23 research outputs found

    POUCHITIS: A TRIDIMENSIONAL VIEW

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    The preferred surgical treatment of ulcerative colitis (UC) and familial adenomatous polyposis (FAP) is represented by proctocolectomy with ileal pouch-anal anastomosis (IPAA). However, patients with UYC who have undergone IPAA are prone to develop several complications, which include surgery related/mecchanical complications; inflammatory or infectious disoreders; dysplasia or neoplasia; and systemic or metabolic disorders. Pouchitis, which is defined as the acute and/or chronic inflammation of the ileal reservoir, represent the most common long-term adverese sequela after IPAA. Gut microbiota play a pivotal role in the initiation and disease progression of pouchitis. Pouchitis can be classified according to the activity of the disease, the duration of the symptoms, the pattern of the disease or response to antibiotic therapy. Patients with IPAA for UC tend to experience a variety of symptoms that may eventually lead to pouch excision thereby necessitating the construction of a permanent ileostomy. To date, the ethiology, the diagnosis and the medical management of pouchitis represent a clinical challenge. In fact pouchitis range from a disease with an acute antibiotic-responsive presentation to a chronic antibiotic-refractory form, with subsequent different disease mechanism and clinical course. A tridimensional and multidisciplinar approach, including endoscopy, histology, and laboratory testing is widely helpful to identify the diferent phenotypes of the disease and to manage correctly its treatment

    COULD THE ENDOSCOPIC RESECTION OF A LARGE RECTAL LEIOMYOMA BE AN EFFETCIVE AND SAFE TECHNIQUE?

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    Summary. Rectal leiomyomas are a rare conditions, with low reported incidence in literature and constitute about 0.1% of rectal tumours; in fact rectal leiomyomas occur in approximately 1 out of 2000-3000 rectal tumors. We report on a patient with a 3 cm semi-pedunculated colonic leiomyoma, which was successfully removed by endoscopic polypectomy after normal saline-epinephrine submucosal injection. When we encounter a tumor during a colonoscopic examination, we usually evaluate the tumor carefully and perform an endoscopic resection when we judge it is appropriate. When a symptomatic smooth muscle tumors smaller than 2 cm are incidentally found on colonoscopy, surgical resection is unnecessary. Furthermore, if a tumor can be lifted with a snare and it is either pedunculated or semi-pedunculated, endoscopic resection might be a safe option. For those tumors with wide-based or exoluminal growth, endoscopic removal should be avoided due to the higher risks of bleeding and perforation. The histological findings of the resected tumor are important. If there is any malignant element that can not be completely eradicated, we would suggest surgical treatment. We believe our process allows to avoid unnecessary surgery and reduces medical costs

    Combined measurements of Higgs boson couplings in proton- proton collisions at v s=13TeV

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    Combined measurements of the production and decay rates of the Higgs boson, as well as its couplings to vector bosons and fermions, are presented. The analysis uses the LHC proton-proton collision data set recorded with the CMS detector in 2016 at fb-1. The combination is based on analyses targeting the five main Higgs boson production mechanisms (gluon fusion, vector boson fusion, and associated production with a W or Z boson, or a top quark-antiquark pair) and the following decay modes: H, ZZ, WW, , bb, and . Searches for invisible Higgs boson decays are also considered. The best-fit ratio of the signal yield to the standard model expectation is measured to be =1.17 +/- 0.10, assuming a Higgs boson mass of 125.09. Additional results are given for various assumptions on the scaling behavior of the production and decay modes, including generic parametrizations based on ratios of cross sections and branching fractions or couplings. The results are compatible with the standard model predictions in all parametrizations considered. In addition, constraints are placed on various two Higgs doublet models.Peer reviewe

    Measurement of prompt D-0 and D-0 meson azimuthal anisotropy and search for strong electric fields in PbPb collisions at root S-NN=5.02 TeV

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    SCOAP

    Search for long-lived particles decaying to leptons with large impact parameter in proton-proton collisions at root s=13 TeV

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    A search for new long-lived particles decaying to leptons using proton–proton collision data produced by the CERN LHC at s√=13TeV is presented. Events are selected with two leptons (an electron and a muon, two electrons, or two muons) that both have transverse impact parameter values between 0.01 and 10cm and are not required to form a common vertex. Data used for the analysis were collected with the CMS detector in 2016, 2017, and 2018, and correspond to an integrated luminosity of 118 (113)fb−1 in the ee channel (eμ and μμ channels). The search is designed to be sensitive to a wide range of models with displaced eμ, ee, and μμ final states. The results constrain several well-motivated models involving new long-lived particles that decay to displaced leptons. For some areas of the available phase space, these are the most stringent constraints to date

    Differential host utilisation by different life history stages of the fish ectoparasite Argulus foliaceus (Crustacea: Branchiura)

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    Contains fulltext : 72168.pdf (publisher's version ) (Open Access

    The floating mass transducer for external auditory canal and middle ear malformations.

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    Abstract OBJECTIVE: The indications for the Med-El Vibrant Soundbridge, currently limited to patients with sensorineural hearing loss and normal middle ear function, have been extended to include patients with conductive or mixed hearing loss because of severe acquired or congenital ossicular chain defects. Patients with congenital aural atresia have combined malformations of the external auditory canal and the middle ear, often accompanied by severe mixed hearing impairment. Long-term results of traditional surgical techniques for treatment of congenital aural atresia show a persistent air-bone gap in most patients, suggesting that new and better techniques for hearing rehabilitation in these patients would be of value. This study demonstrates that placement of the floating mass transducer of the Med-El Vibrant Soundbridge on the round window (RW) allows optimal amplification and enables the restoration of good hearing in these patients. STUDY DESIGN: Retrospective case review. SETTING: Tertiary referral center. PATIENTS: The study population comprised 12 patients-5 adults and 7 children-with severe external auditory canal and middle ear malformations. The patients were either judged not to be candidates for air conduction hearing aids or declined bone conduction and Bone-Anchored Hearing Aids. INTERVENTION: RW implantation. MAIN OUTCOME MEASURES: Pure-tone threshold and speech understanding. RESULTS: Significant improvements were observed in pure-tone threshold and speech understanding immediately after surgery and at follow-up intervals ranging from 12 to 48 months. No complications or instances of device extrusion were observed in these patients. CONCLUSION: The results suggest that RW implantation offers a viable and improved treatment option for patients with severe mixed hearing loss and congenital malformation of the outer and middle ear

    The floating mass transducer for external auditory canal and middle ear malformations.

    No full text
    Objective: The indications for the Med-El Vibrant Soundbridge, currently limited to patients with sensorineural hearing loss and normal middle ear function, have been extended to include patients with conductive or mixed hearing loss because of severe acquired or congenital ossicular chain defects. Patients with congenital aural atresia have combined malformations of the external auditory canal and the middle ear, often accompanied by severe mixed hearing impairment. Long-term results of traditional surgical techniques for treatment of congenital aural atresia show a persistent air-bone gap in most patients, suggesting that new and better techniques for hearing rehabilitation in these patients would be of value. This study demonstrates that placement of the floating mass transducer of the Med-El Vibrant Soundbridge on the round window (RW) allows optimal amplification and enables the restoration of good hearing in these patients. Study Design: Retrospective case review. Setting: Tertiary referral center. Patients: The study population comprised 12 patientsV5 adults and 7 childrenVwith severe external auditory canal and middle ear malformations. The patients were either judged not to be candidates for air conduction hearing aids or declined bone conduction and Bone-Anchored Hearing Aids. Intervention: RW implantation. Main Outcome Measures: Pure-tone threshold and speech understanding. Results: Significant improvements were observed in pure-tone threshold and speech understanding immediately after surgery and at follow-up intervals ranging from 12 to 48 months. No complications or instances of device extrusion were observed in these patients. Conclusion: The results suggest that RW implantation offers a viable and improved treatment option for patients with severe mixed hearing loss and congenital malformation of the outer and middle ear

    Recent development in Bionic Hearing Restoration from the Round window to the Inferior Colliculus

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    Modern auditory prostheses range from implants that impart mechanical energy to the cochlea via the ossicular chain or bypassing a damaged ossicular chain via the round window (round window implants) to implants that, bypassing severely damaged inner ear cells, electrically stimulate the auditory nerve within the cochlea (cochlear implants). Other auditory prosthesis are suitable for electrical stimulation of the central auditory pathways: the auditory brainstem implants which, bypassing a damaged cochlea and auditory nerve auditory, stimulate the brainstem nuclei, and the inferior colliculus implant or auditory midbrain implant which, bypassing damaged brainstem nuclei stimulate the inferior colliculus.With the refinements in implant technology, patient selection criteria for the various different implant devices need to be periodically reconsidered with a view to obtaining increasingly high levels of speech recognition for the different etiologies. We review the latest outcomes, obtained with various implant devices, and propose guidelines for device selection for different etiologies of deafness
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