Labor Scheduling Using NPV Estimates of the Marginal Benefit of Additional Labor Capacity

An extensive literature exists on the problems of daily (shift) and weekly (tour) labor scheduling. In representing requirements for employees in these problems, researchers have used formulations based either on the model of Dantzig (1954) or on the model of Keith (1979). We show that both formulations have weakness in environments where management knows, or can attempt to identify, how different levels of customer service affect profits. These weaknesses results in lower-than-necessary profits. This paper presents a New Formulation of the daily and weekly Labor Scheduling Problems (NFLSP) designed to overcome the limitations of earlier models. NFLSP incorporates information on how changing the number of employees working in each planning period affects profits. NFLP uses this information during the development of the schedule to identify the number of employees who, ideally, should be working in each period. In an extensive simulation of 1,152 service environments, NFLSP outperformed the formulations of Dantzig (1954) and Keith (1979) at a level of significance of 0.001. Assuming year-round operations and an hourly wage, including benefits, of $6.00, NFLSP's schedules were $96,046 (2.2%) and $24,648 (0.6%) more profitable, on average, than schedules developed using the formulations of Danzig (1954) and Keith (1979), respectively. Although the average percentage gain over Keith's model was fairly small, it could be much larger in some real cases with different parameters. In 73 and 100 percent of the cases we simulated NFLSP yielded a higher profit than the models of Keith (1979) and Danzig (1954), respectively.

Diagnosis of intra-abdominal injuries can be challenging in multitrauma patients with associated injuries. Our experience and review of the literature

ntroduction. Trauma is the most common cause of death and disability among patients during the first four decades of life. Abdominal trauma is reported to be the 3rd most common injured region. Clinical examination may be unreliable in the evaluation of these patients especially in the presence of associated injuries. Therefore the use of diagnostic tools is essential in the management of the injured patient with abdominal trauma and additional injuries. Patients and Methods. During 1 year period from December 2010 to November 2011 we recorded the patients that presented to the emergency department of our hospital and were found to suffer from intra-abdominal injuries. These patients were divided in two groups depending on whether they had additional comorbid injuries or not. Several parameters were recorded and compared between the two groups, such as mechanism of injury, general status and hemodynamic stability of the patient on presentation, physical examination, use of imaging modalities and concomitant findings, need for surgical intervention and mortality rates. Furthermore the discrepancy between physical findings and final diagnosis after the use of diagnostic adjuncts is reported. Results. We recorded 31 patients with abdominal trauma. 13 (42%) patients were found to suffer from abdominal trauma and associated injuries (Group I), whereas 18 (58%) presented with abdominal trauma alone (Group II). The patients of the first group presented hemodynamic instability in 38% of cases while the patients of the second in 22% of cases. Reduced consciousness was present in 38% in group I versus 17% in group II. Signs of abdominal injury during clinical examination were present in only 15% in group I versus 72% in group II that represented a remarkable difference between the two groups. Conservative treatment was possible in 15% of patients with additional injuries and in 22% of patients with abdominal injury alone. In group I there were two deaths whereas in group II all patients survived. Conclusion. In patients with abdominal trauma, associated injuries seem to add to the severity of injury and indicate a worse prognosis. Clinical examination is unreliable and misleading in the majority of these patients and the use of diagnostic tools cannot be overemphasized.

Produção e degradação da serrapilheira de espécies lenhosas da caatinga e sua contribuição na recuperação de áreas degradadas.

Resumo: O entendimento do fluxo de produção e do aporte de nutrientes via decomposição da serrapilheira e as interações do processo com parâmetros edáficos e ciclagem de nutrientes de espécies nativas da Caatinga têm sido pouco estudados. O conhecimento sobre ciclagem de nutrientes em florestas manejadas também permite inferências sobre as espécies com maior capacidade de reciclagem de nutrientes e seu potencial para recuperação de áreas degradadas. Objetivou-se com isso avaliar a produção e a degradação da serrapilheira de oito espécies lenhosas da Caatinga e mensurar os efeitos de sua aplicação sobre a fertilidade do solo e sobre a produção de sorgo em solo degradado. Para isso realizou-se três ensaios: para o ensaio I quantificou-se a produção de serrapilheira em um delineamento inteiramente casualizado com 6 repetições, por meio da instalação de coletores sob a projeção da copa das espécies (tratamentos): mofumbo, sabiá, jurema-preta, jucá, catingueira, pereiro, pau-branco e marmeleiro, sendo o material coletado mensalmente; foram quantificadas a produção das frações folhas, caule, material reprodutivo, miscelânea e total, bem como o aporte de nutrientes no período chuvoso e seco. Para o ensaio II avaliou-se a taxa de degradação da fração folhas de cada espécie citada por meio da utilização de litter bags, em delineamento inteiramente casualizado com 4 repetições, as coletas foram aos 0, 30, 60, 90, 120 e 150 dias, em seguida quantificou-se os macro e micronutrientes, celulose, lignina e carbono em cada tempo de amostragem. Para o ensaio III, realizou-se experimento em casa de vegetação para mensurar os efeitos da aplicação dos resíduos da serrapilheira das mesmas espécies mencionadas nos ensaios anteriores (I e II) sobre a fertilidade do solo e a produção de sorgo em solo degradado, neste experimento adotou-se o delineamento em blocos casualizados com 5 tratamentos e 5 repetições, sendo avaliadas doses equivalentes a: 0, 15, 30, 60 e 120 kg ha-1 de N dos resíduos de cada espécie e um tratamento adicional com adubação mineral, totalizando 30 unidades experimentais para cada espécie. As variáveis mensuradas foram biométricas, biomassa, teor relativo de clorofila e nitrogênio total, além de análises de fertilidade do solo. Com a análise dos dados verificou-se que a época de maior produção de serrapilheira ocorreu no final do período chuvoso para o início do período seco. A espécie jucá apresentou maior produção de serrapilheira, comparado às outras espécies. O nutriente cálcio apresentou maior acúmulo na serrapilheira para as espécies mofumbo, sabiá, catingueira, pereiro e marmeleiro e o nitrogênio foi superior para as espécies jurema-preta, jucá e pau-branco. Para todas as espécies avaliadas no ensaio de degradação houve redução significativa na sua biomassa em relação ao tempo zero, apresentando a seguinte ordem de velocidade de decomposição: jurema-preta > catingueira > pau-branco > jucá > marmeleiro > mofumbo > pereiro > sabiá. No ensaio de fertilização com os resíduos verificou-se que o marmeleiro promoveu efeitos negativos no solo, como acidificação. Porém, a aplicação dos resíduos da espécie pau-branco foi a que promoveu aumento nos valores de K, SB e CEC do solo e na produção do sorgo os resíduos de jurema-preta e pau-branco foram as que promoveram aumento na massa seca das plantas. Enquanto a adubação mineral proporcionou aumento na produção de massa seca do sorgo, demonstrando que a associação entre adubo mineral e o uso da serrapilheira de espécies da Caatinga pode ser uma opção viável para acelerar a recuperação de solos degradados. Abstract: The understanding of the production flow and nutrient supply via decomposition of litter and process interactions with edaphic parameters and nutrient cycling of native species of the Caatinga has been little studied. The knowledge of nutrient cycling in managed forests also allow inferences about species with capacity greater nutrient recycling capacity and its potential for recovery of degraded areas. This study aimed to evaluate the production and litter degradation 8 woody species of Caatinga and measure the effects of its application on soil fertility and production of sorghum in degraded soil. To this was carried out three tests: for the test I quantified the production of litter in a completely randomized design with 6 replications, by installing collectors under the canopy projection in the species (treatments): mofumbo, sabiá, jurema-preta, jucá, catingueira, pereiro, pau-branco and marmeleiro for each species, and the material collected monthly, were quantified the production of fractions leaves, stem, reproductive material, miscellany and total nutrient intake in the rainy and dry season. For II test evaluated the degradation rate of the fraction leaves through the use of litter bags, in a completely randomized design with 4 replications, the collected was 0, 30, 60, 90, 120 and 150 days and quantitated nutrients, cellulose, lignin and carbon at each evaluation time. For the III test, there was the experiment in a greenhouse to measure the effects of the application of litter waste of the same species of previous tests (I and II) on soil fertility and production of sorghum in degraded soil, was adopted the randomized block design with 5 treatments and 5 replications and evaluated doses equivalent to: 0, 15, 30, 60 and 120 kg ha-1 N of waste each species and an additional treatment with mineral fertilizer, totaling 30 experimental units for each species. Biometric analysis and biomass, relative chlorophyll content and total nitrogen were proceeded. In addition to soil fertility analysis. With the data analysis it was found that the time of greatest litterfall occurred at the end of the rainy season to the beginning of the dry season. The jucá species showed higher production compared to other species. The nutrient calcium had higher accumulation for the species mofumbo, sabiá, catingueira, pereiro and marmeleiro and nitrogen was higher for species jurema-preta, jucá and pau-branco. All species evaluated in degradation test had a significant reduction in biomass over time zero. They presented the following order of decomposition rate: jurema-preta > catingueira > pau-branco > jucá > marmeleiro > mofumbo > pereiro > sabiá. For fertility test it was found that marmeleiro promoted negative effects on soil, such as acidification. However, pau-branco was the specie that promoted further improvements in the K values, SB and CEC to the soil and for the production of sorghum, the waste jurema-preta and pau-branco promoted increase in dry matter plants. While the mineral fertilization provided an increase in dry matter production of sorghum, demonstrating that the combination of mineral fertilizer and the use of litter of Caatinga species may be a viable option to speed up the recovery of degraded soils.

Spinal Cord Atrophy Correlates With Disease Duration And Severity In Amyotrophic Lateral Sclerosis.

Our objective was to investigate spinal cord (SC) atrophy in amyotrophic lateral sclerosis (ALS) patients, and to determine whether it correlates with clinical parameters. Forty-three patients with ALS (25 males) and 43 age- and gender-matched healthy controls underwent MRI on a 3T scanner. We used T1-weighted 3D images covering the whole brain and the cervical SC to estimate cervical SC area and eccentricity at C2/C3 level using validated software (SpineSeg). Disease severity was quantified with the ALSFRS-R and ALS Severity scores. SC areas of patients and controls were compared with a Mann-Whitney test. We used linear regression to investigate association between SC area and clinical parameters. Results showed that mean age of patients and disease duration were 53.1 ± 12.2 years and 34.0 ± 29.8 months, respectively. The two groups were significantly different regarding SC areas (67.8 ± 6.8 mm² vs. 59.5 ± 8.4 mm², p < 0.001). Eccentricity values were similar in both groups (p = 0.394). SC areas correlated with disease duration (r = - 0.585, p < 0.001), ALSFRS-R score (r = 0.309, p = 0.044) and ALS Severity scale (r = 0.347, p = 0.022). In conclusion, patients with ALS have SC atrophy, but no flattening. In addition, SC areas correlated with disease duration and functional status. These data suggest that quantitative MRI of the SC may be a useful biomarker in the disease.

Apparent digestibility of diets with different concentrations of lysine and energy in piglets with different body weights and post-weaning age

The effects of body weight or age and dietary digestible lysine and metabolizable energy on apparent digestibility of energy and dry matter were evaluated in piglets after weaning. The animals were weaned at 21 days of age and distributed in two groups: 8.68 ± 0.76 kg at 28 days of age (weaned 7 days earlier); and 12.73 ± 0.99 kg at 35 days of age (weaned 14 days earlier). The pigs were allotted in digestibility cages in a completely randomized block design with the following factorial arrangements: 2 × 4 composed of two weight categories and four levels of digestible lysine (1.222; 1.305; 1.390 and 1.497%); and 2 × 3 composed of two weight categories and three levels of metabolizable energy (3,510; 3,700 and 3,830 kcal/kg rations). Digestible lysine was evaluated in six replications and metabolizable energy in eight replications and each animal constituted an experimental unit. Piglets with higher body weight and age were more efficient in nitrogen retention and energetic balance, compared to lighter and younger piglets, particularly those given lower concentration of lysine in the diet. The energy increase favored nitrogen retention by the heavier and older piglets. However, coefficients of dry matter and energy apparent digestibility did not differ among weight categories. Older and heavier piglets were more efficient in nitrogen retention, although this efficacy depended on concentration of the energy in the diet. This better use of protein and energy suggest differences on nutritional requirements.

Fontes de minerais orgânicos e inorgânicos para leitões desmamados

A presente pesquisa foi realizada com o objetivo de comparar os efeitos de fontes orgânicas e inorgânicas de microminerais sobre o desempenho, os parâmetros sanguíneos e a deposição de minerais em tecidos e órgãos de leitões desmamados. Foram utilizados 54 leitões de genética comercial, desmamados com idade média de 24 dias e peso médio de 7,35±0,88kg, num delineamento experimental de blocos ao acaso, com dois tratamentos, nove repetições e três animais por parcela. Os tratamentos foram representados pelo uso de rações suplementadas com minerais de fontes orgânicas ou inorgânicas (Cu, Zn, Fe, Mn e Se) no período dos 24 aos 57 dias de idade. Foram avaliados o consumo diário de ração, o ganho diário de peso, a conversão alimentar, os parâmetros hematológicos e a deposição de minerais em tecidos e órgãos. As fontes orgânicas de minerais nas rações fornecidas dos 24 aos 57 dias de idade melhoraram o ganho diário de peso (P=0,06) e a conversão alimentar (P=0,05) e aumentaram o número de hemáceas (P=0,10), contudo não influenciaram a deposição de minerais no músculo masseter, fígado, coração, baço e rim. Portanto, o suplemento de minerais de fontes orgânicas foi mais eficiente para o desempenho dos leitões na fase de creche.

Effects of Er:YAG Laser Irradiation on the Microtensile Bond Strength to Bleached Enamel

Objective: The objective of this study was to evaluate the influence of different Er:YAG laser (lambda = 2.94 mu m) energy parameters on the microtensile bond strength (mu TBS) and superficial morphology of bovine enamel bleached with 16% carbamide peroxide. Background: Laser irradiation could improve adhesion to bleached enamel surfaces. Methods: Sixty bovine enamel blocks (7x3x3 mm(3)) were randomly assigned to six groups according to enamel preparation procedures (n = 10): G1-bleaching and Er:YAG laser irradiation with 25.52 J/cm(2) (laser A, LA); G2-bleaching and Er:YAG laser irradiation with 4.42J/cm(2) (laser B, LB); G3-bleaching; G4-Er:YAG laser irradiation with 25.52 J/cm(2); G5-Er:YAG laser irradiation with 4.42J/cm(2); G6-control, no treatment. G1 to G3 were bleached for 6 h during 21 days. Afterwards, enamel surfaces in all groups were slightly abraded with 600-grit SiC papers and G1, G2, G4 and G5 were irradiated according to each protocol. Enamel blocks were then restored with an etch-and-rinse adhesive system and a 4-mm thick composite buildup was made in two increments (n = 9). After 24 h, restored blocks were serially sectioned with a cross-section area of similar to 1 mm(2) at the bonded interface and tested in tension in a universal testing machine (1 mm/min). Failure mode was determined at a magnification of x100 using a stereomicroscope. One treated block of each group was selected for scanning electron microscopy (SEM) analysis. mu TBS data were analyzed by two-way ANOVA and no statistical differences were observed among groups. Results: Mean bond strengths (SD) in MPa were: G1-30.4(6.2); G2-27.9(8.5); G3-32.3(3.9); G4-23.7(5.8); G5-29.3(6.0); G6-29.1(6.1). A large number of adhesive failures was recorded for bleached and irradiated enamel surfaces. Conclusions: Bleached enamel surfaces mu TBS values were not significantly different from those of unbleached enamel. Even though Er:YAG laser irradiation with both parameters had no influence on mu TBS for bleached and unbleached enamel, SEM analysis revealed that Er:YAG laser irradiation with 25.52J/cm(2) should not be recommended, as enamel ablation was observed, whereas irradiation with 4.42J/cm(2) did not promote any remarkable changes on enamel surface.

Analysis of Bacteria, Parasites, and Heavy Metals in Lettuce (Lactuca sativa) and Rocket Salad (Eruca sativa L.) Irrigated with Treated Effluent from a Biological Wastewater Treatment Plant

This study aimed to evaluate the viability of using treated residuary water from the Biological Wastewater Treatment Plant of Ribeiro Preto to grow vegetables, through the characterization and quantification of parasites, coliforms, and heavy metals. Three equal cultivation areas were prepared. The first was irrigated with treated/chlorinated (0.2 mg L(-1)) wastewater, the second one with treated wastewater without chlorination, and the third site with potable water, which was the control group. The presence of Hymenolepis nana, Enterobius vermicularis, nematode larvae, and Entamoeba coli was verified in lettuce (Lactuca sativa) samples. Although nematode larvae were observed in rocket salad (Eruca sativa L.), no significant differences were found between the number of parasites and type of irrigation water used. No significant differences were found between the number of fecal coliforms in vegetables and the different types of irrigation. However, the vegetables irrigated with treated effluent without chlorination showed higher levels of fecal coliforms. The risk of pathogens is reduced with bleach addition to the treated effluent at 0.2 mg/L. Concentration of heavy metals in vegetables does not mean significant risks to human health, according with the parameters recommended by the World Health Organization.

Linear viscoelasticity of styrenic block copolymers-clay nanocomposites

In this work, the rheological behavior of block copolymers with different morphologies (lamellar, cylindrical, spherical, and disordered) and their clay-containing nanocomposites was studied using small amplitude oscillatory shear. The copolymers studied were one asymmetric starblock styrene-butadiene-styrene copolymer and four styrene-ethylene/butylenes-styrene copolymers with different molecular architectures, one of them being modified with maleic anhydride. The nanocomposites of those copolymers were prepared by adding organophilic clay using three different preparation techniques: melt mixing, solution casting, and a hybrid melt mixing-solution technique. The nanocomposites were characterized by X-ray diffraction and transmission electron microscopy, and their viscoelastic properties were evaluated and compared to the ones of the pure copolymers. The influence of copolymer morphology and presence of clay on the storage modulus (G`) curves was studied by the evaluation of the changes in the low frequency slope of log G` x log omega (omega: frequency) curves upon variation of temperature and clay addition. This slope may be related to the degree of liquid- or solid-like behavior of a material. It was observed that at temperatures corresponding to the ordered state, the rheological behavior of the nanocomposites depended mainly on the viscoelasticity of each type of ordered phase and the variation of the slope due to the addition of clay was small. For temperatures corresponding to the disordered state, however, the rheological behavior of the copolymer nanocomposites was dictated mostly by the degree of clay dispersion: When the clay was well dispersed, a strong solid-like behavior corresponding to large G` slope variations was observed.

Robust integration of real time optimization with linear model predictive control

Here, we study the stable integration of real time optimization (RTO) with model predictive control (MPC) in a three layer structure. The intermediate layer is a quadratic programming whose objective is to compute reachable targets to the MPC layer that lie at the minimum distance to the optimum set points that are produced by the RTO layer. The lower layer is an infinite horizon MPC with guaranteed stability with additional constraints that force the feasibility and convergence of the target calculation layer. It is also considered the case in which there is polytopic uncertainty in the steady state model considered in the target calculation. The dynamic part of the MPC model is also considered unknown but it is assumed to be represented by one of the models of a discrete set of models. The efficiency of the methods presented here is illustrated with the simulation of a low order system. (C) 2010 Elsevier Ltd. All rights reserved.

Tabasco pepper production with CO(2) application using drip irrigation

Tabasco pepper production with CO(2) application using drip irrigation. Application of CO(2) through water reduces the soil solution pH, causing variations in nutrient mobility and consequent effects on the absorption. The objective of this study was to analyze the effects of carbon dioxide rates supplied by drip irrigation in the production of Capsicum frutescens L. crop. A randomized block design with four treatments and eight replications was used. The treatments were four rates of CO(2): 0 (T1), 451.95 (T2); 677.93 (T3) and 903.92 (T4) kg ha(-1). The fruits were counted and weighed; the length and the diameter were obtained from an average of 20 fruits per plant, randomly taken, from each treatment in the plot. The quadratic effect (p < 0.01) occurred for CO(2) on the yield and there was quadratic effect (p < 0.05) of the rates on the number of fruits. There were no effects of CO(2) rates on the green matter, dry matter and fruit length and diameter. The T2 treatment provided greater yield and higher number of fruits per plant with an increase of 16 and 26%, respectively in relation to T1 (without CO(2)). CO(2) application favored the increase in the yield because of the greater number of fruits per plant in the Tabasco pepper crop.

Carbon and nitrogen cycling in a tropical Brazilian soil cropped with sugarcane and irrigated with wastewater

Carbon (C) and nitrogen (N) dynamics in agro-systems can be altered as a consequence of treated sewage effluent (TSE) irrigation. The present study evaluated the effects of TSE irrigation over 16 months on N concentrations in sugarcane (leaves, stalks and juice), total soil carbon (TC), total soil nitrogen (TN), NO(3)(-)-N in soil and nitrate (NO(3)(-)) and dissolved organic carbon (DOC) in soil solution. The soil was classified as an Oxisol and samplings were carried out during the first productive crop cycle, from February 2005 (before planting) to September 2006 (after sugarcane harvest and 16 months of TSE irrigation). The experiment was arranged in a complete block design with five treatments and four replicates. Irrigated plots received 50% of the recommended mineral N fertilization and 100% (T100), 125% (T125), 150% (T150) and 200% (T200) of crop water demand. No mineral N and irrigation were applied to the control plots. TSE irrigation enhanced sugarcane yield but resulted in total-N inputs(804-1622 kg N ha(-1)) greater than exported N (463-597 kg N ha(-1)). Hence, throughout the irrigation period, high NO(3)(-) concentrations (up to 388 mg L(-1) at T200) and DOC (up to 142 mg L(-1) at T100) were measured in soil solution below the root zone, indicating the potential of groundwater contamination. TSE irrigation did not change soil TC and TN. (C) 2009 Elsevier B.V. All rights reserved.

Temperature dependence of the magnetic susceptibility for triangular-lattice antiferromagnets with spatially anisotropic exchange constants

We present the temperature dependence of the uniform susceptibility of spin-half quantum antiferromagnets on spatially anisotropic triangular lattices, using high-temperature series expansions. We consider a model with two exchange constants J1 and J2 on a lattice that interpolates between the limits of a square lattice (J1=0), a triangular lattice (J2=J1), and decoupled linear chains (J2=0). In all cases, the susceptibility, which has a Curie-Weiss behavior at high temperatures, rolls over and begins to decrease below a peak temperature Tp. Scaling the exchange constants to get the same peak temperature shows that the susceptibilities for the square lattice and linear chain limits have similar magnitudes near the peak. Maximum deviation arises near the triangular-lattice limit, where frustration leads to much smaller susceptibility and with a flatter temperature dependence. We compare our results to the inorganic materials Cs2CuCl4 and Cs2CuBr4 and to a number of organic molecular crystals. We find that the former (Cs2CuCl4 and Cs2CuBr4) are weakly frustrated and their exchange parameters determined through the temperature dependence of the susceptibility are in agreement with neutron-scattering measurements. In contrast, the organic materials considered are strongly frustrated with exchange parameters near the isotropic triangular-lattice limit.

Copolymer hydrogels of 2-hydroxyethyl methacrylate with n-butyl methacrylate and cyclohexyl methacrylate: synthesis, characterization and uptake of water

The bulk free radical copolymerizations of 2-hydroxyethyl methacrylate (HEMA) with n-butyl methacrylate (BMA) or cyclohexyl methacrylate (CHMA) were studied over the composition mole fraction interval of 0-1 for HEMA in the monomer feed. The C-13 NMR (125 MHz) spectra of the copolymers were analysed to determine the copolymer composition and the stereochemical configuration of the copolymers. The terminal model reactivity ratios of HEMA and BMA were found to be r(HEMA) = 1.73 and r(BMA) = 0.65 and for HEMA and CHMA, r(HEMA) = 1.26 and r(CHMA) = 0.31. The BMA and CHMA homopolymers were found to be predominantly syndiotactic with isotacticity parameters of theta(BB) = 0.18 and theta(CC) = 0.19, respectively. The copolymers were also found to be predominantly syndiotactic, indicating a strong tendency for racemic additions of the monomers in the formation of the copolymers. The diffusion of water into cylinders of poly(HEMA-co-BMA) and poly(HEMA-co-CHMA) was studied over a range of copolymer compositions and was found to be Fickian. The diffusion coefficients of water at 37 degrees C were determined from swelling measurements and were found to vary from 1.72 x 10(-11) m(2) s(-1) for polyHEMA to 0.97 x 10(-11) m(2) s(-1) for poly(HEMA-co-BMA) having a mole fraction F-HEMA = 0.80 and to 0.91 x 10(-11) m(2) s(-1) for a poly(HEMA-co-CHMA) also having F-HEMA = 0.80. The mass of water absorbed at equilibrium relative to the mass of dry polymer varied from 58.8 for polyHEMA to 27.2% for poly(HEMA-co-BMA) having F-HEMA = 0.85 and to 21.3% for poly(HEMA-co-CHMA) having F-HEMA = 0.80. (C) 1999 Elsevier Science Ltd. All rights reserved.

Long-term follow up of abdominal rectosigmoidectomy with posterior end-to-side stapled anastomosis for Chagas megacolon

Aim Chagas` disease is an endemic parasitosis found in Latin America. The disease affects different organs, such as heart, oesophagus, colon and rectum. Megacolon is the most frequent long-term complication, caused by damage to the myoenteric and submucous plexus, ultimately leading to a functional barrier to the faeces. Patients with severe constipation are managed surgically. The study aimed to analyse the 10-year minimum functional outcome after rectosigmoidectomy with posterior end-to-side anastomosis (RPESA). Method A total of 21 of 46 patients were available for follow up. Patients underwent clinical, radiological and manometric evaluation, and the results were compared with preoperative parameters. Results Of the 21 patients evaluated, 81% (17) were female, with a mean age of 60.6 years. Good function was achieved in all patients, with significant improvement in defaecatory frequency (P < 0.0001), usage of enemas (P < 0.0001) and patient satisfaction. Barium enema also showed resolution of the colonic and rectal dilatation in 19 cases evaluated postoperatively. Conclusion Minimal 10-year follow up of RPESA showed excellent functional results, with no recurrence of constipation.