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Endoskopinis ūminės storosios žarnos obstrukcijos gydymas
Get PDFKęstutis Adamonis, Dainius Pavalkis, Žilvinas Saladžinskas, Algimantas Tamelis
KMU Gastroenterologijos klinika, KMU Chirurgijos klinika
Šiuolaikis virškinimo trakto piktybinės obstrukcijos gydymas vis labiau tampa minimaliai invazinis. Ligoniai, sergantys storosios žarnos vėžiu, komplikuotu obstrukcija, į gydymo įstaigas patenka skubos tvarka, neretai sunkios būklės, ir nėra idealūs kandidatai chirurginei operacijai. Šiuolaikinėje medicinos literatūroje gausėja mokslinių straipsnių apie sėkmingą ir saugų endoskopiniu būdu įkišamų savaime išsiplečiančių metalinių stentų naudojimą proktologijoje. Nors stentai ir yra brangūs, tačiau proktologinis stentavimas yra rentabili procedūra, leidžianti ligoniams, sergantiems storosios žarnos vėžiu, komplikuotu ūminė storosios žarnos obstrukcija, išvengti neatidėliotinos operacijos, o esant nerezektabiliam vėžiui, – kolostomos. Straipsnyje aprašomas KMU Chirurgijos klinikoje atliktas pirmasis Lietuvoje sėkmingas endoskopinis ūminės žarnų obstrukcijos gydymas stentuojant žarnyną.
Prasminiai žodžiai: žarnyno obstrukcija, kolorektinis vėžys, endoskopija, stentavimas.
Acute colonic obstruction: endoscopical management
Kęstutis Adamonis, Dainius Pavalkis, Žilvinas Saladžinskas, Algimantas Tamelis
Management of malignant gastrointestinal obstruction presents a significant challenge. Most patients are in a profoundly decompensated state due to underlying malignancy and are not ideal candidates for invasive surgical procedures. In recent years, self-expandable metal stents have emerged as an effective and safe, less invasive alternative for the treatment of malignant intestinal obstruction. Although stents are expensive, the procedure appears to be cost-effective, since emergency surgery can be avoided in patients with acute bowel obstruction, and in those with advanced disease no resection of the colon is necessary. Here we report a retrospective analysis of a first self-expandable metal stent placed for colorectal obstruction at Kaunas Medical University Hospital, as well as review the literature published on self-expandable metal stent placement. Our first data confirm self-expandable metal stent efficacy in palliation of malignant intestinal obstruction.
Keywords: intestinal obstruction, colorectal cancer, endoscopy, endoluminal stenting
Nudegusių ligonių ir jų žaizdų patogenų analizė
No full textRokas Bagdonas, Algimantas Tamelis, Rytis Rimdeika, Mindaugas Kiudelis
Įvadas / tikslas
Didžiausia nudegimų chirurgijos problema yra infekcija, nuo kurios miršta daugiau kaip 50% visų nudegusių pacientų. Nudegimų žaizda greitai infekuojasi, kadangi žaizdos aplinka yra ideali mikroorganizmams atsirasti ir daugintis. Studijoje, patvirtintoje Universiteto etikos komiteto, analizuojami nudegę pacientai ir iš nudegimo žaizdų išskirti patogenai.
Pacientai ir metodai
Mes analizavome 2246 nudegusius pacientus (amžiaus vidurkis – 27 metai), gydytus KMU Chirurgijos klinikose 1997–2002 metais. Nudegimo sunkumas buvo vertintas pagal Amerikos nudegimų asociacijos (ABA) schemą. 2462 nudegimo žaizdos pasėliai (2246 pacientų) buvo paimti steriliu tamponu ir pasėti 5% kraujo ir MacConkey terpėse.
Rezultatai
Iš nudegusių pacientų 1447 (74%) buvo vyrai ir 799 (26%) – moterys (p < 0,001). Pacientų amžius – nuo 2 iki 47 metų. 1261 (56%, p < 0,05) pacientai patyrė lengvą, 522 – vidutinį ir 463 – sunkų kūno nudegimą. 2130 pasėliai (86,5%), paimti iš 2462 nudegimo žaizdų, buvo teigiami. Iš 2130 teigiamų pasėlių Staphylococcus aureus išskirtas 1110 (52,1%) pasėliuose, iš jų MRSA – 498 (23,4%).
Išvados
Jauni vyrai dažniausiai patiria lengvus kūno nudegimus. Nudegimo žaizda dažniausiai infekuojasi S. aureus mikroorganizmais. MRSA yra pagrindinis ligoninės patogenas, infekuojantis nudegimo žaizdą.
Prasminiai žodžiai: nudegimo sunkumas, nudegimo žaizdos patogenai, išskirti sukėlėjai
Analysis of burn patients and the isolated pathogens
Rokas Bagdonas, Algimantas Tamelis, Rytis Rimdeika, Mindaugas Kiudelis
Kaunas Medical University, Clinic of Surgery,
Eivenių str. 2, LT-50009, Kaunas, Lithuania
E-mail: [email protected]
Background / objective
The major challenge for a burn team is infection, which is known to cause over 50% of burn deaths. Burns become infected, because the environment at the site of the wound is ideal for the proliferation of infecting organisms. This study, approved by the regional Ethics Committee, analyzes the features of burned patients and the rates of pathogens isolated from burn wounds.
Patients and methods
We studied 2246 burn patients (mean age 27 years) admitted to the tertiary academic hospital in 1997–2002. The differentiation of the severity of burn injury was based on the scheme of the American Burn Association (ABA). 2462 surface swabs for microbiological analysis were taken from all 2246 patients. The wound area was swabbed with an alginate swab and cultured in 5% blood and MacConkey agar.
Results
There were 1447 (74%) men and 799 (26%) women (p < 0.001), age range 2–47 years. There were 1261 patients (56%, p < 0.05) with minor, 522 with moderate and 463 with major burn injuries. 2130 swabs (86.5%) out of 2462 burn wound surface swabs were positive. Out of 2130 isolates positive for pathogenic bacterial culture, there were 1110 (52.1%) isolates positive for Staphylococcus aureus infection. The rate of MRSA was 23.4% (498 isolates).
Conclusions
Young male patients mostly have a minor burn injury. Burn wounds are most commonly infected with S. aureus. MRSA is still the main hospital pathogen in burns.
Keywords: severity of the burn injury, burn swabs, isolated pathogen
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe 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
Get PDF“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
Get PDFWe 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
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
Author-wise bibliometric analysis based on entropy.
No full textAuthor-wise bibliometric analysis based on entropy.</p
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