3,374 research outputs found
TAP Block Prior to Open Ventral Hernia Repair Improves Surgical Outcome
No full textBACKGROUND: Ventral hernias commonly affect patients after major abdominal surgery. To reduce postoperative pain, the effects of the transversus abdominis plane (TAP) block, epidural analgesia and medication-only protocol have been investigated. The primary outcome was the cumulative dosage of opioids (morphine milligram equivalents MME), of acetaminophen and diclofenac for postoperative pain control on postoperative day (POD) 0, 1, and 2. Secondary outcomes were length of stay (LOS) and the pain scale rating using the numeric rating scale (NRS) on POD 0, 1, and 2. METHODS: The data were retrospectively extracted from the charts of the patients admitted for a surgical operation for OVHR from January 2015 to December 2019. RESULTS: Patients receiving medication-only analgesia had longer LOS (mean 6.1 days; p < 0.00001). Cumulative opioid consumption was significantly lower at 24 and 48 h after surgery in the TAP block group than in the other groups (mean MME 1.9 mg and 0.7 mg, respectively; p < 0.05). The cumulative consumption of diclofenac was significantly lower in the TAP block group than in the others (44.1 mg; p ≤ 0.00001 on POD 1; 4.4 mg; p = 0.03 on POD 2). TAP block is more effective in pain control in POD 0 (mean NRS 5.4; p < 0.00001), POD 1 (mean NRS 6.1; p = 0.006), and POD 2 (mean NRS 4.9; p = 0.001) if it is performed after adopting the retromuscular technique. CONCLUSIONS: The comparison between the medication-only technique, epidural, and TAP block demonstrated the superiority of the last one for the aims considered in this study
Letter from Simeon Leo to his father
No full textLetter from Simeon Leo, Esq. to his father on paper torn from a notebook. Written in broken English.Digital imag
Closed Incision Negative Pressure Therapy Achieves Better Outcome Than Standard Wound Care: Clinical Outcome and Cost-Effectiveness Analysis in Open Ventral Hernia Repair With Synthetic Mesh Positioning
No full textBackgroundSurgical site infections (SSIs) and surgical site occurrences (SSOs) are frequent post-operative complications that are dependent on the presence of different risk factors. The use of closed incision negative pressure therapy (ciNPT) is considered a measure by the WHO guidelines for prevention of SSIs. The prevention of SSOs is an extremely important issue in the ventral hernia repair (VHR) surgical field. SSO onset not only affects the patient's quality of life, but can also cause the onset of life-threatening conditions that may require re-hospitalization, re-intervention and often mesh removal. Such outcome can become extremely costly, contributing to increased health care costs for the patient as well as the hospital. This study aims (1) to describe the epidemiological characteristics of SSOs following VHR in our experience; (2) to compare the post-operative outcomes of those who underwent VHR with synthetic mesh when treated with standard wound care (SWC) using gauze dressings vs ciNPT, and finally (3) to perform a spending review of the ciNPT in the hypothesis of its application after VHR with use of synthetic prosthetic material; financial savings including cost-effectiveness were investigated in terms of prevention of wound complications.Materials and methodsA retrospective review was performed on patients who underwent open VHR with synthetic mesh positioning by analyzing the hospital medical records between January 2015 and December 2017, with a primary focus on high risk post-operative complications, such as age > 65, pre-existed wound infection, pulmonary diseases, BMI > 25 kg/m(2), malnutrition, ascites, hypertension, diabetes, active smoking, previous radiation therapy, steroid use, pharmacological immunosuppression, chronic inflammatory diseases. In the final analysis, the outcomes of 70 patients who received ciNPT and 110 who were managed with using adherent gauze dressings were compared.ResultsNine (12.8%) patients in the ciNPT group and 48 (43.6%) in the control group developed a wound complication (p < 0.0001). The relative risk (RR) was 0.29 (0.15 - 0.56), suggesting that infection is less likely to occur in ciNPT-treated incisions, compared with standard wound care. The differences observed between the superficial infection rate and the deep infection rate were significant with p respectively 0.0006 and 0.04. Wound complications were reported in patients after discharge from the hospital. Fever was reported in 28.6% of patients in the ciNPT group vs 54.5% in the control group (p = 0.0006; RR (95% CI) 0.52 (0.35 - 0.79); OR (95% CI) 0.33 (0.18 - 0.63)); leukocytosis affected 21.4% of patients treated with ciNPT vs 45.4% of patients in the control group (p = 0.001; RR (95% CI) 0.47 (0.29 - 0.77); OR 0.33 (0.16 - 0.65)). ciNPT patients had shorter hospitalization stay than control group (3 +/- 1.37 vs 6 +/- 2.39; p < 0.00001). The cost-effectiveness deterministic analysis estimated that if the ciNPT is routinely adopted, the reduction of total costs would be (sic)166'944.00 for 100 patients.ConclusionsThis study demonstrates that ciNPT use in high-risk populations following VHR with synthetic mesh positioning is associated with positive clinical and economic outcomes
Portrait of Hans Sahl
No full textThree quarter profile portrait of the German writer Hans Sahl.Digital imageEstate of the artist.The German Jewish author and poet Hans Sahl was born in 1902 in Dresden. He fled Nazi Germany for France and then immigrated to the United States, where he gained success as a translator of American authors. Sahl returned to Tübingen in 1990, where he died in 1993.Leo Glueckselig was born in Vienna in 1914. He studied architecture and worked as an interior designer. He left Austria with his family in 1938 and immigrated to New York, where he worked as a graphic designer and illustrator. He was part of the Oskar-Maria-Graf Stammitsch. Since 1999 his artwork has been exhibited in Vienna, Salzburg, New York, Washington, and Graz. Leo Glueckselig died in New York in 2003. His brother was the poet Friedrich Bergammer (Fritz Glueckselig)
Ktētōr and Synthesis: Epigrams, Miniatures, and Authorship in the Leo Bible
No full textThesis (Master's)--University of Washington, 2014The Leo Bible (Rome, Vat. Reg. Gr. 1) is an illuminated Old Testament produced in Byzantium during the mid-tenth century. Presented as a gift to a monastery of St. Nicholas by Leo Sakellarios, a court eunuch and palace treasurer, the Bible is the only surviving manuscript of its kind from Byzantium. Known for its luxurious epigrams and miniatures, the Leo Bible's classicizing miniatures are frequently cited as exemplars of tenth-century Byzantine art, although the manuscript is rarely considered as whole. This study takes a new approach to the Leo Bible, focusing on the manuscript as a work of visual and poetic exegesis, in which word and image work together to frame the Old Testament in a Christian context. Beyond its exegetical nature, the Leo Bible also demonstrates a marked interest in the theme of authorship. By considering Byzantine notions of authorship in conjunction with the Bible's visual and epigrammatic program, this study offers new insights into the concept of patronage in Byzantium and the means by which patrons constructed their image and legacy through their commissions. In the case of the Leo Bible, this study will address how Leo Sakellarios is understood to be the author of the manuscript and its exegetical commentary, and how this act of authorship is reflected in the Bible's visual and poetic programs
Leo Katz as an author of children’s books. A failed attempt?
No full textDas Ziel dieses Beitrags ist es, Leo Katz als Kinderbuchautor zu betrachten und darüber
nachzudenken, welche Rolle seine Jugendbücher in seinem gesamten Werk und in der
Geschichte der deutschsprachigen Kinder- und Jugendliteratur spielen. Es werden nicht
nur seine veröffentlichten Kinderbücher betrachtet, sondern auch andere
unveröffentlichte Jugendromane, die unbekannt bzw. unpubliziert geblieben sind.
Um den Autor aus der Vergessenheit zu holen, werden unter anderem die nicht
bekannten Werke des Autors für Jugendliche vorgestellt und es wird überlegt, weshalb
sie damals nicht veröffentlicht wurden.Stadt Wien KulturDepto. de Filología Alemana y Filología EslavaFac. de Comercio y TurismoTRUEpu
Dragonfly Books
No full textMore pictures here than in my Frederick's Fables (1985), but the colors are not as lively. I catch one slight change from Alexander to he. This is a marvelous story of love and of dreams come true. Bravo, Alexander, and bravo, Leo!Leo Lionn
Letter to Dr. Simeon Leo
No full textLetter to Dr. Simeon Leo from Edward Frankel. In English script on stationery with a gothic 'E' printed at top center.Digital imag
Author identification: national and disciplinary approaches
No full textAuthor identication can be provided by authors themselves, or be intermediaries. Authors can be identified ex-post, within sets of bibliographic data, or ex-ante, when publication data is composed. Leo Waaijers introduces the digital author identifier, as working in the DARE project. It is based on old library technology, yet compliant with the forthcoming ISO standard on party identification ISPI. Thomas Krichel introduces the ACIS project (http://acis.openlib.org) and its first implementation in the RePEc author service (http://authors.repec.org). This is a low-cost approach. It relies on authors themselves to register. A central registration is a pure ex-post operation. However, it can be combined with an archival operation to permit additional ex-ante registered author data
Leo Eitinger as essay writer
No full textThe article refers to Leo Eitinger, famous Norwegian psychiatrist and humanist as author of essays and other popular science texts; focusing on Eitinger's issues as well as his style and rhetorical methods. The article depicts Leo Eitinger's cultural context regarding his background as Czechoslovak refugee and Holocaust survivor, his efforts beeing minority and human rights in general.The article refers to Leo Eitinger, famous Norwegian psychiatrist and humanist as author of essays and other popular science texts; focusing on Eitinger's issues as well as his style and rhetorical methods. The article depicts Leo Eitinger's cultural context regarding his background as Czechoslovak refugee and Holocaust survivor, his efforts beeing minority and human rights in general.The article refers to Leo Eitinger, famous Norwegian psychiatrist and humanist as author of essays and other popular science texts; focusing on Eitinger's issues as well as his style and rhetorical methods. The article depicts Leo Eitinger's cultural context regarding his background as Czechoslovak refugee and Holocaust survivor, his efforts beeing minority and human rights in general
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