Conmed

Background: Pragmatic trials inform clinical decision with better generalizability and can bridge different streams of medicine. This study collated the expectations regarding pragmatic trial design of integrative medicine (IM) for diabetes and kidney diseases among patients and physicians. Dissonance between users' perspective and existing pragmatic trial design was identified. The association between risk of bias and pragmatism of study design was assessed. Method: A 10-group semi-structured focus group interview series [21 patients, 14 conventional medicine (ConM) and 15 Chinese medicine (CM) physicians] were purposively sampled from private and public clinics in Hong Kong...

The immunogenicity of HIV-1 envelope (Env) trimers is generally poor. We used the clinically relevant ConM SOSIP trimer to compare the ability of different adjuvants (squalene emulsion, ISCOMATRIX, GLA-LSQ, and MPLA liposomes) to support neutralizing antibody (NAb) responses in rabbits. The trimers were administered as free proteins or on nanoparticles. The rank order for the adjuvants was ISCOMATRIX > SE > GLA-LSQ ~ MPLA liposomes > no adjuvant. Stronger NAb responses were elicited when the ConM SOSIP trimers were presented on ferritin nanoparticles...

Robot-assisted extraperitoneal para -aortic lymphadenectomy has been reported to be feasible option for the surgical management of gynecologic malignancy previously (Narducci et al., 2009) (Hudry et al., 2019). We have reported the feasibility of laparoscopic extraperitoneal total para -aortic and pelvic lymphadenectomy (Andou, 2016). This article aims to show the safety of robot-assisted extraperitoneal "total para -aortic and pelvic" lymphadenectomy. The video is the staging surgery for 67-year-old woman suspected clinical stage IA ovarian clear cell carcinoma after abdominal hysterectomy and salpingo-oophorectomy...

Transanal minimally invasive surgery (TAMIS) can be performed robotically assisted (R-TAMIS) for easier rectal defect suture closure particularly on the anterior rectal wall. The surgical technique described in this technical note emphasizes three safety points: 1) decreased likelihood for rectal injury when the ports are inserted into the GelPOINT® Path Transanal Access Platform (Applied Medical, Rancho Santa Margarita, California) on the back table rather than being inserted into the rectum; 2) decreased external collision between ports when using ports of different length; and 3) increased stabilization of pneumorectum when insufflating with an AirSeal™ port (Intelligent Flow System, ConMed, Utica, New York)...

Background . New insufflators have been developed to manage leaks emanating from the working cavity during laparoscopic surgery. Little data have been published to show the performance of these insufflators. This study evaluates the performance of 2 modern continuous pressure insufflators in various leak conditions. Methods . Performance of a new continuous pressure insufflator, EVA15 (Palliare, Galway, Ireland), was compared with that of a continuous pressure insufflator, Airseal intelligent Flow System (iFS) (CONMED, Utica, NY), and a traditional intermittent pressure insufflator, Endoflator 40 (KARL STORZ, Tuttlingen, Germany)...

Objectives: Many surgeons use uterine manipulator (UM) during laparoscopic hysterectomy (LH). In this study, we aimed to compare the outcomes of LH operations performed by using partially reusable UM with the articulated system (artUM) and disposable (dUM) UM without articulation. Materials and Methods: A total of 99 patients underwent the LH operation. This study was carried out with 35 of those 99 Caucasian patients who met the inclusion criteria. Group 1 consisted for 7 LH operations using the articulated RUMI® II/KOH-Efficient™ (Cooper Surgical, Trumbull, CT, USA) system (artUM), while Group II consisted of 28 patients using old-type V Care® (ConMed Endosurgery, Utica, New York, USA) dUM as UM...

BACKGROUND: Non-disclosure of conventional medicine use to complementary medicine health professionals may result in patient harm. Currently, no standardised validated instrument is available to measure reasons for conventional medicine disclosure or non-disclosure. OBJECTIVE: The aim of this study was to develop and evaluate a multidimensional index for identifying reasons for conventional medicine disclosure and non-disclosure by patients. METHODS: Drawing upon a sub-sample of the Complementary and Alternative Medicine Use Health Literacy Disclosure Study (N = 520), a formative measurement approach was used to develop a Conventional Medicine Disclosure Index (CONMED-DI)...

INTRODUCTION: Arthroscopic Bankart revision after recurrent shoulder dislocation is still a matter of discussion. Several factors are contributing to this injury. Recently the development of all suture anchors has grown in popularity in arthroscopic stabilization. It was proven to preserve bone stock, smaller in size thus more anchors can be made. PRESENTATION OF CASE: We presented a case of 27-year-old woman with recurrent anterior dislocation after seven years of arthroscopic Bankart repair...

BACKGROUND: Extra-articular fluid extravasation is a known complication during shoulder arthroscopy. The risk and amount of extravasation to a large degree is dependent on the fluid pressure delivered to the surgical site. Accurate measurement, knowledge, and control of the pressure delivered is thus important to surgeons, anesthetists, and the patient. The purpose of this study was to compare the pressure measurement accuracy of 3 arthroscopic fluid pumps, with 2 of them having 2 different settings...

OBJECTIVE: In comparison with laparoscopic transperitoneal para-aortic lymphadenectomy, the advantages of laparoscopic extraperitoneal para-aortic lymphadenectomy (ePAL) are that the operative field is not obstructed by bowel and the Trendelenburg position is not required [1]. The ePAL technique has been adopted to the robotic surgery with the da Vinci Xi. There are only a few reports demonstrating the technical feasibility of robot-assisted ePAL (RAePAL) [2 3]. This report describes the new surgical technique of RAePAL with the bipolar cutting method...

BACKGROUND: There is concern regarding bioaerosols from patients having procedures impacting surgical team safety. As pathogens and pollutants have been found in surgical smoke, we examined the potential for aerosol escape during transanal minimally invasive surgery (TAMIS) which may be particularly important given the presence of faecal contamination in the operative workspace and the specifics of its access platforms. METHODS: Both qualitative (thermographic imaging) and quantificative (particle counting) methods were used to assess for aerosol release during TAMIS in comparison to laparoscopic operations of similar duration and equipment both at times of surgical dissection and without...

The study aims to investigate the effects of cardiac fibroblast (CF) paracrine factors on murine embryonic stem cells (ESCs). Conditioned mediums from either neonatal cardiac fibroblasts (ConM-NCF) or adult cardiac fibroblasts (ConM-ACF) were diluted by 1:50 and 1:5, respectively, to investigate whether these conditioned mediums impact murine ESCs distinctly with RT-real time PCR techniques, cell proliferation essay, ELISA and by counting percentage of beating embryoid bodies (EBs) during ESCs differentiation...

Background: COVID-19 era has put laparoscopic surgery a risk procedure because of theoretical risk of viral transmission of COVID-19. However, safe evacuation of stagnant air during laparoscopic surgery is also necessary to safeguard health care warriors. Methods: We are reporting experience of 24 laparoscopic surgeries using a closed smoke evacuation/filtration system using a ultra low-particulate air (ULPA) filtration capability (ConMed AirSeal® System) at a single center between March 22, 2020, and May 30, 2020...

Two-component, self-assembling nanoparticles represent a versatile platform for multivalent presentation of viral antigens. Computational design of protein nanoparticles with differing sizes and geometries enables combination with antigens of choice to test novel multimerization concepts in immunization strategies where the goal is to improve the induction and maturation of neutralizing antibody lineages. Here, we describe detailed antigenic, structural, and functional characterization of computationally designed tetrahedral, octahedral, and icosahedral nanoparticle immunogens displaying trimeric HIV envelope glycoprotein (Env) ectodomains...

Unanticipated behaviours of the Airseal Insufflation and Access System (Conmed, NY, USA), in the public domain since 2017, have been recently restated by the manufacturer in light of the COVID19 pandemic and widespread concerns regarding aerosolization hazards during surgery. The associated video illustrates this device's tendency for intra-abdominal gas effluvium to be continually blown into the operating room during use as well as the phenomenon of air entrainment (i.e. the tendency for room air to be sucked into the abdomen) during high pressure intraoperative suctioning...

BACKGROUND: Difference of perspective between patients and physicians over integrative medicine (IM) research and service provision remains unclear despite significant use worldwide. We observed an exceptionally low utilisation of IM and potential underreporting in diabetes. We aimed to explore the barriers and recommendations regarding service delivery and research of IM service among diabetes patients and physicians. METHODS: A 10-group, 50-participant semi-structured focus group interview series was conducted...

Introduction: The recent COVID-19 pandemic outbreak has made surgeons change and take on newer strategies and safe exercises. All elective cases have been put off, but oncology cases need to be done to prevent progression of the disease. There is concern about minimally invasive surgery due to aerosol formation. Here we discuss how we have dealt with this in our colorectal surgery department taking into account current evidence about the danger of viral transmission during laparoscopic surgery. Discussion: We report a case of 28 years old female patient with carcinoma rectum...

BACKGROUND: This study presents a new technique for assembling an all-suture anchor from existing medical products. The biomechanical characteristics of this self-made anchor (SMA) are compared with those of an industrially manufactured all-suture anchor. METHODS: The SMAs were made from established medical products (FiberWire #2 and 2-mm FiberTape; Arthrex, Naples, FL, USA). Pretesting was performed in biphasic polyurethane foam blocks. In the next step, 10 SMAs and 10 industrially made anchors (IMAs; 1...

BACKGROUND: Mohs micrographic surgery, excisional surgery, and electrodessication and curettage (ED&C) are common dermatologic procedures that often use electrodessication through hyfrecators to achieve hemostasis. According to in vitro studies, electrodessication is considered safe in patients with implanted cardiac devices. To the authors' knowledge, there are no in vivo data to support this claim. OBJECTIVE: In this study, the authors aim to describe the outcomes of hyfrecation during dermatologic procedures in patients with pacemakers and implantable cardiac devices...

Introduction The modified Brostrom-Gould procedure is surgery to repair the lateral ligamentous complex of an ankle with chronic instability. A retrospective study was carried out among patients who had undergone this procedure at a medical center. Aim The aim of the study was to determine the mid-term functional outcome and rate of infection among patients who underwent the surgery using the PopLok® (CONMED, NY, US) Knotless Suture Anchor technique for lateral ankle instability. Methods Twenty patients who failed conservative treatment at the Universiti Kebangsaan Malaysia Medical Centre (UKMMC), Kuala Lumpur, and who were operated on by a single surgeon from January 2011 until March 2015 were selected to participate in this study...