1,721,014 research outputs found
Pediatric esophageal high-resolution manometry: utility of a standardized protocol and size-adjusted pressure topography parameters
No full textGastrointestinal and nutritional problems in neurologically impaired children
Full text linkThe current increasing survival of children with severe central nervous system damage has created a major challenge for medical care. Gastrointestinal and nutritional problems in neurologically impaired children have been recently recognized as an integral part of their disease, often leading to growth failure and worsened quality of life for both children and caregivers. Nutritional support is essential for the optimal care of these children. Undernourished handicapped children might not respond properly to intercurrent diseases and suffer unnecessarily. On the other hand, restoring a normal nutritional status results in a better quality of life in many. The easiest and least invasive method to increase energy intake is to improve oral intake. However, oral intake can be maintained as long as there is no risk of aspiration, the child is growing well and the time required to feed the child remains within acceptable limits. When oral intake is unsafe, insufficient or too time consuming, enteral nutrition should be initiated. Damage to the developing central nervous system may result in significant dysfunction in the gastrointestinal tract and is reflected in impairment in oral-motor function, rumination, gastro-oesophageal reflux (GER), with or without aspiration, delayed gastric emptying and constipation. These problems can all potentially contribute to feeding difficulty in disabled children, carrying further challenging long-term management issues
Laparoscopic esophagomyotomy for the treatment of achalasia in children: a preliminary report of eight cases
No full textBackground: Albeit rare in children, achalasia is a disorder
with severe symptoms that causes growth impairment. The
treatment of choice in children is the esophagomyotomy,
although there are variations in the surgical approaches
available and differences of opinion regarding the inclusion
of an adjunctive antireflux procedure. The recent advent of
the laparoscopic approach has had a profound impact on the
treatment of achalasia in both adults and children.
Methods: In this report, we describe eight patients with
severe achalasia who were treated by laparoscopic Heller’s
operation associated with a fundoplication according to either
Dor’s or Toupet’s technique. The patients’ ages ranged
between 2 and 13 years. A five-port technique was used: a
10-mm port placed infraumbilically for the optics and four
5-mm ports. One was placed in the right abdominal quadrant
for retraction of the left hepatic lobe, one in the left
abdominal quadrant for the first operative instrument, one
below the xyphoid appendix for the second operative instrument,
and the last one to introduce a 5-mm cannula
laterally to the umbilicus to retract the stomach below. A
7–8-cm laparoscopic Heller esophagomyotomy was completed,
followed by an anterior Dor fundoplication in six
cases and a Toupet in two. The longitudinal division of the
anterior esophageal musculature was performed with a scalpel
or scissors. The myotomy was made along the stomach,
extending for $2–3 cm.
Results: Mean operating time was 120 mins. Three complications
were recorded. There were two perforations of the
gastroesophageal mucosa; the first was sutured in laparoscopy
and the second required a second operation. The third
complication was a case of dysphagia resolved by dismounting
a fundoplication that was too tight. At follow-up,
which lasted from 6 months to 5 years, the children were all
free of symptoms.
Conclusions: Laparoscopic Heller esophagomyotomy appears
to be a complex and difficult operation, but it is as safe
and effective as laparotomy in children with achalasia.
However, complications can be numerous and severe at the
beginning of a surgeon’s experience
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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