49 research outputs found
Efficient GRASP+VND and GRASP+VNS metaheuristics for the traveling repairman problem
The traveling repairman problem is a customer-centric routing problem, in which the total waiting time of the customers is minimized, rather than the total travel time of a vehicle. To date, research on this problem has focused on exact algorithms and approximation methods. This paper presents the first metaheuristic approach for the traveling repairman problem
Discrete optimisation based on the combined use of reinforcement and constraint satisfaction schemes
Cyclic and individualized administration of gonadotropin releasing hormone agonists plus progestogens: An alternative protocol for contraception
Twenty-one women presenting with different diseases, with absolute or
relative contraindications to hormonal contraception or the use of
intrauterine devices, received 300-600 mu g/day buserelin intranasally
from the 1st to the 21st day, and 5 mg/day norethisterone acetate orally
from the 16th to the 23rd day of the cycle for a total of 245 cycles.
Serum luteinizing hormone (LH), follicle-stimulating hormone (FSH),
estradiol and testosterone were determined on days 3-5 and 13-15 of the
cycle, while progesterone determinations and ovarian sonography were
performed during the second half of the cycle. According to progesterone
values, 92.7% of the treatment cycles were anovulatory, while in one
cycle pregnancy was detected (0.4%). Values of serum LH, FSH and
estradiol were low, and in most of the cycles ovarian follicular
development was limited to follicles less than or equal to 11 mm. In 21
treatment cycles (9%), statistically significant increases in FSH (p <
0.0001) and LH (p < 0.02), as well as ovarian proliferation to
preovulatory follicles or luteinized follicles, were found. It appears
that in spite of the high cost of medication and monitoring of patients,
this regimen could be useful as an alternative in cases where other
forms of contraception are contraindicated or have failed
The diagnostic value of laparoscopy in 2365 patients with acute and chronic pelvic pain
Objective: To discriminate the etiology in 2365 patients with acute and
chronic pelvic pain (APP, CPP). Methods: Diagnostic laparoscopy was
carried out in 736 patients (31.1%) with APP and in 1629 (68.9%) with
CPP. In 315 patients (13.3%) the diagnostic procedure was extended to
operative laparoscopy. Results: The most frequent laparoscopic findings
in patients with APP were acute salpingitis and pelvic adhesions
(22.8%) and ectopic pregnancy (19%), while in patients with CPP the
most frequent findings were pelvic adhesions (35.4%) and endometriosis
(24.6%). In 7.5% of patients with APP and 24% with CPP, laparoscopy
did not reveal any pathological finding in the pelvis. Among the 315
patients in whom operative laparoscopy was carried out, 40% suffered
from Apr and 60% from CPP. In the 446 patients (18.9%) without
laparoscopic findings no treatment was given, while of the remaining 905
patients 40% were subjected to laparotomy and 60% received
conservative treatment. The total incidence of side effects reached
4.7% and serious side effects resulting from emergency laparotomy
occurred in 0.15% of patients with pelvic pain. Conclusion: Our results
in a large group of patients with pelvic pain show that there are
discrepancies in the incidence of laparoscopic findings between patients
with APP and CPP. Discrepancies between the two groups of patients were
also found during operative laparoscopy, the treatment administered
after laparoscopic diagnosis and the complications encountered