1,720,961 research outputs found
Chirurgia dei meningiomi negli anziani: “si può fare!”, Zoia C, Cattalani A, Bongetta D, Minelli M, Adinolfi D, Gaetani P,
No full textDirect fascia lata reconstruction to reduce donor site morbidity in endoscopic endonasal extended surgery: a pilot study
No full textObjective: Fascia lata is a validated source of autologous grafts, adopted by many surgical figures throughout different types of reconstructive procedures. Postoperative pain and muscle prolapse are frequent complications after harvesting fascia lata; donor site morbidity causes delayed mobilization and increased lenght of hospital stay. In our department fascia lata is used as autologous graft in reconstruction of skull base after extended endoscopic transsphenoidal surgery (EETS) and the thigh defect is usually repaired with allograft to restore tissue continuity and avoid muscle prolapse. Our aim was to evaluate the post-operative pain and muscle prolapse in a group of patients who underwent EETS with fascia lata reconstruction with allograft. Methods: We retrospectively analyzed clinical data of 11 patients who underwent harvesting and reconstruction of fascia lata during EETS, collected in our department of Neurosurgery between January 2012 and September 2015. "Pain on rest" and "pain on walking" data were collected daily according to the Numerical Rating Scale (NRS) system, during hospital stay until sutures removal and 1 month after surgery. Furthermore, the degree of muscle prolapse was analyzed at the time of sutures removal and 1 month following surgery. Results: 11 patients were studied between January 2012 and September 2015: 4 men and 7 women (1:1.75). Mean age 53.6±11.1years. During the post-operative stay, "pain on rest" and "pain on walking" values of all patients did not exceed grade 4 of NRS. While removing sutures, "pain on rest" resulted grade 1 of NRS in 27.3% (3/11) patients, while "pain on walking" was grade 1 of NRS in 18.2% (2/11) and grade 2 in 9.1% (1/11). After a month of surgery "pain on rest" reduced to NRS grade 1 in 9.1% (1/11), while patients NRS results for "pain on walking" were the same as the previous evaluation. Mean duration of hospital stay was 5.7±2.28 days. 10 patients were discharged home, only 1 patient was transferred to a rehabilitation ward. No visible nor palpable muscle prolapse was found in our group of patients during the entire assessment. Conclusion: Findings show how fascia lata reconstruction with allograft reduced post-operative discomfort and muscle prolapse in our serie; it also permitted their early mobilization and discharge. These are promising results. However further studies are needed to see this technique approved
Outcome of elderly patients undergoing intracranial meningioma resection: a single center experience
Full text linkHigher life expectancy and higher mean age in general population created growing interest in medical and surgical management of meningiomas in elderly. It is well known that, due to possible complications, pre-operative status and comorbidities, expecially in aged people, should be carefully considerated in the decision-making process. We described our experience with this kind of patients and analized the influence of complications on the outcome
Transcranial color-coded duplex sonography for evaluation of midline-shift after chronic-subdural hematoma evacuation (TEMASE): A prospective study
No full textAbstract
OBJECTIVE:
The incidence of chronic Subdural hematoma (cSDH) is increasing and its rate of recurrence varies from 5 to 33%. A postoperative brain midline-shift (MLS) on computed tomography (CT) equal or larger than 5mm is a risk factor for recurrence. Transcranial color-coded duplex sonography (TCCDS) is a noninvasive bedside reproducible technique useful to detect MLS. The aim of our study was to compare in patients affected by cSDH, the values of MLS obtained pre- and post-operatively by TCCDS and brain CT.
PATIENTS AND METHODS:
32 patients affected by cSDH entered the study between July 2016 and January 2017. MLS values obtained by TCCDS and brain CT were compared using Bland-Altman plot and linear regression analysis. Using the same techniques we also explored if the agreement between the two imaging modes was comparable in pre- and post-operative data pairs.
RESULTS:
64 data pairs of MLS values obtained by TCCDS and CT were analysed. Bland-Altman diagrams did not show any systematic bias of the data and linear regression indicated a significant correlation between the two measures both before and after hematoma evacuation.
CONCLUSION:
In patients affected by cSDH, MLS values obtained before and after surgery by TCCDS are comparable to those obtained by CT; TCCDS might be considered an alternative to CT scan in the management of patients after cSDH evacuation. We suggest that close clinical bedside examination and TCCDS might be appropriate for the post-operative management of cSDH, reserving CT scan only to patients with overt clinical deterioration and/or increasing MLS
I monitoraggi neurofisiologici nella chirurgia tumorale del rachide, la nostra esperienza, R. Pugliese, F. Lombardi, V. Silvani, V. Custodi, M. Tachimiri, A. Cattalani, D. Bongetta, D. Adinolfi, P. Gaetani,
No full text
Can scoliosis lead to spinal cord ischaemia? Early diagnosis and rehabilitation: A paradigmatic case report and literature review
No full textINTRODUCTION: Scoliosis is frequently associated with pain and radiculopathy, but it is not considered a possible cause of acute spinal cord injury (SCI). Here we present a case report in which scoliosis was apparently linked to spinal cord ischaemia.CASE PRESENTATION: A 20-year-old woman with conservatively treated severe scoliosis presented with acute spinal cord infarction, which occurred during a spinal flexion while she was tidying up the bed. Other causes of SCI were excluded. Early rehabilitation was started and the patient progressively regained motor and sensory functions, with an AIS reduction from A to C. Bowel and bladder disorders persisted and were autonomously managed with a trans-anal irrigation device and intermittent catheterisation after voluntary micturition.DISCUSSION: Early detection and management of spinal curvature disorders are essential in preventing long-term complications of scoliosis. Although the aetiology of spinal cord ischaemia in severe scoliosis should be better clarified, this rare case report suggests that scoliosis might be involved in its pathogenesis. Thus, we recommend early diagnosis of spinal curvature disorders and adequate rehabilitative treatment in order to prevent potential subsequent neurological complications
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
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