Kevin Krautsak

After elective sigmoidectomy for diverticulitis, patients may experience persistent abdominal symptoms. This study aimed to determine the incidence and characteristics of persistent symptoms (PSs) and their risk factors in patients who had no reported recurrence after elective sigmoidectomy. Patients who underwent elective sigmoidectomy for diverticulitis from 2002 to 2016 at a tertiary academic colorectal surgery practice were included. After retrospective review of medical records, patients were contacted with a questionnaire to inquire about recurrence of diverticulitis and persistent abdominal symptoms since resection. Outcomes examined were prevalence of and risk factors for PSs after elective sigmoidectomy. Of 662 included patients, 346 completed the questionnaire and had no recurrent diverticulitis. PSs were reported by 43.9 per cent of the patients. The mean follow-up was 87 months. Female gender and preoperative diagnosis of irritable bowel syndrome were independent risk factors for PSs (Relative Risk 1.65, P < 0.001 and Relative Risk 1.41, P = 0.014). Previous IVantibiotics treatment was associated with PSs (P = 0.034) but not with a significant risk factor. As the follow-up interval increased, prevalence of PSs decreased (P = 0.006). More than 40 per cent of patients experienced persistent abdominal symptoms after sigmoidectomy for diverticulitis. Female patients and those with irritable bowel syndrome were at significantly increased risk.

This study evaluated the influence of simulated inflammation and cathodic polarization on the electrochemical properties of commercially pure titanium (CpTi) and titanium–6%aluminum–4%vanadium (Ti6Al4V). Normal conditions immersed the metals in phosphate buffered saline at open circuit potential (OCP). Inflammatory conditions immersed the metals in a 150 mMhydrogen peroxide titrated to pH = 5.0 at OCP. Cathodic inflammatory conditions immersed the metals in the inflammatory electrolyte at −1 V versus Ag/AgCl. Cathodic polarization scans revealed a more electropositive corrosion potential (E_corr) and an increased corrosion current density (I_corr) for both metals after incubation at inflammatory conditions (CpTi:E_corr = 171 mV,I_corr = 147 nA/cm²and Ti6Al4V:E_corr = 241 mV andI_corr = 413 nA/cm²) as compared to normal conditions (CpTi:E_corr = −249 mV,I_corr = 19 nA/cm²and Ti6Al4V:E_corr = −263 mV andI_corr = 11 nA/cm²). Electrochemical impedance spectroscopy showed the polarization resistance (R_p) decreases and constant phase element (CPE) magnitude increases for both metals when comparing normal (CpTi:R_p = 3.5 MΩ cm², CPE = 35 µS s^α/cm²and Ti6Al4V:R_p = 6.5 MΩ cm²and CPE = 30 µS s^α/cm²) to inflammatory (CpTi:R_p = 79 kΩ cm², CPE = 55 µS s^α/cm²and Ti6Al4V:R_p = 230 kΩ cm²and CPE = 56 µS s^α/cm²) to cathodic inflammatory (CpTi:R_p=24 kΩ cm², CPE = 290 µS s^α/cm²and Ti6Al4V:R_p = 12 kΩ cm²and CPE = 250 µS s^α/cm²) conditions. These observed changes are consistent with the formation of a thin and defective oxide film. Inductively coupled plasma mass spectroscopy revealed that inflammatory conditions increased dissolution of both metals and that the addition of cathodic potential significantly increased the dissolution of the beta phase elements of Ti6Al4V. © 2014 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 102B: 1445–1453, 2014.