The coalescences of binary black hole (BBH) systems, here taken to be non-spinning, are among the most promising sources for gravitational wave (GW) ground-based detectors, such as LIGO and Virgo. To detect the GW signals emitted by BBHs, and measure the parameters of the source, one needs to have in hand a bank of GW templates that are both effectual (for detection), and accurate (for measurement). We study the effectualness and the accuracy of the two types of parametrized banks of templates that are directly defined in the frequency-domain by means of closed-form expressions, namely 'post-Newtonian' (PN) and 'phenomenological' models. In absence of knowledge of the (continuous family of) exact waveforms, our study assumes as fiducial, target waveforms the ones generated by the most accurate version of the effective-one-body (EOB) formalism, calibrated upon a few high-accuracy numerical relativity (NR) waveforms. We find that, for initial GW detectors the use, at each point of parameter space, of the best closed-form template (among PN and phenomenological models) leads to an effectualness > 97% over the entire mass range and > 99% in an important fraction of parameter space; however, when considering advanced detectors, both of the closed-form frequency-domain models fail to be effectual enough in significant domains of the two-dimensional [total mass and mass ratio] parameter space. Moreover, we find that, both for initial and advanced detectors, the two closed-form frequency-domain models fail to satisfy the minimal required accuracy standard in a very large domain of the two-dimensional parameter space. In addition, a side result of our study is the determination, as a function of the mass ratio, of the maximum frequency at which a frequency-domain PN waveform can be 'joined' onto a NRcalibrated EOB waveform without undue loss of accuracy. In the case of mass ratios larger than 4:1 this maximum frequency occurs well before the last stable orbit, leaving probably too many orbital cycles to be covered by current NR techniques if one wanted to construct accurate enough hybrid PN-NR waveforms. This problem will, however, be probably greatly alleviated, or even solved, by using the EOB formalism instead of PN theory.
Surgical site infection rates are high for incisional hernia surgery (16%), and associated with local complications. Surgical site infection requires long-term treatments and leads to a higher one-year recurrence rate.
Having nurses provide a variety of services generally available only from physicians is one way to overcome shortages of physicians in family planning programs. To aid in determining if the quality of care provided by nurses is comparable to that of physicians, a study at a Profamilia clinic in Bogota, Colombia, evaluated the management of family planning clients by physicians and nurses. The study found significant differences between physicians and nurses in the prescription of contraceptives on the client's first visit, in prescription of methods to be used temporarily, in deferment of IUD insertions, and in changing of methods for the client. Continuation rates among the physicians' and nurses' clients, however, did not differ significantly, and clients of physicians and nurses were equally successful in preventing unwanted pregnancies.
FIBRIN GLUE MESH FIXATION UNDER LOCAL ANAESTHESIA FOR THE TREATMENT OF INGUINAL HERNIA IN ELDERLY PATIENTS R LionettF, A Cesaro 1 , E NapolitanoI, L Caruso 1 , B Neola1, M Rutigliano1, 0 P Ferulano1 iDpt. Specialistic Surgeries and Nephrology Policlinic Federico II, Naples, ITALY \ud Introduction: Inguinal hernia repair is one of the most common operations performed in general surgery, especially among elderly patients, due to age-related loss of muscle mass and increase of co-morbidities associated with high intra-abdominal pressure. The purpose of our trial was to assess the safeness and the impact on quality of life of tension free, sutureless hernia repair technique with the use of fibrin glue under local anesthesia in elderly patients. Methods: From January 2010 to December 2012,53 male patients aged 70 and above (mean age 73.9 years) were enrolled; complicated, recurrent, scrotal hernia and ASA IV patients were excluded. Furthermore diabetic patients with glycated hemoglobin level 7% or more were ruled out for presumable neuropathy. Informed consent and data from SF36 questionnaire were collected preoperatively. The Visual Analogue Scale (VAS) for postoperative pain and a new SF36 questionnaire for overall satisfaction at one year, were administered postoperatively. Chronic pain was classified according to Cunningham's criteria. Operative time, length of hospitalization, postoperative use of nonsteroidal anti-inflammatory drugs, complications and recurrences were also assessed. Results: All patients were operated under local anaesthesia (2% Mepivacaine Cloridrate and 7,5mg!ml Ropivacaine) with light sedation; in all cases partially absorbable mesh and plug (polypropylene! polyglecaprone 25) have been implanted and fixed with I ml of fibrin glue. 50 out of 53 patients completed the 2 years follow-up, one died for not related comorbidity. Mean operative time was 54.8 minutes; 46 patients were discharged at home the same day, 5 the following day, 2 patients had to stay one more day for postoperative complications (I haematoma, I urinary retention), no major complications were observed; at two years follow-up, 2 recurrences (4%) have been observed; mean VAS score for post-operative pain, assessed at 6, 12, 24 hours and 7 days after surgery, was 4 or less for 50 (94,3%) patients, only 3 (5,6%) patients referred a score> 4. At one year follow up only 2 (4%) patients suffered of chronic postoperative pain (I mild and I moderate), no severe chronic postoperative pain has been reported. Data from pre and postoperative SF36 questionnaires, analysed by using the Student's t test, showed significant increase of the score both in the Physical Component Summery (PCM) and in the Mental Component Summary (MCS) with a p-value < 0.0001. Conclusion: Inguinal hernia repair with use of fibrin glue and partially absorbable prosthesis under local anaesthesia is a safe technique in elderly patient
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