[Seton drainage in sphincter-sparing treatment of rectal fistulas]. / Dreniruiushchaia ligatura pri sfinkterosokhraniaiushchem lechenii svishchei priamoi kishki.

Sphincter-sparing procedures for rectal fistulas are becoming more popular among coloproctologists. However, the outcomes are not optimal that forces surgeons to seek new approaches in order to improve results. Seton drainage prior to radical stage is one of these methods. The effect of seton drainage on the outcomes is reviewed in the article. Elibrary, Pubmed and Google Scholar databases were analyzed. We have assessed 14 out of 151 trials for the period 1984 - 2017. There were no significant advantages of seton drainage compared with single-stage approach (χ2 = 3.84, p> 0.05, RR = 0.95, CI 95% 0.84 - 1.08). The same situation is observed for mucomuscular flap bringing down to close internal fistula. Fistula healing was more common after seton drainage deployment within 4 - 8 weeks. Bringing down of the flap to anal canal should be preferred after drainage due to less incidence of recurrences. Further trials are necessary to determine advisability of seton drainage and optimal surgical approach.

Scaling law governing the roughness of the swash edge line.

The paper is devoted to the analysis of the shape of the swash edge line. Formation of the swash boundary is treated as an interfacial phenomenon. The simplest quantitative characteristic of the roughness of interface is its width w, defined as the root-mean-square fluctuation around the average position. For rough interfaces, the scaling with size of the system L is observed in the form w(L)∝ L(ζ). The concept of scaling supplies a simple framework for classifying interfaces. It is suggested that the fine structure of the swash boundary results from the combined action of the pinning force applied by random defects of the beach and elasticity of distorted swash boundary. The roughness of the swash front was studied at the Mediterranean Sea coast for uprush and backwash flows. Value of exponent ζ for receding swash front line was 0.64 ± 0.02, when in the case of advancing swash the value 0.73 ± 0.03 was calculated. The scaling exponent established for the receding phase of the swash is very close to the values of the exponent established for the roughness of the triple line for water droplets deposited on rough surfaces, crack propagation front in Plexiglas, and for the motion of a magnetic domain walls.

Revisiting the fine structure of the triple line.

The fine structure of the triple line for water droplets deposited on porous polymer substrates was investigated. Substrates were obtained with the breath-figures self-assembly. Water droplets demonstrated the pronounced Cassie-Baxter wetting regime. The triple line was imaged with environmental scanning electron microscopy. The roughness of a triple line was characterized with its averaged root-mean-square (rms) width w(L), and its scaling experimental dependence upon the length L of the triple line w(L) is proportional to L(ζ) was analyzed. The values of exponents in the range of 0.60-063 were established. The deduced values of ζ evidence the local nature of the triple-line elasticity and support the idea that the elastic potential of the triple line includes only even powers of the displacement.

Wetting transitions and depinning of the triple line.

Physical mechanisms of Cassie-Wenzel wetting transitions are discussed. The origin of the potential barrier separating the Cassie and Wenzel wetting states is clarified. It may contain contributions originating from the filling of hydrophobic pores and displacement of the triple line along the smooth portions of the relief. One- and two-dimensional scenarios of wetting transitions are considered. We demonstrate that the contribution to the potential barrier because of the displacement of the triple line is not negligible in both cases.

Localization of MTT formazan in lipid droplets. An alternative hypothesis about the nature of formazan granules and aggregates.

MTT (3-(4, 5-dimethyl-2-thiazolyl)-2, 5-dihphenyltetrazolium bromide) assay is a widely used method to assess cell viability and proliferation. MTT is readily taken up by cells and enzymatically reduced to formazan, a dark compound which accumulates in cytoplasmic granules. Formazan is later eliminated by the cell by a mechanisms often indicated as exocytosis, that produces characteristic needle-like aggregates on the cell surface. The shape of formazan aggregates and the rate of exocytosis change in the presence of bioactive amyloid beta peptides (Abeta) and cholesterol. Though the cellular mechanisms involved in MTT reduction have been extensively investigated, the exact nature of formazan granules and the process of exocytosis are still obscure. Using Nile Red, which stains differentially neutral and polar lipids, and a fluorescent analog of cholesterol (NBD-cholesterol), we found that formazan localized in lipid droplets, consistent with the lipophilic nature of formazan. However, formazan granules and aggregates were also found to form after killing cells with paraformaldehyde fixation. Moreover, formazan aggregates were also obtained in cell-free media, using ascorbic acid to reduce MTT. The density and shape of formazan aggregates obtained in cell-free media was sensitive to cholesterol and Abeta. In cells, electron microscopy failed to detect the presence of secretory vesicles, but revealed unusual fibers of 50 nm of diameter extending throughout the cytoplasm. Taken together, these findings suggest that formazan efflux is driven by physico-chemical interactions at molecular level without involving higher cytological mechanisms.

Economic analysis of the Confronting COPD survey: methodology.

Chronic obstructive pulmonary disease (COPD) is a condition characterized by progressive airflow limitation, which causes considerable morbidity and mortality worldwide. Yet the burden of COPD is poorly recognized, and the disease remains an inadequately managed health problem. Few studies have attempted to quantify the impact of the disease on patient health, the healthcare system and society as a whole. This provided the rationale for Confronting COPD in North America and Europe, the first large-scale international survey of the burden of COPD. This paper describes how quantitative measures of healthcare resource utilization and workplace productivity loss were derived from patient responses to the Confronting COPD survey, to investigate the country-specific impact of COPD on the healthcare system and society. The aim of this analysis is to inform countries of the economic impact of the condition, and demonstrate the need for better COPD treatment to improve health and reduce the sizeable burden of this disease.

Morbilidad, mortalidad y costes sanitarios evitables medianteuna estrategia de tratamiento del tabaquismo en España / The effects of implementing a smoking cessation intervention in Spain on morbidity, mortality and health care costs

Objetivo: Se valoran los efectos que tendría una intervención destinada a reducir el uso de tabaco en la población española de fumadores sobre la morbilidad, la mortalidad y los costes asociados al consumo de tabaco. Método: Se ha adaptado el modelo Health and Economic Consequences of Smoking patrocinado por la OMS y desarrollado por The Lewin Group. La intervención propuesta incluye el acceso a asistencia farmacológica de un 35% de los fumadores que intentan dejar de fumar, y obtienen una tasa global de cesación al año del 7,2%. Las enfermedades estudiadas son: cáncer de pulmón, enfermedad coronaria, enfermedad cerebrovascular, EPOC, asma y bajo peso al nacer. Se estiman los casos de enfermedad y muerte atribuibles al consumo de tabaco evitados y la reducción en el coste sanitario debidos a la intervención, proyectados a 20 años. Resultados: Sin intervención, en el año 1 del modelo 2.136.094 fumadores padecen alguna de las condiciones clínicas atribuibles al consumo de tabaco, el coste asistencial es de 4.286 millones de euros y las muertes atribuibles son 26.537. La intervención propuesta evita 2.613, 9.192, 17.415 y 23.837 casos de enfermedad atribuible al consumo de tabaco en los años 2, 5, 10 y 20 del modelo, respectivamente. Los costes asistenciales acumulados evitados son 3,5 millones de euros en el año 2 y 386 millones de (..) (AU)

Objective: We estimated the effect that a smoking cessation intervention in the Spanish population of smokers would have on smoking-related morbidity, mortality and healthcare costs. Methods: We adopted the model Health and Economic Consequences of Smoking sponsored by the WHO Health Organization and developed by the The Lewin Group. The smoking cessation intervention proposed incluides pharmacological treatment to 35% of smokers who are trying to quit smoking and obtains a quit rate of 7.2%. The diseases studied are: lung cancer, heart disease, stroke, chronic obstructive pulmonary disease, asthma exacerbation, and low birth weight. The smoking-related cases of disease and of averted death and the reduction in healthcare expenditure due to the intervention were estimated. Results: Without intervention, at year 1 of the model, 2,136,094 smokers would be affected by some smoking-related disease; healthcare expenditure would be 4,286 million € and deaths attributable to smoking would total 26,537. The proposed intervention (..) (AU)

[The effects of implementing a smoking cessation intervention in Spain on morbidity, mortality and health care costs]. / Morbilidad, mortalidad y costes sanitarios evitables mediante una estrategia de tratamiento del tabaquismo en España.

OBJECTIVE: We estimated the effect that a smoking cessation intervention in the Spanish population of smokers would have on smoking-related morbidity, mortality and health care costs. METHODS: We adopted the model Health and Economic Consequences of Smoking sponsored by the WHO Health Organization and developed by the The Lewin Group. The smoking cessation intervention proposed includes pharmacological treatment to 35% of smokers who are trying to quit smoking and obtains a quit rate of 7.2%. The diseases studied are: lung cancer, heart disease, stroke, chronic obstructive pulmonary disease, asthma exacerbation, and low birth weight. The smoking-related cases of disease and of averted death and the reduction in health care expenditure due to the intervention were estimated. RESULTS: Without intervention, at year 1 of the model, 2,136,094 smokers would be affected by some smoking-related disease; health care expenditure would be 4,286 million e and deaths attributable to smoking would total 26,537. The proposed intervention would prevent 2,613, 9,192, 17,415 and 23,837 cases of smoking-related disease at years 2, 5, 10 and 20 of the model, respectively. The saving in accumulated health care costs would amount to 3.5 million e at year 2 and 386 million e over 20 years. The accumulated prevented deaths are 284 at year 2 and 9,205 over 20 years. The intervention would save a total of 78,173 life-years by the end of the period considered. CONCLUSIONS: The availability of new effective smoking cessation interventions and the increase in accessibility to such interventions may contribute significantly to reducing morbidity, mortality and health care costs associated with smoking in Spain.