Postoperative analgesic efficacy of the thoracoabdominal nerves block through perichondrial approach (TAPA) and modified-TAPA for laparoscopic cholecystectomy: a randomized controlled study

Laparoscopic cholecystectomy is one of the most common surgical procedures. Even though there is less postoperative pain with laparoscopic cholecystectomy than with open cholecystectomy, severe pain can occur, particularly within the first 24 hours. Evaluation of the efficacy of ultrasound-guided interfascial plane blocks for postoperative analgesia of laparoscopic cholecystectomy has recently come to prominence. The aim of our study was to compare the postoperative analgesic efficacy of thoracoabdominal nerves block through perichondrial approach (TAPA) and modified-TAPA (m-TAPA) blocks in patients who underwent laparoscopic cholecystectomy. The present study included 56 patients who underwent laparoscopic cholecystectomy under general anesthesia and received TAPA or m-TAPA block for perioperative analgesia. Each patient signed a written informed consent form. Block times and numerical rating scale (NRS) scores 1, 2, 3, and 12 hours postoperatively, hourly and total tramadol amount of use via the patient-controlled analgesia device, and additional analgesic drug consumption were all recorded. The TAPA group had significantly longer block application times than the m-TAPA group. At 1 and 12 hours, NRS scores were lower in the TAPA group. However, the mean NRS scores, total tramadol use, and use of additional analgesics were comparable between the groups. TAPA and m-TAPA block methods reduced NRS scores by alleviating pain after laparoscopic cholecystectomy procedures, thereby reducing the need for additional analgesics. Block times for TAPA were significantly longer than those for m-TAPA. However, both block applications were completed in a short period, smoothly and safely. The analgesic effect of TAPA block was more distinctive at 1 and 12 hours, and NRS scores were lower. However, we think that both block methods, when used under ultrasound guidance, will provide effective analgesia by supplementing the multimodal analgesia planned for laparoscopic cholecystectomy and other abdominal operations.

Methods for image noise level estimation

The article presents a method for estimating the level of discrete white noise in an image, based on the use of linear difference operators with a vector mask. Two variants of a new method for estimating the noise level are proposed, which differ in the accuracy of the obtained estimates and computational complexity. The first version of the method can be attributed to the class of block methods, whereas the second one is intended for the rapid image analysis and is based on processing a small number of rows or columns of an image.

Cell Block Optimization: A Comparative Study of Quality Variables in 4 Different Cell Block Methods

<b><i>Objective:</i></b> The cell block (CB) is an important adjunct to cytological preparations in diagnostic cytopathology. Optimizing cellular material in the CB is essential to the success of ancillary studies such as immunohistochemistry (IHC) and molecular studies (MS). Our aim was to identify which CB method was most suitable in a variety of specimen types and levels of cellularity. <b><i>Study Design:</i></b> We assessed 4 different CB methods, thrombin clot method (TCM), MD Anderson method (MDAM), gelatin foam method (GFM), and agar method (AM), with descriptive observations and ranking of the methods based on quantity of cells and morphological features. <b><i>Results:</i></b> TCM performed best in ranking for both quantity of cells and morphological features, followed by MDAM, GFM, and AM. Lack of adjuvant in the MDAM resulted in some unique morphological advantages which, however, also resulted in inconsistent performance. In low cellularity cases insufficient cells were frequently identified on slides from MDAM and AM CBs. Technique touch time was similar for all methods, with total processing time being shortest for TCM followed by MDAM, GFM, and AM. <b><i>Conclusions:</i></b> TCM was the most robust CB technique, retaining high scores for ranking of quantity and morphology in a variety of specimen cellularities and specimen types.

Four-Step One Hybrid Block Methods for Solution of Fourth Derivative Ordinary Differential Equations

We consider developing a four-step one offgrid block hybrid method for the solution of fourth derivative Ordinary Differential Equations. Method of interpolation and collocation of power series approximate solution was used as the basis function to generate the continuous hybrid linear multistep method, which was then evaluated at non-interpolating points to give a continuous block method. The discrete block method was recovered when the continuous block was evaluated at all step points. The basic properties of the methods were investigated and said to be converge. The developed four-step method is applied to solve fourth derivative problems of ordinary differential equations from the numerical results obtained; it is observed that the developed method gives better approximation than the existing method compared with.

Method for detecting curvilinear trajectories of air targets using parametric transformations

For effective detection of maneuvering targets in conditions of low values of the signal-to-noise ratio, block methods of trajectory processing based on parametric transformations are used. The use of parametric transformations increases the resistance of the trajectory detection algorithm to an increase in the number of false marks and the omission of true ones in the analyzed sample, but is limited by the choice of a certain type of target movement model. The purpose of the article is to expand the possibilities for detecting target trajectories using parametric transformations by developing a new technique that solves the problem of detecting trajectories of air targets moving with lateral accelerations or maneuvering simultaneously in two planes. The paper proposes a method for restoring curvilinear trajectories of air objects (in the form of an ellipse) using the parametric Radon transform. The structure of the methodology is presented in the form of successive stages: formation of a sample of true and false marks for n surveys, parametric conversion of marks, clustering of selected groups, inter-survey identification of marks and making a decision on target detection and its trajectory. A variant of the parametric transformation for the selection of ellipses with various parameters and criteria for choosing the optimal values of the parameters that affect the operation of the technique are proposed. Estimates of the quality of the method are obtained based on the results of a statistical experiment, confirming the high capabilities of detecting target trajectories.