1,722,326 research outputs found
Prospective multicentre clinical trial of stapled transanal rectal resection for obstructive defaecation syndrome.
No full textProspective multicentre clinical trial of stapled transanal rectal resection for obstructive defaecation syndrome (p.1521-1527) A. Arroyo, F. X. Gonzalez-Argente;, M. Garcia-Domingo, E. Espin-Basany, F. De-la-Portilla, F. Perez-Vicente, R. Calpena Published Online: Oct 21 2008 10:57AM DOI: 10.1002/bjs.6328 Sir, we would like to raise some points on the article by Arroyo et al. on stapled transanal rectal resection (STARR) for obstructive defaecation syndrome (ODS) (1). No psychiatric evaluation was performed, in spite of data showing that 66% of patients with ODS suffer from anxiety or depression (2). The authors operated on 59.1% of patients. This matches with operation rates on constipated patients by others, who also perform STARR, such as 58.1% (3), but contrasts with all the others, who consistently report lower operation rates for constipation, such as 7.3% (4) or 14% (2). Are surgeons who perform STARR, by any chance, over-treating their patients? While the authors state that they referred 75 patients for biofeedback, they did not take into any account, prior to operate on the remaining 104, conservative measures such as colonic irrigation, which has proven successful in a substantial number of constipated patients (5). Indeed, STARR can be effective, but, it is a worryingly invasive and irreversible procedure, bearing a number of complications (6). Sadly, STARR was recently passed off to the general Italian public as a panacea to magically solve a complex condition, such as constipation, ‘with no stitches’ (although, in reality, 56 titanium staples are fired), and ‘without opening’ (7). The authors are to be commended for reporting that in 30-72% of patients with ODS anatomical correction is fruitless (1). For those who consider patients with ODS to suffer more from bowel function than from its anatomy, STARR equals to ‘removing part of a lung to treat asthma or chopping off an arm to treat high blood pressure’ (8). Luigi Basso, Giuseppe Gagliardi*, Mario Pescatori*. University of Rome ‘Sapienza’ 1st Medical School, and * Coloproctology Unit, ‘Ars Medica’ Hospital, Rome, Italy. References 1. Arroyo A, González-Argenté FX, García-Domingo M, Espin-Basany E, De-la-Portilla F, Pérez- Vicente F, Calpena R. Prospective multicentre clinical trial of stapled transanal rectal resection for obstructive defaecation syndrome. Br J Surg 2008; 95: 1521-7. 2. Pescatori M, Spyrou M, Pulvirenti d'Urso A. A prospective evaluation of occult disorders in obstructed defecation using the ¿iceberg diagram¿. Colorectal Dis 2006; 8: 785-9. 3. Boccasanta P, Venturi M, Roviaro G. Stapled transanal rectal resection versus stapled anopexy in the cure of hemorrhoids associated with rectal prolapse. A randomized controlled trial. Int J Colorectal Dis 2007; 22: 245-51. 4. Nyam DC, Pemberton JH, Ilstrup DM, Rath DM. Long-term results of surgery for chronic constipation. Dis Colon Rectum 1997; 40: 273-9. 5. Prospective study of colonic irrigation for the treatment of defaecation disorders. Koch SM, Melenhorst J, van Gemert WG, Baeten CG. Br J Surg 2008; 95: 1273-9. 6. Pescatori M, Gagliardi G. Postoperative complications after procedure for prolapsed hemorrhoids (PPH) and stapled transanal rectal resection (STARR) procedures. Tech Coloproctol 2008; 12: 7-19. 7. Pappagallo M. La giungla dei rimborsi. ‘E io opero in Austria’ [The jungle of reimbursements. ‘Hence, I operate in Austria’]. Corriere della Sera (Milan, Italy). 2008 Sep 8: 11. Italian. 8. Phillips RKS. Invited Commentary. Dis Colon Rectum 2004; 47: 1296
Oleari (F.), Gagliardi (G.).— Essai d’analyse phénoménologique et sociologique du problème du suicide lié à la désinstitutionnalisation. Ps. méd., 1984, n° 12, pp. 2057-2059
No full textOleari (F.), Gagliardi (G.).— Essai d’analyse phénoménologique et sociologique du problème du suicide lié à la désinstitutionnalisation. Ps. méd., 1984, n° 12, pp. 2057-2059. In: Bulletin de psychologie, tome 40 n°382, 1987. p. 908
Spinodal-assisted nucleation in the two-dimensional q- state Potts model with short-to-long-range interactions
No full textWe study homogeneous nucleation in the two-dimensional q-state Potts model for q=3,5,10,20 and ferromagnetic couplings Jij Θ(R-|i-j|) by means of Monte Carlo simulations employing heat bath dynamics. Metastability is induced in the low-temperature phase through an instantaneous quench of the magnetic field coupled to one of the q spin states. The quench depth is adjusted, depending on the value of temperature T, interaction range R, and number of states q, in such a way that a constant nucleation time is always obtained. In this setup, we analyze the crossover between the classical compact droplet regime occurring in the presence of short-range interactions R∼1 and the long-range regime R≫1 where the properties of nucleation are influenced by the presence of a mean-field spinodal singularity. We evaluate the metastable susceptibility of the order parameter as well as various critical droplet properties, which along with the evolution of the quench depth as a function of q,T and R are then compared with the field theoretical predictions valid in the large R limit to find the onset of spinodal-assisted nucleation. We find that, with a mild dependence of the values of q and T considered, spinodal scaling holds for interaction ranges R 8-10 and that signatures of the presence of a pseudospinodal are already visible for remarkably small interaction ranges R∼4-5. The influence of spinodal singularities on the occurrence of multistep nucleation is also discussed
Language resources for clinical linguistics: introduction to the special issue
No full textThe article serves as the editorial for the Special Issue "Language Resources for Clinical Linguistics."
The editors retrace the steps leading to the publication of the article collection and summarize its contents
Linguistic biomarkers for the detection of Mild Cognitive Impairment
Full text linkA timely diagnosis of the prodromal stages of dementia remains a big challenge for healthcare systems: many assessment tools have been proposed over recent years, but the commonest screening instruments are largely unreliable for detecting subtle changes in cognition. The scientific literature contains a rising number of reports about language disturbances at the earliest stages of dementia, a clinical syndrome known as “Mild Cognitive Impairment" (MCI). Here we take advantage of these findings to develop a novel NLP method capable of identifying cognitive frailty at a very early stage by processing Italian spoken productions. This study constitutes a first step in the creation of an automatic tool for non-intrusive, low-cost dementia screening exploiting linguistic biomarkers. Our findings show that acoustic features (i.e., fluency indexes and spectral properties of the voice) are the most reliable parameters for MCI early identification. Moreover, lexical and syntactic features, grabbing the erosion of verbal abilities caused by the pathology, emerge as statistically significant and can support speech traits in the classification process
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Gagliardi (G.), Oleari (F.).— Analyse de deux cas d’infanticide-suicide dans deux cellules familiales originaires d’Italie du Sud, immigrées dans l’Italie du Nord. Ps. méd., 1984, n° 12, pp. 2062-2063
No full textGagliardi (G.), Oleari (F.).— Analyse de deux cas d’infanticide-suicide dans deux cellules familiales originaires d’Italie du Sud, immigrées dans l’Italie du Nord. Ps. méd., 1984, n° 12, pp. 2062-2063. In: Bulletin de psychologie, tome 40 n°382, 1987. p. 908
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