922017 research outputs found
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The Long-term Outcomes of Sacral Neuromodulation for Fecal Incontinence: A Single Center Experience
Full text linkBackground: Sacral neuromodulation is an effective treatment for faecal incontinence. Objective: This study aimed to assess the long-term outcomes of sacral neuromodulation and establish the outcomes of patients with inactive devices.cDesign: This is an observational study of patients treated for more than 5 years. A positive outcome was defined as a >50% reduction in faecal incontinence episodes or improvement in a symptom severity score. Data was reviewed from a prospectively managed database. Settings: This study was conducted at a single tertiary referral centre.Patients: Data from 74 patients (72 female) were available at long-term follow up.Main Outcome Measures: Bowel diary, St. Mark’s incontinence score, and Manchester Health Questionnaire data were prospectively recorded at baseline, after peripheral nerve evaluation, and at last follow-up.Results: Patients were analysed in cohorts based on time since sacral neuromodulation implantation: Group 1: 5-10 years (n=20), Group 2: >10 years (n=35), and Group 3: inactive SNM devices (n=19). Median St. Mark’s incontinence score and Manchester Health Questionnaire improved from baseline to last follow-up in Group 1 (p=<0.05) and Group 2 (p=<0.05), but in Group 3 results returned to baseline levels at last follow-up. Similarly, weekly faecal incontinence episodes improved in both active device groups at last follow-up. However, in Group 3 incontinence episodes were no different from baseline (p=0.722). Despite active devices, faecal urgency episodes increased at last follow-up after more than 10 years since peripheral nerve evaluation (p=<0.05). Complete continence was reported by 44% of patients, and at least a 50% improvement in 77% with active devices.Limitations: This study is retrospective with some gaps in the available data at last follow-up.Conclusions: Sacral neuromodulation is an effective treatment for faecal incontinence in the long term, but all outcomes are adversely affected by device inactivity. Therefore, ongoing stimulation is required for continued benefit. <br/
The Long-term Outcomes of Sacral Neuromodulation for Fecal Incontinence: A Single Center Experience
Full text linkBackground: Sacral neuromodulation is an effective treatment for faecal incontinence. Objective: This study aimed to assess the long-term outcomes of sacral neuromodulation and establish the outcomes of patients with inactive devices.cDesign: This is an observational study of patients treated for more than 5 years. A positive outcome was defined as a >50% reduction in faecal incontinence episodes or improvement in a symptom severity score. Data was reviewed from a prospectively managed database. Settings: This study was conducted at a single tertiary referral centre.Patients: Data from 74 patients (72 female) were available at long-term follow up.Main Outcome Measures: Bowel diary, St. Mark’s incontinence score, and Manchester Health Questionnaire data were prospectively recorded at baseline, after peripheral nerve evaluation, and at last follow-up.Results: Patients were analysed in cohorts based on time since sacral neuromodulation implantation: Group 1: 5-10 years (n=20), Group 2: >10 years (n=35), and Group 3: inactive SNM devices (n=19). Median St. Mark’s incontinence score and Manchester Health Questionnaire improved from baseline to last follow-up in Group 1 (p=<0.05) and Group 2 (p=<0.05), but in Group 3 results returned to baseline levels at last follow-up. Similarly, weekly faecal incontinence episodes improved in both active device groups at last follow-up. However, in Group 3 incontinence episodes were no different from baseline (p=0.722). Despite active devices, faecal urgency episodes increased at last follow-up after more than 10 years since peripheral nerve evaluation (p=<0.05). Complete continence was reported by 44% of patients, and at least a 50% improvement in 77% with active devices.Limitations: This study is retrospective with some gaps in the available data at last follow-up.Conclusions: Sacral neuromodulation is an effective treatment for faecal incontinence in the long term, but all outcomes are adversely affected by device inactivity. Therefore, ongoing stimulation is required for continued benefit. <br/
The Long-term Outcomes of Sacral Neuromodulation for Fecal Incontinence: A Single Center Experience
Full text linkBackground: Sacral neuromodulation is an effective treatment for faecal incontinence. Objective: This study aimed to assess the long-term outcomes of sacral neuromodulation and establish the outcomes of patients with inactive devices.cDesign: This is an observational study of patients treated for more than 5 years. A positive outcome was defined as a >50% reduction in faecal incontinence episodes or improvement in a symptom severity score. Data was reviewed from a prospectively managed database. Settings: This study was conducted at a single tertiary referral centre.Patients: Data from 74 patients (72 female) were available at long-term follow up.Main Outcome Measures: Bowel diary, St. Mark’s incontinence score, and Manchester Health Questionnaire data were prospectively recorded at baseline, after peripheral nerve evaluation, and at last follow-up.Results: Patients were analysed in cohorts based on time since sacral neuromodulation implantation: Group 1: 5-10 years (n=20), Group 2: >10 years (n=35), and Group 3: inactive SNM devices (n=19). Median St. Mark’s incontinence score and Manchester Health Questionnaire improved from baseline to last follow-up in Group 1 (p=<0.05) and Group 2 (p=<0.05), but in Group 3 results returned to baseline levels at last follow-up. Similarly, weekly faecal incontinence episodes improved in both active device groups at last follow-up. However, in Group 3 incontinence episodes were no different from baseline (p=0.722). Despite active devices, faecal urgency episodes increased at last follow-up after more than 10 years since peripheral nerve evaluation (p=<0.05). Complete continence was reported by 44% of patients, and at least a 50% improvement in 77% with active devices.Limitations: This study is retrospective with some gaps in the available data at last follow-up.Conclusions: Sacral neuromodulation is an effective treatment for faecal incontinence in the long term, but all outcomes are adversely affected by device inactivity. Therefore, ongoing stimulation is required for continued benefit. <br/
In defence of existence questions
Full text linkDo numbers exist? Do properties? Do possible worlds? Do fictional characters? Many metaphysicians spend time and effort trying to answer these and other questions about the existence of various entities. These inquiries have recently encountered opposition: a group of philosophers, drawing inspiration from Aristotle, have argued that many or all of the existence questions debated by metaphysicians can be answered trivially, and so are not worth debating. Our task is to defend existence questions from the neo-Aristotelians' attacks
In defence of existence questions
Full text linkDo numbers exist? Do properties? Do possible worlds? Do fictional characters? Many metaphysicians spend time and effort trying to answer these and other questions about the existence of various entities. These inquiries have recently encountered opposition: a group of philosophers, drawing inspiration from Aristotle, have argued that many or all of the existence questions debated by metaphysicians can be answered trivially, and so are not worth debating. Our task is to defend existence questions from the neo-Aristotelians' attacks
Toward large scale parallel computer simulation of viscoelastic fluid flow: A study of benchmark flow problems
No full textFollowed by our previous study, an OpenFOAM-based viscoelastic flow solver has been further validated through simulation of viscoelastic flow past a cylinder. The drag coefficients calculated by the Oldroyd-B model under the creeping flow in a range of Weissenberg (Wi) number are in good agreements with those reported in the literature. Using the linear Phan-Thien Tanner (L-PTT) model, time-dependent two-dimensional simulations of flow past cylinder have been carried out in a range of Wi number and Reynolds (Re) number, and revealed interesting cooperative effects of inertia and elasticity on the structural evolution of the wake behind the cylinder. The details of parallel computing strategy are analysed and discussed. The codes are evaluated for large scale parallel simulation of two-dimensional and three-dimensional contraction flow as well as two-dimensional flow past a cylinder. The key bottlenecks, which affect the scalability of parallel computing, are discussed
Toward large scale parallel computer simulation of viscoelastic fluid flow: A study of benchmark flow problems
No full textFollowed by our previous study, an OpenFOAM-based viscoelastic flow solver has been further validated through simulation of viscoelastic flow past a cylinder. The drag coefficients calculated by the Oldroyd-B model under the creeping flow in a range of Weissenberg (Wi) number are in good agreements with those reported in the literature. Using the linear Phan-Thien Tanner (L-PTT) model, time-dependent two-dimensional simulations of flow past cylinder have been carried out in a range of Wi number and Reynolds (Re) number, and revealed interesting cooperative effects of inertia and elasticity on the structural evolution of the wake behind the cylinder. The details of parallel computing strategy are analysed and discussed. The codes are evaluated for large scale parallel simulation of two-dimensional and three-dimensional contraction flow as well as two-dimensional flow past a cylinder. The key bottlenecks, which affect the scalability of parallel computing, are discussed
