1,720,960 research outputs found

    US-guided percutaneous treatment and physical therapy in rotator cuff calcific tendinopathy of the shoulder: outcome at 3 and 12 months

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    Objectives To monitor the results of ultrasound (US)-guided percutaneous treatment of calcific tendinopathy of the shoulder at 12 months (T12) after treatment (T0). To verify the possible relations between some pre- and post-procedural variables with the clinical outcome at T12. Methods Forty-seven patients (26 female and 21 male) were enrolled in the study. Patients' approval and written informed consent were obtained. Symptoms were assessed by Constant Shoulder Score (CSS) at T0 and T12. Thirty of these also underwent a CSS control at 3 months (T3). The treatment efficacy was statistically tested for relation with location and type of calcification, characteristics of the tendon and subdeltoid bursa, impingement, and rehabilitation treatments. Results There was a significant increase in the average CSS value between T0 and T12 (40.7 vs. 75.3). The variables analysed did not show a statistically significant effect on the outcome at T12. A link was noticed only between patients' increasing age and score improvement, particularly among female subjects. Conclusion US-guided treatment of calcific tendonitis is a viable therapeutic option. No pre- or intra-procedural parameters emerged which might help in predicting the outcome, apart from patients' needs in everyday life

    Grading lung neuroendocrine tumors: Controversies in search of a solution

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    BACKGROUND: Pathological grading of tumors is a way to measure biological aggressiveness. In lung neuroendocrine tumors (NET), grading is tautologically included into the current 2015 WHO histologic classification. Little is known, however, about alternative grading systems in lung NET. METHODS: Through an extensive search of the English literature on lung NET (updated to April 2016), the following key questions were addressed: a) current concepts of grading; b) clinicians' requests for grading; c) functional parameters for grading; d) Ki-67 labeling index (LI) for grading; e) towards an effective pathology grading system. RESULTS: There is some room for inconsistency in the histologic classification of lung NET, likely due to the varying attribution of defining criteria. Innovative diffusion-weighted imaging upon magnetic resonance or molecular analysis could help separate indolent from aggressive lung NET, thus integrating a grading approach other than histology. Troubles in the clinical handling of metastatic or individual tumors when relying on morphology alone support the development of a lung-specific grading system for the more accurate prediction of prognosis and planning therapy in individual patients. To integrate the 2015 WHO classification using innovative grading based on Ki-67 LI, mitotic count and necrosis, a new proposal is emerging where three categories of lung NET are identified, namely Lu-NET G1, Lu-NET G2 and Lu-NET G3, which would allow tumors with similar behavior and therapy to be better handled according to their own biological potential. CONCLUSION: This new formulation of lung NET grading could have clinical relevance for the individual handling of patients

    MR and CEUS monitoring of patients with severe rheumatoid arthritis treated with biological agents: a preliminary study

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    PURPOSE: This study was done to propose a study protocol for patients with rheumatoid arthritis (RA) treated with biological agents, by evaluating the contribution of contrast-enhanced magnetic resonance (CE-MR) imaging, a software programme that calculates the volume of synovitis on CE-MR images, and contrast-enhanced ultrasound (CEUS). MATERIALS AND METHODS: Sixteen patients with RA receiving treatment with biologics were analysed. The patients underwent clinical examination, CE-MR imaging and CEUS on the same day. Images were postprocessed with the software and evaluated independently by three physicians in terms of RAMRIS (Rheumatoid Arthritis Magnetic Resonance Imaging Score), SAMIS (Simplified Rheumatoid Arthritis Magnetic Resonance Imaging Score) and CEUS grade. The techniques were correlated statistically. RESULTS: The RAMRIS and SAMIS scores were found to correlate statistically. CE-MR imaging correlated with the clinical data (p < 0.05), whereas CEUS did not. The data provided by the software did not correlate statistically with the other techniques. The most painful joint was consistently found to be the joint with most synovitis. CONCLUSIONS: CE-MR imaging may be used prior to treatment and for long-term follow-up. CEUS might be useful in the short-term follow-up, as it seems to provide an indication of the presence or absence of disease, though not of its severity. The software is a very useful tool that can supplement, but not replace, the other techniques

    Update Of Disease Activity Assessment In Rheumatoid Arthritis: Comparison Between Clinical, Ultrasound And Mri Scores And Introduction Of Volumetric Inflammation Measure Concept

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    Background: Therapeutic decisions in rheumatoid arthritis (RA) are driven by the estimated grade of disease activity. It is clinically evaluated by composite scores such as DAS28, SDAI and CDAI (1). Ultrasound (US) and MRI imaging of the joints provide further characterization of disease activity. US assessments search for the presence of synovitis, joint effusion and Power Doppler (PD) scored semi-quantitatively from 0-3 on joints of DAS28 or proposed reduced score systems (2). MRI joint imaging is evaluated through RAMRIS (RA MRI Scoring) grading separately with a semi-quantitative score (0-3) synovitis after contrast enhancement (CE-MRI), extension of bone marrow edema and erosions on 7 joints of each hand. In 2010 SAMIS (Simplified RA MRI Score) was proposed for reducing examination time by analyzing the most tender or dominant hand only (3). Despite all efforts for objectively quantifying disease activity, all evaluations depend on the subjective feeling of patient or examiner and on the interpretation of imaging data. Objectives: Comparison of clinical, US and MRI scores and volumetric measure of synovial inflammation by dedicated MRI software. Methods: Methods: Clinical data (CRP, ESR, DAS28, CDAI, SDAI and HAQ) were collected from 32 RA patients. Rheumatologists assessed further the number of joints positive for presence of synovitis, effusion and PD (DAS28 and 12-joint US score). Three radiologists independently performed RAMRIS and SAMIS validation on CE-MRI. Moreover, an software was developed in house to estimate total volume of contrast perfusion in joint spaces of both hands. Correlations were analyzed by Spearmen test. Results: SAMIS and RAMRIS correlated significantly for synovitis, edema and erosions (p<0,0001). Interoperator agreement was nearly perfect (Kendall coefficient=0,99). SAMIS and RAMRIS synovitis correlated significantly with DAS28, SDAI, CDAI, HAQ, PCR and ESR (p<0,05), whereas US scores did neither correlate with MRI nor clinical scores. The measure of “inflammation volume” estimated with the software was assumed to be a proxy of synovitis, but did not correlate with clinical, US and MRI scores. Conclusions: MRI remains the gold standard for estimating disease activity in RA, since it correlates with clinical scores more than US-derived scores. Software evaluation of total contrast perfusion or “synovitis volume” is an objective measurement that might provide an independent variable, but its role has yet to be fully tested

    Going Beyond Counting First Authors in Author Co-citation Analysis

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    The 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

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    “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

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    We 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

    Dispelling the Myths Behind First-author Citation Counts

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    We conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more sophisticated methods
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