41 research outputs found
Discussion: teaching tourism history
No full textTourism represents more than a fruitful area for research, it is also an excellent topic of study for students at both the undergraduate and graduate levels. This round table discussion explores the experience of teaching tourism history in Australia, Canada, Italy, the Netherlands, and the United States. Panelists consider approaches, challenges, and some benefits of teaching tourism history
De grenzen tussen fatsoenlijke geschiedschrijving en dirty sociology
No full textIn his book Plaatsen van beschaafd vertier (Places of civilised pleasure) Furnee gives a picture of the social life of the well-to-do classes of The Hague in the nineteenth century. A pivotal insight is the crucial importance of social boundaries in understanding social life. This insight, like many other aspects explored in the book, is not only important in comprehending nineteenth-century Hague society, but is also helpful in understanding group life in any other social context. Therefore, while it is very clear that the book adds insights to the debates in other scientific disciplines, it is remarkable that the author does not formally address these debates. This lack of interdisciplinary discussion however, is largely compensated by the richness of the material and the understanding that is delivered by Furnee
Short-term outcomes of radical excision vs. phenolisation of the sinus tract in primary sacrococcygeal pilonidal sinus disease: a randomized-controlled trial
No full textBackground Phenolisation of Sacrococcygeal pilonidal sinus disease (SPSD) seems to have advantages over radical excision; however, a randomized-controlled trial (RCT) comparing both techniques is lacking. The aim of our study was to compare sinus pit excision and phenolisation of the sinus tract with radical excision in SPSD in terms of return to normal daily activities. Methods This study was a single-center RCT. Fifty patients who presented with primary SPSD were randomized to phenolisation and 50 patients to excision. The primary endpoint was time to return to normal daily activities. Secondary endpoints were quality of life, complaints related to SPSD, surgical site infection, and wound epithelialization. Patients were treated in a 1-day surgery setting. Complaints related to SPSD were evaluated and symptoms were scored by the participants on a 6-point scale before surgery, and patients kept a diary for 2 weeks on complaints related to the surgical treatment (the same scoring system as preoperatively) and pain, evaluated with a VAS. Quality of life (QoL) was measured preoperatively with a VAS and the Short Form-36 Health Survey (SF-36). At 2, 6, and 12 weeks after surgery, patients were evaluated using a questionnaire containing the following items: patients' satisfaction (disease, compared with preoperatively, scored as cured, improved, unchanged or worsened), five complaints related to the surgical treatment (the same scoring system as preoperatively and in the diary), QoL (VAS and SF-36), and return to normal daily activities. The wound was assessed 2, 6, and 12 weeks postoperatively by one of the investigators (EF or NS), using an assessment form Results The mean time to return to normal daily activities was significantly shorter after phenolisation (5.2 +/- SD 6.6 days vs. 14.5 +/- 25.0 days, p = 0.023). 2 weeks after surgery, all patients in the phenolisation group and 85.4% of patients in the excision group returned to normal daily activities (p = 0.026). Pain was significantly lower after phenolisation at 2 weeks postoperatively (0.8 +/- 1.0 vs. 1.6 +/- 1.3, p = 0.003). Surgical site infection occurred significantly more often after radical excision (n = 10, 21.7% vs. n = 2, 4.0%, p = 0.020). At 6 and 12 weeks, complete wound epithelialization was more frequently achieved after phenolisation (69.0% vs. 37.0%, p = 0.003 and 81.0% vs. 60.9%, p = 0.039, respectively). Conclusions Pit excision with phenolisation of SPSD resulted in a quicker return to normal daily activities, less pain, and quicker wound epithelialization compared to radical excision. Surgeons should consider phenolisation in patients with primary SPSD
The effect of hair removal after surgery for sacrococcygeal pilonidal sinus disease:A systematic review of the literature
No full textBackground It has been suggested that removal of body hair in the sacrococcygeal area prevents recurrence after surgery for sacrococcygeal pilonidal sinus disease (SPSD). The aim of this study was to review the literature regarding the effect of hair depilation on the recurrence rate in patients surgically treated for SPSD. Methods A systematic search was performed in PubMed, EMBASE, and The Cochrane Library by using synonyms for SPSD. Title, abstract, and full text were screened by two independent reviewers. Data were systematically collected from all included studies by using a standardized data extraction form. Results The search and selection yielded 14 studies, involving 963 patients. The study design of the included studies was: retrospective cohort (n = 7), prospective cohort (n = 3), randomized controlled trial (n = 2), and case-control (n = 2). The mean length of follow-up was 37.0 (standard error of the mean: 35.0) months. The recurrence rate was 9.3% (34 out of 366 patients) in patients who had laser hair removal, 23.4% (36 out of 154 patients) in those who had razor shaving/cream depilation, and 19.7% (85 out of 431 patients) in those who had no hair removal after surgery for SPSD. Conclusions This systematic review showed a lower recurrence rate after laser hair removal compared to no hair removal and razor/cream depilation. Due to the small sample size and limited methodological quality of the included studies, a highquality randomized controlled trial is required
Sexual Function in Patients Suffering from Sacrococcygeal Pilonidal Sinus Disease
No full textIntroductionSexual function is one of the aspects upon which quality of life (QoL) is based. Although previous studies have evaluated the influence of sacrococcygeal pilonidal sinus disease (SPSD) on QoL, no data are available on the influence of SPSD on sexual function in a highly active sexual population based on the age range. The aim of this prospective study was to evaluate whether SPSD has a negative impact on sexual function and whether this is influenced by the surgical treatment of SPSD.MethodsSexual function was pre- and postoperatively assessed by the Sexual Self-Consciousness Scale (SSCS; score range 0-48), subdivided into the sexual embarrassment (SE; score range 0-24) and sexual self-focus subscale (SFF; score range 0-24). The higher the score, the higher is the sexual dysfunction. Patients were also asked whether SPSD influenced their sexual functioning.ResultsA total of 88 male patients who underwent surgical treatment for SPSD were included in the study. The mean (+/- SD) preoperative SSCS score was 14.5 +/- 9.1 and 13.9 +/- 8.4 two weeks postoperatively (p=0.394). Six and twelve weeks after surgery, there was a significant reduction to 12.2 +/- 9.0 (p=0.002) and 12.3 +/- 8.8 (p=0.013), respectively. SE decreased from 5.5 +/- 5.1 preoperatively to 5.1 +/- 4.6 (p=0.258), 4.2 +/- 4.7 (p=0.004) and 4.0 +/- 4.6 (p=0.013) two, six, and twelve weeks after surgery. For SFF, there was a decrease from 9.0 +/- 5.0 to 8.9 +/- 4.9 (p=0.717), 7.8 +/- 5.2 (p=0.004) and 8.2 +/- 5.3 (p=0.168), respectively. Preoperatively, 70% of the patients totally or partially disagreed that SPSD influenced their sexual functioning, and this increased to 80% of the patients 12 weeks after surgery.ConclusionThis prospective study showed a significant decrease in sexual dysfunction, both six and twelve weeks after surgery, compared to preoperatively in patients suffering from SPSD.</p
Risk factors for non-closure of an intended temporary defunctioning stoma after emergency resection of left-sided obstructive colon cancer
No full textPurpose: A substantial part (21–35%) of defunctioning stomas created during resection for colorectal cancer will never be reversed. Known risk factors for non-closure are age, peri- or postoperative complications, comorbidity, and tumor stage. However, studies performed to identify these risk factors mostly focus on rectal cancer and include both preoperative and postoperative factors. This study aims to identify preoperative risk factors for non-reversal of intended temporary stomas created during acute resection of left-sided obstructive colon cancer (LSOCC) with primary anastomosis. Methods: All patients who underwent emergency resection for LSOCC with primary anastomosis and a defunctioning stoma between 2009 and 2016 were selected from the Dutch ColoRectal Audit, and additional data were collected in the local centers. Multivariable analysis was performed to identify independent preoperative factors for non-closure of the stoma. Results: A total of 155 patients underwent acute resection for LSOCC with primary anastomosis and a defunctioning stoma. Of these, 51 patients (32.9%) did not have their stoma reversed after a median of 53 (range 7–104) months of follow-up. In multivariable analysis, hemoglobin < 7.5 mmol/L (odds ratio (OR) 4.79, 95% confidence interval (95% CI) 1.60–14.38, p = 0.005), estimated glomerular filtration rate (eGFR) ≤ 45 mL/min/1.73 m2 (OR 4.64, 95% CI 1.41–15.10, p = 0.011), and metastatic disease (OR 6.12, 95% CI 2.35–15.94, p < 0.001) revealed to be independent predictors of non-closure. Conclusions: Anemia, impaired renal function, and metastatic disease at presentation were found to be independent predictors for non-reversal of intended temporary stomas in patients who underwent acute resection for LSOCC. In patients who have an increased risk of non-reversal, the surgeon should consider a Hartmann’s procedure
Risk factors for non-closure of an intended temporary defunctioning stoma after emergency resection of left-sided obstructive colon cancer
No full textPurpose: A substantial part (21–35%) of defunctioning stomas created during resection for colorectal cancer will never be reversed. Known risk factors for non-closure are age, peri- or postoperative complications, comorbidity, and tumor stage. However, studies performed to identify these risk factors mostly focus on rectal cancer and include both preoperative and postoperative factors. This study aims to identify preoperative risk factors for non-reversal of intended temporary stomas created during acute resection of left-sided obstructive colon cancer (LSOCC) with primary anastomosis. Methods: All patients who underwent emergency resection for LSOCC with primary anastomosis and a defunctioning stoma between 2009 and 2016 were selected from the Dutch ColoRectal Audit, and additional data were collected in the local centers. Multivariable analysis was performed to identify independent preoperative factors for non-closure of the stoma. Results: A total of 155 patients underwent acute resection for LSOCC with primary anastomosis and a defunctioning stoma. Of these, 51 patients (32.9%) did not have their stoma reversed after a median of 53 (range 7–104) months of follow-up. In multivariable analysis, hemoglobin < 7.5 mmol/L (odds ratio (OR) 4.79, 95% confidence interval (95% CI) 1.60–14.38, p = 0.005), estimated glomerular filtration rate (eGFR) ≤ 45 mL/min/1.73 m2 (OR 4.64, 95% CI 1.41–15.10, p = 0.011), and metastatic disease (OR 6.12, 95% CI 2.35–15.94, p < 0.001) revealed to be independent predictors of non-closure. Conclusions: Anemia, impaired renal function, and metastatic disease at presentation were found to be independent predictors for non-reversal of intended temporary stomas in patients who underwent acute resection for LSOCC. In patients who have an increased risk of non-reversal, the surgeon should consider a Hartmann’s procedure.</p
Long-term Oncologic Outcome After Laparoscopic Converted or Primary Open Resection for Colorectal Cancer:A Systematic Review of the Literature
No full textPurpose: The aim of this study was to critically review the current evidence regarding the oncologic outcomes after laparoscopic converted or open resection for colorectal cancer. Materials and Methods: A literature search was performed in Pubmed. Study selection and data acquisition were independently performed by 2 reviewers. Results: The search strategy yielded a total of 746 articles, resulting in 7 studies eligible for inclusion. A total of 9190 (57 to 8307) patients were included in the open and 238 (17 to 56) in the converted group. In none of the studies, differences were found in disease stage between both groups. There were no significant differences between both groups with regard to overall survival, local recurrence and distant metastasis rate. Conclusions: There is currently insufficient evidence that patients who had a laparoscopic resection for colorectal cancer converted to open surgery have a worse oncologic outcome than patients who were primarily treated by an open approach
