Approximately 30% of patients with rectal cancer present with metastatic disease. Many of these patients have symptoms of bleeding or obstruction. Several treatment options are available to deal with the various compl...Approximately 30% of patients with rectal cancer present with metastatic disease. Many of these patients have symptoms of bleeding or obstruction. Several treatment options are available to deal with the various complications that may afflict these patients. Endorectal stenting, laser ablation, and operative resection are a few of the options available to the patient with a malignant large bowel obstruction. A thorough understanding of treatment options will ensure the patient is offered the most effective therapy with the least amount of associated morbidity. In this review, we describe various options for palliation of symptoms in patients with metastatic rectal cancer. Additionally, we briefly discuss treatment for asymptomatic patients with metastatic disease.展开更多
Maize production in Kenya is constrained by weed infestation and nutrient deficiencies. Field studies were conducted during the 2008/2009 cropping seasons to investigate weeds in maize fields on three dominant soil ty...Maize production in Kenya is constrained by weed infestation and nutrient deficiencies. Field studies were conducted during the 2008/2009 cropping seasons to investigate weeds in maize fields on three dominant soil types in Western Kenya. Weeds were inventoried and their composition was compared using Jaccard＇s index. The economic importance of weed species （potential to reduce yields and the difficulty to control them by manual weeding） was assessed through participatory surveys. Finally, field trials assessed the effects of management options （farmer＇s practice, clean weeding, green manure, zero-tillage ＋ cover crop and zero-tillage） on weed biomass and species composition. Across the three soil types, 55 weed species in 21 families were identified. Soil types influenced species composition as confirmed by Jaccard＇s similarity indices of 0.50, 0.58 and 0.62 for Nitisol vs. Acrisol, Ferralsol vs. Acrisol and Nitisol vs. Ferralsol, respectively. The economically important weeds were Commelina benghalensis, Cynodon nlemfuensis, Bidens pilosa, Galinsoga parviflora and Leonotis nepetifolia. Management options significantly （P 〈 0.05） reduced weed biomass, irrespective of soil type and seasons. Maize biomass response was highest （7-16 Mg ha1） in zero-tillage and zero-tillage ＋ cover crop and lowest （2-8 Mg ha1） in farmer＇s practice. Significantly negative relationships （P 〈 0.01, r2 = 0.37 - 0.51） were established between leaf area index of maize and weed biomass across the soils. Zero-tillage combined with the use of a cover crop had the lowest weed biomass （〈 30% of the farmer practice） and thus appears to be a promising strategy combining soil fertility improvement with weed suppression in smallholder maize farming systems of Western Kenya.展开更多
文摘Approximately 30% of patients with rectal cancer present with metastatic disease. Many of these patients have symptoms of bleeding or obstruction. Several treatment options are available to deal with the various complications that may afflict these patients. Endorectal stenting, laser ablation, and operative resection are a few of the options available to the patient with a malignant large bowel obstruction. A thorough understanding of treatment options will ensure the patient is offered the most effective therapy with the least amount of associated morbidity. In this review, we describe various options for palliation of symptoms in patients with metastatic rectal cancer. Additionally, we briefly discuss treatment for asymptomatic patients with metastatic disease.
文摘Maize production in Kenya is constrained by weed infestation and nutrient deficiencies. Field studies were conducted during the 2008/2009 cropping seasons to investigate weeds in maize fields on three dominant soil types in Western Kenya. Weeds were inventoried and their composition was compared using Jaccard＇s index. The economic importance of weed species （potential to reduce yields and the difficulty to control them by manual weeding） was assessed through participatory surveys. Finally, field trials assessed the effects of management options （farmer＇s practice, clean weeding, green manure, zero-tillage ＋ cover crop and zero-tillage） on weed biomass and species composition. Across the three soil types, 55 weed species in 21 families were identified. Soil types influenced species composition as confirmed by Jaccard＇s similarity indices of 0.50, 0.58 and 0.62 for Nitisol vs. Acrisol, Ferralsol vs. Acrisol and Nitisol vs. Ferralsol, respectively. The economically important weeds were Commelina benghalensis, Cynodon nlemfuensis, Bidens pilosa, Galinsoga parviflora and Leonotis nepetifolia. Management options significantly （P 〈 0.05） reduced weed biomass, irrespective of soil type and seasons. Maize biomass response was highest （7-16 Mg ha1） in zero-tillage and zero-tillage ＋ cover crop and lowest （2-8 Mg ha1） in farmer＇s practice. Significantly negative relationships （P 〈 0.01, r2 = 0.37 - 0.51） were established between leaf area index of maize and weed biomass across the soils. Zero-tillage combined with the use of a cover crop had the lowest weed biomass （〈 30% of the farmer practice） and thus appears to be a promising strategy combining soil fertility improvement with weed suppression in smallholder maize farming systems of Western Kenya.
