1,107 research outputs found

    Safe total intrafascial laparoscopic (TAIL™) hysterectomy: a prospective cohort study

    Get PDF
    This study directly compares total intrafascial laparoscopic (TAIL™) hysterectomy with vaginal (VH) and abdominal (AH) hysterectomy with regard to safety, operating time and time of convalescence. The study is a prospective cohort study (Canadian Task Force classification II-2), including data from patients of a single university-affiliated teaching institution, admitted between 1997 and 2008 for hysterectomy due to benign uterus pathology. Patient data were collected pre-, intra- and postoperatively and complications documented using a standardised data sheet of a Swiss obstetric and gynaecological study group (Arbeitsgemeinschaft Schweizerische Frauenkliniken, Amlikon/Switzerland). Classification of complications (major complications and minor complications) for all three operation techniques, evaluation of surgeons and comparison of operation times and days of hospitalisation were analysed. 3066 patients were included in this study. 993 patients underwent AH, 642 VH and 1,431 total intrafascial hysterectomy. No statistically significant difference for the operation times comparing the three groups can be demonstrated. The mean hospital stay in the TAIL™ hysterectomy, VH and AH groups is 5.8 ± 2.4, 8.8 ± 4.0 and 10.4 ± 3.9 days, respectively. The postoperative minor complications including infection rates are low in the TAIL™ hysterectomy group (3.8%) when compared with either the AH group (15.3%) or the VH group (11.2%), respectively. The total of minor complications is statistically significant lower for TAIL™ hysterectomy as for AH (O.R. 4.52, CI 3.25–6.31) or VH (O.R. 3.16, CI 2.16–4.62). Major haemorrhage with consecutive reoperation is observed statistically significantly more frequent in the AH group when compared to the TAIL™ hysterectomy group, with an O.R. of 6.13 (CI 3.05–12.62). Overall, major intra- and postoperative complications occur significant more frequently in the AH group (8.6%) when compared to the VH group (3%) and the TAIL™ hysterectomy group (1.8%). The incidence of major complications applying the standardised TAIL™ hysterectomy technique is not related to the experience of the surgeons. We conclude that a standardised intrafascial technique of total laparoscopic (TAIL™) hysterectomy using an anatomically developed special uterine device is associated with a very low incidence of minor and major intra- and postoperative complications. The direct comparison of complication rates with either vaginal or abdominal hysterectomy favours the total laparoscopic technique, and therefore, this technique can be recommended as a relatively atraumatic procedure. The operation times are comparable for all three techniques without any statistically significant differences. This technique for laparoscopic hysterectomy is shown to be equally safe when applied by experienced gynaecologic surgeons or by residents in training

    Predicting δPMNS\delta^\text{PMNS}, θ23PMNS\theta_{23}^\text{PMNS} and fermion mass ratios from flavour GUTs with CSD2

    Full text link
    Constrained Sequential neutrino Dominance of type 2 (referred to as CSD2) is an attractive building block for flavour Grand Unified Theories (GUTs) because it predicts a non-zero leptonic mixing angle θ13PMNS\theta_{13}^\text{PMNS}, a deviation of θ23PMNS\theta_{23}^\text{PMNS} from π/4\pi /4, as well as a leptonic Dirac CP phase δPMNS\delta^\text{PMNS} which is directly linked to the CP violation relevant for generating the baryon asymmetry via the leptogenesis mechanism. When embedded into GUT flavour models, these predictions are modified in a specific way, depending on which GUT operators are responsible for generating the entries of fermion Yukawa matrices. In this paper, we systematically investigate and classify the resulting predictions from supersymmetric SU(5)\mathrm{SU}(5) based flavour models by fitting the known fermion mass and mixing data, in order to provide a roadmap for future model building. Interestingly, the promising models predict the lepton Dirac CP phase δPMNS\delta^\mathrm{PMNS} between 230∘230^\circ and 290∘290^\circ, and the quark CP phase δCKM\delta^\mathrm{CKM} in accordance with a right-angled unitarity triangle (αUT=90∘\alpha_\mathrm{UT}=90^\circ). Also, our model setup predicts the quantities θ23PMNS\theta_{23}^\mathrm{PMNS} and md/msm_d/m_s with less uncertainty than current experimental precision, and allowing with future sensitivity to discriminate between them.Comment: 46 pages, 6 figures, 3 tables; we provide neutrino RGE data tables at https://particlesandcosmology.unibas.ch/fileadmin/user_upload/particlesandcosmology-unibas-ch/files/RGrunning.zi

    The validity of clinical diagnoses of dementia in a group of consecutively autopsied memory clinic patients

    Get PDF
    Background: Epidemiological studies show that up to 10 % of individuals aged 65 years and older suffer from dementia, most commonly from dementia of the Alzheimer Type (DAT) [1]. Clinicopathological studies are critical to our understanding of this disease and improving the accuracy of clinical diagnoses.Objectives: Our objectives were to examine the validity of clinical diagnoses of DAT, to determine the prevalence of different forms of dementia in this sample, and to investigate the relationship between age at death and polymorbidity.Subjects and method: Clinical data were available from 221 patients who had been examined at the Basel Memory Clinic between 1986 and 1996. From this population, 34 % (75 patients) were autopsied in the Department of Pathology, University Hospital Basel, and neuropathological examinations were additionally performed on 62 (83 %) of these patients. Clinical and neuropathological data were retrospectively compared.Results: 67.8 % of the neuropathologically examined patients received a definitive diagnosis of AD (Alzheimer's disease), vascular dementia (VaD) or mixed dementia (AD and VaD). AD alone or with other histopathological hallmarks of dementia was the most prevalent neuropathological diagnosis (63 %). VaD was deemed the only cause of dementia in only 4.8 % of patients. The sensitivity for DAT was 75.9 %, the specificity 60.6 %. Increasing age was associated with an increasing number of clinical and neuropathological diagnoses.Conclusion: The sensitivity and specificity of the clinical diagnoses of DAT found in our study are similar to previous reports (2-5). Older patients had more etiologies of their dementia than younger patients. This study reaffirms the need for internationally accepted criteria for clinical and neuropathological diagnoses, as well as further clinical-neuropathological investigations to further refine the clinical diagnostic proces

    Policing by consent: understanding the dynamics of police power and legitimacy

    Get PDF
    This is the first of the country-specific European Social Survey topline results reports. Focusing on UK data from the Round 5 module entitled ‘trust in justice,' we link people’s perceptions of police legitimacy to their compliance with the law and their willingness to cooperate with the police and criminal courts. We also extend the existing literature by addressing wider forms of trust and people’s attachment to order and security. Framing the findings in the context of a long and rich history of policing by consent, we show the value of the European Social Survey in shaping public policy, practice and debate
    • …
    corecore