RESUMEN

Hydrothermal venting is rather prevalent in many marine areas around the world, and marine shallow vents are relatively abundant in the Mediterranean Sea, especially around Italy. However, investigations focusing on the characterization of meiofaunal organisms inhabiting shallow vent sediments are still scant compared to that on macrofauna. In the present study, we investigated the meiobenthic assemblages and nematode diversity inhabiting the Secca delle Fumose (SdF), a shallow water vent area located in the Gulf of Naples (Italy). In this area, characterized by a rapid change in the environmental conditions on a relative small spatial scale (i.e., 100 m), we selected four sampling sites: one diffusive emission site (H); one geyser site (G) and two inactive sites (CN, CS). Total meiofauna abundance did not vary significantly between active and inactive sites and between surface and deeper sediment layers due to a high inter-replicate variability, suggesting a pronounced spatial-scale patchiness in distribution of meiofauna. Nematofauna at site H presented the typical features of deep-sea vents with low structural and functional diversity, high biomass and dominance of few genera (i.e., Oncholaimus; Daptonema) while from site G we reported diversity values comparable to that of the inactive sites. We hypothesized that site G presented a condition of "intermediate disturbance" that could maintain a high nematode diversity. Environmental features such as sediment temperature, pH, total organic carbon and interstitial waters ions were found to be key factors influencing patterns of meiofauna and nematofauna assemblages at SdF. Even though the general theory is that nematodes inhabiting shallow vent areas include a subset of species that live in background sediments, this was not the case for SdF vent area. Due to a marked change in nematode composition between all sites and to the presence of many exclusive species, every single investigated site was characterized by a distinct nematofauna reflecting the high spatial heterogeneity of SdF.

RESUMEN

PURPOSE: Temperature-controlled radiofrequency (RF) energy delivery to the sphincter complex has been proposed as an option for those patients not susceptible to a major surgical procedure for fecal incontinence (FI). The aim of the study was to evaluate the long-term (15 years) functional outcomes obtained after RF procedure for FI. METHODS: This was a retrospective analysis of our prospectively collected database of patients that underwent RF procedure for FI. Primary outcomes measured were the Cleveland Clinic Florida Fecal Incontinence scale (CCF-FI), Fecal Incontinence-related Quality of Life Score (FIQLS), the 36-Item Short Form survey (SF-36), endoanal ultrasound, and anorectal manometry. Evaluations were compared at baseline and at 15 years of follow-up. RESULTS: Ten patients were followed up 15 years after RF procedure. There was no significant improvement in the CCF-FI score (13.8 vs. 12.4, p = 0.24). No significant changes in the FIQLS were observed including lifestyle (2.39 vs. 2.13, p = 0.23), coping (1.91 vs. 1.92, p = 0.96), and embarrassment (1.66 vs. 1.86; p = 0.43). However, significant worsening was found in the depression category (2.47 vs. 1.60, p = 0.001). The SF-36 showed significant worsening in the mental (36.7 vs. 25.8, p < 0.001), physical (53.1 vs. 41.4, p = 0.01), and social functions (50.9 vs. 31.25, p = 0.001). Anorectal manometry and endoanal ultrasound showed no significant changes. No complications were found in the long-term follow-up. CONCLUSIONS: Radiofrequency procedure for fecal incontinence did not maintain its efficacy during long-term follow-up.

Asunto(s)

RESUMEN

BACKGROUND: Fecal Incontinence (FI) can seriously affect quality of life. The treatment of fecal incontinence starts conservatively but in case of failure, different surgical approaches may be proposed to the patient. Recently several not invasive approaches have been developed. One of these is the radiofrequency (RF) energy application to the internal anal sphincter. CASE PRESENTATION: We report a rare case of an anal abscess related to a SECCA procedure in a 66-year-old woman affected by gas and FI for twenty years. CONCLUSIONS: The complications post-SECCA procedure reported in literature are generally not serious and often self-limited, such as bleeding or anal pain. This is a case of an anal abscess. We suggest that this finding could consolidate the importance of administering antibiotic therapy to patients and to run a full course of at least 6 days rather than a short-term (24 h) therapy, with the aim to minimize the incidence of this complication.

Asunto(s)

RESUMEN

BACKGROUND: Controlled delivery of radiofrequency energy (SECCA procedure) as treatment for anal incontinence (AI) was introduced 15 years ago. Since then, several clinical studies have emerged. This article evaluates the clinical response and sustainability of SECCA for patients with AI. METHODS: Only original clinical studies retrieved from PubMed and Medline were included. The outcome measures, faecal incontinence scores, definition of response, clinical results and anorectal evaluation were analysed. RESULTS: Ten studies were included, which involved 150 original patients. Three studies reported a long-term follow-up. The one-year follow-up shows a moderate effect, which declines somewhat over time. Only minor temporary side-effects are reported and none of the patients declined treatment. CONCLUSION: SECCA is a safe and well-tolerated procedure that is easy to perform without any serious short- or long-term complications, but with only a moderate clinical effect that declines over time. Results of randomized, sham-controlled controlled trials are awaited.

RESUMEN

AIM: The SECCA system is a treatment option for patients with faecal incontinence and was introduced into clinical practice in 2002. Clinical studies of radiofrequency energy to treat patients with faecal incontinence have been published. This article aimed to review all published series to assess the results of this treatment. METHOD: Twelve studies were included. Outcomes analysed included quality of life, the Wexner incontinence score, anorectal manometry and endoanal ultrasound findings. RESULTS: A total of 220 patients from 10 studies were included. In the majority of clinical studies, the SECCA procedure has been shown to be an effective treatment of mild-to-moderate faecal incontinence. CONCLUSION: When patient selection is appropriate, this treatment has demonstrated clinically significant improvements in symptoms, as demonstrated by statistically significant reductions in the Wexner incontinence and quality of life scores.

Asunto(s)

RESUMEN

Fecal incontinence is a devastating problem for those afflicted. It can lead to embarrassment and social isolation. Treating the problem begins with a thorough history and physical examination. Further testing (such as anal physiology testing or anal endosonography) depends on the examination and treatment plan. Conservative medical therapies (such as dietary manipulation, medication to slow the stool, and biofeedback) are usually tried first. Surgery includes sphincter repair, SECCA, artificial bowel sphincter, and stoma. New therapies continue to evolve with the intention of further improving quality of life for these afflicted patients.

RESUMEN

The treatment of fecal incontinence by means of radiofrequency energy is based on the concept that collagen deposition and subsequent scarring may increase one's ability to recognize and retain stool and permit improved continence. The procedure is undertaken on an outpatient basis. Individuals may be considered candidates even if they have a potentially reparable defect since the technique does not limit one to the application of a subsequent procedure. Clearly, those for whom other treatment methods have failed and those who have no other reasonable option in the management of their fecal incontinence should be considered for this procedure. Preliminary results are quite encouraging, and the results of a prospective, sham-controlled, randomized clinical trial are awaited.