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Determining the need for a thoracoscopic approach to treat a giant hiatal hernia when abdominal access is poor

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World Journal of Gastrointestinal Surgery 2023年第12期15卷 2739-2746页

作者： Francisco Javier Pérez Lara Rogelio Zubizarreta Jimenez Tatiana Prieto-Puga Arjona Pilar Gutierrez Delgado Juan Manuel Hernández Carmona Jose Manuel Hernández Gonzalez maria pitarch martinez Department of Surgery Hopital de AntequeraAntequera 29200Spain DOXA MicrofluidicsRincon de la Victoria 29730Spain Department of Surgery HRU Carlos HayaUnidad Cirugia Hepatobiliopancreat&TrasplantesMalaga 29200Spain

BACKGROUND Giant hernias present a significant challenge for digestive *** approach taken(laparoscopic vs thoracoscopic)depends largely on the preferences and skills of each surgeon,although in most cases today the laparoscopic approach is *** To determine whether patients presenting inadequate laparoscopic access to the intrathoracic hernial sac obtain poorer postoperative results than those with no such problem,in order to assess the need for a thoracoscopic *** For the retrospective series of patients treated in our hospital for hiatal hernia(n=112),we calculated the laparoscopic field of view and the working area accessible to surgical instruments,by means of preoperative imaging tests,to assess the likely outcome for cases inaccessible to *** Patients with giant hiatal hernias for whom a preoperative calculation suggested that the laparoscopic route would not access all areas of the intrathoracic sac presented higher rates of perioperative complications and recurrence during follow-up than those for whom laparoscopy was *** difference was statistically ***,the insertion of mesh did not improve results for the non-accessible *** For patients with giant hiatal hernias,it is essential to conduct a preoperative evaluation of the angle of vision and the working area for *** parts of the intrathoracic sac are inaccessible laparoscopically,the thoracoscopic approach should be considered.

关键词： Hiatal hernia Abdominal surgery Laparoscopy Thoracoscopy surgery

Preoperative calculation of angles of vision and working area in laparoscopic surgery to treat a giant hiatal hernia

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World Journal of Gastrointestinal Surgery 2021年第12期13卷 1638-1650页

作者： Francisco Javier Perez Lara Rogelio Zubizarreta Jimenez Francisco Javier Moya Donoso Jose Manuel Hernández Gonzalez Tatiana Prieto-Puga Arjona Arturo del Rey Moreno maria pitarch martinez Surgery Service Antequera HospitalRincón de la Victoria 29730MálagaSpain DOXA Microfluidics Rincon de la Victoria 29738MálagaSpain

BACKGROUND Giant hiatal hernias still pose a major challenge to digestive surgeons,and their repair is sometimes a highly complex *** is usually performed by laparoscopy,while the role of the thoracoscopic approach has yet to be clearly *** To preoperatively detect patients with a giant hiatal hernia in whom it would not be safe to perform laparoscopic surgery and who,therefore,would be candidates for a thoracoscopic *** In the present study,using imaging test we preoperatively simulate the field of vision of the camera and the working area(instrumental access)that can be obtained in each patient when the laparoscopic approach is *** From data obtained,we can calculate the access angles that will be obtained in a preoperative computerised axial tomography coronal section,according to the location of the *** also provide the formula for performing the angle calculations If the trocars are placed in loss common situations,thus enabling us to determine the visibility and manoeuvrability for any position of the *** The working area determines the cases in which we can operate safely and those in which certain areas of the hernia cannot be accessed,which is when the thoracoscopic approach would be safer.

关键词： Hiatal hernia Angles Approach Laparoscopy Thoracoscopy

Novel suturing technique,based on physical principles,achieves a breaking point double that obtained by conventional techniques

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World Journal of Gastrointestinal Surgery 2021年第9期13卷 1039-1049页

作者： Francisco Javier Pérez Lara Rogelio Zubizarreta Jimenez Francisco Javier Moya Donoso Jose Manuel Hernández Gonzalez Tatiana Prieto-Puga Arjona Ricardo Marín Moya maria pitarch martinez Department of Surgery Hopital de AntequeraMalaga 29200Spain DOXA Malaga 29730Spain

BACKGROUND Sutures have been used to repair wounds since ancient ***,the basic suture technique has not significantly *** Phase I of our project,we proposed a“double diabolo”suture design,using a theoretical physical study to show that this suture receives 50%less tension than conventional sutures,and so a correspondingly greater force must be applied to break *** To determine whether these theoretical levels of resistance were met by the new type of *** An observational study was performed to compare three types of sutures,using a device that exerted force on the suture until the breaking point was *** tension produced by this traction was *** following variables were considered:Tearing stress on entry/exit points,edge separation stress,and suture break *** study sample consisted of 30 sutures with simple interrupted stitches(Group 1),30 with continuous stitches(Group 2),and 30 with the“double diabolo”design(Group 3).RESULTS The mean degree of force required to reach the breaking point for each of these variables(tearing,separation,and final breaking)was highest in Group 3(14.56,18.28,and 21.39 kg),followed by Group 1(7.36,10.38,and 12.81 kg)and Group 2(5.77,7.7,and 8.71 kg).These differences were statistically significant(P<0.001)in all *** The experimental results show that with the“double diabolo”suture,compared with conventional sutures,greater force must be applied to reach the breaking point(almost twice as much as in the simple interrupted suture and more than double that required for the continuous suture).If these results are confirmed in Phase III(the clinical phase)of our study,we believe the double diabolo technique should be adopted as the standard approach,especially when the suture must withstand significant tension(e.g.,laparotomy closure,thoracotomy closure,diaphragm suture,or hernial orifice closure).

关键词： Suture Technique Physical principles Tension

Treatment of spinal cord injury with biomaterials and stem cell therapy in non-human primates and humans

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Neural Regeneration Research 2025年第2期20卷 343-353页

作者： Ana Milena Silva Olaya Fernanda Martins Almeida Ana maria Blanco martinez Suelen Adriani Marques PhD Program in Pathological Anatomy Federal University of Rio de JaneiroRio de JaneiroBrazil Biomedical Science Institute Federal University of Rio de JaneiroRio de JaneiroBrazil Graduate Program in Pathological Anatomy Federal University of Rio de JaneiroRio de JaneiroBrazil Graduate Program in Pathological Anatomy(PPGAP/UFRJ) Department of Neurobiology/Institute of BiologyCampus do GragoatáNiteróiRio de JaneiroBrazil

Spinal cord injury results in the loss of sensory,motor,and autonomic functions,which almost always produces permanent physical ***,in the search for more effective treatments than those already applied for years,which are not entirely efficient,researches have been able to demonstrate the potential of biological strategies using biomaterials to tissue manufacturing through bioengineering and stem cell therapy as a neuroregenerative approach,seeking to promote neuronal recovery after spinal cord *** of these strategies has been developed and meticulously evaluated in several animal models with the aim of analyzing the potential of interventions for neuronal repair and,consequently,boosting functional *** the majority of experimental research has been conducted in rodents,there is increasing recognition of the importance,and need,of evaluating the safety and efficacy of these interventions in non-human primates before moving to clinical trials involving therapies potentially promising in *** article is a literature review from databases(PubMed,Science Direct,Elsevier,Scielo,Redalyc,Cochrane,and NCBI)from 10 years ago to date,using keywords(spinal cord injury,cell therapy,non-human primates,humans,and bioengineering in spinal cord injury).From 110 retrieved articles,after two selection rounds based on inclusion and exclusion criteria,21 articles were ***,this review arises from the need to recognize the experimental therapeutic advances applied in non-human primates and even humans,aimed at deepening these strategies and identifying the advantages and influence of the results on extrapolation for clinical applicability in humans.

关键词： bioengineering biomaterials cell therapy humans non-human primates spinal cord injury stem cell therapy

Challenges and improvement strategies in the hospitalization of chronic multimorbid patients

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World Journal of Clinical Cases 2025年第3期13卷 35-41页

作者： Andres Fontalba-Navas Francisco Pozo Muñoz Rogelio Garcia Cisneros maria Jose Garcia Larrosa maria del Mar Callejon Gil Ignacio Garcia Delgado maria Belen Jimenez martinez Antequera Hospital Northern Málaga Integrated Healthcare AreaAntequera 29200AndalusiaSpain Department of Public Health and Psychiatry University of MálagaMálaga 29010Spain Antequera Hospital Northern Málaga Antequera Integrated Healthcare AreaAntequera 29200MálagaSpain

BACKGROUND Addressing the growing challenge of hospitalizing chronic multimorbid patients,this study examines the strain these conditions impose on healthcare systems at a local level,focusing on a pilot *** diseases and complex patients require comprehensive management strategies to reduce healthcare burdens and improve patient *** proven effective,this pilot model has the potential to be replicated in other healthcare settings to enhance the management of chronic multimorbid *** To evaluate the effectiveness of the high complexity unit(HCU)in managing chronic multimorbid patients through a multidisciplinary care model and to compare it with standard hospital *** The study employed a descriptive longitudinal approach,analyzing data from the Basic Minimum Data Set(BMDS)to compare hospitalization variables among the HCU,the Internal Medicine Service,and other services at Antequera Hospital throughout *** HCU,designed for patients with complex chronic conditions,integrates a patient-centered model emphasizing multidisciplinary care and continuity *** The study employed a descriptive longitudinal approach,analyzing data from the BMDS to compare hospitalization variables among the HCU,the Internal Medicine Service,and other services at Antequera Hospital throughout *** HCU,designed for patients with complex chronic conditions,integrates a patient-centered model emphasizing multidisciplinary care and continuity *** This study demonstrates the effectiveness of the HCU in managing patients with complex chronic diseases through a multidisciplinary *** coordinated care provided by the HCU results in improved patient outcomes,reduced unnecessary hospitalizations,and better management of patient *** superiority of the HCU compared to standard care is evident in key outcomes such as fewer readmissions and higher patient satisfaction,reinforcing its value as a model of ca

关键词： High complexity unit Chronic multimorbidity Patient-centered care Integrated care Healthcare management

Production of electrical energy from living plants in microbial fuel cells

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Clean Energy 2023年第2期7卷 408-416页

作者： Raymond Daniel Rodriguez martinez maria Eugenia Alvarez Bermudez Department of Industrial Production Faculty of EngineeringUniversidad Metropolitana1073 CaracasVenezuela Department of Energy and Automation Faculty of EngineeringUniversidad Metropolitana1073 CaracasVenezuela

Growing energy demand is a current problem with greater incidence in the *** research objective is to establish seed bases to give a leading role to plants used in anthropogenic production activities and consumption,and even plants belonging to wildlife in terms of energy *** use of living plants to obtain electrical energy through a microbial-vegetable fuel cell is proposed as a mech-anism to supply the energy demand with easy access worldwide,especially in areas far from urban *** this work,the voltage produced by microbial-vegetable fuel cells was measured using graphite electrodes and plants belonging to the species of aloe(Aloe vera),corn(Zea mays),black beans(Phaseolus vulgaris),tomato(Solanum lycopersicum)and moss(Dicranidae).They were selected for their presence in everyday life and their great commercial and agricultural value,reaching a maximum voltage of 884 mV from *** is evidence that all plants can be a source of energy to a greater or lesser extent and that their performance is given by the plant root interactions at the ***,an extensive root system can favour the accumulation of substrate after the hydrolysis of dead roots,provided that their presence does not interfere with microbial activity on the anodic *** this,using plants with low resistance to thermal stress can lead to a substrate richer in substances that can be ***,it is recommended to use plants according to their life cycle and the morphology of their roots,and plants that can grow in waterlogged conditions or without direct contact with the Sun.

关键词： ecosystems microorganisms renewable energy photosynthesis sustainability

Effect of asphalt thin beams mixed with three nominal maximum aggregate sizes in the bending beam rheometer on the prediction of thermal properties of bituminous material

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Frontiers of Structural and Civil Engineering 2017年第1期11卷 1-7页

作者： Chun-Hsing HO maria Francisca martinez GONZALEZ Cristina Pilar Martin LINARES Department of Civil Engineering Construction Management and Environmental Engineering Northern Arizona UniversityFlagstaff Arizona 86001 USA

The objective of this research is to evaluate an impact of asphalt mixture beams with varying sizes of aggregate in the Bending Beam Rheometer （BBR） for testing/predicting thermal cracking properties of asphalt pavements. The BBR test has following benefits： the equipment is cheaper, it uses smaller specimens, faster conditioning, easier availability for quality control, easier to manage, etc. However some concerns have been raised： some consider that the size of the aggregate may affect the test＇s results; the other concern is that such small beams cannot represent the whole properties of the asphalt pavement. To address these criticisms, imaging techniques, statistical analysis, and viscoelastic modeling are used. Asphalt thin beams prepared with three different nominal maximum aggregate size （NMAS）（12.5mm, 9.5 mm, and 4.75 mm） were tested at three different temperatures （-18℃, -24℃, and -30℃）. Based on results from statistical analyses and viscoelasticity, the ratio of asphalt binders and voids and stiffness differences among the three NMAS specimens are not significant, meaning that the impact of asphalt thin beams prepared with the three NMAS on the prediction of thermal cracking is minimal and can be neglected.

关键词： bending beam rheometer thin beams thermal cracking

Tubular conduits,cell-based therapy and exercise to improve peripheral nerve regeneration

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Neural Regeneration Research 2015年第4期10卷 565-567页

作者： Camila Oliveira Goulart Ana maria Blanco martinez Laboratório de Neurodegeneracao e Reparo Departamento de PatologiaFaculdade de MedicinaHUCFF-UFRJ-Rio de Janeiro-RJBrazil

Peripheral nerve injuries （PNI） are a major clinical prob- lem. In general, PNI results from motor vehicle accidents, lacerations with sharp objects, penetrating trauma （gunshot wounds） and stretching or crushing trauma and fractures. It is estimated that PNI occur in 2.8% of trauma patients and this number reaches 5% if plexus and root lesions are in- cluded. However, due to lack of recent epidemiological stud- ies, these data probably underestimate the actual number of nerve injuries

关键词： cell Tubular conduits,cell-based therapy and exercise to improve peripheral nerve regeneration PNI

In‑depth proteome characterization of endometrium and extraembryonic membranes during implantation in pig

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Journal of Animal Science and Biotechnology 2024年第3期15卷 1027-1055页

作者： maria A.Gil Josep M.Cambra Heriberto Rodriguez‑martinez Cristina Cuello Inmaculada Parrilla Emilio A.martinez Department of Medicine and Animal Surgery International Excellence Campus for Higher Education and Research“Campus Mare Nostrum”University of MurciaMurciaSpain Institute for Biomedical Research of Murcia(IMIB-Pascual Parrilla) MurciaSpain Technical University of Munich MunichGermany Department of Biomedical&Clinical Sciences(BKV) BKH/Obstetrics&GynaecologyLinkoping UniversityLinkopingSweden

Background Proteome characterization of the porcine endometrium and extraembryonic membranes is important to understand mother-embryo *** this study,the proteome of the endometrium and cho-rioallantoic membrane was characterized in pregnant sows(PS)during early gestation(d 18 and 24 of gestation)and in the endometrium of non-pregnant sows(NPS)during the same days using LC-MS/MS *** UniProtKB database and ClueGO were used to obtain functional Gene Ontology annotations and biological and functional networks,*** Our analysis yielded 3,254 and 3,457 proteins identified in the endometrium of PS and NPS,respectively;of these,1,753 being common while 1,501 and 1,704 were exclusive to PS and NPS,*** addition,we iden-tified 3,968 proteins in the extraembryonic membranes of *** analyses of function revealed some proteins had relevance for the immune system process and biological adhesion in endometrium while the embryonic chorion displayed abundance of proteins related to cell adhesion and cytoskeletal organization,suggesting they dominated the moment of endometrial remodeling,implantation and adhesion of the lining *** are available via Pro-teomeXchange with identifier *** This is the first in-depth proteomic characterization of the endometrium and extraembryonic mem-branes during weeks 3 to 4 of gestation;data that contribute to the molecular understanding of the dynamic environ-ment during this critical period,associated with the majority of pregnancy losses.

关键词： Endometrium Extraembryonic membranes Implantation Pig Proteome