EP.TH.421A Systematic Review of Early versus Late Closure of Loop Ileostomy

Abstract Aim A Loop ileostomy is one of the most common techniques used in colorectal surgery, in order to protect either a downstream colorectal anastomosis or a coloanal anastomosis. However, it is a procedure that can cause a plethora of complications. Currently, there is no consensus regarding the optimal time for its reversal. Some studies suggested the early reversal of ileostomy procedure as a solution to reduce these complications. This study aims to review the available literature in order to ascertain the benefits behind early closure of loop ileostomy. Methods The literature was searched for all studies that included a comparison between the outcomes of early and late closure of loop ileostomy in terms of morbidity, mortality, or quality of life, where available. Early closure of loop ileostomy is defined as closure less than three months and late as more than three months, in accordance with conventional literature. The resultant articles were filtered using our inclusion and exclusion criteria. Finally, the remaining articles were assessed for quality and their results were compared to one another in order to draw our conclusions. Results The results were slightly inclined toward early closure of loop ileostomy, despite the limitations of the studies reviewed. Conclusion There were limitations of the studies reviewed, including the heterogenicity of studies, selection bias, lack of clear definition of measured outcomes, and small sample size. Taking that into consideration, the results of early closure of loop ileostomies in the selected patients were promising and require further investigation.

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A Systematic Review of Early versus Late Closure of Loop Ileostomy

Surgery Research and Practice ◽

10.1155/2020/9876527 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Ahmed A. Aljorfi ◽

Abdulhameed H. Alkhamis

Keyword(s):

Small Sample Size ◽

Loop Ileostomy ◽

Colorectal Anastomosis ◽

Small Sample ◽

Optimal Time ◽

Late Closure ◽

Early Closure ◽

Faecal Diversion ◽

Conventional Literature ◽

Definition Of

Introduction. A Loop ileostomy is one of the most common techniques used in colorectal surgery to establish a reversible faecal diversion and bypass the large bowels, in order to protect either a downstream colorectal anastomosis or a coloanal anastomosis. However, it is a procedure that can cause a plethora of complications including long term ones such as the psychological effects. Currently, there is no consensus regarding the optimal time to perform closure of a loop ileostomy. Some studies suggested the early reversal of ileostomy procedure as a solution to reduce these complications. This study aims to review the available literature in order to ascertain the benefits behind early closure of loop ileostomy. Methods. The literature was searched for all studies that included a comparison between the outcomes of early and late closure of loop ileostomy in terms of morbidity, mortality, or quality of life, where available. Early closure of loop ileostomy is defined as closure less than three months and late as more than three months, in accordance with conventional literature. The resultant articles were filtered using our inclusion and exclusion criteria. Finally, the remaining articles were assessed for quality and their results were compared to one another in order to draw our conclusions. Results and Discussion. The results were slightly inclined toward early closure of loop ileostomy. However, there were limitations of the studies reviewed, including the heterogenicity of studies, selection bias, lack of clear definition of measured outcomes, and small sample size. Taking that into consideration, the results of early closure of loop ileostomies in the selected patients were promising and require further investigation.

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Congenital Micropenis: Aetiology And Management

Journal of the Endocrine Society ◽

10.1210/jendso/bvab172 ◽

2021 ◽

Author(s):

Marianna Rita Stancampiano ◽

Kentaro Suzuki ◽

Stuart O’Toole ◽

Gianni Russo ◽

Gen Yamada ◽

...

Keyword(s):

Racial Differences ◽

Small Sample Size ◽

Small Sample ◽

Long Term Outcomes ◽

Penile Length ◽

Appearance Quality ◽

Wide Range ◽

The Impact

Abstract In the newborn, penile length is determined by a number of androgen dependent and independent factors. The current literature suggests that there are inter-racial differences in stretched penile length in the newborn and although congenital micropenis should be defined as a stretched penile length of less than 2.5SDS of the mean for the corresponding population and gestation, a pragmatic approach would be to evaluate all boys with a stretched penile length below 2 cm, as congenital micropenis can be a marker for a wide range of endocrine conditions. However, it remains unclear as to whether the state of micropenis, itself, is associated with any long-term consequences. There is a lack of systematic studies comparing the impact of different therapeutic options on long-term outcomes, in terms of genital appearance, quality of life and sexual satisfaction. To date, research has been hampered by a small sample size and inclusion of a wide range of heterogeneous diagnoses; for these reasons, condition specific outcomes have been difficult to compare between studies. Lastly, there is a need for a greater collaborative effort in collecting standardized data so that all real-world or experimental interventions performed at an early age can be studied systematically into adulthood.

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Effectiveness of Directional Microphones and Noise Reduction Schemes in Hearing Aids: A Systematic Review of the Evidence

Journal of the American Academy of Audiology ◽

10.3766/jaaa.16.7.7 ◽

2005 ◽

Vol 16 (07) ◽

pp. 473-484 ◽

Cited By ~ 91

Author(s):

Ruth A. Bentler

Keyword(s):

Systematic Review ◽

Noise Reduction ◽

Hearing Aids ◽

Small Sample Size ◽

Careful Consideration ◽

Small Sample ◽

Experimental Conditions ◽

Directional Microphones ◽

Directional Microphone

A systematic review of the literature was undertaken to find evidence of real-world effectiveness of directional microphone and digital noise reduction features in current hearing aids. The evidence was drawn from randomized controlled trials, nonrandomized intervention studies, and descriptive studies. The quality of each study was evaluated for factors such as blinding, power of statistical analyses, and use of psychometrically strong outcome measures. Weaknesses in the identified studies included small sample size, resultant poor power to detect potentially worthwhile differences, and overlapping experimental conditions. Nine studies were identified for directional microphones, and the evidence (albeit weak) supports effectiveness. Two studies were identified for the noise reduction feature, and the evidence was equivocal. For the researcher, such a systematic review should encourage the careful consideration of appropriate methodologies for assessing feature effectiveness. For the clinician, the outcomes reported herein should encourage use of such a systematic review to drive clinical practice.

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‘There is no sincerer love than the love of food’ (George Bernard Shaw, 1903): The meaning of food and its uses in prison subculture

European Journal of Criminology ◽

10.1177/1477370818769258 ◽

2018 ◽

Vol 16 (2) ◽

pp. 127-146 ◽

Cited By ~ 1

Author(s):

Tomer Einat ◽

Moran Davidian

Keyword(s):

Small Sample Size ◽

Food Products ◽

Analysis Data ◽

Small Sample ◽

Structured Interviews ◽

Maximum Security ◽

Maximum Security Prison ◽

The Social ◽

Bernard Shaw

This study examines the ways in which the prison service handles food and analyses the uses and meanings of food in prison subculture. Using semi-structured interviews and content analysis, data were collected and analysed from 20 ex-prisoners who were incarcerated in maximum-security prison facilities for a period of three years or more. Our main findings are that, according to the interviewees’ testimonies, (a) the Israel Prison Service (IPS) makes manipulative and abusive use of food in order to perpetuate its power; and (b) food serves as a means to determine the relationship between prisoners and staff, govern social status or rejection in the prison subculture, or pass the time. We have four main conclusions. First, the IPS nutrition policy differentiates and discriminates among prisoners and clearly violates the basic human rights of prisoners, thus suggesting an abuse of power. Second, the IPS’s use of food as a tool for punishing or rewarding introduces and perpetuates inequalities and encourages the illegal prison trade in food and food products. Third, cooking in prison, especially in light of its illegality, constitutes a symbolic expression of resistance to the institution and a meaningful way of coping with boredom. Lastly, food and its possession in prison serve as very powerful tools for constructing and perpetuating exploitation and unequal power relations among prisoners. Although the study suffers from two limitations – the validity of the adolescents’ responses and the small sample size – its findings lead us to propose that an improvement in the food products that are accessible to prisoners and permission to cook in their cells are inexpensive and legitimate means of bettering both the prisoners’ quality of life and the social atmosphere in prison.

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An initial validation of a new quality of life measure for adults with intellectual disability: The Mini-MANS-LD

Journal of Intellectual Disabilities ◽

10.1177/1744629518787895 ◽

2018 ◽

Vol 24 (2) ◽

pp. 177-193

Author(s):

Roman Raczka ◽

Kate Theodore ◽

Janice Williams

Keyword(s):

Quality Of Life ◽

Intellectual Disability ◽

Small Sample Size ◽

Initial Study ◽

Small Sample ◽

Self Report ◽

Life Measure ◽

Acceptable Internal Consistency ◽

Report Measure

There is an appropriate increasing focus on the need to ensure the voices of people with intellectual disability are captured as part of assessing individuals’ quality of life; however, there remains a lack of a consensus on ways to achieve this. This article describes the development of a self-report measure of quality of life for people with intellectual disability, the ‘Mini-MANS-LD’, based on the concepts of Maslow’s hierarchy of needs. Following use with 33 individuals with intellectual disability, the Mini-MANS-LD was found to have acceptable psychometric properties, including moderate congruent validity and acceptable internal consistency. Administrators’ feedback suggested good acceptability and feasibility, and the measure was relatively quick to administer, easy to use and acceptable to service users. Despite a small sample size, this initial study suggests that the Mini-MANS-LD may present a conceptually relevant, feasible and acceptable self-report measure of quality of life for people with intellectual disability.

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A debate about implementing immersive technology for higher education: Pre-study examining the usability of virtual reality for lectures

Human Systems Management ◽

10.3233/hsm-201058 ◽

2020 ◽

Vol 39 (4) ◽

pp. 565-571

Author(s):

Matej Hopp ◽

Sandra Pfiel ◽

René Mario Schuster ◽

Florian Tiefenbacher ◽

Michael Reiner

Keyword(s):

Applied Sciences ◽

Higher Education ◽

Virtual Reality ◽

Response Rate ◽

Small Sample Size ◽

Theoretical Background ◽

Small Sample ◽

Advanced Technologies ◽

University Of Applied Sciences

BACKGROUND: As the COVID-pandemic has shown, the need for innovative (digitalized) solutions is in high demand across almost every field of interest. The implementation of advanced technologies in higher education provides an intriguing opportunity to expand its scope by reaching new audiences as well as ensuring a high quality of learning outcome. OBJECTIVE: In this article we tried to examine if virtual reality can be a suitable option by placing lectures into a virtual setup. METHODS: First, we explored the theoretical background if and how virtual reality has been adapted for usage in higher education. We then asked five lecturers from the IMC University of Applied Sciences Krems to test a virtual environment (Mozilla Hubs) and evaluate the platform for their teaching purposes. RESULTS: Among one of the results was, that 80 percent would recommend using the platform for lectures to their colleagues. Due to the small sample size the findings need to be further evaluated. CONCLUSIONS: In the foreseeable future virtual reality will become a valuable teaching assistance in higher education. Findings show that the response rate when training with virtual reality applications is much higher than to common studying methods.

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Randomized Controlled Trial of Strain-Specific Probiotic Formulation (Renadyl) in Dialysis Patients

BioMed Research International ◽

10.1155/2014/568571 ◽

2014 ◽

Vol 2014 ◽

pp. 1-9 ◽

Cited By ~ 52

Author(s):

Ranganathan Natarajan ◽

Bohdan Pechenyak ◽

Usha Vyas ◽

Pari Ranganathan ◽

Alan Weinberg ◽

...

Keyword(s):

Quality Of Life ◽

Statistical Power ◽

Small Sample Size ◽

Controlled Trial ◽

Statistical Significance ◽

Venous Blood ◽

Small Sample ◽

Uremic Toxin ◽

Double Blind

Background. Primary goal of this randomized, double-blind, placebo-controlled crossover study of Renadyl in end-stage renal disease patients was to assess the safety and efficacy of Renadyl measured through improvement in quality of life or reduction in levels of known uremic toxins. Secondary goal was to investigate the effects on several biomarkers of inflammation and oxidative stress.Methods. Two 2-month treatment periods separated by 2-month washout and crossover, with physical examinations, venous blood testing, and quality of life questionnaires completed at each visit. Data were analyzed with SAS V9.2.Results. 22 subjects (79%) completed the study. Observed trends were as follows (none reaching statistical significance): decline in WBC count(-0.51×109/L,P=0.057)and reductions in levels of C-reactive protein(-8.61 mg/L,P=0.071)and total indoxyl glucuronide(-0.11 mg%,P=0.058). No statistically significant changes were observed in other uremic toxin levels or measures of QOL.Conclusions. Renadyl appeared to be safe to administer to ESRD patients on hemodialysis. Stability in QOL assessment is an encouraging result for a patient cohort in such advanced stage of kidney disease. Efficacy could not be confirmed definitively, primarily due to small sample size and low statistical power—further studies are warranted.

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Safety of Stoma Closure within 90 Days after Low Anterior Resection and Diverting Ileostomy

10.21203/rs.3.rs-95487/v1 ◽

2020 ◽

Author(s):

Ian Fukudome ◽

Hiromichi Maeda ◽

Ken Okamoto ◽

Hajime Kuroiwa ◽

Sachi Yamaguchi ◽

...

Keyword(s):

Rectal Cancer ◽

Treatment Guidelines ◽

Small Sample Size ◽

Small Sample ◽

Lower Rectal Cancer ◽

Stoma Closure ◽

Diverting Ileostomy ◽

Cancer Resection ◽

Rectal Cancer Resection ◽

Early Closure

Abstract Background This study aimed to clarify the safety of early closure in diverting ileostomy with lower anterior rectal-cancer resection.MethodsWe retrospectively reviewed 47 patients who underwent diverting ileostomy with lower rectal-cancer resection between May 2009 and October 2017. The results of the stoma closure were compared between patients who underwent stoma closure within 90 days (early closure [EC] group) and those who underwent late closure (LC group; closure after 90 days). Because of the small sample size, the frequency of severe complications post closure was analyzed. ResultsAmong 47 patients, 29 were in the EC group. Postoperative complications occurred in 48.3% (14/29) and 27.8% (5/18) of patients in the EC and LC groups, respectively. This difference was due to minor complications (Clavien-Dindo Classification I/II), such as superficial incisional surgical site infections (n=5) in the EC group. The rate of severe complications (Clavien-Dindo Classification ≥ III) was similar between the groups (20.7% vs. 16.7%, p=1, Fisher’s exact test). ConclusionsNo association was observed between the time of closure and development of major complications; however, there was an increased likelihood of minor complications after EC. This study provides a basis on which future treatment guidelines for early stoma closure may be developed without affecting patient quality of life.

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Experience of Using an App in HIV Patients Older Than 60 Years: Pilot Program (Preprint)

10.2196/preprints.9904 ◽

2018 ◽

Author(s):

Julián Olalla ◽

Jose María García de Lomas ◽

Efrén Márquez ◽

Francisco Jesús González ◽

Alfonso Del Arco ◽

...

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Hiv Infection ◽

New Technologies ◽

Small Sample Size ◽

Mobile App ◽

Small Sample ◽

Control Group

BACKGROUND New technologies can promote knowledge of HIV infection among patients suffering from this disease. Older patients with HIV infection represent an increasingly large group that could benefit from the use of specific apps. OBJECTIVE The aim of the study was to observe the acceptability and use of a mobile app on HIV infection in patients at least 60 years old and offer them the possibility of anonymously establishing contact with their peers. METHODS A series of clinical and psychosocial parameters were studied in 30 HIV-infected patients of over 60 years. The patients must be at least 60 years old, with a follow-up in the outpatient clinic for at least 1 year and without pathologies that limit his or her life expectancy to less than a year. They must know how to read and write. To be part of the group assigned to the app, they had to have their own smartphone and confirm that they were connected to the internet from that device. Overall, 15 of them were randomized to use an app and 15 were in the control group. All tests were repeated after 6 months. RESULTS The median age of patients was 66.5 years. Among them, 29 patients had an undetectable viral load at baseline. The median number of comorbid diseases was 2. Overall, 11 of them lived with their partners and 19 lived alone. They spent an average of 5 hours a day sitting down, and 56% (17/30) of them referred high physical activity. They scored 4 out of 5 for general quality of life perception. Moreover, 80% (24/30) presented high adherence to their treatment, and the average number of concomitant medications was 5. In the 6-min walking test, they covered a distance of 400 meters, and 3 of them desaturated during the test. The 15 patients made frequent use of the app, with 2407 sessions and an average of 7 min and 56 seconds time of use with a total of 13,143 screen views. During the 6 months of the trial, 3 non-AIDS events took place. There were no significant modifications to body mass index, blood pressure measurements, lipid profile, or immuno-virology information data. There were no differences in the questionnaire scores for perception of quality of life, confessed physical activity, or antiretroviral treatment (ART) and non-ART treatment adherence. CONCLUSIONS Significant differences between studied parameters were not objectified in these patients, possibly because this trial has significant limitations, such as a small sample size and only a brief follow-up period. However, patients did use the app frequently, making this a possible intervention to be proposed in future subsequent studies.

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Service Quality of Traditional and Islamic Commercial Banks in Bangladesh

Khulna University Business Review ◽

10.35649/kubr.2019.14.1.1 ◽

2021 ◽

pp. 7-16

Author(s):

Shohel Rana ◽

Imran Ahmed Shakeer

Keyword(s):

Service Quality ◽

Commercial Banks ◽

Small Sample Size ◽

Secondary Data ◽

Structured Interview ◽

Small Sample ◽

Primary Data ◽

Significant Difference ◽

Practical Implications

Purpose: This study aims to know the service quality of the different private commercial banks operating in Bangladesh with the rapid advancement in information technology and provide some guidelines to improve their service qualities. Methodology: The study used both primary and secondary data to support the objective. Primary data were collected from 240 customers, of whom 120 customers are from traditional private commercial banks and the rest from private Islamic commercial banks operating in Bangladesh using a structured interview schedule, naming SERVQUAL. The study used a convenience sampling method to select respondents. Secondary data were collected from different journals, newspaper articles, books, and various published sources. An independent samples t-test was conducted in the test of the hypothesis. Findings: This study found a significant difference between the traditional and Islamic commercial banks’ service quality and added that the study area’s customers/clients are not fully satisfied with either traditional private commercial banks or Islamic banks. However, Islamic commercial banks are showing a relatively better picture. Research Limitations: The Study is limited to Bangladesh’s small marginal market and a small sample size of only 240 respondents, which cannot sufficiently reflect the large population’s actual scenario. Practical Implications: The Study will help manage the traditional and Islamic commercial banks and policymakers to improve their service quality and improve monitoring efficiency. Originality/value: The Study extensively identified some factors to improve the traditional and Islamic commercial banks’ service quality for both the banks’ and policymakers’ management. In this regard, the critical factors can be the number of employees and the number of counters, increasing ATM services, ensuring faster services, flexible loan disbursement policy, sufficient floor space, suitable sitting arrangements, and improved online services.

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