14 research outputs found
Fistulotomy and drainage of deep postanal space abscess in the treatment of posterior horseshoe fistula
Get PDFFistulotomy and drainage of deep postanal space abscess in the treatment of posterior horseshoe fistula
Get PDFAbstract Background Posterior horseshoe fistula with deep postanal space abscess is a complex disease. Most patients have a history of anorectal abscess drainage or surgery for fistula-in-ano. Methods Twenty-five patients who underwent surgery for posterior horseshoe fistula with deep postanal space abscess were analyzed retrospectively with respect to age, gender, previous surgery for fistula-in-ano, number of external openings, diagnostic studies, concordance between preoperative studies and operative findings for the extent of disease, operating time, healing time, complications, and recurrence. Results There were 22 (88%) men and 3 (12%) women with a median age of 37 (range, 25–58) years. The median duration of disease was 13 (range, 3–96) months. There was one external opening in 12 (48%) patients, 2 in 8 (32%), 3 in 4 (16%), and 4 in 1 (4%). Preoperative diagnosis of horseshoe fistula was made by contrast fistulography in 4 (16%) patients, by ultrasound in 3 (12%), by magnetic resonance imaging in 6 (24%), and by physical examination only in the remainder (48%). The mean ± SD operating time was 47 ± 10 min. The mean ± SD healing time was 12 ± 3 weeks. Three of the 25 patients (12%) had diabetes mellitus type II. Nineteen (76%) patients had undergone previous surgery for fistula-in-ano, while five (20%) had only perianal abscess drainage. Neither morbidity nor mortality developed. All patients were followed up for a median of 35 (range, 6–78) months and no recurrence was observed. Conclusions Fistulotomy of the tracts along the arms of horseshoe fistula and drainage of the deep postanal space abscess with posterior midline incision that severs both the lower edge of the internal sphincter and the subcutaneous external sphincter and divides the superficial external sphincter into halves gives excellent results with no recurrence. When it is necessary, severing the halves of the superficial external sphincter unilaterally or even bilaterally in the same session does not result in anal incontinence. Close follow-up of patients until the wounds completely healed is essential in the prevention of premature wound closure and recurrence.</p
From microscopic to macroscopic perspectives and back: the study of leadership and health/well-being
Get PDFThis is the author accepted manuscript. The final version is available from the American Psychological Association via the DOI in this recordThis special issue introduces a set of papers that contribute to research on leadership and
health/well-being from multiple perspectives. To situate these papers in current research debates,
this introduction to the special issue provides an overview of research on leadership and
health/well-being by using a microscope-macroscope perspective as an organizing framework.
The microscope-macroscope organizing framework highlights that a comprehensive
understanding of leadership and well-being requires researchers to include multiple perspectives,
including those of leaders and followers, embedded in their context and time. It encourages
researchers to transcend more narrow input-process-output perspectives that are typically
adopted when studying leadership, health and well-being
Breast cancer and immune thrombocytopenic purpura: Is there any association between these 2 distinct diseases?
No full textBackground: An association between breast cancer and immune thrombocytopenic purpura (ITP) is very rare; there are only 18 cases reported in the English literature so far. Patients and Methods: A 65-year-old woman who had been diagnosed with ITP 5 years ago presented with 2 palpable masses in her left breast. Following establishment of the histopathologic diagnosis of invasive ductal carcinoma by fine needle aspiration biopsy, the patient underwent left modified radical mastectomy. Results: Histopathologic examination confirmed invasive ductal carcinoma in the bigger mass, and in situ ductal carcinoma in the smaller. The case was T2NoMo, therefore exclusive anti-estrogen therapy was started for the next 5 years. However, thrombocytopenia recurred twice in the first postoperative year. Fluorodeoxyglucose positron emission tomography (FDG-PET) scanning showed no breast cancer metastases anywhere in the body. Following immunoglobulin infusion, the platelet count increased enough for surgery, and the patient underwent splenectomy for ITP in the 10th month after the previous breast cancer surgery. After an uneventful postoperative period, the patient has been symptom-free during the 1-year of follow-up with normal platelet levels. Conclusion: Although the relevant current data are conflicting, in the present case no direct relationship between ITP and breast cancer could be observed clinically
An unusual cause of small bowel obstruction: Gossypiboma – case report
No full textAbstract Background The term "gossypiboma" denotes a mass of cotton that is retained in the body following surgery. Gossypiboma is a medico-legal problem especially for surgeons. To the best of our knowledge, the patient presented herein is the second reported patient in whom the exact site of migration of a retained surgical textile material into the intestinal lumen could be demonstrated by preoperative imaging studies. Case presentation A 74-year-old woman presented with symptoms of small bowel obstruction due to incomplete intraluminal migration of a laparotomy towel 3 years after open cholecystectomy and umbilical hernia repair. Plain abdominal radiography did not show any sign of a radio-opaque marker in the abdomen. However, contrast enhanced abdominal computerized tomography revealed a round, well-defined soft-tissue mass with a dense, enhanced wall, containing an internal high-density area with air-bubbles in the mid-abdomen. A fistula between the abscess cavity containing the suspicious mass and gastrointestinal tract was identified by upper gastrointestinal series. The presence of a foreign body was considered. It was surgically removed with a partial small bowel resection followed by anastomosis. Conclusions Although gossypiboma is rarely seen in daily clinical practice, it should be considered in the differential diagnosis of acute mechanical intestinal obstruction in patients who underwent laparotomy previously. The best approach in the prevention of this condition can be achieved by meticulous count of surgical materials in addition to thorough exploration of surgical site at the conclusion of operations and also by routine use of surgical textile materials impregnated with a radio-opaque marker.</p
Weak Subdifferential in Nonsmooth Analysis and Optimization
Get PDFSome properties of the weak subdifferential are considered in this paper. By using the definition and properties of the weak subdifferential which are described in the papers (Azimov and Gasimov, 1999; Kasimbeyli and Mammadov, 2009; Kasimbeyli and Inceoglu, 2010), the author proves some theorems connecting weak subdifferential in nonsmooth and nonconvex analysis. It is also obtained necessary optimality condition by using the weak subdifferential in this paper
Author Correction: Exploring solar dynamo behavior using an annually resolved carbon-14 compilation during multiple grand solar minima
No full textUse of Metaverse in Education
No full text22nd International Conference on Computational Science and Its Applications , ICCSA 2022 -- 4 July 2022 through 7 July 2022 -- -- 281299With the introduction of Metaverse, its use is increasing day by day. In this study, the factors affecting the historical development of Metaverse, the Metaverse architecture and the use of Metaverse in the field of education are discussed. The strengths and weaknesses of the use of Metaverse in the field of education are emphasized; the opportunities it will offer and the problems and threats that may be encountered are examined. Since Metaverse is a new concept, a resource for the use of Metaverse in the field of education has been tried to put forward by using the limited number of sources currently available in the literature. In this study, it is emphasized that the Metaverse environment can add a new dimension to the field of educational technologies. However, it should be taken into account that the necessary technologies and architectures in this field are not mature enough yet. Therefore, it is considered a necessity to determine appropriate strategies for the use of Metaverse in the educational field and to start determining its widespread effect until the infrastructure of Metaverse matures. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG
(How) do Work Placements Work? Scrutinizing the Quantitative Evidence for a Theory-Driven Future Research Agenda
Get PDFThis is the author accepted manuscript. The final version is available from Elsevier via the DOI in this recordWhile supervised work placements are increasingly popular in higher education, evidence regarding their effects on career outcomes remain somewhat sparse and atheoretical. The aim of this systematic literature review is to evaluate the effectiveness of placements for career outcomes and to identify any underpinning core psychological processes and to offer a theoretically grounded framework for future research. Drawing on transition theory (Schlossberg, 1981) and career construction theory (Savickas, 1997), we argue that supervised work experiences are central transition experiences that enable social learning processes and trigger changes in a person's identity development as a professional, thereby increasing career resources and employability which in turn affect future career outcomes positively. We screened 2394 systematically selected abstracts across several databases and disciplines. Only quantitative studies that either offered a control-group or a longitudinal design were included, resulting in an in-depth review of 40 studies, applying a rigorous evaluation protocol. Placement participation elicits an overall positive (but small) effect on career outcomes: Graduates who completed a work placement found employment more quickly. Work placements also changed students' perceptions of self-efficacy, their knowledge, skills, and attitudes. We suggest that these changes could be seen as indicative of the proposed social learning processes and identity changes that positively affect career resources. Our review points to several gaps in the literature, and building on existing career theories, we develop a theoretical model and offer new avenues for future research to integrate the heterogenic field of placement research and inform career research in other areas.This project was supported by a Research Stimulation and Impact Fund awarded to Eva Selenko by the University of Sheffield Management School
