1,720,967 research outputs found
Definitive Care of Abdominal Solid Organ Injuries
No full textNon-operative management (NOM) for solid organ injuries has long become the standard of care and it continues to have high success rates in the appropriate patient population, both in blunt and penetrating trauma. In selected and well-developed trauma centers, NOM can even be pursued in borderline patients or transient responders without other indications for laparotomy. At the Trauma Center of the Ospedale Maggiore in Bologna (Italy), in the last 5 years the success rate of NOM was 75% for splenic injuries, 90.9% for hepatic injuries, 88.6% for pancreatic and 89.9% for kidney injuries, out of all traumas observed. The development of NOM has meant that we now perform surgical interventions only in unstable patients with serious bleeding lesions, which almost always require either removal of the organ or a damage control procedure. Other surgical options for the definitive treatment of such injuries are to be reserved for either complications of NOM, after damage control surgery (DCS) [4] or—as in the case of kidney and pancreatic trauma—when there is a rupture of the main duct or urine leakage
HYPOTHERMIC PERFUSION OF THE KIDNEY: FROM RESEARCH TO CLINICAL PRACTICE
No full textKidney transplantation is the treatment of choice for patients with end stage renal disease (ESRD). Donor availability is lower than demand, therefore suboptimal grafts retrieved from donors after brain death with expanded criteria donors (EC-DBD) and from donors after cardiac death (DCD) are in-creasingly used. These organs carry a higher risk of worse clinical outcomes, and subsequently need more advanced preservation systems than static cold storage (SCS). Hypothermic perfusion represents one of the aforementioned strategies.This review summarizes the main features of hypothermic perfusion: its mechanism of action through analysis of preclinical models and its clinical ef-ficacy in kidney transplantation with a focus on marginal donors. Oxygenated hypothermic perfusion was also evaluated focusing on its potential benefits on cell metabolism and graft immungenicity. Finally, as hypothermic perfu-sion not only allows to recover marginal grafts, but may also recondition grafts unsuitable for transplantation, the possible methods of graft evalu-ation and treatment options during perfusion are described in this review
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
Hepatopancreatoduodenectomy for locally advanced perihilar cholangiocarcinoma: A case report and a plea not to underestimate surgical resectability
Full text link• Cholangiocarcinomas are characterized by low resectability most often due to late presentation; • Longitudinally spreading cholangiocarcinoma can extend from the biliary plate to the intrapancreatic choleducus, being difficult to treat radically either with liver resection or pancreatoduodenectomy; • Hepatoduodenopancreatectomy can treat locally advanced cholangiocarcinomas, but is characterized with a high rate of complications and few cases are performed in the Western world; • Locally advanced cholangiocarcinomas should be evaluated in a high volume and skill HPB surgical centre; • Clinical management must address potential complications (e.g. liver failure) in order to minimize failure to rescue from complications
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe 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
VA-ECMO Cardiac Support During Liver Transplant: A Case Report
No full textExtracorporeal membrane oxygenation (ECMO) is a rescue therapy for cardiovascular collapse during and after liver transplantation (LT). According to the most recent guidelines, patients with severe cardiomyopathy are excluded from LT because of high-mortality risk during surgery. Intraoperative ECMO support could give these patients the opportunity to undergo LT by reducing the risk of heart failure and reperfusion syndrome. In this case report, we present a case of veno-arterial ECMO (VA-ECMO) support started before LT surgery in a patient with severe pulmonary hypertension, mitral valve steno-insufficiency, and right heart dysfunction. The presence of severe heart disease would have contraindicated LT, but simultaneous liver cirrhosis contraindicated mitral valve surgery, leaving the patient locked in a "Catch-22" state. The best solution was to perform LT with VA-ECMO support before, during, and after the surgery to reduce cardiac load and possible heart failure. LT was performed with good hemodynamic stability and the patient was successfully weaned from ECMO a few hours after surgery. At the 6 month follow-up, normal liver and kidney functions were recorded as well as an overall improvement of heart function; the patient successfully underwent mitral valve replacement and tricuspid annuloplasty 10 months after transplant and is now in good condition
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