scholarly journals Pneumoretroperitoneum after a STARR Procedure Performed One Year after a Posterior Colporrhaphy: A Case Report and Review of the Literature

2020 ◽  
pp. 1-4
Author(s):  
Ibrahim Darwich ◽  
Badrig Melekian ◽  
Serpil Demirel-Darwich ◽  
Frank Willeke
Keyword(s):  
Rectal Resection ◽  
Staple Line ◽  
Obstructed Defecation ◽  
Review Of The Literature ◽  
Posterior Colporrhaphy ◽  
Management Of Complications ◽  
Wide Range ◽  
Tailored Approach ◽  
One Year ◽  
Starr Procedure

Transanal rectal resection with a stapling instrument (STARR) has been shown to be effective and safe for the treatment of obstructed defecation syndrome (ODS). Nevertheless, the wide range of complications described in the literature necessitates a rigorous patient selection and a tailored approach for the management of complications. We present here a case of pneumoretroperitoneum which occurred after a STARR procedure for ODS was performed nearly a year after previous anterior and posterior colporrhaphy. The diagnostic workup did not reveal a staple-line defect. Laparoscopy did not show any intra-abdominal pathology. The symptoms resolved under oral antibiotics. The patient was discharged on day 10 after admission. Scarring in the rectovaginal septum from a colporrhaphy 1 year earlier might have contributed to a suboptimal staple-line closure during the STARR procedure, leading to a pneumoretroperitoneum. We discuss this complication and provide a brief review of the literature.

scholarly journals Management of staple line stricture with new laser four quadrant stricturoplasty: a case series

2018 ◽  
Vol 5 (10) ◽  
pp. 3356
Author(s):  
Ashwin Porwal ◽  
Jaya Maheshwari
Keyword(s):  
Staple Line ◽  
Obstructed Defecation ◽  
Case Series ◽  
Anal Stricture ◽  
History Of ◽  
Data History ◽  
One Year ◽  
Four Quadrant ◽  
Ethical Clearance

Background: To assess the outcomes of Laser Four Quadrant stricturoplasty surgery in patients with staple line anal stricture post MIPH and STARR surgery.Methods: A prospective observational study was planned with purposive sampling. Cases with staple line stricture during the period February 2014 to July 2015 were included. There were 30 patients included in the study after informed consent and ethical clearance from hospital ethical committee. The data collected was background data, history of previous surgery, duration of Laser Four Quadrant stricturoplasty and Hospital stay, post-operative relief of symptoms and any complications, assessment of pain on VAS up to one year follow up period, overall patients’ satisfaction.Results: Out of 30 patients, 22 anal stricture patients were post STARR surgery and 8 were post MIPH surgery.  The mean surgery and hospitalization duration were 24.48±6.31 minutes and 13.72±4.30 hours respectively. Symptoms reported were Obstructed defecation (n=30), painful evacuation (n=30) and episodes of minor rectal bleeding (n=9). There was significant (p<0.0001) reduction in pain from preoperative 7.13±1.04 to 1.13±0.54, 0.27±0.45, 0.16±0.38 and 0.06±0.25 at baseline (post-operative), day 7, month 1 and month 3 respectively. At the end of one year, 86.67% patient were highly satisfied, 13.33 % were not satisfied. Recurrence was reported by 3 patients within 6 to 10 weeks post-surgery.Conclusions: Laser Four Quadrant Stricturoplasty is an easy and effective surgery for the treatment of staple line stricture with a low recurrence rate.

scholarly journals Outcomes of a modified Bresler procedure for the treatment of rectocele with rectal intussusception

2020 ◽  
Author(s):  
Qun Deng ◽  
Kai-Lin Yu ◽  
Zhi-Yong Liu ◽  
Zhong Shen ◽  
Ya-Hui Wang ◽  
...  
Keyword(s):  
Rectal Resection ◽  
Rectal Wall ◽  
Obstructed Defecation ◽  
Rectal Intussusception ◽  
Purse String ◽  
Treatment Groups ◽  
Significant Difference ◽  
Operative Complications ◽  
Starr Procedure ◽  
Post Operative Complications

Abstract Background Obstructed defecation syndrome (ODS) is a condition that is frequently caused by rectocele and rectal intussusception. This study aimed to evaluate the effectiveness of a modified Bresler procedure for the treatment of ODS. The outcomes of this modified procedure were compared with the stapled transanal rectal resection (STARR) procedure. Methods We performed a retrospective analysis of the clinical data from 76 female patients who presented with ODS between June 2014 and June 2016. The patients were divided into two treatment groups, namely Modified and STARR. Patients in the Modified group (n = 36) underwent the modified Bresler procedure, which involved posterior rectal-wall resection using a circular tubular stapler with multilevel purse-string sutures. Patients in the STARR group (n = 40) underwent the standard STARR procedure. We analysed post-operative complications, Wexner constipation scores (WCS), rectocele depths, and four-point post-operative satisfaction scales. Results Patients in the Modified group exhibited shorter operative times and fewer post-operative complications (both P &lt; 0.05). At 12 months post-operatively, both the Modified and STARR groups displayed a significant improvement in the Wexner constipation score and the depth of rectocele. The post-operative WCS for the Modified group were significantly improved compared to those for the STARR group (P &lt; 0.05), while there was no significant difference in the rectocele depth between the two groups (P &gt; 0.05). Post-operative interviews at post-operative 12 months showed that patients in the Modified group had a better satisfaction (P = 0.05). Conclusions Our modified procedure may be an effective treatment strategy for patients experiencing ODS caused by rectocele and rectal intussusception, with fewer complications and effective relief of symptoms.

Intimate Partner Violence and Help-Seeking

2017 ◽  
Vol 22 (4) ◽  
pp. 263-281 ◽  
Author(s):  
Solveig Lelaurain ◽  
Pierluigi Graziani ◽  
Grégory Lo Monaco
Keyword(s):  
Social Psychology ◽  
Intimate Partner Violence ◽  
Partner Violence ◽  
Help Seeking ◽  
Intimate Partner ◽  
Review Of The Literature ◽  
Social Concern ◽  
Inclusion Criteria ◽  
Inhibiting Factors ◽  
Wide Range

Abstract. Intimate partner violence (IPV) is a global social concern: many women are affected by this phenomenon and by the difficulty of putting an end to it. This review of the literature aims to identify help-seeking facilitating and inhibiting factors in response to IPV. It was carried out on the PsycINFO and Medline databases using the following keywords: “intimate partner violence,” “domestic violence,” “help-seeking,” and “help-seeking barrier.” Ninety out of 771 eligible publications were included on the basis of inclusion criteria. The results highlight that (1) research on this phenomenon is very recent and underdeveloped in Europe, (2) theoretical and conceptual frameworks are poorly developed and extended, (3) there is a significant impact of violence characteristics (e.g., severity, type) on help-seeking, and (4) help-seeking is a complex and multifactorial process influenced by a wide range of factors simultaneously individual and social. To conclude, these findings lead us to propose a psychosocial conceptualization of the help-seeking process by indicating how the levels of explanation approach in social psychology can be applied to this field of research in order to increase our understanding of this phenomenon.

COMPETITIVE STATUS OF UKRAINE

2017 ◽  
Author(s):  
Olena Zayats ◽  
Keyword(s):  
National Economy ◽  
Financial System ◽  
Product Market ◽  
Global Competitiveness ◽  
Innovation Potential ◽  
Wide Range ◽  
Ict Adoption ◽  
World Economic ◽  
Global Competitiveness Index ◽  
One Year

The article examines the competitive status and competitive positions of Ukraine. It proves that in the current context the competitive status of the national economy is determined by the presence of a strong global competitive force that provides dynamic growth based on innovation potential, developed institutions, infrastructure, ICT adoption, macroeconomic stability, health, skills, product market, labor market, financial system, market size, business dynamism rather than by traditional factors (natural resources, geopolitical situation). It has been identified that a wide range of factors in global competitive force establishment suggests the complexity of its assessment. It has been noted that in world economic practice the Global Competitiveness Index of the World Economic Forum is predominantly used to assess the competitive status of the national economy. It has been determined that according to this index, in the overall ranking among 141 countries in 2019, Ukraine ranked 85th (2009-2010 – 82/133; 2018 – 83/140). The article analyzes of the competitive status of Ukraine in the international arena in terms of twelve pillars of the studied index and in the context of components of the said pillars. The dynamics of Ukraine's global competitive force in recent years shows that there has not been any build up. However, if one analyzes it in terms of the criteria of the global competitive force of the domestic economy, their assessment is volatile: the main regression can be traced in the sphere of the financial system, where Ukraine dropped by 19 positions in one year (2018 – 117/140, 2019 – 136/141), and the greatest progress is observed in the product market, where Ukraine rose by 16 positions in one year (2018 – 73/140, 2019 – 57/141). Analysis of the components of Ukraine’s global competitive force criteria shows that the worst positions in terms of such components are as follows: non-performing loans (% of gross total loans) – 139/141 and soundness of banks – 131/141. The best positions are in terms of the following components: costs of starting a business – 14/141 and attitude towards entrepreneurial risk – 18/141.

scholarly journals Novel Protein-Repellent and Antibacterial Resins and Cements to Inhibit Lesions and Protect Teeth

2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Li Cao ◽  
Junling Wu ◽  
Qiang Zhang ◽  
Bashayer Baras ◽  
Ghalia Bhadila ◽  
...  
Keyword(s):  
Orthodontic Treatment ◽  
The Novel ◽  
Dental Resin ◽  
Biofilm Growth ◽  
New Class ◽  
Dental Resins ◽  
Wide Range ◽  
Oral Biofilms ◽  
One Year

Orthodontic treatment is increasingly popular as people worldwide seek esthetics and better quality of life. In orthodontic treatment, complex appliances and retainers are placed in the patients’ mouths for at least one year, which often lead to biofilm plaque accumulation. This in turn increases the caries-inducing bacteria, decreases the pH of the retained plaque on an enamel surface, and causes white spot lesions (WSLs) in enamel. This article reviews the cutting-edge research on a new class of bioactive and therapeutic dental resins, cements, and adhesives that can inhibit biofilms and protect tooth structures. The novel approaches include the use of protein-repellent and anticaries polymeric dental cements containing 2-methacryloyloxyethyl phosphorylcholine (MPC) and dimethylaminododecyl methacrylate (DMAHDM); multifunctional resins that can inhibit enamel demineralization; protein-repellent and self-etching adhesives to greatly reduce oral biofilm growth; and novel polymethyl methacrylate resins to suppress oral biofilms and acid production. These new materials could reduce biofilm attachment, raise local biofilm pH, and facilitate the remineralization to protect the teeth. This novel class of dental resin with dual benefits of antibacterial and protein-repellent capabilities has the potential for a wide range of dental and biomedical applications to inhibit bacterial infection and protect the tissues.

Cognitive impairment in long-term benzodiazepine users

1988 ◽  
Vol 18 (2) ◽  
pp. 365-374 ◽  
Author(s):  
Susan Golombok ◽  
Parimala Moodley ◽  
Malcolm Lader
Keyword(s):  
Neuropsychological Tests ◽  
Matched Control ◽  
Control Group ◽  
Therapeutic Practice ◽  
The Past ◽  
Visual Spatial ◽  
Wide Range ◽  
High Doses ◽  
One Year

SynopsisIn view of the very extensive and often prolonged use of benzodiazepines in therapeutic practice, this study was designed to investigate whether or not cognitive ability is impaired in longterm benzodiazepine users, and to determine the nature and extent of any deficit. Fifty patients currently taking benzodiazepines for at least one year, thirty-four who had stopped taking benzodiazepines, and a matched control group of subjects who had never taken benzodiazepines or who had taken benzodiazepines in the past for less than one year were administered a battery of neuropsychological tests designed to measure a wide range of cognitive functions. It was found that patients taking high doses of benzodiazepines for long periods of time perform poorly on tasks involving visual-spatial ability and sustained attention. This is consistent with deficits in posterior cortical cognitive function.

Meningitis Due to Haemophilus influenzae Other Than Type b: Case Report and Review

PEDIATRICS ◽  
1978 ◽  
Vol 62 (6) ◽  
pp. 1021-1025
Author(s):  
Gerald R. Greene
Keyword(s):  
Clinical Trial ◽  
Age Distribution ◽  
Effective Vaccine ◽  
Type B ◽  
Review Of The Literature ◽  
Large Clinical Trial ◽  
Serious Infections ◽  
One Year ◽  
Age Range ◽  
Observation Period

A 4-month-old female infant with meningitis caused by Haeinophilus influenzae type f had a hospital course complicated by sterile subclural effusions and persistent neurologic normalities. One year later she was normal in all respects. The infant's mother had serum bactericidal antibodies to H. influenzae type b but not to type f. During recovery the patient had no bactericidal antibodies to type b, and the type f organism could not be maintained in her serum. Review of the literature identified 40 cases of meningitis reported as caused by H. influenzae other than type b. An evaluation of the ten cases described as due to encapsulated strains (a, e, and f) shows that the age distribution and clinical features are similar to those of meningitis caused by type b. Only five cases of meningitis caused by unencapsulated H. influenzae have been described. Four of the patients were older than the usual age range for type b meningitis and two had prior head trauma. A large clinical trial in Finland with a two-year observation period has denionstrated no untoward increase in non-b H. influenzae meningitis in recipients of a type b vaccine. Serious infections caused by other H. influenzae types will continue to occur sporadically and may increase in frequency when an effective vaccine against type b is widely used in infants.

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