[Surgical treatment of fecal incontinence].

This article describes the surgical treatment of fecal incontinence. There are many surgical methods for fecal incontinence, and each treatment has its own advantages and disadvantages and indications. The appropriate surgical procedure should be selected according to the patient's history, anatomical structure and severity of incontinence. Injectable bulking agents is suitable for passive fecal incontinence. Sphincteroplasty is suitable for patients with sphincter injury caused by vaginal delivery or surgical trauma. Sacral nerve stimulation and posterior tibial nerve stimulation are relatively conservative methods. Gracilomyoplasty, artificial anal sphincter or magnetic anal sphincter can be used in the treatment of refractory fecal incontinence, but with many complications. Colostomy is the ideal choice for patients who have failed to respond to conservative treatment and cannot undergo these procedures.

Clinical characteristics of two human-to-human transmitted coronaviruses: Corona Virus Disease 2019 vs. Middle East Respiratory Syndrome Coronavirus.

OBJECTIVE: Subsequent to a global outbreak of the Middle East Respiratory Syndrome (MERS) in 2012, a novel human coronavirus, known as Corona Virus Disease 2019 (COVID-19) has caused a major disease outbreak. The aim of this study was to perform a systematic review to compare epidemiological, clinical, and laboratory features of COVID-19 and MERS-COV populations. MATERIALS AND METHODS: We searched PubMed, EMBASE, and Cochrane Central Register of Controlled Trials database to identify potential studies that have reported COVID-19 or MERS-COV disease. Epidemiology, clinical, and laboratory outcomes, intensive care unit (ICU) admission rates, discharge rates, and fatality rates were evaluated using Graph-Pad Prism software. RESULTS: A total of forty-two studies were included in our research, involving in 4,720 patients (COVID-19 = 2,012, MERS-COV = 2,708). The present study revealed that main clinical manifestations of both COVID-19 and MERS-COV populations are fever, cough and generalized weakness or myalgia, and Acute Respiratory Distress Syndrome (ARDS) is the main complication. The COVID-19 population has a lower rate of ICU admissions, discharges, fatalities, and shorter incubation periods than those of MERS-COV population. CONCLUSIONS: The main clinical features of both COVID-19 and MERS-COV populations are fever, cough and generalized weakness or myalgia. ARDS is the main complication of both populations. COVID-19 cases have a shorter incubation period and lower rate of ICU admissions, discharges and fatalities compared to MRES-COV population.

Primary presacral adenocarcinoma: a case report and review of the literature.

Primary presacral adenocarcinoma is a rare presacral lesion. We report a 36-year-old male patient with -primary presacral adenocarcinoma. The patient presented with a six-month history of sacrococcygeal pain. MRI demonstrated a 4×3 cm2, well-defined presacral mass. He underwent a parasacrococcygeal procedure with complete resection of the -tumor, which subsequent histology showed adenocarcinoma. At 15 months follow-up, he remains disease free.

Systematic review and meta-analysis of randomized controlled trials comparing stapled haemorrhoidopexy with conventional haemorrhoidectomy.

BACKGROUND: This paper compares stapled haemorrhoidopexy with conventional haemorrhoidectomy for the treatment of haemorrhoids. METHODS: An electronic literature search was undertaken to identify primary studies and systematic reviews. Results on efficacy and safety were analysed. A meta-analysis was conducted to examine long-term outcomes. RESULTS: Twenty-nine randomized clinical trials recruiting 2056 patients were identified. Meta-analysis showed that stapled haemorrhoidopexy was less painful than conventional haemorrhoidectomy. Stapled haemorrhoidopexy required a shorter inpatient stay (weighted mean difference (WMD) -0.95 (95 per cent confidence interval (c.i.) -1.32 to -0.59) days; P < 0.001) and operating time (WMD -11.42 (95 per cent c.i. -18.26 to -4.59) min; P = 0.001). It was also associated with a faster return to normal activities (WMD -11.75 (95 per cent c.i. -21.42 to -2.08) days; P = 0.017). No significant difference was noted between the two techniques in terms of the total incidence of complications. Stapled haemorrhoidopexy was associated with a higher rate of recurrent disease (relative risk 2.29 (95 per cent c.i. 1.57 to 3.33); P < 0.001). CONCLUSION: Stapled haemorrhoidopexy offers some short-term benefits over conventional operation but the total complication rates are similar for both techniques. Stapled haemorrhoidopexy is associated with a higher rate of recurrent disease.

Movement-related modulation across the receptive field of neurons in the primary somatosensory cortex of the monkey.

Cutaneous signals are modulated at the various relays just preceding and during voluntary movements. In these conditions, neuronal discharge in the primary somatosensory cortex (SI) related to movement per se is still evident while discharge to air puff stimulation on the skin is diminished. This selective modulation could be explained by rapid movement-related changes in receptive field (RF) configuration. We tested this hypothesis by giving air puff stimuli at different sites within and at the edges of the RF of SI cells during rest and elbow flexions in one awake monkey. For 40 cells, analysis of the global response yielded four different types of modulation: non-modulated cells, completely gated cells, partially and uniformly modulated cells, and non-uniformly modulated cells. Cell discharge for successive 5-ms intervals was also analyzed at the different sites and showed that response uniformity across time is more robust at the RF center than at peripheral sites in the RF. While this study did not show any clear RF displacement, intra-RF excitability seems to be affected by movement in various ways at the level of the cortex. These facts could have implications for information processing during movement.