1,720,968 research outputs found
Evoluzione delle indicazioni chirurgiche nell'iperaldosteronismo primario [Development of surgical indications in primary hyperaldosteronism]
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Prediction of bone mass gain by bone turnover parameters after parathyroidectomy for primary hyperparathyroidism: neural network software statistical analysis.
No full textBackground: Primary hyperparathyroidism (pHPT) is the most frequent endocrine hypersecretion disease, and parathyroidectomy is the only curative option, since pharmacologic therapy reduces hypercalcemia but does not impede parathyroid hormone hypersecretion. According to guidelines from the National Institutes of Health, parathyroidectomy is associated with bone mass increase in some asymptomatic patients, while in others bone mass is not changed after surgery. Therefore, we performed the present study in an attempt to elucidate whether a preoperative biochemical bone parameter can be predictive of a significant vertebral bone mass increase in patients with pHPT. Methods: For each patient we analyzed the following preoperative parameters: parathyroid hormone, urinary calcium excretion, urinary type I collagen cross-linked N-telopeptide (NTX), osteocalcin, and vertebral computerized bone mineralography. All patients underwent vertebral computerized bone mineralography 12 months after the operation. Statistical analysis was carried out by a neural network program, an event-predicting software modeled on human brain neuronal connections, which is able to examine independent statistical parameters. Results: The patients presenting with high preoperative bone turnover (especially high NTX levels) will have a 5% vertebral bone mass gain in 83.33% of cases after surgery, independently of the National Institutes of Health guidelines. Conclusions: A high preoperative NTX level seems to be the best predictor parameter for postoperative vertebral bone mass gain in patients with pHPT. Our study also illustrates that neural network software may be a valuable method to help elucidate which pHPT patients should undergo surgical treatmen
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
Surgical therapy for rectal prolapse: Advantages and limits of proctopexy using an abdominal route
No full textIn the surgical treatment of prolapse proctopexies using an abdominal route and synthetic mesh appear to represent the most effective type of surgery. Various techniques can be used, all with similar results: in particular, it is worth emphasising the low operating risk even in elderly patients, the small number of recurrences, and the improved continence reported in many cases. The authors discuss whether the mobilisation of the rectum as far as the levators ani, a stage which precedes the plasty, should be circumferential or limited to the posterior wall in order to avoid nerve lesions. Although specific complications are limited in overall terms (in particular the risk of sepsis), the occurrence of a considerable numer of alterations of the alvus, ranging from persistent stipsis to real occlusion, are worth noting in the postoperative period. These may be explained by the formation of a convoluted sigmoid loop and damage to nerve fibres in the autonomous system. Alternative operations such as simple presacral proctopexy associated with sigmoid resection or surgery using a perineal route (e.g. Delorme's technique) are therefore used and should not only be reserved for those patients in generally poor conditions. Moreover, these techniques are often not simple and a much higher number of recurrences are reported compared to abdominal proctopexy
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