avoid potential complications, such as problematic bleeding.
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Affiliation(s)
- G Anania
- Unit of General Surgery, S. Anna University Hospital of Ferrara, Via Aldo Moro 8, Cona, FE, Italy
- Department of Medical Science, University of Ferrara, Via Fossato di Mortara 64/B, 44121, Ferrara, FE, Italy
| | - A Campagnaro
- Unit of General Surgery, S. Anna University Hospital of Ferrara, Via Aldo Moro 8, Cona, FE, Italy.
- Department of Medical Science, University of Ferrara, Via Fossato di Mortara 64/B, 44121, Ferrara, FE, Italy.
| | - M Chiozza
- Unit of General Surgery, S. Anna University Hospital of Ferrara, Via Aldo Moro 8, Cona, FE, Italy
- Department of Medical Science, University of Ferrara, Via Fossato di Mortara 64/B, 44121, Ferrara, FE, Italy
| | - J Randolph
- Georgia Baptist College of Nursing, Mercer University, Atlanta, GA, 30341, USA
| | - G Resta
- Unit of General Surgery, S. Anna University Hospital of Ferrara, Via Aldo Moro 8, Cona, FE, Italy
| | - S Marino
- Unit of General Surgery, S. Anna University Hospital of Ferrara, Via Aldo Moro 8, Cona, FE, Italy
| | - S Pedon
- Unit of General Surgery, S. Anna University Hospital of Ferrara, Via Aldo Moro 8, Cona, FE, Italy
- Department of Medical Science, University of Ferrara, Via Fossato di Mortara 64/B, 44121, Ferrara, FE, Italy
| | - A Agrusa
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, PA, Italy
| | - D Cuccurullo
- Division of Laparoscopic and Robotic Surgery Unit, A.O.R.N. Colli Monaldi Hospital, Napoli, NA, Italy
| | - R Cirocchi
- Department of Medicine and Surgery, University of Perugia, Piazza Università 1, 06123, Perugia, PG, Italy
- Division of Digestive and Emergency Surgery, Santa Maria Hospital, Via Tristano di Joannuccio 05100, Terni, TR, Italy
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Heo S, Kang J, Umeakunne E, Lee S, Bertulfo TF, Barbé T, Kim J, Black V, An M, Randolph J. Effects of Meditation Intervention on Self-management in Adult Patients With Type 2 Diabetes: A Systematic Literature Review and Meta-analysis. J Cardiovasc Nurs 2023; 38:581-592. [PMID: 37816085 DOI: 10.1097/jcn.0000000000000973] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Diabetes complications are prevalent and cause adverse effects on the physical, psychological, and economic status of adult patients with type 2 diabetes. Meditation may positively affect self-management and, in turn, reduce diabetes complications. However, the systematic examination of the effects of meditation without additional components on self-management in this population have been rarely examined. PURPOSE The aim of this study was to examine the effects of meditation interventions on self-management (ie, control of glucose, blood pressure, cholesterol, and obesity and self-management) among adult patients with type 2 diabetes in randomized controlled trials. METHODS In this systematic review and meta-analysis, 6 electronic databases were searched using major keywords of meditation , diabetes , and self-management during March 2022. RESULTS Eight studies (9 articles) using mindfulness-based meditation were included. The meta-analysis showed that meditation improved hemoglobin A 1c (effect size = -0.75; 95% confidence interval, -1.30 to -0.21; P = .007) but not fasting blood glucose. Only a few studies examined meditation effects on other types of self-management (eg, blood pressure, body mass index, cholesterol, diet, exercise, foot care, and monitoring of blood glucose), and the effects were inconsistent. In 1 study, meditation improved diabetes self-management. CONCLUSIONS Mindfulness-based meditation reduced hemoglobin A 1c levels in adult patients with type 2 diabetes but did not consistently improve other types of self-management in a few studies examined. This may imply the need for additional intervention components to improve different types of self-management. Further studies are needed to examine the effects of different types of meditations with additional components on different types of self-management.
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Brachini G, Matteucci M, Sapienza P, Cirocchi R, Favilli A, Avenia S, Cheruiyot I, Tebala G, Fedeli P, Davies J, Randolph J, Cirillo B. Systematic Review and Meta-Analysis of the Variants of the Obturatory Artery. J Clin Med 2023; 12:4932. [PMID: 37568334 PMCID: PMC10420221 DOI: 10.3390/jcm12154932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 06/05/2023] [Accepted: 06/28/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Knowledge of vascular anatomy and its possible variations is essential for performing embolization or revascularization procedures and complex surgery in the pelvis. The obturator artery (OA) is a branch of the anterior division of the internal iliac artery (IIA), and it has the highest frequency of variation among branches of the internal iliac artery. Possible anomalies of the origin of the obturator artery (OA) should be known when performing pelvic and groin surgery, where its control or ligation may be required. The purpose of this systematic review and meta-analysis, based on Sanudo's classification, is to analyze the origin of the obturator artery (OA) and its variants. METHODS Thirteen articles published between 1952 and 2020 were included. RESULTS The obturator artery (OA) was present in almost all cases (99.8%): the pooled prevalence estimate for the origin from the IIA axis was 77.7% (95% CI 71.8-83.1%) vs. 22.3% (95% CI 16.9-28.2%) for the origin from EIA axis. In most cases, the obturator artery (OA) originated from the anterior division trunk of the internal iliac artery (IIA) (61.6%). CONCLUSIONS Performing preoperative radiological examination to determine the pelvic vascular pattern and having the awareness to evaluate possible changes in the obturator artery can reduce the risk of iatrogenic injury and complications.
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Affiliation(s)
- Gioia Brachini
- Department of Surgery, Sapienza University, Viale del Policlinico 155, 00161 Rome, Italy; (G.B.); (P.S.)
| | - Matteo Matteucci
- Department of Medicine and Surgery, University of Milan, 20122 Milan, Italy;
| | - Paolo Sapienza
- Department of Surgery, Sapienza University, Viale del Policlinico 155, 00161 Rome, Italy; (G.B.); (P.S.)
| | - Roberto Cirocchi
- Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy; (R.C.); (A.F.); (S.A.)
| | - Alessandro Favilli
- Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy; (R.C.); (A.F.); (S.A.)
| | - Stefano Avenia
- Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy; (R.C.); (A.F.); (S.A.)
| | - Isaac Cheruiyot
- Department of Human Anatomy, University of Nairobi, P.O. Box 30197, Nairobi 00100, Kenya;
| | - Giovanni Tebala
- Department of Surgery, Azienda Ospedaliera Santa Maria di Terni, 05100 Terni, Italy;
| | - Piergiorgio Fedeli
- Department of Legal Medicine, University of Camerino, 62032 Camerino, Italy;
| | - Justin Davies
- Cambridge Colorectal Unit, Addenbrooke’s Hospital, University of Cambridge, Cambridge CB0QQ, UK;
| | - Justus Randolph
- Georgia Baptist College of Nursing, Mercer University, Atlanta, GA 30341, USA;
| | - Bruno Cirillo
- Department of Surgery, Sapienza University, Viale del Policlinico 155, 00161 Rome, Italy; (G.B.); (P.S.)
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Cirocchi R, Randolph J, Cheruiyot I, Davies RJ, Gioia S, Henry BM, Anania G, Donini A, Mingoli A, Sapienza P, Avenia S. Discontinuity of marginal artery at splenic flexure and rectosigmoid junction: A systematic review and meta-analysis. Colorectal Dis 2023. [PMID: 37317032 DOI: 10.1111/codi.16624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 02/08/2023] [Accepted: 04/02/2023] [Indexed: 06/16/2023]
Abstract
AIM The aim of this study was to provide comprehensive evidence-based assessment of the discontinuity of the marginal artery at the splenic flexure (SF) and the rectosigmoid junction (RSJ). METHOD A systematic review was conducted of literature published to 26 December 2022 in the electronic databases PubMed, SCOPUS and Web of Science to identify studies eligible for inclusion. Data were extracted and pooled into a meta-analysis using the Metafor package in R. The primary outcomes were the pooled PPEs of the marginal artery at the SF and the RSJ. The secondary outcome was the size of vascular anastomoses. RESULTS A total of 21 studies (n = 2,864 patients) were included. The marginal artery was present at the splenic flexure in 82% (95% CI: 62-95) of patients. Approximately 81% (95% CI: 63-94%) of patients had a large macroscopic anastomosis, while the remainder (19%) had small bridging ramifications forming the vessel. The marginal artery was present at the RSJ in 82% (95% CI: 70-91%) of patients. CONCLUSION The marginal artery may be absent at the SF and the RSJ in up to 18% of individuals, which may confer a higher risk of ischaemic colitis. As a result of high interstudy heterogeneity noted in our analysis, further well-powered studies to clarify the prevalence of the marginal artery at the SF and the RSJ, as well as its relationship with other complementary colonic collaterals (intermediate and central mesenteric), are warranted.
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Affiliation(s)
- Roberto Cirocchi
- Department of Medicine and Surgery, University of Perugia, Piazza dell' Universitá, Perugia, Italy
| | - Justus Randolph
- Georgia Baptist College of Nursing, Mercer University, Atlanta, USA
| | - Isaac Cheruiyot
- Department of Human Anatomy, University of Nairobi, Nairobi, Kenya
- International Evidence-Based Anatomy Working Group, Krakow, Poland
| | - R Justin Davies
- Cambridge Colorectal Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- University of Cambridge, Cambridge, UK
| | - Sara Gioia
- Section of Legal Medicine, Hospital of Terni, Terni, Italy
| | | | - Gabriele Anania
- Department of Medical Science, Sant'Anna Hospital, University of Ferrara, Ferrara, Italy
| | - Annibale Donini
- Department of Medicine and Surgery, University of Perugia, Piazza dell' Universitá, Perugia, Italy
| | - Andrea Mingoli
- Department of Surgery "Pietro Valdoni", "Sapienza" University of Rome, Rome, Italy
| | - Paolo Sapienza
- Department of Surgery "Pietro Valdoni", "Sapienza" University of Rome, Rome, Italy
| | - Stefano Avenia
- Department of Medicine and Surgery, University of Perugia, Piazza dell' Universitá, Perugia, Italy
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Schlairet MC, Heddon MA, Randolph J. Predicting Survivorship Appointment Nonattendance in a Community Cancer Center: A Machine-Learning Approach. West J Nurs Res 2023:1939459231165749. [PMID: 37085980 DOI: 10.1177/01939459231165749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2023]
Abstract
Understanding and predicting cancer survivors' health care utilization is critical to promote quality care. The consultative system of survivorship care uses a onetime consultative appointment to transition patients from active treatment into survivorship follow-up care. Knowledge of attributes associated with nonattendance at this essential appointment is needed. An ability to predict patients with a likelihood of nonattendance would be of value to practitioners. Unfortunately, traditional data modeling techniques may not be useful in working with large numbers of variables from electronic medical record platforms. A variety of machine-learning algorithms were used to develop a model for predicting 843 survivors' nonattendance at a comprehensive community cancer center in the southeastern United States. A parsimonious model resulted in a k-fold classification accuracy of 67.3% and included three variables. Practitioners may be able to increase utilization of follow-up care among survivors by knowing which patient groups are more likely to be survivorship appointment nonattenders.
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Affiliation(s)
- Maura C Schlairet
- Georgia Baptist College of Nursing, Mercer University, Atlanta, GA, USA
| | - Mary Ann Heddon
- Clinical Trials Program, Pearlman Cancer Center of South Georgia Medical Center, Valdosta, GA, USA
| | - Justus Randolph
- Georgia Baptist College of Nursing, Mercer University, Atlanta, GA, USA
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Graykowski A, Lambert RA, Marchis F, Cazeneuve D, Dalba PA, Esposito TM, O'Conner Peluso D, Sgro LA, Blaclard G, Borot A, Malvache A, Marfisi L, Powell TM, Huet P, Limagne M, Payet B, Clarke C, Murabana S, Owen DC, Wasilwa R, Fukui K, Goto T, Guillet B, Huth P, Ishiyama S, Kukita R, Mitchell M, Primm M, Randolph J, Rivett DA, Ryno M, Shimizu M, Toullec JP, Will S, Yue WC, Camilleri M, Graykowski K, Janetzke R, Janke D, Kardel S, Loose M, Pickering JW, Smith BA, Transom IM. Light curves and colours of the ejecta from Dimorphos after the DART impact. Nature 2023; 616:461-464. [PMID: 36858076 PMCID: PMC10115630 DOI: 10.1038/s41586-023-05852-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 02/15/2023] [Indexed: 03/03/2023]
Abstract
On 26 September 2022, the Double Asteroid Redirection Test (DART) spacecraft struck Dimorphos, a satellite of the asteroid 65803 Didymos1. Because it is a binary system, it is possible to determine how much the orbit of the satellite changed, as part of a test of what is necessary to deflect an asteroid that might threaten Earth with an impact. In nominal cases, pre-impact predictions of the orbital period reduction ranged from roughly 8.8 to 17 min (refs. 2,3). Here we report optical observations of Dimorphos before, during and after the impact, from a network of citizen scientists' telescopes across the world. We find a maximum brightening of 2.29 ± 0.14 mag on impact. Didymos fades back to its pre-impact brightness over the course of 23.7 ± 0.7 days. We estimate lower limits on the mass contained in the ejecta, which was 0.3-0.5% Dimorphos's mass depending on the dust size. We also observe a reddening of the ejecta on impact.
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Affiliation(s)
| | - Ryan A Lambert
- SETI Institute, Carl Sagan Center, Mountain View, CA, USA
| | - Franck Marchis
- SETI Institute, Carl Sagan Center, Mountain View, CA, USA
- Unistellar, Marseille, France
| | | | - Paul A Dalba
- SETI Institute, Carl Sagan Center, Mountain View, CA, USA
- Department of Astronomy and Astrophysics, University of California, Santa Cruz, CA, USA
- Heising-Simons 51 Pegasi b Postdoctoral Fellow, New York City, NY, USA
| | - Thomas M Esposito
- SETI Institute, Carl Sagan Center, Mountain View, CA, USA
- Unistellar, Marseille, France
- Astronomy Department, University of California, Berkeley, CA, USA
| | - Daniel O'Conner Peluso
- SETI Institute, Carl Sagan Center, Mountain View, CA, USA
- Centre for Astrophysics, University of Southern Queensland, Toowoomba, Queensland, Australia
| | - Lauren A Sgro
- SETI Institute, Carl Sagan Center, Mountain View, CA, USA
- Unistellar, Marseille, France
| | | | | | | | | | - Tyler M Powell
- Department of Earth, Planetary, and Space Sciences, University of California, Los Angeles, CA, USA
| | | | | | - Bruno Payet
- Unistellar Citizen Scientist, La Rivière, Réunion
| | - Colin Clarke
- Armagh Observatory and Planetarium, College Hill, Armagh, UK
- The Travelling Telescope, Nairobi Planetarium, Nairobi, Kenya
- Unistellar Citizen Scientist, College Hill, UK
| | - Susan Murabana
- The Travelling Telescope, Nairobi Planetarium, Nairobi, Kenya
- Unistellar Citizen Scientist, Nairobi, Kenya
| | - Daniel Chu Owen
- The Travelling Telescope, Nairobi Planetarium, Nairobi, Kenya
- Unistellar Citizen Scientist, Nairobi, Kenya
| | - Ronald Wasilwa
- The Travelling Telescope, Nairobi Planetarium, Nairobi, Kenya
- Unistellar Citizen Scientist, Nairobi, Kenya
| | | | | | | | - Patrick Huth
- Community College of Allegheny County, Pittsburgh, PA, USA
- Unistellar Citizen Scientist, Schenley, PA, USA
| | | | | | - Mike Mitchell
- Unistellar Citizen Scientist, Oklahoma City, OK, USA
| | | | | | - Darren A Rivett
- Unistellar Citizen Scientist, Lake Macquarie, New South Wales, Australia
| | - Matthew Ryno
- Unistellar Citizen Scientist, Milwaukee, WI, USA
| | | | | | - Stefan Will
- Unistellar Citizen Scientist, Raleigh, NC, USA
| | | | | | | | - Ron Janetzke
- Unistellar Citizen Scientist, San Antonio, TX, USA
| | - Des Janke
- Unistellar Citizen Scientist, Toowoomba, Queensland, Australia
| | - Scott Kardel
- Palomar Community College, San Marcos, CA, USA
- Unistellar Citizen Scientist, San Marcos, CA, USA
| | | | - John W Pickering
- Department of Medicine, University of Otago, Christchurch, New Zealand
- Emergency Care Foundation, Christchurch Hospital, Christchurch, New Zealand
- Unistellar Citizen Scientist, Christchurch, New Zealand
| | | | - Ian M Transom
- Hamilton Astronomical Society Observatory, Hamilton, New Zealand
- Unistellar Citizen Scientist, Cambridge, New Zealand
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Crawford RP, Barbé T, Randolph J. Demographic Differences in Satisfaction and Work-Life Balance of Prelicensure Nursing Faculty. Nurse Educ 2023; 48:92-97. [PMID: 36730976 DOI: 10.1097/nne.0000000000001309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND A need exists to recruit and retain nursing faculty of differing generations, races/ethnicities, and genders. PURPOSE The purpose of this study was to examine whether generational cohort, race/ethnicity, and gender predicted job satisfaction, life satisfaction, or work-life balance for full-time faculty teaching in prelicensure, baccalaureate nursing programs. METHODS Faculty (N = 363) from multiple schools of nursing in the United States completed a survey that included demographics, the Job Satisfaction Scale, the Satisfaction with Life Scale, and the Work-Life Balance Self-Assessment. RESULTS Significant relationships and differences were noted for nursing faculty. Faculty of color reported lower job and life satisfaction than their White counterparts. CONCLUSIONS As calls to increase diversity among nursing faculty increase, continued research should focus on differences in the experience of faculty of color.
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Affiliation(s)
- Ryan P Crawford
- Assistant Professor of Nursing (Dr Crawford), Mary Black College of Nursing, University of South Carolina Upstate, Spartanburg; Associate Dean for Graduate Programs (Dr Barbé) and Professor (Dr Randolph), Georgia Baptist College of Nursing, Mercer University, Atlanta
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Moore CH, Oliver TL, Randolph J, Dowdell EB. Interventions for reducing weight bias in healthcare providers: An interprofessional systematic review and meta-analysis. Clin Obes 2022; 12:e12545. [PMID: 35946476 DOI: 10.1111/cob.12545] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 05/24/2022] [Accepted: 06/28/2022] [Indexed: 11/28/2022]
Abstract
Weight bias is prevalent in many healthcare disciplines and negatively impacts the quality of care for patients with obesity. This warrants interventions to reduce weight bias shown by providers to improve care for individuals with obesity. However, past reviews have identified only marginal success in improving the attitudes and beliefs of healthcare providers about individuals with obesity. This systematic review and meta-analysis identifies and synthesizes recent peer-reviewed intervention studies aimed at reducing weight bias in healthcare students and professionals. The databases Embase, Cumulative Index to Nursing and Allied Health Literature, PsychINFO, PubMed and Google Scholar were searched for peer-reviewed studies published between 2016 and August 2021. Search terms included a combination of surrogate terms for the concepts of weight bias, intervention and healthcare students or professionals. The search yielded 1136 articles, and 14 articles met the inclusion criteria for the systematic review. Nineteen effect sizes from nine studies were included in the meta-analysis. Overall, the interventions in the included studies result in a 0.38 SD reduction (Hedge's g) in obesity-bias with 95% confidence intervals from -0.52 to -0.24, indicating a small to moderate effect size in the reduction of weight bias. Most studies included students and focused on evoking empathy or educating on the causality/controllability of obesity. Measurement tools, intervention type, limitations of the studies and recommendations for future research are discussed.
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Affiliation(s)
- Caroline Hallen Moore
- Georgia Baptist College of Nursing, Mercer University, Atlanta, Georgia, USA
- M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, Pennsylvania, USA
| | - Tracy L Oliver
- M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, Pennsylvania, USA
| | - Justus Randolph
- Georgia Baptist College of Nursing, Mercer University, Atlanta, Georgia, USA
| | - Elizabeth B Dowdell
- M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, Pennsylvania, USA
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Heo S, Bertulfo TF, Troyan P, Randolph J. Factors Associated with Human Papillomavirus Vaccination and the Intention among Undergraduate Nursing Students: A Cross-Sectional, Correlational Study. J Community Health Nurs 2022; 39:178-192. [PMID: 35653794 DOI: 10.1080/07370016.2022.2077075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE To examine factors associated with overall human papillomavirus (HPV) vaccination status, completion of HPV vaccination, and intention to receive vaccination among nursing students. DESIGN A Cross-sectional, correlational study. METHODS Data from 86 students were analyzed using logistic and multiple regression. FINDINGS Among knowledge, attitudes and beliefs, and recommendation, more positive attitudes and beliefs were the only factors associated with initiation and/or completion of HPV vaccination and the intention to receive HPV vaccination. CONCLUSIONS More positive attitudes and beliefs need to be enhanced for HPV vaccination. CLINICAL EVIDENCE Changes in attitudes and beliefs can be important targets of interventions to increase HPV vaccination.
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Affiliation(s)
- Seongkum Heo
- Georgia Baptist College of Nursing 3001 Mercer University Drive, Mercer University, Atlanta, Georgia, USA
| | - Tara F Bertulfo
- Georgia Baptist College of Nursing 3001 Mercer University Drive, Mercer University, Atlanta, Georgia, USA
| | - Patricia Troyan
- Georgia Baptist College of Nursing 3001 Mercer University Drive, Mercer University, Atlanta, Georgia, USA
| | - Justus Randolph
- Georgia Baptist College of Nursing 3001 Mercer University Drive, Mercer University, Atlanta, Georgia, USA
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Randolph J, Pak E, McMains J, Koontz B, Hannan J. Cocultured Schwann Cells Rescue Irradiated Pelvic Neuron Outgrowth and Increase Survival. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.01.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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12
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Smith NE, Barbé T, Randolph J. Application of the cognitive load theory in prelicensure nursing education: a quantitative measurement focusing on instructional design. Int J Nurs Educ Scholarsh 2022; 19:ijnes-2021-0127. [PMID: 35166089 DOI: 10.1515/ijnes-2021-0127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 01/31/2022] [Indexed: 11/15/2022]
Abstract
The objective of this study was to examine differences in principles from the cognitive load theory (CLT) combined with active learning strategies. To examine these differences, simple to complex activities were imbedded into two active learning instructional strategies: cooperative learning (CPL) and problem-based learning (PBL) and evaluated for its impact on mental effort for learning and intrinsic cognitive load. A two-within repeated-measures design was used in a nursing fundamentals classroom. The simple and complex activities were grounded in recommendations from the CLT and validated by nurse experts. The instructional strategies of CPL and PBL were chosen based on recommendations from the literature. Results revealed no statistically significant differences. A small interaction showed a decrease in mental effort and intrinsic load when problem-based learning was used. Progressing learning activities from simple to complex, informed by the CLT, offers an approach to designing instruction in nursing classrooms when using active learning strategies.
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Affiliation(s)
- Nicole E Smith
- School of Nursing, University of Maryland Baltimore, MD, USA
| | - Tammy Barbé
- Nursing, Mercer University Georgia Baptist College of Nursing, Atlanta, GA, USA
| | - Justus Randolph
- Nursing, Mercer University Georgia Baptist College of Nursing, Atlanta, GA, USA
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Bertulfo TF, Heo S, Troyan P, Randolph J, An M. An instrument assessing attitudes and beliefs toward human papillomavirus vaccination. Public Health Nurs 2022; 39:856-864. [PMID: 35005796 DOI: 10.1111/phn.13046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 12/20/2021] [Accepted: 12/22/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The purpose of this study was to test the psychometric properties of a brief attitudes and beliefs toward human papillomavirus (HPV) vaccination instrument in college students. DESIGN Cross-sectional, observational study. SAMPLE Eighty-six nursing students. MEASUREMENTS The Attitudes and Beliefs Toward Human Papillomavirus Vaccination was used to test the reliability (Cronbach's alpha), homogeneity (item-analyses), and validity (factor analysis and correlations). RESULTS The reliability of this 8-item instrument was supported by a Cronbach's alpha of .854. Item homogeneity was supported by coefficients for all items > .30. Convergent validity was supported by significant correlations of attitudes and beliefs assessed by this instrument to attitudes, subjective norm, and perceived behavioral control assessed by different instruments (all ps < .001). Construct validity was supported by exploratory and confirmatory factor analyses (all factor loadings ≥ .40). Predictive validity was supported by a significant relationship of attitudes and beliefs to completion of the vaccination (p < .001). CONCLUSIONS The Attitudes and Beliefs Toward Human Papillomavirus Vaccination Questionnaire was a reliable and valid instrument. This short instrument can be used to assess and improve attitudes and beliefs toward HPV vaccination, and, in turn, to facilitate the completion of the vaccination.
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Affiliation(s)
- Tara F Bertulfo
- Georgia Baptist College of Nursing, Mercer University, Atlanta, Georgia, USA
| | - Seongkum Heo
- Georgia Baptist College of Nursing, Mercer University, Atlanta, Georgia, USA
| | - Patricia Troyan
- Georgia Baptist College of Nursing, Mercer University, Atlanta, Georgia, USA
| | - Justus Randolph
- Georgia Baptist College of Nursing, Mercer University, Atlanta, Georgia, USA
| | - Minjeong An
- Chonnam National University College of Nursing, Gwangju, South Korea
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Cirocchi R, Randolph J, Davies RJ, Cheruiyot I, Gioia S, Henry BM, Carlini L, Donini A, Anania G. A systematic review and meta-analysis of variants of the branches of the superior mesenteric artery: the Achilles heel of right hemicolectomy with complete mesocolic excision? Colorectal Dis 2021; 23:2834-2845. [PMID: 34358401 DOI: 10.1111/codi.15861] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 06/29/2021] [Accepted: 07/27/2021] [Indexed: 12/18/2022]
Abstract
AIM Dissection with subsequent ligation and resection of arteries at their origin (central vascular ligation) is essential for adequate oncological resection during right hemicolectomy with complete mesocolic excision. This technique is technically demanding due to the highly variable arterial pattern of the right colon. Therefore, this study aims to provide a comprehensive evidence-based assessment of the arterial vascular anatomy of the right colon. METHODS A thorough systematic literature search through September 2020 was conducted on the electronic databases PubMed, Scopus and Web of Science to identify studies eligible for inclusion. Data were extracted and pooled into a meta-analysis using MetaXl software. RESULTS A total of 41 studies (n = 4691 patients) were included. The ileocolic artery (ICA), right colic artery (RCA) and middle colic artery (MCA) were present in 99.7% (95% CI 99.4%-99.8%), 72.6% (95% CI 61.3%-82.5%) and 96.9% (95% CI 94.2%-98.8%) respectively of patients. Supernumerary RCA and MCA were observed in 3.2% and 11.4% respectively of all cases. The RCA shared a common trunk with the ICA and MCA in 13.2% and 17.7% respectively of patients. A retro-superior mesenteric vein course of the ICA and RCA was observed in 55.1% and 11.4% respectively of all cases. CONCLUSION The vascular anatomy of the right colon displays several notable variations, namely the absence of some branches (RCA absent in 27.4% of cases), supernumerary branches, common trunks, and retro-superior mesenteric vein courses. These variations should be taken into consideration during right hemicolectomy with complete mesocolic excision to ensure adequate oncological resection while minimizing intra-operative complications.
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Affiliation(s)
- Roberto Cirocchi
- Department of Surgical Science, University of Perugia, Piazza dell' Universitá, Perugia, Italy
| | - Justus Randolph
- Georgia Baptist College of Nursing, Mercer University, Atlanta, Georgia, USA
| | - R Justin Davies
- Cambridge Colorectal Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Isaac Cheruiyot
- Department of Human Anatomy, University of Nairobi, Nairobi, Kenya.,International Evidence-Based Anatomy Working Group, Krakow, Poland
| | - Sara Gioia
- School of Medicine, Perugia, 3 Section of Legal Medicine, Hospital of Terni, University of Perugia, Terni, Italy
| | | | - Luigi Carlini
- School of Medicine, Perugia, 3 Section of Legal Medicine, Hospital of Terni, University of Perugia, Terni, Italy
| | - Annibale Donini
- Department of Surgical Science, University of Perugia, Piazza dell' Universitá, Perugia, Italy
| | - Gabriele Anania
- Department of Medical Science, Sant'Anna Hospital, University of Ferrara, Ferrara, Italy
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Cheruiyot I, Cirocchi R, Munguti J, Davies RJ, Randolph J, Ndung'u B, Henry BM. Surgical anatomy of the accessory middle colic artery: a meta-analysis with implications for splenic flexure cancer surgery. Colorectal Dis 2021; 23:1712-1720. [PMID: 33721386 DOI: 10.1111/codi.15630] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 11/16/2020] [Accepted: 03/07/2021] [Indexed: 12/12/2022]
Abstract
AIM Surgical resection of splenic flexure cancers (SFCs) is technically demanding due to the complex regional anatomy, characterized by the presence of embryological adhesions, close proximity to the pancreas and spleen, and a highly heterogeneous arterial supply and lymphatic drainage. The accessory middle colic artery (AMCA) is increasingly being recognized as an important source of blood supply to the splenic flexure. The aim of this study is to determine the prevalence and anatomical features of the AMCA. METHOD A systematic search of the scientific literature was conducted on PubMed and Embase from inception to November 2020 to identify potentially eligible studies. Data were extracted and prevalence was pooled into a meta-analysis using MetaXL and Meta-Analyst software. RESULTS A total of 16 studies (n = 2203 patients) were included. The pooled prevalence (PP) of the AMCA was 25.4% (95% CI 18.1-33.4). Its prevalence was higher in patients without a left colic artery (LCA) (PP = 83.2%; 95% CI 70.4-93.1). The commonest origin for the AMCA was the superior mesenteric artery (PP = 87.9%; 95% CI 86.4-90.7). The AMCA shared a common trunk/gave rise to pancreatic branches in 23.1% of cases (95% CI 15.3-31.9). CONCLUSION The AMCA contributes to the vascularization of the splenic flexure in approximately 25% of individuals, and may be an important feeder artery to SFCs, especially in the absence of a LCA. Preoperative identification of this artery is important to ensure optimal surgery for SFC and minimize complications.
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Affiliation(s)
- Isaac Cheruiyot
- Department of Human Anatomy, University of Nairobi, Nairobi, Kenya.,International Evidence-Based Anatomy Working Group, Krakow, Poland
| | - Roberto Cirocchi
- Department of Surgical Science, University of Perugia, Perugia, Italy
| | - Jeremiah Munguti
- Department of Human Anatomy, University of Nairobi, Nairobi, Kenya
| | - R Justin Davies
- Cambridge Colorectal Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Justus Randolph
- Georgia Baptist College of Nursing. Mercer University, Atlanta, GA, USA
| | - Bernard Ndung'u
- Department of Human Anatomy, University of Nairobi, Nairobi, Kenya
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Cirocchi R, Randolph J, Panata L, Verdelli AM, Mascagni D, Mingoli A, Zago M, Chiarugi M, Lancia M, Fedeli P, Davies J, Occhionorelli S. The tip of the iceberg of colorectal perforation from enema: a systematic review and meta-analysis. Tech Coloproctol 2020; 24:1109-1119. [DOI: 10.1007/s10151-020-02294-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 07/05/2020] [Indexed: 01/19/2023]
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17
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Cirocchi R, Randolph J, Cheruiyot I, Davies JR, Wheeler J, Lancia M, Gioia S, Carlini L, di Saverio S, Henry BM. Systematic review and meta-analysis of the anatomical variants of the left colic artery. Colorectal Dis 2020; 22:768-778. [PMID: 31655010 DOI: 10.1111/codi.14891] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Accepted: 09/30/2019] [Indexed: 12/12/2022]
Abstract
AIM To provide a comprehensive evidence-based assessment of the anatomical variations of the left colic artery (LCA). METHOD A thorough systematic search of the literature up until 1 April 2019 was conducted on the electronic databases PubMed, SCOPUS and Web of Science (WOS) to identify studies eligible for inclusion. Data were extracted and pooled into a meta-analysis using the Metafor package in R. The primary outcomes of interest were the absence of the LCA and the anatomical variants of its origin. The secondary outcomes were the distance (mean ± SD) between the origin of the inferior mesenteric artery (OIMA) and the origin of the left colic artery (OLCA). RESULTS A total of 19 studies (n = 2040 patients) were included. The pooled prevalence estimate (PPE) of LCA absence was 1.2% (95% CI 0.0-3.6%). Across participants with either a Type I or Type II LCA, the PPE of a Type I LCA was 49.0% (95% CI 40.2-57.8%). The PPE of a Type II LCA was therefore 51.0%. The pooled mean distance from the OIMA to the OLCA was 40.41 mm (95 CI% 38.69-42.12 mm). The pooled mean length of a Type I LCA was 39.12 mm (95% CI 36.70-41.53 mm) while the pooled mean length of a Type IIa and Type IIb LCA was 41.43 mm (95% CI 36.90-43.27 mm) and 39.64 mm (95% CI 37.68-41.59 mm), respectively. CONCLUSION Although the absence of the LCA is a rare occurrence (PPE 1.2%), it may be associated with an important risk of anastomotic leakage as a result of insufficient vascularization of the proximal colonic conduit. It is also necessary to distinguish variants I and II of Latarjet, the frequency of which is identical, with division of the LCA being technically more straightforward in variant I of Latarjet. Surgeons should be aware that technical difficulties are likely to be more common with variant II of Latarjet, as LCA ligation may be more difficult due to its close proximity to the inferior mesenteric vein (IMV).
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Affiliation(s)
- R Cirocchi
- Department of Surgical Science, University of Perugia, Perugia, Italy
| | - J Randolph
- Georgia Baptist College of Nursing, Mercer University, Atlanta, Georgia, USA
| | - I Cheruiyot
- Department of Human Anatomy, University of Nairobi, Nairobi, Kenya.,International Evidence-Based Anatomy Working Group, Krakow, Poland
| | - J R Davies
- Cambridge Colorectal Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Trust, Cambridge, UK
| | - J Wheeler
- Cambridge Colorectal Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Trust, Cambridge, UK
| | - M Lancia
- Department of Surgical Science, University of Perugia, Perugia, Italy
| | - S Gioia
- Department of Surgical Science, University of Perugia, Perugia, Italy
| | - L Carlini
- Department of Surgical Science, University of Perugia, Perugia, Italy
| | - S di Saverio
- Cambridge Colorectal Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Trust, Cambridge, UK
| | - B M Henry
- International Evidence-Based Anatomy Working Group, Krakow, Poland.,Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
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Cochetti G, Abraha I, Randolph J, Montedori A, Boni A, Arezzo A, Mazza E, Rossi De Vermandois JA, Cirocchi R, Mearini E. Surgical wound closure by staples or sutures?: Systematic review. Medicine (Baltimore) 2020; 99:e20573. [PMID: 32569183 PMCID: PMC7310845 DOI: 10.1097/md.0000000000020573] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
AIM To compare the effects of sutures and staples for skin closure of surgical wounds. MATERIAL AND METHODS We included published and unpublished randomized controlled trials (RCTs) and cluster-randomized trials comparing staples with sutures. Patients were adults (aged 18 years or over) who had undergone any type of surgery. The primary outcomes were risk of overall and severe wound infection. Secondary outcomes included length of hospital stay, readmission rate, adverse events, patient satisfaction with cosmetic results, postoperative pain. RESULTS Forty-two very low to low quality RCTs with a total of 11,067 patients were included. Sutures resulted in slightly fewer overall wound infections (4.90%) compared to staples (6.75%) but it is uncertain whether there is a difference between the groups (risk ratio [RR] 1.20, 95% confidence intervals [CI] 0.80-1.79; patients = 9864; studies = 34; I = 70%). The evidence was also insufficient to state a difference in terms of severe wound infection (staples 1.4% vs sutures 1.3%; RR 1.08, 95% CI 0.61-1.89; patients = 3036; studies = 17; I = 0%), grade of satisfaction (RR 0.99, 95% CI 0.91-1.07; patients = 3243; studies = 14; I = 67%) and hospital stay. Staples may increase the risk of adverse events (7.3% for staples vs 3.5% for sutures; RR 2.00, 95% CI 1.44-2.79; patients = 6246; studies = 21; I = 33%), readmission rate (RR 1.28, 95% CI 0.18-9.05; patients = 2466; studies = 5; I = 66%) and postoperative pain (standardized mean difference [SMD] 0.41,95%CI -0.35 to 1.16; I = 88%, patients = 390 patients, studies = 5). CONCLUSIONS Due to the lack of high quality evidence, we could not state if sutures are better than staples in terms of wound infection, readmission rate, adverse events, and postoperative pain. With a low quality of evidence, sutures reduce postoperative pain and improve grade of satisfaction with the cosmetic outcome.
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Affiliation(s)
- Giovanni Cochetti
- Department of Surgical and Biomedical Sciences, University of Perugia
| | - Iosief Abraha
- Health Planning Service, Regional Health Authority of Umbria, Perugia, Italy
| | - Justus Randolph
- Tift College of Education, Mercer University, Atlanta, GA, USA
| | | | - Andrea Boni
- Department of Surgical and Biomedical Sciences, University of Perugia
| | - Alberto Arezzo
- Department of Surgical Sciences, University of Torino, Turin
| | - Elena Mazza
- Department of Surgical Sciences, University of Torino, Turin
| | | | - Roberto Cirocchi
- Department of General Surgery, University of Perugia, Terni, Italy
| | - Ettore Mearini
- Department of Surgical and Biomedical Sciences, University of Perugia
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Shaver J, Bellis E, Iwaki C, Qualls J, Randolph J, Smith J. Massard Prairie Restoration and Soil Microbiome Succession. J Ark Acad Sci 2020; 74:5. [PMID: 33709089 PMCID: PMC7946111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
We have initially sequenced soil microbial DNA from 4 restored and 3 virgin tallgrass prairie soil samples from Ben Geren Park and Massard Prairie (Fort Smith, AR), respectively. As expected, the soil microbiomes are distinct, with several lineages of nitrogen-fixing bacteria more common in virgin tallgrass prairie. However, we predict that as restoration of tallgrass prairie in Ben Geren Park progresses, the soil microbiome of restored prairie will more closely mirror those of the virgin prairie.
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Affiliation(s)
- J.M. Shaver
- Department of Biology, University of Arkansas Fort Smith, Fort Smith, AR 72904
| | - E.S. Bellis
- Department of Computer Science, Arkansas State University, Jonesboro, AR 72467
- Arkansas Biosciences Institute, Arkansas State University, Jonesboro, AR 72467
| | - C. Iwaki
- Department of Mathematics, University of Arkansas Fort Smith, Fort Smith, AR 72904
| | - J. Qualls
- Department of Computer Science, Arkansas State University, Jonesboro, AR 72467
| | - J. Randolph
- Ben Geren Golf Course, Sebastian County, Fort Smith, AR 72903
| | - J. Smith
- Department of Biology, University of Arkansas Fort Smith, Fort Smith, AR 72904
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Randolph J, Pak E, Koontz B, Hannan J. 309 Radiation-induced Schwann Cell Dedifferentiation Leads to Opposing Growth in Whole Ganglia vs Dissociated Cultured Pelvic Neurons. J Sex Med 2020. [DOI: 10.1016/j.jsxm.2019.11.205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Randolph J, Randolph J, Wishart H. B-12 Cognitive Resilience in MS: Associations with Lesion Volume, Pain, and Smoking Status. Arch Clin Neuropsychol 2019. [DOI: 10.1093/arclin/acz034.95] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Objective
Cognitive dysfunction is common in people with MS (pwMS), but relatively little is known about those with no objective or subjective impairment. We sought to further examine a previously characterized cognitively resilient group of pwMS (MS-RES)—individuals without cognitive impairment, without subjective cognitive complaints, and without informant-reported cognitive difficulties—and considered neuroimaging, pain-related, and smoking correlates in this group.
Method
We derived two groups of pwMS: cognitively resilient (MS-RES; N = 15) and other MS (N = 85). MS groups showed equivalent education, gender, symptom and diagnosis duration, MS subtype, EDSS rating, and reported hours of sleep, and endorsed no more than mild depression. Both MS groups were compared to age- and gender-matched healthy controls (N = 31) on appropriate variables, and MS groups were compared on lesion volume, pain, and smoking variables.
Results
Despite showing intact subjective and objective cognition, the MS-RES group had lesion volume comparable to other MS participants. The MS-RES group also reported less of an impact of pain on overall functioning, recreational activities, and life enjoyment compared to other MS participants (p < .05), and were comparable to healthy controls. There was a trend toward MS-RES participants being less likely to be current smokers than others with MS (p = .09), and MS-RES and healthy controls showed comparable smoking status.
Conclusions
We found that cognitively resilient pwMS have unique clinical features that differentiate them from others with MS despite similar lesion volumes. A more complete understanding of cognitively resilient pwMS may inform interventions that promote MS symptom management and general resilience.
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Cirocchi R, D'Andrea V, Lauro A, Renzi C, Henry BM, Tomaszewski KA, Rende M, Lancia M, Carlini L, Gioia S, Randolph J. The absence of the common hepatic artery and its implications for surgical practice: Results of a systematic review and meta-analysis. Surgeon 2019; 17:172-185. [DOI: 10.1016/j.surge.2019.03.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 01/22/2019] [Accepted: 03/05/2019] [Indexed: 02/06/2023]
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Cirocchi R, Arezzo A, D'Andrea V, Abraha I, Popivanov GI, Avenia N, Gerardi C, Henry BM, Randolph J, Barczyñski M. Intraoperative neuromonitoring versus visual nerve identification for prevention of recurrent laryngeal nerve injury in adults undergoing thyroid surgery. Cochrane Database Syst Rev 2019; 1:CD012483. [PMID: 30659577 PMCID: PMC6353246 DOI: 10.1002/14651858.cd012483.pub2] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Injuries to the recurrent inferior laryngeal nerve (RILN) remain one of the major post-operative complications after thyroid and parathyroid surgery. Damage to this nerve can result in a temporary or permanent palsy, which is associated with vocal cord paresis or paralysis. Visual identification of the RILN is a common procedure to prevent nerve injury during thyroid and parathyroid surgery. Recently, intraoperative neuromonitoring (IONM) has been introduced in order to facilitate the localisation of the nerves and to prevent their injury during surgery. IONM permits nerve identification using an electrode, where, in order to measure the nerve response, the electric field is converted to an acoustic signal. OBJECTIVES To assess the effects of IONM versus visual nerve identification for the prevention of RILN injury in adults undergoing thyroid surgery. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, ICTRP Search Portal and ClinicalTrials.gov. The date of the last search of all databases was 21 August 2018. We did not apply any language restrictions. SELECTION CRITERIA We included randomised controlled trials (RCTs) comparing IONM nerve identification plus visual nerve identification versus visual nerve identification alone for prevention of RILN injury in adults undergoing thyroid surgery DATA COLLECTION AND ANALYSIS: Two review authors independently screened titles and abstracts for relevance. One review author carried out screening for inclusion, data extraction and 'Risk of bias' assessment and a second review author checked them. For dichotomous outcomes, we calculated risk ratios (RRs) with 95% confidence intervals (CIs). For continuous outcomes, we calculated mean differences (MDs) with 95% CIs. We assessed trials for certainty of the evidence using the GRADE instrument. MAIN RESULTS Five RCTs with 1558 participants (781 participants were randomly assigned to IONM and 777 to visual nerve identification only) met the inclusion criteria; two trials were performed in Poland and one trial each was performed in China, Korea and Turkey. Inclusion and exclusion criteria differed among trials: previous thyroid or parathyroid surgery was an exclusion criterion in three trials. In contrast, this was a specific inclusion criterion in another trial. Three trials had central neck compartment dissection or lateral neck dissection and Graves' disease as exclusion criteria. The mean duration of follow-up ranged from 6 to 12 months. The mean age of participants ranged between 41.7 years and 51.9 years.There was no firm evidence of an advantage or disadvantage comparing IONM with visual nerve identification only for permanent RILN palsy (RR 0.77, 95% CI 0.33 to 1.77; P = 0.54; 4 trials; 2895 nerves at risk; very low-certainty evidence) or transient RILN palsy (RR 0.62, 95% CI 0.35 to 1.08; P = 0.09; 4 trials; 2895 nerves at risk; very low-certainty evidence). None of the trials reported health-related quality of life. Transient hypoparathyroidism as an adverse event was not substantially different between intervention and comparator groups (RR 1.25; 95% CI 0.45 to 3.47; P = 0.66; 2 trials; 286 participants; very low-certainty evidence). Operative time was comparable between IONM and visual nerve monitoring alone (MD 5.5 minutes, 95% CI -0.7 to 11.8; P = 0.08; 3 trials; 1251 participants; very low-certainty evidence). Three of five included trials provided data on all-cause mortality: no deaths were reported. None of the trials reported socioeconomic effects. The evidence reported in this review was mostly of very low certainty, particularly because of risk of bias, a high degree of imprecision due to wide confidence intervals and substantial between-study heterogeneity. AUTHORS' CONCLUSIONS Results from this systematic review and meta-analysis indicate that there is currently no conclusive evidence for the superiority or inferiority of IONM over visual nerve identification only on any of the outcomes measured. Well-designed, executed, analysed and reported RCTs with a larger number of participants and longer follow-up, employing the latest IONM technology and applying new surgical techniques are needed.
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Affiliation(s)
- Roberto Cirocchi
- University of PerugiaDepartment of General SurgeryTerniItaly05100
| | - Alberto Arezzo
- University of TorinoDepartment of Surgical SciencesCorso Achille Mario Dogliotti 14TurinItaly10126
| | - Vito D'Andrea
- Sapienza University of RomeDepartment of Surgical SciencesViale Regina Elena, 324RomeItaly00161
| | - Iosief Abraha
- Regional Health Authority of UmbriaHealth Planning ServicePerugiaItaly06124
| | - Georgi I Popivanov
- Medical Military Academy of SofiaDepartment of Surgery"Sv. Georgi Sofiiski" 3SofiaBulgaria1606
| | - Nicola Avenia
- University of PerugiaDepartment of Surgical SciencesPerugiaItaly06034
| | - Chiara Gerardi
- IRCCS Istituto di Ricerche Farmacologiche Mario NegriVia La Masa, 19MilanItaly20156
| | - Brandon Michael Henry
- Cincinnati Children’s Hospital Medical CenterDivision of Cardiology3333 Burnet AveCincinnatiOhioUSA45229
| | - Justus Randolph
- Mercer UniversityGeorgia Baptist College of Nursing3001 Mercer University Dr.AtlantaGAUSA30341
| | - Marcin Barczyñski
- Jagiellonian University, Medical CollegeDepartment of Endocrine Surgery, Third Chair of General Surgery37 Pradnicka StreetKrakowPoland31‐202
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Arezzo A, Bullano A, Cochetti G, Cirocchi R, Randolph J, Mearini E, Evangelista A, Ciccone G, Bonjer HJ, Morino M. Transperitoneal versus retroperitoneal laparoscopic adrenalectomy for adrenal tumours in adults. Cochrane Database Syst Rev 2018; 12:CD011668. [PMID: 30595004 PMCID: PMC6517116 DOI: 10.1002/14651858.cd011668.pub2] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Laparoscopic adrenalectomy is an accepted treatment worldwide for adrenal gland disease in adults. The transperitoneal approach is more common. The retroperitoneal approach may be preferred, to avoid entering the peritoneum, but no clear advantage has been demonstrated so far. OBJECTIVES To assess the effects of laparoscopic transperitoneal adrenalectomy (LTPA) versus laparoscopic retroperitoneal adrenalectomy (LRPA) for adrenal tumours in adults. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, ICTRP Search Portal, and ClinicalTrials.gov to 3 April 2018. We applied no language restrictions. SELECTION CRITERIA Two review authors independently scanned the abstract, title, or both sections of every record retrieved to identify randomised controlled trials (RCTs) on laparoscopic adrenalectomy for preoperatively assessed adrenal tumours. Participants were affected by corticoid and medullary, benign and malignant, functional and silent tumours or masses of the adrenal gland, which were assessed by both laboratory and imaging studies. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data, assessed trials for risk of bias, and evaluated overall study quality using GRADE criteria. We calculated the risk ratio (RR) for dichotomous outcomes, or the mean difference (MD) for continuous variables, and corresponding 95% confidence interval (CI). We primarily used a random-effects model for pooling data. MAIN RESULTS We examined 1069 publications, scrutinized 42 full-text publications or records, and included five RCTs. Altogether, 244 participants entered the five trials; 127 participants were randomised to retroperitoneal adrenalectomy and 117 participants to transperitoneal adrenalectomy. Two trials had a follow-up of nine months, and three trials a follow-up of 31 to 70 months. Most participants were women, and the average age was around 40 years. Three trials reported all-cause mortality; in two trials, there were no deaths, and in one trial with six years of follow-up, four participants died in the LRPA group and one participant in the LTPA group (164 participants; low-certainty evidence). The trials did not report all-cause morbidity. Therefore, we analysed early and late morbidity, and included specific adverse events under these outcome measures. The results were inconclusive between LRPA and LTPA for early morbidity (usually reported within 30 to 60 days after surgery; RR 0.56, 95% CI 0.27 to 1.16; P = 0.12; 5 trials, 244 participants; very low-certainty evidence). Nine out of 127 participants (7.1%) in the LRPA group, compared with 16 out of 117 participants (13.7%) in the LTPA group experienced an adverse event. Participants in the LRPA group may have a lower risk of developing late morbidity (reported as latest available follow-up; RR 0.12, 95% CI 0.01 to 0.92; P = 0.04; 3 trials, 146 participants; very low-quality evidence). None of the 78 participants in the LRPA group, compared with 7 of the 68 participants (10.3%) in the LTPA group experienced an adverse event.None of the trials reported health-related quality of life. The results were inconclusive for socioeconomic effects, assessed as time to return to normal activities and length of hospital stay, between the intervention and comparator groups (very low-certainty evidence). Participants who had LRPA may have had an earlier start on oral fluid or food intake (MD -8.6 hr, 95% CI -13.5 to -3.7; P = 0.0006; 2 trials, 89 participants), and ambulation (MD -5.4 hr, 95% CI -6.8 to -4.0 hr; P < 0.0001; 2 trials, 89 participants) than those in the LTPA groups. Postoperative and operative parameters (duration of surgery, operative blood loss, conversion to open surgery) showed inconclusive results between the intervention and comparator groups. AUTHORS' CONCLUSIONS The body of evidence on laparoscopic retroperitoneal adrenalectomy compared with laparoscopic transperitoneal adrenalectomy is limited. Late morbidity might be reduced following laparoscopic retroperitoneal adrenalectomy, but we are uncertain about this effect because of very low-quality evidence. The effects on other key outcomes, such as all-cause mortality, early morbidity, socioeconomic effects, and operative and postoperative parameters are uncertain. LRPA might show a shorter time to oral fluid or food intake and time to ambulation, but we are uncertain whether this finding can be replicated. New long-term RCTs investigating additional data, such as health-related quality of life, surgeons' level of experience, treatment volume of surgical centres, and details on techniques used are needed.
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Affiliation(s)
- Alberto Arezzo
- University of TorinoDepartment of Surgical SciencesCorso Achille Mario Dogliotti 14TurinItaly10126
| | - Alberto Bullano
- University of TorinoDepartment of Surgical SciencesCorso Achille Mario Dogliotti 14TurinItaly10126
| | - Giovanni Cochetti
- University of PerugiaDepartment of Surgical and Biomedical SciencesSant’Andrea delle FrattePerugiaItaly06100
| | - Roberto Cirocchi
- University of PerugiaDepartment of General SurgeryTerniItaly05100
| | - Justus Randolph
- Mercer UniversityGeorgia Baptist College of Nursing3001 Mercer University Dr.AtlantaGAUSA30341
| | - Ettore Mearini
- University of PerugiaDepartment of Surgical and Biomedical SciencesSant’Andrea delle FrattePerugiaItaly06100
| | - Andrea Evangelista
- Città della Salute e della ScienzaUnit of Cancer EpidemiologyTorinoItaly
| | - Giovannino Ciccone
- Città della Salute e della ScienzaUnit of Cancer EpidemiologyTorinoItaly
| | - H. Jaap Bonjer
- Erasmus Medical CenterDepartment of SurgeryPO Box 2040RotterdamNetherlands3000 CA
| | - Mario Morino
- University of TurinDigestive and Colorectal Surgery, Centre for Minimally Invasive SurgeryCorso Achille Mario Dogliotti 14TurinItaly10126
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Cirocchi R, Henry BM, Mercurio I, Tomaszewski KA, Palumbo P, Stabile A, Lancia M, Randolph J. Is it possible to identify the inguinal nerves during hernioplasty? A systematic review of the literature and meta-analysis of cadaveric and surgical studies. Hernia 2018; 23:569-581. [PMID: 30570686 PMCID: PMC6586705 DOI: 10.1007/s10029-018-1857-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 11/08/2018] [Indexed: 11/27/2022]
Abstract
Purpose Patients who undergo inguinal hernioplasty may suffer from persistent postoperative pain due to inguinal nerve injuries. The aim of this systematic review and meta-analysis was to provide comprehensive data on the prevalence (identification rates), anatomical characteristics, and ethnic variations of the ilioinguinal (IIN), the iliohypogastric (IHN) and the genital branch of the genitofemoral (GNF) nerves. Methods The systematic literature search was conducted using the PubMed, Scopus and Web of Science databases. Results A total of 26 articles (5265 half-body examinations) were included in this study. The identification rate of the IIN was 94.4% (95% CI 89.5–97.9) using a random-effects model. Unweighted multiple regression analysis showed that study sample size (β = − 0.74, p = .036) was the only statistically significant predictor of lower prevalence. The identification rates of the IHN and GNF was 86.7% (95% CI 78.3%–93.3%) and 69.1% (95% CI 53.1%–83.0%) using a random-effects model, respectively. For those outcomes, a visual analysis of funnel and Doi plots indicated irregularity and provided evidence that larger studies tended to have lower identification rates. In terms of the synthesis of anatomical reference points, there was a large and statistically significant amount of heterogeneity for most outcomes. Conclusions The identification rates of the inguinal nerves in our study were lower than reported in literature. The lowest was found for GNF, suggesting that this nerve was the most difficult to identify. Knowledge regarding the anatomy of the inguinal nerves can facilitate their proper identification and reduce the risk of iatrogenic injury and postoperative pain.
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Affiliation(s)
- R Cirocchi
- Department of Surgical and Biomedical Sciences, University of Perugia, Perugia, Italy
| | - B M Henry
- Department of Anatomy, Jagiellonian University Medical College, 12 Kopernika Street, 31-034, Kraków, Poland.
| | - I Mercurio
- Department of Surgical and Biomedical Sciences, University of Perugia, Perugia, Italy
| | - K A Tomaszewski
- Department of Anatomy, Jagiellonian University Medical College, 12 Kopernika Street, 31-034, Kraków, Poland
| | - P Palumbo
- Department of Surgical Sciences, The University of Rome "La Sapienza", Rome, Italy
| | - A Stabile
- Department of Surgical and Biomedical Sciences, University of Perugia, Perugia, Italy
| | - M Lancia
- Department of Surgical and Biomedical Sciences, University of Perugia, Perugia, Italy
| | - J Randolph
- Tift College of Education, Mercer University, Atlanta, GA, USA
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Vettoretto N, Reggiani L, Cirocchi R, Henry BM, Covarelli P, D'Andrea V, Popivanov G, Randolph J. Three-dimensional versus two-dimensional laparoscopic right colectomy: a systematic review and meta-analysis. Int J Colorectal Dis 2018; 33:1799-1801. [PMID: 29998352 DOI: 10.1007/s00384-018-3121-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/05/2018] [Indexed: 02/04/2023]
Abstract
BACKGROUND Three-dimensional (3D) vision technology has recently been validated for the improvement of surgical skills in a simulated setting. Clinical studies on specific operations have been published in the field of general, urologic, and gynecologic laparoscopic surgery. We hypothesized that 3D vision laparoscopic right colectomy has better intra and short-term postoperative outcomes than two-dimensional (2D) vision. AIM The outcomes of this review and meta-analysis were to compare the 3D vision and the 2D vision laparoscopic right colectomy. METHODS A systematic search of the literature was performed on Pubmed, WOS, Google Scholar, and Scopus databases (Prospero reg. nr. 42016047704) for comparative studies between 2D and 3D laparoscopic right colectomy. Primary endpoints were safety issues and secondarily patients' related and surgeons' comfort outcomes. Meta-analyses, when possible, were conducted with a random-effects model. RESULTS Two retrospective comparative studies (for a total of 56 patients in the 2D arm and 52 patients for the 3D arm) were selected out of 680 screened records. Methodological quality was fair. Three-dimensional laparoscopic right colectomy has similar safety and secondary outcomes when compared to 2D, with not statistically significant shorter operating times (mean difference 11.81 min). The results are comparable also for anastomosis leakage. The results for other outcomes were not aggregated for heterogeneity. CONCLUSIONS 3D laparoscopic right colectomy shows equivalent patients' outcomes compared to 2D operation, but the scarce clinical data and the potential amelioration of surgeons' skills, especially on difficult intracorporeal tasks like suturing, suggest the publication of further trials.
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Affiliation(s)
- Nereo Vettoretto
- Department of Surgery, Montichiari Hospital, Spedali Civili Brescia, Via G. Ciotti 154, 25018, Montichiari, Italy
| | - Luisa Reggiani
- Department of Surgery, Montichiari Hospital, Spedali Civili Brescia, Via G. Ciotti 154, 25018, Montichiari, Italy
| | - Roberto Cirocchi
- Department of General Surgical Science, University of Perugia, Piazza dell'Università 1, 06100, Perugia, Italy.
- General and Emergency Surgery, University of Perugia, 05100, Terni, Italy.
| | | | - Piero Covarelli
- Department of General Surgical Science, University of Perugia, Piazza dell'Università 1, 06100, Perugia, Italy
| | - Vito D'Andrea
- "Advanced Surgical Technologies," Department of Surgical Sciences, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - Georgi Popivanov
- Clinic of Endoscopic, Endocrine Surgery and Coloproctology, Military Medical Academy, G. Sofiiski Str. 3, 1606, Sofia, Bulgaria
| | - Justus Randolph
- Tift College of Education, Mercer University, 3001 Mercer University Dr. Atlanta, Atlanta, GA, 30341, USA
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Cirocchi R, Henry BM, Rambotti M, Tomaszewski KA, Cappelli M, Vettorello G, Pistilli A, D'Andrea V, Amato B, Randolph J. Systematic review and meta-analysis of the anatomic variants of the saphenofemoral junction. J Vasc Surg Venous Lymphat Disord 2018; 7:128-138.e7. [PMID: 30448153 DOI: 10.1016/j.jvsv.2018.06.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 06/07/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND The aim of this systematic review was to provide comprehensive data on the prevalence of variations of the saphenofemoral junction (SFJ) to prevent misidentification of the SFJ or the incomplete ligation of the tributaries of the great saphenous vein. METHODS A systematic review was conducted using the PubMed, Embase, and Cochrane Library databases through September 14, 2017. To be included in the meta-analysis, a study had to report prevalence data on the morphology of the SFJ or the presence of venous tributaries. RESULTS A total of 16 studies (7433 legs) were included. The majority of studies were performed during varicose vein surgery (74.14%), with fewer studies by means of computed tomography venography and cadaveric dissection. The pooled prevalence estimate (PPE) for a duplication of the SFJ with a bifid junction was 9.6% (P = .001). The PPE for a duplication of the SFJ with two separate junctions was 1.7%. The PPE for ectasia of the SFJ was 2.3% in type 1, 1.2% in type 2, and 1.7% in type 3. The distribution of the PPE for the number of venous SFJ tributaries was approximately normal with a slight right skew; a higher rate was observed in the group with four venous tributaries to the SFJ. CONCLUSIONS This analysis found high heterogeneity in the prevalence of SFJ anatomic variants and the number of venous SFJ tributaries. For this reason, it is highly recommended that a preoperative Doppler ultrasound assessment of the SFJ and great saphenous vein be performed.
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Affiliation(s)
- Roberto Cirocchi
- Department of Surgery and Biomedical Sciences, University of Perugia, Perugia, Italy
| | | | - Massimo Rambotti
- Unit of Surgery, Casa di Cura "Villa Pini", Civitanova Marche, Italy
| | | | | | | | - Alessandra Pistilli
- Department of Surgery and Biomedical Sciences, University of Perugia, Perugia, Italy
| | - Vito D'Andrea
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
| | - Bruno Amato
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
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Cirocchi R, Randolph J, Montedori A, Cochetti G, Arezzo A, Mearini E, Abraha I, Trastulli S. Staples versus sutures for surgical wound closure in adults. Cochrane Database of Systematic Reviews 2018. [DOI: 10.1002/14651858.cd011250.pub2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Roberto Cirocchi
- University of Perugia; Department of General Surgery; Terni Italy 05100
| | - Justus Randolph
- Mercer University; Georgia Baptist College of Nursing; 3001 Mercer University Dr. Atlanta GA USA 30341
| | - Alessandro Montedori
- Regional Health Authority of Umbria; Health Planning Service; Via Mario Angeloni 61 Perugia Umbria Italy 06124
| | - Giovanni Cochetti
- University of Perugia; Department of Surgical and Biomedical Sciences; Sant’Andrea delle Fratte Perugia Italy 06100
| | - Alberto Arezzo
- University of Torino; Department of Surgical Sciences; Corso Achille Mario Dogliotti 14 Turin Italy 10126
| | - Ettore Mearini
- University of Perugia; Department of Surgical and Biomedical Sciences; Sant’Andrea delle Fratte Perugia Italy 06100
| | - Iosief Abraha
- Regional Health Authority of Umbria; Health Planning Service; Via Mario Angeloni 61 Perugia Umbria Italy 06124
| | - Stefano Trastulli
- University of Perugia; Department of General Surgery; Terni Italy 05100
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Cirocchi R, Georgi P, Mutafchiyski VM, Boccolini A, Randolph J, Massimo L, Carlini L. Negative pressure wound therapy versus healing by secondary intention in pressure ulcers. NPWTJ 2017. [DOI: 10.18487/npwtj.v4i2.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Pressure ulcers are a highly prevalent source of morbidity with an equally high incidence of up to 38.0\% amongst different categories of healthcare institutions. Therefore, the management and therapeutic approach toward these often hospital- or facility-acquired problems remain critical aspects of long-term care. Negative pressure wound therapy (NPWT) has proven effective in addressing the barriers to pressure ulcer healing including increasing blood flow to previously ischemic wound areas by generating subatmospheric pressure which vacuums in circulation. The objective of this study was to compare negative pressure wound therapy (NPWT) versus surgical wounds healing by secondary intention (SWHSI). A systematic literature search was conducted using the PubMed and Scopus search engine up until the 20 Th January 2017 including the terms: “negative pressure wound therapy” and “pressure ulcers”. In this systematic review, six randomized controlled trials were included. NPWT is deemed appropriate and effective method and widely used by clinicians to promote the healing of wounds and ulcers of different etiology. The heterogeneity found in individual trials regarding the inclusion criteria, therapeutic procedures, the criteria and methods of outcome evaluation, however, did not allow for a data evaluation with statistically valid conclusions. It is reasonable to assume that their subset of patients with pressure ulcers that can be effectively treated with NPWT, with optimal results and good cost-benefit ratio, also with respect to the quality of life.
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Tabola R, Cirocchi R, Fingerhut A, Arezzo A, Randolph J, Grassi V, Binda GA, D'Andrea V, Abraha I, Popivanov G, Di Saverio S, Zbar A. A systematic analysis of controlled clinical trials using the NiTi CAR™ compression ring in colorectal anastomoses. Tech Coloproctol 2017; 21:177-184. [PMID: 28132113 DOI: 10.1007/s10151-017-1583-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 01/09/2017] [Indexed: 02/08/2023]
Abstract
Anastomotic leak following colorectal surgery can be a devastating adverse event. The ideal stapling device should be capable of rapid creation of an anastomosis with serosal apposition without the persistence of a foreign body or a foreign body reaction which potentially contribute to early anastomotic dehiscence or late anastomotic stricture. A systematic review was performed examining available data on controlled randomized and non-randomized trials assessing the NiTi compression anastomosis ring-(NiTi CAR™) (NiTi Solutions, Netanyah Israel) in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) standards. A protocol for this meta-analysis has been registered on PROSPERO (CRD42016050934). The initial search yielded 45 potentially relevant articles. After screening titles and abstracts for relevance and assessment for eligibility, 39 of these articles were eventually excluded leaving 6 studies for analysis in the review. Regarding the primary outcome measure, the overall anastomotic leak rate was 2.2% (5/230) in the compression anastomosis group compared with 3% (10/335) in the conventional anastomosis group; this difference was not statistically significant (RR 0.75, 95% CI 0.25-2.24; participants = 565; studies = 6; I 2 = 0%). There were no statistically significant differences between compression and conventional anastomoses in any of the secondary outcomes. This review was unable to demonstrate any statistically significant differences in favor of the compression anastomosis technique over conventional manual or stapled mechanical anastomoses.
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Affiliation(s)
- R Tabola
- Department of General and Gastrointestinal Surgery, Medical University of Wrocław, Wrocław, Poland
| | - R Cirocchi
- Department of General and Oncologic Surgery, University of Perugia, Perugia, Italy.
| | - A Fingerhut
- Section for Surgical Research, Department of Surgery, Medical University of Graz, Graz, Austria
| | - A Arezzo
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - J Randolph
- Tift College of Education, Mercer University, Atlanta, GA, USA
| | - V Grassi
- Department of General and Oncologic Surgery, University of Perugia, Perugia, Italy
| | - G A Binda
- Colorectal Surgery Unit, Galliera Hospital, Genoa, Italy
| | - V D'Andrea
- Department of Surgical Sciences, "Sapienza" University of Rome, Rome, Italy
| | - I Abraha
- Department of Geriatrics and Geriatric Emergency Care, Italian National Research Center on Aging (IRCCS-INRCA), Ancona, Italy
| | - G Popivanov
- Department of Abdominal Surgery, Military Medical Academy, Sofia, Bulgaria
| | - S Di Saverio
- General (Colorectal), Emergency and Trauma Surgery Service, Maggiore Hospital Regional Emergency Surgery and Trauma Center, Bologna Local Health Services, Bologna, Italy
| | - A Zbar
- Department of Surgery and Transplantation, Chaim Sheba Medical Center, Ramat Gan, Israel.,Department of Anatomy, University of Otago, Dunedin, New Zealand
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Tamburrino D, Partelli S, Renzi C, Crippa S, Muffatti F, Perali C, Parisi A, Randolph J, Fusai GK, Cirocchi R, Falconi M. Systematic review and meta-analysis on laparoscopic pancreatic resections for neuroendocrine neoplasms (PNENs). Expert Rev Gastroenterol Hepatol 2017; 11:65-73. [PMID: 27781493 DOI: 10.1080/17474124.2017.1253473] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The safety of laparoscopic resections (LPS) of pancreatic neuroendocrine neoplasms (PNENs) has been well established in the literature. Areas covered: Studies conducted between January 2003 and December 2015 that reported on LPS and open surgery (OPS) were reviewed. The primary outcomes were the rate of post-operative complications and the length of hospital stay (LoS) after laparoscopic and open surgical resection. The rate of recurrence was the secondary outcome. Eleven studies were included with a total of 907 pancreatic resections for PNENs, of whom, 298 (32.8%) underwent LPS and 609 (67.2%) underwent open surgery. LPS resulted in a significantly shorter LoS (p < 0.0001) and lower blood loss (p < 0.0001). The meta-analysis did not show any significant difference in the pancreatic fistula rate, recurrence rate or post-operative mortality between the two groups. Expert commentary: LPS is a safe approach even for PNENs and it is associated with a shorter LoS.
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Affiliation(s)
- Domenico Tamburrino
- a HPB and Liver Transplant Surgery , Royal Free Hospital, NHS Foundation Trust , London , UK
| | - Stefano Partelli
- b Pancreatic surgery Unit, Pancreas Translational & Clinical Research Center - IRCCS San Raffaele Scientific Institute , 'Vita e Salute' University , Milan , Italy
| | - Claudio Renzi
- c Department of General and Oncologic Surgery , University of Perugia, St. Mary's Hospital , Terni , Italy
| | - Stefano Crippa
- b Pancreatic surgery Unit, Pancreas Translational & Clinical Research Center - IRCCS San Raffaele Scientific Institute , 'Vita e Salute' University , Milan , Italy
| | - Francesca Muffatti
- b Pancreatic surgery Unit, Pancreas Translational & Clinical Research Center - IRCCS San Raffaele Scientific Institute , 'Vita e Salute' University , Milan , Italy
| | - Carolina Perali
- b Pancreatic surgery Unit, Pancreas Translational & Clinical Research Center - IRCCS San Raffaele Scientific Institute , 'Vita e Salute' University , Milan , Italy
| | - Amilcare Parisi
- d Department of Digestive Surgery , University of Perugia, St. Mary's Hospital , Terni , Italy
| | - Justus Randolph
- e Tift College of Education , Mercer University , Atlanta , GA , USA
| | - Giuseppe Kito Fusai
- a HPB and Liver Transplant Surgery , Royal Free Hospital, NHS Foundation Trust , London , UK
| | - Roberto Cirocchi
- c Department of General and Oncologic Surgery , University of Perugia, St. Mary's Hospital , Terni , Italy
| | - Massimo Falconi
- b Pancreatic surgery Unit, Pancreas Translational & Clinical Research Center - IRCCS San Raffaele Scientific Institute , 'Vita e Salute' University , Milan , Italy
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Cirocchi R, Trastulli S, Randolph J, Guarino S, Di Rocco G, Arezzo A, D'Andrea V, Santoro A, Barczyñski M, Avenia N. Total or near-total thyroidectomy versus subtotal thyroidectomy for multinodular non-toxic goitre in adults. Cochrane Database Syst Rev 2015; 2015:CD010370. [PMID: 26252202 PMCID: PMC9587693 DOI: 10.1002/14651858.cd010370.pub2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND Total thyroidectomy (TT) and subtotal thyroidectomy (ST) are worldwide treatment options for multinodular non-toxic goitre in adults. Near TT, defined as a postoperative thyroid remnant less than 1 mL, is supposed to be a similarly effective but safer option than TT. ST has been shown to be marginally safer than TT, but it may leave an undetected thyroid cancer in place. OBJECTIVES The objective was to assess the effects of total or near-total thyroidectomy compared to subtotal thyroidectomy for multinodular non-toxic goitre. SEARCH METHODS We searched the Cochrane Library, MEDLINE, PubMed, EMBASE, as well as the ICTRP Search Portal and ClinicalTrials.gov. The date of the last search was 18 June 2015 for all databases. No language restrictions were applied. SELECTION CRITERIA Two review authors independently scanned the abstract, title or both sections of every record retrieved to identify randomised controlled trials (RCTs) on thyroidectomy for multinodular non-toxic goitre for further assessment. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data, assessed studies for risk of bias and evaluated overall study quality utilising the GRADE instrument. We calculated the odds ratio (OR) and corresponding 95% confidence interval (CI) for dichotomous outcomes. A random-effects model was used for pooling data. MAIN RESULTS We examined 1430 records, scrutinized 14 full-text publications and included four RCTs. Altogether 1305 participants entered the four trials, 543 participants were randomised to TT and 762 participants to ST. A total of 98% and 97% of participants finished the trials in the TT and ST groups, respectively. Two trials had a duration of follow-up between 12 and 39 months and two trials a follow-up of 5 and 10 years, respectively. Risk of bias across studies was mainly unknown for selection, performance and detection bias. Attrition bias was generally low and reporting bias high for some outcomes. In the short-term postoperative period no deaths were reported for both TT and ST groups. However, longer-term data on all-cause mortality were not reported (1284 participants; 4 trials; moderate quality evidence). Goiter recurrence was lower in the TT group compared to ST. Goiters recurred in 0.2% (1/425) of the TT group compared to 8.4% (53/632) of the ST group (OR 0.05 (95% CI 0.01 to 0.21); P < 0.0001; 1057 participants; 3 trials; moderate quality evidence). Re-intervention due to goitre recurrence was lower in the TT group compared to ST. Re-intervention was necessary in 0.5% (1/191) of TT patients compared to 0.8% (3/379)of ST patients (OR 0.66 (95% CI 0.07 to 6.38); P = 0.72; 570 participants; 1 trial; low quality evidence). The incidence of permanent recurrent laryngeal nerve palsy was lower for ST compared with TT. Permanent recurrent laryngeal nerve palsy occurred in 0.8% (6/741) of ST patients compared to 0.7% (4/543) of TT patients (OR 1.28, (95% CI 0.38 to 4.36); P = 0.69; 1275 participants; 4 trials; low quality evidence). The incidence of permanent hypoparathyroidism was lower for ST compared with TT. Permanent hypoparathyroidism occurred in 0.1% (1/741) of ST patients compared to 0.6% (3/543) of TT patients (OR 3.09 (95% CI 0.45 to 21.36); P = 0.25; 1275 participants: 4 trials; low quality evidence). The incidence of thyroid cancer was lower for ST compared with TT. Thyroid cancer occurred in 6.1% (41/669) of ST patients compared to 7.3% (34/465)of TT patients (OR 1.32 (95% CI 0.81 to 2.15); P = 0.27; 1134 participants; 3 trials; low quality evidence). No data on health-related quality of life or socioeconomic effects were reported in the included studies. AUTHORS' CONCLUSIONS The body of evidence on TT compared with ST is limited. Goiter recurrence is reduced following TT. The effects on other key outcomes such as re-interventions due to goitre recurrence, adverse events and thyroid cancer incidence are uncertain. New long-term RCTs with additional data such as surgeons level of experience, treatment volume of surgical centres and details on techniques used are needed.
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Affiliation(s)
- Roberto Cirocchi
- University of PerugiaDepartment of General SurgeryTerniItaly05100
| | | | - Justus Randolph
- Mercer UniversityTift College of Education3001 Mercer University Dr.AtlantaGAUSA30341
| | - Salvatore Guarino
- Sapienza University of RomeDepartment of Surgical SciencesViale Regina Elena 324RomeItaly00161
| | - Giorgio Di Rocco
- Sapienza University of RomeDepartment of Surgical SciencesViale Regina Elena 324RomeItaly00161
| | - Alberto Arezzo
- University of TorinoDepartment of Surgical SciencesCorso Achille Mario Dogliotti 14TurinItaly10126
| | - Vito D'Andrea
- Sapienza University of RomeDepartment of Surgical SciencesViale Regina Elena 324RomeItaly00161
| | - Alberto Santoro
- Sapienza University of RomeDepartment of Surgical SciencesViale Regina Elena 324RomeItaly00161
| | - Marcin Barczyñski
- Jagiellonian University, Medical CollegeDepartment of Endocrine Surgery, Third Chair of General Surgery37 Pradnicka StreetKrakowPoland31‐202
| | - Nicola Avenia
- University of PerugiaDepartment of Endocrine SurgeryTerniTerniItaly
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Vettoretto N, Cirocchi R, Randolph J, Morino M. Acute appendicitis can be treated with single-incision laparoscopy: a systematic review of randomized controlled trials. Colorectal Dis 2015; 17:281-9. [PMID: 25406831 DOI: 10.1111/codi.12839] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Accepted: 08/13/2014] [Indexed: 02/08/2023]
Abstract
AIM Single-incision laparoscopic surgery (SILS) has been proposed as the next step in minimally invasive surgery for appendicectomy. Previous reviews have summarized the results of low-evidence comparative studies, suggesting that the two approaches are comparable in terms of outcomes but showing the need for randomized controlled trials (RCTs). This review offers a meta-analyses of RCTs on this topic to evaluate the safety and efficacy of single-incision laparoscopic appendectomy (SILA). METHOD A comprehensive research of electronic databases was performed. Primary outcomes (overall and access-specific morbidity) were designated as safety issues. Secondary outcomes were pain, cosmesis, operative time, conversion rate and length of hospital stay. RESULTS After exclusions, five RCTs satisfied the inclusion criteria. They included a total of 761 patients [379 SILA and 382 conventional three-port laparoscopic appendectomies (CLA)]. No significant differences were found in overall morbidity, early wound morbidity or length of stay between SILA and CLA. Cosmesis and pain were not comparable due to different scales and time records. Conclusions on the incisional hernia rate were not reliable due to short follow-up periods. CONCLUSION SILA can be considered an acceptable alternative to CLA in the treatment of acute appendicitis, but an economic evaluation of the various techniques for single access must be performed before its widespread clinical introduction. Better-designed RCTs are necessary to define a population in which SILA could have major benefits.
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Affiliation(s)
- N Vettoretto
- Laparoscopic Surgical Unit, M. Mellini Hospital, Chiari (BS), Italy
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Lanham M, Kim C, Karvonen-Gutierrez C, Harlow S, Randolph J, McConnell D. Predictors of a subsequent detectable antimüllerian hormone (AMH) level after an undetectable AMH level in population-based cohort. Fertil Steril 2014. [DOI: 10.1016/j.fertnstert.2014.07.854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Randolph J, Arnett P, Strober L, Ukueberuwa D, Vargas G, Rabinowitz A, Wishart H. B-07 * The Cognitive Health Questionnaire: Initial Psychometric Data in a Multisite Multiple Sclerosis Sample. Arch Clin Neuropsychol 2014. [DOI: 10.1093/arclin/acu038.95] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Cirocchi R, Cochetti G, Randolph J, Listorti C, Castellani E, Renzi C, Mearini E, Fingerhut A. Laparoscopic treatment of colovesical fistulas due to complicated colonic diverticular disease: a systematic review. Tech Coloproctol 2014; 18:873-85. [PMID: 24848529 DOI: 10.1007/s10151-014-1157-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 04/13/2014] [Indexed: 12/19/2022]
Abstract
Colovesical fistulas originating from complicated sigmoid diverticular disease are rare. The primary aim of this review was to evaluate the role of laparoscopic surgery in the treatment of this complication. The secondary aim was to determine the best surgical treatment for this disease. A systematic search was conducted for studies published between 1992 and 2012 in PubMed, the Cochrane Register of Controlled Clinical Trials, Scopus, and Publish or Perish. Studies enrolling adults undergoing fully laparoscopic, laparoscopic-assisted, or hand-assisted laparoscopic surgery for colovesical fistula secondary to complicated sigmoid diverticular disease were considered. Data extracted concerned the surgical technique, intraoperative outcomes, and postoperative outcomes based on the Cochrane Consumers and Communication Review Group's template. Descriptive statistics were reported according to the PRISMA statement. In all, 202 patients from 25 studies were included in this review. The standard treatment was laparoscopic colonic resection and primary anastomosis or temporary colostomy with or without resection of the bladder wall. Operative time ranged from 150 to 321 min. It was not possible to evaluate the conversion rate to open surgery because colovesical fistulas were not distinguished from other types of enteric fistulas in most of the studies. One anastomotic leak after bowel anastomosis was reported. There was zero mortality. Few studies conducted follow-up longer than 12 months. One patient required two reoperations. Laparoscopic treatment of colovesical fistulas secondary to sigmoid diverticular disease appears to be a feasible and safe approach. However, further studies are needed to establish whether laparoscopy is preferable to other surgical approaches.
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Affiliation(s)
- R Cirocchi
- Department of General and Oncologic Surgery, St. Maria Hospital, University of Perugia, Località Sant'Andrea delle Fratte, Via Gambuli n.1, 06156, Perugia, Italy
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Vettoretto N, Cirocchi R, Randolph J, Parisi A, Farinella E, Romano G. Single incision laparoscopic right colectomy: a systematic review and meta-analysis. Colorectal Dis 2014; 16:O123-32. [PMID: 24354622 DOI: 10.1111/codi.12526] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Accepted: 09/20/2013] [Indexed: 12/13/2022]
Abstract
AIM A meta-analysis was performed to compare the outcome of single incision laparoscopic right hemicolectomy with standard multiport laparoscopic right hemicolectomy. METHOD A systematic search of databases was carried out to extract comparative studies (randomized and non-randomized, prospective and retrospective). Data were analysed according to Cochrane Collaboration guidelines. A meta-analysis was performed when the data permitted this form of analysis. RESULTS Nine comparative studies were retrieved comprising 241 patients with single incision and standard laparoscopy. None of these was randomized. There was no significant difference between the two methods for the primary end-points of mortality, morbidity and cancer-specific parameters and for the secondary end-points of operation time, blood loss, ileus, hospital stay and conversion. It was not possible to analyse pain and cosmetics data owing to insufficient information. CONCLUSION Single incision laparoscopic right hemicolectomy is comparable with standard multiport laparoscopic right hemicolectomy in primary and secondary outcomes. Given current information it is justified to use single incision laparoscopic right hemicolectomy, but there is a need for a prospective randomized study.
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Affiliation(s)
- N Vettoretto
- Laparoscopic Surgical Unit, M. Mellini Hospital, Chiari, Italy
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Su EP, Perna M, Boettner F, Mayman DJ, Gerlinger T, Barsoum W, Randolph J, Lee G. A prospective, multi-center, randomised trial to evaluate the efficacy of a cryopneumatic device on total knee arthroplasty recovery. ACTA ACUST UNITED AC 2013; 94:153-6. [PMID: 23118406 DOI: 10.1302/0301-620x.94b11.30832] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Pain, swelling and inflammation are expected during the recovery from total knee arthroplasty (TKA) surgery. The severity of these factors and how a patient copes with them may determine the ultimate outcome of a TKA. Cryotherapy and compression are frequently used modalities to mitigate these commonly experienced sequelae. However, their effect on range of motion, functional testing, and narcotic consumption has not been well-studied. A prospective, multi-center, randomised trial was conducted to evaluate the effect of a cryopneumatic device on post-operative TKA recovery. Patients were randomised to treatment with a cryopneumatic device or ice with static compression. A total of 280 patients were enrolled at 11 international sites. Both treatments were initiated within three hours post-operation and used at least four times per day for two weeks. The cryopneumatic device was titrated for cooling and pressure by the patient to their comfort level. Patients were evaluated by physical therapists blinded to the treatment arm. Range of motion (ROM), knee girth, six minute walk test (6MWT) and timed up and go test (TUG) were measured pre-operatively, two- and six-weeks post-operatively. A visual analog pain score and narcotic consumption was also measured post-operatively. At two weeks post-operatively, both the treatment and control groups had diminished ROM and function compared to pre-operatively. Both groups had increased knee girth compared to pre- operatively. There was no significant difference in ROM, 6MWT, TUG, or knee girth between the 2 groups. We did find a significantly lower amount of narcotic consumption (509 mg morphine equivalents) in the treatment group compared with the control group (680 mg morphine equivalents) at up to two weeks postop, when the cryopneumatic device was being used (p < 0.05). Between two and six weeks, there was no difference in the total amount of narcotics consumed between the two groups. At six weeks, there was a trend toward a greater distance walked in the 6MWT in the treatment group (29.4 meters versus 7.9 meters, p = 0.13). There was a significant difference in the satisfaction scores of patients with their cooling regimen, with greater satisfaction in the treatment group (p < 0.0001). There was no difference in ROM, TUG, VAS, or knee girth at six weeks. There was no difference in adverse events or compliance between the two groups. A cryopneumatic device used after TKA appeared to decrease the need for narcotic medication from hospital discharge to 2 weeks post-operatively. There was also a trend toward a greater distance walked in the 6MWT. Patient satisfaction with the cryopneumatic cooling regimen was significantly higher than with the control treatment.
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Affiliation(s)
- E P Su
- Hospital for Special Surgery, 535 East 70th Street, New York, New York 10021, USA.
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Escabi Y, San Miguel L, Judd T, Hertza J, Nicholson J, Schiff W, Bell C, Estes B, Millikin C, Shelton P, Marotta P, Wingler I, Barth J, Parmenter B, Andrews G, Riordan P, Lipinski D, Sawyer J, Brewer V, Kirk J, Green C, Kirkwood M, Brooks B, Fay T, Barlow K, Chelune G, Duff K, Wang A, Franchow E, Card S, Zamrini E, Foster N, Duff K, Chelune G, Wang A, Card S, Franchow E, Zamrini E, Foster N, Green D, Polikar R, Clark C, Kounios J, Malek-Ahmadi M, Kataria R, Belden C, Connor D, Pearson C, Jacobson S, Yaari R, Singh U, Sabbagh M, Manning K, Arnold S, Moelter S, Davatzikos C, Clark C, Moberg P, Singer R, Seelye A, Smith A, Schmitter-Edgecombe M, Viamonte S, Murman D, West S, Fonseca F, McCue R, Golden C, Cox D, Crowell T, Fazeli P, Vance D, Ross L, Ackerman M, Hill B, Tremont G, Davis J, Westervelt H, Alosco M, O'Connor K, Ahearn D, Pella R, Jain G, Noggle C, Sohi J, Jeetwani A, Thompson J, Barisa M, Sohi J, Noggle C, Jeetwani A, Jain S, Thompson J, Barisa M, Vanderslice-Barr J, Gillen R, Zimmerman E, Holdnack J, Creamer S, Rice J, Fitzgerald K, Elbin R, Patwardhan S, Covassin T, Kiewel N, Kontos A, Meyers C, Hakun J, Ravizza S, Berger K, Paltin I, Hertza J, Phillips F, Estes B, Schiff W, Bell C, Anderson J, Horton A, Reynolds C, Huckans M, Vandenbark A, Dougherty M, Loftis J, Langill M, Roberts R, Iverson G, Appel-Cresswell S, Stoessl A, Lazarus J, Olcese R, Juncos J, McCaskell D, Walsh K, Allen E, Shubeck L, Hamilton D, Novack G, Sherman S, Livingson R, Schmitt A, Stewart R, Doyle K, Smernoff E, West S, Galusha J, Hua S, Mattingly M, Rinehardt E, Benbadis S, Borzog A, Rogers-Neame N, Vale F, Frontera A, Schoenberg M, Rosenbaum K, Norman M, Woods S, Houshyarnejad A, Filoteo W, Corey-Bloom J, Pachet A, Larco C, Raymond M, Rinehardt E, Mattingly M, Golden C, Benbadis S, Borzog A, Rogers-Neame N, Vale F, Frontera A, Schoenberg M, Schmitt A, Stewart R, Livingston R, Doyle K, Copenheaver D, Smernoff E, Werry A, Claunch J, Galusha J, Uysal S, Mazzeffi M, Lin H, Reich D, August-Fedio A, Sexton J, Zand D, Keller J, Thomas T, Fedio P, Austin A, Millikin C, Baade L, Shelton P, Yamout K, Marotta J, Boatwright B, Kardel P, Heinrichs R, Blake T, Silverberg N, Anton H, Bradley E, Lockwood C, Hull A, Poole J, Demadura T, Storzbach D, Acosta M, Tun S, Hull A, Greenberg L, Lockwood C, Hutson L, Belsher B, Sullivan C, Poole J, La Point S, Harrison A, Packer R, Suhr J, Heilbronner R, Lange R, Iverson G, Brubacher J, Lange R, Waljas M, Iverson G, Hakulinen U, Dastidar P, Trammell B, Hartikainen K, Soimakallio S, Ohman J, Lee-Wilk T, Ryan P, Kurtz S, Dux M, Dischinger P, Auman K, Murdock K, Mazur-Mosiewicz A, Kane R, Lockwood C, Hull A, Poole J, MacGregor A, Watt D, Puente A, Marceaux J, Dilks L, Carroll A, Dean R, Ashworth B, Dilks S, Thrasher A, Carbonaro S, Blancett S, Ringdahl E, Finton M, Thaler N, Drane D, Umuhoza D, Barber B, Schoenberg M, Umuhoza D, Allen D, Roebuck-Spencer T, Vincent A, Schlegel R, Gilliland K, Lazarus T, Brown F, Katz L, Mucci G, Franchow E, Suchy Y, Kraybill M, Eastvold A, Funes C, Stern S, Morris M, Graham L, Parikh M, Hynan L, Buchbinder D, Grosch M, Weiner M, Cullum M, Hart J, Lavach J, Holcomb M, Allen R, Holcomb M, Renee A, Holland A, Chang R, Erdodi L, Hellings J, Catoe A, Lajiness-O'Neill R, Whiteside D, Smith A, Brown J, Hardin J, Rutledge J, Carmona J, Wang R, Harrison D, Horton A, Reynolds C, Horton A, Reynolds C, Jurado M, Monroy M, Eddinger K, Serrano M, Rosselli M, Chakravarti P, Riccio C, Banville F, Schretlen D, Wahlberg A, Vannorsdall T, Yoon H, Sung K, Simek A, Gordon B, Vaughn C, Kibby M, Barwick F, Arnett P, Rabinowitz A, Vargas G, Barwick F, Arnett P, Rabinowitz A, Vargas G, Davis J, Ramos C, Hynd G, Sherer C, Stone M, Wall J, Davis J, Bagley A, McHugh T, Axelrod B, Hanks R, Denning J, Gervais R, Dougherty M, Sellbom M, Wygant D, Klonoff P, Lange R, Iverson G, Carone D, O'Connor Pennuto T, Kluck A, Ball J, Pella R, Rice J, Hietpas-Wilson T, McCoy K, VanBuren K, Hilsabeck R, Shahani L, Noggle C, Jain G, Sohi J, Thomspon J, Barisa M, Golden C, Vincent A, Roebuck-Spencer T, Cooper D, Bowles A, Gilliland K, Womble M, Rohling M, Gervais R, Greiffenstein M, Harrison A, Jones K, Suhr J, Armstrong C, Mazur-Mosiewicz A, Holcomb M, Trammell B, Dean R, Puente A, Whigham K, Rodriguez M, West S, Golden C, Kelley E, Poole J, Larco C, May N, Nemeth D, Olivier T, Whittington L, Hamilton J, Steger A, McDonald K, Jeffay E, Gammada E, Zakzanis K, Ramanathan D, Wardecker B, Slocomb J, Hillary F, Rohling M, Demakis G, Larrabee G, Binder L, Ploetz D, Schatz P, Smith A, Stolberg P, Thayer N, Mayfield J, Jones W, Allen D, Storzbach D, Demadura T, Tun S, Sutton G, Ringdahl E, Thaler N, Barney S, Mayfield J, Pinegar J, Allen D, Terranova J, Kazakov D, McMurray J, Mayfield J, Allen D, Villemure R, Nolin P, Le Sage N, Yeung E, Zakzanis K, Gammada E, Jeffay E, Yi A, Small S, Macciocchi S, Barlow K, Seel R, Rabinowitz A, Arnett P, Rabinowitz A, Barwick F, Arnett P, Bailey T, Brown M, Whiteside D, Waters D, Golden C, Grzybkowska A, Wyczesany M, Katz L, Brown F, Roth R, McNeil K, Vroman L, Semrud-Clikeman T, Terrie, Seydel K, Holster J, Corsun-Ascher C, Golden C, Holster J, Corsun-Ascher C, Golden C, Bolanos J, Bergman B, Rodriguez M, Patel F, Frisch D, Golden C, Brooks B, Holdnack J, Iverson G, Brown M, Lowry N, Whiteside D, Bailey T, Dougherty M, West S, Golden C, Estes B, Bell C, Hertza J, Dennison A, Jones K, Holster J, Caorsun-Ascher C, Armstrong C, Golden C, Mackelprang J, Karle J, Najmabadi S, Valley-Gray S, Cash R, Gonzalez E, Metoyer K, Holster J, Golden C, Natta L, Gomez R, Trettin L, Tennakoon L, Schatzberg A, Keller J, Davis J, Sherer C, Wall J, Ramos C, Patterson C, Shaneyfelt K, DenBoer J, Hall S, Gunner J, Miele A, Lynch J, McCaffrey R, Lo T, Cottingham M, Aretsen T, Boone K, Goldberg H, Miele A, Gunner J, Lynch J, McCaffrey R, Miele A, Benigno A, Gunner J, Leigh K, Lynch J, Drexler M, McCaffrey R, Weiss E, Ploetz D, Rohling M, Lankey M, Womble M, Yeung S, Silverberg N, Zakzanis K, Amirthavasagam S, Jeffay E, Gammada E, Yeung E, McDonald K, Constantinou M, DenBoer J, Hall S, Lee S, Klaver J, Kibby M, Stern S, Morris M, Morris R, Whittington L, Nemeth D, Olivier T, May N, Hamilton J, Steger A, Chan R, West S, Golden C, Landstrom M, Dodzik P, Boneff T, Williams T, Robbins J, Martin P, Prinzi L, Golden C, Barber B, Mucci G, Brzinski B, Frish D, Rosen S, Golden C, Hamilton J, Nemeth D, Martinez A, Kirk J, Exalona A, Wicker N, Green C, Broshek D, Kao G, Kirkwood M, Quigg M, Cohen M, Riccio C, Olson K, Rice J, Dougherty M, Golden C, Sharma V, Rodriguez M, Golden C, Paltin I, Walsh K, Rosenbaum K, Copenheaver D, Zand D, Kardel P, Acosta M, Packer R, Vasserman M, Fonseca F, Tourgeman I, Stack M, Demsky Y, Golden C, Horwitz J, McCaffey R, Ojeda C, Kadushin F, Wingler I, Lazarus G, Green J, Barth J, Puente A, Parikh M, Graham L, Hynan L, Grosch M, Weiner M, Cullum C, Tourgeman I, Bure-Reyes A, Stewart J, Stack M, Demsky Y, Golden C, Zhang J, Tourgeman I, Demsky Y, Stack M, Golden C, Bures-Reye A, Stewart J, Tourgeman I, Demsky Y, Stack M, Golden C, Finlay L, Goldberg H, Arentsen T, Lo T, Moriarti T, Mackelprang J, Karle J, Aragon P, Gonzalez E, Valley-Gray S, Cash R, Mackelprang J, Karle J, Hardie R, Cash R, Gonzalez E, Valley-Gray S, Mason J, Keller J, Gomez R, Trettin L, Schatzberg A, Moore R, Mausbach B, Viglione D, Patterson T, Morrow J, Barber B, Restrepo L, Mucci G, Golden C, Buchbinder D, Chang R, Wang R, Pearlson J, Scarisbrick D, Rodriguez M, Golden C, Restrepo L, Morrow J, Golden C, Switalska J, Torres I, DeFreitas C, DeFreitas V, Bond D, Yatham L, Zakzanis K, Gammada E, Jeffay E, Yeung E, Amirathavasagam S, McDonald K, Hertza J, Bell C, Estes B, Schiff W, Bayless J, McCormick L, Long J, Brumm M, Lewis J, Benigno A, Leigh K, Drexler M, Weiss E, Bharadia V, Walker L, Freedman M, Atkins H, Jackson A, Perna R, Cooper D, Lau D, Lyons H, Culotta V, Griffith K, Coiro M, Papadakis A, Weden S, Sestito N, Brennan L, Benjamin T, Ciaudelli B, Fanning M, Giovannetti T, Chute D, Vathhauer K, Steh B, Osuji J, Steh B, Katz D, Ackerman M, Vance D, Fazeli P, Ross L, Strang J, Strauss A, Bienia K, Hollingsworth D, Ensley M, Atkins J, Grigorovich A, Bell C, Fish J, Hertza J, Leach L, Schiff W, Gomez M, Estes B, Dennison A, Davis A, Roberds E, Lutz J, Byerley A, Mazur-Mosiewicz A, Davis M, Sutton S, Moses J, Doan B, Hanna M, Adam G, Wile A, Butler M, Self B, Heaton K, Brininger T, Edwards M, Johnson K, O'Bryan S, Williams J, Joes K, Frazier D, Moses J, Giesbrecht C, Nielson H, Barone C, Thornton A, Vila-Rodriguez F, Paquet F, Barr A, Vertinsky T, Lang D, Honer W, Hart J, Lavach J, Hietpas-Wilson T, Pella R, McCoy K, VanBuren K, Hilsabeck R, James S, Robillard R, Holder C, Long M, Sandhu K, Padua M, Moses J, Lutz J, Mazur-Mosiewicz A, Dean R, Olivier T, Nemeth D, Whittington L, May N, Hamilton J, Steger A, Roberg B, Hancock L, Jacobson J, Tyrer J, Lynch S, Bruce J, Sordahl J, Hertza J, Bell C, Estes B, Schiff W, Sousa J, Jerram M, Wiebe-Moore D, Susmaras T, Gansler D, Vertinski M, Smith L, Thaler N, Mayfield J, Allen D, Buscher L, Jared B, Hancock L, Roberg B, Tyrer J, Lynch S, Choi W, Lai S, Lau E, Li A, Covassin T, Elbin R, Kontos A, Larson E, Hubley A, Lazarus G, Puente A, Ojeda C, Mazur-Mosiewicz A, Trammell B, Dean R, Patwardhan S, Fitzgerald K, Meyers C, Wefel J, Poole J, Gray M, Utley J, Lew H, Riordan P, Sawyer J, Buscemi J, Lombardo T, Barney S, Allen D, Stolberg P, Mayfield J, Brown S, Tussey C, Barrow M, Marcopulos B, Kingma J, Heinly M, Fazio R, Griswold S, Denney R, Corney P, Crossley M, Edwards M, O'Bryant S, Hobson V, Hall J, Barber R, Zhang S, Johnson L, Diaz-Arrastia R, Hall J, Johnson L, Barber R, Cullum M, Lacritz L, O'Bryant S, Lena P, Robbins J, Martin P, Stewart J, Golden C, Martin P, Prinzi L, Robbins J, Golden C, Ruchinskas R, West S, Fonseca F, Rice J, McCue R, Golden C, Fischer A, Yeung S, Thornton W, Rossetti H, Bernardo K, Weiner M, Cullum C, Lacritz L, Yeung S, Fischer A, Thornton W, Zec R, Kohlrus S, Fritz S, Robbs R, Ala T, Cummings T, Webbe F, Srinivasan V, Gavett B, Kowall N, Qiu W, Jefferson A, Green R, Stern R, Hill B, Su T, Correia S, O'Bryant S, Gong G, Spallholz J, Boylan M, Edwards M, Hargrave K, Johnson L, Stewart J, Golden C, Broennimann A, Wisniewski A, Austin B, Bens M, Carroll C, Knee K, Mittenberg W, Zimmerman A, Mazur-Mosiewicz A, Roberds E, Dean R, Anderson C, Parmenter B, Blackwell E, Silverberg N, Douglas K, Gassermar M, Kranzler H, Chan G, Gelenter J, Arias A, Farrer L, Giummarra J, Bowden S, Cook M, Murphy M, Hancock L, Bruce J, Peterson S, Tyrer J, Murphy M, Jacobson J, Lynch S, Holder C, Mauseth T, Robillard R, Langill M, Roberts R, Iverson G, Appel-Cresswell S, Stoessl A, Macleod L, Bowden S, Partridge R, Webster B, Heinrichs R, Baade L, Sandhu K, Padua M, Long M, Moses J, Schmitt A, Werry A, Hu S, Stewart R, Livingston R, Deitrick S, Doyle K, Smernoff E, Schoenberg M, Rinehardt E, Mattingly M, Borzog A, Rodgers-Neame N, Vale F, Frontera A, Benbadis S, Ukueberuwa D, Arnett P, Vargas G, Riordan P, Arnett P, Lipinski D, Sawyer J, Brewer V, Viner K, Lee G, Walker L, Berrigan L, Ress L, Cheng A, Freedma M, Hellings J, Whiteside D, Brown J, Singer R, Woods S, Weber E, Cameron M, Dawson M, Grant I, Frisch D, Brzinski B, Golden C, Hutton J, Vidal O, Puente A, Klaver J, Lee S, Kibby M, Mireles G, Anderson B, Davis J, Rosen S, Scarisbrick D, Brzinski B, Golden C, Simek A, Vaughn C, Wahlberg A, Yoon H, Riccio C, Steger A, Nemeth D, Thorgusen S, Suchy Y, Rau H, Williams P, Wahlberg A, Yoon V, Simek A, Vaughn C, Riccio C, Whitman L, Bender H, Granader Y, Freshman A, MacAllister W, Freshman A, Bender H, Whitman L, Granader Y, MacAllister W, Yoon V, Simek A, Vaughn C, Wahlberg A, Riccio C, Noll K, Cullum C, O'Bryant S, Hall J, Simpson C, Padua M, Long M, Sandhu K, Moses J, Scarisbrick D, Holster J, Corsun-Ascher C, Golden C, Stang B, Trettin L, Rogers E, Saleh M, Che A, Tennakoon L, Keller J, Schatzberg A, Gomez R, Tayim F, Moses J, Morris R, Thaler N, Lechuga D, Cross C, Salinas C, Reynolds C, Mayfield J, Allen D, Webster B, Partridge R, Heinrichs R, Badde L, Weiss E, Antoniello D, McGinley J, Gomes W, Masur D, Brooks B, Holdnack J, Iverson G, Banville F, Nolin P, Henry M, Lalonde S, Dery M, Cloutier J, Green J, Sokol D, Lowery K, Hole M, Helmus A, Teat R, DelMastro C, Paquette B, Grosch M, Hynan L, Graham L, Parikh M, Weiner M, Cullum M, Hubley A, Lutz J, Dean R, Paterson T, O'Rourke N, Thornton W, Randolph J, Suffiield J, Crockett D, Spreen O, Trammell B, Mazur-Mosiewicz A, Holcomb M, Dean R, Busse M, Wald D, Whiteside D, Breisch A, Fieldstone S, Vannorsda T, Lassen-Greene C, Gordon B, Schretlen D, Launeanu M, Hubley A, Maruyama R, Cuesta G, Davis J, Takahashi T, Shinoda H, Gregg N, Davis J, Cheung S, Takahashi T, Shinoda H, Gregg N, Holcomb M, Mazur A, Trammell B, Dean R, Perna R, Jackson A, Villar R, Ager D, Ellicon B, Als L, Nadel S, Cooper M, Pierce C, Hau S, Vezir S, Picouto M, Sahakian B, Garralda E, Mucci G, Barber B, Semrud-Clikeman M, Goldenring J, Bledsoe J, Vroman L, Crow S, Zimmerman A, Mazur-Mosiewicz A, Roberds E, Dean R, Sokol D, Hole M, Teat R, Paquett B, Albano J, Broshek D, Elias J, Brennan L, Chakravarti P, Schultheis L, Kibby M, Weisser V, Hynd G, Ang J, Crockett D, Puente A, Weiss E, Longman R, Antoniello D, Axelrod B, McGinley J, Gomes W, Masur D, Davis A, Lutz J, Roberds E, Williams R, Gupta A, Estes B, Dennison A, Schiff W, Hertza J, Ferrari M. Grand Rounds. Arch Clin Neuropsychol 2010. [DOI: 10.1093/arclin/acq056] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Cederberg J, Frodermann E, Tollerud H, Huber K, Bongard M, Randolph J, Nitz D. Nuclear electric quadrupole moments of Rb from the hyperfine spectrum of RbF. J Chem Phys 2006; 124:244304. [PMID: 16821974 DOI: 10.1063/1.2212414] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The molecular beam electric resonance technique has been used to examine the hyperfine spectrum of RbF. The Rb nuclear electric quadrupole interaction, the spin-rotation interactions, and tensor and scalar spin-spin interactions have been measured for both Rb isotopes, including their dependence on vibrational and rotational states. Transition frequencies have been determined to a precision of better than 1 Hz in many cases. The magnetic interactions in the two isotopomers are consistent with what is expected from the known masses and magnetic dipole moments. In the case of the Rb nuclear electric quadrupole interaction, adjustments have been made for a small isotopomer shift, and for the ratio of the effective nuclear electric quadrupole moments, Q(87Rb)Q(85Rb) = 0.483 830 1+/-0.000 001 8. The effective quadrupole interaction includes a pseudoquadrupole interaction that may be significant at this level of precision, but cannot be distinguished experimentally.
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Affiliation(s)
- J Cederberg
- Department of Physics, St. Olaf College, Northfield, Minnesota 55057, USA.
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D Harlow S, Cain K, Crawford S, Dennerstein L, Little R, Mitchell ES, Nan B, Randolph J, Taffe J, Yosef M. The Restage Project: Evaluating Bleeding Criteria for Staging Reproductive Aging in Four Cohorts. Am J Epidemiol 2006. [DOI: 10.1093/aje/163.suppl_11.s153-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Cederberg J, Nichol J, Frodermann E, Tollerud H, Hilk G, Buysman J, Kleiber W, Bongard M, Ward J, Huber K, Khanna T, Randolph J, Nitz D. An anomaly in the isotopomer shift of the hyperfine spectrum of LiI. J Chem Phys 2005; 123:134321. [PMID: 16223302 DOI: 10.1063/1.2052588] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
A high-precision examination of the hyperfine spectrum of 6LiI in comparison with 7LiI shows a shift in the iodine nuclear electric quadrupole moment that cannot be accounted for by a model in which the electric field gradient at the iodine site is assumed to depend only upon the internuclear distance between Li and I. The other hyperfine interactions are consistent between the two isotopomers, including the previously reported electric hexadecapole interaction of the iodine nucleus.
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Affiliation(s)
- J Cederberg
- Department of Physics, St. Olaf College, Northfield, Minnesota 55057, USA.
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Kronen PWM, Moon-Massat PF, Ludders JW, Gleed RD, Kern TJ, Randolph J, Erb HN. Comparison of two insulin protocols for diabetic dogs undergoing cataract surgery. Vet Anaesth Analg 2001; 28:146-155. [DOI: 10.1046/j.1467-2987.2001.00053.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2000] [Accepted: 12/15/2000] [Indexed: 11/20/2022]
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Sowers MF, Beebe JL, McConnell D, Randolph J, Jannausch M. Testosterone concentrations in women aged 25-50 years: associations with lifestyle, body composition, and ovarian status. Am J Epidemiol 2001; 153:256-64. [PMID: 11157413 DOI: 10.1093/aje/153.3.256] [Citation(s) in RCA: 120] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
While there is substantial evidence of the importance of endogenous and exogenous estrogen in reproductive health and chronic disease, there is little consideration of androgens in women's health. In the Michigan Bone Health Study (1992-1995), the authors examined the correlates of testosterone concentrations in pre- and perimenopausal women (i.e., age, menopausal status, body composition, and lifestyle behaviors) in a population-based longitudinal study including three annual examinations among 611 women aged 25-50 years identified through a census in a midwestern community. Current smokers had the highest testosterone concentrations with decreasing values in former and nonsmokers (p = 0.0001). Body composition measures (body mass index, body fat (%), weight (kg), lean body mass (kg), and fat mass (kg)) were significantly and positively associated with total testosterone concentrations in a dose-response manner. Hysterectomy with oophorectomy was associated with significantly lower testosterone concentrations. Alcohol consumption, physical activity, and dietary macronutrient intake were not associated with testosterone concentrations. This is one of the first studies to examine correlates of serum testosterone concentrations in anticipation of the growing interest in the role of androgens in women's health. The greater circulating levels of testosterone in obese women and smokers suggest that testosterone concentrations should be considered in the natural history of disease conditions where obesity and smoking are risk factors, including cardiovascular disease.
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Affiliation(s)
- M F Sowers
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
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Hoff PM, Janjan N, Saad ED, Skibber J, Crane C, Lassere Y, Cleary KR, Benner S, Randolph J, Abbruzzese JL, Pazdur R. Phase I study of preoperative oral uracil and tegafur plus leucovorin and radiation therapy in rectal cancer. J Clin Oncol 2000; 18:3529-34. [PMID: 11032595 DOI: 10.1200/jco.2000.18.20.3529] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Preoperative combined-modality therapy for rectal cancer may allow for sphincter preservation, while decreasing recurrence rates and improving the overall prognosis. Oral chemotherapy with uracil and tegafur (UFT) plus leucovorin (LV) may reduce costs and complications associated with protracted infusions of fluorouracil. Our goal was to evaluate the safety of UFT plus LV combined with preoperative radiation and determine the maximum-tolerated dose (MTD) and dose-limiting toxicity (DLT) of UFT plus LV in this setting. PATIENTS AND METHODS Patients with tumor-node-metastasis stage II or III rectal cancer received escalating doses of UFT (starting at 250mg/m(2)/d, with 50-mg/m(2)/d increments between consecutive cohorts) and fixed doses of LV (90 mg/d). The UFT and LV combination was given 5 days per week concurrently with a 5-week course of preoperative radiation totaling 45 Gy (1.8 Gy/fraction). Surgery was performed 4 to 6 weeks after radiation and was followed by four 35-day cycles of fixed doses of UFT and LV (28 days of therapy each cycle). RESULTS Fifteen patients were treated, and 13 received the full preoperative chemotherapy. All planned radiation was delivered successfully. The MTD of UFT with radiation was 350 mg/m(2)/d with 90 mg/d of LV. Diarrhea was the DLT. Sphincter-preserving surgery was performed in 12 of 14 patients. One patient had progressive disease before surgery. Pathologic evaluation of 14 resected specimens showed a complete response in three cases. CONCLUSION Preoperative chemoradiation with oral UFT plus LV is feasible and well tolerated and should be further investigated.
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Affiliation(s)
- P M Hoff
- Departments of Gastrointestinal Medical Oncology and Digestive Diseases, Radiation Oncology, Surgical Oncology, and Pathology, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA.
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Randolph J. FORUM: The Relationship of Ecosystem Management to NEPA and Its Goals. Environ Manage 2000; 26:1-12. [PMID: 10799636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
/ The National Environmental Policy Act of 1969 (NEPA) was intended to promote a systematic, comprehensive, interdisciplinary approach to planning and decisionmaking, including the integration of the natural and social sciences and the design arts. NEPA critics have cited three key shortcomings in its implementation: (1) a lack of engagement with the NEPA process early in the planning process through interdisciplinary collaboration; (2) a lack of rigorous science and the incorporation of ecological principles and techniques; and (3) a lack of emphasis on the Act's substantive goals and objectives. In recent years and independent of NEPA, a policy of ecosystem management has been developed, which represents a fundamental change from a fragmented, incremental planning and management approach to a holistic, comprehensive, interdisciplinary land and resource management effort. We postulate that by incorporating ecosystem management principles in their planning and decisionmaking, federal agencies can address the shortcomings in NEPA implementation and move closer to NEPA's intent. A case analysis of EISs prepared by the USDA Forest Service before and after adopting an ecosystem management approach supports our hypothesis.
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Sommers LS, Marton KI, Barbaccia JC, Randolph J. Physician, nurse, and social worker collaboration in primary care for chronically ill seniors. Arch Intern Med 2000; 160:1825-33. [PMID: 10871977 DOI: 10.1001/archinte.160.12.1825] [Citation(s) in RCA: 184] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVES To examine the impact of an interdisciplinary, collaborative practice intervention involving a primary care physician, a nurse, and a social worker for community-dwelling seniors with chronic illnesses. METHODS A concurrent, controlled cohort study of 543 patients in 18 private office practices of primary care physicians was conducted. The intervention group received care from their primary care physician working with a registered nurse and a social worker, while the control group received care as usual from their primary care physician. The outcome measures included changes in number of hospital admissions, readmissions, office visits, emergency department visits, skilled nursing facility admissions, home care visits, and changes in patient self-rated physical, emotional, and social functioning. RESULTS From 1992 (baseline year) to 1993, the two groups did not differ in service use or in self-reported health status. From 1993 to 1994, the hospitalization rate of the control group increased from 0.34 to 0.52, while the rate in the intervention group stayed at baseline (P= .03). The proportion of intervention patients with readmissions decreased from 6% to 4%, while the rate in the control group increased from 4% to 9% (P=.03). In the intervention group, mean office visits to all physicians fell by 1.5 visits compared with a 0.5-visit increase for the control group (P=.003). The patients in the intervention group reported an increase in social activities compared with the control group's decrease (P=.04). With fewer hospital admissions, average per-patient savings for 1994 were estimated at $90, inclusive of the intervention's cost but exclusive of savings from fewer office visits. CONCLUSIONS This model of primary care collaborative practice shows potential for reducing utilization and maintaining health status for seniors with chronic illnesses. Future work should explore the specific benefit accruing from physician involvement in the collaborative practice team.
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Affiliation(s)
- L S Sommers
- Internal Medicine Residency Program, St Mary's Medical Center, San Francisco, Calif 94117-1079, USA.
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Pincus SM, Padmanabhan V, Lemon W, Randolph J, Rees Midgley A. Follicle-stimulating hormone is secreted more irregularly than luteinizing hormone in both humans and sheep. J Clin Invest 1998; 101:1318-24. [PMID: 9502773 PMCID: PMC508686 DOI: 10.1172/jci985] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Recently introduced statistical tools capable of discerning differences between the pattern of luteinizing hormone (LH) secretion and that of follicle-stimulating hormone (FSH) could be valuable in understanding ovulation and menopause, and ultimately in making diagnostic decisions and treating infertility and polycystic ovary syndrome. We assessed the validity and scope of the hypothesis that FSH is secreted more irregularly than LH in ewes and fertile women. We compared secretory irregularity of LH to that of FSH in both ovariectomized ewes (n = 7) and women of proven fertility (n = 5) during the follicular and luteal phases of their reproductive cycles. In each sheep, time series from both hypophyseal portal blood (HPB) and peripheral blood were evaluated in 72 samples obtained every 5 min; in each human, both luteal and follicular periods were studied in 192 samples obtained every 7.5 min. To quantify serial irregularity, we used approximate entropy (ApEn), a scale- and model-independent statistic. FSH secretion was consistently more irregular than that of LH in each subject. For sheep HPB, ApEn(FSH) = 1.415+/-0.097 was larger than ApEn(LH) = 0. 822+/-0.213, P < 0.0001 (mean+/-SD, paired t test). This difference persisted peripherally: ApEn(FSHper) = 1.431+/-0.101 > ApEn(LHper) = 1.252+/-0.086, P = 0.024. In women, ApEn(FSH) = 1.467+/-0.217 > ApEn(LH) = 0.923+/- 0.305, P < 0.0001. ApEn(FSH) > ApEn(LH) in 100% of women (peripheral) and sheep HPB. Secretion during the follicular phase was more irregular than during the luteal phase for both FSH and LH (P < 0.01). LH mean level secretion showed a wake/sleep difference in women, P < 0.005, with higher values awake. The consistency and statistical significance of these findings suggest that this LH/FSH difference may be broadly based within higher mammals. Ranges of normative and abnormal regularity values of LH, FSH, and their difference can be used in a number of settings, both (currently) research and (potentially ultimately) clinical milieus.
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