1,720,960 research outputs found
Pulsed radiofrequency for low-back pain and sciatica
No full textLow-back pain is usually defined as pain, muscle tension, or stiffness localized below the costal margin and above the inferior gluteal folds, with or without leg pain (sciatica). The annual prevalence of low-back pain with leg pain traveling below the knee lies between 9.9% and 25% [1]. About 90% of patients with low-back pain will have symptoms without a clear-specific cause. The presence of nerve root problems is an indicator of possible underlying pathology [2]: the most common cause of lumbar radicular pain is intervertebral disc herniation (DH), followed by failed back surgery (FBSS) and spinal stenosis (SS) [3].
Medication (paracetamol, NSAIDs, opioids) is a possible option for the treatment of radicular pain, but there is a lack of evidence to support the prescription of any particular drug [4]. Noninvasive non – pharmacological interventions, which consist in physical exercise (biomechanical, aerobic, mind-body or a combination of approaches) with or without manual therapy (spinal manipulation, mobilization, and massage) or psychological therapy have outcomes that are often not long-lasting [5,6]. Epidural corticosteroid injection has been widely used in clinical practice for many years, but it should be recommended as a means of reducing pain in the short term although no longterm effects can be expected, with a complication rate ranging between 0% and 9.65%. Transforaminal injection (TFESI) under radiological guidance seems to be more effective than epidural injection [4]. Surgery (discectomy, microdiscectomy, and other microsurgical techniques) is usually recommended in selected patients with severe symptoms and no benefit from conservative treatment, or in case of major neurologic impairment. Surgery provides for a better short-term pain relief as compared to prolonged conservative care, but no significant differences have been found between surgery and conservative treatment after one or 2 years [7]. Moreover, surgery is associated with several side effects [8].
Pulsed radiofrequency (PRF) is a relatively new noninvasive technique that relies on the intermittent administration of high-frequency current, avoiding temperature to rise beyond the critical level of 42°C, described as the threshold for neuronal damage. Thus, PRF is based on a different mechanism of
action from conventional continuous radiofrequency (CRF), where temperature easily rises above this critical value because of continuous administration, inducing tissue heating and thermal coagulation
Magnetic resonance guided focused ultrasound surgery (MRgFUS) of bone metastases: from primary pain palliation to local tumor control
Full text linkPurpose: To evaluate the clinical performance of MRgFUS in primary pain palliation of painful bone metastases and in local tumor control. Materials and Methods: We enrolled 26 consecutive patients (female/male 12/14; age: 64.7±7.5yrs) with painful bone metastases. Before and 3 months after MRgFUS treatment pain severity and pain interference scores were assessed according to Brief Pain Inventory-Quality of Life (BPI-QoL) criteria and patients underwent both CT and MRI. Local tumor control was evaluated according to lesion size, density and perfusion at CT, dynamic contrast enhancement at MRI (Discovery 750HD, GE; Gd-Bopta, Bracco) and metabolic activity at PET or scintigraphy. Patients were classified as responders or non-responders. Results: No treatment-related adverse events were recorded during the study. As statistically significant difference between baseline and follow-up values for both pain severity and pain interference scores was observed (p<0.05). Increased bone density was observed in 9/26 (34.6%) patients. Non-Perfused Volume values ranged between 20% and 92%. There was no difference in NPV values between responders and non-responders (46.7±24.2% [25 - 90 %] vs. 45±24.9% [20 - 93 %]; p=0.7). In 6 patients (5 prostate and 1 breast primary cancer) there was nearly absence of metabolic activity after treatment (mean SUV=1.2). Conclusion: MRgFUS can be safely and effectively used as the primary treatment for pain palliation in patients with painful bone metastases; moreover our experience demonstrated also a potential role for the MRgFUS in local tumor control
Uterine myomas: focused ultrasound surgery
No full textUterine fibroids are the most common neoplasm in women. These lesions may be associated with impaired fertility and adverse obstetric outcomes. Medical treatment, myomectomy, hysterectomy and uterine artery embolization have been employed for the management of uterine fibroids. Focused ultrasound surgery (FUS) is a relatively recent technique that relies on mechanical and thermal energy of ultrasound for the ablation of a target tissue under an imaging guidance, that can be either ultrasound (US-guided FUS, USgFUS) or magnetic resonance (MR-guided FUS, MRgFUS). Pre- and peri-menopausal women are potential candidates for treatment; however, individual criteria need to be evaluated in order to establish the eligibility for the procedure. FUS procedure can be performed in an outpatient setting; it is a safe and effective treatment that has demonstrated to reduce symptoms associated with uterine fibroids. The adverse event rate is 8.7% and only 0.2% of patients experiences major complications. Pregnancy is possible after the treatment, and no damage to the endometrium has been observed following FUS procedure
Pleuritis with pleural effusion due to a Bacillus megaterium infection
No full textPleural effusions may be related to pleuro-pulmonary or systemic disorders, including malignancy. Thoracentesis and thoracoscopy may be useful to diagnosis. In some cases, the diagnosis may be difficult and uncommon. We report the case of a hospitalized male for a pleuritis, with pleural effusion caused by a Bacillus megaterium infection, a Gram-positive, aerobic, spore-forming, and rod-shaped bacterium. To our knowledge, our case report is the first evidence of pleuritis due to B. megaterium. In the literature, up to now, B. megaterium infection has only been reported as involving the eye, skin, and brain
Non-invasive focal therapy of organ confined prostate cancer with magnetic resonance guided focused ultrasound surgery
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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
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe 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
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