1,720,991 research outputs found
Fattori psicologici, qualità di vita e benessere percepito in pazienti obesi operati con chirurgia bariatrica.
No full textCognitive representations of illness, emotional state and quality of life in Idiopathic Environmental Intolerance (IEI)
No full textSensibilità Chimica Multipla (SCM): componenti psicologiche nell'evoluzione del disturbo.
No full textIntroduzione. La Sensibilità Chimica Multipla (SCM) è una malattia dall’eziologia ancora ignota, caratterizzata da sintomi attribuibili a un’intolleranza per agenti chimici presenti nell’ambiente, in assenza di altre spiegazioni mediche. Nonostante la patogenesi della malattia sia ancora incert,a sono stati chiamati in causa fattori sia psicologici, sia fisici per spiegarne le cause. Il presente studio qualitativo ha lo scopo di riportare le opinioni, le credenze e il modo di raccontare la malattia in pazienti affetti da MCS.
Metodo. Hanno partecipato allo studio 40 soggetti, lamentanti sintomi riconducibili alla MCS, di età compresa tra i 32 e i 78 anni. Tutti i soggetti hanno partecipato a un colloquio clinico guidato da intervista semi strutturata.
Risultati. I sontomi maggiormente riportati dai partecipanti sono: ipersensibilità olfattiva a sostanze chimiche, nausea, mal di testa, mancanza di concentrazione, difficoltà mnestiche. I pazienti riferiscono una bassa qualità di vita, depressione, ansia ed episodi di attacco di panico.
Conclusioni. Questo studio evidenzia la cronicità e la condizione disabilitante in cui si trovano i pazienti con MCS e sottolinea l’importanza di lavorare per il miglioramento della loro qualità di vita.Comprendere l’impatto della malattia sulla salute globale dei soggetti é fondamentale per comprendere e trattare le persone con MCS
Clinical features, risk of mass enlargement, and development of endocrine hyperfunction in patients with adrenal incidentalomas: a long-term follow-up study
No full textAbstract
Purpose: To evaluate the risk of mass enlargement and endocrine function modification in patients with adrenal incidentaloma (AI).
Methods: In this retrospective study, we examined clinical and hormonal characteristics of 310 patients with AI (200 females and 110 males; age: 58.3 ± 12.9 years), followed up for a median (interquartile range) of 31.4 months (13.0-78.6) and evaluated for possible modification in adrenal mass size and hormonal function. The hormonal evaluation included morning serum cortisol and plasma ACTH at 8 a.m., aldosterone, plasma renin activity/direct renin concentration, and 24-h urine metanephrines/normetanephrines. One microgram overnight dexamethasone suppression test (DST) was performed. Autonomous cortisol secretion (ACS) was diagnosed in the presence of cortisol after 1 mg DST > 5 μg/dl (138 nmol/l) or >1.8 and ≤5 μg/dl (50-138 nmol/l) and at least one of the following: (i) low ACTH; (ii) increased 24-h urinary-free cortisol; (iii) absence of cortisol rhythm; and (iv) post-LDDST cortisol level > 1.8 μg/dl (50 nmol/l). When there was no biochemical evidence of adrenal hormonal hyperactivity, AIs were classified as nonfunctioning (NFAIs). The mass was considered significantly enlarged when the size increase was more than 20% and at least 5 mm compared to baseline.
Results: At diagnosis, NFAIs were found in 209 patients, while ACS and overt adrenal hyperfunction were diagnosed in 81 and 20 patients, respectively. During follow-up, 3.3% and 1.5% of patients with NFAI developed subtle and overt endocrine hyperfunction, respectively, while a significant mass enlargement was observed in 17.7% of all AIs. The risk of developing ACS was significantly higher in patients with adenoma >28 mm (hazard ratio [HR] 12.4; 95% confidence interval [CI], 2.33-66.52, P = 0.003), in those with bilateral adrenal tumors (HR: 5.36; 95% CI, 1.17-24.48, P = 0.030), and with low/suppressed ACTH values (HR: 11.2, 95% CI 2.06-60.77; P = 0.005). The risk of mass enlargement was lower for patients in the fourth quartile of body mass index than those in the first quartile (HR 0.33; 95% CI, 0.14-0.78; P = 0.012).
Conclusions: In patients with AI, the risk of developing hormonal hyperfunction and mass enlargement is overall low, although some tumor characteristics and anthropometric features might increase this risk. Taking account of all these aspects is important for planning a tailored follow-up in AI patients.
Keywords: ACS; AI; Adrenal; Adrenal incidentaloma; Autonomous cortisol secretion; Cushing’s syndrome
Clinical features, risk of mass enlargement, and development of endocrine hyperfunction in patients with adrenal incidentalomas: a long-term follow-up study
No full textPurpose To evaluate the risk of mass enlargement and endocrine function modification in patients with adrenal
incidentaloma (AI).
Methods In this retrospective study, we examined clinical and hormonal characteristics of 310 patients with AI (200 females
and 110 males; age: 58.3 ± 12.9 years), followed up for a median (interquartile range) of 31.4 months (13.0–78.6) and
evaluated for possible modification in adrenal mass size and hormonal function. The hormonal evaluation included morning
serum cortisol and plasma ACTH at 8 a.m., aldosterone, plasma renin activity/direct renin concentration, and 24-h urine
metanephrines/normetanephrines. One microgram overnight dexamethasone suppression test (DST) was performed.
Autonomous cortisol secretion (ACS) was diagnosed in the presence of cortisol after 1 mg DST > 5 μg/dl (138 nmol/l) or
>1.8 and ≤5 μg/dl (50–138 nmol/l) and at least one of the following: (i) low ACTH; (ii) increased 24-h urinary-free cortisol;
(iii) absence of cortisol rhythm; and (iv) post-LDDST cortisol level > 1.8 μg/dl (50 nmol/l). When there was no biochemical
evidence of adrenal hormonal hyperactivity, AIs were classified as nonfunctioning (NFAIs). The mass was considered
significantly enlarged when the size increase was more than 20% and at least 5 mm compared to baseline.
Results At diagnosis, NFAIs were found in 209 patients, while ACS and overt adrenal hyperfunction were diagnosed in 81
and 20 patients, respectively. During follow-up, 3.3% and 1.5% of patients with NFAI developed subtle and overt endocrine
hyperfunction, respectively, while a significant mass enlargement was observed in 17.7% of all AIs. The risk of developing
ACS was significantly higher in patients with adenoma >28 mm (hazard ratio [HR] 12.4; 95% confidence interval [CI],
2.33–66.52, P = 0.003), in those with bilateral adrenal tumors (HR: 5.36; 95% CI, 1.17–24.48, P = 0.030), and with low/
suppressed ACTH values (HR: 11.2, 95% CI 2.06–60.77; P = 0.005). The risk of mass enlargement was lower for patients
in the fourth quartile of body mass index than those in the first quartile (HR 0.33; 95% CI, 0.14–0.78; P = 0.012).
Conclusions In patients with AI, the risk of developing hormonal hyperfunction and mass enlargement is overall low,
although some tumor characteristics and anthropometric features might increase this risk. Taking account of all these aspects
is important for planning a tailored follow-up in AI patients
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
- …
