scholarly journals Fiber Type Determines Feline Gut Microbiome Metabolism and Bioactive Lipid Profiles in Feces (P20-034-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Matthew Jackson ◽  
Dennis Jewell
Keyword(s):  
Mixed Model ◽  
Fiber Type ◽  
Serum Levels ◽  
Short Chain Fatty Acids ◽  
Fatty Acid Esters ◽  
Crude Fiber ◽  
Bioactive Lipids ◽  
Funding Sources ◽  
Randomized Design ◽  
The Impact

Abstract Objectives Dietary fiber consists of indigestible carbohydrate. A distinction in fiber classification is “soluble” (SOL) vs “insoluble” (INSOL). Fiber is not absorbed in the small intestine, but arrives intact to the colon where it is metabolized by microbiota. Metabolomics screening determined the impact of foods with SOL vs INSOL fiber on microbiome metabolites and bioactive lipids in feces from cats. Methods Healthy cats were housed in environments promoting social interaction with other cats and people, had access to natural light varying with season, opportunity to exercise and were fed to maintain body weight. Collections under IACUC approved protocols. Two foods produced: SOL (5.2% crude fiber analyzed) and INSOL (10.1% crude fiber analyzed). SOL had citrus & beet pulps, oat bran and barley. INSOL had pea & tomato fiber, and cellulose. Randomized design, with cats assigned SOL (n = 15), INSOL (n = 16). Cats fed for 12 weeks. Metabolomics by LC-MS, short chain fatty acids (SCFA) by GC-FID (feces). Data analyzed by mixed model, paired t-test, Hotelling's T2 test and correlation. Significant when P < 0.05. Results SOL increased flavonoids in the feces, likely from fiber-bound sources; these were metabolized by gut microbiota to postbiotics. Only SOL increased SCFA acetate and propionate but not butyrate. INSOL decreased, and SOL increased putrefactive branched SCFA. Polyamine putrefaction products were decreased by INSOL relative to SOL; fecal polyamine levels predicted serum levels. Fecal microbial metabolites of resistant starch, polyphenols and redox congeners were all correlated to fecal taurine across both foods. INSOL significantly decreased the N-acyl classes of fecal endocannabinoids while leaving the O-acyl class unchanged. SOL increased the O-acyl class. Fecal anti-inflammatory fatty acid esters of hydroxystearate (FAHSA; linoleic, oleic and palmitic) were significantly increased by INSOL relative to SOL. Fecal 9/13 hydroxyoctadecadienoates (HODE) were increased by INSOL relative to SOL, but the 9–10/12–13 dihydroxyoctadecaenoates (DiHOME) were not affected. Conclusions There are apparent microbiome benefits to both SOL and INSOL fibers. The results here increase awareness of the importance of fiber for felines and further the effort to optimize fiber type and quantity in foods for cats. Funding Sources Hill's Pet Nutrition.

scholarly journals Differences in the Fecal Metabolome and Microbiome Between Exclusive and Partial Breastfed Infants are More Pronounced at 2 Months Compared to 5 Months

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1097-1097 ◽  
Author(s):  
Aidong Wang ◽  
Aly Diana ◽  
Sofa Rahmannia ◽  
Rosalind Gibson ◽  
Lisa Houghton ◽  
...  
Keyword(s):  
Exclusive Breastfeeding ◽  
Feeding Practices ◽  
Illumina Miseq ◽  
Short Chain Fatty Acids ◽  
P Value ◽  
Fecal Samples ◽  
Breastfed Infants ◽  
Funding Sources ◽  
Gates Foundation ◽  
The Impact

Abstract Objectives This study aimed to characterize the impact of feeding practices on the infant fecal metabolome and microbiome at 2 months and 5 months of age in exclusive breastfeeding (EBF) and partial breastfeeding (PBF) infants. Methods Fecal samples were collected from infants at 2 months and 5 months of age from Bandung, Indonesia. Exclusive breastfeeding was determined using the stable isotope deuterium dose-to-mother (DTM) technique. Fecal metabolites were extracted using Dulbecco's phosphate-buffered saline, and analyzed using NMR spectroscopy. Fecal microbial DNA was extracted at the same time using the MoBio PowerLyzer PowerSoil DNA isolation kit (MoBio, Carlsbad, CA). The V4 region of 16SrRNA was targeted. The DNA library sample was analyzed via 300-bp paired-end sequencing on the Illumina MiSeq platform. Results Fecal samples from EBF infants at 2 months of age revealed significantly higher human milk oligosaccharides (HMOs), short-chain fatty acids and related metabolites compared to PBF infants. However, fecal samples from infants at 5 months of age revealed no differences in metabolome between EBF and PBF after p-value adjustment for multiple comparisons. Gut microbes, especially Bifidobacterium were higher in EBF infants at age 2 months even though not statistically significant. However, this difference was eliminated at age 5 months. Conclusions In the present study, infant feeding practices had a stronger influence on the infant fecal metabolome and microbiome at the age of 2 months as compared to 5 months. Funding Sources 2014 Bill & Melinda Gates Foundation. CS would also like to acknowledge funding from the Kinsella endowed chair in Food, Nutrition, and health as well as USDA-NIFA Hatch project 1,021,411.

scholarly journals Changes in Eating Behaviors and Confidence Towards Cooking After an 8-Week Online Cooking and Nutrition Tutorials in Adults Living with an Overweight Condition or Obesity

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1294-1294
Author(s):  
Tamara Cohen ◽  
May Slim ◽  
Hugues Plourde ◽  
Valerie Bouzo ◽  
Vanessa Dumeaux ◽  
...  
Keyword(s):  
Self Efficacy ◽  
Food Access ◽  
Eating Behaviors ◽  
Fruits And Vegetables ◽  
Mixed Model ◽  
Eating Behaviour ◽  
Eating Behaviours ◽  
Funding Sources ◽  
Long Term Follow Up ◽  
The Impact

Abstract Objectives This study tested the impact of online cooking and nutrition tutorials on eating behaviours and psychosocial determinants of cooking skills among adults living with an overweight condition or obesity. Methods Healthy adults 18–65 y living with an overweight condition or obesity (25 &lt; body mass index [BMI] &lt; 40 kg/m2) living in the greater Montreal (Quebec) Canada were randomized (1:1:1) to one of three groups: Control [Ctrl; weekly delivery of food with paper-based recipes], Nutrition [weekly delivery of food, access to online cooking and nutrition tutorials] or Behaviour [weekly delivery of food, access to online cooking and eating behaviour tutorials] over 8 weeks. Cooking and education videos were &lt;4 min long total and were viewed through private YouTube links. At baseline and 8 weeks, anthropometrics and sociodemographic were surveyed, as were appetitive traits (i.e., Food Responsiveness, Hunger, Emotional Overeating, Enjoyment of Food, Satiety Responsiveness, Food Fussiness, Emotional Undereating and Slowness in Eating) using the Adult Eating Behavior Questionnaire [AEBQ]. Cooking barriers and confidence towards cooking, confidence in consuming fruits and vegetables and self-efficacy were also assessed. Mixed model ANOVAs were used to test for differences among groups over time. Results At baseline, forty-eight participants with a mean age of 34.0 ± 12.9 y and BMI of 30.2 ± 4.5 kg/m2 were enrolled. Significant differences were seen in the Slowness in Eating subscale between Behaviour (1.64 ± 0.98) and Ctrl (2.46 ± 0.88) (P &lt; 0.02). At 8 weeks, Emotional Overeating scores significantly decreased in both Nutrition and Behaviour compared to Ctrl (P = 0.03). Other AEBQ subscales did not vary by time or group. From baseline to 8 weeks, all groups significantly increased scores for confidence towards cooking (P &lt; 0.001), confidence in consuming of fruits and vegetables (P &lt; 0.001) and general self-efficacy (P &lt; 0.001). Conclusions The weekly provision of food baskets with online cooking and nutrition tutorials elicited changes in eating behaviours in adults living with an overweight condition and obesity. Future studies including a long-term follow-up and larger sample size are needed to confirm these positive findings. Funding Sources R. Howard Webster Foundation.

scholarly journals The impact of daily troponin-I and D-dimer serum levels on mortality of moderate-to-severe COVID-19 pneumonia patients

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
B Stavileci ◽  
E Ozdemir
Keyword(s):  
Intensive Care ◽  
Troponin I ◽  
Coronary Bypass ◽  
Serum Levels ◽  
Chronic Obstructive ◽  
High Morbidity ◽  
Obstructive Pulmonary Disease ◽  
Funding Sources ◽  
The Impact ◽  
D Dimer

Abstract Introduction Coronavirus Disease 2019 (COVID-19) caused by that infection resulted in a very high morbidity and mortality rates globally. Purpose The aim of this study is to analyses the daily Troponin-I and D-dimer levels and their impact on the need for intensive care and mortality of the COVID-19 infected patients. Methods 206 patients who were hospitalized between 20.03.2020–05.05.2020 with a diagnosis of moderate-to-severe COVID-19 pneumonia were analyzed retrospectively. Serum Troponin-I and D-dimer levels were recorded at least 10 days. Results Average age was higher in mortality group compared to non-mortality group (respectively 67.79±14.9, 56.87±18.15, p:&lt;0.001). Presence of hypertension, diabetes mellitus, previous coronary bypass surgery, heart failure, chronic renal failure and chronic obstructive pulmonary disease were statistically significant affecting mortality (respectively p:0.003, p:0.004, p:0.045, p:0.02, p:0.003, p:0.007). First 10 days measurements of Troponin-I and D-dimer values was associated with mortality and intensive care requirement (p&lt;0.001). Both Troponin-I and D-dimer were higher in mortality group compared to the patients requiring intensive care. Troponin-I value on the 7th day ≥16.05 pg/ml was related with need for intensive care (AUC: 0.896, sensitivity: %78.6, specificity: %78.3, p&lt;0.001). Troponin-I value ≥30.25 pg/ml on the 9th day was related with mortality (AUC: 0.920, sensitivity: %89.5, specificity: %89.3, p&lt;0.001). D-dimer value ≥878 hg/ml on the 2nd day was associated with intensive care need (AUC: 0.896, sensitivity: %78.6, specificity %78.3, p&lt;0.001). D-dimer value ≥1106 hg/ml on the 10th day was associated with mortality (AUC: 0.817, sensitivity: %68.4, specificity: %65.2, p&lt;0.001). It was observed that hospitalization periods ≥9.5 days were associated with mortality (AUC: 0.738, sensitivity %68.4, specificity: %65.9, p&lt;0.001). Conclusion We observed that hospitalizations ≥9.5 days increased mortality. Troponin-I and D-dimer follow-ups in serum are more effective than other inflammatory markers to show the need for intensive care and mortality. A high Troponin-I value should alert the clinician in terms of clinical deterioration. FUNDunding Acknowledgement Type of funding sources: None.

Impact of Pseudomonas putida on the Growth Parameters of Fenugreek (Trigonella foenum- graecum L.): A Traditional Herbal Boon for Rural Areas

2017 ◽  
Vol 5 (2) ◽  
pp. 93-96
Author(s):  
Shashi Kant Shukla ◽  
◽  
Awadhesh Kumar ◽  
Anupam Dikshit ◽  
◽  
...  
Keyword(s):  
Pseudomonas Putida ◽  
Rural Areas ◽  
Growth Parameters ◽  
Leguminous Plant ◽  
Food Protein ◽  
Botany Department ◽  
Medicinal Value ◽  
Randomized Design ◽  
Trigonella Foenum Graecum L ◽  
The Impact

The present study aims the impact of Pseudomonas putida on different growth parameters of Trigonella sp., a leguminous plant to support the requirement of food, protein along with their medicinal value in the rural areas of India. A pot experiment was arranged based on completely randomized design with four replications at Biological Product Laboratory, Botany Department, University of Allahabad. Treatments were given at the seed level with one of control. Results indicated that application of P. putida significantly improved vegetative growth and showed an edge on the growth of the fenugreek as compared to the control.

Investigating the Impact of Cognitive Training for Individuals With Bothersome Tinnitus: A Randomized Controlled Trial

2021 ◽  
pp. 019459982199474
Author(s):  
Maggie Xing ◽  
Dorina Kallogjeri ◽  
Jay F. Piccirillo
Keyword(s):  
Randomized Controlled Trial ◽  
Cognitive Training ◽  
Mixed Model ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Functional Index ◽  
Open Label ◽  
Randomized Controlled ◽  
The Impact

Objective To evaluate the effectiveness of cognitive training in improving tinnitus bother and to identify predictors of patient response. Study Design Prospective open-label randomized controlled trial. Setting Online. Methods Participants were adults with subjective idiopathic nonpulsatile tinnitus causing significant tinnitus-related distress. The intervention group trained by using auditory-intensive exercises for 20 minutes per day, 5 days per week, for 8 weeks. The active control group trained on the same schedule with non–auditory intensive games. Surveys were completed at baseline, 8 weeks, and 12 weeks. Results A total of 64 participants completed the study. The median age was 63 years (range, 25-69) in the intervention group and 61 years (34-68) in the control group. Mixed model analysis revealed that within-subject change in Tinnitus Functional Index in the intervention group was not different than the control group, with marginal mean differences (95% CI): 0.24 (–11.20 to 10.7) and 2.17 (–8.50 to 12.83) at 8 weeks and 2.33 (–8.6 to 13.3) and 3.36 (–7.91 to 14.6) at 12 weeks, respectively. When the 2 study groups were compared, the control group had higher Tinnitus Functional Index scores than the intervention group by 10.5 points at baseline (95% CI, –0.92 to 29.89), 8.1 at 8 weeks (95% CI, –3.27 to 19.42), and 9.4 at 12 weeks (95% CI, –2.45 to 21.34). Conclusion Auditory-intensive cognitive training was not associated with changes in self-reported tinnitus bother. Given the potential for neuroplasticity to affect tinnitus, we believe that future studies on cognitive training for tinnitus remain relevant.

scholarly journals A prospective, observational clinical trial on the impact of COVID-19-related national lockdown on thyroid hormone in young males

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Giulia Brigante ◽  
Giorgia Spaggiari ◽  
Barbara Rossi ◽  
Antonio Granata ◽  
Manuela Simoni ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Serum Levels ◽  
Stressful Event ◽  
Italian Population ◽  
Reference Ranges ◽  
Endocrine Regulation ◽  
Before And After ◽  
Hpt Axis ◽  
The Impact

AbstractTrying to manage the dramatic coronavirus disease 2019 (COVID-19) infection spread, many countries imposed national lockdown, radically changing the routinely life of humans worldwide. We hypothesized that both the pandemic per se and the consequent socio-psychological sequelae could constitute stressors for Italian population, potentially affecting the endocrine system. This study was designed to describe the effect of lockdown-related stress on the hypothalamic-pituitary-thyroid (HPT) axis in a cohort of young men. A prospective, observational clinical trial was carried out, including patients attending the male infertility outpatient clinic before and after the national lockdown for COVID-19 pandemic. The study provided a baseline visit performed before and a follow-up visit after the lockdown in 2020. During the follow-up visit, hormonal measurements, lifestyle habits and work management were recorded. Thirty-one male subjects were enrolled (mean age: 31.6 ± 6.0 years). TSH significantly decreased after lockdown (p = 0.015), whereas no significant changes were observed in the testosterone, luteinising hormone, follicle-stimulating hormone, estradiol and prolactin serum levels. No patient showed TSH serum levels above or below reference ranges, neither before nor after lockdown. Interestingly, TSH variation after lockdown was dependent on the working habit change during lockdown (p = 0.042). We described for the first time a TSH reduction after a stressful event in a prospective way, evaluating the HPT axis in the same population, before and after the national lockdown. This result reinforces the possible interconnection between psychological consequences of a stressful event and the endocrine regulation.

scholarly journals Association of Genetic Polymorphisms and Serum Levels of IL-6 and IL-8 with the Prognosis in Children with Neuroblastoma

Cancers ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 529
Author(s):  
Silvia Selene Moreno-Guerrero ◽  
Arturo Ramírez-Pacheco ◽  
Luz María Rocha-Ramírez ◽  
Gabriela Hernández-Pliego ◽  
Pilar Eguía-Aguilar ◽  
...  
Keyword(s):  
Overall Survival ◽  
Genetic Polymorphisms ◽  
Poor Prognosis ◽  
Serum Levels ◽  
Control Group ◽  
Mexican Children ◽  
Genotype Frequencies ◽  
Pcr Rflp ◽  
The Impact ◽  
Circulating Levels

There is evidence that high circulating levels of IL-6 and IL-8 are markers of a poor prognosis in various types of cancer, including NB. The participation of these cytokines in the tumor microenvironment has been described to promote progression and metastasis. Our objective was to evaluate the prognostic role of genetic polymorphisms and serum levels of IL-6 and IL-8 in a cohort of Mexican pediatric patients with NB. The detection of the SNPs rs1800795 IL-6 and rs4073 and rs2227306 IL-8 was carried out by PCR-RFLP and the levels of cytokines were determined by the ELISA method. We found elevated circulating levels of IL-8 and IL-6 in NB patients compared to the control group. The genotype frequencies of the rs1800795 IL-6 and rs4073 IL-8 variants were different between the patients with NB and the control group. Likewise, the survival analysis showed that the GG genotypes of rs1800795 IL-6 (p = 0.014) and AA genotypes of rs4073 IL-8 (p = 0.002), as well as high levels of IL-6 (p = 0.009) and IL-8 (p = 0.046), were associated with lower overall survival. We confirmed the impact on an adverse prognosis in a multivariate model. This study suggests that the SNPs rs1800795 IL-6 and rs4073 IL-8 and their serum levels could be promising biomarkers of a poor prognosis, associated with overall survival, metastasis, and a high risk in Mexican children with NB.

scholarly journals Prognostic role of docetaxel-induced suppression of free testosterone serum levels in metastatic prostate cancer patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Paula Kappler ◽  
Michael A. Morgan ◽  
Philipp Ivanyi ◽  
Stefan J. Brunotte ◽  
Arnold Ganser ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Metastatic Prostate Cancer ◽  
Cox Regression ◽  
Specific Antigen ◽  
Progression Free Survival ◽  
Serum Levels ◽  
Biologically Active ◽  
Free Form ◽  
Total Testosterone ◽  
The Impact

AbstractTo date, only few data concerning the biologically active, free form of testosterone (FT) are available in metastatic prostate cancer (mPC) and the impact of FT on disease, therapy and outcome is largely unknown. We retrospectively studied the effect of docetaxel on FT and total testosterone (TT) serum levels in 67 mPC patients monitored between April 2008 and November 2020. FT and TT levels were measured before and weekly during therapy. The primary endpoint was overall survival (OS). Secondary endpoints were prostate-specific antigen response and radiographic response (PSAR, RR), progression-free survival (PFS), FT/TT levels and safety. Median FT and TT serum levels were completely suppressed to below the detection limit during docetaxel treatment (FT: from 0.32 to < 0.18 pg/mL and TT: from 0.12 to < 0.05 ng/mL, respectively). Multivariate Cox regression analyses identified requirement of non-narcotics, PSAR, complete FT suppression and FT nadir values < 0.18 pg/mL as independent parameters for PFS. Prior androgen-receptor targeted therapy (ART), soft tissue metastasis and complete FT suppression were independent prognostic factors for OS. FT was not predictive for treatment outcome in mPC patients with a history of ART.

scholarly journals POS0329 GASTROINTESTINAL INVOLVEMENT IN SYSTEMIC SCLEROSIS: PATHOGENETIC ROLE OF GUT MICROBIOME, CYTOKINES AND ADIPOKINES

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 392.1-392
Author(s):  
E. Pigatto ◽  
M. Schiesaro ◽  
M. Caputo ◽  
M. Beggio ◽  
P. Galozzi ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Gut Microbiome ◽  
Serum Levels ◽  
High Serum ◽  
Healthy Population ◽  
Gastrointestinal Involvement ◽  
Degrading Bacteria ◽  
Gi Symptoms ◽  
Low Levels ◽  
The Impact

Background:Gastrointestinal (GI) involvement is very common in patients with Systemic Sclerosis (SSc). The pathophysiology of GI manifestations has not yet been defined. Cell-mediated immunological reactions appear to lead to endothelial damage resulting in fibrosis. The risk of developing malnutrition reinforces the need to better understand GI pathophysiology in these patients.Objectives:The study aimed to evaluate GI symptoms (GIT 2.0) and malnutrition status (MUST) and to determine specific bacterial changes in gut microbiome by investigating the possible presence of positive hot spots in bacterial species in SSc patients and their potential role in the disease progression. We also evaluated serum levels of adipokines and cytokines involved in the pathogenesis of SSc and their role, in addition to gut microbiome, in predicting the onset of GI involvement and malnutrition in SSc patients.Methods:We enrolled 25 scleroderma patients (EULAR/ACR 2013 criteria). UCLA-SCTC GIT 2.0 questionnaire to evaluate GI symptoms and MUST to investigate the risk of malnutrition were used. Gut microbiome was analyzed and the samples were subjected to extraction for the 16S rRNA gene (Earth Microbiome Project and the NIH-Human Microbiome Project). The microbiome was investigated at phenotypic and genotypic level. Serum levels of cytokines and adipokines (adiponectin and leptin) were evaluated by ELISA.Results:79.9% of patients had GERD and 63.5% abdominal distension at GIT 2.0 questionnaires. 48% of patients had moderate risk of malnutrition (MUST=2) and 12% had high risk (MUST=3). Gut microbioma: 19 patients (76%) had low similarity and 11 (44%) low diversity compared to the healthy population. The prevailing enterotypes of gut microbiome was Bacteroides (80%) and Prevotella (20%). The genotypic evaluation showed a reduced concentration of: gluten-digesting (Lactobacillus); lactose-digesting (Faecalibacterium); vitamin K-producing (Enterococcus, Desulfovibrio and Veillonella); acetaldehyde-degrading bacteria. 24 patients (96%) showed a reduction in bacteria devoted to maintaining weight control (Bifidobacterium and Ruminococcus). The patients had an altered intestinal permeability with less mucolytic bacteria (Bacteroides) and reduced production of LPS (Enterobacter and Escherichia). Low levels of butyrate (Eubacterium and Clostridium), acetate and propionate were found for SCFA-producing bacteria. Potentially pathogenic bacteria were also investigated: Salmonella was found in 14 (56%), Klebsiella in 9 (36%) and Enterococcus Faecalis in 3 (12%) patients. 11 (44%) patients had elevated serum levels of IL10 and IL12; 4 (16%) had high value of leptin. Correlation was found in patients who had a reduced concentration of gluten-digesting bacteria and MUST. Elevated MUST was correlated with serological increase in IL17A and IFN-α. Serum levels of IL12 and IL10 were found to correlate with specific bacteria alterations: high concentration of acetaldehyde-producing bacteria and low levels of acetaldehyde-degrade bacteria (also correlated with high serum levels of IL6), mucolytic bacteria and producers of hydrogen sulphide, acetate and propionate. Finally, reduced levels of mucolytic bacteria and acetate producing bacteria correlated with high serum leptin levels.Conclusion:The relationship between the gut microbiome and SSc seems to be multifactorial. In our study genotypic changes of gut microbioma might play a role in damaging the permeability of the mucosa and increasing risk of malnutrition. The evaluation of gut microbiome and cytokine profile is probably going to be of value in the follow-up of SSc. However, further studies are needed to clarify the impact of GI dysbiosis on the immune system in SSc.References:[1]Patrone V. et al. Gut microbiota profile in systemic sclerosis patients with and without clinical evidence of gastrointestinal involvement, Sci Rep. 2017; 7: 14874Disclosure of Interests:None declared

scholarly journals Clinical implementation of a 3D4K-exoscope (Orbeye) in microneurosurgery

2021 ◽  
Author(s):  
Judith Rösler ◽  
Stefan Georgiev ◽  
Anna L. Roethe ◽  
Denny Chakkalakal ◽  
Güliz Acker ◽  
...  
Keyword(s):  
User Satisfaction ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Intraoperative Complications ◽  
Rank Test ◽  
User Group ◽  
Clinical Implementation ◽  
Physical Strain ◽  
Conventional Microscope ◽  
The Impact

AbstractExoscopic surgery promises alleviation of physical strain, improved intraoperative visualization and facilitation of the clinical workflow. In this prospective observational study, we investigate the clinical usability of a novel 3D4K-exoscope in routine neurosurgical interventions. Questionnaires on the use of the exoscope were carried out. Exemplary cases were additionally video-documented. All participating neurosurgeons (n = 10) received initial device training. Changing to a conventional microscope was possible at all times. A linear mixed model was used to analyse the impact of time on the switchover rate. For further analysis, we dichotomized the surgeons in a frequent (n = 1) and an infrequent (n = 9) user group. A one-sample Wilcoxon signed rank test was used to evaluate, if the number of surgeries differed between the two groups. Thirty-nine operations were included. No intraoperative complications occurred. In 69.2% of the procedures, the surgeon switched to the conventional microscope. While during the first half of the study the conversion rate was 90%, it decreased to 52.6% in the second half (p = 0.003). The number of interventions between the frequent and the infrequent user group differed significantly (p = 0.007). Main reasons for switching to ocular-based surgery were impaired hand–eye coordination and poor depth perception. The exoscope investigated in this study can be easily integrated in established neurosurgical workflows. Surgical ergonomics improved compared to standard microsurgical setups. Excellent image quality and precise control of the camera added to overall user satisfaction. For experienced surgeons, the incentive to switch from ocular-based to exoscopic surgery greatly varies.

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