1,721,725 research outputs found
Use of biological mesh in trans-anal treatment for recurrent recto-urethral fistula
No full textDear Author, I read with interest the letter by Deepak Batura about our paper entitled Use of biological mesh in trans-anal treatment for recurrent recto-urethral fistula. I thank the colleague for his accurate comments. I take this opportunity to clarify the following points: 1.All 7 patients reported in the original article underwent double diversion at least 2 months before the author's procedure. In this situation, no enteric preparation is necessary with a surgical field clean and ideal to use a mesh in a potential infected site. The biological mesh has a great capacity to progressively integrate itself; 2.All 7 patients we described underwent extensive clinical investigations during serial follow-up visits that excluded urethral stricture, signs of infections or urethral sequelae. That's way the patients did not undergo extra exams (endoscopic or bacteriological) once the stoma was closed; I hope this additional information will help to clarify up your querie
Coloquio internacional: “El imaginario testimonial en el Cono Sur. Las configuraciones desde el género”. Universidad Nacional de La Plata, La Plata, 4 y 5 de noviembre de 2019
Full text linkFil: Codaro, Laura. Universidad Nacional de La Plata. Facultad de Humanidades y Ciencias de la Educación; Argentina.Fil: Inama, Ramón Oscar. Universidad Nacional de La Plata
Idealismus und Realismus in der Nationalökonomie : Rede gehalten bei der Jahresfeier der Wiederherstellung der Leopold-Franzens-Universität zu Innsbruck
No full textKarl Theodor von Inama-Sterneg
Adam Smith und die Bedeutung seines Wealth of Nations für die moderne Nationalökonomie : zur Erinnerung an die 100jährige Wirksamkeit seines berühmten Werkes ; Rede bei Gelegenheit der feierlichen Kundmachung der Preisaufgaben
No full textgehalten von Karl Theodor von Inama-Sterneg
Asco que mucho brega, o el o la cuerda
No full textTexto italiano traduzido pela Lic. Carla Inama, assistente da Cadeira de Língua e Literatura Italiana da Faculdade de Filosofia, Ciências e Letras da Universidade de São Paul
Three-Dimensional vs Two-Dimensional Minimally Invasive Surgery. A comparison of the visual work load and surgical outcomes
Full text linkBACKGROUND
Three-dimensional (3D) imaging, a recent technical innovation in laparoscopic surgery, has been introduced to enhance depth perception and facilitate operations. The clear benefit of the 3D laparoscopy has never been tested. Some concerns emerged regarding the possible negative effects over the visual system in those surgeons who performed 3D surgery every day. 3D laparoscopy has been validated both in “in-vitro” and “in-vivo” (clinical) settings. All survey done in laparoscopic simulator comparing surgical exercise (suturing, peg transfer, cutting) performed with 2D or 3D system reported better results in
the second group, regardless the surgeon experience. Less data is disposable in the clinical setting, but with same conclusions. The use of 3D technology needs passive or active polarized glasses. Optometric tests, objective exams (RMN or EEG) and subjective questionnaires have been widely used to evaluate the alterations in the visual system utilizing the 3D technology. Each test concluded that 3D technology causes alteration in the EEG waves, but how long these alterations last is still unknown.
AIM
The aim of this study was to evaluate the possible benefit of using the 3D technology in terms of surgical outcomes (study 1) and to evaluate the alterations over the visual system operating in 3D laparoscopy (study 2).
MATERIALS AND METHODS
The study was a single-center prospective observational clinical trial, divided in two sub-study with a single patients-population. Participants included patients aged 18 years old and above, eligible for colorectal resections for neoplastic or inflammatory diseases. Four experienced surgeons in colorectal and laparoscopic surgery participated in the study. Each surgeon followed the standard laparoscopic
surgical rules performing the different type of colorectal resection, regardless the study subgroup. Data were collected at the pre-operative clinic, during surgery, during the hospitalizations and at the short term follow-up (30th days). For each study, there was a primary endpoint:
1. Primary endpoint for Study 1: incidence of Clavien grade 3, 4 and 5 postsurgical complications in patients undergone 3D colorectal resection;
2. Primary endpoint for Study 2: to grade the visual work load of surgeons operating with 3D screens and glasses.
At the end of each procedure (2D or 3D) the first surgeon had to fill in two different subjective questionnaire (the NASA task load index questionnaire and the Simulator Sickness questionnaire) to grade the visual sickness felt during the operation.
RESULTS
From January 2015 to September 2017, 313 patients were enrolled in the study: 82 in the 2D group, 231 in the 3D group.
STUDY 1: Colorectal cancer was the main indication for surgery (n 235, 75.1%), followed by colonic diverticulosis, benign polyposis and inflammatory bowel diseases (IBD), respectively 43 (13.8 %), 25 (7.9 %) and 10 (3.2 %). Age, sex, ASA score were comparable between the two groups. The median operative time showed no statistically significant difference between the 3D and 2D groups (p 0.611). Less drains were positioned at the end of the 3D operations comparing with 2D procedures (p 0.013). The stapled anastomosis was the most frequent performed over other techniques. The other intra-operative findings showed no significant difference between the two study groups. The median hospitalization and the reoperation rate showed no difference between the two groups.
STUDY 2: The statistical analysis done over all 313 cases divided in 2D and 3D did not reveled significant difference of the visual work scored by the NASA TLX. Data emerging from the SSQ questionnaire reveled no case of moderate or severe symptoms in both groups.
CONCLUSIONS
3D laparoscopic surgery had the same postoperative results of the 2D standard laparoscopy. The more frequent intra-abdominal anastomosis in the 3D group might suggest a more safeness felt by the surgeon using the new technology. The NASA TLX and the SSQ questionnaire did not reveled significant difference of the visual work between 2D and 3D vision
Fracture analysis and depositional geometries of a high relief carbonate platform from UAV photogrammetry and Digital Outcrop Modeling. The case of the Lastoni di Formin (Italian dolomites).
Full text linkLe piattaforme carbonatiche rappresentano un importante oggetto di studio in diversi campi applicativi delle geoscienze (ad esempio, per l'esplorazione di idrocarburi, l' approvvigionamento di risorse idriche e lo stoccaggio di CO2). Molto spesso, questo tipo di affioramenti sono altamente eterogenei in termini di architettura e distribuzione delle facies e sono spesso soggetti a intensa fratturazione. A loro volta, fratture e faglie rappresentano dei percorsi preferenziali per il flusso dei fluidi all'interno del corpo carbonatico, esercitando un forte impatto sulla qualità del giacimento. Tuttavia, molte delle caratteristiche salienti di un reservoir sono difficilmente rilevabili tramite tecniche di indagine geofisica, e le stratigrafie dei pozzi esplorativi rappresentano solo volumi limitati di roccia. In questo contesto, lo studio di piattaforme carbonatiche affioranti rappresenta una delle metodologie più efficaci per integrare i dati di pozzo nella valutazione delle caratteristiche di un giacimento. L'applicazione di modelli digitali dell'affioramento (Digital Outcrop Modeling o DOM) a questo tipo di studi fornisce un'importante fonte di dati per l'analisi e l'interpretazione dei sistemi carbonatici. Questo tipo di approccio multidisciplinare combina diverse aree di competenza, (geologia strutturale, sedimentologia, stratigrafia, informatica), che contribuiscono in diversa misura allo studio e all'interpretazione delle caratteristiche geologiche dell' affioramento in esame. In questo lavoro, sono state applicate avanzate tecniche di fotogrammetria digitale e Digital Outcrop Modeling allo studio di una piattaforma carbonatica di età triassica e più precisamente del Carnico (Lastoni di Formin, Dolomiti, Italia). L'acquisizione fotogrammetrica è stata eseguita sia da terra che tramite l' utilizzo di un veicolo a pilotaggio remoto (drone), che ha consentito di raggiungere porzioni inaccessibili e remote dell'affioramento e di acquisire grandi quantità di dati digitali in modo rapido ed efficace. Le immagini ottenute sono state elaborate utilizzando tecniche di Structure from Motion (SfM), che hanno reso possibile la ricostruzione 3D dell'affioramento che è stato successivamente visualizzato, analizzato e misurato in stereoscopia 3D. Inoltre, lo studio del DOM è stato affiancato a un'intensa campagna di rilevamento sul terreno, con l'obiettivo sia di validare i dati acquisiti in digitale che di integrare il set di misure. La combinazione di telerilevamento e rilevamento geologico tradizionale si è rivelata efficace per il raggiungimento degli obiettivi prefissati. La prima parte del progetto è stata dedicata alla ricostruzione dell'architettura e delle geometrie deposizionali della piattaforma dei Lastoni; nella seconda parte dello studio sono state eseguite l'analisi strutturale e la caratterizzazione del network di fratture della piattaforma stessa.Carbonate platforms represent an important target of hydrocarbon exploration, water resources and CO2 sequestration and storage. In many cases, these types of sedimentary bodies are highly heterogeneous in terms of facies architecture and distribution, and are often characterized by intensive fracturing. Fractures and faults, in turn, represents preferential conducts for the fluids flow within the carbonate body and therefore their features (e.g. size, connection and distribution), strongly impact the quality of a carbonate body as a reservoir. Since most of these features are below seismic resolution, and wells, although providing key information, represent only small volumes of the rock, the study of outcrop analogues have become a powerful methodology in for the assessment of reservoirs. In particular, the analysis of outcrop analogues by the use of Digital Outcrop Modeling can provide relevant informations for the analysis and interpretation of carbonate systems, as it make it possible to collect large volumes of data from objects that for size and exposition would be otherwise inaccessibile.
In the present study we applied Digital Outcrop Modeling and digital photogrammetry to the study of a Triassic isolated platform (Lastoni di Formin, Dolomites, Italy), to reconstruct the platform architecture and the distribution and genesis of the fracture pattern that affect it. The photogrammetric acquisition was performed both from the ground and by the use of an Unmanned Aerial Vehicles (drone), that allowed to reach inaccessible and remote portions of the outcrop and to acquire large amounts of digital data in a quick and effective way. The obtained images were processed using Structure from Motion (SfM) techniques, producing the 3D Digital Outcrop Model (DOM). The DOM was subsequently visualized, analyzed and sampled in 3D stereoscopic environment. Furthermore, the study was supported by an intense field survey campaign, with the aim of both validating the digitally acquired data and integrating the set of measurements. The combination of remote sensing and traditional field studies has proven to be effective in achieving the objectives of the project. A first part of the study was dedicated to the reconstruction of the architecture and depositional geometries of the platform. Secondly, the structural analysis of the Lastoni platform and the characterization of the fracture network were undertaken
Risk factors for unfavourable postoperative outcome in patients with Crohn's disease undergoing right hemicolectomy or ileocaecal resection An international audit by ESCP and S-ECCO
No full textBACKGROUND: Patient and disease-related factors, as well as operation technique all have the potential to impact on postoperative outcome in Crohn's disease. The available evidence is based on small series and often displays conflicting results. AIM: To investigate the effect of pre- and intra-operative risk factors on 30-day postoperative outcome in patients undergoing surgery for Crohn's disease. METHOD: International prospective snapshot audit including consecutive patients undergoing right hemicolectomy or ileocaecal resection. This study analysed a subset of patients who underwent surgery for Crohn's disease. The primary outcome measure was the overall Clavien-Dindo postoperative complication rate. The key secondary outcomes were anastomotic leak, re-operation, surgical site infection and length of stay at hospital. Multivariable binary logistic regression analyses were used to produce odds ratios (OR) and 95% confidence intervals (CI). RESULTS: Three hundred and seventy five resections in 375 patients were included. The median age was 37 and 57.1% were female. In multivariate analyses, postoperative complications were associated with preoperative parenteral nutrition (OR 2.36 95% CI 1.10-4.97)], urgent/expedited surgical intervention (OR 2.00, 95% CI 1.13-3.55) and unplanned intraoperative adverse events (OR 2.30, 95% CI 1.20-4.45). The postoperative length of stay in hospital was prolonged in patients who received preoperative parenteral nutrition (OR 31, CI [1.08-1.61]) and those who had urgent/expedited operations (OR 1.21, CI [1.07-1.37]). CONCLUSION: Preoperative parenteral nutritional support, urgent/expedited operation and unplanned intraoperative adverse events were associated with unfavourable postoperative outcome. Enhanced preoperative optimization and improved planning of operation pathways and timings may improve outcomes for patients. This article is protected by copyright. All rights reserved
Comparative evaluation of surgeon visual work load of 3d vs 2d colorectal resections
No full textOBIETTIVI Molti studi hanno evidenziato il beneficio della chirurgia laparoscopica 3D di ultima generazione rispetto ai sistemi ottici 2D. I reali effetti sul nostro sistema visivo nell'utilizzo di occhiali 3D non sono ancora stati valutati. Lo scopo principale di questo studio è stato quello di valutato lo stress visivo a cui il chirurgo viene sottoposto durante le procedure laparoscopiche in 3D. Obiettivo secondario è stato quello di valutare i risultati nell'impiego della tecnologia 3D HD comparando i risultati chirurgici del 2D vs il 3D nelle resezioni laparoscopiche colo-rettali per tumori del crosso intestino. MATERIALI E METODI Da Gennaio 2016 a Marzo 2017, 137 pazienti sono stati sottoposti a resezione colo-rettali per patologia neoplastica, di cui 64 mediante l' impiego di tecnologia 3d (gruppo 3d) e 71 mediante tecnologia 2d (gruppo 2d). Tra questi due gruppi sono stati confrontati dati intra-operatori e dati post-operatori. Al termine di ogni procedura chirurgica il primo operatore è stato invitato a rispondere a due questionari soggettivi per valutare il carico di lavoro visivo: il NASA task load questionnaire e il Simulator Sickness questionnaire (SSI). RISULATATI Tutte gli interventi sono stati completati mediante tecnica laparoscopica senza richiedere conversione in laparotomia. L'incidenza di procedure chirurgiche più complesse come resezioni sec. Miles, colectomie totale e resezioni anteriore di retto è stata maggiore nel gruppo 3D. La durata dell'intervento è stata significativamente più lunga nel gruppo 3D ( 177 ± 7 3D vs 157± 6 2D, P=0.03) mentre l' incidenza di complicanze post-operatorie è stata significativamente superiore nel gruppo 2D (26% 3D vs 9% 3D, P<0.01). Non sono emerse differenze significative tra i due gruppi per quanto riguarda il questionario SSI (vertigini, lacrimazione, nausea), mentre dal questionario NASA, lo sforzo mentale, fisico e visivo percepito dal chirurgo con la tecnologia 3D è superiore rispetto al 2D (p<0,001). CONCLUSIONI La laparoscopia associata alla tecnologia 3D risulta avere un'incidenza di complicanze postoperatorie inferiori rispetto ai vecchi sistemi 2D nell'eseguire interventi chirurgici complessi. Nonostante i disturbi determinati dalla visione 3D quali nausea lacrimazione e mal di testa risultino sovrapponibili alla laparoscopia 2d, lo sforzo visivo, mentale e fisico percepito dal chirurgo risulta superiore durante procedure 3D rispetto alla 2D
The relationship between method of anastomosis and anastomotic failure after right hemicolectomy and ileo-caecal resection: an international snapshot audit
No full textAnastomosis technique following right sided colonic resection is widely variable and may affect patient outcomes. This study aimed to assess the association between leak and anastomosis technique (stapled versus handsewn) METHODS: This was a prospective, multicentre, international audit including patients undergoing elective or emergency right hemicolectomy or ileo-caecal resection operations over a two-month period in early 2015. The primary outcome measure was the presence of anastomotic leak within 30 days of surgery, using a pre-specified definition. Mixed effects logistic regression models were used to assess the association between leak and anastomosis method, adjusting for patient, disease and operative cofactors, with centre included as a random effect variable
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