Στην βιολογία, το περιβάλλον μπορεί να καθοριστεί σαν ενα σύνολο κλιματικών, βιοτικών, κοινωνικών και εδαφικών παραγόντων που δρουν σε έναν οργανισμό και καθορίζουν την ανάπτυξη και την επιβίωση του. Έτσι, περιλαμβάνει οτιδήποτε μπορεί να επηρεάσει άμεσα τον μεταβολισμό ή τη συμπεριφορά των ζωντανών οργανισμών ή ειδών, όπως το φως, ο αέρας, το νερό, το έδαφος και άλλοι παράγοντες. Δείτε επίσης το άρθρο για το φυσικό περιβάλλον και τη φυσική επιλογή.
Στην αρχιτεκτονική, την εργονομία και την ασφάλεια στην εργασία, περιβάλλον είναι το σύνολο των χαρακτηριστικών ενός δωματίου ή κτιρίου που επηρεάζουν την ποιότητα ζωής και την αποδοτικότητα, περιλαμβανομένων των διαστάσεων και της διαρρύθμισης των χώρων διαβίωσης και της επίπλωσης, του φωτισμού, του αερισμού, της θερμοκρασίας, του θορύβου κλπ. Επίσης μπορεί να αναφέρεται στο σύνολο των δομικών κατασκευών. Δείτε επίσης το άρθρο για το δομημένο περιβάλλον.
Στην ψυχολογία, περιβαλλοντισμός είναι η θεωρία ότι το περιβάλλον (με τη γενική και κοινωνική έννοια) παίζει μεγαλύτερο ρόλο από την κληρονομικότητα καθορίζοντας την ανάπτυξη ενός ατόμου. Συγκεκριμένα, το περιβάλλον είναι ένας σημαντικός παράγοντας πολλών ψυχολογικών θεωριών.
Στην τέχνη, το περιβάλλον αποτελεί κινητήριο μοχλό και μούσα εμπνέοντας τους ζωγράφους ή τους ποιητές. Σε όλες τις μορφές της Τέχνης αποτελεί έμπνευση και οι Καλές Τέχνες φανερώνουν την επιρροή οπού άσκησε σε όλους τους καλλιτέχνες με όποιο είδος Τέχνης κι αν ασχολούνται. Ο άνθρωπος μέσα στο περιβάλλον δημιουργεί Μουσική, Ζωγραφική, Ποίηση, Γλυπτική, χορό, τραγούδι, θέατρο, αλλά και όλες οι μορφές τέχνης έχουν άμεση έμπνευση από το περιβάλλον.

Τετάρτη 6 Οκτωβρίου 2021

Loupe Assisted Thyroidectomy: A Tool for Reducing Complications

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Abstract

The objective of this study is to assess if the use of magnification can reduce the incidence of hypocalcemia and vocal cord palsy in thyroid surgery. Data of patients who underwent total thyroidectomy (N = 50) for thyroid malignancy were analyzed retrospectively for 1 year. The patients were divided into two groups based on surgery with and without loupes. Hypocalcemia and Vocal cord palsy was assessed pre as well as post-operatively and the observations were noted. Descriptive statistics were performed to assess the proportion of the respective groups. Inferential statistics to find out the difference between the groups was done using the chi-square test. Significance level was kept at 5%. The incidence of hypocalcemia was 36.9% in the group done without loupes compared to 7.6% with loupes. The event of vocal cord injury though transient was 33% when done without loupes (p < 0.05). Magnification is crucial for the visualization of the n eurovascular anatomy which is depicted in our study. Although the study includes less number of cases, it is evident that the use of loupe magnification can reduce the morbidity associated with thyroid surgery to a great extent. We recommend the use of loupe magnification during surgery whenever possible.

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Efficacy of Sucralfate in Alleviating Post Tonsillectomy Symptoms and Morbidity: A Comparative Randomized Interventional Study

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Abstract

Pain following tonsillectomy still remains the main concern of topic and it occurs along with sever ear pain and trismus until and unless the exposed and inflamed mucosa gets covered with the regenerated mucosa. To study the efficacy of sucralfate in alleviating postoperative pain and morbidity following tonsillectomy. Subjects included in our study were patients which were fulfilling criteria for tonsillectomy and were admitted under the Department of Otorhinolaryngology, SMS Medical College and Hospital, Jaipur from 1st July 2019 to 31st March 2020. 64 patients were evaluated and were randomly allocated into study and control group based on the administration of topical sucralfate. 64 patients who were admitted for tonsillectomy under the Department of Otorhinolaryngology, SMS Medical College and Hospital, Jaipur from 1st July 2019 to 31st March 2020 were included in study. Patients were evaluated and were randomly allocated into study and control group based o n the administration of topical sucralfate. The incidence of throat pain and otalgia showed significant difference among both the group following postoperative day 2 onwards. On postoperative day 2, significant difference in trismus was also found. Effective alleviation of pain not only improves early dietary intake of the patients but also allays fear of apprehensive parents.

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First dorsal metacarpal artery perforator-based propeller flap: functional anatomy and clinical application in soft-tissue defects of the dorsal hand and digits

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Surg Radiol Anat. 2021 Oct 6. doi: 10.1007/s00276-021-02845-z. Online ahead of print.

ABSTRACT

BACKGROUND: Many approaches have been reported to repair soft-tissue defects of the hand using dorsal metacarpal artery flaps. Use of a perforator-based propeller flap from the first intermetacarpal space to the dorsum of the hand has been described. The aim of this study was to confirm the functional anatomy of a first dorsal metacarpal artery (FDMA) perforator flap.

METHODS : Twenty-nine fixed cadaveric hands were dissected to determine the origin, course, and branches of the FDMA. Clinically, five cases of soft tissue defects of the hand underwent reconstructive surgery using an FDMA perforator-based propeller flap.

RESULTS: The FDMA was found in 27 specimens (93%). The ulnar branch of the FDMA always supplied the cutaneous perforator (mean ± SD, 4.3 ± 1.6), and the most distal cutaneous perforating branch was found along the metacarpal long axis within 25 mm of the tip of the metacarpal head with high frequency (28/29, 97%). In the two hands that had aplasia of the FDMA, well-developed perforators arose directly from the radial artery and advanced to the metacarpal head. Seven hands (24%) had perforators arising from the palmar arterial system, penetrating through or passing close by the second metacarpal bone. In clinical application, all the flaps survived completely without major complications.

CONCLUSIONS: The FDMA perforator-based propeller flap is minimally invasive and technically simple. It is expected to be a new option for hand reconstruction.

PMID:34613448 | DOI:10.1007/s00276-021-02845-z

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Τρίτη 5 Οκτωβρίου 2021

Case Reports in Otolaryngology

Frontal Sinus "Hump": An Anatomical Risk Factor for Anterior Skull Base Injury in the Endoscopic Modified Lothrop Approach (Outside-In Frontal Drill-Out), Teppei Takeda, Kazuhiro Omura, Haw Torng, Teru Ebihara, Satoshi Aoki, Kosuke Tochigi, Hiromi Kojima, and Nobuyoshi Otori
Volume 2021 (2021), Article ID 3402496, 5 pages
Unilateral Cysticercosis of the Parotid Gland: Case Report, Diagnosis, and Clinical Management, Zachary Elwell, Shethal Bearelly, Khalid Aboul-Nasr, and Jonathan Lara
Volume 2021 (2021), Article ID 9999441, 4 pages
Traumatic Cochlear Implant Electrode Extrusion: Considerations, Management, and Outcome, Ching Yee Chan, Feifan Wang, Haryani Omar, and Henry Kun Kiaang Tan
Volume 2021 (2021), Article ID 2918859, 4 pages
The Rare Cases of Parotid Gland Arteriovenous Malformations, Manish Gupta, Vijay Shrawan Nijhawan, Cynthia Kaur, Sukhpreet Kaur, and Akanksha Gupta
Volume 2021 (2021), Article ID 6072155, 5 pages
Osteochondroma Arising from the Thyroid Cartilage: A Case Report and Literature Review, Jessa E. Miller, Shaghauyegh S. Azar, and Dinesh K. Chhetri
Volume 2021 (2021), Article ID 8286012, 4 pages
A Rare Case of Posttraumatic Bilateral BPPV Presentation, Sinisa Maslovara, Andro Kosec, Ivana Pajic Matic, and Anamarija Sestak
Volume 2021 (2021), Article ID 8636676, 5 pages
Nasopharyngeal Coil Dislocation of an Embolized Internal Carotid Artery Pseudoaneurysm, Nazli Ay, Ingo Todt, and Holger Sudhoff
Volume 2021 (2021), Article ID 4270441, 4 pages
Presence of Two Separate Hairy Polyps with Meningothelial Elements in a 15-Month-Old Child, Ahmad Saeed A. Alghamdi, Nasser Almutairi, and Ghassan Alokby
Volume 2021 (2021), Article ID 1844244, 5 pages
Case of Amelanotic Malignant Melanoma of the Lingual Base That Was Diagnosed Based on a Biopsy of Late Metastasis to a Lumbar Vertebra after Being Misdiagnosed as HPV-Positive Oropharyngeal Anterior Wall Squamous Cell Carcinoma, Takumi Okuda, Shinsuke Ide, Kei Kajihara, and Tetsuya Tono
Volume 2021 (2021), Article ID 7139280, 6 pages
Survival of Toddler with Aortoesophageal Fistula after Button Battery Ingestion, Hannah Gibbs, Rishabh Sethia, Patrick I. McConnell, Jennifer H. Aldrink, Toshiharu Shinoka, Kent Williams, and Kris R. Jatana
Volume 2021 (2021), Article ID 5557054, 7 pages

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Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
Telephone consultation 11855 int 1193,

TRPV1 mediates itch‐associated scratching and skin barrier dysfunction in DNFB‐induced atopic dermatitis mice

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Abstract

In chronic pruritic diseases such as atopic dermatitis (AD), pruritus and skin lesions is exacerbated by scratching in clinical and experimental settings. TRPV1 is known to mediate itch and neurogenic inflammation, but the role of TRPV1 in itch-associated scratching in AD is poorly understood. In this study, we examined the efficacy of cutting off nails and TRPV1 antagonist, ruthenium red (RR) in a murine model of AD induced by DNFB and further investigated the underlying mechanism. Nail clipping or RR could markedly ameliorate the general AD-like symptoms as manifested by the reduced clinical severity of dermatitis, IgE and Th2-related cytokine levels, and mast cell degranulation. Moreover, scratching behavior, the levels of pruritogenic mediators, including HIS, TSLP, IL-31 and SP, and skin pH and TEWL were all significantly decreased in nail clipping or RR-treated mice, suggesting a reduction in itch-associated scratching and skin barrier defects. Immunofluorescence staini ng and western blot results revealed that that antipruritic effect of nail clipping or RR in AD may be explained, at least in part, by the suppression of TRPV1 activation. In summary, these data show that TRPV1 mediates itch-associated scratching and subsequent skin barrier defects, suggesting its potential as a therapeutic target in AD.

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A systematic review and meta-analysis of urethral complications and outcomes in transgender men

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J Plast Reconstr Aesthet Surg. 2021 Sep 4:S1748-6815(21)00384-3. doi: 10.1016/j.bjps.2021.08.006. Online ahead of print.

ABSTRACT

BACKGROUND: Urologic problems, such as urethral fistulas and strictures, are among the most frequent complications occurring after phalloplasty. Although many studies have reported successful phalloplasty and urethral reconstruction with reliable outcomes in transgender men, no method has become standardized so far. This study aimed to summarize the results of reports on urological complications and outcomes in transgender men with respect to various types of urethral reconstruction.

METHODS: A comprehensive literature search of PubMed, Scopus, and Google Scholar databases was conducted for studies related to phalloplasty in transsexuals. Data on various phallic urethral techniques, urethral complications, and outcomes were collected and analyzed using the random-effects model.

RESULTS: A total o f 21 studies (1,566 patients) were included: eight studies (1,061 patients) on "tube-in-tube," nine studies (273 patients) on "prelaminated flap," and six studies (221 patients) on "second flap." Compared with the tube-in-tube technique, the prelaminated flap was associated with a significantly higher urethral stricture/stenosis rate; however, there was no difference between the prelaminated flap and the second flap techniques. For all phalloplasty patients, the pool rate of urethral fistula or stenosis is 48.9%, the rate of the ability to void while standing is 91.5%, occurrence rate of tactile or erogenous sensation is 88%, the prosthesis complication rate is 27.9%, and patient-reported satisfactory outcome rate is 90.5%.

CONCLUSION: Urethral reconstruction with a prelaminated flap was associated with a significantly higher urethral stricture rate and increased need of revision surgery compared with that observed using a skin flap. Overall, most patients were able to void wh ile standing and were satisfied with the outcomes.

PMID:34607781 | DOI:10.1016/j.bjps.2021.08.006

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KTP laser endoscopic cricopharyngeal myotomy and pharyngeal pouch diverticulotomy: how I do it

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Eur Arch Otorhinolaryngol. 2021 Oct 5. doi: 10.1007/s00405-021-07101-z. Online ahead of print.

ABSTRACT

BACKGROUND: Various endoscopic methods of dividing the cricopharyngeus muscle and the common wall of pharyngeal pouches have been described, most commonly the carbon dioxide laser and stapler. The potassium titanyl phosphate (KTP) laser is an alternate endoscopic method of treatment.

METHODS: The KTP laser is used in a similar fashion to the carbon dioxide laser to carefully divide the cricopharyngeus muscle fibres ± the common wall of the pharyngeal pouch, under microscopic visualization.

CONCLUSION: The KTP laser is an alternative and safe technique for these surgeries.

PMID:34609606 | DOI:10.1007/s00405-021-07101-z

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