No abstract

The purpose of this retrospective study is to show that transcervical diverticulectomy (TD) in treatment of Zenker diverticulum (ZD) can still be a first choice procedure in selected patients and in experienced hands its safety might be compared to the minimally invasive endoscopic diverticulostomy.The study cohort consisted of 44 patients (18 male, 26 female) operated for (ZD). All the patients underwent open diverticulectomy. The decision to choose open surgical repair depended on surgical risk, age of the patient, size of the diverticular septum (the distance between the top of the diverticulum and its bottom on barium study), and patient's preference.Mean age of patients was 64.6 ± 11.9 years; range: 26 to 88 years. A total of 36.4% out of them finished 70 years. Postoperative mortality was nil. Two major complications (4.5%) requiring surgical intervention occurred: leak and hematoma.Data were analyzed by t test for independent samples using Statistica 12.5 software. P value <0.05 was considered statistically significant.Surgical treatment of patients with ZD should be individualized. Large Zenker diverticula with the septum longer than 6 cm should preferably be resected through an open approach because it is not possible to remove the septum completely during one-step endoscopic procedure and diverticulostomy creates a weak and large common cavity in the esophagus. Surgical repair is effective for all sizes of diverticula, but its most serious complications such as leakage or laryngeal nerve injury should be considered, especially in elderly patients with comorbidities. However, age alone should not be the main criterion if choosing the treatment option.

Sustainable development has by now become an element deeply integrated in the everyday design. It has many shades and may be found under many names. We speak about resiliency in design and procurement of passive, ecologic, plus energy, or nZEB buildings. Nevertheless, if we look closely, we may distinguish certain characteristic ideas. First, sustainable development of societies and urbanization processes should be consistent on a deeper level than presently, and be included within design processes, organization, and planning, as well as modernization and redevelopment procedures of existing urban tissue. Secondly, urbanization should be perceived holistically, as an interaction and harmonious development of both natural and manmade environments, with solutions based on the best technical and technological standards available. Lastly, described ideas are achievable only, if we include continuous cooperation between urban planners, architects, specialist consultants, as well as energy-efficient interdisciplinary solutions to achieve high standard energy measures. One of the thresholds is economic feasibility; the other is health and well-being of the users which should always be discussed as a priority. This paper-outside a brief theoretical approach to initial procedures in design management-will dwell on transformation and modernization of an existing building belonging to the Warsaw University of Technology, one of the oldest universities in Poland, its founding dating back to the beginning of the twentieth century. In 2015, a Nordic Finance Mechanism grant dedicated to the nZEB technology transfer from Norway to Poland was awarded to a group of researchers from Warsaw University of Technology and NTNU Trondheim. The main aim of the project is implementation of nZEB knowledge in Poland, as well as preparation of two integrated concept designs for public (University) buildings as exemplary case studies which could act as the benchmarks for other public buildings.

No abstract

No abstract