Colonic irrigation for defecation disorders after dynamic graciloplasty

AB - BACKGROUND AND AIMS: Dynamic graciloplasty (DGP) improves anal continence and quality of life for most patients. However, in some patients, DGP fails and fecal incontinence is unsolved or only partially improved. Constipation is also a significant problem after DGP, occurring in 13-90%. Colonic irrigation can be considered as an additional or salvage treatment for defecation disorders after unsuccessful or partially successful DGP. In this study, the effectiveness of colonic irrigation for the treatment of persistent fecal incontinence and/or constipation after DGP is investigated. MATERIALS AND METHODS: Patients with defecation disorders after DGP visiting the outpatient clinic of the University Hospital Maastricht were selected for colonic irrigation as additional therapy or salvage therapy in the period between January 1999 and June 2003. The Biotrol(R) Irrimatic pump or the irrigation bag was used for colonic irrigation. Relevant physical and medical history was collected. The patients were asked to fill out a detailed questionnaire about colonic irrigation. RESULTS: Forty-six patients were included in the study with a mean age of 59.3 +/- 12.4 years (80% female). On average, the patients started the irrigation 21.39 +/- 38.77 months after the DGP. Eight patients started irrigation before the DGP. Fifty-two percent of the patients used the irrigation as additional therapy for fecal incontinence, 24% for constipation, and 24% for both. Irrigation was usually performed in the morning. The mean frequency of irrigation was 0.90 +/- 0.40 times per day. The mean amount of water used for the irrigation was 2.27 +/- 1.75 l with a mean duration of 39 +/- 23 min. Four patients performed antegrade irrigation through a colostomy or appendicostomy, with good results. Overall, 81% of the patients were satisfied with the irrigation. Thirty-seven percent of the patients with fecal incontinence reached (pseudo-)continence, and in 30% of the patients, the constipation completely resolved. Side effects of the irrigation were reported in 61% of the patients: leakage of water after irrigation, abdominal cramps, and distended abdomen. Seven (16%) patients stopped the rectal irrigation. CONCLUSION: Colonic irrigation is an effective alternative for the treatment of persistent fecal incontinence after DGP and/or recurrent or onset constipation additional to unsuccessful or (partially) successful DG

Thrombotic risk assessment in antiphospholipid syndrome: do noncriteria antibodies contribute?

BACKGROUND/AIM: In this cross-sectional study, it was aimed to test the predictive value of noncriteria antiphospholipid antibodies (aPL) in addition to the global antiphospholipid syndrome score (GAPSS) in predicting vascular thrombosis (VT) in a cohort of patients with APS and aPL (+) systemic lupus erythematosus (SLE). MATERIAL AND METHODS: This study included 50 patients with primary APS, 68 with SLE/APS, and 52 with aPL (+) SLE who were classified according to VT as VT ± pregnancy morbidity (PM), PM only or aPL (+) SLE. Antiphospholipid serology consisting of lupus anticoagulant (LA), anticardiolipin (aCL) immunoglobulin G (IgG)/IgM/IgA, antibeta2 glycoprotein I (aβ2GPI) IgG/IgM/IgA, antiphosphatidylserine/prothrombin (aPS/PT) IgG/IgM and antidomain-I (aDI) IgG was determined for each patient. The GAPSS and adjusted GAPSS (aGAPSS) were calculated for each patient, as previously defined. Logistic regression analysis was carried out with thrombosis as the dependent variable and high GAPSS, aCL IgA, aβ2GPI IgA, and aDI IgG as independent variables. RESULTS: The mean GAPSS and aGAPSS of the study population were 11.6 ± 4.4 and 9.6 ± 3.8. Both the VT ± PM APS (n = 105) and PM only APS (n = 13) groups had significantly higher GAPSS and aGAPSS values compared to the aPL (+) SLE (n = 52) group. The patients with recurrent thrombosis had higher aGAPSS but not GAPSS than those with a single thrombotic event. The computed area under the receiver operating characteristic curve demonstrated that a GAPSS ≥13 and aGAPSS ≥10 had the best predictive values for thrombosis. Logistic regression analysis including a GAPSS ≥13, aCL IgA, aβ2GPI IgA, and aDI IgG showed that none of the factors other than a GAPSS ≥13 could predict thrombosis. CONCLUSION: Both the GAPSS and aGAPSS successfully predict the thrombotic risk in aPL (+) patients and aCL IgA, aβ2GPI IgA, and aDI IgG do not contribute to high a GAPSS or aGAPSS

Cardamine Occulta: A New Weed and Alien Plant Species in Banana Production Greenhouses in Türkiye

Banana is a cash crop in Mediterranean Region of Türkiye, which is grown mainly in greenhouses and open fields. In weed flora surveys carried out in 2021 and 2022, an Eastern Asian plant, Cardamine occulta Hornem. (Brassicaceae), was determined first time in 60% of banana greenhouses in Türkiye. The species had been recorded in Europe in the second half of the 20th century, and then spread especially in urban areas of many European countries and Mediterranean Basin, which implies many habitats in Türkiye under the threat of C. occulta . The main diagnostic morphological features and an identification key are presented in comparison with those for allied C. flexuosa With. and C. hirsuta L. An eradication program is suggested because it is not scattered but limited with banana greenhouses in Türkiye

Scaling Agile Beyond Organizational Boundaries: Coordination Challenges in Software Ecosystems

The shift from sequential to agile software development originates from relatively small and co-located teams but soon gained prominence in larger organizations. How to apply and scale agile practices to fit the needs of larger projects has been studied to quite an extent in previous research. However, scaling agile beyond organizational boundaries, for instance in a software ecosystem context, raises additional challenges that existing studies and approaches do not yet investigate or address in great detail. For that reason, we conducted a case study in two software ecosystems that comprise several agile actors from different organizations and, thereby, scale development across organizational boundaries, in order to elaborate and understand their coordination challenges. Our results indicate that most of the identified challenges are caused by long communication paths and a lack of established processes to facilitate these paths. As a result, the participants in our study, among others, experience insufficient responsivity, insufficient communication of prioritizations and deliverables, and alterations or loss of information. As a consequence, agile practices need to be extended to fit the identified needs

X-ray detector XRD on BeEagleSat and the development of the improved x-ray detector iXRD

Many interesting astrophysical objects are intense X-ray emitters. Hard X-ray observatories in various sizes have been operating in space and providing exciting scientific results that we cannot obtain in our laboratories on Earth. Nanosatellites with CdZnTe hard X-ray detectors have been launched into orbit as well, and the future holds great promise with such small satellites contributing significantly to high energy astrophysics. One of those satellites is the BeEagleSat which carried the X-ray detector (XRD)to low Earth orbit. The XRD has a 15⨯15⨯3 mm 3 volume CdZnTe detector, a cross-strip electrode design, a RENA readout chip controlled by an MSP 430 microcontroller. Due to a communication problem with the receiver, no science data could have been downloaded from the XRD. Recently, an improved version of the XRD has been designed (called the iXRD)and currently it is in the production phase. The improvements compared to the XRD are the larger volume crystal with almost three times the collecting area, a collimator to limit the field of view for focused scientific return, and a motherboard-daughterboard design to reduce electronic noise

Feasibility of pseudocontinuous arterial spin labeling at 7 T with whole-brain coverage

Neuro Imaging Researc

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

26th Annual Computational Neuroscience Meeting (CNS*2017): Part 3 - Meeting Abstracts - Antwerp, Belgium. 15–20 July 2017

This work was produced as part of the activities of FAPESP Research,\ud Disseminations and Innovation Center for Neuromathematics (grant\ud 2013/07699-0, S. Paulo Research Foundation). NLK is supported by a\ud FAPESP postdoctoral fellowship (grant 2016/03855-5). ACR is partially\ud supported by a CNPq fellowship (grant 306251/2014-0)

Political novel in the post-war German Literature in the sample of Koeppen’s Das Treibhaus

Avrupa ulusları ortak kültürel değerlere ve kökenlere sahip oldukları için, ortak bir sanat anlayışı geliştirebilmişlerdir. Bununla beraber her ulusun farklı karakterlere sahip olması ve uluslara özgü sosyal, ekonomik ve politik gelişmelerin boyutlarının benzer olmayışı, etkisini roman gibi yazınsal türlerde de göstermiş ve ortaya farklılıklar çıkmıştır. Bu farklılıklar, kendisini İkinci Dünya Savaşı sonrası Alman politik romanında daha da çok gösterir. Politik ağırlıklı Alman romanları arasında ise Wolfgang Koeppen'in "Das Treibhaus" romanının farklı bir yeri vardır. Çünkü Koeppen bu eserinde savaş sonrası politik roman geleneğini sürdürmekle beraber, hiçbir geleneğe bağlı kalmamış, gerek ele aldığı siyasal sorunlar ve gerekse onların sanatsal boyutu bakımından vatandaşlarından farklı bir çizgi takip ederek, Alman politik romanını dünya edebiyatıyla bütünleştirmiştir. Bu çalışma, Savaş Sonrası Alman Romanı içinde Koeppen'in "Das Treibhaus" romanı örneğinde görülen bu farklı olguyu çeşitli düzlemlerde incelemeyi amaçlamaktadır. Konu politik roman olduğu için, çalışmada “Dış dünyaya ve Topluma Dönük Edebiyat Eleştirisi” yöntemiyle dönemin sosyal ve politik gerçekleri ve ayrıca Koeppen’in politik edebiyata yaklaşımı saptanmaya çalışıldı.As known, the roots of the cultures of the European nations trace back to the Greek-Roman and Christian basic values. Besides, there are also different factors, which played important role with the emergence of a common European art and literature. Since they have lived for centuries in a common geographical area together, they had very close relations in history within all ranges of life Thus, it caused a common view of art to emerge. However, the literary works reflect the viewpoint of that the time in which they are written. Therefore, German political novel is affected by the political developments in the country after the second World War. In this new literary period the writers tried to bring about the socio-political issues. Particularly, novel, as a genre, came to be based on socio-political issues. Wolfgang Koeppen’s novel "Das Treibhaus" is one of the best examples of that time. This study aims to show the developments in the political novel in terms of characters in the novel, Koeppen’s political view and the novel itself