319 research outputs found
Elective Surgery of Ulcerative Colitis. Ileo-Rectal Anastomosis v/s Restorative Proctocolectomy
No full textCrohn’s Disease and Postoperative Recurrence. Role of the Intestinal Resection and Anastomosis.
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I piccoli padiglioni universitari progettati da Enrico Mandolesi a Cagliari
No full textBetween 1962 and 1964, Enrico Mandolesi designed three small pavilions for the University of Cagliari: the Great Models Pavilion for the Institute of Construction 377 377 Antonello Sanna, Giuseppina Monni, Emanuela Quaquero I PICCOLI PADIGLIONI UNIVERSITARI PROGETTATI DA ENRICO MANDOLESI A CAGLIARI Science, the Pavilion for the Institute of Hydraulics and the Institute of Genetics. In all cases, the “pictorial” dimension, placing on the same level the warm tones of the clinker and the neutral one of the reinforced concrete, shows the author’s firm belief that all the materials have the same relevance. This is a lesson that Mandolesi learns from Mario Ridolfi, precursor of the Italian realism that abolishes the hierarchy between structural elements and finishes and declares that the creative idea of architecture lies in the precision of details. In the Great Models Pavilion for the Institute of Construction Science he chose to create a new volume connected to preexisting buildings with a small building. The horizontal and vertical windows declare the non-structural nature of the envelope made of bricks. A cultured design approach that uses the paradigm of the Illinois Institute of Technology by Mies van de Rohe. The Institute of Genetics is a building composed of two small volumes articulated on two levels and hinged to an independent stairway with a square plan. In this case, on a formal level, the basic principle is the horizontality that Mandolesi pursues at every level of detail. The author applied a combined solution that includes solid brick walls and a steel structure that connects to the frames of the fixtures. Both cases represent an accurate narration of construction stories that uses the combination of different materials, classic elements and modern solutions, the rough surfaces of reinforced concrete and the smooth ones of brick strips
Surgery of Crohn’s Disease. Does the type of Anastomosis and Resection really play a role in the prophylaxis of Postoperative Recurrence?
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“She Looks at Him with the Eyes of a Camera”: Female Visual Pleasures and the Polemic with Fetishism in Sally Potter’s Tango Lesson
No full textAuthor accepted manuscript version of an article published by Taylor & Francis in
Emanuela Guano (2004) She looks at him with the eyes of a camera: female visual pleasures and the polemic with fetishism in Sally Potter's Tango Lesson,Third Text, 18:5, 461-474, https://doi.org/10.1080/0952882042000251732.</p
Elective surgery for ulcerative colitis : ileo-rectal anastomosis or restorative proctocolectomy. An Update
No full textAnn Ital Chir. 2019;90:565-573. Elective surgery for ulcerative colitis, ileo-rectal anastomosis or restorative proctocolectomy An Update. Fornaro R, Casaccia M, Caristo G, Batistotti P, Di Maira L, Atzori G, Oliva A, Stratta E, Razzore A, Caratto M, Caratto E, Giovinazzo D, Frascio M. BACKGROUND: Despite advances in the medical management of Ulcerative Colitis (UC), surgery is required in about a third of patients. AIMS AND METHODS: A review of the literature of the last 20 years was conducted in order to analyze the results of Ileo-Rectal Anastomosis (IRA) and of Ileal Pouch-Anal Anastomosis (IPAA) in the treatment of mild-to-moderate UC. Postoperative complications, functional results and the risk of cancer were analyzed in each of the two groups of patients. RESULTS: In IRA group postoperative morbidity is low, varying from 8 to 28%. The risk of urinary and sexual dysfunction are rare and fertility rates are higher, compared to IPAA. The cumulative probability of success (working IRA) is 84% at 5 years and 51-69% at 10 years. The postoperative morbidity of IPAA is higher; dehiscence and pelvic sepsis were observed respectively in 9.5% and in 5.5%. A sexual dysfunction is present in 3.4%. In 18.8% occurs pouchitis. The risk of failure of the pouch is 6.8% and increased to 8.5% after 5 years. The risk of cancer is higher after IRA than after IPAA, with a cumulative risk at 20 years of 6-14% and 4.2% respectively. DISCUSSION: The choice between IPAA or IRA is based upon patient's preference and clinical criteria (malignancy or sphincter injury). IPAA, intervention of choice, is burdened by a higher rate of complications, such as anastomotic leak with pelvic sepsis and subsequent functional pouch failure, pouchitis, infertility in young women, lesions of the pelvic nerves and portal vein thrombosis. There have been reports of cancer not only in the anal transitional zone, but also in the same pouch, either after mucosectomy that after stapled anastomosis. IRA is less invasive than IPAA and postoperative complications are lower. Does not require dissection of the pelvic and presents no risk of injury of the nerves of the urogenital sphere. The long-term results of the IRA are generally satisfactory and most of the patients stated that after the intervention improve both the health status and quality of life. CONCLUSION: Today IPAA is the gold standard. The IRA is indicated in selected patients where they meet the following requirements: normal sphincter tone, absence of severe perineal disease, rectum does not actively involved by the disease, absence of dysplasia or cancer. It is also indicated in patients who refuse an ileostomy and it can be proposed as a possible interim procedure in young women, because it does not need a pelvic dissection and because the risk of infertility is minimal or absent when compared to IPAA. Because the risk of cancer is higher, patients undergoing IRA must be adequately informed about the risk, as well as recurrent proctitis, also of cancer, and must fully understand the need for surveillance and accept at least annual endoscopy with rectal biopsies; if these conditions are not met, patients should not be candidates for IRA. KEY WORDS: IPAA, IRA, Surgical treatment, Ulcerative Colitis. PMID: 3192917
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