Laparoscopic sacrocolpopexy with bone anchor fixation: short-term anatomic and functional results

Contains fulltext : 108485.pdf (publisher's version ) (Open Access)INTRODUCTION AND HYPOTHESIS: The aim of this study was to evaluate short-term anatomic and functional outcomes and safety of laparoscopic sacrocolpopexy with bone anchor fixation. METHODS: A prospective cohort study of women undergoing laparoscopic sacrocolpopexy between 2004 and 2009. Anatomic outcome was assessed using the pelvic organ prolapse quantification score (POP-Q). Functional outcomes were assessed using the Urogenital Distress Inventory, Defecatory Distress Inventory, and the Incontinence Impact Questionnaire preoperatively and at 6 months postoperatively. The Wilcoxon signed rank test was used to test differences between related samples. RESULTS: Forty-nine women underwent laparoscopic sacrocolpopexy. The objective success rate in the apical compartment was 98%, subjective success rate was 79%. One mesh exposure (2%) was found. One conversion was necessary due to injury to the ileum. CONCLUSIONS: Laparoscopic sacrocolpopexy with bone anchor fixation is a safe and efficacious treatment for apical compartment prolapse. It provides excellent apical support and good functional outcome 6 months postoperatively.1 april 201

A farm-level study of risk factors associated with the colonization of broiler flocks with Campylobacter spp. in Iceland, 2001 – 2004

<p>Abstract</p> <p>Background</p> <p>Following increased rates of human campylobacteriosis in the late 1990's, and their apparent association with increased consumption of fresh chicken meat, a longitudinal study was conducted in Iceland to identify the means to decrease the frequency of broiler flock colonization with <it>Campylobacter</it>. Our objective in this study was to identify risk factors for flock colonization acting at the broiler farm level.</p> <p>Methods</p> <p>Between May 2001 and September 2004, pooled caecal samples were obtained from 1,425 flocks at slaughter and cultured for <it>Campylobacter</it>. Due to the strong seasonal variation in flock prevalence, analyses were restricted to a subset of 792 flocks raised during the four summer seasons. Flock results were collapsed to the farm level, such that the number of positive flocks and the total number of flocks raised were summed for each farm. Logistic regression models were fitted to the data using automated and manual selection methods. Variables of interest included manure management, water source and treatment, other poultry/livestock on farm, and farm size and management.</p> <p>Results</p> <p>The 792 flocks raised during the summer seasons originated from 83 houses on 33 farms, and of these, 217 (27.4%) tested positive. The median number of flocks per farm was 14, and the median number of positive flocks per farm was three. Three farms did not have any positive flocks. In general, factors associated with an increased risk of <it>Campylobacter </it>were increasing median flock size on the farm (p ≤ 0.001), spreading manure on the farm (p = 0.004 to 0.035), and increasing the number of broiler houses on the farm (p = 0.008 to 0.038). Protective factors included the use of official (municipal) (p = 0.004 to 0.051) or official treated (p = 0.006 to 0.032) water compared to the use of non-official untreated water, storing manure on the farm (p = 0.025 to 0.029), and the presence of other domestic livestock on the farm (p = 0.004 to 0.028).</p> <p>Conclusion</p> <p>Limiting the average flock size, and limiting the number of houses built on new farms, are interventions that require investigation. Water may play a role in the transmission of <it>Campylobacter</it>, therefore the use of official water, and potentially, treating non-official water may reduce the risk of colonization. Manure management practices deserve further attention.</p

Priorities for synthesis research in ecology and environmental science

Synthesis research in ecology and environmental science improves understanding, advances theory, identifies research priorities, and supports management strategies by linking data, ideas, and tools. Accelerating environmental challenges increases the need to focus synthesis science on the most pressing questions. To leverage input from the broader research community, we convened a virtual workshop with participants from many countries and disciplines to examine how and where synthesis can address key questions and themes in ecology and environmental science in the coming decade. Seven priority research topics emerged: (1) diversity, equity, inclusion, and justice (DEIJ), (2) human and natural systems, (3) actionable and use-inspired science, (4) scale, (5) generality, (6) complexity and resilience, and (7) predictability. Additionally, two issues regarding the general practice of synthesis emerged: the need for increased participant diversity and inclusive research practices; and increased and improved data flow, access, and skill-building. These topics and practices provide a strategic vision for future synthesis in ecology and environmental science

Conservation of tropical forests: maintaining ecological integrity and resilience

While acknowledging the critical importance of maintaining large, core areas of tropical forests as free as possible from human interference, this chapter addresses the need for tropical forest conservation efforts in the wider tropical landscape, beyond the boundaries of strictly protected areas. It highlights the need to understand the resilience of tropical forests to anthropogenic perturbations, focusing on ecosystem-level processes, particularly food web changes, ecological cascades, and alterations to ecosystem functions. Next, it reviews empirical evidence for the resilience of tropical forests to different anthropogenic drivers, considers what humans can do to maximize resilience at various scales, and suggests that it may be possible to maintain tropical forest biodiversity by working within the bounds of 'natural' disturbances. Further, it suggests that conservation efforts in the wider tropical landscape may increasingly need to retain functioning and resilient ecosystems, rather than biodiversity per se. © 2013 John Wiley and Sons, Ltd