Use of the KSVM-based system for the definition, validation and identification of the incisional hernia recurrence risk factors.

BACKGROUND: Incisional hernia is one of the most common complications after abdominal surgery with an incidence rate of 11 to 20% post laparotomy. Many different factors can be considered as risk factors of incisional hernia recurrence. The aim of this study is to confirm and to validate the incisional hernia recurrence risk factors and to identify and to validate new ones. METHODS: In the period from July 2007 to July 2017, 154 patients were selected and subjected to incisional hernia repair. The surgical operations were conducted under general anaesthesia. Patients received antibiotic prophylaxis when indicated, according to the hospital prophylaxis scheme. Inclusion criteria of the study were single operator case studies and open laparotomy for incisional hernia repair. The statistical analysis proposed to identify and to verify the risk factors for recurrence of incisional hernia is the Support Vector Machine (SVM). The analysis was conducted verifying 34 risk factors. RESULTS: The data analysis confirmed the known correlations showed in the international literature with a greater incidence of comorbidities such as diabetes 37%, dyslipidaemia and hypercholesterolemia with a cumulative incidence of 16%; tobacco smoke - by combining categories smokers and ex-smokers - reach 46%, COPD 16% and hypertension 51%. CONCLUSIONS: The analysis of the data therefore confirmed the correlations showed in the international literature. A KSVM-based system to classify incisional hernia recurrence has been presented. The type of prosthesis and the site of its implant also play a significant role in the development of the recurrence. Sensitivity (86,25%), Specificity (87,14%), Negative Predictive Value (84,72%), Precision (88,46%), Accuracy (86,67%), and Error (13,33%) scores obtained using the proposed technique highlight the validity for the relapse's classification methodology.

Preliminary results about a novel technique of mesh positioning in the abdominal wall hernia repair.

INTRODUCTION: The surgical techniques described to approach the incisional hernia repair are various and there is not consensus about which of them to use. The Intra-Peritoneal Onlay Technique (IPOM) with classic mesh positioning is burdened by high post-operative complication rate. The study shows the preliminary results of a novel technique of open IPOM mesh positioning with "percutaneous" approach. PATIENTS AND METHODS: From January 2010 to December 2016 patients with abdominal wall incisional hernia that underwent surgical operation via open mesh technique for abdominal wall hernia repair at the "Policlinico Paolo Giaccone" at Palermo University Hospital were identified and the data collected were retrospectively reviewed; patients' medical and surgical records were collected from charts and the surgical registries. One hundred thirty-five patients with open IPOM percutaneous mesh positioning were selected. DISCUSSION AND CONCLUSIONS: The observational study proposed showed that the technique described for the abdominal wall incisional hernia repair seems to be hopeful in order to set a post-operative course not burdened by elevated rate of post-operative complications, estimated to be near 37% vs 13% reported by our series.

The abdominal wall incisional hernia repair in cirrhotic patients.

BACKGROUND: The incidence of abdominal wall hernia in cirrhotic patients with ascites is between 20 and 40%. Controversies regarding the treatment modality and surgical timing of abdominal wall incisional hernia repair in cirrhotic patients remain. The study proposed wants to analyze the abdominal incisional hernia repair in cirrhotic patients with ascites performed in a single center to determine post-operative morbidity, mortality and complication rate. PATIENTS AND METHODS: Cirrhotic patients with abdominal incisional hernia that underwent surgical operation for abdominal wall hernia repair at the "Policlinico Paolo Giaccone" at Palermo University Hospital between January 2015 and December 2016 were identified and the data collected were retrospectively reviewed; patients' medical and surgical records were collected from charts and the surgical and ICU registries. The degree of hepatic dysfunction was classified using Child-Pugh classification. Post-operative mortality was considered up to 30-days after surgery. A follow-up period of 6 months at least was performed to evaluate hernia recurrence and complications. RESULTS: Mortality rate is of 18.5% (p 0.002). Recurrence rate (p 0.004) and seroma formation rate (p 0.001) are most frequent in urgency group. The elevated ASA score and the prediction of a complicated post-operative course is higher in urgency group (p 0.004) as higher is the in-hospital stay (p 0.001) and the ICU stay (p 0.001). CONCLUSIONS: Elective surgery for abdominal wall hernia repair in cirrhotic patients seems to be successful and associated with lower mortality/morbidity rate and recurrence rate than urgency.

Fungicide residues in pears and apples after post harvest treatments by drencher.

Aim of this trial was to verify the residues of two fungicides, already authorised for the use in field (the admitted maximum limit of residues have been fixed), after post harvest treatments on pears and apples for defence against main post harvest rots. The use of formulation in post harvest must consider also the technique of product application. In fact there are different systems to carry out the treatments for the protection of the commodities during cold storage. In this trial two formulations of pyrimethanil and imazalil were applied by drencher on pome fruit.

Presence of plant protection products in three agricultural areas of Regione Lazio.

Aim of the research was to verify the impact of plant protection products on three significant agricultural areas of Regione Lazio: Maccarese, Cisterna di Latina, Sabaudia-Terracina. This research studied the presence of some active ingredients, indicated by technicians as distributed, on soil, water, crop and air samples, the last one in greenhouse; the analysis, carried out by multi-residue methods, allowed to investigate also on a large amount of active ingredients not indicated by technicians. The determinations have been obtained, using internal standards, by GC-NPD, GC-ECD, HPLC-UV, HPLC-DAD, with different columns, conditions and wavelength of adsorption. Taking into account the results we could to assert that only a small part of the molecules searched were found in the samples and that they are typical for the crops and the environment treated. In greenhouse, more persistence was founded in wood greenhouse, treated from the outside, probably for the release of a.i. in time from wood and for a better distribution. The active ingredients more frequently founded must be controlled to avoid possible accumulation or leaching, especially for herbicides in the areas of Maccarese and Cisterna di Latina. Furthermore, the molecule on which more attention must be done when applied, are: linuron on carrots, penconazole on zucchini and cymoxanil, often used inappropriately, particularly on minor crops, like red-radish. Although the number of sampling was limited, it has been possible to outline the situation in the three zones considered, for directing choices, that could be more sensible at sanitary spin-off and at the environment.

Histochemical characteristics of rabbit stapedius muscle.

A histochemical analysis of rabbit stapedius muscle fibers was conducted using the myofibrillar ATPase and NADH-tetrazolium reductase techniques. Two different fiber types, type 1 and type 2b, were identified. The functional significance of the results is discussed.