1,721,114 research outputs found
Extrapleural access with removal of the 11th rib in type IV thoracoabdominal aneurysms: Impact on postoperative management
No full textAim. Postoperative respiratory failure is one of the most frequent complications of thoracoabdominal aortic aneurysms (-TAAA): its occurrence is mainly linked to the extent of the surgical access (thoraco-phreno-laparotomy). The aim of this study was to evaluate the postoperative management of Type 4 TAAA, paying special attention to respiratory complications, with left extrapleural surgical access and removal of the 11th rib. Methods. Type IV TAAA treated using left extrapleural surgical access and removal of the 11th rib were examined in a retrospective study. The following parameters were analysed: preoperative respiratory (FEV1) and renal function, postoperative intubation time, length of intensive care unit stay, postoperative respiratory complications, postoperative renal insufficiency, perioperative morbidity and mortality (30 days). Results. The study was performed in 10 patients (9 males) with a mean age of 69 years (range 60-75), diagnosed with Type 4 TAAA whose upper proximal limit was the celiac tripod. None of the patients were obese; 90% of the patients were smokers. The preoperative chest X-ray showed a supraelevation of the left hemidiaphragm in 2 cases. In 10 cases, FEV1 ranged from 57% to 144%. Preoperative renal insufficiency was present in 2 cases (creatinine >2.0 mgdl). Surgery was performed electively in all cases. In total, there were 2 cases of postoperative respiratory failure (postoperative intubation time >12 hours). In the remaining cases mean postoperative intubation time was 5.3 hours (range: 4-8 hours). Both cases of respiratory failure were associated with transient renal insufficiency. The mean length of intensive care unit stay was 3.5 days (range: 0-15 days): a single day was sufficient in 50% of cases. Postoperative chest X-rays revealed only 1 new case of supraelevation of the left hemidiaphragm (2 were already present preoperatively), no case of pneumothorax and no case of infection. Two cases of transient postoperative renal insufficiency were observed: only 1 case required temporary hemodialysis. Redo surgery was necessary in 2 cases: in 1 case to empty the retroperitoneal hematoma and cross-over surgery in 1 case due to thrombosis of an iliac branch. There was no case of perioperative mortality. Conclusion. Based on these preliminary results, when practicable, this surgical access appears to promote a more rapid recovery of postoperative respiratory function
Regarding "The brachiocephalic elbow fistula: A useful alternative angioaccess for permanent hemodialysis"
No full textInflammatory peripheral arterial aneurysms
No full textThe in fl ammatory changes occurring in the wall of arterial aneurysms have been extensively studied in the abdominal aorta since the fi rst description by While in 1972. However, similar aspects of atherosclerotic aneurysms located in other sites of the arterial system, such as the popliteal and femoral arteries, have been reported only exceptionally. To our knowledge, after an extensive search of PubMed using the terms in fl ammatory aneurysms, peripheral in fl ammatory aneurysms, peripheral aneuysms, and popliteal aneurysms, only two papers were found in the English language literature, and one of them is a case report [1, 2]. The fact that an in fl ammatory in fi ltrate has been described in a series of anatomical locations, such as the coronary arteries and the thoracic aorta, leads to the assumption that similar pathological processes occur more frequently than reported for �atherosclerotic� aneurysms of any anatomical distric
Dissecting trauma of the extracranial carotid artery: Elective surgical treatment of a stabilized case
No full textThis study describes a case of stabilized dissecting trauma of the common carotid artery and related surgical treatment. A 46-year-old man was admitted because of blunt neck injury, with crushing of the vessel and symptoms of dysarthria. Magnetic resonance imaging showed dissection of the left common carotid artery at the bifurcation and a hypodense cerebral area in the left temporoparietal region. Echo Doppler ultrasonography confirmed dissection of the intima; flowmeter study showed hemodynamically significant stenosis. The clinico-neurologic picture was stable; surgical repair of the carotid artery was performed. On surgery, the vessel appeared dilated at the level of the bulb, whereas the remaining portion of the common, internal and external carotid was normal. On opening of the bifurcation, dissection with endothelialization of the intimal flap were observed. A PFTA graft (6 mm) was fashioned in a 5-cm segment between the common carotid and the bifurcation. Intraoperative angiographic control showed good morphology. Histology showed thickening of the intima, with neointimal hyperplasia and diffuse fibrotic areas, whereas the media was affected by lymphomonoplasmocytary infiltration. The postoperative course was uneventful and the patient was discharged on the 7th day with antiplatelet therapy. On postoperative follow-up at 12 months, echo Doppler sonography showed the graft to be patent, with no internal morphologic or flowmeter changes. Blunt injuries to the extracranial carotid artery can lead to vessel wall damage, with acute and/or progressive neurologic events that require emergency repair. If the neurologic picture is stabile, and the carotid lesion does not tend to rapid progression, elective repair surgery is indicated instead. Repair is essential when the lesion determines significant hemodynamic alterations
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
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