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Bernhard Widmann,Christian Galata,Rene Warschkow,Ulrich Beutner,Önder Ögredici,Franc H Hetzer,Bruno M Schmied,Stefan Post,Lukas Marti 대한소화기 기능성질환∙운동학회 2019 Journal of Neurogastroenterology and Motility (JNM Vol.25 No.1
Background/Aims The aim of this study was to evaluate the sustainability of sacral neuromodulation (SNM) success in patients with fecal incontinence (FI) and/or constipation. Methods This is a retrospective analysis of a prospective database of patients who received SNM therapy for FI and/or constipation between 2006 and 2015. Success rates, complications and reintervention rates were assessed after up to 10 years of follow-up. Results Electrodes for test stimulation were implanted in 101 patients, of whom 79 (78.2%) received permanent stimulation. The mean follow-up was 4.4 ± 3.0 years. At the end of follow-up, 57 patients (72.2%) were still receiving SNM. The 5-year success rate for FI and isolated constipation was 88.2% (95% confidence interval [CI], 80.1–97.0%) and 31.2% (95% CI, 10.2–95.5%), respectively (P < 0.001). In patients with FI, involuntary evacuations per week decreased > 50% in 76.1% of patients (95% CI, 67.6–86.2%) after 5 years. A lead position at S3 was associated with an improved outcome (P = 0.04). Battery exchange was necessary in 23 patients (29.1%), with a median battery life of 6.2 years. Reinterventions due to complications were necessary in 24 patients (30.4%). For these patients, the 5-year success rate was 89.0% (95% CI, 75.3–100.0%) compared to 78.4% (95% CI, 67.2–91.4%) for patients without reintervention. Conclusions SNM offers an effective sustainable treatment for FI. For constipation, lasting success of SNM is limited and is thus not recommended. Reinterventions are necessary but do not impede treatment success. Background/Aims The aim of this study was to evaluate the sustainability of sacral neuromodulation (SNM) success in patients with fecal incontinence (FI) and/or constipation. Methods This is a retrospective analysis of a prospective database of patients who received SNM therapy for FI and/or constipation between 2006 and 2015. Success rates, complications and reintervention rates were assessed after up to 10 years of follow-up. Results Electrodes for test stimulation were implanted in 101 patients, of whom 79 (78.2%) received permanent stimulation. The mean follow-up was 4.4 ± 3.0 years. At the end of follow-up, 57 patients (72.2%) were still receiving SNM. The 5-year success rate for FI and isolated constipation was 88.2% (95% confidence interval [CI], 80.1–97.0%) and 31.2% (95% CI, 10.2–95.5%), respectively (P < 0.001). In patients with FI, involuntary evacuations per week decreased > 50% in 76.1% of patients (95% CI, 67.6–86.2%) after 5 years. A lead position at S3 was associated with an improved outcome (P = 0.04). Battery exchange was necessary in 23 patients (29.1%), with a median battery life of 6.2 years. Reinterventions due to complications were necessary in 24 patients (30.4%). For these patients, the 5-year success rate was 89.0% (95% CI, 75.3–100.0%) compared to 78.4% (95% CI, 67.2–91.4%) for patients without reintervention. Conclusions SNM offers an effective sustainable treatment for FI. For constipation, lasting success of SNM is limited and is thus not recommended. Reinterventions are necessary but do not impede treatment success.
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Cost of Illness Due to Typhoid Fever in Pemba, Zanzibar, East Africa
Riewpaiboon, Arthorn,Piatti, Moritz,Ley, Benedikt,Deen, Jacqueline,Thriemer, Kamala,von Seidlein, Lorenz,Salehjiddawi, Mohammad,Busch, Clara Jana-Lui,Schmied, Wolfgang H.,Ali, Said Mohammed,The Typhoi International Centre for Diarrhoeal Disease Resear 2014 Journal of health, population, and nutrition Vol.32 No.3
<P><B>ABSTRACT</B></P><P>The aim of this study was to estimate the economic burden of typhoid fever in Pemba, Zanzibar, East Africa. This study was an incidence-based cost-of-illness analysis from a societal perspective. It covered new episodes of blood culture-confirmed typhoid fever in patients presenting at the outpatient or inpatient departments of three district hospitals between May 2010 and December 2010. Cost of illness was the sum of direct costs and costs for productivity loss. Direct costs covered treatment, travel, and meals. Productivity costs were loss of income by patients and caregivers. The analysis included 17 episodes. The mean age of the patients, was 23 years (range=5-65, median=22). Thirty-five percent were inpatients, with a mean of 4.75 days of hospital stay (range=3-7, median=4.50). The mean cost for treatment alone during hospital care was US$ 21.97 at 2010 prices (US$ 1=1,430.50 Tanzanian Shilling─TSH). The average societal cost was US$ 154.47 per typhoid episode. The major expenditure was productivity cost due to lost wages of US$ 128.02 (83%). Our results contribute to the further economic evaluation of typhoid fever vaccination in Zanzibar and other sub-Saharan African countries.</P>
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Danilovic, S.,Solanki, S. K.,Barthol, P.,Gandorfer, A.,Gizon, L.,Hirzberger, J.,Riethmü,ller, T. L.,van Noort, M.,Rodrí,guez, J. Blanco,Del Toro Iniesta, J. C.,Suá,rez, D. Orozco,Schmi American Astronomical Society 2017 The Astrophysical journal, Supplement series Vol.229 No.1
<P>Ellerman Bombs are signatures of magnetic reconnection, which is an important physical process in the solar atmosphere. How and where they occur is a subject of debate. In this paper, we analyze SUNRISE/IMaX data, along with 3D MHD simulations that aim to reproduce the exact scenario proposed for the formation of these features. Although the observed event seems to be more dynamic and violent than the simulated one, simulations clearly confirm the basic scenario for the production of EBs. The simulations also reveal the full complexity of the underlying process. The simulated observations show that the Fe I 525.02 nm line gives no information on the height where reconnection takes place. It can only give clues about the heating in the aftermath of the reconnection. However, the information on the magnetic field vector and velocity at this spatial resolution is extremely valuable because it shows what numerical models miss and how they can be improved.</P>
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