10 research outputs found
Long-Term Results of Laparoscopic Sleeve Gastrectomy: a Review of Studies Reporting 10+ Years Outcomes
No full text: Laparoscopic sleeve gastrectomy (LSG) is the most commonly performed bariatric procedure worldwide. Systematic search of Pubmed, Cochrane, and Embase was performed in order to find all the articles reporting 10+ years of LSG results. Eleven studies including 1020 patients met the inclusion criteria. Overall weighted mean %TWL was 24.4% (17-36.9%), and remission rates from TD2M to HTN were 45.6% (0-94.7%) and 41.4% (0-78.4%), respectively. De novo GERD had an overall prevalence of 32.3% (21.4-58.4%), and five cases (0.5%) of Barrett's disease were reported. Revisional surgery was required for 19.2% (1-49.5%) of patients, Roux-en-Y gastric bypass being the most common secondary procedure
Vitamin D Deficiency in Patients with Morbid Obesity before and after Metabolic Bariatric Surgery
No full textBackground: Metabolic bariatric surgery (MBS) is the most effective treatment for severe obesity. Vitamin D deficiency is a common complication encountered both during preoperative workup and follow-up. Aim: To estimate the prevalence of vitamin D deficiency in patients undergoing MBS. Methods: Prospectively maintained database of our university MBS center was searched to assess the rate of preoperative and postoperative vitamin D deficiency or insufficiency in patients undergoing MBS over a one-year period. Results: In total, 184 patients were included, 85 cases of Sleeve Gastrectomy (SG), 99 Gastric Bypass (GB; 91 One Anastomosis and 8 Roux-en-Y). Preoperative vitamin D deficiency and insufficiency were respectively found in 61% and 29% of patients, with no significant difference between SG and GB. After six months, 15% of patients had vitamin D deficiency, and 34% had vitamin D insufficiency. There was no significant difference in the rate of vitamin D deficiency or insufficiency and the percentage of total weight loss (%TWL) at 1, 3, and 6 postoperative months between SG and GB. Conclusions: Preoperative vitamin D deficiency or insufficiency is common in MBS candidates. Regular follow-up with correct supplementation is recommended when undergoing MBS. Early postoperative values of vitamin D were comparable between SG and OAGB
Implementation of updated enhanced recovery after bariatric surgery guidelines: adapted protocol in a single tertiary center
No full text: The aim of this study is to evaluate the effects of an adapted protocol of enhanced recovery after bariatric surgery (ERABS) on outcomes. This is a single-center observational study comparing patients managed according to adapted ERABS protocol (March-May 2022) with a control group of old method (January 2021-February 2022). Totally, 253 bariatric patients were included in the study (n = 68) and control (n = 185) groups. Patients were mostly females (57.3% vs 70.2%; p = 0.053), of mean age 38.8 years and body mass index 41 ± 6.53 vs. 44.60 ± 7.37 kg/m2 (p = 0.007) in study and control groups, respectively. The majority (90.5%) underwent primary bariatric surgery. Adapted ERABS protocol compliance was 98.5%. The study group had shorter hospital stay (mean 2.86 ± 0.51 vs. 4.03 ± 0.28 days; p < 0.001), similar rates of total (3% vs. 2.7%, p = 0.92) and major complications (1.5% vs. 0, p = 0.10). Readmission rates were similar (1.5% vs 1.6%, p = 0.92). Applied only in the study group, early ambulation (p < 0.001), opioid restriction, and preventing postoperative nausea and vomiting (PONV), resulted in satisfactory scores (mean total visual analogue score 1.93 ± 0.80, morphine milligram equivalent 34.0 ± 14.5, and mean total PONV grade 0.17 ± 0.36). In conclusion, implementing adapted ERABS guidelines improved patients' postoperative care, raising awareness to pain management. Length of stay was shortened without safety compromise. Efforts to abandon old-school routines seem worthwhile, even if ERABS is partially implemented
The concept of fear in Winnicott
No full textOrientador: Zeljko LoparicDissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Filosofia e Ciências HumanasResumo: Este trabalho discute o conceito de medo em D.W. Winnicott nas suas múltiplas faces partindo do pressuposto que os diferentes sentidos do conceito estão atrelados no âmbito etiológico à temporalidade do amadurecimento emocional. A revisão bibliográfica da obra do autor empreende a pesquisa centrada no termo medo ou a conceitos a ele associados tais como fobia, ansiedade, angústia, pânico, pavor noturno, terror, agonia impensável, pesadelo, etc. O percurso se divide na apresentação do conceito de medo no contexto dos binômios saúde-doença e normal-patológico, e na temporalidade do amadurecimento. Sob a perspectiva da primeira discussão, o medo se inscreve como fenômeno afetivo de ordem defensiva que como tal é recurso de enfrentamento e comunicação constituindo-se em material diagnóstico da condição emocional da pessoa. Nesta concepção, em detrimento de um preconceito estabelecido de estado psicopatológico, o medo atinge uma compreensão de condição existencial do ser humano. É fenômeno universal, cujo afeto ou não afeto, respeitando-se os diferentes contextos, matizes e níveis de intensidade marcam a distinção entre o normal e o patológico. Os medos, em sua tipologia, dizem respeito às etapas do amadurecimento emocional que abrange o que está acontecendo nas relações interpessoais entre o par mãe-filho na dependência absoluta, na dependência relativa e na formação triangular na independência relativa. Assim se configuram em medos relacionados à sobrevivência psíquica e à identidade, medos da separação da mãe, medos relativos à ambivalência amor-ódio e edípicos. Entende-se que o aprofundamento da pesquisa sobre o medo origina-se na observação e acompanhamento do sofrimento dos pacientes na clínica e, portanto, é para a prática clínica que este conhecimento se justifica e se destinaAbstract: This work discusses the concept of fear in D.W. Winnicott in its multiple faces assuming that different meanings of the concept are associated, in etiologic sphere, to emotional maturational process. The bibliographical review of the author followed the term fear and its associated concepts such as phobia, anxiety, panic, night terror, unthinkable agony, nightmare, etc. The research script is divided into two moments: the presentation of the concept of fear in context of the oppsoition health-sickness and normal-pathology, and in the maturational process temporality. On the first moment, fear is seen as an affective defensive phenomenon that enables the person to face the world and communicate his/her emotional condition. Therefore it may be considered as diagnostic material. Thus, fear is not taken as a psychopathological prejudice, but as a tool that allow us to understand the existential condition of the human being as such. It is an universal phenomenon whose affection or non-affection, regarding its different contexts, grades and levels of intensity, reveals the normal or pathological condition of the person. On the second monent, the tipology of fear has its origins in the stages of emotional maturational process which comprehends interpersonal relations between mother and son in the absolute dependency, relative dependency and in triangular formation during relative indenpendency. Such types of fear are then configurated as fear related to psychological survival and identity, fear of separation from the mother, fear related to love-hate ambivalence and the edipic complex. The research on fear, such as this one, has its origins in the clinical observation of patient suffering, and shall be oriented towards it, where it shall find its deeper justificationMestradoFilosofiaMestra em Filosofi
Designing Met Gala dress for singer Björk
No full textDiplomsko delo z naslovom Oblikovanje Met Gala obleke za pevko Björk raziskuje tehnološki vidik oblikovanja oblačila s pomočjo umetne inteligence in 3D-tiskanja.
Teoretični del raziskuje Björk kot glasbeno, kulturno in umetniško ikono. Opisan je njen pristop k modi in nošenju netradicionalnih, skoraj kostumskih oblačilnih kosov. Obravnavani so tako njen odnos do 3D-tiskane mode kot tudi drugi umetniki, ki se s tovrstno modo predstavljajo v modnem svetu. Podrobneje so predstavljeni modni oblikovalci Iris van Herpen, Danit Peleg, ThreeASFOUR, Nervous Systems in Sew Printed, ki so bili ključni za razvoj. Za delo je bila potrebna tudi raziskava dogodka Met Gala, in sicer iz leta 2024 z naslovom »Sleeping Beauties: Reawakening Fashion«. Predstavljene so tudi umetna inteligenca, njena vloga v vsakdanjem svetu in možnosti njene uporabe v sodobni modi.
Eksperimentalni del obsega zasnovo in oblikovanje oblačila s pomočjo umetne inteligence ter več računalniških programov. Detajlno so opisani proces izdelave z namiznim 3D-tiskalnikom, uporabljeni materiali in stroški izdelave. Avtorica s procesom raziskuje novo tehniko oblikovanja, se spoznava z nepoznanim materialom in premika meje svojega oblikovanja.
Glavni cilj je bil oblikovanje nosljivega oblačila s pomočjo nove, še precej neraziskane tehnologije. Rezultat diplomskega dela je gibljivo oblačilo, v celoti natisnjeno in izdelano iz plastičnega materiala s pomočjo domačega 3D-tiskalnika.Diploma thesis titled Designing a Met Gala dress for singer Björk explores the technological aspect of garment design using artificial intelligence and 3D printing.
The theoretical part examines Björk as a musical, cultural and artistic icon. Her approach to fashion and her wearing of non-traditional, almost custom-like clothing pieces is explored. The thesis also covers her perspective on 3D printed fahion, as well as the artists who have showcased it in the fashion world. Fashion designers such as Iris van Herpen, Danit Peleg, ThreeASFOUR, Nervous Systems and Sew Printed, who have been crucial in the further development of 3D printed fashion, are discussed in detail. Additionally, the research includes the Met Gala event, specifically the 2024 edition titled »Sleeping Beauties: Reawakening Fashion«. The use of artificial intelligence, its application in everyday life, and its potential in contemporary fashion are also addressed.
The experimental part involves the design and creation of the garment using artificial intelligence and various computer programs. The process of production with a desktop 3D printer is described in detail, including the materials used and cost of manufacturing. The author explores a new design technique, learns about an unfamiliar material, and pushes the boundaries of her design process.
The main objective was to create a wearable garmet using a new, still relatively unexplored technology. The result of the thesis is a movable garment, fully printed and made from plastic material using a home 3D printer
Revisional Surgery of One Anastomosis Gastric Bypass for Severe Protein–Energy Malnutrition
No full textBackground: One anastomosis gastric bypass (OAGB) is safe and effective. Its strong malabsorptive component might cause severe protein–energy malnutrition (PEM), necessitating revisional surgery. We aimed to evaluate the safety and outcomes of OAGB revision for severe PEM. Methods: This was a single-center retrospective analysis of OAGB patients undergoing revision for severe PEM (2015–2021). Perioperative data and outcomes were retrieved. Results: Ten patients underwent revision for severe PEM. Our center’s incidence is 0.63% (9/1425 OAGB). All patients were symptomatic. Median (interquartile range) EWL and lowest albumin were 103.7% (range 57.6, 114) and 24 g/dL (range 19, 27), respectively, and 8/10 patients had significant micronutrient deficiencies. Before revision, nutritional optimization was undertaken. Median OAGB to revision interval was 18.4 months (range 15.7, 27.8). Median BPL length was 200 cm (range 177, 227). Reversal (n = 5), BPL shortening (n = 3), and conversion to Roux-en-Y gastric bypass (RYGB) (n = 2) were performed. One patient had anastomotic leak after BPL shortening. No death occurred. Median BMI and albumin increased from 22.4 kg/m(2) (range 20.6, 30.3) and 35.5 g/dL (range 29.2, 41), respectively, at revision to 27.5 (range 22.2, 32.4) kg/m(2) and 39.5 g/dL (range 37.2, 41.7), respectively, at follow-up (median 25.4 months, range 3.1, 45). Complete resolution occurs after conversion to RYGB or reversal to normal anatomy, but not after BPL shortening. Conclusions: Revisional surgery of OAGB for severe PEM is feasible and safe after nutritional optimization. Our results suggest that the type of revision may be an important factor for PEM resolution. Comparative studies are needed to define the role of each revisional option
Cytoreduction surgery with hyperthermic intraperitoneal chemotherapy in recurrent ovarian cancer improves progression‐free survival, especially in BRCA‐positive patients—A case‐control study
No full textWounds, roots, conservations and confrontations: family ties and their meanings between daughters and sons with sexual dissidence
No full textilustraciones, diagramas, fotografíasEl vínculo familiar se entiende como una relación íntima y afectiva en el espacio privado y desde el que interactúan los miembros de ese grupo; se trata de una relación conectada con el mundo externo y el mundo interno en las dinámicas familiares. La investigación buscó comprender los significados que hijas e hijos con disidencia sexual atribuyen a sus vínculos familiares. Esta propuesta de investigación busca reflexionar y responder a la comprensión de esos significados desde el Interaccionismo Simbólico y la teoría del vínculo afectivo. La investigación se fundamenta en cuatro producciones narrativas construidas desde grupos de discusión y entrevistas semiestructuradas a hijas e hijos con disidencia sexual considerando algunos aspectos de la metodología Queer. Se encontró que la familia presenta un vínculo tensionado-cuidador ante la existencia de la disidencia sexual de hijas e hijos que, idealiza el amor como un punto de fuga a la vinculación dolorosa y violenta. De igual manera, se identificó que el vínculo familiar seguro por medio de la interacción, forma la personalidad de las hijas e hijos y les permite explorar su propia identidad y orientación sexual en relación con su familia y otros contextos. En conclusión, se encontró que la configuración de los vínculos familiares ejerce por un lado un vínculo violento asumido por los miembros de la familia que expresa el rechazo y la relación filial cuando la hija o el hijo manifiestan su identidad sexual diversa; por otro lado, hay un vínculo familiar en transición en el proceso de revelación que se comprende ambivalente. (Texto tomado de la fuente).The family tie is understood as an intimate and emotional relationship in private space in which the members of that group interact; it is a relationship connected with the external and the internal world in family dynamics. The research looked for understand the indications that daughters and sons with sexual dissidence attribute to their family ties. This research proposal is looking for reflect and respond to the understanding of these indications from Symbolic Interactionism and the theory of the emotional tie. This research is based on four narrative productions constructed from discussion groups and semi-structured interviews with daughters and sons with sexual dissidence, taking into account some aspects of the Queer methodology. It was found that the family presents a strained caregiver bond due to the existence of sexual dissidence of daughters and sons who idealize love as a point of escape from painful and violent bonding. Likewise, it was identified that a secure family bond through interaction forms the personality of daughters and sons and allows them to explore their own identity and sexual orientation in relation to their family and other contexts. In conclusion, it was found that the configuration of family ties assumes, on the other hand, an assumed violent tie which expresses rejection and filial relationship when the daughter or son expresses their diverse sexual identity; On the other side, there is a family tie in transition in the revelation process that is understood as ambivalent.MaestríaMagíster en Trabajo Social con énfasis en Familia y Redes SocialesMetodología Queer desde la técnica de Producciones Narrativas.Familia y redes sociale
