Middle-grade led Expedited Gall bladder lists: Is it safe and feasible?

Introduction: Gallstone-related acute admissions account for a significant percentage of acute general surgery admissions. Providing a dedicated expedited gall bladder list service to deal with these cases appears to be not only clinically effective but also cost-effective. There are various logistical reasons why hospitals are unable to provide such dedicated lists, inadequate surgical staff being one of them.

Dopamine Pharmacodynamics: New Insights.

Dopamine is a key neurotransmitter involved in physiological processes such as motor control, motivation, reward, cognitive function, and maternal and reproductive behaviors. Therefore, dysfunctions of the dopaminergic system are related to a plethora of human diseases. Dopamine, via different circuitries implicated in compulsive behavior, reward, and habit formation, also represents a key player in substance use disorder and the formation and perpetuation of mechanisms leading to addiction.

Reward System Dysfunction and the Motoric-Cognitive Risk Syndrome in Older Persons.

During aging, many physiological systems spontaneously change independent of the presence of chronic diseases. The reward system is not an exception and its dysfunction generally includes a reduction in dopamine and glutamate activities and the loss of neurons of the ventral tegmental area (VTA). These impairments are even more pronounced in older persons who have neurodegenerative diseases and/or are affected by cognitive and motoric frailty.

Cognitive and Behavior Deficits in Parkinson's Disease with Alteration of FDG-PET Irrespective of Age.

Significant progress has been made in our understanding of the neurobiology of Parkinson's disease (PD). Post-mortem studies are an important step and could help to comprehend not only the progression of motor symptoms, but also the involvement of other clinical domains, including cognition, behavior and impulse control disorders (ICDs). The correlation of neuropathological extension of the disease with the clinical stages remains challenging.

All-Oxide p-n Junction Thermoelectric Generator Based on SnO and ZnO Thin Films.

Achieving thermoelectric devices with high performance based on low-cost and nontoxic materials is extremely challenging. Moreover, as we move toward an Internet-of-Things society, a miniaturized local power source such as a thermoelectric generator (TEG) is desired to power increasing numbers of wireless sensors. Therefore, in this work, an all-oxide p-n junction TEG composed of low-cost, abundant, and nontoxic materials, such as n-type ZnO and p-type SnO thin films, deposited on borosilicate glass substrate is proposed.

Economic Convenience of Hybrid Thermoelectric-Photovoltaic Solar Harvesters.

Over the last few years, a growing interest has surfaced about the possibility of enhancing solar harvester efficiency by coupling photovoltaic (PV) cells with thermoelectric generators (TEGs). To be effective solutions, hybrid thermoelectric-photovoltaic (HTEPV) solar harvesters must not only increase the solar conversion efficiency but should also be economically competitive. The aim of this paper is to estimate the profitability of HTEPV solar harvesters with no reference to specific materials, relating it instead to their physical properties only and thus providing a tool to address research effort toward classes of HTEPV systems able to compete with current PV technologies.

Intrathoracic hand-sewn esophagogastric anastomosis in prone position during totally minimally invasive two-stage esophagectomy for esophageal cancer.

Utilization of totally minimally invasive esophagectomy for cancer is on the rise. Esophagogastric anastomosis is mechanically or robotically performed routinely; little report exists of hand-sewn esophagogastric anastomosis. This is the largest so far study with thoracoscopic hand-sewn esophagogastric anastomosis during fully minimally invasive two-stage esophagectomy for esophageal cancer in prone position.

Self-powered broadband photo-detection and persistent energy generation with junction-free strained BiTe thin films.

We experimentally demonstrate efficient broadband self-powered photo-detection and power generation in thin films of polycrystalline bismuth telluride (BiTe) semiconductors under inhomogeneous strain. The developed simple, junction-free, lightweight, and flexible photo-detectors are composed of a thin active layer and Ohmic contacts on a flexible plastic substrate, and can operate at room temperature and without application of an external bias voltage. We attribute the observed phenomena to the generation of an electric field due to a spontaneous polarization produced by strain gradient, which can separate both photo-generated and thermally-generated charge carriers in bulk of the semiconductor material, without a semiconductor junction.

Microvascular grafting to enhance perfusion in colonic long-segment oesophageal reconstruction.

Purpose: Oesophagectomy with long-segment colon reconstruction is the first-line treatment when the stomach is not available. Supercharging of the newly formed conduit can improve vascular function utilizing intraoperative perfusion imaging system, following thoracoscopic oesophagectomy for distal-oesophageal and gastroesophageal junction cancer. The purpose of this study is to examine the safety and efficacy of microvascular augmentation of left colonic interposition following oesophagectomy for oesophageal cancer.

Prone position thoracoscopic management of neck chyle leak following major head and neck surgery. A case series.

Chyle leak is a major compication following head and neck surgery, with reported incidence of 0.5% up to 8.3% in published literature.

Completely Minimally Invasive Esophagectomy Versus Hybrid Esophagectomy for Esophageal and Gastroesophageal Junctional Cancer: Clinical and Short-Term Oncological Outcomes.

Background: Minimally invasive surgery for resectable esophageal and gastroesophageal junctional (GEJ) cancer significantly reduces morbidity when compared with open surgery, as is evident from published landmark trials. Comparison of outcomes between hybrid esophagectomy (HE) and completely minimally invasive esophagectomy (CMIE) remains unclear.

Objective: We aimed to ascertain whether CMIE is associated with less postoperative complications compared with HE without oncological compromise.

Minimally invasive esophagectomy for esophageal cancer in octogenarians. Clinical and oncological outcomes.

Purpose: Studies on patients undergoing esophagectomy for esophageal cancer have shown that thoracic and abdominal surgery may be performed safely in patients without an uppermost age cut-off. The aim of this study was to evaluate the morbidity and mortality of radical minimally invasive esophagectomy for cancer in patients over 80 years old.

Methods: A retrospective analysis of prospectively collected data over a period of 4 years was conducted.

High mortality rate of oesophageal perforation is associated with delayed hospital admission : a prospective observational case series study.

Background: To assess mortality rate of oesophageal perforation cases and study their etiology, diagnosis and management in a single specialized UK centre.

Patients And Methods: A prospective observational study was performed between January 2012 and January 2015. All consecutive patients admitted with acute iatrogenic or spontaneous esophageal perforation were included.

Hybrid Minimally-invasive Esophagectomy for Esophageal Cancer: Clinical and Oncological Outcomes.

Background/aim: Esophagectomy is a major surgical procedure associated with a significant risk of morbidity and mortality that has traditionally been performed by an open approach. Although minimally invasive procedures for benign esophageal disease have been widely accepted worldwide, they have not yet been established for the treatment of malignancy.

Patients And Methods: A total of 137 consecutive hybrid esophagectomies for cancer were performed by the same surgical team.

Preservation of replaced left hepatic artery during 3D laparoscopic totally minimally invasive esophagectomy for cancer.

Preserving a replaced left hepatic artery may be feasible and safe during 3D laparoscopic totally minimally invasive esophagectomy. Avoidance of conversion to an open procedure may be achieved after careful dissection of the celiac trunk lymph nodes, expertise and the visual advantage that 3D vision offers.

Over-the-scope-clip treatment of gastrobronchial fistula following minimally invasive oesophagectomy: a novel approach.

Gastrobronchial fistulae (GBF) following minimally invasive oesophagectomy (MIO) is a rare entity, with an estimated incidence of 0.3-1.5% according to the published literature.

Prognostic Value of Subcarinal Lymph Nodes in Minimally Invasive Esophagectomy for Cancer.

Background/aim: Surgical resection for esophageal cancer has remained the gold-standard therapy provided worldwide. Subcarinal lymph-nodes are classified as peri-esophageal nodes and their dissection may be performed during a 2- or 3-stage esophagectomy. The necessity and prognostic value of subcarinal lymphadenectomy is still debatable.

Reinforcement of intrathoracic oesophago-gastric anastomosis with fibrin sealant (Tisseel®) in oesophagectomy for cancer: A prospective comparative study.

Purpose: Fibrin sealant (Tisseel) is a human protein and thrombin soluble fibrinogen that has been indicated for reinforcement of gastro-intestinal anastomoses to prevent leakage. The objective of this study is to examine the impact of fibrin sealant regarding anastomotic leak, following Ivor-Lewis procedure.

Methods: This is a prospective comparative study on 2-stage oesophagectomy for cancer of the distal oesophagus or oesophagogastric junction.

Laparoscopic repair of Amyand's hernia complicated with acute appendicitis. Report of a case.

The presence of vermiform appendix in an inguinal hernia sac is known as Amyand's hernia. Amyand's hernia complicated with acute appendicitis is an extremely rare entity with challenging diagnosis and large debate about the optimal treatment option. We report a case of a 58-year-old man presenting to the Emergency Department with an incarcerated right inguinal hernia.

Minimally Invasive Circumferential Hiatal Dissection for the Treatment of Adenocarcinoma of the Distal Esophagus and Esophago-gastric Junction: Technical Considerations Combined With Histopathological Outcomes.

Background/aim: Circumferential resection margin involvement is an independent prognostic factor in patients with adenocarcinoma of the distal esophagus and esophago-gastric junction. However, there is currently no consensus on the extent and the technique of hiatal dissection. We describe a minimally invasive technique of circumferential hiatal dissection for adenocarcinoma of the distal esophagus and esophago-gastric junction with its related histopathological results.

Transmural migration of azygous vein Hem-O-lok clip causing food bolus 3 months following uneventful minimally invasive oesophagectomy.

Background: Hem-o-lok clips are widely deployed in various laparoscopic and robotic operations. Their migration is not very common and majority of reported cases are limited to biliary, prostatic and vesico-urethral cases.

Methods: Herein, we would like to report the first case of transmural migration of Hem-o-lok clip from azygous vein stump following totally minimally invasive two-stage oesophagectomy for squamous cell carcinoma of the distal oesophagus, into the gastric conduit 3-months following uneventful discharge.

Theoretical Analysis of Two Novel Hybrid Thermoelectric-Photovoltaic Systems Based on Cu₂ZnSnS₄ Solar Cells.

The development and commercialization of Photovoltaic (PV) cells with good cost-efficiency trade-off not using critical raw materials (CRMs) is one of the strategies chosen by the European Community (EC) to address the Energy Roadmap 2050. In this context Cu2ZnSnS4 (CZTS) solar cells are attracting a major interest since they have the potential to combine low price with relatively high conversion efficiencies. Although a ≈9% lab scale efficiency has already been reported for CZTS this technology is still far from being competitive in terms of cost per peak-power (€/Wp) with other common materials.

Left Gastric Artery Embolisation for the Treatment of Obesity: a Systematic Review.

Background: Endovascular left gastric artery (LGA) embolisation has gained significant attention in the treatment of obesity/morbid obesity and reduction of ghrelin. The objective of this systematic review is to evaluate the recent literature, strengths, limitations and practical aspects of this new procedure in combination with its physiological and anatomical paradigm.

Methods: A systematic electronic search of literature from 1966 to June 2017 in Medline, CINHAL, Embase, Scopus and Cochrane library in English language and adult subjects was conducted.

Thoracoscopic total esophagogastrectomy with supercharged colon interposition for the treatment of esophageal adenocarcinoma in situs inversus.

Esophagectomy in situs inversus is challenging. With long-segment supercharged reconstruction, it becomes more perplexing and multidisciplinary surgical skills are needed. Challenges met and the surgical technique used is presented in this case report.