1,720,979 research outputs found
Laparoscopic/Thoracoscopic surgery for complex non axial hiatus hernia.
No full textBackground: In order to demonstrate the feasibility and the corner stones of the minimally invasive
surgical technique for the treatment of paraoesophageal and massive incarcerated hiatus hernia
we show the case of a 66 years old woman with 20 years history of GORD symptoms, dyspnoea
with orthopnea, erosive oesophagitis and recurrent sideropenic anaemia. Barium swallow shows
a paraoesophageal hiatus hernia. We present a second case of a 56 years old man complaining
severe GORD symptoms since 6 years with painful dysphagia, erosive oesophagitis. Barium
swallow shows a non-reducible 10 cm diameter massive incarcerated hiatus hernia.
Methods: The steps of the surgical procedure are: 1) complete resection of the hernia sac and
fat pad with preservation of the vagus nerves, 2) localization of the position of the GO junction
with respect to the apex of the hiatus with a combined endoscopic–laparoscopic procedure, 3)
measurement of the length of the esophageal submerged segment, 4) isolation of the mediastinal
oesophagus, 5) Collis gastroplasty in case of short oesophagus , 6) hiatus alloplasty, 7) Nissen
floppy fundusplication.
Results: After maximal oesophageal mobilization , in the first patient the GO junction was placed
2,5 cm below the hiatus and a standard fundusplication was performed , in the second case the
GO junction was placed across the hiatus and a combined laparoscopic-left thoracoscopic Collis
gastroplasty was necessary.
Conclusions: The minimally invasive approach for complex hiatus hernias appears feasible. 15
patients (mean age 65.8 ± 11.7 years) underwent laparoscopic Nissen and 14 (mean age 66.5 ±
11.7 years) thoraco-laparoscopic Collis-Nissen. Median follow up was 21 months (r. 6-58) with
1 mortality in each group (pulmonary embolus and Collis fistula). Results were excellent and
good in 93%, and fair or poor in 7%
Case Report: Lesson learned on a case of three synchronous NSCLC‘S
No full textBackground: In order to raise discussion on the management of multiple pulmonary nodules,
we describe the unusual case of a 70 years old man affected by three synchronous NSCLC’s
Methods: Past medical history was significant for 40 pack year smoking, hypertension, COPD,
type II diabetes mellitus and gout arthropathy, previous gastric resection for peptic ulcer. An
incidental chest CT scan revealed: 1) a 0,5 cm very small non calcified nodule in the middle lobe;
2) a 2.5 cm nodule in the apical segment of the right upper lobe presenting irregular margins, a
pleural tail and a mixed density; 3) a 2.5 cm nodule, solid and rounded, with irregular borders,
in the posterior segment of the right lower lobe; 4) a 2 cm nodule, solid and irregular, located in
the apical-dorsal segment of the left upper lobe. Trans-bronchial biopsy of the right upper lobe
nodule was positive for bronchiolar-alveolar carcinoma , PET showed ipermetabolic activity in
correspondence of the three bigger nodules. The clinical staging was T1N0M1 (Stage IV).
Results: Considering the impossibility to discriminate among primary or metastatic lesions on
the basis of fine needle biopsies, through mid sternotomy the wedge resection of the nodules was
uneventfully performed. Histology and immunohistochemistry provided diagnosis of synchronous
right lung adenocarcinomas and left lung neuroendocrine carcinoma. The 0,5 cm nodule was
benign. Pathological staging was pT1NXMX. After 24 months the patient is disease free.
Conclusions: When radiological imaging supports the possibility of multiple synchronous
NSCLC’s, an aggressive surgical approach is recommended not to exclude patients from effective
cure
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
The Gastroesophageal Prolapse in GERD: Clinical Patterns and Surgical Outcome.
No full textAims. To assess the clinical profile of patients with gastro-esophageal prolapse and GERD and the outcome of surgical therapy.
Methods. Since 1983 to 2006, 50 patients, mean age 48.84, r. 27-73 were observed. The severity of symptoms and Reflux esophagitis were graded from 0 to 3. The anatomy of the gejunction was assessed by barium swallow.
Results. Median symptoms duration was 51 months (r. 2~300). Epigastric pain was in 98% of pts. Belching or gagging in 70% (35/50), Sl=38, 76%; S2=11, 22%, SR3=31, 62%; SR2=19, 38%. Reflux esophagitis in 94% (47/50; El=15, 30%; E2= 21, 42%; E3=11, 22%). At barium swallow 18 pts (36%) had normal anatomy, 11 (22%) had Sliding Hiatus Ernia, while in 21 pts (42%) the oral migration of the g-e junction. NissenFundoplication was performed in 28 (56%) with 2 Collis techniques. No mortality, morbility (7,1%), (Median FU 15 months, r 6-192 ). 22 patients underwent medical therapy (Median FU 60 months, r 24-120). Postoperative symptoms and reflux esophagitis improved statistically after surgery and after medical treatment (Preoperative versus Postoperative p = 0.000).
In the comparison between surgical versus medical patients statistically significant differences were observed with regard to severity of pre-treatment reflux symptoms (p = 0.034) and with regard to post-treatment clinical evaluation of symptoms and esophagitis (p = 0.000).
Conclusions. Epigastric pain, belching and gagging seem to be related to the g-e prolapse because they are reduced more by surgery than by antacid therapy. In g-e prolapse+GERD, surgery is more effective than medical therapy
Short-term onset of fatal pulmonary toxicity in a patient treated with intravenous amiodarone for post-operative atrial fibrillation.
No full textNo abstract availabl
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
- …
