Purpose: This study was performed to evaluate the association between mechanical bowel preparation (MBP) and perioperative outcomes following nephrectomy in the minimally invasive surgery (MIS) era. Methods: All partial and radical nephrectomies between 2019 and 2021 from the National Surgical Quality Improvement Program database were evaluated. Thirty-day perioperative outcomes were compared between groups where MBP was performed vs. not, in both the MIS and open surgery (OS) cohorts. A propensity score matching technique was utilized within MIS cases to control for covariates. The chi-square and t tests were used to determine significance. Results: A total of 11,869 cases met the inclusion criteria and were included in the analysis.Of these, 8,204 (69.1%; comprising 65.3% robotic and 34.7% laparoscopic) underwent MIS, while 3,655 (30.9%) underwent OS. The rate of MBP was higher in the MIS group (16.0% vs.10.0%, p < 0.001). Within the MIS group, MBP was associated with reduced rates of postoperative ileus (0.9% vs. 1.9%, p = 0.02), while other complications were comparable.Propensity score matching showed no association between MBP and postoperative ileus.However, a lower rate of 30-day readmission in the MBP group became statistically significant (4.4% vs. 6.4%, p = 0.01). Conversely, patients in the MBP group also demonstrated higher rates of pneumonia (1.29% vs. 0.46%, p = 0.002) and pulmonary embolism (0.6% vs. 0%, p < 0.001) after matching. Conclusion MBP practice prior to nephrectomy is infrequent in both OS and MIS cases, with minor differences in perioperative outcomes for patients undergoing MIS. Routine MBP should continue to be excluded from the standard of care for nephrectomy in the MIS era.

The hand coordinate systems for measuring vibration exposures and biodynamic responses have been standardized, but they are not actually used in many studies. This contradicts the purpose of the standardization. The objectives of this study were to identify the major sources of this problem, and to help define or identify better coordinate systems for the standardization. This study systematically reviewed the principles and definition methods, and evaluated typical hand coordinate systems. This study confirms that, as accelerometers remain the major technology for vibration measurement, it is reasonable to standardize two types of coordinate systems: a tool-based basicentric (BC) system and an anatomically based biodynamic (BD) system. However, these coordinate systems are not well defined in the current standard. Definition of the standard BC system is confusing, and it can be interpreted differently; as a result, it has been inconsistently applied in various standards and studies. The standard hand BD system is defined using the orientation of the third metacarpal bone. It is neither convenient nor defined based on important biological or biodynamic features. This explains why it is rarely used in practice. To resolve these inconsistencies and deficiencies, we proposed a revised method for defining the realistic handle BC system and an alternative method for defining the hand BD system. A fingertip-based BD system for measuring the principal grip force is also proposed based on an important feature of the grip force confirmed in this study.
Hand Strength ; Hand* ; Vibration*

OBJECTIVE: This study aims to determine the prevalence of low bone mass density (BMD) among premenopausal women with type 2 Diabetes Mellitus, the factors associated with low BMD and the relationships between BMD in association to the duration of DM, the type of physical activity and calcium intake of the patient.METHODOLOGY: This prospective study involved 33 patients seen at the Fatima Medical Center - OPD on October 2004. Bone mass density was determined using the dual-energy x-ray absorptiometry (DEXA scan). Relationship associations were computed using Chi square.RESULTS: Mean age was 49.55 yrs, mean weight 59.00 kg, mean height 1.56 m and mean duration of DM was 3.58 yrs. Only 27 percent of the subjects have low BMD. Majority (64 percent) have normal body mass index (BMI). As to the duration of DM, nine (27 percent) were newly diagnosed with less than one year duration, 45 percent had diabetes for 1-5 years. Most of the subjects (73 percent) are classified with moderate physical activity. As to their calcium intake, fifteen (45 percent) were not taking any calcium supplement, twelve (36 percent) in less than once a week calcium, and six (18 percent) more than once a week.CONCLUSION: There is minor prevalence (27 percent) of low BMD among the premenopausal type 2 diabetics. Factors associated with low bone mass density (age, BMI) had no significant association in this study. (Author)
Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Prospective Studies ; Absorptiometry, Photon