1,721,106 research outputs found
Major thoracic trauma - sternal trauma
No full textFrom 1999 to 2003, 101 patients (M/F = 83/18, mean age = 46 ± 18 y) with thoracic trauma have been admitted to the (.enter for Thoracic Surgery in Varese. Over 50% of pts. with major thoracic trauma were treated by chest tube drainage; however, surgery was necessary just in 16/101 pts.; 29 pts. were admitted to ICU; deaths were 3/101. The Authors recorded 23/101 sternal fractures. Routine blood test, chest radiography and FKC were performed in all patients; in case of abnormal FKCi, echocardiography was performed; in case of widened mediastinum, chest CT was mandatory. 13/23 pts. showed associated injuries, 12 pts. a non-aligned sterna! fracture, 7 pts. mediastinal hematoma. Simple observation in hospital was indicated in 15/23 pts. with sternal fractures; chest tubes were positioned in J pts. (hemopneumothorax) and one patient was surgically treated because of painful sternal pseudoarthrosis (2 months after trauma). Admission in ICU was necessary in 3 pts. with non-aligned sternal fracture, mediastinal hematoma and associated injuries. No patient with sternal fracture died. Copyright © 2005 Edizioni Luigi Pozzi
Intraoperative localization of gut endocrine tumors with radiolabeled somatostatin analogs and a gamma-detecting probe
No full textGut endocrine tumors are sometimes difficult to localize by radiological techniques. Carcinoids and gastrinomas, however, possess high density of somatostatin receptors, thus, scintigraphy with radiolabeled somatostatin analogs may prove useful for detection of occult gastroenteropancreatic endocrine tumors when conventional diagnostic methods fail. A novel method of radioguided surgery with a hand-held gamma-detecting probe (GDP) has been used to localize gut endocrine tumors by binding radiolabeled somatostatin analogs. We also applied the method in a patient with occult carcinoid: after injecting 125-Iodine (125I)-octreotide intraoperatively, we obtained accurate localization of the jejunal carcinoid and of a liver metastasis previously undetected. Seventeen cases of gut endocrine tumors detected by this technique that have been reported in the literature are reviewed and discussed. Intraoperative localization of gastrointestinal endocrine tumors with radiolabeled somatostatin analogs and a GDP expands the possibility of accurate tumor detection one step beyond that obtained by conventional imaging and by intraoperative inspection and palpation
A tool to assess and certificate the skills in the operating room according to the LaNTS model (life and non-technical skills)
No full textIntroduction: Operating Room (OR) department is a dynamic business environment involving teamwork and advanced technology together with a population of patients with multiple problems and high productivity demands. Tension between the contradictory aims of efficiency and safety may produce risks for adverse incidents. Multiple factors are critical to achieving patient safety, including teamwork, managerial and organizational factors, individual resources, cognitive abilities and work environment Aim: The aim of this study was to describe and compare attitudes to patient safety among the various professionals in Operating Room (OR) in Northern Greece Hospitals. Methods: A quantitative survey with the Safety Attitudes Questionnaire (SAQ) - OR version was used to obtain estimations from surgical teams. The SAQ-OR version was translated into Greek and comprises 36 items. The answers are based on respondent experiences in OR where they work, given on a 5-point Likert scale: 1=Disagree Strongly, 2=Disagree Slightly, 3=Neutral, 4=Agree Slightly and 5=Agree Strongly.The sample size of this research included 150 operating room nurses and 65 physicians or surgeons. For the data analysis, the statistical package SPSS v.22 was utilized. Results: The mean for surgical team members shows that respondents’ attitudes to patient safety were overall positive regarding teamwork climate. Job satisfaction, safety climate, working conditions and stress recognition had lower mean scores. Surgeons rated working conditions significantly higher than did perioperative nurses and perceptions of management significantly higher than did or nurses. Although perceptions of management showed the lowest scores in both professional teams
Ileo-anal anastomosis and ileal pouch. Surgical treatment of complications
No full textThe percentage of complications that request a reoperation after total colectomy with ileo-anal anastomosis is around 20-40%, varying by casistics. Amongst complications, the most frequent is pouchitis, which needs a reoperation only when medical therapy is not successful in controlling the inflammatory process. Reoperation consists in pouch resection and rebuilding. An excessively long efferent loop may cause an impaired emptying of the pouch, fecal incontinence, transanal prolapse and stenosis of the loop itself. In these cases it is useful to shorten the efferent loop, with or without a reduction of diameter of the pouch. The case of a patient affected by ulcerative pancolitis, who underwent surgery repeatedly, with ileal pouch and ileo-anal anastomosis after total colectomy is reported. Because of a progressive difficulty in evacuating, with no stimulus to defecation and lower abdominal pain, and a preoperative diagnosis of stenosis of the efferent loop, the patient underwent exploratory laparotomy. Intraoperatively, an efferent loop with an «S» aspect was observed. Thus, an anastomosis with circular stapler between the efferent loop and the descending part of the pouch was confectioned by transanal route. The patient was discharged with complete remission of symptoms
The organ transplant recipient, a chimera subject, who develops a neoplastic lesion may be the suitable model to reconstruct the hierarchical organization of tumors
No full textTumors are collections of cells that grow out of control and invade tissue. These cells originate from a single mutated one whose lineage continuously accrues somatic aberrations resulting in a heterogeneous population where a hierarchical organisation seems possible. The recognition of first cells, faintly changed compared to the normal ones, is extremely difficult: the differences are nearly undetectable, but of critical importance for understanding the earliest events in tumorigenesis and may pave the way for earlier detection and prevention, since early stages in cancer development might be present years before cancer becomes clinically apparent. To discriminate these cells, which are at the apex of the hierarchy, we hypothesize that the transplanted patient who develops a donor-derived tumor might be a useful model. In fact, as a chimera subject, he might allow the identification and detection of the tumor-initiating cells taking advantage of signature consisting in the genomic mismatch
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
- …
