1,720,968 research outputs found
La terapia dell’algodistrofia
No full textL’algodistrofia è una condizione multifattoriale
ad eziologia e patogenesi complessa. I principali
obiettivi della terapia dell’algodistrofia
sono il miglioramento della sintomatologia
dolorosa, il ripristino funzionale e la stabilizzazione
dello stato ansioso-depressivo.
L’approccio interdisciplinare è riconosciuto
come il più pragmatico, disponibile e conveniente,
ma fondamentale è la precocità della
terapia. Le tecniche interdisciplinari di gestione
del dolore sottolineano come il recupero
funzionale possa essere la terapia più
efficace, andando ad agire sull’alterata elaborazione
centrale e/o la normalizzazione dell’ambiente
distale. La mobilizzazione precoce
deve essere quindi incoraggiata con esercizi
attivi e passivi che consentano di mantenere
l’escursione articolare evitando la rigidità e la
perdita del trofismo e della forza muscolare.
Diversi farmaci sono stati utilizzati per migliorare
la sintomatologia dolorosa e lo stato funzionale
nell’algodistrofia, nonostante la man -
canza di un’evidenza scientifica a sostegno del
loro utilizzo. Essi comprendono gli antinfiammatori,
gli analgesici, gli anestetici, gli anticonvulsivanti,
gli antidepressivi, i miorilassanti, i
corticosteroidi, la calcitonina, i bisfosfonati, i
blocchi del simpatico e gli agenti topici. Tra i
farmaci antinfiammatori solo i glucocorticoidi
posseggono un’evidenza scientifica diretta, ma
solo nella fase iniziale della patologia. Gli oppioidi
sono una ragionevole opzione di trattamento
di seconda o di terza scelta, anche se
la tolleranza e la tossicità a lungo termine costituiscono
ancora delle problematiche irrisolte.
Gli anticonvulsivanti e gli antidepressivi
triciclici non sono mai stati studiati per il trattamento
dell’algodistrofia, e le evidenze a loro
sostegno sono soltanto aneddotiche.
La classe farmacologica che a tutt’oggi offre
le maggiori garanzie di efficacia è quella dei
bisfosfonati. Il loro razionale d’impiego ha
fatto inizialmente riferimento all’efficacia analgesica
nel trattamento di alcune patologie
scheletriche (morbo di Paget, malattia metastatica
scheletrica) e, più recentemente, alla
dimostrazione che i bisfosfonati interferiscono
positivamente con l’edema midollare
osseo e la sintomatologia dolorosa in alcune
patologie flogistiche articolari. Aldilà della
modalità di azione, negli ultimi 15-20 anni
sono molti gli studi e le esperienze cliniche
che hanno dimostrato l’efficacia di diversi
bisfosfonati, soprattutto se somministrati per
La terapia
dell’algodistrofia
Giuseppina Resmini1, Chiara Ratti2, Gianluca Canton2, Luigi Murena2,
Antimo Moretti3, Giovanni Iolascon3
1Centro per lo Studio dell’Osteoporosi e delle Malattie Metaboliche dell’Osso
U.O. Ortopedia e Traumatologia - A.O. Ospedale di Treviglio-Caravaggio (BG)
2Clinica Ortopedica, Università di Trieste
3Dipartimento Multidisciplinare di Specialità Medico-Chirurgiche e Odontoiatriche
Seconda Università di Napoli
15
L a t e r a p i a d e l l ’ a l g o d i s t r o f i a
FIGURA 2. Efficacia del trattamento con neridronato EV versus placebo. Risultati della open extension phase dello
studio, quando i pazienti arruolati nel gruppo placebo passavano al trattamento con neridronato alla stessa posologia
del gruppo trattato.
80
60
40
20
– 10 1 10 20 30 40
Giorni
p = 0.0001
p < 0.0001
Neridronato
100 mg x 4
Wash out
via endovenosa e a dosaggi elevati, nel migliorare
la sintomatologia dolorosa e il deficit funzionale
nei pazienti con algodistrofia, con un
buon profilo di sicurezza e tollerabilità. Tuttavia,
spesso, questi stessi studi sono stati sponsorizzati
e basati su pochi pazienti. Studi randomizzati
con calcitonina vs placebo non
hanno riportato risultati significativi. Mancano
dimostrazioni di efficacia relative ai blocchi
del simpatico ed alle tecniche di simpaticec-
FIGURA 1. Efficacia del trattamento con neridronato EV versus placebo.
80
60
40
20
1 10 20 30 40
Giorni
VAS, media + DS
VAS, media (DS)
p = 0.043 p < 0.0001
Placebo
Neridronato
16
L a t e r a p i a d e l l ’ a l g o d i s t r o f i a
tomia. Deboli prove di efficacia per il dimetilsolfossido
(DMSO) ad uso topico sono state
registrate sui segni di flogosi, ma non sulla sintomatologia
dolorosa.
In termini preventivi l’utilizzo di vitamina C, in
ragione delle sue proprietà antiossidanti, sembra
essere in grado di ridurre l’incidenza di algodistrofia
nei soggetti con frattura di polso.
Recentemente, in uno studio randomizzato
controllato condotto su 82 pazienti affetti da
CRPS di tipo 1 è stata evidenziata l’efficacia
della somministrazione endovenosa di neridronato.
Una significativa diminuzione della sintomatologia
dolorosa (VAS) e un significativo miglioramento
della qualità di vita sono stati osservati
nei pazienti affetti da algodistrofia alla mano o
al piede che hanno ricevuto 400 mg di neridronato
per via endovenosa nell’arco di 10 giorni
versus placebo (Figura 1).
La stessa tendenza è stata osservata anche
nella fase di estensione dello studio in aperto,
quando i pazienti del gruppo placebo hanno
ricevuto neridronato allo stesso dosaggio (Figura
2).
Una rivalutazione dei pazienti a un anno di distanza
non ha mostrato segni clinici residui o
recidivanti di algodistrofia. In conclusione, l’approccio
terapeutico più condiviso è di tipo
multimodale e si fonda sull’impiego di diverse
classi di farmaci associato ad un intervento riabilitativo
precoce. Il neridronato ha dimostrato
un significativo beneficio, clinicamente rilevante
e persistente, nel trattamento dell’algodistrofia,
agendo sia sulla modulazione del
dolore sia sulla qualità dell’osso coinvolto
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
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
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
Author-wise bibliometric analysis based on entropy.
No full textAuthor-wise bibliometric analysis based on entropy.</p
Author Under Sail The Imagination of Jack London, 1893-1902
No full textIn Author Under Sail, Jay Williams offers the first complete literary biography of Jack London as a professional writer engaged in the labor of writing. It examines the authorial imagination in London's work, the use of imagination in both his fiction and nonfiction, and the ways he defined imagination in the creative process in his business dealings with his publishers, editors, and agents. In this first volume of a two-volume biography, Williams traverses the years 1893 to 1902, from London's "Story of a Typhoon" to The People of the Abyss. The Jack London who emerges in the pages of Author Under Sail is a writer whose partnership with publishers, most notably his productive alliance with George Brett of Macmillan, was one of the most formative in American literary history. London pioneered many author models during the heyday of realism and naturalism, blurring the boundaries of these popular genres by focusing on absorption and theatricality and the representation of the seen and unseen. London created an impassioned, sincere, and extremely personal realism unlike that of other American writers of the time. Author Under Sail is a literary tour de force that reveals the full range of London as writer, creative citizen, and entrepreneur at the same time it sheds light on the maverick side of machine-age literature.Intro -- Title Page -- Copyright Page -- Dedication -- Contents -- Acknowledgments -- Introduction -- 1. Spirit Truth -- 2. From Absorption to Theatricality and Back Again -- 3. "I Will Build a New Present" -- 4. Sons as Authors -- 5. Fathers as Publishers -- 6. The Daughter as Author -- 7. Lovers as Authors -- 8. At Sea with the Family -- 9. Yellow News, Yellow Stories -- 10. The Return Home -- Notes -- Bibliography -- Index -- About Jay WilliamsIn Author Under Sail, Jay Williams offers the first complete literary biography of Jack London as a professional writer engaged in the labor of writing. It examines the authorial imagination in London's work, the use of imagination in both his fiction and nonfiction, and the ways he defined imagination in the creative process in his business dealings with his publishers, editors, and agents. In this first volume of a two-volume biography, Williams traverses the years 1893 to 1902, from London's "Story of a Typhoon" to The People of the Abyss. The Jack London who emerges in the pages of Author Under Sail is a writer whose partnership with publishers, most notably his productive alliance with George Brett of Macmillan, was one of the most formative in American literary history. London pioneered many author models during the heyday of realism and naturalism, blurring the boundaries of these popular genres by focusing on absorption and theatricality and the representation of the seen and unseen. London created an impassioned, sincere, and extremely personal realism unlike that of other American writers of the time. Author Under Sail is a literary tour de force that reveals the full range of London as writer, creative citizen, and entrepreneur at the same time it sheds light on the maverick side of machine-age literature.Description based on publisher supplied metadata and other sources.Electronic reproduction. Ann Arbor, Michigan : ProQuest Ebook Central, YYYY. Available via World Wide Web. Access may be limited to ProQuest Ebook Central affiliated libraries
- …
