139,783 research outputs found
Peritoneal perforation is less a complication than an expected event during transanal endoscopic microsurgery. experience from 194 consecutive cases
No full textBackground: Indications for transanal endoscopic microsurgery (TEM) have been extended to technically challenging tumors, which may be associated with an increased risk of peritoneal perforation (PP). The aim of the present study was to investigate the occurrence, management and outcome of PP in patients having TEM. Methods: All the patients who had TEM for rectal adenoma or adenocarcinoma in our unit were included. Patients in whom PP occurred (Group A) were compared to those without PP (Group B). Results: From 2007 to 2015, 194 TEM (116 men, median age 66 [range 21–100] years) were divided into Groups A (n = 28, 14%) and B (n = 166). The latter group included four patients, in whom a laparoscopy did not confirm suspicion of PP made during TEM. In 2 of 28 patients (7%), the diagnosis of PP was made postoperatively during reoperation for peritonitis. For the 26 other patients (93%), routine exploratory laparoscopy was performed with suture of the peritoneal defect on the pouch of Douglas in 24 cases and a rectal suture alone in 2 cases. Independent predictive factors for PP were: distance from the anal verge >10 cm (OR = 3.6), circumferential tumor (OR = 3.0) and anterior location (OR = 2.7). Hospital stay was significantly longer in Group A (7.5 [3–31] days) than in Group B (4 [1–38] days; p < 0.0001), whereas there was no significant difference regarding postoperative morbidity and recurrence rate. Conclusions: Our results suggested that PP is not a very rare event during TEM, especially in anterior, circumferential and/or high rectal tumors. Laparoscopic treatment of PP is feasible and safe. The occurrence of PP is not associated with poor oncologic results
Recension de l'ouvrage de Daniel Panis, "Il y a le il y a. L'énigme de Heidegger"
No full textpeer reviewe
Is there a limit to transanal endoscopic surgery? A comparative study between standard and technically challenging indications among 168 consecutive patients
No full textAIM:
To assess the surgical outcome of transanal endoscopic surgery (TES) for rectal neoplasms in technically challenging indications.
METHOD:
All patients who underwent TES for a rectal neoplasm from 2007 to 2014 were included. Technically challenging indications included a tumour with (i) diameter ≥ 5 cm, (ii) involving ≥ 50% of the rectal circumference and (iii) located ≥ 10 cm from the anal verge. Patients were divided into three groups according to how many of these features they had, as follows: Group 1, none; Group 2, one; Group 3, two or more.
RESULTS:
Of the 168 patients (80 benign and 88 malignant tumours) included in the study, 73 (44%) were in Group 1, 46 (27%) in Group 2 and 49 (29%) in Group 3. There was no difference between Group 1 and Group 2 with regard to peritoneal perforation (P = 0.210), severe postoperative morbidity (P = 0.804), length of hospital stay (P = 0.444), incomplete resection (P = 0.441), piecemeal resection (P = 0.740), locoregional recurrence (P = 0.307) and long-term symptomatic rectal stenosis (P = 0.076). Conversely Group 3 showed significantly impaired results compared with Group 1 with regard to peritoneal perforation (P = 0.003), piecemeal resection (P = 0.005), incomplete resection (P = 0.025), locoregional recurrence (P = 0.035) and long-term symptomatic rectal stenosis (P < 0.001), but no difference in severe postoperative morbidity (P = 0.328).
CONCLUSION:
Transanal endoscopic surgery for rectal neoplasms appears to be safe and effective, even in patients presenting with a technically challenging tumours. Although the short- and long-term outcomes after TES are worse in patients with highly challenging tumours, nevertheless the technique should still be considered in patients at high risk of requiring a proctectomy
P720 Recurrent rectovaginal fistula in patients with Crohn’s disease: How can we improve the success rate of graciloplasty? A bi-centric European study in 30 patients
No full textEgo sum panis vivus. Giovanni Animuccia
No full textEste trabajo se inscribe dentro de las actividades del Grupo de Investigación Consolidado 2009 SGR 973, "Aula Música Poética", financiado por la Generalitat de Catalunya (Comissionat per a Universitats i Recerca del DIUE)El documento contiene la composición “Ego sum panis vivus” a seis voces del compositor Giovanni Animuccia. Se ofrece el texto en latín, la partitura con la transcripción musical a notación moderna, el facsímil parcial de la obra y varios datos de interés musical y musicológico.Consejo Superior de Investigaciones Científicas (CSIC). Universitat de Barcelona (UB)Peer reviewe
Mucosal changes in ileal pouches after restorative proctocolectomy for ulcerative and Crohn's colitis.
No full textPURPOSE: Inflammation and dysplasia may affect the ileal pouch after restorative
proctocolectomy and ileal pouch-anal anastomosis. The aim of this prospective
study was to evaluate the morphologic changes and the risk of dysplasia within
the pouch after ileal pouch-anal anastomosis.
METHODS: Thirty-seven patients with ileal pouch-anal anastomosis underwent
endoscopies and biopsies of the pouch: 21 patients were affected by ulcerative
colitis and 16 by Crohn's colitis. The mucosal biopsy specimens were studied to
investigate the degree of acute and chronic inflammation and the occurrence of
dysplasia. A score system was calculated for each patient and correlated with the
histologic diagnosis of ulcerative colitis or Crohn's colitis.
RESULTS: After a median follow-up of 85 (range, 7-198) months, the inflammation
histologic score evaluated was 3.8 (95 percent confidence interval, 2.4-5.1) and
3.5 (95 percent confidence interval, 2.6-4.3), respectively, in patients with
Crohn's colitis and ulcerative colitis (mean and 95 percent confidence interval;
P = 0.74, not significant), and no patient developed mucosal dysplasia. Fifteen
patients (40.5 percent) developed clinical pouchitis that occurred in Crohn's
colitis (9/16 patients or 56 percent) and in ulcerative colitis (6/21 patients or
28 percent; P not significant). The score was 4.1 (95 percent confidence
interval, 3.2-5) in patients with pouchitis and 3.2 (95 percent confidence
interval, 2.1-4.3) in patients without clinical pouchitis (P = 0.012) and was 4.1
(95 percent confidence interval, 2.6-5.5) and 4 (95 percent confidence interval,
2.9-5.3), respectively, in pouchitis patients with Crohn's colitis and ulcerative
colitis.
CONCLUSION: No difference in the inflammation histologic score was observed in
ileal pouches after restorative proctocolectomy for ulcerative and Crohn's
colitis. In our series, which includes those patients with longer follow-up (>5
years) or with chronic unremitting pouchitis, no case of dysplasia was found. The
occurrence of pouchitis was higher in the case of ileal pouch-anal anastomosis
for Crohn's disease than for ulcerative colitis, but no difference in the
severity of the histologic score was noted
Mucosal changes in ileal pouches after restorative proctocolectomy for ulcerative and Crohn's colitis
No full textPURPOSE: Inflammation and dysplasia may affect the ileal pouch after restorative proctocolectomy and ileal pouch-anal anastomosis. The aim of this prospective study was to evaluate the morphologic changes and the risk of dysplasia within the pouch after ileal pouch-anal anastomosis. METHODS: Thirty-seven patients with ileal pouch-anal anastomosis underwent endoscopies and biopsies of the pouch: 21 patients were affected by ulcerative colitis and 16 by Crohn's colitis. The mucosal biopsy specimens were studied to investigate the degree of acute and chronic inflammation and the occurrence of dysplasia. A score system was calculated for each patient and correlated with the histologic diagnosis of ulcerative colitis or Crohn's colitis. RESULTS: After a median follow-up of 85 (range, 7-198) months, the inflammation histologic score evaluated was 3.8 (95 percent confidence interval, 2.4-5.1) and 3.5 (95 percent confidence interval, 2.6-4.3), respectively, in patients with Crohn's colitis and ulcerative colitis (mean and 95 percent confidence interval; P = 0.74, not significant), and no patient developed mucosal dysplasia. Fifteen patients (40.5 percent) developed clinical pouchitis that occurred in Crohn's colitis (9/16 patients or 56 percent) and in ulcerative colitis (6/21 patients or 28 percent; P not significant). The score was 4.1 (95 percent confidence interval, 3.2-5) in patients with pouchitis and 3.2 (95 percent confidence interval, 2.1-4.3) in patients without clinical pouchitis (P = 0.012) and was 4.1 (95 percent confidence interval, 2.6-5.5) and 4 (95 percent confidence interval, 2.9-5.3), respectively, in pouchitis patients with Crohn's colitis and ulcerative colitis. CONCLUSION: No difference in the inflammation histologic score was observed in ileal pouches after restorative proctocolectomy for ulcerative and Crohn's colitis. In our series, which includes those patients with longer follow-up (>5 years) or with chronic unremitting pouchitis, no case of dysplasia was found. The occurrence of pouchitis was higher in the case of ileal pouch-anal anastomosis for Crohn's disease than for ulcerative colitis, but no difference in the severity of the histologic score was noted
Comunicación de César de Orleans [al gobernador de Texas, Jacinto de Barrios y Jáuregui] en que expresa que las tierras de los indios panis y apaches de Nadotes pertenecen a los...
No full textManuscrito que contiene Comunicación de César de Orleans [al gobernador de Texas, Jacinto de Barrios y Jáuregui] en que expresa que las tierras de los indios panis y apaches de Nadotes pertenecen a los dominios de su Majestad Cristianísima [el rey de Francia]: Nachitoos, 22 de febrero 1743. Seguida de respuesta del gobernador Barrios en que afirma que los indios de Nadotes y Nasones pertenecen al Rey Católico: Real presidio de los Adaes, 15 marzo 1753
Ubi panis, et libertas, ibi patria.
No full textScène d'extérieur représentant une mère nourricière entourée de nombreux enfants. Des hommes, descendus d'un bateau, font la ronde.Tome 1.r (en haut à gauche); C. Bornet inv. (en bas à gauche); P. Martini Sculp. (en bas à droite); Ubi panis, et libertas, ibi Patria (en bas au centre).FrontispiceLe frontispice du premier tome des "Lettres d’un cultivateur américain" de Crèvecœur, de 1787, offre une image idyllique de l’établissement des Européens en Amérique. Des hommes descendus du navire s’apprêtent à débarquer et rejoindre leurs compatriotes dansant une ronde. À l’avant-plan, une figure féminine dont la tête et les hanches sont ceintes de plumes, un carquois posé à ses pieds et entourée d’enfants, allaite deux d’entre eux. Par ses attributs iconographiques, cette figure constitue à la fois une allégorie de l’Amérique et une allégorie de la Charité.
Cette planche réitère une idée véhiculée dans les textes et les images au temps des Lumières selon laquelle les peuples indigènes d’Amérique sont dotés de vertus maternelles et morales servant de modèles à la civilisation de l’Europe. Dans l’"Histoire philosophique des deux Indes" par exemple, qui était alors la référence sur les peuples non européens, ces enfants sont réputés jouir des meilleurs soins et de la meilleure éducation pour assurer leur bonheur et par conséquent, "ils sont les enfants les plus heureux de la terre".
En plus d’évoquer la vertu du monde primitif comme antidote à la corruption du monde civilisé, cette estampe paraît aussi anticiper les allégories révolutionnaires dans lesquelles la République, entourée du peuple dansant la carmagnole, est figurée comme une mère nourricière traitant avec égalité les enfants de la patrie. Le titre de la gravure "Ubi panis, et libertas, ibi Patria" (Où il y a du pain et la liberté, là est ma patrie) renforce cette association avec l’idée de la mère-patrie.
Référence(s) : Peggy Davis, "Allaitement funèbre et Caritas Indiana : les vertus maternelles d’une race en voie d’extinction au Nouveau Monde", Actes du 3e Colloque du Département d'histoire de l’Université Laval, Québec, CÉLAT/Artefact, 2004, p.39-40.
Chercheur : Peggy Davis
Contracultura e transgressão: uma análise do álbum “tropicalia ou panis et circencis” (1968)
No full textTropicalismo movement is a significant example of the cultural manifestations that characterized the 1960s in Brazil. The mutual influence approached musicians who felt challenged by the cultural critique at that time. The present article tries to show “Tropicália” as a counterculture movement that aimed to highlight certain conservative practices and customs of Brazilian society, as well as to transgress them. The criticism proposed in the songs goes beyond that one addressed against the repressive forces that composed the military state, and it includes conservative positions in the musical, aesthetic, behavioral and sexual aspects. Released in 1968, the collective “manifest álbum” “Tropicália or panis et circencis” represents a new moment in Brazilian music: the explicit opening to cultural dialogues. The study of some of the songs from this manifest-album is the proposal of this present study.O movimento tropicalista é um exemplo significativo das manifestações culturais que marcaram a década de 1960 no Brasil. A influência mútua aproximou músicos que sentiam-se desafiados à crítica cultural do período. O presente artigo intenta mostrar a Tropicália como um movimento de contracultura que se propôs a evidenciar certas práticas e costumes conservadores da sociedade brasileira, bem como a transgredi-los. A crítica proposta no álbum vai além daquela endereçada às forças repressoras do Estado-militar, e abrangem as posturas conservadoras no âmbito musical, estético, comportamental e sexual. Lançado no ano de 1968 o disco-manifesto coletivo Tropicália ou panis et circenses, representa um novo momento na canção brasileira: a abertura explícita aos diálogos culturais. O estudo de algumas canções desse disco-manifesto é o que impulsiona esse estudo. El movimiento tropicalista es un ejemplo significativo de las manifestaciones culturales
que marcaron la década de 1960 en Brasil. La influencia mutua acercó músicos que se sentían
desafiados por la crítica cultural del período. El presente artículo intenta mostrar la Tropicália como un
movimiento de contracultura que se propuso a evidenciar ciertas prácticas y costumbres conservadores
de la sociedad brasileña, así como a transgredirlos. La crítica propuesta en las canciones va más allá de
la aquella dirigida a las fuerzas represoras del Estado-militar, y abarca las posturas conservadoras en el
ámbito musical, estético, comportamental y sexual. Lanzado en el año de 1968, el disco-manifiesto
colectivo “Tropicália ou Panis et circencis”, representa un nuevo momento en la música brasileña: la
apertura explícita a los diálogos culturales. El análisis de algunas canciones de ese disco-manifiesto es
lo que impulsa ese artículo
- …
