Visible Loss Research Articles

“Through-stent enterography”: first experience with a novel technique intended to improve safety in endosonography-guided gastroenterostomy

Background and AimsEndosonographic-guided gastroenterostomy (EUS-GE) is a novel technique to manage symptoms of gastric outlet obstruction. Major challenges are the high mobility of intestinal loops and the transient loss of endosonographic visibility during the puncture. This can lead to stent-misdeployment, which can be associated with potentially fatal adverse events. By injecting contrast medium through the guidewire-channel of the lumen apposing metal stent (LAMS) application system under fluoroscopic guidance, a positive enterogram can confirm the position of the stent inside the intestinal lumen before its deployment. The aim of this study was to describe this novel technique and to assess its feasibility. MethodsThe data of 39 consecutive patients undergoing EUS-GE with “through-stent-enterography” between July 2020 and March 2022 were retrospectively collected and analyzed. Primary endpoint was to assess the technical success. Secondary endpoints were to assess adverse events, rate of reinterventions and clinical success. ResultsTechnical success was achieved in all cases (n=39). In two cases a second puncture was required to place the stent successfully. In one case, misdeployment could be avoided after a negative enterogram. In the other case, misdeployment occurred despite a positive enterogram a reintervention was needed. Clinical success was achieved in 92.3% (n=36). No major adverse events or mortalities were encountered. Conclusions“Through-stent-enterography” after the puncture to confirm the correct position of the stent in the small bowel is a novel and simple technique, which can potentially reduce the risk of misdepolyment of the stent.

Adaptive Image Compression via Optimal Mesh Refinement

Abstract The JPEG algorithm is a defacto standard for image compression. We investigate whether adaptive mesh refinement can be used to optimize the compression ratio and propose a new adaptive image compression algorithm. We prove that it produces a quasi-optimal subdivision grid for a given error norm with high probability. This subdivision can be stored with very little overhead and thus leads to an efficient compression algorithm. We demonstrate experimentally, that the new algorithm can achieve better compression ratios than standard JPEG compression with no visible loss of quality on many images. The mathematical core of this work shows that Binev’s optimal tree approximation algorithm is applicable to image compression with high probability, when we assume small additive Gaussian noise on the pixels of the image.

Экспериментальная оценка объёмной концентрации и размеров твёрдых частиц дыма, образующихся при терморазложении горючих материалов

Purpose. The purpose of the work is the experimental assessment of size as well as mass and calculated volumetric concentration of smoke solid particles formed during burning of combustible materials, using wood, insulation of cables and microelectronics elements as the examples. Methods. The authors used the experimental method for measuring the amount, size and mass of suspended solids particles in a gaseous medium formed in a small-scale experimental installation during the combustion of various substances and materials. Findings. The enhancement of experimental installation has been carried out and the experimental methodology has been developed that allows measuring the parameters of solid smoke particles. Experimental dependencies on the time of mass and countable volumetric concentration of smoke particles depending on their size have been obtained during testing wood samples, insulating cables and microelectronics elements. It has been found that the most dangerous, in terms of the effect on a human body during evacuation in case of a fire, finely dispersed solid particles of smoke are formed throughout the entire burning time. It is shown that the maximum mass and countable volume concentration of particles is formed at the incipient stage of combustion, and the mass volume concentrations of particles of all sizes significantly exceed their critical values. Research application field. The results can be applied at determining the blocking time of escape routes by visibility loss, and the consequences of human body exposure to smoke particles. Conclusions. It is necessary to conduct further studies in order to justify the introduction of a new fire hazard into regulatory documents on fire safety – the concentration and size of smoke particles, as well as create a database on the size of smoke particles formed during combustion of modern combustible substances and materials, and their mass and calculated volumetric concentrations.

Role of Injection Tranexamic Acid in Reducing Blood Loss in Peri Trochanter Fracture Surgeries

Background: For patients undergoing surgery for peritrochanteric fractures, blood loss is a big issue. The purpose of this study was to see if tranexamic acid (TXA) could reduce postoperative blood loss in individuals who had hip surgery for peritrochanteric fracture. Methods: A total of 69 patients with intertrochanteric fractures were enrolled in this prospective study. Patients are randomly divided into two groups. Group A patients received 200 mL (1 g) of TXA intravenously before peritrochanter surgery and Group B patients did not receive an injection of TXA. Haemoglobin and hematocrit values were measured preoperatively and postoperatively at days 1 and 3. Visible and hidden blood loss volumes were calculated on postoperative day 3. Results: The blood transfusion rate was reduced significantly in patients by injecting tranexamic acid before surgery. However, mean haemoglobin and hematocrit levels were not significantly different between patients who received injection tranexamic acid and those who did not receive injection tranexamic acid. Conclusion: TXA significantly reduced postoperative blood loss in patients with Peritrochanteric fractures who underwent surgery.

Investigating Visible Cane Loss and Stump Damage Due to Sugarcane Chopper Harvester Usage in Thailand

Sugarcane farmers face a primary concern regarding cane losses when employing mechanized harvesters. The present study aimed to investigate visible cane losses resulting from the use of large- and medium-sized chopper harvesters. Investigation of the cane losses by sugarcane harvesters was focused on the loss from remaining cane stumps, the extractors, and the elevators. The damage index of sugarcane stumps was investigated in the presented study. Large harvester usage led to cane losses of 2.19, 0.53, and 0.27 t/ha attributed to remaining sugarcane stumps, extractor-stage losses, and elevator-stage losses, respectively. The total cane loss from using large harvesters amounted to 2.99 t/ha (4.0% of total yield). Similarly, the use of medium-sized harvesters led to cane losses of 2.21, 0.44, and 0.20 t/ha attributed to remaining sugarcane stumps, extractor-stage losses, and elevator-stage losses, respectively. The total cane loss from using medium-sized harvesters was 2.85 t/ha (3.4% of total yield). Notably, the primary factor contributing to visible cane loss from sugarcane harvesters was the remaining stumps, which account for 71% and 76% of the total cane loss when using large- and medium-sized harvesters, respectively. The damage index for sugarcane stumps due to large- and medium-sized harvester usage was 0.04 and 0.12, respectively. Overall, these findings emphasize that resolving cane loss and stump damage caused by sugarcane harvesters is crucial for improving harvesting efficiency.

The increase in the surface brightness of the night sky and its importance in visual astronomical observations

The problem of sky pollution with artificial light currently affects practically all branches that are related to the broadly understood environment. This is especially true for astronomical observations. This paper presents the results of measurements of the surface brightness of the night sky for the city of Rzeszów and the surrounding area, which were made in 2015, 2018 and 2021 using the photometer Sky Quality Meter (SQM-L). The measurements show that the surface brightness of the night sky in Rzeszów in 2015 was in the range from 19.20 to 18.67 mag/arcsec2, in 2018 the value of brightness oscillated in the range from 18.53 to 16.47 mag/arcsec2, and in 2021 this value was in the range from 17.13 by 15.11 mag/arcsec2. Translating the obtained values on the Bortle scale, we can see an increase in the brightness of the night sky from class VI in 2015 to class IX in 2021. A similar trend applies to neighboring towns, for which an increase in brightness from class IV in 2015 to class VIII in 2021 was also observed. An increase in the surface brightness of the night sky causes a deterioration or even loss of visibility of astronomical objects in the night sky. This is especially true for comets and low-brightness stars. Based on the measurement results, a forecast of the development of light pollution was prepared for the study areas until 2025. This forecast shows that we will still have to deal with an increase in the surface brightness of the night sky. Due to the further projected increase in the brightness of the night sky, it should be expected that observers in small towns will experience changes in the quality of the sky over the coming years, which will undoubtedly make astronomical observations difficult, in particular for faint celestial bodies such as comets.

Atom Interferometry with Coherent Enhancement of Bragg Pulse Sequences.

We report here on the realization of light-pulse atom interferometers with large-momentum-transfer atom optics based on a sequence of Bragg transitions. We demonstrate momentum splitting up to 200 photon recoils in an ultracold atom interferometer. We highlight a new mechanism of destructive interference of the losses leading to a sizable efficiency enhancement of the beam splitters. We perform a comprehensive study of parasitic interferometers due to the inherent multiport feature of the quasi-Bragg pulses. Finally, we experimentally verify the phase shift enhancement and characterize the interferometer visibility loss.

Systematic review and meta-analysis of topical tranexamic acid in spine surgery.

Tranexamic acid (TXA) is an antifibrinolytic drug associated with reduced blood loss in a range of surgical specialties, including neurosurgery, orthopedic surgery, and cardiac surgery. Concerns about venous thromboembolism and seizures from intravenous (IV) TXA have led to increased use of topical TXA. Given the relative scarcity of the literature on topical TXA compared with that on IV TXA within neurosurgery, the authors aimed to conduct a systematic review and meta-analysis on the safety, efficacy, and optimal administration of topical TXA in a wide range of spinal procedures and pathologies. The PRISMA guidelines, Cochrane risk of bias tool, and Newcastle-Ottawa Scale were used to extract randomized controlled trials and high-quality case-control and cross-sectional/cohort studies (adult studies only) from PubMed, Web of Science, Cochrane Library, and Embase published between 2016 and 2023. Studies were analyzed by two independent reviewers for variables including dosage, TXA administration route, type of spine procedure, blood loss, adverse events including thromboembolism and infection, postoperative hemoglobin level, and hospitalization length. Pooled analysis comparing intraoperative and postoperative blood loss, postoperative hemoglobin levels, and hospitalization length of stay on the basis of route of TXA administration was conducted. Four cohort studies, 1 cross-sectional study, 1 case-control study, and 12 randomized controlled trials, together involving 2045 patients, were included. The most common route of topical TXA administration was via TXA in saline solution. Other routes of topical TXA included retrograde injection and TXA-soaked Gelfoam. In pooled analysis, topical TXA significantly reduced visible blood loss (standardized mean difference [SMD] -0.22, 95% CI -0.45 to -0.00001), postoperative blood loss (SMD -1.63, 95% CI -2.03 to -1.22), and length of hospital stay (SMD -1.02, 95% CI -1.42 to -0.61), as well as higher postoperative hemoglobin (SMD 0.59, 95% CI 0.34-0.83), compared with non-TXA controls. No significant differences in outcomes were found between topical and IV TXA or between combined (topical and IV) and IV TXA. Thromboembolism and infection rates did not significantly differ between any TXA administration group and non-TXA controls. In pooled analyses, topical TXA was associated with decreased perioperative blood loss in a wide range of scenarios, including cervical spine surgery and thoracolumbar trauma, as well as in patients with a thromboembolic history.

N-Heterocyclic carbene-based gold etchants.

N-Heterocyclic carbenes (NHCs) are an emerging alternative to thiols for the formation of stable self-assembled monolayers (SAMs) on gold. We examined several different species that have been used to produce NHC-based monolayers on gold, namely 1,3-diisopropyl-5-nitrobenzimidazolium iodide, 1,3-diisopropyl-5-nitrobenzimidazolium hydrogen carbonate, bis(1,3-diisopropyl-5-nitrobenzimidazolium)gold(I) iodide, and 1,3-diisopropyl-5-nitrobenzimidazole-2-ylidene. Contrary to expectation, solutions containing the first two species in tetrahydrofuran and dichloromethane caused visible loss of gold from thin-film-coated glass slides. The use of toluene solutions of all species resulted in no apparent dissolution of gold. We present scanning electron micrographs and elemental imaging analyses by energy dispersive X-ray spectroscopy to examine the effect of solutions of each species on the gold film. This work highlights the risk of unwanted etching during some routes to NHC-based surface functionalization but also the potential for deliberate etching, with the outcome determined by choice of chemically synthesized organic species and solvent.

Continuous and Impact Cutting in Mechanized Sugarcane Harvest: Quality, Losses and Impurities

Sugarcane harvesting requires improvements, particularly in cutting tools. Continuous cutting saws have been introduced as a solution to this issue. This study evaluates the performance of two basal sugarcane cutting systems in different fields: a traditional impact cut system (ICS) with knives and a continuous cut system (CCS) with saw blades. Tests were conducted during two crop cycles in three areas, using a 3 × 2 factorial design with two cutting devices and four replications per treatment. Cut quality indices and ratoon damage were analyzed using descriptive statistics. Raw material losses were subjected to the Shapiro–Wilk normality test, ANOVA, and Tukey’s test at 5% probability. Significant differences in cutting quality were found across different areas. The total crop productivity influenced sugarcane cut quality, with the CCS showing (0.8 Mg ha−1) visible losses in higher productivity areas, which is a 74% increase compared to the ICS. In lower productivity areas, the CCS demonstrated better loss performance (0.8 Mg ha−1). Additionally, the stumps damage rate for the CCS was lower than that for the ICS (0.15 and 0.28, respectively), indicating that saws can preserve cane fields and enhance longevity.

Production and Characterization of k-Carrageenan Films Incorporating Cymbopogon winterianus Essential Oil as New Food Packaging Materials.

The global production of synthetic plastics from petroleum-based raw ingredients exceeds 150 million metric tons. The environment is threatened by tons of plastic waste, thus endangering wildlife and the public's health. These consequences increased the interest in biodegradable polymers as potential substitutes for traditional packaging materials. This study aimed to produce and characterize k-carrageenan films incorporating Cymbopogon winterianus essential oil, in which citronellal was determined to be the major compound (41.12%). This essential oil presented remarkable antioxidant activity, as measured through DPPH (IC50 = 0.06 ± 0.01%, v/v; AAI = 85.60 ± 13.42) and β-carotene bleaching (IC50 = 3.16 ± 0.48%, v/v) methods. The essential oil also showed antibacterial properties against Listeria monocytogenes LMG 16779 (diameter of inhibition zone = 31.67 ± 5.16 mm and MIC = 8 µL/mL), which were also observed when incorporated in the k-carrageenan films. Moreover, scanning electron microscopy showed the reduction of the biofilms of this bacterium, and even its inactivation, due to visible destruction and loss of integrity when the biofilms were created directly on the developed k-carrageenan films. This study also revealed the quorum sensing inhibition potential of Cymbopogon winterianus essential oil (diameter of violacein production inhibition = 10.93 ± 0.81 mm), where it could impede intercellular communication and, hence, lower violacein synthesis. The produced k-carrageenan films were transparent (>90%) and slightly hydrophobic (water contact angle > 90°). This work demonstrated the viability of using Cymbopogon winterianus essential oil to produce k-carrageenan bioactive films as new food packaging materials. Future work should focus on the scale-up production of these films.

Nanocomposite Organogel for Art Conservation─A Novel Wax Resin Removal System.

We describe a new, safe, and effective method for removing wax resin adhesive from the canvases of paintings conserved by the once widely used Dutch Method, which involved attaching a new canvas to the back of a painting using an adhesive made of beeswax and natural resin. First, a low-toxicity cleaning mixture for dissolving the adhesive and removing it from the canvases was developed, and then a nanocomposited organogel was obtained. The ability of the organogel to remove the adhesive from canvases was investigated on the lining of the 1878 painting "Battle of Grunwald" by Jan Matejko, with promising results. Additionally, we found that the organogel can be used several times with no visible loss of cleaning ability. Finally, the effectiveness and safety of the method were confirmed on two oil paintings (one from the National Museum in Warsaw): all the wax resin adhesive was removed and the painting regained its original brightness and vivid colors.

“It’s the not being seen that is most tiresome”: Older women, invisibility and social (in)justice

Older women experience intersectional discrimination at the nexus of ageism and sexism. This is embodied, women’s aging bodies being culturally devalued within youth-privileging cultures and the hyper-sexualization of younger, able-bodied, women. Older women often face the dilemma of attempting to mask the signs of aging or aging “authentically” but encountering heightened stigma, prejudice, and discrimination. Very old women in the fourth age who “fail” to age “successfully” are subject to extreme social exclusion. Many older women speak of experiencing a loss of visibility as they age, however how this occurs, and what it means, has not yet been analyzed in depth. This is an important issue, as recognition—cultural status and visibility—is essential for social justice. This article reports on findings taken from a U.K. survey on experiences of ageism and sexism completed by 158 heterosexual, lesbian, and bisexual women aged 50 to 89. Their perceived invisibility took five forms: (a) being under-seen/mis-seen in the media; (b) being mis-seen as objects of sexual undesirability; (c) being “ignored” in consumer, social, and public spaces; (d) being “grandmotherized,” that is, seen only through the lens of (often incorrectly) presumed grandmotherhood; (e) being patronized and erroneously assumed to be incompetent. The findings are compared with Fraser’s social justice model. The argument presented is that older women’s experiences of nonrecognition and misrecognition are profound sources of social injustice. Both increased visibility and cultural worth are needed for older women to enjoy the benefits of social justice in later life.

Exploring the life experiences of stroke survivors in Nigeria using the interpretive phenomenological analysis

BackgroundThe consequence of living as a stroke survivor has received significant attention in literature from different parts of the world. Enriching social relations and other factors are reported to influence the post-stroke experience. Differences in health systems, cultural factors and available resources have made it apt to explore the experience of life after a stroke in Nigerian stroke survivors. This study explored the lived experiences of Nigerian adult stroke survivors, with a focus on their concerns, hopes, dreams and daily routine experiences.MethodsThis qualitative study employed a phenomenological approach based on in-depth interviews with stroke survivors. Interpretative phenomenological analysis was used to analyse the in-depth exploration of the personal experiences of these stroke survivors and the meanings they attached to that experience.ResultsThe participants in this study described their experiences, emphasising both the visible loss of mobility and emotional issues related to their condition. Three superordinate themes were identified: (1) stroke presentation; (2) affect, coping, and adaptation; and (3) social supports.ConclusionThe study concluded that the experience of Nigerian stroke survivors is unique as it is a blend of supportive and non-supportive care scenarios, which is greatly associated with environmental and other intrinsic variables. Post-stroke mobility strongly influences the overall stroke experience.

Neural message-passing for objective-based uncertainty quantification and optimal experimental design

Various real-world scientific applications involve the mathematical modeling of complex uncertain systems with numerous unknown parameters. Accurate parameter estimation is often practically infeasible in such systems, as the available training data may be insufficient and the cost of acquiring additional data may be high. In such cases, based on a Bayesian paradigm, we can design robust operators retaining the best overall performance across all possible models and design optimal experiments that can effectively reduce uncertainty to enhance the performance of such operators maximally. While objective-based uncertainty quantification (objective-UQ) based on MOCU (mean objective cost of uncertainty) provides an effective means for quantifying uncertainty in complex systems, the high computational cost of estimating MOCU has been a challenge in applying it to real-world scientific/engineering problems. In this work, we propose a novel scheme to reduce the computational cost for objective-UQ via MOCU based on a data-driven approach. We adopt a neural message-passing model for surrogate modeling, incorporating a novel axiomatic constraint loss that penalizes an increase in the estimated system uncertainty. As an illustrative example, we consider the optimal experimental design (OED) problem for uncertain Kuramoto models, where the goal is to predict the experiments that can most effectively enhance robust synchronization performance through uncertainty reduction. We show that our proposed approach can accelerate MOCU-based OED by four to five orders of magnitude, without any visible performance loss compared to the state-of-the-art. The proposed approach applies to general OED tasks, beyond the Kuramoto model.

The effect of intravenous unit-dose tranexamic acid on visible and hidden blood loss in posterior lumbar interbody fusion: a randomized clinical trial

There are few reports of intravenous unit-dose tranexamic acid (TXA) on the relationship between visible blood loss (VBL) and hidden blood loss (HBL) in posterior lumbar interbody fusion (PLIF). Therefore, the objective of this randomized, prospective, double-blind, single center study was to investigate the effect of intravenous unit-dose TXA on VBL and HBL in patients who underwent PLIF. Among 100 patients, 11 were excluded due to failue to comply with the study, 1 was excluded due to non-conpliance with the study, and 88 were eligible for inclusion in the study. 46 patients who treated with PLIF received unit-dose of TXA (1 g/100 mL) intravenously 15 min before skin incision after general anesthesia (observation group) and 42 patients were given 100 mL of normal saline (control group). The operation time, intraoperative blood loss, postoperative drainage, VBL, HBL, blood transfusion rate, and adverse events were recorded in the two groups. Besides, activated partial prothrombin time (APTT), prothrombin time (PT), thrombin time (TT), fibrinogen (FIB), platelets (PLT), red blood cells (RBC), hemoglobin (HB), hematocrit (HCT), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) on the 1st postoperative day; and RBC, HB, HCT, CRP, ESR on the 4th postoperative day were recorded. All 88 patients successfully completed the operation, the incision healed well, and there was no deep vein thrombosis of the lower extremity after operation. The intraoperative blood loss, postoperative drainage, VBL, HBL, and blood transfusion rate in the observation group were lower than those in the control group, and the differences were statistically significant (p < 0.05). There was no significant difference in operation time between the two groups (p > 0.05). There was no significant difference in postoperative APTT, PT, TT, FIB, PLT, RBC, HB, HCT, CRP and ESR between the two groups (p > 0.05). Intravenous unit-dose TXA is safe and feasible in PLIF, and it can effectively reduce perioperative VBL and HBL.

İçme Suyu Şebekelerinde Kayıp Kaçak Seviyesinin Belirlenmesi: Merzifon İlçesi Örneği

Bu çalışmada içme suyu şebekelerinde meydana gelen fiziki su kayıplarının su kaynağının korunmasında önemli hususlardan biri olduğu gözler önüne serilmiştir. İçme suyu talebi nüfus artışıyla birlikte her geçen gün artmaktadır. Buna karşın içilebilir su miktarı azalmakta ve içme suyu şebekelerinde suyun etkin kullanımı önemli hale gelmektedir. Su şebekesine verilen ancak kullanıcılara ulaşmayan su kayıp kaçak olarak bilinmektedir. Kayıp kaçaklar fiziki ve görünür kayıplar olarak adlandırılmaktadır. Araştırmada su kayıp kaçak seviyesinin belirlenmesi için 2020 yılına ait sisteme verilen su miktarları, boru arıza sayıları, kullanım alanlarına göre su tüketim miktarları, minimum gece debi bilgileri belediyeden temin edilmiştir. Merzifon örneğinde su kayıp kaçak seviyesinin tespiti için su dengesi oluşturularak, altyapı sızıntı indeksi tespit edilmiştir. Merzifon örneğinde 2020 yılına ait fiziki su kayıp miktarının % 44.12 olduğu tespit edilmiştir. Altyapı sızıntı indeksi (ILI) 13.6 olarak tespit edilmiştir. Su kaynağının korunması için içme suyu şebekesindeki basınç yönetimi, şebeke yenileme, aktif sızıntı kontrolü, onarım hız ve kalitesinin iyileştirilmesi çalışmaları yapılmalıdır.

Can severity of trunnion damage be estimated by visual inspection alone?

Taper corrosion has been widely reported to be problematic for modular total hip arthroplasty implants. A simple and systematic method to evaluate taper damage with sufficient resolution is needed. We introduce a semiquantitative grading system for modular femoral tapers to characterize taper corrosion damage. After examining a unique collection of retrieved cobalt-chromium (CoCr) taper sleeves (n = 465) using the widely-used Goldberg system, we developed an expanded six-point visual grading system intended to characterize the severity, visible material loss, and absence of direct component contact due to corrosion. Female taper sleeve damage was evaluated by three blinded observers using the Goldberg scoring system and the expanded system. A subset (n = 85) was then re-evaluated following destructive cleaning, using both scoring systems. Material loss for this subset was quantified using metrology and correlated with both scoring systems. There was substantial agreement in grading among all three observers with uncleaned (n = 465) and with the subset of cleaned (n = 85) implants. The expanded scoring criteria provided a wider distribution of scores which ultimately correlated well with corrosion material loss. Cleaning changed the average scores marginally using the Goldberg criteria (p = 0.290); however, using the VGS, approximately 40% of the scores for all observers changed, increasing the average score from 4.24 to 4.35 (p = 0.002). There was a strong correlation between measured material loss and new grading scores. The expanded scoring criteria provided a wider distribution of scores which ultimately correlated well with corrosion material loss. This system provides potential advantages for assessing taper damage without requiring specialized imaging devices.

Is the use of blue dye really necessary in axillary sentinel lymph node biopsy in staging of breast cancer?

Sentinel lymph node biopsy (SLNB) is the standard of care for staging the clinically node-negative axilla in early breast cancer. Evidence guiding current practice describes dual localization technique using Patent blue dye and radioisotope (99mTc). Adverse effects of blue dye include 1:1000 risk of anaphylaxis, skin staining and loss of plane visibility, which may increase operative time and reduce resectional accuracy. The risk to a patient posed by anaphylaxis may be greater when operating in a unit without on-site ITU support - a situation more common with recent restructuring during the COVID-19 pandemic. Aim is to quantify the benefit of blue dye above radioisotope alone in identifying nodal disease. This is a retrospective analysis of prospectively collected sentinel node data including all consecutive sentinel node biopsies in a single center during the period 2016-2019.In terms of results, 760 sentinel nodes were taken in 435 patients. 59 nodes (7.8%) were detected by blue dye alone; 120 (15.8%) 'hot' only, 581 (76.5%) hot and blue. 4 of the blue only nodes contained macrometastases but 3 of these patients had further hot nodes excised that also contained macrometastases. 1 out of 435 patients (0.2%) had macro metastatic disease identified as a result of blue dye alone which would have been missed had it not been used. In conclusion, the use of blue dye carries risk and offers little benefit in terms of staging in SLNB and its use may be unnecessary in the hands of the skilled surgeon. This study supports the omission of blue dye, which may be advisable if operating in units without ITU support. If larger studies support these figures, it may become as outdated.

Hidden blood loss between percutaneous pedicle screw fixation and the mini-open Wiltse approach with pedicle screw fixation for neurologically intact thoracolumbar fractures: a retrospective study

BackgroundThe aim of this study was to determine the proportion of hidden blood loss (HBL) in patients treated with minimally invasive surgery, and to compare the HBL between patients treated with percutaneous pedicle screw fixation (PPSF) and the mini-open Wiltse approach with pedicle screw fixation (MWPSF).MethodsFrom January 2017 to January 2019, a total of 119 patients with thoracolumbar fractures were included in the analysis, of which 58 cases received PPSF and 61 cases received MWPSF. The clinical information and demographic results were collected and compared. And the HBL of the patients is calculated by the combination formulas of Nadler, Gross and Sehat.ResultsCompared with the PPSF group, operation time of MWPSF is shorter. The fluoroscopy times are 13.6 ± 3.0 in PPSF group and 5.6 ± 1.6 in MWPSF group (p < 0.001). As shown in Table 3, the intraoperative blood loss in PPSF group is 31.9 ± 9.6 ml, which is significantly less than that in the MWPSF group (44.0 ± 14.9 ml). The HBL (445.7 ± 228.9 ml), and HBL% (91.2 ± 7.7%) of the PPSF group are significantly higher than that in the MWPSF group (P < 0.05). And the total blood loss (TBL) of the PPSF group (477.6 ± 228.8 ml) is also more than that in the MWPSF group (401.0 ± 171.3 ml).ConclusionsOur results suggest that in the minimally invasive surgical treatment of thoracolumbar fractures, the perioperative HBL is much higher than visible blood loss (VBL). Although PPSF has less intraoperative blood loss, it has higher TBL and HBL than those of MWPSF. Compared with MWPSF, we should pay more attention to the postoperative anemia status of patients with thoracolumbar fractures undergoing PPSF surgery.