20 research outputs found

    WSES Jerusalem guidelines for diagnosis and treatment of acute appendicitis

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    Acute appendicitis (AA) is among the most common cause of acute abdominal pain. Diagnosis of AA is challenging; a variable combination of clinical signs and symptoms has been used together with laboratory findings in several scoring systems proposed for suggesting the probability of AA and the possible subsequent management pathway. The role of imaging in the diagnosis of AA is still debated, with variable use of US, CT and MRI in different settings worldwide. Up to date, comprehensive clinical guidelines for diagnosis and management of AA have never been issued. In July 2015, during the 3rd World Congress of the WSES, held in Jerusalem (Israel), a panel of experts including an Organizational Committee and Scientific Committee and Scientific Secretariat, participated to a Consensus Conference where eight panelists presented a number of statements developed for each of the eight main questions about diagnosis and management of AA. The statements were then voted, eventually modified and finally approved by the participants to The Consensus Conference and lately by the board of co-authors. The current paper is reporting the definitive Guidelines Statements on each of the following topics: 1) Diagnostic efficiency of clinical scoring systems, 2) Role of Imaging, 3) Non-operative treatment for uncomplicated appendicitis, 4) Timing of appendectomy and in-hospital delay, 5) Surgical treatment 6) Scoring systems for intra-operative grading of appendicitis and their clinical usefulness 7) Non-surgical treatment for complicated appendicitis: abscess or phlegmon 8) Pre-operative and post-operative antibiotics.Peer reviewe

    Heterotrophic bacterial and viral dynamics in Arctic freshwaters: results from a field study and nutrient-temperature manipulation experiments

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    Heterotrophic bacterial and viral concentrations (range, 0.7 x 10(4) to 206.2 x 10(4) ml(-1) and 0.05 x 10(6) to 128.9 x 10(6) ml(-1), respectively) were determined in several Arctic freshwater environments, including lakes and glacial ecosystems (78.55 degrees N, 11.56 degrees E). Our bacteria and virus results mirrored trends seen in temperate lakes, with an average virus-to-bacteria ratio (VBR) of 13 (range, 7.3-25.2) and viral concentrations and DOC positively correlated with bacterial concentrations (R = 0.964, P < 0.01 and R = 0.813, P < 0.05, respectively). Lysogenic bacteria, determined by induction with Mitomycin C, were not detected in any of the investigated Arctic freshwater environments. Nutrient-addition experiments at in situ and at elevated temperatures were performed to elucidate the factors which influenced the bacterial growth and the virus-bacteria interactions in Arctic freshwaters. Our results suggest that multiple limiting factors interacted and constrained bacterial growth. Bacterial concentrations and doubling times increased at elevated temperatures and appeared to be co-stimulated by phosphorus and carbon. However, viral concentrations showed a lack of response to nutrient addition thus indicating an uncoupling between bacteria and viruses in the experiment

    Mapping and interpreting a decision-making framework for the implicit managerial theory in the Arab Gulf States

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    This article developed an empirical design to examine the direct effects of four dimensions of the strategic decision-making process (SDMP) on the organizational innovation in the context of cultural value characteristics of executive managers in Qatar. The study used the cultural relativity theory to explain and advance hypotheses regarding the associations between SDMP dimensions, culture attributes, and innovation performance in an input-process-outcome model. To test the raised research hypotheses of the proposed framework, the methodology of structural equation models was used. Based on quantitative evidence of 140 Qatari public and private organizations, the results demonstrated the following three major issues: (1) strategic decision-making practices have a direct and more significant impact on process innovation performance than product/service innovation performance, (2) innovation performance is both process and context specific, and (3) certain contextualizing constructs verify a particular cultural orientation. The Author(s) 2014.Scopu
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