1,721,038 research outputs found
Bilateral shoulder pain after a generalized tonic-clonic seizure: case report of an acute undiagnosed bilateral fracture of proximal humerus
No full textBilateral shoulder fracture is a rare event and convulsive epileptic seizure is one of the most common causes. Detailed physical and neurovascular examination are important but shoulder’s antero- posterior and axillary radiographs are essential to reveal a possible fracture and/or dislocation. Diagnosis could be difficult and often missed because of the importance given to patient’s neurological issue. We present a case of a young man with an acute undiagnosed bilateral fracture of proximal humerus as complication of a generalized tonic-clonic seizure. After seven days we performed a surgical procedure of bilateral reduction and osteosynthesis with angular stability plate and screws
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Computer Tomography Prototyping and Virtual Procedure Simulation in Difficult Cases of Hip Replacement Surgery.
No full textEach year approximately 1 million total hip replacements (THR) are performed worldwide. A percentage of failure due to surgical approach and imprecise implant placement still exists. These result in several serious complications. We propose an approach to plan, to simulate, and to assist prosthesis implantation for difficult cases of THR based on 3-D virtual models, generated by segmenting patients' CT images, 3-D solid models, obtained by rapid prototyping (RP), and virtual procedure simulation. We carried out 8 THR with the aid of 3-D reconstruction and RP. After each procedure a questionnaire was submitted to the surgeon to assess the perceived added value of the technology. In all cases, the surgeon evaluated the 3-D model as useful in order to perform the planning. The clinical results showed a mean increase in the Harris Hip Score of about 42.5 points. The mean time of prototyping was 7.3 hours, (min 3.5 hours, max 9.3 hours). The mean surgery time was 65 minutes (min 50 minutes, max 88 minutes). Our study suggests that meticulous preoperative planning is necessary in front of a great aberration of the joint and in absence of normal anatomical landmarks, CT scan is mandatory, and 3-D reconstruction with solid model is useful
The Use of ECMO and Free‐Fillet‐Leg Flap for Complex Pelvic Reconstruction: A Case Report
No full textAdvanced sarcoma treatment in complex anatomical regions such as the pelvis poses significant surgical challenges. This report details a case involving a 35-year-old man with recurrent osteosarcoma of the left hemipelvis, who underwent a 16 h surgery for hemipelvectomy and reconstruction using a free tibia and fibula fillet leg flap. The procedure, necessitated by an infected, exposed iliac prosthesis, utilized extracorporeal membrane oxygenation (ECMO) for 8 h to maintain flap viability. The flap, incorporating tibia, fibula, and associated musculature was successfully inset and anastomosed to the left common iliac artery and vein, with additional venous anastomosis to the right iliac vein. Despite postoperative challenges such as venous stasis and intestinal ischemia, necessitating further surgical interventions, the patient achieved mobility with a walker at 3 months post-surgery, with stable conditions observed during a 2 years follow-up. ECMO enabled successful preservation and integration of the free fillet leg flap, demonstrating its potential in complex reconstructive surgeries. Specifically, ECMO may extend free flap viability in complex cases, offering new possibilities for challenging oncological and reconstructive surgeries
The fifty most cited Italian articles in the orthopaedic literature
No full textIt is widely known that in Orthopaedics, as in each specialty, the academic influence of an article is also determined by the number of times the article is cited. The aim of this study was to identify the 50 most frequently cited Italian orthopaedics journal articles and to analyse the characteristics that might have made them more citable.
METHODS:
Science Citation Index Expanded was searched for the 50 most frequently cited Italian orthopaedics journal articles between 1988 and 2013 in the subject category "Orthopaedics".
RESULTS:
The 50 most frequently cited articles were all published in English and were published in 12 of the 67 journals in the subject category "Orthopaedics" in the Institute for Scientific Information Web Science (Thomson Reuters, New York, New York, USA). One half of the articles were published before 2000 and the other half later. The number of citations ranged from 423 of the first article (mean citation/years 21.15) to 83 of the fiftieth (mean citation/years 16.60). The articles were all categorized under orthopaedic field, but each of them spanned from orthopaedics to a specific sub-specialty. The majority was clinical articles (n = 39), and the most common fields were sport orthopaedic surgery (including arthroscopy and cartilage) (n = 19) and biomechanics (n = 12).
CONCLUSIONS:
This list of 50 most frequently cited Italian articles is, to our knowledge, significantly important for the general orthopaedic scientific community, particularly for the Italian orthopaedic community. Researchers and doctors may use this work to make their future publications more influential and citable
UTILIZZO DI MODELLI TRIDIMENSIONALI VIRTURALI E REALI, OTTENUTI MEDIANTE PROTOTIPAZIONE RAPIDA, PER IL TRAINING CHIRURGICO IN CHIRURGIA PROTESICA DELL’ANCA
No full textIntroduzione: Scopo del presente lavoro è di valutare l’utilizzo
di tridimensionali paziente specifici virtuali e reali (3D printing)
non solo come strumento di pianificazione chirurgica ma anche
come strumento di training chirurgico nella chirurgia protesica
dell’anca.
Materiali e Metodi: Il modello 3D dell’articolazione coxo-femorale
viene ottenuto mediante un processo di segmentazione
semi-automatica delle immagini TC del paziente realizzato con
un apposito tool, denominato “EndoCAS segmentation Pipeline”
basato sul software open-source ITK Snap 1.5. Una volta ottenuto
e validato da parte del chirurgo il modello 3D Virtuale viene
esportato in formato STL ed inviato alla stampa tridimendisionale
(Elite Dimension-Stratasys) in modo da generare il modello 3D
reale del Paziente in ABS. A scopo di training chirurgico sono
stati quindi costruiti dei simulatori chirurgici (e-SPres3D s.r.l), in
cui il modello 3D dell’articolazione coxo-femorale è stato inserito
all’interno di un emibacino in materiale morbido sul quale il discente
può eseguire il test di impianto. Sono stati quindi istituiti
dei corsi surgeon to surgeon basati sull’utilizzo di questi simulatori
ed alla fine di ciascun corso a ciascun discente è stato
sottoposto un questionari di valutazione.
Risultati: Dai questionari somministrati i primi feedback ottenuti
dagli utilizzatori sono stati molto incoraggianti. Il modello solido
dell’articolazione riesce a riprodurre in maniera abbastanza fedele
la complessità chirurgica del Paziente e permette, di eseguire
simulatori di difficoltà crescente ai fini della realizzazione di percorsi
di formazione strutturati
Discussione: Come evidenziato da altri lavori presenti in letteratura
eseguire il planning in ambiente tridimensionale con l’utilizzo
di modelli 3D virtuali e reali consente di ottimizzare la scelta del
tipo impianto (forma, fissazione, dimensione, posizionamento) in
base alla specifica anatomia del paziente fino a rendere evidente
la necessità, in casi particolari, di utilizzare componenti su misura
“custom made”. L’utilizzo di questi stessi modelli a fini di
formazione chirurgica rappresenta una nuova opportunità che
a differenza del training su cadavere consente di poter scegliere
in anticipo, da una libreria di pazienti, il grado di complessità del
caso ed adattarlo a livello di esperienza del chirurgo (da corsi
base → a corsi avanzati).
Conclusioni: Riteniamo che l’utilizzo dei modelli 3D paziente
specifici virtuali e reali rappresentino un valido strumento per una
precisa pianificazione di casi complessi di sostituzione protesica
di anca. L’utilizzo di simulatori basati su modelli 3D si è dimostrato
uno strumento molto utile a fini didattici e di formazione
chirurgica consentendo a chirurghi una vera e propria simulazione
della procedura sia in ambiente virtuale sia in ambiente reale
mediante l’esecuzione di prove di impianto sul modello solido
Prospective Randomized Controlled Trial of Two Different Intramedullary Nails for Pertrochanteric Fractures of the Femur
No full textThe purpose of this prospective randomized trial was to assess whether an intramedullary nail is superior or not to another one in the treatment of pertrochanteric fractures. Eighty-one patients with a 31-A1 or A2 Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) pertrochanteric fracture were randomly allocated to fixation with either the Gamma® or the ENDOVIS® nail. In order to estimate the functional outcome the Parker-Palmer mobility score, Barthel Index, and EuroQol-5D (EQ-5D) were used. All patients were followed up at 1, 3, 6, and 12 months postoperatively. There was no statistical difference in Parker mobility score between groups. The statistical analysis revealed that there was no significant difference between the two patient groups as far as the operating time, the amount of blood transfused, and the latest functional outcome. Both kinds of intramedullary nails used in our study provide effective methods of treatment for intertrochanteric fractures in elderly patients. Our data showed slightly worse results for the ENDOVIS nail compared with the Gamma nail, but this did not reach a statistical significance
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