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To present a surgical observation while using NIR-ICG technology. And furtherly, how this observation translates in a potential application for Endometriosis surgery. Descriptive observational study. Tertiary private clinic. Two patients with Deep Infiltrating Endometriosis (DIE) nodules affecting the bladder. Bladder shaving aided by ICG staining after ureteral catheterization for parametrial and posterior compartment endometriosis. After retrieving catheters, Bladder urothelium stains and helps identifying urothelial limits facilitating bladder shaving without entering the bladder's lumen. This is a proof of concept, a feasibility study. As DIE nodules of the bladder come from the peritoneal side of the bladder, in the same way as deep rectal nodules, shaving is a surgical gesture with less potential complications compared to full thickness bladder resections. ICG-stained bladder mucosa is clearly visible making it possible to avoid entering the bladder´s lumen which can potentially decrease the need for post-operatory use of bladder catheter. [ABSTRACT FROM AUTHOR]

To show an important issue concerning Sentinel Lymph node mapping strategy. A descriptive video highlighting the technical details to succesfuly harvest the correct sentinel node. A tertiary private center. two cases of endometrial cancer with Sentinel node mapping using NIR-ICG platform. Description of a possible pitfall while performing endoscopic surgery for endometrial cancer. The selection of the correct node to harvest is commented and explaned in the two similar cases but with different decision. Correct SLN mapping requires careful pathway tracking from the paracervix until the appearance of the first lymph node following the usual lymphatic courses. Therefore, finding a highlighted lymph node does not result in an SLN. Each highlighted pathway must be thoroughly explored to identify deeper and true SLNs. The technique of SLN mapping demands careful exploration of ICG spread into lymphatic channels to guarantee a low false negative nodal status. [ABSTRACT FROM AUTHOR]

Due to the international demand for fresh agricultural products, especially fruits, which result in long travel times from the production centers to the final markets, the preservation of these products becomes very important. Within the most common conservation methods, sulfite stands out. However, to preserve the ecosystem and the environment, it is the great interest to remove this substance from residual waters of preservation treatments and to prevent the contamination of layers of water and soils. Due to the great importance of the fruit industry in our country is necessary to develop techniques that allow treating this kind of wastewater to avoid affecting environmental and human conditions. For that reason, in this work we describe a system specially designed to carry out tests of absorption of sulfite by membranes, using a Celgard Liquicel® module, which puts in contact indirect two solutions, a feeding solution with the sulfite to extract and a solution NaOH receptor. The sulfite transferred from the feeding solution to the NaOH solution in the form of sulfur dioxide reacts with NaOH. Later, sulfite can be sensed via electrochemistry using modified reticular carbon electrodes. The best extraction results were obtained for a sodium hydroxide of 0.2 mol/dm³ and a concentration of 1,500 mg/dm³ sodium sulfite for the feeding, obtaining about 78% extraction, at a constant flow rate of 0.0083 dm³/s. By varying the flow rates keeping both concentrations constant, in the levels earlier mentioned, an increase in the extraction was observed from the flow of 0.0042 dm³/s to 0.0083 dm³/s, but no appreciable difference between the maximum of 0.0083 dm³/s and 0.0125 dm³/s was achieved. In addition, these results can lead to a marketable prototype that includes the separation and removal of sulfite from wastewater from the fruit and agricultural industry quickly and effectively. [ABSTRACT FROM AUTHOR]

In recent years, the use of timber in construction substantially increased due to the material's renewable nature, lower climate impact and increased economic competitiveness. Another driving factor is great improvements in modelling techniques for the design of timber structures. Suitable prediction of the connection behaviour, as a fundamental part of the structural behaviour of timber structures, is crucial for a more economic and reliable design. However, the more realistic and complete connection models, the more complex and difficult to handle they are, which might hinder their practical application. A good trade-off between complexity and computational efficiency can be achieved with the so-called Beam-On-Foundation (BOF) method, which is applied herein in a 2-step hierarchical model to analyse and predict the rotational stiffness, ductile capacity and load distribution among fasteners of four different configurations of moment transmitting beam-to-column timber-to-timber connections. The connection model is validated with experiments on the global response of the connection as well as with a 3-D solid FEM model. The herein proposed connection model well predicted the overall connection response and provided insight into the local fastener behaviour. As compared to the 3-D solid model, which additionally gives access to more realistic local stresses in the timber, the 2-step model is however much more efficient with a great reduction of computation time. This makes the approach suitable for parametric studies and the analysis and engineering design of timber structures. • Numerical model for beam-to-column connections in timber structures. • Hierarchical 2-step numerical model based on the Beam-On-Foundation method. • Prediction of global rotational stiffness, ductile capacity and load distribution. • Accuracy and savings on computational resources. • Suitability for parametric studies and engineering design. [ABSTRACT FROM AUTHOR]

To raise awareness of how complicated second and subsequent surgeries for deep infiltrating endometriosis are. To emphasize the relevance of good quality preoperative imaging when planning the first surgery for suspected DIE. Observational cohort study. Single institution, Single-center endometriosis unit. Five consecutive patients referred for persistent dyschezia after recent DIE surgery and postoperative hormonal support treatment with Dienogest. DIE imaging study protocol and second surgery by Endometriosis unit Surgical team. Patients age ranged from 36 to 41 years. All 5 patients had previous DIE surgery within 12 months of referral/consultation in our unit. All patients presented with persistent dyschezia as their main complaint. Only one patient declared fertility desire. Previous surgical procedures included pelvic adhesiolysis (5), rectal shaving (3), subtotal hysterectomy (1), rectal segmental resection (1), unilateral adnexectomy (1) and unilateral oophorectomy. Imaging studies (Ultrasound Endometriosis systematic mapping protocol and pelvic contrasted MRI) depicted gross rectal nodules (1,5-4,5 cm), all of which had transmural rectal infiltration with variable distance to the anal verge (11-6 cm). All surgical procedures included rectal resection (2 discoid, 3 segmental), with 1 patient requiring a protective ileostomy. Operative time ranged from 150 to 210 minutes. All patients were discharged between 3-5 days. Follow up after surgery (8-20 months) show no late complications and no dyschezia recurrence. An incomplete surgical excision of DIE rectal nodules can result in persistent dyschezia and prompt the need for further complex surgical procedures. We believe the first surgery for DIE should be preceded by an exhaustive clinical and imaging workup to plan an adequate personalized surgical procedure. [ABSTRACT FROM AUTHOR]

Easter Island (Rapa Nui), Chile, is remote, located in the Polynesian Triangle in Oceania. The closest continental point is Chile, 3,512 km east. It has a population of 7,750 inhabitants, who are Chilean citizens, and receives more than 60,000 tourists a year. For this entire population, there is a medium complexity hospital without a neurology specialist. In 2019, local professionals were trained in a Telestroke program with remote clinical support conducted by neurologists located on mainland Chile. We present a 50-year-old native male, with unknown medical history, who suddenly presented right-half-body weakness and aphasia. He was evaluated via Telestroke consultation, and thrombolysis with tenecteplase was indicated. The patient improved rapidly and 45 min later the NIHSS score was 0 points. To our knowledge, this is the first reported case of Telestroke treatment in such a remote area, highlighting the importance of telemedicine to overcome geographical and technological stroke care barriers and to improve patients' outcome, no matter where they live. [ABSTRACT FROM AUTHOR]

The development of accurate structural modelling techniques is required to promote the use of timber as a renewable alternative to other structural materials. Due to their remarkable influence on the global behaviour of a timber structure, an accurate description of the performance of structural connections is needed. Particularly in the case of moment transmitting beam-to-column connections with dowel-type fasteners, such properties are difficult to obtain experimentally. This paper develops a finite element (FE) model that simulates the behaviour of these connections under quasi-static loading, with a focus on the estimation of rotational stiffness and load distribution among the dowels. The model is validated against short-term laboratory tests. Resulting friction between timber members due to the installation procedure must be considered, as it greatly influences the rotational response. Besides, non-linear behaviour of timber and a softened contact parameter have been implemented, and their influence on the FE model validation process is demonstrated. • New modelling strategy for moment transmitting connections. • Rotational stiffness before timber failure is accurately predicted. • Load distribution among dowels is analysed. • Frictional behaviour must be taken into account for this type of connections. • Non-elastic material response is necessary for correct a validation of the FE model. [ABSTRACT FROM AUTHOR]

To present a practical approach to assess bowel perfusion at anastomotic site using ICG Imaging during Deep Infiltrating Endometriosis (DIE) surgery. Case report. OR. Use of ICG imaging after segmental resection for DIE. Test results prompted a second resection/Anastomosis. 43-year-old-woman, G1P1A0, Partial right oophorectomy (open surgery), 8 years before. Seven years of progressive dysmenorrhea (8/10), dyspareunia (7/10) and Dyschezia (9/10) with occasional hematochezia. After imaging and colonoscopy, posterior compartment and biparametrial DIE was diagnosed, including a 4 cm rectal nodule with submucosal involvement. Video shows surgical procedure in which after colorectal anastomosis, there was a vascular impairment detected by ICG imaging, that prompted the team to perform a further colonic resection with a new anastomosis. Uneventful postoperative course. Discharged on POD 3. No bladder voiding or defecatory disfunctions. After two years follow up the symptoms have not reappeared. ICG imaging, in the context of colorectal anastomosis, is a valuable tool which probably reduces the rate of anastomotic leakage detecting microvascular impairment in the anastomotic site. [ABSTRACT FROM AUTHOR]

To present a case in which Minimally Invasive surgery proved to be useful in a pelvic recurrence of a Serous Borderline Ovarian tumor. Case report with full description of preoperative imaging, surgical setup considerations, surgical findings, tumor management and follow up. Private Clinic, Gynecologic Endoscopy Unit. 48 year-old woman with a complete open surgical staging 3 years before presentation in our clinic. She had a FIGO IB Serous Borderline Tumor (TIbN0M0). She received no adyuvant chemotherapy. Uneventful follow up with normal Ca125 and Ca19-9 levels. She complained of mild progressive defecatory discomfort for the last 6 months. MRI showed a 4,5 cm cystic complex lesion, subperitoneally in the pouch of Douglas, in contact with the vaginal cuff. FDG-PET/CT showed a mild increase in metabolic activity with an SUV of 3,6. She underwent an exploratory laparoscopy for secondary citorreduction. With the aid of saline filling of the bladder, a vaginal gauze pushed by a Foerster clamp to highlight the vaginal cuff apex, and a rectal probe to identify the rectal wall the cystic tumor was carefully dissected. Frozen section confirmed the absence of invasive disease, so after a complete resection of the tumor we considered there was no need for further surgery. Discharged on POD2. Received no adyuvant chemotherapy. 14 months follow up without evidence of disease and normal radiologic studies and tumor markers. Laparoscopic secondary citorreduction. The technique showed to be feasible and useful in managing such recurrent tumor in this location. We believe such tumors should be managed in this way, offering the widely accepted benefits of minimally invasive surgery while maintaining oncologic outcomes. [ABSTRACT FROM AUTHOR]

Herein, we demonstrate the versatility and high sensitivity of the meniscus-based approach of a novel on-line electrochemical mass spectrometry (EC-MS) by studying the formation of gaseous/volatile products during ethanol oxidation on carbon-supported Pt electrode. In this way, methane is detected for the first time during ethanol adsorption at this electrode. Accordingly, new insights on the ethanol oxidation reactions are achieved. [ABSTRACT FROM AUTHOR]

• FEA tend to overestimate the elastic response of structural timber connections. • The stiffness contact defines the pressure-overclosure relationship of contact areas • The proposed stiffness contact improves the joint behaviour obtained by FEM. • The stiffness contact parameter is defined only based on geometrical parameters • Larger contact areas have a lower value of stiffness contact Finite element models tend to overestimate the actual elastic response of structural timber connections. The paper shows how such overprediction relates to the modelling of the contact between fasteners and timber. The use of a control parameter called stiffness contact is proposed. After an experimental campaign, a method to determine it, based only on the geometry of a rectangular contact area, is proposed. The modeling adequacy is demonstrated by applying it to dowel embedment and moment resistant wood joint tests. The obtained results show good agreement with the experimental test series. [ABSTRACT FROM AUTHOR]

Nanoplatforms can optimize the efficacy and safety of chemotherapy, and thus cancer therapy. However, new approaches are encouraged in developing new nanomedicines against malignant cells. In this work, a reproducible methodology is described to prepare Δ 9 -tetrahidrocannabinol (Δ 9 -THC)-loaded poly( d , l -lactide- co -glycolide) (PLGA) nanoparticles against lung cancer. The nanoformulation is further improved by surface functionalization with the biodegradable polymers chitosan and poly(ethylene glycol) (PEG) in order to optimize the biological fate and antitumor effect. Mean nanoparticle size (≈290 nm) increased upon coating with PEG, CS, and PEG–CS up to ≈590 nm, ≈745 nm, and ≈790 nm, respectively. Surface electrical charge was controlled by the type of polymeric coating onto the PLGA particles. Drug entrapment efficiencies (≈95%) were not affected by any of the polymeric coatings. On the opposite, the characteristic sustained (biphasic) Δ 9 -THC release from the particles can be accelerated or slowed down when using PEG or chitosan, respectively. Blood compatibility studies demonstrated the adequate in vivo safety margin of all of the PLGA-based nanoformulations, while protein adsorption investigations postulated the protective role of PEGylation against opsonization and plasma clearance. Cell viability studies comparing the activity of the nanoformulations against human A-549 and murine LL2 lung adenocarcinoma cells, and human embryo lung fibroblastic MRC-5 cells revealed a statistically significant selective cytotoxic effect toward the lung cancer cell lines. In addition, cytotoxicity assays in A-549 cells demonstrated the more intense anticancer activity of Δ 9 -THC-loaded PEGylated PLGA nanoparticles. These promising results were confirmed by in vivo studies in LL2 lung tumor-bearing immunocompetent C57BL/6 mice. [ABSTRACT FROM AUTHOR]

Highlights: [•] Theiler’s murine encephalomyelitis virus (TMEV) induces demyelination in susceptible strains of mice. [•] TMEV infection syndrome is a model system to study multiple sclerosis. [•] An overexpression of genes for Ca2+ channels in TMV infected mouse astrocytes was observed. [•] DNA hybridization, Western blotting and RT-PCR and qRT-PCR showed an increased expression of Ca2+ channel subunits. [•] Functional L- and N-type Ca2+ currents were shown to be upregulated in TMV infected astrocytes. [Copyright &y& Elsevier]

En bloc pediatric transplantation (EBPT) began with the aim of increasing the donor pool due to the existing high demand for donors. At its inception, it was considered a type of suboptimal transplantation due to its association with a high incidence of vascular, urologic, and immunologic complications. The main objective of this study was to update information on EBPT with the largest case series that exists on a worldwide scale. In a retrospective study, the results obtained from brain-dead donors (BDDs; n = 770) were compared to those of EBPT (n = 100) from January 1990 to December 2012. The median of follow-up was 12.8 years (interquartile range 8.1 to 17.2). The variables collected for analysis were demographic factors (age and sex of recipients, age and weight of donors), renal function, graft survival, recipient survival, surgical complications (thrombosis, lymphocele, urologic complications, and renal artery stenosis and need for revascularization with angioplasty and/or stents). Subsequently in a second analysis, we studied the association between graft survival, thrombosis, angioplasty, stents, and appearance of lymphoceles with the different factors that were considered to be related in accordance with published literature and our own experience. Graft loss due to surgical complications was more frequent in EBPT than in BDD (15% vs 2.2 % in BDD; P < .001), and interstitial fibrosis and tubular atrophy were more frequent in BDD (13% vs 2%; P < .001). EBPT offers a good survival rate after overcoming the possible surgical complications that may arise. [ABSTRACT FROM AUTHOR]

Abstract: In the present study, a novel synthesis technique based on the flow focusing (FF) technology is investigated for the preparation of green fluorescent protein (GFP)-loaded poly(d,l-lactide-co-glycolide) (PLGA) microparticles. To our knowledge, this novel technique has never been applied to the formulation of proteins in polymeric systems. A simple, specific and rapid reversed-phase HPLC (RP-HPLC) method was validated for the determination of GFP in PLGA microparticles with the best chromatographic peak resolution, reduced run time and low cost of analysis. In order to achieve the finest GFP-loaded polymeric particles, experimental parameters mainly associated to the FF device were studied (liquid flow rate and pressure of the focusing air). Very high GFP encapsulation values (>90%) were obtained by this technique, and the electrokinetic characterization of these systems suggested that this protein was incorporated into the polymeric matrix. This study is intended to offer information on which to base the development of high molecular weight protein-loaded polymeric delivery systems prepared by FF. [Copyright &y& Elsevier]

Abstract: In the present work, two methods for the preparation of lidocaine-loaded PLGA microparticles are compared. The differences between the polymeric particles obtained by solvent evaporation (SEVM) or flow focusing (FF) were studied by means of scanning electron microscopy and surface thermodynamics determinations. A detailed investigation of the capabilities of the polymer particles to load this drug is described. The physical state of the drug in the polymeric particles and the existence of interactions between both entities were studied by differential scanning calorimetry. The main factors determining the lidocaine incorporation and the release kinetics were the synthesis procedure followed, the amount of drug dissolved in the organic phase during the synthesis routine, the type of polymer (molecular weight and end chemical groups) and the size and the hydrophobic/hydrophilic properties of the particles. The FF technology allowed higher drug incorporations and slower release kinetics. The release studies showed a biphasic profile probably due to diffusion-cum-degradation mediated processes. [Copyright &y& Elsevier]

Inert matrices of didanosine (ddI) were elaborated as controlled release dosage forms, using two different types of polymers: Eudragit® RS-PM, an anionic acrylic acid copolymer, and Ethocel® 100 Premium, an ethylcellulose. A preformulation study of the drug was designed to address the following points: (a) the development of two alternative methods (high performance liquid chromatography (HPLC) and UV spectrophotometry) for the analysis and quantifying of ddI; (b) the determination of the aqueous solubility of ddI; and (c) the characterization of ddI from the following points of view: morphological (scanning electronic microscopy (SEM)) and thermal (differential scanning calorimetry (DSC)). Furthermore, some of these techniques were used for the characterization of those components which will be included in the oral controlled release system to be developed. The in vitro release of ddI matrices was studied at pH 7.4, because of the instability of ddI at pH values lower than 3 units. A significant reduction in the release rate of drug from both ddI controlled release systems was found. Furthermore, Ethocel® 100 Premium showed a minor efficiency in the dissolution process, with a reduction of more than double in the final dissolution efficiency (DE) value. This parameter and the fit factors (f1 and f2) have been compared for the characterization of dissolution profiles. [Copyright &y& Elsevier]