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Copyright of Arquivos Brasileiros de Oftalmologia is the property of Arquivos Brasileiros de Oftalmologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Arquivos Brasileiros de Oftalmologia is the property of Arquivos Brasileiros de Oftalmologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Achilles tendon ruptures can be counted as the most common traumatic ankle injuries. As such, there is a comparatively large set of treatment options including surgical and nonsurgical approaches. The purpose of this case report is to demonstrate a new technique for a specific subgroup of Achilles tendon ruptures that present with a large tendinous gap. We used a 2-step procedure designed to grant additional stability through an autograft from the anterior rectus sheath of the patient. Two patients were treated after suffering traumatic Achilles tendon ruptures on the left side with a gap of >3.5 cm and a high demand in daily activities. The reconstruction was performed using an upper quadrant recuts sheath as a WRAP-augmentation. After securing the transplant tissue, the abdominal wall was reconstructed using a Vicryl™-Prolene™ mesh (VYPRO®, Johnson & Johnson Medical GmbH, Ethicon Deutschland, Norderstedt, Germany). After, a standard approach to the Achilles tendon was performed with a Kirchmayr-Kessler suture. The end result was then stabilized with a rectus sheath WRAP over a length of 14 to 15 cm. On the cases reported here, multiple clinical follow-ups were performed over a 5-year period. We can report highly satisfying results, with a return to sports activity after 6 months and no complications. As such we believe the rectus sheath autograft an effective solution for Achilles tendon ruptures with large gaps in healthy patients that demonstrate a high demand in daily activities. [ABSTRACT FROM AUTHOR]

Copyright of Anthos is the property of Bund Schweizer Landschaftsarchitekten und Landschaftsarchitektinnen and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Supplemental Digital Content is available in the text Objective: The aim of this paper is to report, with a high follow-up rate, 10-year results in a large cohort of patients after Roux-en-Y gastric bypass (RYGBP) done essentially by laparoscopy. Background: RYGBP has been performed for 50 years, including 20 years by laparoscopy, yet very few long-term results have been reported, mostly after open surgery. Methods: Prospective bariatric database established since the introduction of bariatric surgery. Retrospective data analysis on weight loss, long-term complications, quality of life, and comorbidities. Results: In all, 658 consecutive patients (515 women/143 men) were included: 554 with primary RYGBP, 104 with reoperative RYGBP. There was 1 (0.15%) postoperative death. Thirty-two (5%) patients died during follow-up from causes unrelated to surgery. Ten years after primary RYGBP, patients lost 28.6 ± 10.5% of their initial weight, corresponding to a mean of 13.2 body mass index (BMI) units. Among them, 72.8% achieved a BMI <35. Weight loss ≥20% was seen in 80.3% and <10% in 3.9% of patients. Results were similar in patients undergoing primary or reoperative RYGBP, but were better in patients who were initially less obese (BMI <50 kg/m2) than in superobese patients. Quality of life and comorbidities significantly improved with 80% resolution or improvement of metabolic comorbidities. All patients required supplementations, and 14.6% required long-term reoperation. Conclusions: RYGBP provides long-term satisfactory weight loss up to 10 years, and significantly improves quality of life and comorbidities. Long-term complications requiring reoperation can develop. Mineral and vitamin supplementation are universally necessary. Other more effective surgical options should be discussed in patients with very severe obesity. [ABSTRACT FROM AUTHOR]

Background: The links between chronic illness, psychological well-being, and social support have previously been established. Social isolation and loneliness have shown an increased mortality risk for those with heart failure (HF). Increasingly more people with HF are living with an implantable cardioverter defibrillator (ICD), but only a few small-scale studies have focused on social support in this population. Objective: The aim of this study was to explore factors related to perceived social support in a large cohort of individuals with HF living with an ICD. Methods: All eligible adult ICD recipients in the Swedish ICD registry were invited to participate in this cross-sectional study. For this analysis, those with HF and complete data on perceived social support were included (N = 1550; age, 67.3 (SD, 9.8) years; 19.5% female). Results: Most reported a high level of social support, but 18% did not. In logistic regression, living alone was the greatest predictor of low/medium support. Lower social support for those living alone was associated with poorer perceived health status, having symptoms of depression, and experiencing low perceived control. For those living with someone, lower support was associated with female gender, symptoms of depression and anxiety, and less control. Heart failure status and perceived symptom severity were not related to the outcome. Conclusion: One in five participants reported low/medium social support. Our study underlines the complex relationships between perceived social support, psychological well-being and perceived control over the heart condition. Multiple aspects need to be taken into account when developing interventions to provide psychosocial support and optimize outcomes in this patient group. [ABSTRACT FROM AUTHOR]

Copyright of Arquivos Brasileiros de Oftalmologia is the property of Arquivos Brasileiros de Oftalmologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study assessed the accuracy of preoperative staging in patients undergoing oncological esophagectomy for adenocarcinoma and squamous cell carcinoma. All patients undergoing surgery for resectable esophageal cancer in a university hospital from2005 to 2016 were identified fromour institutional database. Patients with neoadjuvant treatment were excluded to avoid bias from down-staging effects. Routinely, all patients had an upper endoscopy with biopsy, a thoracoabdominal CT scan, an 18-FEG PET-CT, and endoscopic ultrasound. Preoperative staging was compared to histopathological staging of surgical specimen that was considered as gold standard. There were 51 patients with a median age of 65 years (IQR: 59.3-73 years) having 21 squamous cell carcinoma and 30 adenocarcinoma, respectively. T- and N-stages were correctly predicted in 26 (51%) and 37 patients (72%), respectively. Overall, 18 patients (35%) were preoperatively diagnosed with a correct T- and N-stage. There was no difference between adenocarcinoma and squamous cell carcinoma. Accuracy of the T-stage was not influenced by the smoking status. The N-stage was not correct in 7/22 smoking patients (32%) and 6/29 nonsmoking patients (21%).The N-stage was underestimated in smoking patients as 6/22 patients (27%) had a histologically confirmed N+who were preoperatively classified as N0. In conclusion, only 35% of patients had a correct assessment. Separate T- and N-stage prediction was improved with 51% and 72%, respectively. Major efforts are needed for improvement. [ABSTRACT FROM AUTHOR]

Summary Background & aims Polyphenol intake has been linked to improvements in human vascular function, although data on hydroxycinnamates, such as chlorogenic acid (CGA) have not yet been studied. We aimed to investigate the impact of coffee intake rich in chlorogenic acid on human vascular function and whether CGAs are involved in potential effects. Methods Two acute randomized, controlled, cross-over human intervention trials were conducted. The impact of coffee intake, matched for caffeine but differing in CGA content (89, and 310 mg) on flow-mediated dilatation (FMD) was assessed in 15 healthy male subjects. In a second intervention trial conducted with 24 healthy male subjects, the impact of pure 5-caffeoylquinic acid (5-CQA), the main CGA in coffee (5-CQA; 450 mg and 900 mg) on FMD was also investigated. Results We observed a bi-phasic FMD response after low and high polyphenol, (89 mg and 310 mg CGA) intake, with increases at 1 (1.10 ± 0.43% and 1.34 ± 0.62%, respectively) and 5 (0.79% ± 0.32 and 1.52% ± 0.40, respectively) hours post coffee consumption. FMD responses to coffee intake was closely paralleled by the appearance of CGA metabolites in plasma, notably 3-, 4- and 5-feruloylquinic acid and ferulic-4′-O-sulfate at 1 h and isoferulic-3′-O-glucuronide and ferulic-4′-O-sulfate at 5 h. Intervention with purified 5-CQA (450 mg) also led to an improvement in FMD response relative to control (0.75 ± 1.31% at 1 h post intervention, p = 0.06) and concomitant appearance of plasma metabolites. Conclusions Coffee intake acutely improves human vascular function, an effect, in part, mediated by 5-CQA and its physiological metabolites. Study registration The National Institutes of Health (NIH) on ClinicalTrials.gov NCT01813981 and NCT01772784 . [ABSTRACT FROM AUTHOR]

Numerous challenges – from population increase to climate change – threaten the sustainable development of cities and call for a fundamental change of urban development and green-blue resource management. Urban forests are vital in this transition, as they provide various ecosystem services and allow to re-shape and re-think cities. Based on a Europe-wide community effort with diverse experts centered around urban forests and urban greening, we propose five key research fields to generate the knowledge required to unlock fundamental changes in urban development and green-blue resource management: circular bioeconomy, climate resilience, governance, social and human environment, and biodiversity. To support the design of greener, cooler, more inclusive and resilient cities, all these research fields require inter- and transdisciplinary collaboration, engaging stakeholders in transforming urban engagement and functioning. We summarise main inter-, trans- und multi-disciplinary research paths for each field and the cross-cutting knowledge areas that can help to address the challenges many cities face (e.g., modelling and assessment of the urban microclimate). For transforming cities further knowledge is needed on e.g., urban innovation, transition, participation, and more. Finally, we address how the identified research gaps can be implemented (e.g., international coordinated research effort, interdisciplinary networks). [Display omitted] [ABSTRACT FROM AUTHOR]

Copyright of Arquivos Brasileiros de Oftalmologia is the property of Arquivos Brasileiros de Oftalmologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)