Diseases of the colon and rectum
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The aim of this study was to evaluate the effect of vaginal delivery on the pelvic floor by serial measurement of pudendal nerve terminal motor latency, perineal descent, and anal pressure before and after delivery. ⋯ Pudendal nerve damage and functional impairment in the pelvic floor sphincter musculature occurs during vaginal delivery. Pudendal nerve terminal motor latency recovers after two months, whereas functional disturbance in the pelvic floor persists at least until six months.
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Comparative Study
Operative mortality rates among surgeons: comparison of POSSUM and p-POSSUM scoring systems in gastrointestinal surgery.
The original Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity and the more recent Portsmouth predictor equation for mortality scoring systems were developed to provide risk-adjusted mortality rates in general surgery. The aim of this study was to compare crude and risk-adjusted operative mortality rates among four surgeons using the above scoring systems and assess their applicability for patients scored retrospectively. ⋯ The Portsmouth predictor equation for mortality equation seems to be a more accurate predictor of mortality in gastrointestinal surgery. It would seem to provide the best choice for analyzing operative mortality rates for individual surgeons, taking into account variation in case mix and fitness of patients even when scored retrospectively. This has important implications for the future assessment of surgeons' clinical standards and the assessment of quality of surgical care.