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Hierro LÁ, Patiño D, Atienza P, Garzón AJ, Cantarero D. The effect of altruism on COVID-19 vaccination rates. Health Econ Rev 2023; 13:2. [PMID: 36595138 PMCID: PMC9807973 DOI: 10.1186/s13561-022-00415-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 12/22/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND After the emergence of the first vaccines against the COVID-19, public health authorities have promoted mass vaccination in order to achieve herd immunity and reduce the effects of the disease. Vaccination rates have differed between countries, depending on supply (availability of resources) and demand (altruism and resistance to vaccination) factors. METHODS This work considers the hypothesis that individuals' health altruism has been an important factor to explain the different levels of vaccination between countries, using the number of transplants as a proxy for altruism. Taking European Union's countries to remove, as far as possible, supply factors that might affect vaccination, we carry out cross-sectional regressions for the most favorable date of the vaccination process (maximum vaccination speed) and for each month during the vaccination campaign. RESULTS Our findings confirm that altruism has affected vaccination rates against the COVID-19. We find a direct relationship between transplants rates (proxy variable) and vaccination rates during periods in which the decision to be vaccinated depended on the individual's choice, without supply restrictions. The results show that other demand factors have worked against vaccination: political polarization and belonging to the group of countries of the former Eastern bloc. CONCLUSIONS Altruism is a useful tool to define future vaccination strategies, since it favors the individuals' awareness for vaccination.
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Affiliation(s)
- Luis Á Hierro
- Department of Economics and Economic History, University of Sevilla, Avda. Ramón y Cajal, S/N, 41018, Seville, Spain
| | - David Patiño
- Department of Economics and Economic History, University of Sevilla, Avda. Ramón y Cajal, S/N, 41018, Seville, Spain
| | - Pedro Atienza
- Department of Economics and Economic History, University of Sevilla, Avda. Ramón y Cajal, S/N, 41018, Seville, Spain.
| | - Antonio J Garzón
- Department of Economics and Economic History, University of Sevilla, Avda. Ramón y Cajal, S/N, 41018, Seville, Spain
| | - David Cantarero
- Department of Economics, Universidad de Cantabria, Research Group on Health Economics and Health Services Management-Marqués de Valdecilla Research Institute (IDIVAL), Avda. de los Castros S/N, 39005, Santander, Spain
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Villar R, Olmo M, Atienza P, Garzón AJ, Wright IJ, Poorter H, Hierro LA. Applying the economic concept of profitability to leaves. Sci Rep 2021; 11:49. [PMID: 33420171 PMCID: PMC7794281 DOI: 10.1038/s41598-020-79709-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 12/07/2020] [Indexed: 11/23/2022] Open
Abstract
Economic principles can be extended to biological organisms as they optimize the use of resources, but their use in biology has been limited. We applied concepts from traditional economics to the main production unit of plants, the leaf. We quantified the profitability (profit/cost of investment) of leaves from seven biomes worldwide and compared those to the profitability of companies. Here we demonstrate for the first time key similarities and differences between leaf and human economics. First, there was a weak, but positive relationship between profitability and size, both for leaves and companies. Second, environment has a strong effect on profitability, with high values in leaves from biomes with short growth periods and, for companies associated with innovation. Third, shorter longevity of productive units was related to higher profitability. In summary, by comparing economic behaviours of plants and humans there is potential to develop new perspectives on plant ecological strategies and plant evolution.
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Affiliation(s)
- Rafael Villar
- Area de Ecología, Dpto de Botánica, Ecología y Fisiología Vegetal, Facultad de Ciencias, Universidad de Cordoba, Cordoba, Spain.
| | - Manuel Olmo
- Area de Ecología, Dpto de Botánica, Ecología y Fisiología Vegetal, Facultad de Ciencias, Universidad de Cordoba, Cordoba, Spain
| | - Pedro Atienza
- Departamento de Economía e Historia Económica, Universidad de Sevilla, Sevilla, Spain
| | - Antonio J Garzón
- Departamento de Economía e Historia Económica, Universidad de Sevilla, Sevilla, Spain
| | - Ian J Wright
- Department of Biological Sciences, Macquarie University, North Ryde, NSW, 2109, Australia
| | - Hendrik Poorter
- Department of Biological Sciences, Macquarie University, North Ryde, NSW, 2109, Australia
- Plant Sciences (IBG-2), Forschungszentrum Jülich GmbH, 52425, Jülich, Germany
| | - Luis A Hierro
- Departamento de Economía e Historia Económica, Universidad de Sevilla, Sevilla, Spain
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Egal A, London J, Lidove O, Atienza P, Etienney I. [Anorectal manifestations in systemic diseases]. Rev Med Interne 2019; 40:729-732. [PMID: 31400822 DOI: 10.1016/j.revmed.2019.07.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 06/08/2019] [Accepted: 07/17/2019] [Indexed: 11/25/2022]
Abstract
Numerous systemic diseases (vasculitis, connective tissue disease or sarcoidosis) can display an involvement of the perianal skin, the rectum and/or the anus. Such knowledge is important in order to treat these complications specifically when possible. Lesions of the anorectum arising from systemic diseases can sometimes cause perforations in the peritoneal cavity (if concerning the higher portion of the rectum) and/or fistulization to the anal margin. Differential diagnosis, mostly infectious or inflammatory (Crohn's disease) must be ruled out in every case. Other systemic diseases can display specific manifestations as this is the case in scleroderma which can lead to anal incontinence. Despite the relative rarity of these manifestations, their ignorance would forbid global management of these complex diseases. It should thus be detected in each consultation and a regular follow-up must be provided with a proctologist and/or a gastroenterologist when needed.
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Affiliation(s)
- A Egal
- Service de proctologie chirurgicale, hôpital Croix Saint-Simon, 75020 Paris, France.
| | - J London
- Service de médecine interne, hôpital Croix Saint-Simon, 75020 Paris, France
| | - O Lidove
- Service de médecine interne, hôpital Croix Saint-Simon, 75020 Paris, France
| | - P Atienza
- Service de proctologie chirurgicale, hôpital Croix Saint-Simon, 75020 Paris, France
| | - I Etienney
- Service de proctologie chirurgicale, hôpital Croix Saint-Simon, 75020 Paris, France
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Abstract
All practitioners caring for patients with Crohn's disease (CD) must know all the various aspects of anoperineal lesions in this singular entity. Suppuration in CD does not follow the classic routes and spaces of diffusion and is often associated with endolumenal lesions that can evolve on their own. Abscesses and fistulas require specific medico-surgical management where seton drainage, staged operative and sphincter-sparing procedures have a dominant place. The variability of associated lesions and the particularly individualized efficacy of drugs call for case-by-case management, thus, making standardization and comparisons difficult. Recent therapeutic progress has led to modifications of the minimally invasive management policies practiced in the last decades.
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Affiliation(s)
- P Atienza
- Service de proctologie médico-interventionnelle, groupe hospitalier Diaconesses-Croix Saint-Simon, 125, rue d'Avron, 75020 Paris, France.
| | - M Ksiaa
- Service de gastroentérologie, CHU Sahloul, Sousse, Tunisia
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Hierro LA, Gómez-Álvarez R, Atienza P. A consistent decomposition of the redistributive, vertical, and horizontal effects of health care finance by factor components. Health Econ 2014; 23:117-121. [PMID: 23389915 DOI: 10.1002/hec.2898] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2011] [Revised: 11/16/2012] [Accepted: 11/27/2012] [Indexed: 06/01/2023]
Abstract
In studies on the redistributive, vertical, and horizontal effects of health care financing, the sum of the contributions calculated for each financial instrument does not equal the total effects. As a consequence, the final calculations tend to be overestimated or underestimated. The solution proposed here involves the adaptation of the Shapley value to achieve additive results for all the effects and reveals the relative contributions of different instruments to the change of whole-system equity. An understanding of this change would help policy makers attain equitable health care financing. We test the method with the public finance and private payments of health care systems in Denmark and the Netherlands.
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Affiliation(s)
- Luis A Hierro
- Department of Economics and Economic History, University of Seville, Seville, Spain
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de Parades V, Fathallah N, Blanchard P, Zeitoun JD, Bennadji B, Atienza P. Horseshoe tract of anal fistula: bad luck or an avoidable extension? Lessons from 82 cases. Colorectal Dis 2012; 14:1512-5. [PMID: 22443225 DOI: 10.1111/j.1463-1318.2012.03034.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
AIM The aim of this study was to analyse the characteristics of horseshoe tract formation in anal fistula. METHOD We retrospectively analysed the data from all consecutive patients who underwent surgery for an anal fistula from November 2004 to March 2011. A horseshoe tract was defined as a circumferential extension connecting both sides of the anorectum. RESULTS During the period of analysis, 1876 patients were operated on for a fistula. Of these, 82 (4.4%) had a horseshoe extension. The majority (72%) were male and the median age was 46 (17-84) years. The primary tract was high transsphincteric in 90% of cases and the primary opening was posterior in 65% of cases. The location of the horseshoe extension was posterior in 66% of cases with spread in the deep perianal space in 62%. In all, 71% were cryptoglandular and 24% were seen in Crohn's disease (20). Of the 62 non-Crohn's patients previous treatment was common and included surgery (42), antibiotics alone (41) and non-steroidal anti-inflammatory drugs (21). CONCLUSION Horseshoe extension in anal fistula is uncommon. With Crohn's disease excepted, the majority had had previous treatment.
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Affiliation(s)
- V de Parades
- Proctologie Médico-Interventionnelle, Groupe Hospitalier Diaconesses-Croix Saint Simon, Paris, France.
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de Parades V, Dahmani Z, Blanchard P, Zeitoun JD, Sultan S, Atienza P. Endorectal advancement flap with muscular plication: a modified technique for rectovaginal fistula repair. Colorectal Dis 2011; 13:921-5. [PMID: 20528893 DOI: 10.1111/j.1463-1318.2010.02338.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
AIM Endorectal advancement flap is the most used treatment for acquired rectovaginal fistula but is liable to failure. We describe our experience with a modified technique. METHOD Patients were included who had an acquired rectovaginal fistula. Exclusions included patients with Crohn's disease with proctitis, malignant or radiation-related fistula, stricture of the anorectum or those with an external sphincter defect. Surgery included closure of the internal opening with a figure-of-eight reabsorbable suture, plication of the anorectal muscular layer and mucosal flap advancement. Total parenteral nutrition was administered postoperatively for seven days. RESULTS Between March 2003 and July 2008, 23 consecutive women (mean age 45.5 [28-78] years) were treated. The cause of fistulation included obstetric injury (n = 5), cryptoglandular disease (n = 11) and Crohn's disease (n = 7). Thirteen (57%) patients had a previous failed repair. At a mean follow-up of 14 (2-67) months, success was achieved in 65% (15/23) of patients. The mean Wexner incontinence scores pre- and postoperatively were 1.3 (0-15) and 0.6 (0-6), respectively. CONCLUSION The success rate was promising with no deterioration of anal continence.
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Affiliation(s)
- V de Parades
- Proctologie médico-interventionnelle, Groupe hospitalier Diaconesses - Croix Saint Simon, Paris, France.
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Fourti M, de Parades V, Atienza P. Nicorandil: A curable cause of anal ulceration to be known…. ACTA ACUST UNITED AC 2010; 34:639-40. [DOI: 10.1016/j.gcb.2010.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2010] [Revised: 07/21/2010] [Accepted: 08/04/2010] [Indexed: 10/19/2022]
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Abstract
AIM To prospectively evaluate the long-term results and assess patient satisfaction after stapled haemorrhoidopexy (HS). METHOD A total of 150 patients (121 male patients) with symptomatic grade II (n = 50) or III (n = 100) haemorrhoids underwent stapled HS. Patients were followed up during consultations at regular intervals, allowing prospective data collection. A final telephone follow up was also undertaken. RESULTS Follow up data were obtained for 130 of 150 patients (86.6%). After a median follow up of 39 months (range, 12-72), 90% of the patients were fully satisfied and 92% were free of haemorrhoidal symptoms. There were no intraoperative complications. Postoperative bleeding that required operation was observed in five patients (3.3%). Most late postoperative complications were benign and easily resolved: unexplained pain for over a month (n = 1), external haemorrhoidal thrombosis (n = 2), anal fissure (n = 6) one with hypertrophic papilla, anal fistula (n = 1), rectal stenosis (n = 1), anal incontinence for (n = 1). Eight patients needed rubber band ligation to treat persistent or recurrent symptomatic prolapse. Four patients (2.6%) were reoperated on during the follow up period but none for haemorrhoidal pathology. CONCLUSION Stapled HS procedure is effective and has low morbidity, high patient satisfaction and provided good long-term control of haemorrhoidal symptoms in the treatment of second and third-degree haemorrhoids.
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Affiliation(s)
- S Sultan
- Service de proctologie interventionnelle, Groupe hospitalier Diaconesses-Croix, Saint Simon, Paris, France.
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Abstract
OBJECTIVE The study aimed to evaluate the efficacy of fibrin glue in the treatment of complex anal fistula. METHOD Thirty consecutive patients with a complex anal fistula underwent glue instillation after an 8 week period of seton drainage. Cure was defined as complete closure of any secondary opening, absence of fistula seepage, and no abscess formation. RESULTS The mean age of the patients (15 males) was 40.5 (range, 22.8-69.1) years. The mean duration of follow-up was 11.7 (range, 0.2-33.5) months. Complete closure of the fistula was achieved in 17 patients at 1 month but in two patients a delayed abscess occurred. At the end of follow-up, 15 (50%) patients were considered to have been cured. The success rate was no different in cases of Crohn's disease or when postoperative antibiotic therapy was given. There was, however, a significant difference in success following regional vs general anaesthesia (68.4 vs 18.2% success, P = 0.02). CONCLUSION Fibrin glue cured 50% of our first 30 patients, and regional anaesthesia was predictive of success.
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Affiliation(s)
- V de Parades
- Proctologie médico-interventionnelle Groupe hospitalier Diaconesses - Croix Saint Simon, rue du Sergent Bauchat, Paris, France.
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Atienza P. [Questions for doctor Patrick Atienza]. Gastroenterol Clin Biol 2010; 34:69-71. [PMID: 20143479 DOI: 10.1016/j.gcb.2009.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Affiliation(s)
- P Atienza
- Service de proctologie médico-interventionnelle, groupe hospitalier Diaconesses-Croix Saint-Simon, 18, rue du Sergent-Bauchat, 75012 Paris, France.
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Affiliation(s)
- V de Parades
- Service de Proctologie Médico-Interventionnelle, Groupe hospitalier Diaconesses-Croix Saint Simon-Paris
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Arias F, Dominguez M, Villafranca E, Manterola A, Romero P, Martinez E, Oria E, Arraras J, Atienza P, Garcia-Bragado F, Medina J. Hyperfractionated Radiation Therapy and Cisplatin for Locally Advanced Head and Neck Cancer (LAHNC): a Comparison among Two Consecutive Protocols of Treatment at a Single-Institution. Int J Radiat Oncol Biol Phys 2005. [DOI: 10.1016/j.ijrobp.2005.07.613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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de Parades V, Parisot C, Atienza P. [Milligan and Morgan hemorrhoidectomy]. J Chir (Paris) 2005; 142:302-5. [PMID: 16292209 DOI: 10.1016/s0021-7697(05)80934-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Affiliation(s)
- V de Parades
- Service de Proctologie Médico-Interventionnelle, Groupe hospitalier Diaconesses - Croix Saint Simon - Paris
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de Parades V, Etienney I, Thabut D, Beaulieu S, Tawk M, Assemekang B, Marié V, Toubia ML, Wehbe A, Mosnier H, Gadonneix P, Harvey T, Atienza P. Anal sphincter injury after forceps delivery: myth or reality? A prospective ultrasound study of 93 females. Dis Colon Rectum 2004; 47:24-34. [PMID: 14719147 DOI: 10.1007/s10350-003-0007-8] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE This study was designed to estimate the prevalence of anal sphincter injury after forceps delivery in a large population of females managed by trained obstetricians in a French hospital and to identify factors predictive for anal sphincter injury. METHODS We performed a prospective study of healthy females older than 18 years with no history of anal incontinence, anorectal abnormalities, or anorectal surgery after their first vaginal delivery. All females were interviewed using a standardized questionnaire concerning intestinal transit and continence status. Physical examination and endoanal ultrasonography were performed after delivery. RESULTS Between November 1999 and November 2000, 93 females were included in the study after their first forceps delivery. Eleven patients (11.8 percent) had a partial defect involving the external sphincter, visible on ultrasonography. One patient (1.1 percent) had a partial defect of external sphincter with complete defect of internal sphincter (sequelae of primary repair of a third-degree perineal tear). Seventeen patients (18.2 percent) had flatus incontinence, and four patients (4.3 percent) had liquid stool incontinence. A high daily number of stools was significantly associated with sphincter defect visible on ultrasonography (P=0.02). The development of anal incontinence was not related to sphincter defect on ultrasonography. There was a strong association between perineal tear and sphincter defect visible on ultrasonography (odds ratio, 4.5 (range, 1.2-16.7)). CONCLUSIONS Anal sphincter injury after forceps delivery was identified in <13 percent of our large population of healthy females. Our study does not confirm previous observations that anal sphincter injury is common after forceps delivery; previously published studies may have overestimated the prevalence of this condition. The only factor with significant predictive value for anal sphincter injury was perineal tear. Anal endosonography should be recommended after obstetric perineal tear.
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Affiliation(s)
- V de Parades
- Proctologie Médico-Chirurgicale, Groupe Hospitalier Diaconesses-Croix Saint Simon, Paris, France.
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Abstract
PURPOSE Anoperineal tuberculosis is a rare extrapulmonary form of the disease that we must learn to recognize because it requires specific treatment. METHODS Data from seven patients with anoperineal tuberculosis observed in a Parisian proctology unit between 1982 and 1999 were reviewed. RESULTS All the patients were male (median age, 55 years); five were born in underdeveloped countries, and two were still living there. The average length of time between first manifestation of the disease and diagnosis was three years (range, 3 months to 9 years); all patients had undergone surgery previously. There were six recurring anal fistulas (complex in 5 cases) and one recurring abscess. In every case, the diagnosis had been suspected or confirmed by systematic histologic study of the surgically excised tissue. An association with pulmonary tuberculosis was found in each case. Treatment included two parts: conventional surgical treatment of anal sepsis and specific medical antituberculosis treatment. Evolution was favorable in all cases, with no recurrence of disease. Human immunodeficiency virus infection did not increase the incidence of anoperineal tuberculosis. CONCLUSION Tuberculosis should be suspected in all recurrent fistulas. Histologic examination of the excised tissue and a lung x-ray should be performed to avoid delay in diagnosing an easily curable disease.
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Affiliation(s)
- S Sultan
- Medical and Surgical Proctology Unit, Hôpital des Diaconesses, Paris, France
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Abstract
BACKGROUND Full thickness rectal prolapse in young adults with normal pelvic floor is a disease in which the rectum is exceedingly long and mobile. Surgical treatment should correct both anatomical defects by combined rectopexy and colonic resection, which is expected to be less constipating than rectopexy alone. The aim of this study was to describe an original procedure of rectopexy to the pelvic floor with prosthetic material combined with sigmoid resection, and to evaluate prospectively anatomical and functional results. METHODS Thirty-five patients (30 women) of median age 44 years (range 18 to 74) were operated on for full thickness rectal prolapse with normal pelvic floor. The rectum was mobilized posteriorly without division of the lateral ligaments and attached to the pelvic floor previously repaired with a nonabsorbable mesh. The sigmoid colon was resected with hand-sewn anastomosis. Clinical results were assessed by a questionnaire. RESULTS There were no deaths or any septic or anastomotic complications. Small bowel obstruction was corrected laparoscopically in 1 patient. Mean hospital stay was 8 days (range 6 to 14). Mean follow-up was 34 months (range 10 to 93). No recurrence was seen. Preoperatively, 33 patients (94%) complained of constipation mainly with emptying problems (21 patients) and 25 patients (71.5%) were incontinent. Postoperatively, no constipated or incontinent patient's condition worsened. Rectal emptying was restored in 17 patients (81%). Eighteen incontinent patients (72%) regained full continence. On the other hand, 2 patients with normal bowel function worsened and 1 patient with an altered rectal compliance after Delorme's operation became incontinent. CONCLUSIONS In young adults with rectal prolapse and normal pelvic floor undergoing prosthetic rectopexy and sigmoid resection (a) morbidity was low, (b) anatomical control was obtained in all cases, (c) emptying problems were corrected, and (d) deleterious effects are likely to occur if they had no constipation before operation or if rectal compliance was previously altered.
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Affiliation(s)
- J P Lechaux
- Service de Chirurgie Digestive, Hôpital des Diaconesses, 18 rue du Sergent Bauchat, 75012, Paris, France.
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Beaulieu S, De Parades V, Manaouil D, Parisot C, Atienza P. [Retrosacral hematoma of Morel-Lavallée: a rare cause of perianal sepsis]. Gastroenterol Clin Biol 2001; 25:1031-2. [PMID: 11845060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
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De Parades V, Bauer P, Parisot C, Atienza P. [Treatment of hemorrhoidal disease]. Gastroenterol Clin Biol 2000; 24:1211-22. [PMID: 11173735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Affiliation(s)
- V De Parades
- Service de Proctologie Médico-Chirurgicale, Hôpital des Diaconesses, 18, rue de Sergent-Bauchat, 75012 Paris, France.
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Atienza P. [Anal fistula]. J Chir (Paris) 2000; 137:103-6. [PMID: 10863211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Affiliation(s)
- P Atienza
- Service de Proctologie Médico-Chirurgicale, Hôpital des Diaconesses, Paris.
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Lévy P, Levard H, Lenoir S, Bougaran J, Atienza P, Gayet B. [Pseudo-aneurysmal aspect and colic fistulization of an acinar cell tumor of the pancreas]. Gastroenterol Clin Biol 2000; 24:236-8. [PMID: 12687970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
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Bourguignon J, Bauer P, Atienza P. [Effect of delivery on the anal sphincter]. Presse Med 1998; 27:1702-6. [PMID: 9834789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
UNLABELLED SPHINCTER TEARS: Vaginal delivery can lead to tears in the anal sphincters. Total perineal distension following expulsion concerns less than 1% of all deliveries. Initially, sphincter tears generally go unnoticed although echographically detectable defects can be found in one-third of all primiparturients. The inner or outer sphincter may be involved alone or in combination as is seen in half of the cases. NEUROLOGICAL LESIONS Moderate signs of incontinence (gas, urge) are frequently reversible although the long-term outcome remains unknown. In half of the cases, perineal denervation is secondary to stretch lesions of the pudendal nerve terminasions. FAVORING FACTORS Primiparity, forceps delivery, fetal macrosomy, and certain presentations (breech, occipitoposterior) may favor sphincter lesions. DIAGNOSIS A complete examination of the posterior perineum is required with anorectal manometry, a perineal electrophysiologic study, and a transanal ultrasound study whenever function signs are found at the post partum follow-up. TREATMENT The therapeutic strategy is guided by the exploration results. In case of symptomatic rupture of the external sphincter, sphicteroplasty is needed followed by functional rehabilitation therapy with biofeedback. Women who have suffered traumatic lesions of the posterior perineum should be carefully followed for signs of secondary incontinence. Cesarean section may be indicated as a preventive measure in case of a new pregnancy.
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Affiliation(s)
- J Bourguignon
- Service de Proctologie Médico-chirurgicale, Hôpital des Diaconesses, Paris
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Lechaux JP, Atienza P, Husson E, Lechaux D, Bars I. [Treatment of complete rectal prolapse with rectopexy to the pelvic floor with prosthesis and sigmoid resection. Anatomoclinical results of a prospective study]. Chirurgie 1998; 123:351-7. [PMID: 9828508 DOI: 10.1016/s0001-4001(98)80004-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
UNLABELLED BACKGROUND, AIM OF THE STUDY: Full thickness rectal prolapse in young adults with normal perineal structures is a disease of the rectum which is exceedingly long and mobile. Surgical treatment should correct both anatomical defects by combined rectopexy and colonic resection, expected to be less constipating than rectopexy alone. The aim of this study was to describe an original procedure of rectopexy to the pelvic floor with prosthetic material combined with sigmoid resection, and to evaluate prospectively anatomical and functional results. PATIENTS AND METHODS Twenty patients (16 women and four men) of median age 41 years were operated on for full thickness rectal prolapse with normal perineal structures. The rectum was mobilised posteriorly without division of the lateral ligaments and attached to the pelvic floor previously repaired, with a semi-absorbable prosthesis. The sigmoid colon was resected with hand-sewn anastomosis. Clinical results were assessed by a questionnaire. RESULTS There were no deaths or any septic or anastomotic complications. Small bowel obstruction was corrected laparoscopically in one patient. Mean hospital stay was 8.7 days. Mean follow up was 30 (range 9-75) months. No recurrence was seen. Pre-operatively, 18 patients (90%) complained of constipation mainly with emptying problems (15 patients) and 13 patients (65%) were incontinent. Post-operatively, no constipated or incontinent patient's condition worsened. Rectal emptying was restored in 13 patients (86.5%). Eight incontinent patients (61.5%) regained full continence. On the other hand, two patients with normal bowel function worsened and one patient with an altered rectal compliance after Delorme's operation became incontinent. CONCLUSIONS In young adults with rectal prolapse and normal perineal structures undergoing prosthetic rectopexy and sigmoid resection: a) morbidity was low, b) anatomical control was obtained in all cases, c) emptying problems were corrected, d) deleterious effects are likely to occur if they had no constipation before operation or if rectal compliance was previously altered.
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Affiliation(s)
- J P Lechaux
- Service de chirurgie digestive, hôpital des Diaconesses, Paris, France
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de Parades V, Bauer P, Girodet J, Marteau P, Parisot C, Atienza P. [Non-surgical treatment of chronic radiation proctitis]. Gastroenterol Clin Biol 1998; 22:688-96. [PMID: 9823557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Affiliation(s)
- V de Parades
- Service de Proctologie Médico-Chirurgicale, Hôpital des Diaconesses, Paris
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Atienza P. [Effect of botulinum toxin in the treatment of chronic anal fissure]. Gastroenterol Clin Biol 1998; 22:654-5. [PMID: 9917192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Affiliation(s)
- P Atienza
- Service de Proctologie Médico-Chirurgicale, Hôpital des Diaconesses, Paris, France
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31
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Atienza P. [Proctology teaching: impossible reality? Creation of a Complementary Special Study Diploma of Medico-surgical Proctology]. Gastroenterol Clin Biol 1998; 22:263-5. [PMID: 9762207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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32
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Thomas C, Salet-Lizée D, Atienza P. [Anal incontinence: role of perineal neuropathy]. Presse Med 1997; 26:1444-7. [PMID: 9404362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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33
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Rakotomalala L, de Parades V, Parisot C, Atienza P. [Multiple ruptures of the internal sphincter after anal rape: an underknown cause of fecal incontinence]. Gastroenterol Clin Biol 1996; 20:1142-3. [PMID: 9033866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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34
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De Parades V, Parisot C, Atienza P. [Colloid cancer of the anus: value of anal ultrasonography and nuclear magnetic resonance imaging]. Ann Gastroenterol Hepatol (Paris) 1995; 31:284-6. [PMID: 8572563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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35
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Plaza JA, Atienza P, Juez JM, Martínez A. [Fibroadenoma on an ectopic breast]. Rev Clin Esp 1990; 186:147. [PMID: 2356359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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36
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Chaussade S, Beretta O, Atienza P. [Apropos of the article by M. Veyrac and colleagues]. Gastroenterol Clin Biol 1989; 13:749-50. [PMID: 2806814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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37
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Etienne DJ, Atienza P, Couturier D. [Esophageal cinescintigraphy and esophageal motor disorders]. Gastroenterol Clin Biol 1989; 13:607-13. [PMID: 2666246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- D J Etienne
- Service de Médecine Nucléaire, Hôpital Necker-Enfants malades, Paris
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Abstract
Liver involvement is common in acute and chronic Q fever and consists of nonspecific hepatitis and granulomas without fibrosis. We report the case of a patient suffering from chronic Q fever with nonspecific hepatitis and granulomas, in whom progressive development of extensive liver fibrosis was documented by repeated biopsies.
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Affiliation(s)
- P Atienza
- Service d'Hépatologie, Hôpital Beaujon, Clichy, France
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39
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Brion N, Pibarot ML, Atienza P, Robin P, Carbon C. [Comparative serum pharmacokinetics of prednisone and prednisolone methylsulfobenzoate after oral administration]. Presse Med 1988; 17:569-71. [PMID: 2967477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Pharmacokinetic values of prednisone and prednisolone were measured in the serum of 6 healthy volunteers after oral administration of either prednisolone methylsulfobenzoate 30 mg or prednisone 30 mg. Peak serum concentrations of prednisolone obtained after dosing with prednisone occurred earlier and were higher (473 +/- 106 ng/ml) than those obtained after dosing with prednisolone methylsulfobenzoate (232 +/- 70 ng/ml; P less than 0.01). Similarly, areas under the 0-8 h concentration curves were significantly greater after dosing with prednisone than after dosing with prednisolone methylsulfobenzoate (prednisolone: P less than 0.001; prednisone: P less than 0.02). The differences may be due to prednisolone methylsulfobenzoate not being absorbed as well as prednisone. These kinetic data may warrant a reappraisal of the therapeutic equivalence of the two drugs taken for granted in France.
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Affiliation(s)
- N Brion
- Service de Médecine interne, Hôpital Bichat, Paris
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40
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Lobo Beristain J, Ochoa F, Barrón M, Atienza P. Atelectasia redonda yuxtacisural. Nódulo subpleural de localización desconcertante. Arch Bronconeumol 1988. [DOI: 10.1016/s0300-2896(15)31877-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Atienza P, Chaussade S, Hiltgen M, Couturier D, Guerre J. [A hazard of the edrophonium test (Tensilon) in vagal hypertonia syndrome]. Gastroenterol Clin Biol 1988; 12:180-1. [PMID: 3366323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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42
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Parnaud E, Atienza P, Bauer P, Parisot C. [Rectal prolapse. Clinical and complementary tests]. Rev Prat 1987; 37:2969-78. [PMID: 3432978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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43
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Atienza P, Couturier D, Grandjouan S, Guerre J, Bettan L, Chapuis Y, Vasile N. [Intrahepatic collections of fluid of pancreatic origin. A case]. Presse Med 1987; 16:1195-8. [PMID: 2955363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
A case of intrahepatic liquid collections of pancreatic origin is reported. A search in the literature yielded 8 cases of pancreatic pseudocysts which developed in the liver left lobe. The present case was original owing to its localization in the right hepatic lobe, to the large volume of the intrahepatic effusions and to the scarcity of underlying pancreatic symptoms. Ultrasonography and computerized axial tomography were useful aids to the diagnosis as well as to the therapeutic procedures. Surgery, which usually is a matter of discussion in chronic pancreatitis, was necessary to obtain the favourable outcome expected in such diseases.
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