10 research outputs found

    Traumatic Cloaca

    Get PDF

    Intersphincteric Resection for Low Rectal Cancer: An Overview

    Get PDF
    The treatment of rectal cancer has evolved from being solely a surgical endeavor to a multidisciplinary practice. Despite the improvement in outcomes conferred by the addition of chemoradiation therapy to rectal cancer treatment, advances in surgical technique have significantly increased rates of sphincter preservation and the avoidance of a permanent stoma. In recent years, intersphincteric resection for low rectal cancer has been offered and performed in patients as an alternative to abdominoperineal resection. An overview of this procedure, including indications, oncological and functional results based on current literature, is presented herein

    Strategic goal accomplishment in export ventures: the role of capabilities, knowledge, and environment

    No full text
    The management literature suggests that setting strategic goals facilitates the identification of appropriate business strategies and focuses management attention and available resources on their accomplishment, enabling subsequent goal realization. Yet the literature also indicates that firms often find it difficult to realize their strategic goals and may find it even more challenging to do so when operating in foreign markets. However, little is known empirically about the extent to which strategic goals enable desired strategic positions to be achieved and factors that may affect this relationship. We examine this important issue using primary data from a sample of exporting manufacturers. Results support the existence of previously theorized strategic goal–realized strategic position gaps and show that these negatively impact performance. Thus, simply setting strategic goals does not necessarily aid in accomplishing the desired outcomes, and any failure to do so is costly. Drawing on organization theory, we find that internal capabilities and knowledge, and external market factors play important roles in minimizing such strategic goal–realized strategic position gaps. Specifically, we show that businesses with stronger architectural capabilities, those with higher levels of internationalization, and those operating in less dynamic market environments are better able to realize their intended strategic objectives and thereby enjoy superior performance

    When Does International Marketing Standardization Matter to Firm Performance?

    No full text

    Second asymptomatic carotid surgery trial (ACST-2) : a randomised comparison of carotid artery stenting versus carotid endarterectomy

    No full text
    Background: Among asymptomatic patients with severe carotid artery stenosis but no recent stroke or transient cerebral ischaemia, either carotid artery stenting (CAS) or carotid endarterectomy (CEA) can restore patency and reduce long-term stroke risks. However, from recent national registry data, each option causes about 1% procedural risk of disabling stroke or death. Comparison of their long-term protective effects requires large-scale randomised evidence. Methods: ACST-2 is an international multicentre randomised trial of CAS versus CEA among asymptomatic patients with severe stenosis thought to require intervention, interpreted with all other relevant trials. Patients were eligible if they had severe unilateral or bilateral carotid artery stenosis and both doctor and patient agreed that a carotid procedure should be undertaken, but they were substantially uncertain which one to choose. Patients were randomly allocated to CAS or CEA and followed up at 1 month and then annually, for a mean 5 years. Procedural events were those within 30 days of the intervention. Intention-to-treat analyses are provided. Analyses including procedural hazards use tabular methods. Analyses and meta-analyses of non-procedural strokes use Kaplan-Meier and log-rank methods. The trial is registered with the ISRCTN registry, ISRCTN21144362. Findings: Between Jan 15, 2008, and Dec 31, 2020, 3625 patients in 130 centres were randomly allocated, 1811 to CAS and 1814 to CEA, with good compliance, good medical therapy and a mean 5 years of follow-up. Overall, 1% had disabling stroke or death procedurally (15 allocated to CAS and 18 to CEA) and 2% had non-disabling procedural stroke (48 allocated to CAS and 29 to CEA). Kaplan-Meier estimates of 5-year non-procedural stroke were 2·5% in each group for fatal or disabling stroke, and 5·3% with CAS versus 4·5% with CEA for any stroke (rate ratio [RR] 1·16, 95% CI 0·86-1·57; p=0·33). Combining RRs for any non-procedural stroke in all CAS versus CEA trials, the RR was similar in symptomatic and asymptomatic patients (overall RR 1·11, 95% CI 0·91-1·32; p=0·21). Interpretation: Serious complications are similarly uncommon after competent CAS and CEA, and the long-term effects of these two carotid artery procedures on fatal or disabling stroke are comparable
    corecore