5 research outputs found
Whitehead Hemorrhoidectomy: Is It Time for a Second Look?
No full textBackground:
Hemorrhoidal problems are common causes of patient complaints. Most of the hemorrhoid-related issues can be managed conservatively; however, some patients with grade III and IV hemorrhoids are referred for surgical management. Several techniques including classic hemorrhoidectomy and dearterialization with or without Doppler guidance have been described. Although not as frequently performed, the Whitehead procedure remains occasionally utilized.
Objectives:
The goal of this study is to assess the short- and long-term outcomes of the Whitehead procedure in comparison to the Milligan–Morgan procedure.
Design:
Retrospective review.
Patients and Methods:
A review of all patients undergoing surgical treatment for grade III and IV hemorrhoids at 7th city hospital in Kyiv, Ukraine, between 2015 and 2021 was conducted. The rates of perioperative complications of the Whitehead procedures and overall outcomes were compared to the Milligan–Morgan techniques.
Main Outcome Measures:
Primary outcome included postoperative pain and secondary outcomes included short- and long-term postoperative complications.
Sample Size:
Three hundred and twenty-three patients were included in the study.
Results:
One hundred and seventy-three patients underwent the Whitehead procedure and 140 patients underwent the Milligan–Morgan procedure. There was no difference in age, sex, and comorbidities between the groups. There were no statistical differences between short-term complications, but the Whitehead group experienced less pain throughout the 14 days after surgery. All the patients were seen and examined 6 months after surgery; the patients who underwent the Whitehead procedure showed less prolapse when compared to those in the Milligan–Morgan group without increase in other complications.
Conclusions:
Whitehead hemorrhoidectomy is safe and shows less pain during recovery without remarkable increase in long-term complications.
Limitations:
This was a retrospective review and non-validated instruments were used in surveys.
Conflict of Interest:
The authors have no conflict of interest to declare
Complementarity and institutional change: How useful a concept?
No full textThe concept of institutional complementarity – i.e. the idea that the co-existence of two or more institutions enhances the functioning of each – is increasingly used to explain why institutions are resistant to change and why introducing new institutions into a system often leads to unintended consequences or failure to achieve the intended objective. While the concept is appealing and intuitive, in reality its utility for explaining change is less than straightforward. This paper utilizes examples from comparative political economy to, first, unpack and delineate the concept and address the issue of how to measure the strength or ‘binding force’ of complementarities. Second, it assesses the utility of the concept for explaining institutional change. It is suggested that one’s view of the methods and utility of measuring complementarity will hinge importantly on one’s general theory of institutions and institutional change. In the end, while institutional complementarities are significant, assessing their causal effect on institutional change is difficult and ambiguous in most instances. A better understanding requires that we embed complementarities within a more general theory of institutional change which takes a broader view of the ways in which institutions interconnect and change. -- Das Konzept der institutionellen Komplementarität – d.h. die Idee, dass zwei oder mehr Institutionen sich gegenseitig stützen und ihre Funktionsfähigkeit erhöhen – gilt mehr und mehr als Erklärung dafür, dass Institutionen gegen Veränderungen resistent sind und das Einführen neuer Institutionen in ein bestehendes System oft unerwartete Konsequenzen oder nicht darin erfolgreich sind, das gewünschte Ziel zu erreichen. Obwohl das Konzept attraktiv und intuitiv ist, ist sein Erklärungsnutzen nicht offensichtlich. In diesem Aufsatz werden Beispiele aus der vergleichenden politischen Ökonomie verwendet, um zunächst den Inhalt des Konzeptes zu umschreiben und die Frage zu stellen, wie die Stärke bzw. „Bindungskraft“ von Komplementaritäten zu messen sind. Dann bewertet er den Nutzen des Konzeptes zur Erklärung von institutionellem Wandel. Dabei ist darauf hinzuweisen, dass es stark vom Hintergrund des Betrachters, seiner allgemeinen Theorie von Institutionen und institutionellem Wandel, abhängt, welchen Blickwinkel er in Bezug auf die Einschätzung der Methoden und des Nutzen der Komplementaritätsmessung einnimmt. Abschließend stellt sich heraus, dass institutionelle Komplementaritäten wichtig sind, es aber in den meisten Fällen schwierig und unklar bleibt, ihren kausalen Effekt auf institutionellen Wandel zu bewerten. Zum besseren Verständnis ist es notwendig, dass das Konzept der Komplementaritäten in eine allgemeine Theorie des institutionellen Wandels eingebettet wird, die eine breitere Sicht über die Art und Weise zulässt, wie Institutionen untereinander verbunden sind und sich verändern.Institutions,Complementarities,Political Economy,Varieties of Capitalism
An experiment in contextualised comparative hermeneutics : a reading of Genesis 1-11 in the context of parallel Qur'anic material and Christian mission amongst Muslims in Elswick, Newcastle upon Tyne.
No full textGlobal disparities in surgeons' workloads, academic engagement and rest periods: the on-calL shIft fOr geNEral SurgeonS (LIONESS) study
No full text: The workload of general surgeons is multifaceted, encompassing not only surgical procedures but also a myriad of other responsibilities. From April to May 2023, we conducted a CHERRIES-compliant internet-based survey analyzing clinical practice, academic engagement, and post-on-call rest. The questionnaire featured six sections with 35 questions. Statistical analysis used Chi-square tests, ANOVA, and logistic regression (SPSS® v. 28). The survey received a total of 1.046 responses (65.4%). Over 78.0% of responders came from Europe, 65.1% came from a general surgery unit; 92.8% of European and 87.5% of North American respondents were involved in research, compared to 71.7% in Africa. Europe led in publishing research studies (6.6 ± 8.6 yearly). Teaching involvement was high in North America (100%) and Africa (91.7%). Surgeons reported an average of 6.7 ± 4.9 on-call shifts per month, with European and North American surgeons experiencing 6.5 ± 4.9 and 7.8 ± 4.1 on-calls monthly, respectively. African surgeons had the highest on-call frequency (8.7 ± 6.1). Post-on-call, only 35.1% of respondents received a day off. Europeans were most likely (40%) to have a day off, while African surgeons were least likely (6.7%). On the adjusted multivariable analysis HDI (Human Development Index) (aOR 1.993) hospital capacity > 400 beds (aOR 2.423), working in a specialty surgery unit (aOR 2.087), and making the on-call in-house (aOR 5.446), significantly predicted the likelihood of having a day off after an on-call shift. Our study revealed critical insights into the disparities in workload, access to research, and professional opportunities for surgeons across different continents, underscored by the HDI
Global disparities in surgeons' workloads, academic engagement and rest periods: the on-calL shIft fOr geNEral SurgeonS (LIONESS) study
No full textThe workload of general surgeons is multifaceted, encompassing not only surgical procedures but also a myriad of other responsibilities. From April to May 2023, we conducted a CHERRIES-compliant internet-based survey analyzing clinical practice, academic engagement, and post-on-call rest. The questionnaire featured six sections with 35 questions. Statistical analysis used Chi-square tests, ANOVA, and logistic regression (SPSS® v. 28). The survey received a total of 1.046 responses (65.4%). Over 78.0% of responders came from Europe, 65.1% came from a general surgery unit; 92.8% of European and 87.5% of North American respondents were involved in research, compared to 71.7% in Africa. Europe led in publishing research studies (6.6 ± 8.6 yearly). Teaching involvement was high in North America (100%) and Africa (91.7%). Surgeons reported an average of 6.7 ± 4.9 on-call shifts per month, with European and North American surgeons experiencing 6.5 ± 4.9 and 7.8 ± 4.1 on-calls monthly, respectively. African surgeons had the highest on-call frequency (8.7 ± 6.1). Post-on-call, only 35.1% of respondents received a day off. Europeans were most likely (40%) to have a day off, while African surgeons were least likely (6.7%). On the adjusted multivariable analysis HDI (Human Development Index) (aOR 1.993) hospital capacity > 400 beds (aOR 2.423), working in a specialty surgery unit (aOR 2.087), and making the on-call in-house (aOR 5.446), significantly predicted the likelihood of having a day off after an on-call shift. Our study revealed critical insights into the disparities in workload, access to research, and professional opportunities for surgeons across different continents, underscored by the HDI
