Anastomosis configuration and technique following ileocaecal resection for Crohn's disease: a multicentre study

A limited ileocaecal resection is the most frequently performed procedure for ileocaecal CD and different anastomotic configurations and techniques have been described. This manuscript audited the different anastomotic techniques used in a national study and evaluated their influence on postoperative outcomes following ileocaecal resection for primary CD. This is a retrospective, multicentre, observational study promoted by the Italian Society of Colorectal Surgery (SICCR), including all adults undergoing elective ileocaecal resection for primary CD from June 2018 May 2019. Postoperative morbidity within 30 days of surgery was the primary endpoint. Postoperative length of hospital stay (LOS) and anastomotic leak rate were the secondary outcomes. 427 patients were included. The side to side anastomosis was the chosen configuration in 380 patients (89%). The stapled anastomotic (n = 286; 67%), techniques were preferred to hand-sewn (n = 141; 33%). Postoperative morbidity was 20.3% and anastomotic leak 3.7%. Anastomotic leak was independent of the type of anastomosis performed, while was associated with an ASA grade ≥ 3, presence of perianal disease and ileocolonic localization of disease. Four predictors of LOS were identified after multivariate analysis. The laparoscopic approach was the only associated with a reduced LOS (p = 0.017), while age, ASA grade ≥ 3 or administration of preoperative TPN were associated with increased LOS. The side to side was the most commonly used anastomotic configuration for ileocolic reconstruction following primary CD resection. There was no difference in postoperative morbidity according to anastomotic technique and configuration. Anastomotic leak was associated with ASA grade ≥ 3, a penetrating phenotype of disease and ileo-colonic distribution of CD

National variations in perioperative assessment and surgical management of Crohn's disease: a multicentre study

Aim: Crohn's disease (CD) requires a multidisciplinary approach and surgery should be undertaken by dedicated colorectal surgeons with audited outcomes. We present a national, multicentre study, with the aim to collect benchmark data on key performance indicators in CD surgery, to highlight areas where standards of CD surgery excel and to facilitate targeted quality improvement where indicated. Methods: All patients undergoing ileocaecal or redo ileocolic resection in the participating centres for primary and recurrent CD from June 2018 to May 2019 were included. The main objective was to collect national data on hospital volume and practice variations. Postoperative morbidity was the primary outcome. Laparoscopic surgery and stoma rate were the secondary outcomes. Results: In all, 715 patients were included: 457 primary CD and 258 recurrent CD with a postoperative morbidity of 21.6% and 34.7%, respectively. Laparoscopy was used in 83.8% of primary CD compared to 31% of recurrent CD. Twenty-five hospitals participated and the total number of patients per hospital ranged from 2 to 169. Hospitals performing more than 10 primary CD procedures per year showed a higher adoption of laparoscopy and bowel sparing surgery. Conclusions: There is significant heterogeneity in the number of CD surgeries performed per year nationally in Italy. Our data suggest that high-volume hospitals perform more complex procedures, with a higher adoption of bowel sparing surgery. The rate of laparoscopy in high-volume hospitals is higher for primary CD but not for recurrent CD compared with low-volume hospitals

Traditional medicine in the Yaghnob Valley. Notes on body therapy, pregnancy and birth care

The Yaghnobi community preserved, until the early decades of the 1900's, archaic traditions and customs. Many of these traditions were linked, for centuries, to medicine, birth and delivery. A report on Yaghnobi's traditional medicine was prepared by E. M. Peščereva during the expeditions to the Yaghnob Valley of 1924-27. Peščereva's report represents an important point of comparison and a reading-guide to the interpretation of the current situation in order to find elements of continuity and compare impressions and observations

Il cibo

La spedizione nella Valle dello Yaghnob è un progetto dell'Università di Bologna diretto da Antonio Panaino. Questo contributo è dedicato all'incontro dell'equipe universitaria con l'alimentazione di una popolazione che vive in alta montagna in Tajikistan

The Gundēšābūr school. The knowledge of the human body (Anatomy and Physiology) and the transmission of medical-scientific theories in Sasanian and post-Sasanian Times.

Questo lavoro traccia un quadro della diffusione e trasmissione delle conoscenze riguardanti l’anatomia e la fisiologia del corpo umano nel mondo iranico in età sasanide (III-VII sec. d.C.). La tesi analizza il ruolo delle scuole di medicina in territorio iranico, come quelle sorte a Nisibi e Gundēšābūr, delle figure dei re sasanidi interessati alla filosofia e alla scienza greca, e dei centri di studio teologico e medico che, ad opera dei cristiani siro-orientali, si fecero promotori della conoscenza medico-scientifica greca in terra d’Iran.This paper provides an overview of the spread and transmission of knowledge about the anatomy and physiology of the human body in the Iranian world in Sasanian times (3rd to 7th Century AD). The thesis analyzes the role of medical schools in the Iranian territory, such as those arising in Nisibis and Gundēšābūr, the figures of the Sasanian kings interested in philosophy and Greek science, and theological study centers and physicians who, by the work of East-Syrian Christians, became promoters of Greek scientific medical knowledge in the Iranian world

Farmacie e sostegno dell'allattamento materno, un approccio di rete tra operatori sanitari

L'articolo illustra un progetto ideato dall'autore, patrocinato da UNICEF, e attivo su scala nazionale, basato su un approccio di rete tra madri, ostetriche, pediatri e farmacisti in contatto continuo e impegnati a sostenere l'inizio, l'esclusività e la durata dell'allattamento materno

Investigation Into the Pharmacist’s Role in Breastfeeding Support in the “Roma B” Local Health Authority in Rome

Background: Breastfeeding is the biological norm for feeding infants and a public health strategy with such a significant impact on the health of the population in the short, medium, and long terms that it should be considered a priority. A pharmacy can be a place for breastfeeding support, since it is open 24 hours a day and is easily accessible. Objective: The main objective of our fact-finding investigation into the breastfeeding support role of pharmacists in the “Roma B” Local Health Authority was to understand how often pharmacists came into contact with nursing mothers, and if pharmacists felt the need to have a greater knowledge of issues regarding breastfeeding. Methods: This survey was done by administering 144 questionnaires (to 1 pharmacist per pharmacy) with items about the support and the protection of breastfeeding and lactation, the perceived need for specific training courses, and openness to establishing virtuous network mechanisms with stakeholders who work in breastfeeding in that geographical area. Results: Our survey shows that mothers come to pharmacies for advice about various health problems. Although pharmacists had little knowledge about breastfeeding, they were interested in participating in a training course. Ninety percent of them declared their interest in collaborating with local breastfeeding stakeholders. Conclusions: The role of the pharmacist in the protection, promotion, and support of breastfeeding has become increasingly important, along with the awareness of being competent and ethical on issues about breastfeeding

Esperienze e tecniche dell’estasi tra Oriente e Occidente

The book aims to provide an opportunity to rethink and redefine on a historical-comparative and interdisciplinary basis a crucial issue in historical-religious and ethno-anthropological studies. Ecstasy, together with its related of the trance, constitutes, in ancient and modern cultures, one of the main forms of mythic-ritual elaboration of the altered states of consciousness and of the incorporation of the divine. Nine scholars of historical-cultural areas apparently distant but indeed united by deep connections, retracing a chronological band that goes from Neoplatonism to modern Jewish mysticism and through Eastern Christian Syria, pre-Islamic Iran, mystical low-mysticism, Islamic Sufism, medieval India, shamanism and the medical anthropology of Southern Italy) will try, on the one hand, to explain the analytical and historiographical categories of research on a mobile and elusive objective like that of ecstasy; on the other hand they will propose monographic fills on specific and differentiated contexts. The aim is to contribute to the refinement of the historical-religious and historical-anthropological vocabulary of a crucial aspect for the human sciences.Il volume intende offrire un’occasione per ripensare e ridefinire su base storico-comparativa e interdisciplinare una questione cruciale negli studi storico-religiosi ed etno-antropologici. L’estasi, insieme al suo correlato della trance, costituisce, nelle culture antiche e moderne, una delle principali forme di elaborazione mitico-rituale degli stati alterati di coscienza e di incorporazione del divino. Nove studiosi di ambiti storico-culturali in apparenza distanti ma invero uniti da connessioni profonde, ripercorrendo una fascia cronologica che va dal neoplatonismo alla mistica ebraica moderna e passando per la Siria orientale cristiana, l’Iran preislamico, la mistica bassomedievale, il sufismo islamico, l’India medievale, lo sciamanesimo e l’antropologia medica del Mezzogiorno d’Italia) tenteranno da un lato di esplicitare le categorie analitiche e storiografiche delle ricerche su un obiettivo mobile e sfuggente come quello dell’estasi; dall’altro proporranno affondi monografici su contesti specifici e differenziati. Il fine è quello di contribuire all’affinamento del lessico storico-religioso e storico-antropologico di un aspetto cruciale per le scienze dell’uomo