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Primary Liposarcoma of the Spleen: Case Report With Review of the Literature
No full textWe present a 55-year-old woman with a palpable mass in the right upper abdomen. Contrast-enhanced computed tomography showed a highly vascularized and primary resectable tumor of the spleen. We performed an open splenectomy with locoregional lymphadenectomy. Histopathological and immunohistochemical evaluation did not reveal classic markers of angiosarcoma, littoral cell angioma, or follicular dendritic cell sarcoma, but showed MDM2-amplification by FISH in all tumor cells as a marker for liposarcoma. The tumor showed growth limited to the spleen tissue. No MDM2-amplification was detectable in the perisplenic adipose tissue, so that infiltration of the spleen by retroperitoneal liposarcoma could be excluded. In summary, well-differentiated liposarcoma confined to the spleen was diagnosed. To the best of our knowledge, this is the first description of a primary liposarcoma of the spleen reported in the literature. Due to the local recurrence risk of liposarcomas, even after R0 resection, we recommended long-term periodic follow-up
Evaluation of the implementation of a visceral surgical interprofessional training station with special consideration of patient safety
No full textHintergrund. Interprofessionelle Ausbildungsstationen (IPSTAs) sind zu-nehmend Bestandteil von Lehr- und Ausbildungskonzepten in Deutschland und werden somit fortwährend auch in viszeralchirurgischen Kliniken implementiert.
Fragestellung. Wie sicher ist die Patientenversorgung auf einer viszeral-chirurgischen IPSTA?
Material und Methoden. In dieser prospektiven, nicht-randomisierten Evaluationsstudie wurde die Häufigkeit und Schwere von Patientenschäden in drei Gruppen einer deutschen viszeralchirurgischen Klinik eines Maximal-versorgers mit jeweils 100 Patient:innen untersucht. Bei den Gruppen handelte es sich um die Patient:innen der IPSTA sowie der Normalstation dieser Klinik vor und nach der IPSTA-Einführung. Die Suche nach Patientenschäden erfolgte mit Hilfe des Global Trigger Tools. Die Datenerhebung auf der Normalstation vor der IPSTA-Einführung erfolgte im November und Dezember 2021, auf der IPSTA und auf der Normalstation nach der IPSTA-Einführung von Mitte Januar bis Dezember 2022.
Zur parallelen Ermittlung der patient:innenzentrierten Bewertung der Behandlung (PROMs) erfolgte eine Patientenbefragung nach der Picker-Methode.
Zudem wurde der Kompetenzerwerb der Medizinstudierenden während ihres vierwöchigen IPSTA-Aufenthalts durch einen wöchentlich auszufüllenden Frage-bogen zu zwölf anvertraubaren professionellen Tätigkeiten (EPAs) gemessen.
Ergebnisse. Die Basisdaten, Operationscharakteristika und Outcomeparameter der Patient:innen der drei Studiengruppen waren vergleichbar. Insgesamt sind 79 Schäden bei 63 (21%) der Patient:innen entdeckt worden, davon zwölf mit einer Ursache vor dem Krankenhausaufenthalt und 67 mit einer Ursache während des Krankenhausaufenthalts. Im Krankenhaus lag die Ursache bei 50 Schäden im OP-Bereich und bei 17 Schäden auf der Station. Von den insgesamt fünf vermeidbaren Schäden bei fünf (1,7%) der Patient:innen war keiner durch die Versorgung auf der IPSTA bedingt. Von den Patient:innen wurde die Sicherheit auf der IPSTA als gleich gut wie auf der Normalstation und besser als bei über 90% der deutschen Kliniken der Picker-Vergleichskohorte bewertet.
Die IPSTA-Absolvent:innen berichteten bei jeder einzelnen der zwölf abgefragten EPAs über einen deutlichen Kompetenzgewinn.
Diskussion. Gemäß den erhobenen Daten kann die Patientenversorgung auf einer adäquat implementierten viszeralchirurgischen IPSTA als sicher an-gesehen werden. IPSTAs stellen ein wertvolles Instrument zur Ergänzung der klinischen Lehre dar.Background. Interprofessional training wards (ITWs) are increasingly being integrated into teaching and training concepts in Germany and therefore a growing number of ITWs are implemented in departments of visceral surgery, too.
Objectives. How safe is patient care on an ITW in visceral surgery?
Materials and methods. In this non-randomized prospective evaluation study we investigated the frequency and severity of adverse events (AE) in three groups of 100 patients each in a German department of visceral surgery. Groups comprised of the patients of the ITW and of the normal ward of this department before and after implementation of the ITW. We used the Global Trigger Tool to search for AE. Data collection on the normal ward before implementation of the ITW took place in November and December 2021 and from mid-January to December 2022 for the other two groups.
Simultaneously we conducted a survey of the treatment according to the Picker method to measure patient reported outcomes (PROMs).
Furthermore we asked the medical students of the ITW to estimate their competence regarding twelve entrustable professional activities (EPAs) by filling out a questionnaire every week.
Results. Baseline characteristics and clinical outcome parameters of the patients of the three groups were comparable. Altogether we found 79 AE in 63 (21%) of the patients caused in twelve cases before and in 67 cases during hospital stay. During hospital stay 50 AE were caused in the operating theatre and 17 on the ward. None of the five preventable AE (in 1.7% of the patients) was caused on the ITW.
Patients rated patient safety on the ITW better than in 90% of the hospitals included in the German benchmark of the contractor and as good as on the normal ward.
ITW participants reported on a substantial gain in competence for their future jobs.
Conclusions. Due to our data patient care on a carefully implemented ITW in visceral surgery can be considered as safe. ITW are a valuable instrument to complement clinical teaching
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe 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
Get PDF“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
Get PDFWe 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
Get PDFWe 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
Elektronenmikroskopische Untersuchung zum Einfluß partikulärer Bestandteile aus intensivmedizinischen Maßnahmen auf die Lungenmorphologie von Patienten mit 'ARDS' : klin. u. experimentelle Unters
No full textElektronenmikroskopische Untersuchung zum Einfluß partikulärer Bestandteile aus intensivmedizinischen Maßnahmen auf die Lungenmorphologie von Patienten mit 'ARDS' : klin. u. experimentelle Unters
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