1,720,989 research outputs found
Computer-assisted quantitative assessment of prostatic calcifications in patients with chronic prostatitis
No full textBackground: The aim of this study was the development of quantitative assessment of prostatic calcifications at prostatic ultrasound examination by the use of an image analyzer. Materials and Methods: A group of 82 patients was evaluated by medical history, physical, and transrectal ultrasound examination. Patients had a urethral swab, a 4-specimen study and culture of the seminal fluid. Patients were classified according to National Institute of Diabetes and Digestive and Kidney Diseases/National Institutes of Health. Subjective symptoms were scored by Chronic Prostatitis Symptom Index (CPSI) questionnaire. Ultrasound images were analyzed by the digital processing software Image J to quantitatively assess the presence of calcifications. Results: Computer-assessed calcified areas were significantly higher in chronic bacterial prostatitis (n = 18; group II; 6.76 ± 8.09%) than in the chronic pelvic pain syndrome group IIIa (n = 26; 2.07 ± 1.01%) and IIIb (n = 38; 2.31 ± 2.18%). The area of calcification of the prostate was significantly related to the CPSI score for domains of micturition (r = 0.278, p = 0.023), Prostatic Specific Antigen values (r = 0341, p = 0.005), postvoiding residual urine (r = 0.262, p = 0.032), total prostate volume (r = 0.592, p = 0.000), and adenoma volume (r = 0.593; p = 0.000). Conclusions: The presence of calcifications is more frequently observed in patients with chronic bacterial prostatitis and is related to urinary symptoms
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
The role of preoperative controlling nutrtional status (CONUT) score in the assessment of pathological features and survival outcomes in clear-cell renal cell carcinoma (ccRCC): A population-based study
No full textAim of the study: To assess the correlation between pre-operative assessment of CONUT score and pathological features, overall survival (OS) and recurrence-free survival (RFS) in patients with primary diagnosis of clear-cell renal cell carcinoma and no evidence of clinical nodal/distant metastatic disease before surgery.
Materials and methods: We retrospectively review clinical data of patients treated with radical nephrectomy from 2006 to 2017. Lymph node dissection was performed for cases with intraoperative evidence of lymphadenopathy or at surgeons’ discretion for patients deemed to be at high risk for occult nodal metastases at the time of surgery. A population of 110 patients were enrolled. For each patient CONUT score was determined considering the values of pre-operative albumin, total cholesterol and lymphocyte count. ROC curve was calculated and an optimal cut-off point was set at 1. Patients were divided into 2 categories: low (≤1) and high (≥) CONUT score. Univariate and multivariate analysis were performed. RFS and OS rates were calculated and compared between the two groups.
Results: High-CONUT patients were more frequently males ( p = 0.002) with pre-operative high mean fibrinogen level ( p = 0.001), longer mean hospitalization ( p = 0.012), even with no differences in Clavien- Dindo score ( p = 0.32) and more severe pathological features ( pT stage ≥3, p = 0.002; pN+, p = 0.005; venous thrombus, p = 0.036) than low- CONUT patients. No differences were observed in mean age and follow-up between the two cohorts. On multivariate analysis high- CONUT was significantly associated with worse OS (HR 10.96, 2.31– 52.15; p = 0.003), even if it didn’t result as an independent factor, comparing to age (HR 0.06, 0.02–0.29; <0.0001) and pT stage ≥3 (HR 2.63, 1.41–4.91; p = 0.002). High-CONUT wasn’t significantly asso- ciated with worse RFS (HR 1.41, 0.47–4,21; p = 0.54).
Discussion: CONUT score is a low time-consuming and a good cost- effective tool, which can be easily derived from blood values that are routinely checked before surgery. In this population-based study we found that in patients diagnosed with primary ccRCC with a clinical organ-confined disease, a pre-operative high-CONUT score was a strong predictor of worse pathological stage, lymphonode status and presence of renal vein thrombosis
Gender affirming surgery: Vaginoplasty and clitoroplasty with modified peno-scrotal flap technique
No full textIntroduction & Objectives: Surgical management of female-to-male transsexual patients has been recently discussed.There is no consensus about the best surgical technique to obtain satisfying aesthetic and functional results. In this video we aim to describe step by step our surgical technique for vaginoplasty with inverted penoscrotal flap and clitoroplasty with urethral flap and report aesthetic and functional outcomes according to our post-operative care program.
Materials & Methods: In 2011 we introduced a new technique of neoclitoroplasty aimed to improve functional and aesthetic results. We reviewed retrospectively data stored in a perspective maintained database of 37 patients who underwent male-to-female gender affirming surgery in our tertiary referral hospital between April 2014 and September 2018.
Results: 37 Patients new recruited in this study. Median age at surgery was: 35 years (24-46). All patients had taken hormone therapy for at least one year before surgery. 36 Patients were heterosexual, 1 was homosexual. Median follow-up was 28,5 months (6-58). Median intraoperative neovaginal depth was 11 cm (7,5-13,5). At 3 months follow up 35 patients were continuing daily dilation program, median neovaginal depth was 12cm (3-14 cm). 2 Patients discontinued dilation program after surgery and both developed neovaginal stenosis. 7 Patients had erogenous sensitivity and ability to achieve orgasm, 6 patients referred penetrative vaginal intercourse. 6 Patients reported history of sporadic or recurrent cystitis. At 6 months follow-up 32 patients were continuing daily dilation program, median neovaginal depth was 11,5 cm (0-14 cm). 3 Patients discontinued daily dilation program but referred frequent penetrative sexual intercourses and to perform dilation once or twice per week: all of them maintained neovaginal depth, none developed neovaginal stenosis. 20 Patients had penetrative sexual intercourse and 18 of them also erogenous sensitivity and ability to achieve orgasm. 5 patients referred history of sporadic or recurrent cystitis. In the group of 19 patients with follow-up >24 months, 14 patients referred satisfying neovaginal penetrative intercourse with ability to achieve orgasm.
Conclusions: Over the years many techniques have been proposed and are currently in use but research is still ongoing in order to achieve better possible results in terms of functional and aesthetical outcomes. All patients treated who were interested in penetrative neovaginal intercourse and regularly followed vaginal dilation program referred comfortable sexual relationships, 90% of them are able to achieve orgasm. To our experience importance of daily vaginal dilation should be stressed before sex reassignment surgery and during follow-up. Considering these results the technique presented could be considered a valid option to create an aesthetically pleasant neovagina with erogenous sensitivity
Utility of serum markers in the assessment of perioperative and postoperative morbidity and mortality after radical cystectomy
No full textAim of the study: Despite significant improvements in surgical techniques, radical cystectomy (RC) remains a highly morbid operation. The ability to predict complications and create prevention
strategies is crucial in the surgical decision-making process and to optimise treatment outcomes. Recently, there is growing interest in the association of preoparetive inflammation and immuno-nutritional serum markers with postsurgical complications and survival out- comes. The aim of this study was to investigate and compare the ability of preoperative Controlling Nutritional Status (CONUT), Prognostic Nutritional Index (PNI), neutrophil to lymphocyte ratio (NLR), platlet to lymphocyte ratio (PLR), lymphocyte to monocyte ratio (LMR), systemic immune-inflammation index (SII), albumin, fibrinogen and PCR to predict perioperative and postoperative morbidity and mortality after RC.
Materials and methods: We retrospectively evaluated 164 patients who underwent open RC for muscle-invasive bladder cancer (MIBC) at our Institute between December 2004 and June 2018. We excluded those patients who received neoadjuvant therapy and patients in whom data were incomplete. Covariates were analyzed to determine associations with complication rates (according to the Clavien-Dindo system), mean hospitalization length, 30-days readmission rates and 90-days mortality. A multivariable binomial logistic regression determined associations with postsurgical outcomes taking into account age, sex, urinary diversion, pT stage and each serum marker, or American Society of Anesthesiologists (ASA) classification and Charlson Comorbity Index (CCI) categorization.
Results: Cut-off values to discriminate threshold of these biomarkers were determined calculating the ROC curve and the maximum Youden index. We included 164 patients underwent RC for MIBC. The mean age at surgery was 72.1 years (range, 46–88) and the majority of urinary diversions were ileal conduit (78.1%). Overall, 44(26.8%) patients experienced a major complication (Clavien grade≥3) and there were 9(5.5%) deaths within 3 months of surgery. ASA, CONUT, NLR, PLR, SII and PCR showed statistically significant differences in distribution of complications (all p < 0.05). There were no differences in mean hospitalization length while CONUT, PNI, fibrinogen, PCR, SII and CCI were statistically associated with 30-days readmission. Fibrinogen was the only serum marker associated with 90-days mortality (p=0.01). Multivariable binomial logistic regression ana- lysys confirmed the association of CONUT, SII, ASA, NLR, PCR and fibrinogen with surgical complications (all p < 0.05).
Discussion: Preoperative inflammation and immuno-nutritional serum markers based on standard laboratory measurements may be simple and inexpensive potentially effective risk-assessment tools to predict outcomes after RC. Further investigations should be necessary to confirm these results
Preoperative impact of albumin to fibrinogen ratio (AFR) on oncological outcomes in patients with muscle invasive bladder cancer treated with radical cystectomy
No full textAim of the study: Recent evidence has demonstrated that coagulation is associated with tumor progression in various cancers. Fibrinogen, an essential protein in the coagulation cascade and an acute phase element, plays an important role in cancer: different studies have reported that high preoperative fibrinogen level is associated with tumor development and indicates poor prognosis in some malignan- cies. Moreover, it is known that malnutrition is a predictor of progression in several types of cancer and albumin is a commonly used index in clinical practice to assess nutritional status. The aim of the study was to investigate the ability of the albumin to fibrinogen ratio (AFR) to predict survival outcomes in patients affected by muscle invasive bladder cancer (MIBC) treated with radical cystectomy (RC). Materials and methods: We retrospectively evaluated data from 122 patients who underwent RC for MIBC at our Institute with a minimum follow-up of 12 months. AFR score was calculated based on the serum albumin concentration and plasma fibrinogen. Patients were classified into two groups: those with low AFR and those with high AFR. Univariate and multivariate analysis were performed. Recurrence-free (RFS) and Overall Survival (OS) rates were calculated and compared between the two groups. To the best of our knowledge no study in literature have combined albumin with fibrinogen in patients with MIBC.
Results: Cut-off value to discriminate between low and high AFR score was determined calculating the ROC curve: the area under the curve was 0.78 with an optimal cut-off of 9.53 points. 41(33.6%) patients had low AFR. Distribution of data in low and high AFR groups as mean age at surgery (72.3 ± 8.8 vs 71.1 ± 8.9, p = 0.35), sex (male 23 vs 44 and female 18 vs 37, p = 0.85), presence of high grade disease (39 vs 72, p = 0.33) lymphovascular invasion (LVI) (16 vs 27, p = 0.55), adjuvant chemotherapy (24 vs 58, p = 0.16), mean BMI (25.2 ± 3.9 vs 26.4 ± 4.3, p = 0.17) and urinary diversion were not statistically different between two groups. Pathological features as pT and pN stages were statistically different (0.01 and 0.03 respectively). OS and RFS rates were calculated with a mean follow-up greater in high AFR group (55.2 ± 39.2 vs 37.7 ±34, p = 0.02). Results of the multivariate analysis, after adjustment for age, pT, pN, LVI, surgical margins (R) and ASA score, revealed that AFR was an independent predictor of RFS (HR 4.21, 2.25–7.88; p < 0.001) and OS (HR 1.82, 1.01–3.32, p < 0.001).
Discussion: AFR is a potential prognostic predictor of both OS and RFS in patients with MIBC who underwent surgery. Further investigations should be necessary to confirm the good potential of this malnutri- tion-inflammation related tools
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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