Laparoscopic mesh repair of parastomal hernia. Is it a sufficient and free of complication technique? a case presentation and review of the literature.

Parastomal hernia is a complication of stoma formation. It is accompanied by high morbidity. It affects stoma's function and patient's quality of life. There several alternative treatment options including stoma relocation, primary prophylactic repair during the stoma construction and open or laparoscopic mesh repair. We describe the case of a young woman with Crohn's disease that presented a parastomal hernia at the site of an ileostomy. We performed a laparoscopic mesh placement and repair of the hernia. After 28 months of follow-up, the patient remains complications and recurrence-free. The laparoscopic mesh repair is a challenging way to treat parastomal hernias. In the studies have been done so far comparing this approach with the other alternative treatments, the laparoscopic way seems to offer remarkable therapeutic results with minor complication and recurrence rates. Our department's experience is suggesting that laparoscopic repair is an effective and sufficient treatment option.

A monitoring/auditing mechanism for SSL/TLS secured service sessions in Health Care Applications.

This paper analyzes the SSL/TLS procedures and defines the functionality of a monitoring/auditing entity running in parallel with the protocol, which is decoding, checking the certificate and permitting session establishment based on the decoded certificate information, the network addresses of the endpoints and a predefined access list. Finally, this paper discusses how such a facility can be used for detection impersonation attempts in Health Care applications and provides case studies to show the effectiveness and applicability of the proposed method.

Psychometric modeling of consumer decisions in primary health care.

A psychometric technique, functional measurement, was used to measure the preferences of 77 persons for hypothetical health care providers identified by various levels of cost, travel time, and waiting time; responses were subjected to analysis of variance and graphic analysis to determine the functional relation by which respondents combined the three attributes in arriving at their preferences. Both modes of analysis suggested multiplicative decision models, but these yielded lower values of R2 than did linear models derived for comparison. Respondents were grouped by the proportion of response variance that was explained by each of the three attributes, and decision models were derived for each group. Discriminant analysis of socioeconomic characteristics of the respondents identified the variables that distinguished the groups and contributed to forming their preferences.