ASO Author Reflections: Assessment of Transduodenal Ampullectomy as a Feasible Option Compared with Pancreaticoduodenectomy

2022 ◽  
Author(s):  
Eun-Ki Min ◽  
Seung Soo Hong ◽  
Ji Su Kim ◽  
Munseok Choi ◽  
Hyeo Seong Hwang ◽  
...  
Keyword(s):  
Feasible Option

scholarly journals Changes in Water Quality of the River das Antas as It Passes through Rural and Urban Areas

Urban Science ◽  
2021 ◽  
Vol 5 (1) ◽  
pp. 22
Author(s):  
Valdemir Antoneli ◽  
Manuel Pulido-Fernández ◽  
João Anésio Bednarz ◽  
Leonardo Brandes ◽  
Michael Vrahnakis ◽  
...  
Keyword(s):  
Rural Area ◽  
Urban Areas ◽  
Human Consumption ◽  
Rural And Urban Areas ◽  
Ph Values ◽  
Rural And Urban ◽  
Feasible Option ◽  
Decreasing Ph ◽  
The City

The catchment area of River das Antas (Irati, Paraná, Brazil) is of high importance both for human consumption and irrigation. Within Irati, this river passes through a rural area and through the city of Irati, crossing both poor and rich neighbourhoods. We selected three study areas downstream (a rural area, poor community, and rich neighbourhood) in which we measured turbidity, the concentration of sediments and pH during rainy days. Our results showed downstream trends of increasing turbidity and concentrations of sediments with decreasing pH. The values of turbidity and of concentration of sediments were significantly different in the rural area, while the pH values were significantly different between the three study areas. These findings highlight the effect of agricultural activities in the generation of sediments and turbidity. The—presumably expected—effects of organic urban waste from the poor neighbourhood were also detected in the pH values. We conclude that efforts should be made to ensure that land planning and training/education programmes on sustainable farming practices are undertaken by the authorities to reduce water pollution and its effects on water bodies during rainfall events, since paving streets is not a feasible option in the short term due to the high costs associated with this measure.

Cardiac surgery simulation: A low‐cost feasible option in an Australasian setting

2021 ◽  
Author(s):  
Varun J Sharma ◽  
Calum Barton ◽  
Sarah Page ◽  
Jegatheesan Saravana Ganesh ◽  
Nishith Patel ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Low Cost ◽  
Surgery Simulation ◽  
Feasible Option

scholarly journals Lung autotransplantation for bronchial necrosis after radiotherapy: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Yuya Nobori ◽  
Masaaki Sato ◽  
Mizuki Morota ◽  
Yoshikazu Shinohara ◽  
Daisuke Yoshida ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Pulmonary Function ◽  
Treatment Success ◽  
Locally Advanced ◽  
Fistula Formation ◽  
Bronchial Anastomosis ◽  
Silicone Stent ◽  
Feasible Option ◽  
Malignant Germ Cell Tumor ◽  
The Right

Abstract Background Bronchial necrosis is a rare but fatal complication after radiation therapy. Because of the anatomical complexity and rarity of this condition, determining the most appropriate management for individual patients is extremely challenging. Lung autotransplantation is a surgical technique that has been applied to hilar neoplastic lesions to preserve pulmonary function and avoid pneumonectomy. We herein report a case of bronchial necrosis secondary to radiotherapy that was treated with lung autotransplantation. Case presentation A 46-year-old man developed broad necrosis and infection of the right bronchus secondary to previous stereotactic body-radiation therapy. This treatment was supplied close to a right hilar metastatic pulmonary tumor derived from a mediastinal malignant germ cell tumor that had been surgically resected with the left phrenic nerve. The bronchial necrosis accompanied by infection with Aspergillus fumigatus was progressive despite antibiotics and repetitive bronchoscopic debridement. Because of the patient’s critical condition and limited pulmonary function, right lung autotransplantation with preservation of the right basal segment was selected. An omental flap was placed around the bronchial anastomosis to prevent later complications. The postoperative course involved multiple complications including contralateral pneumonia and delayed wound healing at the bronchial anastomosis with resultant stenosis, the latter of which was overcome by placement of a silicone stent. The patient was discharged 5 months postoperatively. Three months after discharge, however, the patient developed hemoptysis and died of bronchopulmonary arterial fistula formation. Conclusions We experienced an extremely challenging case of bronchial necrosis secondary to radiotherapy. The condition was managed with lung autotransplantation and omental wrapping; however, the treatment success was temporary and the patient eventually died of bronchopulmonary arterial fistula formation. This technique seems to be a feasible option for locally advanced refractory bronchial necrosis, although later complications can still be fatal.

scholarly journals Territorial governance of managed retreat in Sweden: addressing challenges

2021 ◽  
Author(s):  
Gunnel Göransson ◽  
Lisa Van Well ◽  
David Bendz ◽  
Per Danielsson ◽  
Jim Hedfors
Keyword(s):  
Climate Adaptation ◽  
Governance Framework ◽  
Case Study Site ◽  
Feasible Option ◽  
Flexible Planning ◽  
Barriers And Opportunities ◽  
Study Sites ◽  
Inland Flooding

AbstractMany climate adaptation options currently being discussed in Sweden to meet the challenge of surging seas and inland flooding advocate holding the line through various hard and soft measures to stabilize the shoreline, while managed retreat is neither considered as feasible option nor has it been explicitly researched in Sweden. However, failure to consider future flooding from climate change in municipal planning may have dangerous and costly consequences when the water does come. We suggest that managed retreat practices are challenging in Sweden, not only due to public opinions but also because of a deficit of uptake of territorial knowledge by decision-makers and difficulties in realizing flexible planning options of the shoreline. A territorial governance framework was used as a heuristic to explore the challenges to managed retreat in four urban case studies (three municipalities and one county) representing different territorial, hydrological and oceanographic environments. This was done through a series of participatory stakeholder workshops. The analysis using a territorial governance framework based on dimensions of coordination, integration, mobilization, adaptation and realization presents variations in how managed retreat barriers and opportunities are perceived among case study sites, mainly due to the differing territorial or place-based challenges. The results also indicate common challenges regardless of the case study site, including coordination challenges and unclear responsibility, the need for integrated means of addressing goal conflicts and being able to adapt flexibly to existing regulations and plans. Yet rethinking how managed retreat could boost community resilience and help to implement long-term visions was seen as a way to deal with some of the territorial challenges.

scholarly journals Term gravid uterus in a congenital umbilical hernia: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Friday Saidi ◽  
Bakari Rajab ◽  
Lameck Chinula ◽  
Nomsa Kafumba ◽  
Maganizo Chagomerana ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Umbilical Hernia ◽  
Primary Repair ◽  
Recurrent Hernia ◽  
Gravid Uterus ◽  
Patient Centered ◽  
Medical Practitioners ◽  
Vaginal Deliveries ◽  
Feasible Option ◽  
Associated Risk Factors

Abstract Background Umbilical hernias are a frequent and well-known pathology in children or adults. Congenital umbilical hernias are commonly diagnosed in childhood, and in adulthood such a hernia is usually acquired. Umbilical hernia in pregnancy may result in serious obstetric complications including antepartum hemorrhage, intrauterine fetal demise, and preterm labor, particularly if incarcerated. Case presentation We present a rare case of a congenital umbilical hernia in a term pregnancy. The patient was a 34-year-old African (Malawian) woman, living with human immunodeficiency virus (HIV) and on antiretroviral treatment, gravida 4, with three previous vaginal deliveries, and with two babies weighing 4 kg at birth. We performed herniorrhaphy at caesarean section, and at 3 months of follow-up she had no evidence of a recurrent hernia. Conclusion Congenital umbilical hernias are commonly diagnosed in childhood but might first be seen by medical practitioners in adulthood. A patient-centered approach addressing patient complaints, associated risk factors, and possible complications is recommended. Primary repair at caesarean section is a feasible option.

scholarly journals Deceased donor skin allograft banking: Response and utilization

2010 ◽  
Vol 43 (S 01) ◽  
pp. S114-S120
Author(s):  
Madhuri A. Gore ◽  
Anuradha S. De
Keyword(s):  
Burn Injury ◽  
Deceased Donor ◽  
Indian Society ◽  
Skin Substitutes ◽  
Skin Allograft ◽  
Medical College ◽  
Skin Allografts ◽  
Donor Skin ◽  
Life Saving ◽  
Feasible Option

ABSTRACT Background: In the absence of xenograft and biosynthetic skin substitutes, deceased donor skin allografts is a feasible option for saving life of patient with extensive burn injury in our country. Aims: The first deceased donor skin allograft bank in India became functional at Lokmanya Tilak Municipal (LTM) medical college and hospital on 24th April 2000. The response of Indian society to this new concept of skin donation after death and the pattern of utilization of banked allografts from 2000 to 2010 has been presented in this study. Settings and Design: This allograft skin bank was established by the department of surgery. The departments of surgery and microbiology share the responsibility of smooth functioning of the bank. Materials and Methods: The response in terms of number of donations and the profile of donors was analyzed from records. Pattern and outcome of allograft utilization was studied from specially designed forms. Results: During these ten years, 262 deceased donor skin allograft donations were received. The response showed significant improvement after counselling was extended to the community. Majority of the donors were above 70 years of age and procurement was done at home for most. Skin allografts from 249 donors were used for 165 patients in ten years. The outcome was encouraging with seven deaths in 151 recipients with burn injuries. Conclusions: Our experience shows that the Indian society is ready to accept the concept of skin donation after death. Use of skin allografts is life saving for large burns. We need to prepare guidelines for the establishment of more skin banks in the country.

scholarly journals The Flexible Operation of Coal Power and Its Renewable Integration Potential in China

2019 ◽  
Vol 11 (16) ◽  
pp. 4424 ◽  
Author(s):  
Chunning Na ◽  
Huan Pan ◽  
Yuhong Zhu ◽  
Jiahai Yuan ◽  
Lixia Ding ◽  
...  
Keyword(s):  
Renewable Energy ◽  
Power Systems ◽  
Power System ◽  
Large Scale ◽  
Renewable Integration ◽  
Flexible Resources ◽  
Feasible Option ◽  
Coal Power ◽  
Simulation Results ◽  
Flexible Operation

At present time, China’s power systems face significant challenges in integrating large-scale renewable energy and reducing the curtailed renewable energy. In order to avoid the curtailment of renewable energy, the power systems need significant flexibility requirements in China. In regions where coal is still heavily relied upon for generating electricity, the flexible operations of coal power units will be the most feasible option to face these challenges. The study first focused on the reasons why the flexible operation of existing coal power units would potentially promote the integration of renewable energy in China and then reviewed the impacts on the performance levels of the units. A simple flexibility operation model was constructed to estimate the integration potential with the existing coal power units under several different scenarios. This study’s simulation results revealed that the existing retrofitted coal power units could provide flexibility in the promotion of the integration of renewable energy in a certain extent. However, the integration potential increment of 20% of the rated power for the coal power units was found to be lower than that of 30% of the rated power. Therefore, by considering the performance impacts of the coal power units with low performances in load operations, it was considered to not be economical for those units to operate at lower than 30% of the rated power. It was believed that once the capacity share of the renewable energy had achieved a continuously growing trend, the existing coal power units would fail to meet the flexibility requirements. Therefore, it was recommended in this study that other flexible resources should be deployed in the power systems for the purpose of reducing the curtailment of renewable energy. Furthermore, based on this study’s obtained evidence, in order to realize a power system with high proportions of renewable energy, China should strive to establish a power system with adequate flexible resources in the future.

Hypogastric preservation using a retrograde endovascular bypass in a patient with ruptured AAA and concomitant bilateral common iliac aneurysms: a feasible option in the acute setting

2021 ◽  
Author(s):  
Vangelis G. Alexiou ◽  
John D. Kakisis ◽  
Georgios I. Karaolanis ◽  
Evangelos G. Baltagiannis ◽  
Anna Ntanika ◽  
...  
Keyword(s):  
Acute Setting ◽  
Feasible Option

Arthroscopic Biceps Tenodesis: Technique and Results in Six Dogs

2005 ◽  
Vol 41 (2) ◽  
pp. 121-127 ◽  
Author(s):  
James L. Cook ◽  
Keith Kenter ◽  
Derek B. Fox
Keyword(s):  
Surgical Management ◽  
Biceps Tendon ◽  
Interference Screw ◽  
Cannulated Screw ◽  
Biceps Tenodesis ◽  
Fixation Methods ◽  
Feasible Option ◽  
Successful Outcomes ◽  
Tendon Pathology

Biceps tenodesis was performed using an arthroscopic-assisted technique on six dogs diagnosed with chronic bicipital tendon pathology. The technique was performed using two different fixation methods (i.e., cannulated interference screw, cannulated screw and tissue washer). All six dogs had successful outcomes in terms of return to full function at a mean follow-up time of 11.7 months after surgery. Arthroscopic biceps tenodesis is a feasible option for surgical management of biceps tendon pathology, and it may have advantages over open tenodesis and open or arthroscopic tenotomy. Further study is needed before definitive recommendations regarding indications, complications, and prognosis associated with arthroscopic biceps tenodesis can be made.

Meniscal transplantation: state of the art

2017 ◽  
Vol 2 (6) ◽  
pp. 339-349 ◽  
Author(s):  
Pablo E Gelber ◽  
Peter Verdonk ◽  
Alan M Getgood ◽  
Juan C Monllau
Keyword(s):  
State Of The Art ◽  
Surgical Techniques ◽  
Return To Sport ◽  
Reoperation Rate ◽  
Controversial Issues ◽  
Future Perspectives ◽  
Meniscal Allograft Transplantation ◽  
Meniscal Allograft ◽  
Feasible Option ◽  
Chondroprotective Effect

Meniscal resection is the most common surgical procedure in orthopaedics. When a large meniscal loss becomes clinically relevant, meniscal allograft transplantation (MAT) is a feasible option. However, although this technique has evolved since the ‘80s, there are still several controversial issues related to MAT. Most importantly, its chondroprotective effect is still not completely proven. Its relatively high complication and reoperation rate is another reason for this procedure not yet being universally accepted. Despite its controversial chondroprotective effect, nevertheless, MAT has become a successful treatment for pain localised in a previously meniscectomised knee, in terms of pain relief and knee function. We conducted a careful review of the literature, highlighting the most relevant studies in various aspects of this procedure. Precise indications, how it behaves biomechanically, surgical techniques, return to sport and future perspectives are among the most relevant topics that have been included in this state-of-the-art review.

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