Embedded surfaces of arbitrary genus minimizing the Willmore energy under isoperimetric constraint

The isoperimetric ratio of an embedded surface in $R^3$ is defined as the ratio of the area of the surface to power three to the squared enclosed volume. The aim of the present work is to study the minimization of the Willmore energy under fixed isoperimetric ratio when the underlying abstract surface has fixed genus $g\geq 0$. The corresponding problem in the case of spherical surfaces, i.e. $g=0$, was recently solved by Schygulla with different methods.Comment: 38 page

Tunisia\u27s Claims Over Adjacent Seas and the Doctrine of Historic Rights

This article examines Tunisia\u27s claims to have historic rights to the seas along its coasts

L∞ estimates and integrability by compensation in Besov-Morrey spaces and applications

estimates in the integrability by compensation result of H. Wente fail in dimension larger than two when Sobolev spaces are replaced by the ad-hoc Morrey spaces (in dimension ). However, in this paper we prove that estimates hold in arbitrary dimension when Morrey spaces are replaced by their Littlewood-Paley counterparts: Besov-Morrey spaces. As an application we prove the existence of conservation laws for solutions of elliptic systems of the form where is antisymmetric and both and belong to these Besov-Morrey spaces for which the system is critica

L∞L^{\infty} estimates and integrability by compensation in Besov-Morrey spaces and applications

$L^{\infty}$ estimates in the integrability by compensation result of H. Wente fail in dimension larger than two when Sobolev spaces are replaced by the ad-hoc Morrey spaces. However, in this paper we prove that $L^{\infty}$ estimates hold in arbitrary dimension when Morrey spaces are replaced by their Littlewood Paley counterparts: Besov-Morrey spaces. As an application we prove the existence of conservation laws to solution of elliptic systems of the form $-\Delta u= \Omega \cdot \nabla u$ where $\Omega$ is antisymmetric and both $\nabla u$ and $\Omega$ belong to these Besov-Morrey spaces for which the system is critical.Comment: 37 page

Emergency treatment of complicated colorectal cancer

Aim: To find evidence to suggest the best approach in patients admitted as an emergency for complicated colorectal cancer. Methods: The medical records of 131 patients admitted as an emergency with an obstructing, perforated, or bleeding colorectal cancer to Noble’s Hospital, Isle of Man, and the Umberto I University Hospital, Rome, were retrospectively evaluated. Patients were divided in 3 groups on the basis of the emergency treatment they received, namely 1) immediate resection, 2) damage control procedure and elective or semielective resection, and 3) no radical treatment. Demographic variables, clinical data, and treatment data were considered, and formed the basis for the comparison of groups. Primary endpoints were 90-day mortality and morbidity. Secondary endpoints were length of stay, number of lymph nodes analyzed, rate of radical R0 resections, and the number of patients who had chemoradiotherapy. Results: Forty-two patients did not have any radical treatment because the cancer was too advanced or they were too ill to tolerate an operation, 78 patients had immediate resection and 11 had damage control followed by elective resection. There was no statistically significant difference between immediate resections and 2-stage treatment in 90-day mortality and morbidity (mortality: 15.4% vs 0%; morbidity: 26.9% vs 27.3%), number of nodes retrieved (16.6±9.4 vs 14.9±5.7), and rate of R0 resections (84.6% vs 90.9%), but mortality was slightly higher in patients who underwent immediate resection. The patients who underwent staged treatment had a higher possibility of receiving a laparoscopic resection (11.5% vs 36.4%). Conclusion: The present study failed to demonstrate a clear superiority of one treatment with respect to the other, even if there is an interesting trend favoring staged resection

Operative and nonoperative management for renal trauma. Comparison of outcomes. A systematic review and meta-analysis

INTRODUCTION: Preservation of kidney and renal function is the goal of nonoperative management (NOM) of renal trauma (RT). The advantages of NOM for minor blunt RT have already been clearly described, but its value for major blunt and penetrating RT is still under debate. We present a systematic review and meta-analysis on NOM for RT, which was compared with the operative management (OM) with respect to mortality, morbidity, and length of hospital stay (LOS). METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-analyses statement was followed for this study. A systematic search was performed on Embase, Medline, Cochrane, and PubMed for studies published up to December 2015, without language restrictions, which compared NOM versus OM for renal injuries. RESULTS: Twenty nonrandomized retrospective cohort studies comprising 13,824 patients with blunt (2,998) or penetrating (10,826) RT were identified. When all RT were considered (American Association for the Surgery of Trauma grades 1-5), NOM was associated with lower mortality and morbidity rates compared to OM (8.3% vs 17.1%, odds ratio [OR] 0.471; 95% confidence interval [CI] 0.404-0.548; P<0.001 and 2% vs 53.3%, OR 0.0484; 95% CI 0.0279-0.0839, P<0.001). Likewise, NOM represented the gold standard treatment resulting in a lower mortality rate compared to OM even when only high-grade RT was considered (9.1% vs 17.9%, OR 0.332; 95% CI 0.155-0.708; P=0.004), be they blunt (4.1% vs 8.1%, OR 0.275; 95% CI 0.0957-0.788; P=0.016) or penetrating (9.1% vs 18.1%, OR 0.468; 95% CI 0.398-0.0552; P<0.001). CONCLUSION: Our meta-analysis demonstrated that NOM for RT is the treatment of choice not only for AAST grades 1 and 2, but also for higher grade blunt and penetrating RT

Electromyographic analysis of the masseter and suprahyoid muscles in the oral phase of swallowing in healthy adult individuals

Objective: to evaluate by means of electromyographic analysis of the masseter and suprahyoid muscles the oral phase of the swallowing of different volumes of saliva and liquid in healthy adult individuals. Material and Methods: the method consisted in analyzing samples of three swallowing trials: voluntary and single swallow of saliva (dry), voluntary and single swallow of 10 ml of water, and voluntary and single swallow of 20ml of water. Statistical analysis: Through Friedman’s ANOVA test we observed a significant variation in the medium potential of the right suprahyoid muscle (p=0.010) when compared to the left suprahyoid muscle (p=0.05). Other correlations were verified by using the Nemenyi test, the Wilcoxon test and the Spearman coefficient to support the different analyses of the results. Results: the analysis found a direct relation between the electrical activity of the masseter and suprahyoid muscles when swallowing 20 ml water as regards the highest potential values, irrespective of face side – left or right; i.e., when swallowing 20ml water, the higher the potential of one muscle group, the higher the expected value of its antagonist. Conclusion: the electromyographic behavior of the masseter and suprahyoid muscles during voluntary swallowing of saliva and two standardized liquid volumes showed that the electrical activity of the masseter muscles did not vary according to the type of swallowing.info:eu-repo/semantics/publishedVersio

Hollow viscus injuries. Predictors of outcome and role of diagnostic delay

INTRODUCTION: Hollow viscus injuries (HVIs) are uncommon but potentially catastrophic conditions with high mortality and morbidity rates. The aim of this study was to analyze our 16-year experience with patients undergoing surgery for blunt or penetrating bowel trauma to identify prognostic factors with particular attention to the influence of diagnostic delay on outcome. METHODS: From our multicenter trauma registry, we selected 169 consecutive patients with an HVI, enrolled from 2000 to 2016. Preoperative, intraoperative, and postoperative data were analyzed to assess determinants of mortality, morbidity, and length of stay by univariate and multivariate analysis models. RESULTS: Overall mortality and morbidity rates were 15.9% and 36.1%, respectively. The mean length of hospital stay was 23±7 days. Morbidity was independently related to an increase of white blood cells (P=0.01), and to delay of treatment >6 hours (P=0.033), while Injury Severity Score (ISS) (P=0.01), presence of shock (P=0.01), and a low diastolic arterial pressure registered at emergency room admission (P=0.02) significantly affected postoperative mortality. CONCLUSION: There is evidence that patients with clinical signs of shock, low diastolic pressure at admission, and high ISS are at increased risk of postoperative mortality. Leukocytosis and delayed treatment (>6 hours) were independent predictors of postoperative morbidity. More effort should be made to increase the preoperative detection rate of HVI and reduce the delay of treatment

Surgical risk and pathological results of emergency resection in the treatment of acutely obstructing colorectal cancers. A retrospective cohort study

The treatment of acutely obstructing colorectal cancers is still a matter of debate. The most diffuse attitude is to perform an immediate resection whenever possible. This study has been carried out to try to answer the following questions regarding immediate resection: (1) is it safe? (2) is it oncologically valid

Needlestick injuries, glove perforation and round-tipped blunt needles

We read with great interest the article by Battersby et al. [1] about the impairment of surgical knot quality due to double gloving. The practice to wearing two pairs of gloves during surgical procedures to reduce the risks of exposure to patient’s blood and transmission of infectious organisms has been recommended worldwide, by several healthcare authorities, also on the basis of a Cochrane review showing the absence of compromised dexterity as a result of double gloving [2]. The study performed by Battersby and Colleagues clearly shows that double gloving reduces the quality of surgical knots by 24%, no matter the suture type used. A wider reduction of knot quality (50%) was noted with 4.0 sutures. These results question the safety of surgical knots tied wearing double gloves and, as a consequence, push surgeons to consider other precautions to reduce bloody contamination during surgery ..