Surgical mistake causing an high recto-vaginal fistula. A case report with combined surgical and endoscopic approach: therapeutic considerations

BACKGROUND: Rectovaginal fistulas (RVFs) have multiple causes, size and location on which the surgical treatment depends. DESCRIPTION: The Authors consider different approaches to RVFs and describe a clinical case of recurrent high RVF. CONCLUSIONS: Most RVFs can be successfully repaired, although many interventions may be necessary. A colostomy with delayed repair may improve RVFs outcome. Moreover, several authors indicate Mucosal Advancement Flap and Babcock-Bacon technique as the treatments of choice respectively for low and high RVFs (complex and recurrent) and emphasize the placement of endoscopic prothesis in cases of difficult healing of the anastomosis

Caratteri geomorfologici della instabilità del versante sinistro del Fiume Basento interessato dalla grande frana di Brindisi di Montagna Scalo (Potenza, Basilicata).

Geomorphological instability in the left slope of the river Basento involved in the huge Brindisi di Montagna ScaloLandslide (Potenza, Basilicata) ABSTRACT: The left slope of the river Basento valley near Brindisi di Montagna (PZ) railway station is characterized by the presence of diffuse geomorphological instability. There is a large complex landslide that from Tempa Pizzuta hill develops down to the base of the slope where river Basento flows and the Potenza-Metaponto railway and an important motorway occur. In the upper part the landslide has the form of a deep slide, that in the lower part of the hill becomes a large earthflow with retrogressive evolution. A detailed study of the stability condition of the whole left hand slope of river Basento valley has been carried out after the last reactivation of the earth-flow. On the base of a detailed geological and geomorphological survey it has been possible to define the relationships between the different geological formations outcropping in the area and to define the geomorphological evolution. In the area a complex superposition of tectonic units have, characterized by an eastward vergence, can be observed. The study, starting from the analysis of the geomorphological characters of the studied area, tried to explain the complex interaction between the slide in the upper part of the slope and the earth-flow at the bottom

Neutrophil-to-Lymphocyte, Platelet-to-Lymphocyte and Monocyte-to-Lymphocyte Ratio in Bipolar Disorder

Background: Several inflammatory hypotheses have been suggested to explain the etiopathogenesis of bipolar disorder (BD) and its different phases. Neutrophil-to-lymphocyte (NLR), platelet-to-lymphocyte (PLR), and monocyte-to-lymphocyte (MLR) ratios have been proposed as potential peripheral biomarkers of mood episodes. Methods: We recruited 294 patients affected by BD, of which 143 were experiencing a (hypo)manic episode and 151 were in a depressive phase. A blood sample was drawn to perform a complete blood count. NLR, PLR, and MLR were subsequently calculated. A t-test was performed to evaluate differences in blood cell counts between depressed and (hypo)manic patients and a regression model was then computed. Results: Mean values of neutrophils, platelets, mean platelet volume, NLR, PLR, and MLR were significantly higher in (hypo)manic than depressed individuals. Logistic regression showed that PLR may represent an independent predictor of (hypo)mania. Conclusions: Altered inflammatory indexes, particularly PLR, may explain the onset and recurrence of (hypo)manic episodes in patients with BD. As inflammatory ratios represent economical and accessible markers of inflammation, further studies should be implemented to better elucidate their role as peripheral biomarkers of BD mood episodes

Evaluating spintronics-compatible implementations of Ising machines

The commercial and industrial demand for the solution of hard combinatorial optimization problems push forward the development of efficient solvers. One of them is the Ising machine which can solve combinatorial problems mapped to Ising Hamiltonians. In particular, spintronic hardware implementations of Ising machines can be very efficient in terms of area and performance, and are relatively low-cost considering the potential to create hybrid CMOS-spintronic technology. Here, we perform a comparison of coherent and probabilistic paradigms of Ising machines on several hard Max-Cut instances, analyzing their scalability and performance at software level. We show that probabilistic Ising machines outperform coherent Ising machines in terms of the number of iterations required to achieve the problem s solution. Nevertheless, high frequency spintronic oscillators with sub-nanosecond synchronization times could be very promising as ultrafast Ising machines. In addition, considering that a coherent Ising machine acts better for Max-Cut problems because of the absence of the linear term in the Ising Hamiltonian, we introduce a procedure to encode Max-3SAT to Max-Cut. We foresee potential synergic interplays between the two paradigms.Comment: 26 pages, 6 Figures, submitted for publication in Phys. Rev. Applied (it will be presented at intermag 2023 in Japan

incidence and factors influencing retinal displacement in eyes treated for rhegmatogenous retinal detachment with vitrectomy and gas or silicone oil

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A New Myohaptic Instrument to Assess Wrist Motion Dynamically

The pathophysiological assessment of joint properties and voluntary motion in neurological patients remains a challenge. This is typically the case in cerebellar patients, who exhibit dysmetric movements due to the dysfunction of cerebellar circuitry. Several tools have been developed, but so far most of these tools have remained confined to laboratories, with a lack of standardization. We report on a new device which combines the use of electromyographic (EMG) sensors with haptic technology for the dynamic investigation of wrist properties. The instrument is composed of a drivetrain, a haptic controller and a signal acquisition unit. Angular accuracy is 0.00611 rad, nominal torque is 6 N·m, maximal rotation velocity is 34.907 rad/sec, with a range of motion of −1.0472 to +1.0472 rad. The inertia of the motor and handgrip is 0.004 kg·m2. This is the first standardized myohaptic instrument allowing the dynamic characterization of wrist properties, including under the condition of artificial damping. We show that cerebellar patients are unable to adapt EMG activities when faced with an increase in damping while performing fast reversal movements. The instrument allows the extraction of an electrophysiological signature of a cerebellar deficit