The challenge of environment management is a sustainable development of both environmental systems and the green economy. The main objective of this study was the optimization and testing of plant ...growth-promoting rhizobacteria soil biopreparation and soil amendments as the alternative to or to help offset use of mineral soil fertilizers. A field study was conducted on a degraded area to improve plant biomass yield using inoculated bacteria. Moreover, organic additives (sewage sludge) and inorganic fertilizers were also used to compare their effectiveness. The conducted study investigated the combined effect of immobilized microbial consortium and soil substrates for plant growth (red fescue) on degraded areas and confirmed synergistic interactions between plants, microorganisms and soil substrates in the process of phytoremediation. The formulation consisted of immobilized bacterial consortia having mechanisms for the synthesis of compounds preferably affecting growth and development of (crop) plants. The conducted studies confirmed that the PGPR bacteria used in the experiment have the potential to promote plant growth, increase organic nitrogen the bioavailable P pool in soil.
The results of the field study (synergy effect of alternative fertilization and bacteria) can be used to create effective methods in assisted soil bioremediation. This approach has a high social acceptance and reduces resource consumption of fertilizers having an impact on sustainable development. Implementing methods of supporting plant growth using microorganisms can undoubtedly contribute to the development of ‘green’ resource management.
•PGPR biopreparations may be supplementation to mineral soil fertilizers.•PGPR bacterial consortium increased roots biomass in field conditions.•Both organic (biosolid) and inorganic fertilizers improved aboveground biomass.•Bacteria application enhanced the effect of soil fertilization.•PGPR soil application may minimize droughts effects for plants.
Background and ObjectiveUrinary incontinence following prostate treatment (IPT) is a common complication with corresponding negative impacts on quality of life. Pelvic floor muscle training (PFMT) is ...a non-invasive treatment strategy to treat combat this clinical issue, and has been recognized by medical associations globally and increasingly supported by large bodies of literature. Accordingly, many studies demonstrate a significant benefit of pelvic floor muscle training to continence status and quality of life in men with incontinence following prostate treatment. However, related research is limited by variety in treatment regimens, outcome measures, and study designs, with unclear impact on treatment success. We aim to provide a brief overview of pathology and incidence of incontinence following prostate surgery and an understanding how PFMT is currently used to treat and prevent this clinical consequence. MethodsA comprehensive literature search was conducted utilizing PubMed, Medline, and Google Scholar. Search criteria included systematic reviews and randomized control trials published in the year 2000 to present. References of resulting studies were further analyzed to identify further articles of relevance. Keywords searched included: "post-prostatectomy incontinence", "pelvic muscle strengthening", "Benign Prostatic Hyperplasia", and "pelvic floor muscle training". Peer-reviewed publications that demonstrated a novel addition to the existing body of literature on this subject were included. Key Content and FindingsUpon review of the current research landscape, PFMT is largely supported in treatment of IPT. Analysis of current literature on this subject demonstrates heterogeneity in protocols, measures of treatment success, and patient numbers. Nevertheless, benefits to continence and quality of life are noted across an expansive body of literature and as such, PFMT is therefore recommended as an important part of the treatment algorithm following radical prostatectomy. ConclusionsPFMT is an important and effective part of the treatment algorithm in the prevention and treatment of IPT. Additional research is needed to more extensively assess PFMT's role in treating this clinical consequence, especially following other prostate surgeries.
Abstract Background Resident involvement in operations increases operative duration. This study investigated resident impact on operative time for a single general surgeon in an outpatient surgical ...setting. Methods A retrospective review was performed of index general surgical operations meeting inclusion criteria. Operative duration, patient demographics, 30-day complication/readmission rates, and degree of resident involvement were collected. Results 625 cases were analyzed. Patient demographics were similar for all procedural comparison groups. Operative time increased with resident involvement for each operation—umbilical hernia repairs were associated with a 19% increase (22.3 ± 6.7 versus 26.5 ± 7.5 min, p = 0.002), laparoscopic cholecystectomies demonstrated a 15% increase (25.8 ± 8.7 versus 29.7 ± 10.2 min, p = 0.001), and laparoscopic inguinal hernia repairs demonstrated a 25% increase (32.1 ± 11.3 versus 40.2 ± 8.9 min, p < 0.001). Conclusions Each surgeon must decide if the increase in operative duration caused by resident involvement is justified by the intangible benefits residents provide.
IntroductionIncontinence and urgency are common after prostatectomy. The University of Virginia prostatectomy functional outcomes program (PFOP) was developed to comprehensively assess and optimise ...continence outcomes following robotic-assisted laparoscopic prostatectomy (RALP). Patients are prospectively evaluated by a Female Pelvic Medicine and Reconstructive Surgery specialist. This study assessed for predictors of 3- and 6-month stress urinary incontinence (SUI) and urgency symptom outcomes following RALP.MethodsWe performed a post hoc review of patients from our PFOP receiving a minimum of 6-month follow-up. Urinary symptoms are prospectively assessed using the validated International Consultation on Incontinence Questionnaire-Male Lower Urinary Tract Symptoms (ICIQ-MLUTS) questionnaire and daily pad use (pads per day PPD). Primary study outcomes included ICIQ-MLUTS SUI and urgency domain scores and PPD. Multivariable linear regression was performed to identify variables associated with outcomes at 3 and 6 months postoperatively. Variables included patient, oncologic and surgical factors. Each variable was run in a separate model with pelvic floor muscle therapy and surgeon to reduce confounding and prevent overfitting.ResultsForty men were included. In assessment of ICIQ-MLUTS SUI domain score, at 3 months, body mass index (BMI) was associated with worse scores, and at 6 months, BMI, hypertension and estimated blood loss (EBL) were associated with worse scores, whereas bilateral nerve-sparing technique was associated with better scores. For ICIQ-MLUTS Urgency domain score, at 3 months, preoperative use of benign prostatic hyperplasia (BPH) medication was associated with better scores. No covariates predicted 6-month ICIQ-MLUTS Urgency domain scores. For PPD use, at both 3 and 6 months, BMI was a positive predictor, while preoperative use of BPH medication was a negative predictor.ConclusionIncreased BMI, EBL and hypertension are associated with worsened SUI outcomes following RALP, whereas bilateral nerve-sparing technique and preoperative BPH medication are associated with improved SUI outcomes. These data may inform patient counselling and help identify patients who may benefit from closer surveillance and earlier anti-incontinence intervention.
Shot in the womb Hutchison, Dylan; Uitvlugt, Neal D; Crumb, Teri L ...
Journal of pediatric surgery case reports,
08/2018, Letnik:
35
Journal Article
Recenzirano
Odprti dostop
Abstract A fetus surviving a prenatal penetrating gunshot injury is rarely encountered. We report the case of a 26-week pregnant mother shot in the abdomen. Her uterine wound was missed at ...exploration, and when the baby was born 6 weeks later, the bullet was found in the superficial soft tissues of his posterior neck. It was removed without difficulty, and the baby, our youngest trauma patient ever, recovered without sequelae.
A novel pathology of a mediastinal neoplasm Hutchison, Dylan Deans; Kudirka, Adam Antanas; Posa, Antonio ...
Comparative clinical pathology,
07/2018, Letnik:
27, Številka:
4
Journal Article
Recenzirano
Primary extragonadal malignant germ cell tumors (EMGCTs) are rare and account for only 2–5% of malignant germ cell tumors. Vascular tumors are uncommon mediastinal masses making up < 1% of all ...mediastinal masses. We report the case of a 20-year-old man presenting with a germ cell seminoma as well as an atypical hemangioma encapsulated in one mass within the mediastinum. This clinical report focuses on a 20-year-old man who presented with both a germ cell seminoma as well as an atypical hemangioma within one encapsulated mass, a unique case not presented before in literature to our knowledge. The histological analysis is essential in correctly diagnosing a neoplasm. Combining the unique histology of this case with the clinical and scientific knowledge of several specialties allowed the clinicians to successfully develop a treatment for this patient.
The paper presents an evaluation of efficiency and economic potential of the phytoremediation technology, based on the use of energy crops (P. arundinacea L. and B. Napus L.), combined with the ...fertilization with compost, supported by the addition of nano SiO2. The experiment was conducted in in-situ conditions, using two experimental blocks, divided according to used plant species. Each block included four types of plots with different fertilization treatments (control plots; treatment with nano SiO2; treatment with compost; treatment with mixture of compost and nano SiO2). During the studied period (three vegetation seasons), a cyclic analysis of 16 PAH's content were conducted. Furthermore, a quantitative determination of biomass production was performed as well as assessment of economic potential of different strategies.
Data collected during research, shows that method based on energy crops use, due to the join effect of the dangerous pollutants removal and the production of removable energy resource, can be considered as sustainable and should be recommended for use during heavy polluted soil remediation. Moreover, it should be also noted, that the best results for both PAH's removal efficiency and biomass production, were acquired on plots with P. arundinacea L. cultivation, fertilized with mix of compost and nano SiO2.
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•Energy crops can be used during PAH-polluted soil phytoremediation.•P.arundinace L. is more adapted to grow on heavy polluted soil than B. napus L.•SiO2 hydrophilic nano powder can temporary decrease a toxic effect of PAHs in soil.•The use of energy crops can contribute to the phytoremediation costs reduction.•The use of compost increase PAH removal efficiency during phytoremediation.
Energy crops are one of the possible solutions for reclamation of degraded or contaminated terrain. Their cultivation requires adequate fertilization typically containing high content of organic ...matter, nitrogen and phosphorous. While sewage sludge may be one source of these necessary nutrients, it may also modify some plant biomass properties, such as total carbon content. In our study, we determined whether sewage sludge (containing different value of heavy metals) could be an effective fertilizer to obtain good quality energy crops (such as Miscanthus x gigantheus and reed canary grass, Phalaris arundinacea) and simultaneously play positive role for improvement of phytoremediation. The 3-year experiment was performed on degraded soil from terrain of steel mill of Czestochowa (Silesian region, Poland). During the study, it was confirmed that sewage sludge (also in combination with urea, CH4N2O) influences the mobility of Pb, Zn, Cd in soil solution, however the intensity of the process can be limited by plant species and time. Both miscanthus, and reed canary grass were characterized by the low value of bioconcentration factor (BCF), but because biomass was high, the total concentration of heavy metals in crops was comparable with hyperaccumulators. Additionally, modification of the fertilization affected energetic parameters, such as the content of carbon, S/Cl ratio, unitary CO2 emission. However, this effect was not statistically significant.
•Sewage sludge can positively modified biomass properties of energetic plants.•Biomass parameters like content, S/Cl ratio, unitary CO2 emission can be modified.•Sustainable phytoremediation creates additional source of renewable energy.
To compare continence outcomes in post-prostatectomy patients undergoing supervised in-person versus online pelvic floor muscle training and pelvic floor education (iPMFT vs oPFMT/PFE). Despite the ...proven benefit of in-person PFMT for urinary incontinence (UI) following prostatectomy, numerous barriers impede access. We developed a comprehensive online program to deliver oPFMT/PFE.
We performed a retrospective review of patients receiving iPFMT versus oPFMT/PFE with minimum 12-month follow-up. Outcomes were assessed at 3 weeks, 3-, 6-, and 12 months following robotic-assisted laparoscopic prostatectomy using validated ICIQ-MLUTS and IIQ-7 questionnaires and additional items (daily pad use PPD and satisfaction). The primary study outcome was ICIQ-MLUTS SUI domain score (SDS). Secondary outcomes were PPD, PPD cure (0 PPD at 12 months), SUI cure (12-month SDS=baseline score), and QOL score (IIQ-7 Sum).
Analysis included 41 men. Though men enrolled in oPFMT/PFE demonstrated lower SUI domain scores than iPFMT at most time points (3wk P <.01, 3 mo P = .04, 6 mo P = .15, 12 mo P = .04), the rate of improvement from 3 weeks to other time points was similar between groups (P = NS at all time points). SDS Cure was no different for oPFMT/PFE (75%, 15/20) compared to iPFMT (60%, 12/20, P = .3). PPD and IIQ-7 were also similar at all time points and demonstrated a similar rate of decrease over time through 12 months.
Significant and similar improvements in UI and QOL are seen both in men completing iPFMT or oPFMT/PFE programs. Our novel online program provides another option to improve PFMT/PFE access in men undergoing RALP.
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