262,312 research outputs found
Going Beyond Counting First Authors in Author Co-citation Analysis
No full textThe 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
Endoscopic endonasal clipping of a ruptured vertebral-posterior inferior cerebellar artery aneurysm: technical case report
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Management of cerebrospinal fluid leaks according to size. Our experience
No full textObjective: We present our experience in the reconstruction of cerebrospinal fluid (CSF) leaks according to their size and location. Material and methods: Fifty-four patients who underwent advanced skull base surgery (large defects) and 62 patients with CSF leaks of different origin (small and medium-sized defects) were included. Large defects were reconstructed with a nasoseptal pedicled flap positioned on fat and fascia lata and lumbar drainage was used. In small and medium-sized leaks of other origin, intrathecal fluorescein 5% was applied previously to identify the defect. Fascia lata in an underlay position was used for reconstruction, which was then covered with mucoperiosteum from the turbinate. Perioperative antibiotics were administered for 5-7 days. Nasal packing was removed after 24-48 hours. Results: The most frequent aetiology for small and medium-sized defects was spontaneous (48.4%), followed by trauma (24.2%), iatrogenic (5%) and others. The success rate was of 91% after the first surgery and 98% in large skull base defects and small/medium-sized respectively. After rescue surgery, the rate of closure achieved was 100%. The follow-up was 15.6 +/- 12.4 months for large defects and 75.35 +/- 1.3 months for small/medium-sized defects without recurrence. Conclusions: Endoscopic surgery for closure of any type of skull base defect is the gold standard approach. Defect size does not play a significant role in the success rate. Fascia lata and mucoperiosteum allow a reconstruction of small/medium-sized defects. For larger skull base defects, a combination of fat, fascia lata and nasoseptal pedicted flaps provide a successful reconstruction. (C)2013 Elsevier Espana, S.L. All rights reserved
Neurosurgeon-otolaryngologist collaboration in endonasal approaches to the clivus and suprasellar region
No full textEndoscopic endonasal surgery for pituitary tumors. Results in a series of 121 patients operated at the same center and by the same neurosurgeon
No full textIntroduction: Pituitary adenomas account for approximately 15% of intracranial benign tumors. The neurosurgical results achieved since the endoscopic endonasal transsphenoidal (EET) approach was introduced in our center in 2005 are reported here. Patients and methods: A retrospective analysis of 121 patients with sellar lesions (58% females, age 55.7 16 years, range 18-82) who underwent EET surgery from February 2005 to January 2012 and were followed up for a mean time of 4.58 years (range 1.08-8.58). Results: Six Rathke cleft cysts (3 intra-suprasellar, 1 intrasellar, 2 suprasellar); 114 pituitary adenomas (16 microadenomas, 98 macroadenomas), and 1 case of normal MRI were included. Baseline findings included hormonal changes in 59 patients (48.7%) and visual field changes in 38 patients (31%); in 7 patients (5.8%), clinical presentation was pituitary apoplexy. Complete resection was achieved in 77 patients (63.6%), subtotal resection in 29 (23.9%), and partial resection in 15 (12.3%). In patients with Grade 3 and 4 cavernous sinus invasion, resection was subtotal in 30% (12/39) and complete in 46% (18/39). Hormonal remission was achieved in 16 patients with Cushing disease (84%), 18 patients with prolactinoma (78.2%), and 18 patients with acromegaly (85.7%). There were 12 cases (9%) of cerebrospinal fluid leak, 4 cases of diabetes insipidus, and 3 cases with transient SIADH/hyponatremia. Seven patients developed panhypopituitarism. Postoperative mortality rate was 2.4%. One hundred and three patients (85.3%) were discharged from the hospital less than 48 h after surgery. Conclusion: Our results are similar to those reported by renowned pituitary units. Results achieved using an endoscopic approach in pituitary neurosurgery are better than those of microneurosurgery for cavernous sinus invasion. (C) 2013 SEEN. Published by Elsevier Espana, S.L.U. All rights reserved
Endoscopic endonasal surgery for skull base tumours: technique and preliminary results in a consecutive case series report
No full textBackground: The introduction of the endoscope in transsphenoidal surgery has allowed access to lesions located in complex regions of the skull base under direct visual control. With the application of this technique, our group started treating pituitary tumours and from 2009 onwards began treating skull base lesions through extended endoscopic endonasal approaches. The aim of the present study is to report our experience with extended endoscopic approaches. Indications, results, limitations and complications of this new technique are also discussed. Material and methods: From January 2007 to January 2012, the endonasal approach was used in 40 patients with different cancerous lesions. Results: Total tumour removal, as assessed by postoperative magnetic resonance imaging, occurred in 30/40 patients (75%), but in 10 patients only partial removal was possible. Major complications, including cerebrospinal fluid leak, were observed in 5/40 patients (8%). One patient died 3 months after surgery due to a severe systemic sepsis. Conclusion:The extended endoscopic endonasal approach could be used as a minimally invasive and innovative technique for the removal of selected skull base lesions
Protecting Animals 36: Author Witi Ihimaera
No full textIn this very special episode of Knowing Animals I am joined by beloved New Zealand author Witi Ihimaera. Witi has written many books featuring nonhuman animals. He offers us a non-colonial lens through which to think about the human/nonhuman relationship
Author Under Sail The Imagination of Jack London, 1893-1902
No full textIn Author Under Sail, Jay Williams offers the first complete literary biography of Jack London as a professional writer engaged in the labor of writing. It examines the authorial imagination in London's work, the use of imagination in both his fiction and nonfiction, and the ways he defined imagination in the creative process in his business dealings with his publishers, editors, and agents. In this first volume of a two-volume biography, Williams traverses the years 1893 to 1902, from London's "Story of a Typhoon" to The People of the Abyss. The Jack London who emerges in the pages of Author Under Sail is a writer whose partnership with publishers, most notably his productive alliance with George Brett of Macmillan, was one of the most formative in American literary history. London pioneered many author models during the heyday of realism and naturalism, blurring the boundaries of these popular genres by focusing on absorption and theatricality and the representation of the seen and unseen. London created an impassioned, sincere, and extremely personal realism unlike that of other American writers of the time. Author Under Sail is a literary tour de force that reveals the full range of London as writer, creative citizen, and entrepreneur at the same time it sheds light on the maverick side of machine-age literature.Intro -- Title Page -- Copyright Page -- Dedication -- Contents -- Acknowledgments -- Introduction -- 1. Spirit Truth -- 2. From Absorption to Theatricality and Back Again -- 3. "I Will Build a New Present" -- 4. Sons as Authors -- 5. Fathers as Publishers -- 6. The Daughter as Author -- 7. Lovers as Authors -- 8. At Sea with the Family -- 9. Yellow News, Yellow Stories -- 10. The Return Home -- Notes -- Bibliography -- Index -- About Jay WilliamsIn Author Under Sail, Jay Williams offers the first complete literary biography of Jack London as a professional writer engaged in the labor of writing. It examines the authorial imagination in London's work, the use of imagination in both his fiction and nonfiction, and the ways he defined imagination in the creative process in his business dealings with his publishers, editors, and agents. In this first volume of a two-volume biography, Williams traverses the years 1893 to 1902, from London's "Story of a Typhoon" to The People of the Abyss. The Jack London who emerges in the pages of Author Under Sail is a writer whose partnership with publishers, most notably his productive alliance with George Brett of Macmillan, was one of the most formative in American literary history. London pioneered many author models during the heyday of realism and naturalism, blurring the boundaries of these popular genres by focusing on absorption and theatricality and the representation of the seen and unseen. London created an impassioned, sincere, and extremely personal realism unlike that of other American writers of the time. Author Under Sail is a literary tour de force that reveals the full range of London as writer, creative citizen, and entrepreneur at the same time it sheds light on the maverick side of machine-age literature.Description based on publisher supplied metadata and other sources.Electronic reproduction. Ann Arbor, Michigan : ProQuest Ebook Central, YYYY. Available via World Wide Web. Access may be limited to ProQuest Ebook Central affiliated libraries
Estudi prospectiu epidemiològic i socioeconòmic sobre el diagnòstic i el tractament de la rinosinusitis aguda a les consultes d’otorinolaringologia d’Espanya - Estudi PROSINUS
No full textPrograma de Doctorat en Medicina i Recerca Translacional[cat] La Rinosinusitis aguda és una malaltia amb una alta incidència en la població. Tot i que el diagnòstic és clínic i l’evolució és majoritàriament auto-limitada, la hipòtesis principal d’aquesta tesis fou que els metges empren excessives proves diagnòstiques i medicaments. Així doncs, l’objectiu principal de l’estudi PROSINUS va ser descriure l’ús d’eines de diagnòstic i de medicaments prescrits en pacients amb RSA, tot comparant-ho amb el recomanat per les guies internacionals i analitzant els costos associats.
Es tracta d’un estudi observacional prospectiu on es van incloure 1.610 pacients amb
diagnòstic clínic de RSA procedents de consultes d’ORL arreu d’Espanya. Es van fer
dues visites principals, a la inclusió. i 2-4 setmanes després. Segons la durada dels símptomes (classificació EPOS), els pacients amb RSA van ser classificats com a RSA viral (refredat comú) o RSA post-viral, i amb diferents nivells de gravetat. Es van avaluar les característiques sociodemogràfiques, els símptomes, la gravetat, la qualitat de vida (SNOT-16), les eines de diagnòstic i els medicaments utilitzats. Es va comparar el maneig realitzat abans de la inclusió (pels metges generals) i entre visites (per l’otorinolaringòleg). Els costos directes es van calcular sumant el cost unitari de les visites mèdiques, de l’ús d’eines de diagnòstic i de la prescripció de medicaments. Els costos indirectes es van estimar basant-se en estudis previs.
D’entre els pacients inclosos, el 36% tenia RSA viral, el 63% RSA post-viral i l’1% es va cronificar. Essent l’única eina de diagnòstic recomanada la rinoscòpia/endoscòpia, en la RSA post-viral es van sol·licitar un nombre més elevat (p<0,05) de proves de diagnòstic que en la RSA viral: rinoscòpia/endoscòpia nasal (80% vs. 70%),
radiografia simple (70% vs. 55%) y TC (22% vs. 12%). Els metges d’atenció primària
van realitzar més radiografies (45% vs. 36%, p<0,0001) que els especialistes ORL, que
van realitzar més rinoscòpies/endoscòpies (68% vs. 27%, p<0,0001) i TC (15% vs.
5%, p<0,0001). Essent el tractament recomanat purament simptomàtic ± corticoides intranasals, els pacients amb RSA post-viral van rebre més medicaments que els amb RSA viral: antibiòtics orals (76% vs. 62%), corticoides intranasals (54% vs 38%),
antihistamínics (46% vs 31%), mucolítics (48% vs 60%), fitoteràpia (46% vs 41%).
Els metges de família van receptar més antibiòtics orals (53% vs 39%, p<0,0001),
antihistamínics (26% vs 22%, p=0,0068) i mucolítics (45% vs 21%, p<0,0001) que
els especialistes ORL. Tanmateix, els especialistes ORL van prescriure més fitoteràpia
nasal (39% vs 9%, p<0,0001) i més corticoides intranasals (30% vs 26%, p=0,0721)
que els metges d’atenció. primària. Independentment de la medicació emprada, la
qualitat de vida (SNOT-16) es va veure més afectada en la RSA post-viral (38,7±14,2,
p<0,05) que en RSA viral (36,0±15,3), mentre que la proporció. de pacients amb
símptomes suggestius de complicacions va ser superior a la RSA post-viral (2,8%,
p<0,05) que a la RSA viral (0,4%). En global, els costos directes per episodi van ser superiors a la RSA post-viral que a la viral (441,1±344,3€ vs 322,3±301,2€, p<0,001). En la RSA post-viral els costos van ser també superiors a la viral per a les visites mèdiques (328,4±301,9€ vs 245,0±265,4€, p<0,001), eines de diagnòstic (61,9€±78,8 vs 38,1±64,0€, p<0,001) i medicaments prescrits (50,8±25,3€ vs 39,2±25,9€, p<0,001)
En conclusió aquest estudi suggereix un ús excessiu d’eines diagnòstiques i de
prescripcions de medicaments, fet que implica que a RSA, no bacteriana i no complicada, representa una càrrega socio-econòmica important.[eng] Background: Acute rhinosinusitis (ARS) have a high incidence in the general population. Although diagnosis is clinical and evolution is mostly self-limited, there is and overuse of diagnostic tools and medications which increases direct medical costs of disease.
Objectives: To describe the sociodemographic characteristics and use of diagnostic tools and medications in patients with ARS, and to quantify the direct medical costs of ARS management in Spain.
Design: In a prospective observational study, 1.610 patients with clinical diagnosis of non-bacterial, non-complicated ARS in Spain were included. According to the duration of symptoms by EPOS, patients with ARS were classified as having viral or postviral ARS with different levels of severity. Sociodemographic characteristics, symptoms, disease severity, quality of life (Sino-Nasal Outcome Test-16), used diagnostic tools and
medications, and the management performed by primary care physicians (PCPs) and by otorhinolaryngologists (ORLs) were assessed. Direct medical costs were calculated according to medical visits, use of diagnostic tools, and prescribed medications.
Results: Of the patients 36% were classified as having viral ARS, 63% post-viral ARS and 1% as chronic rhinosinusitis. A higher number of diagnostic tools (rhinoscopy/endoscopy: 80% vs. 70%; plain X-ray: 70% vs 55%; CT scan: 22% vs. 12%; P<0.0001) were performed in post-viral than viral cases. Patients, more those with post-viral than viral ARS, received a high number of medications (oral antibiotics: 76% vs. 62%; intranasal corticosteroids: 54% vs. 38%; antihistamines: 46% vs 31%; mucolytic: 48% vs. 60%; P<0.0001). ARS resolution was obtained after 6.04 (viral) and 16.55 (post-viral) days, with intranasal corticosteroids being associated with longer (OR: 1.07, 95% 1.02 to 1.12) and phytotherapy with shorter (OR: 0.95, 95% CI 0.91 to 1.00) duration. Overall, the direct medical costs per episode were €322.3±301.2 vs. €441.1±344.3 for viral and post-viral ARS episodes respectively (p<0.001)
Conclusions: There is a significant overuse of diagnostic tools and prescribed medications, predominantly oral antibiotics, by PCPs and ORLs, for viral and post-viral
ARS. The direct medical costs of post-viral ARS episodes were higher than viral. Non-complicated non-bacterial ARS represents an important socio-economical burden due to an excessive number of medical visits, use of diagnostic tools, and prescribed medications
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