1,721,036 research outputs found
Laparoscopic treatment for perforated gastroduodenal ulcer: direct repair surgical technique
Full text linkPerforated peptic ulcer (PPU) disease represents about 5% of abdominal surgical emergencies. The sooner the patient is operated, the better the outcome is going to be. Surgery can be performed by either an open or a laparoscopic approach. In general, in the hemodynamically stable patient and in the absence of absolute contraindications (i.e., cardiac/pulmonary contraindication to pneumoperitoneum, simultaneous bleeding in unstable patients, expected hostile abdomen), a minimally invasive approach is a safe and feasible option allowing for decreased postoperative pain and length of hospital stay without significant increased rates in suture line leakage, intra-abdominal collection and postoperative ileus. No consensus exists as to how to perform the repair of the perforation site. According to the latest World Society of Emergency Surgery (WSES) and European Association of Endoscopic Surgery (EAES) guidelines, the choice of the closure technique should depend on the lesion characteristics. When the margins can be easily brought together without tension, primary repair by direct suturing is indicated. So far, no recommendations are made on the use of an omental patch, as literature evidence is sparse. Damage control surgery should be considered in case of big holes (diameter >2.0–2.5 cm), poor local conditions (i.e., ischemic, necrotic, or severely inflamed margins, difficult to mobilize), and patient’s instability. The present article is accompanied by a video describing a standard laparoscopic direct closure technique in a step-by-step and self-explanatory manner, which will help the reader to visualize the key steps of the procedure
An uncommon case of inferior vena cava injury during atrial fibrillation ablation
Full text linkA 64-year-old man underwent catheter ablation (CA) of atrial fibrillation with intracardiac echocardiography (ICE) assistance. As the probe was advanced toward the right atrium, sudden abdominal pain was felt by the patient with hypotension and tachycardia requiring fluids and vasopressors for hemodynamic stabilization. The inferior vena cava (IVC) was injured by the passing probe and open repair was then performed. To our knowledge, this is the first reported case of symptomatic IVC laceration by the probe used for ICE during CA
Costal fracture assessment for relief and enhancement of quality of life-CARE study
No full textPURPOSE: Rib fractures account for 10-15% of trauma-related hospital admissions. Few data are available regarding long-term follow-up of patients undergoing non-operative management. Our aim is to evaluate quality of life at 1, 2, 4, 12 and 24 weeks from the trauma. Pain management, respiratory infection rate and length of hospitalization (LOS) will be recorded. METHODS: Patients with rib fractures older than 18 years of age will be prospectively included. EXCLUSION CRITERIA: cognitive impairment, chronic pain due to pathologic fractures, active cancer. Patients will be asked to complete a specific survey at 1, 2, 4, 12 and 24 weeks from the trauma to assess their quality of life. Pain management, respiratory infection rate and LOS will be recorded. CLINICALTRIAL: gov ID NCT06405841. RESULTS: The study will provide a detailed quality of life assessment for patients with rib fractures treated conservatively. It will identify the most effective types of analgesic therapies in controlling rib fracture-related pain, respiratory infections rate, and LOS. CONCLUSIONS: The results could have broad practical applications, providing guidance on best practices for rib fracture treatment. This could lead to greater efficacy in management protocols, reducing or increasing the need for surgical interventions. The study could have a significant impact on the health-care system by providing evidence to optimize healthcare resources through more targeted management. If the results demonstrate that conservative treatment is ineffective for certain types of fractures, these patients could be selected for surgical treatment, resulting in savings for the healthcare system and improvement in patient quality of life
Implementing recycling in the operating room: a single-center experience
No full textBackground: Climate change poses significant challenges to global health, exacerbated by healthcare systems' carbon footprint and waste generation. Surgical activities contribute to these impacts, necessitating sustainable practices to mitigate environmental harm. This study aims to assess the feasibility and effectiveness of a recycling program in reducing waste, carbon emissions, and disposal costs in the operating rooms (ORs). Methods: The study was conducted from June 2023 to April 2024, focusing on 2 elective surgery ORs. A recycling program was implemented in four phases: Preliminary Monitoring Phase (Months 1-3), Data Analysis, Planning and Preparation (Months 4-6), Program Implementation (Months 7-18), and Monitoring (monthly). Results: Initial data collection revealed substantial waste production and associated emissions and costs in both ORs. Through the implementation of the recycling protocol, we successfully recycled a total of 2548.7 kg of waste, representing 21.80% of the total waste generated. This effort resulted in a reduction of CO2 equivalent by 5133.25 kg (11.56%) and achieved cost savings of €2203.30 (13.47%). Conclusions: Implementing recycling practices in ORs is feasible and effective in reducing environmental impact and costs associated with waste disposal. The findings underscore the importance of structured recycling initiatives in healthcare settings to achieve sustainable practices and mitigate climate impact
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
Resuscitative thoracotomy for non‐traumatic tension viscerothorax
Full text linkA case of acute herniation of small bowel in thorax after blunt trauma is described, emphasizing the necessity ao a resuscitation emergency thoracotom
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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