1,720,969 research outputs found
Surgical treatment of splenic hydatidosis: Report of a case
No full textHydatid disease is a zoonitic infection caused by Echinococcus granulosus and rarely by multilocularis, that affects predominantly liver, to a lesser extent lung and occasionally other organs. This paper discusses a case study conducted at our Institute to evaluate the surgical management of splenic hydatidosis, and to illustrate the utility of a range of new techniques.
Splenic involvement alone is a rare event, even in endemic countries; many patients have no symptoms and its diagnosis can be either made fortuitously during diagnostic procedures such as chest or abdomen X-ray, or based on the appearance of those local symptoms caused by the pressure of growing cyst.
The treatment of hydatidosis traditionally consists of surgery, either conservative or radical, along with a perioperative course of antielmintic medications.
A number of therapeutic options for splenic localization exist, including conservative treatments such as Percutaneous Aspiration, Injection and Reaspiration (PAIR), cyst enucleation and partial splenectomy; and radical interventions such as total splenectomy.
The splenectomy remains today, as it was in the past, the treatment of choice for the radical treatment of the disease under consideration because of its associated rates of low mortality, low relapse and low hemorrhagic complications. The laparoscopic approach has to be reserved for well-selected cases: small cysts without adhesion to others organs
Incidental thyroid carcinoma (ITC): a retrospective study in a series of 737 patients treated for benign disease
No full textAim: aim of the study is to evaluate correlations between incidental thyroid carcinoma (ITC) and benign thyroid pathologies (BTP), to determine the most represented histotype and to point out the total thyroidectomy’s possible advantages in terms of radicality, follow-up management and incidence of complications.Materials and Methods: during 10 years, 739 patients underwent thyroid surgery for BTP. Fine needle biopsy (FNAB) was negative in all cases; 503 total thyroidectomies(TT), 5 subtotal thyroidectomies(ST) and 231 emithyroidectomies(ET) were performed.Results: the specimens pathological examination revealed the presence of a ITC in 82 patients (11,1%); the prevalent histotype was the papillary one with a less than 1cm diameter in almost the totality of cases but with nodes metastasis in the 3,6% of cases. Complications were detected in 117 patients with a morbidity rate of 15,8%. Discussion: in our study the ITC prevalence was of 11,1% similar to literature with a higher incidence in patients affected by multinodular than uninodular goiter. No statistical significant differences were found between euthyroid and toxic pathologies. In our series hyperthyroidism doesn’t seem to hold a protective role towards the ITC onset. Conclusions: The ITC incidence is relevant; the prevalent histotype is papillary and nodes metastasis are present even if in a low percentage of cases. Besides, the complications of TT are similar to conservative procedures. The recurrence of goiter and ITC require a second surgical procedure, with a higher risk of complications. So we can claim that the standard surgical treatment of bilateral PBT would be represented by TT
A rare case of acute abdomen in the adult: The intestinal duplication cyst. case report and review of the literature
Full text linkIntroduction: Duplications of the gastrointestinal tract are rare congenital anomalies that can occur anywhere throughout the gastrointestinal tract. The reported incidence is 1/4500, and more than 80% occurs before the age of two as an acute abdomen or bowel obstruction. The most common site is Ileum (60%), while the colonic localisation is reported between 4 and 18%. Presentation of the case: Herein we report the case of a 35-year-old man, presented at the Emergency Department with fever and localised abdominal pain in the right iliac fossa. Preoperative abdominal ultrasound and CT scan showed a cystic mass of 44 × 43 × 70 mm adjoining the posterior wall of the right colon. He underwent explorative laparoscopy, laparotomy conversion, right hemicolectomy with an intra-operative diagnosis of colonic duplication cyst, confirmed by histology. Discussion: The review of the literature showed as the intestinal duplication cysts are rare congenital anomalies. The clinical presentation is variable and depends on the site and the related complications. A surgical approach based on the resection of the involved bowel tract is the treatment associated with the best long-term outcomes. Conclusion: It is important to include intestinal duplication in the differential diagnosis of acute abdomen, to ensure the best therapeutic strategy
CYTOREDUCTIVE SURGERY AND HIPEC IN A 14 YEARS OLD PATIENT WITH PERITONEAL RECURRENCE OF ADENOCARCINOMA OF THE RIGHT COLON
Full text linkIntroduction Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is nowadays a feasible and effective treatment for peritoneal metastasis. We present a case of a 14 years old child with peritoneal metastasis from recurrent colorectal cancer. Presentation of case Colonoscopy and CT-scan were performed leading to the diagnosis of a stenosing adenocarcinoma of the right colon in 2015. Two pelvic lesions were found at the total body PET scan, suspected for peritoneal metastasis. Neoadjuvant chemotherapy was administered, and restaging CT-scan and magnetic resonance (MRI) highlighted a partial response. The patient underwent right laparoscopic hemicolectomy. The postoperative staging was T4 N1 G3. Seven months after the last cycle of adjuvant chemotherapy, CT-scan revealed two huge abdominal masses. The patient underwent explorative laparotomy and bilateral oophorectomy, positive for metastasis from colorectal cancer and peritoneal washing cytology was positive for neoplastic cells. A CT-scan was performed on December 2017 showed a suspect lesion below the anterior abdominal wall. The case was discussed at the tumour board and the indication for CRS and HIPEC was given. In January 2018 the child underwent complete CRS and HIPEC with no complications. No adjuvant chemotherapy was administered. After 11 months the follow up is negative for the recurrent disease. Discussion and Conclusion Cytoreduction and HIPEC can be performed even in children as a feasible and safe treatment with successful outcomes. As for adults, an appropriate multidisciplinary pre-operative work up and a correct cases selection is needed to have the best results even regarding the quality of life
A novel surgical approach with peritonectomy to extranodal multisystemic histiocytic sarcoma: A case report and literature review
No full textHistiocytic sarcoma (HS) is a very rare malignant histiocytic derivation cancer. The extranodal multisystemic HS has an aggressive clinical course and poor Disease-Free Survival (DFS) and Overall Survival (OS). There are no shared and effective therapeutic protocols; our approach aims to improve the prognosis for advanced diseases
Use of strictureplasty technique for surgical treatment of ileal endometriosis: a case series
Full text linkIntestinal deep infiltrating endometriosis is the most frequent extragenital
localisation and its traditional surgical treatment is segmental resection of
the affected tract. The need for implementing alternative techniques in the
treatment of intestinal endometriosis arises from those cases of multiple
ileal and recto-sigmoidal localisations, in which removing excessive lengths
of intestine could lead to a higher rate of adverse events. Ileal
endometriosis represents 4.7% of all intestinal localisations, often
associated with multiple lesions and yet, to the best of our knowledge, there
are no data on techniques other than intestinal resection for its treatment.
Since its capacity to solve fibrostenotic lesions without removing
centimeters of intestine, strictureplasty is widely implemented in the
management of Crohn’s disease. We propose the use of strictureplasty for
the treatment of ileal endometriosis. We performed surgical treatment for
symptomatic deep infiltrating endometriosis in two patients with either ileal
and sigmoidal localisations. We approached ileal nodules with
strictureplasty technique, while sigmoidal nodules were removed by
traditional segmental resection. No complications occurred and both
patients are now asymptomatic after a 12 months-follow up. Therefore,
strictureplasty could provide a tool to eliminate small bowel endometriosis
maintaining a regular caliber of the ileal tract without modifying its length
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
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