1,721,050 research outputs found
Re-evaluation of risk for Down syndrome by means of the combined test in pregnant women of 35 years or more
No full textObjective: Evaluation of combined test in pregnant women 35 years of age and over to detect fetal Down syndrome. Materials and Methods: The study population included 408 pregnant women of 35 years and over, who requested the combined test (nuchal translucency, PAPP-A, free beta hCG, maternal age, cut-off 1:250) before deciding whether to undergo amniocentesis. Results: The test was positive in 66 women who then requested amniocentesis for fetal karyotype determination; the other women had a negative test and declined amniocentesis. False-positives increased with maternal age from 6.6% at 35 years to about 50% at 40 to 41 and 100% in women over 41. Six cases of Down syndrome and two cases of trisomy 18 were detected. Not a single case of Down syndrome or trisomy 18 was missed, and other chromosome abnormalities were detected as well. Conclusions: The application of the combined test reduced the need for invasive testing to only 14% of the studied pregnant population, without missing any of the fetuses with trisomy 21 or 18. Copyright © 2005 John Wiley & Sons, Ltd
A case of cervical pregnancy
No full textA cervical pregnancy diagnosed by transvaginal ultrasonography and successfully treated by aspiration and curettage is disucssed
A report of early (13 + 0 to 14 + 6 weeks) and mid-trimester amniocenteses: 10 years' experience
No full textObjective: To report in singleton pregnancies the post-procedure safety and maternal complications of early amniocenteses performed between 13 + 0 and 14 + 6 weeks of gestation and mid-trimester amniocenteses performed between 15 + 0 and 18 + 6 weeks of gestation. Methods: The study was carried out at the Prenatal Diagnosis Center, Siena University, Italy, during a 10-year period, following the Regional Protocol for Prenatal Diagnosis. Our study population included 3769 amniocenteses, 475 early and 3294 mid-trimester. Complications considered included miscarriage (immediately after the procedure and until 24 weeks of gestation), blood-stained amniotic fluid, failed cell culture, amniotic fluid leakage, preterm premature rupture of the membranes (PROM), preterm delivery and presence of neonatal talipes equinovarous. Results: Cytogenetic anomalies were found in 111 cases (2.9%), 18 occurring early and the other 93 in mid-trimester. Miscarriage occurred in two cases in the early amniocentesis group (0.4%) and in ten cases among the mid-trimester group (0.3%). The overall loss of pregnancies due to amniocentesis in this study was 0.3%. Amniotic fluid was stained in 1.2% in the early group and 0.9% in the mid-trimester group. Amniotic fluid leakage was noted in 1.4% and 1.2%, preterm PROM was noted in 3.3% and 3%, and preterm delivery occurred in 8% and 7.6%, respectively. There were no cases of failed amniotic culture and no cases of talipes equinovarous documented. Conclusions: The risks of early amniocentesis performed between 13 + 0 and 14 + 6 weeks appear to be comparable to those of mid-trimester amniocentesis and thus early amniocentesis could be offered to the parents, as an alternative to chorionic villus sampling, in order to obtain cytogenetic results earlier in pregnancy without a significantly increased risk for both mother and fetus. Further operators' experience with the method, based on long and accurate follow-up, and further studies are necessary to assess the safety of the method
Condizioni organizzative per l’implementazione delle logiche lean in sanità
No full textNel contesto di erogazione dei servizi sanitari, per far fronte alle dinamiche di costante crescita della spesa e di progressiva riduzione delle risorse disponibili, si sono aperti spazi per una riorganizzazione delle prassi operative e dei processi produttivi interni alle organizzazioni attingendo a strategie e pratiche manageriali improntate all’approccio lean. Quello che interessa a manager e policy maker è capire l’effettiva replicabilità ed efficacia di questi modelli al caso specifico della sanità. Il presente contributo, attraverso un’estesa revisione della letteratura scientifica nazionale ed internazionale, intende provare a rispondere a questo quesito fornendo una panoramica sulle condizioni organizzative e di contesto agevolanti l’implementazione, lo sviluppo e la sostenibilità di iniziative lean nelle organizzazioni sanitarie. Riclassificando i numerosi elementi emersi a partire dai contributi presenti in letteratura, sono state identificate sette macro categorie di condizioni organizzative che è necessario presidiare quando si adotta ed implementa una strategia di cambiamento improntata sul modello lean in sanità: (i) integrazione tra il programma di cambiamento e la strategia aziendale; (ii) coinvolgimento dei professionisti e commitment della direzione strategica; (iii) gestione del cambiamento (change management) e cultura organizzativa; (iv) disponibilità di risorse e assetti organizzativi; (v) organizzazione per processi; (vi) sistemi informativi e tecnologie; (vii) lay-out e organizzazione degli spazi
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
Prenatal diagnosis of esophageal atresia with the pouch sign
No full textA 19-year-old primipara was referred to our center for a routine scan at 33 + 4 weeks' gestation. A visible but small stomach bubble (18 mm) was detected in the fetal abdomen, associated with a dilation of the esophagus with a tapering distal part. Direct visualization of filling and emptying of the proximal esophagus suggested the presence of obstruction. A cystic pouch in the region of the esophagus was observed to be full and empty in accordance with fetal swallowing. No other fetal anomalies were detected. Fetal biometric measurements were on the 10th percentile and polyhydramnios was detected. Esophageal atresia type I was suspected. Fetal karyotyping was declined by the parents, no therapy was given and the pregnancy continued until week 37 when a female baby was delivered following spontaneous labor. Esophageal atresia type I was radiographically confirmed. Bougienage was used for 8 weeks and esophageal anastomosis was successfully performed when the infant was 11 months old. No other anomalies were found and the child is currently in excellent health. The present case shows that the upper neck pouch sign may be a delayed manifestation present only in certain types of esophageal atresia. However, when it occurs it should prompt careful fetal examination as it is an important step in the diagnosis of esophageal atresia
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