1,721,168 research outputs found
Organizational aspects in one phlebology center: the Tuscany model [Aspetti organizzativi di un Centro di Flebologia: il modello toscano]
No full textThe author reports about the organization of the phlebology center at the University of Siena, directed since 1985 by Professor Mancini. The center is equipped with 5 phlebology outpatient settings, with own instruments for non-invasive vascular diagnostics, with one operating theatre and with own equipment for phlebological rehabilitation. At present, in this center a group of specialist doctors and experts in phlebological formation works and practices everyday more than 30 performances instrumental vascular diagnostic both in election, both also in urgency for the patients coming from the Ready Aid. The therapeutic performance, which the phlebology surgical activity, the sclerotherapy, the ulcer dressing, are carried out on specific days of the week. The organization of the Center of Phlebology has to answer indeed to the demands of the use, simplifying the procedures of access, decreasing the times of attended of the diagnostic performance and the therapeutics and the reducing to the least one the interferences with the common habits of life, kind of the elderly patient
Venous leg ulcers infected by Stenotrophomonas maltophilia
Full text linkStenotrophomonas maltophilia is a ubiquitous bacterium, aerobic, non-fermentative, belonging to the gram-negative group, closely linked to Pseudomonas species. It is the only species of Stenotrophomonas known to infect the human race and it is an opportunistic pathogen typical in the debilitated patients. The most common sites of infections by Stenotrophomonas Maltophilia are lungs, kidney, circulatory system and skin. Risk factors such as the use of broad-spectrum antibiotics, long periods of hospitalization, chemotherapy-induced neutropenia, parenteral nutrition increases the possibility of contracting the infectious process. A 48 years old man came to our attention at the outpatient clinic of the Phlebological Unit of Siena Hospital for the presence of venous ulcers and edema of lower legs. The patient has been suffering from leg ulcers for about ten years and he was followed in several hospitals in Tuscany region. The ulcers are revived after the discontinuation of antibiotic therapy. A bacterial culture was carried out at our microbiological laboratory and it highlighted the presence of Stenotrophomonas Maltophilia. Then after results of antibiotics susceptibility testing the therapy has been established with Trimethoprim/Sulfametoxazole two tablet die for three weeks. At the end, it was repeated the buffer with culture test that confirmed to be negative. The ulcer lesion of patient is currently in slow, but progressive increase. In our clinical experience this bacterium is a germ is expanding, since on 31 crop tests run in the last year this is already the second, equal to 6% of the total. If we look at the potential danger of this bacterium in patients with multiple illnesses, the elderly with complex drug therapies as are patients who come to our clinics we can see the need for a continuous monitoring of bacterial flora to prevent first evolution up to paintings by cellulitis, cutaneous necrosis and ectyma gangrenosum and mucocutaneous ulcers up to more serious forms like urinary tract infections, endocarditis, bacteremia, septicemia, meningitis. The prevention of infection with Stenotrophomonas maltophilia is very important and this can be achieved through the education of health personnel to prevent the transmission and spread of the bacterium, the regular cleaning and disinfection of medical instruments and surfaces, the routine handwashing protocol of Tuscany, the regular maintenance of hospital equipment and replacement of defective and worn parts, and the targeted use of antibiotics in order to limit antimicrobial resistance and the spread of the organism. Is therefore of particular importance an appropriate antibiotic selection and the establishment of surveillance systems in place to monitor possible contamination of the environment
The Lazarus’ syndrome
No full textAim: In the last 10 years, endovascular procedures have taken over on saphenous stripping in rich countries. The recent literature is full of scientific papers that magnify the results of endovascular procedures, and guidelines in many countries attribute to them the role of a new golden standard in the treatment of varicose disease. But surely in the world there are still some surgeons who perform saphenous stripping in patients in which the indication is placed after preoperative ultrasound analysis. Therefore stripping is not dead and cannot yet be buried. Methods: In our experience the traditional ablative surgery in the treatment of patients with varicose veins of the lower limbs (CEAP 2-6) is always in the first place and continues to be performed in a percentage that approaches 70% compared to the total of phlebological interventions performed annually. Over the past 3 years on a total of 858 patients (554 F and 304 M) aged between 22 and 84 years, 590 patients (68.7%) underwent saphenectomy by stripping, often associated with multiple phlebectomies of the thigh and/or leg. Results: With the various techniques used there was neither mortality, nor infectious complications. We complain about a case of hematoma in the thigh in a subject operated by stripping in anticoagulant treatment, because of serious heart disease. No thrombotic complication, neither immediate nor at 3-month follow-up, has been documented. Conclusion. Our current experience makes us conclude that surgery still represents for long-term efficacy the therapeutic strategy of reference, but it is undeniable that the endovascular procedures for their minimally invasiveness, fewer complications, reduced need for general anesthesia, quicker return to work and equivalent recurrence rates, are destined to become in the near future the gold standard for treatment of varicose disease. However, due to the heterogeneity of the diseases, it is not possible to perform only one type of operation for all varicose patients, and probably saphenous stripping will always have a role, though reduced over time
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
Highly stereoselective direct aldol reactions catalyzed by (S)-NOBIN-L-prolinamide
No full text(S)-NOBIN-L-prolinamide was employed as organocatalyst in the direct aldol reactions of different ketones and aromatic aldehydes using dioxane as solvent and in the presence of water as additive. Acetone led to the aldol products in up to 93% ee, while cyclic ketones furnished the anti-aldols in moderate to high yield, excellent diastereoselectivity (up to > 99/< 1 anti/syn ratio) and high ee (up to 95%)
MACROLIDE, LINCOSAMIDE, STREPTOGRAMIN AND TETRACYCLINE TRANSFERABLE RESISTANCE IN THE BACTEROIDES-FRAGILIS GROUP
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