4,857 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
Synchronized permutation tests in I*J designs.
No full textIn this paper we present an extension of the synchronized permutation tests for main factors and interaction introduced by Pesarin [2001. Multivariate Permutation Tests with Applications to Biostatistics. Wiley, Chichester] and Salmaso [2003. Synchronized permutation tests in factorial designs. Comm. Statist. Theory Methods 32, 1419-1437] in the case of a 2k complete factorial design with n replicates. This extension considers the more general case when the main factors can assume, respectively, I and J lelvels. An algorithm to obtain Monte Carlo synchronized permutations is introduced and a comparative simulation study with the parametric ANOVA is reported. We also implemented the nonparametric simultaneous confidence intervals based on syncrhonized permutations for main factor effects. A graphical representation for the simultaneous confidence intervals is suggested and illustrated with some examples from the literature
Rosamunde, Fürstin von Zypern
No full textin Musik gesetzt von Franz SchubertTenore 1mo 1 Seite, Tenore 2do 1 Seite, Basso 1mo 1 Seite, Basso 2do 1 Seite, Corno 1o. in D/Corno 2o. in D/Corno 3o. in D 1 Seite, Trombone 1o./Trombone 2o./Trombone 3o. 1 SeiteVorlageform der Veröffentlichungsangabe: Eigenthum des Verlegers Wien bey M. J. Leidesdorf. ; Preis 36 x./10 gl.Bibliographischer Nachweis: SchubertWV, Seite 499PlattendruckText deutsc
Valutazione del tasso di crescita in coltura delle alghe calcaree Lithophyllum stictaeforme e Mesophyllum lichenoides: primi risultati
No full textThe growth of the calcareous algae Lithophyllum stictaeforme (J.E. Areschoug) Hauck and Mesophyllum lichenoides (J. Ellis) M. Lemoine (Rhodophyta, Corallinales), two common Mediterranean coralligenous builders, ha sbeen estimated under controlled conditions in laboratory cultures, by marking the thalli with Alizarin-S. Preliminary results of marginal growth of M. lichenoides ranges from 1290 to 3260 μm/yr, with thickness increment from 10 to about 97 μm/yr. The thallus thickening in L. stictaeforme is 21-80 μm/yr
Indications of low macrobenthic activity in the deep sediments of the eastern Mediterranean Sea
No full textThe fluxes and budget of organic matter from the oligotrophic surface waters of the eastern Mediterranean to the deep waters are poorly known, and little information is available on past and present macrobenthic activity on the sea floor. Evidence of macrobenthic activity can be direct, through recovery of living organisms or their autochthonous skeletal remains, or indirect, through bioturbation and trace fossils. The evidence of biological activity in deep eastern Mediterranean sediments has been evaluated and compared through 210Pb profiles from box-cores and study of dredge samples from sites on Medina Rise (1374 m water depth), the Messina Abyssal Plain (4135 m) and several sites along the Mediterranean Ridge, SW and S of Crete (1783 to 3655 m). All these sites are remote from the continental shelves, so the biological benthic activity is expected to depend primarily on primary production from surface waters. The results show that present-day macrobenthos and trace fossils are generally scarce, especially at depths > 2500 m. This observation is supported by surface sediment 210Pb excess distributions that show a surface mixed layer (SML) 2500 m. The historical layer of some box-cores and the Pleistocene hardgrounds collected in the Cleft area (Mediterranean Ridge) do, however, record a macrobenthic activity that is apparently more intense than at present, which may be related to higher primary production of the Pleistocene glacial intervals. In contrast with most areas of the present-day deep eastern Mediterranean which depend on surface primary production based on photosynthesis, a relatively dense and diversified macrobenthic community based on chemosynthesis has been recognised at depths > 1100 m on the Napoli Dome mud volcano in the Olimpi area, and on the Kazan and other mud volcanoes in the Anaximander Mountains.En el Mediterráneo oriental los flujos de materia orgánica desde las aguas superficiales oligotróficas hasta las aguas profundas son poco conocidos y en general hay poca información sobre la actividad del macrobentos en el fondo del mar. La evidencia de la actividad macrobentónica puede ser directa, a través de los organismos vivos o de los restos de esqueletos autóctonos, o inidrecta, a través d ela bioturbación y fósiles. La evidencia de la actividad biológica en los sedimentos profundos del mediterráneo Oriental se ha evaluado y comparado por medio de los perfiles del 210Pb provenientes de muestreos con box-corer y dragas tomados en varios puntos del dorsal mediterráneo, al SO y S de Creta (entre 1783 y 3655 m). Se espera que la actividad biológica de estos fondos alejados de la plataforma continental dependa principalmente de la producción primaria de las aguas superficiales. Los resultados muestran que el macrobentos actual y los fósiles son generalmente escasos, especialmente en fondos superiores a los 2500 m. Estas observaciones se basan en la distribución del exceso de 210Pb que se ha encontrado en la capa superficial de mezcla del sedimento, inferior a 6 cm de grosor, en los cores de aguas inferiores a 2500 m; y de solo 2-3 cm a mayor profundida. Estos valores son mucho más bajos que la media de la capa supqerfical de mezcla de unos 10 cm en los sedimentos marinos de otras zonas. Es probable que la producción primaria actual en el Mediterráneo oriental no pueda soportar ninguna actividad macrobentónica estructurada a más de 2500 m. la capa histórica en algunos box-corer de los fondos duros del Pleistoceno muestreados en el áreade Cleft registran, sin embargo, una catividad macrobentónica aparentemente más inyensa que la actual, y que podría relacionarse con una producción primaria alta durante los intervalos interglaciales del Pleistoceno. Contrariamente a lo encontrado en la mayoría de las áreas actuales en el mediterráneo oriental profundo, el cual depende de la producción primaria superficial basada en la fotosíntesis, en le volcán fangoso de Napoli Dome en el área de Olimpi, en el Kazan y otros volcanes fangosos de las montañas Anaximader, se ha encontrado una comunidad macrobentónica relativamente densa y diversificada basada en procesos quimiosintéticos
Allevamento ovino e lavorazione della lana nella Venetia: spunti di riflessione
No full textL’allevamento degli ovini e la lavorazione della lana costituivano attività di rilevante impatto economico per le società antiche e come tali rivestono un grande interesse nella ricerca storica e archeologica.
Nel contributo si affronta questo tema in età romana soffermandosi sull’area veneta: qui, infatti, tali attività hanno conosciuto un’ininterrotta continuità fino ai nostri giorni, con particolare sviluppo in età romana, già oggetto di acute indagini di carattere territoriale e esaustive raccolte della documentazione letteraria ed epigrafica. In questa sede il tema viene affrontato dai tre autori secondo diversi approcci: gli spazi per la convivenza tra agricoltura e allevamento; i luoghi e i modi di conduzione dell'allevamento ovino attraverso l'analisi dell'insediamento rurale scavato a Ca'Tron (Roncade-Treviso) nell'agro di Altino; i luoghi e i modi della lavorazioni della lana
Assessing and modeling spatial variability of soil water content and nitrogen dynamics on durum wheat yield and grain quality
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