1,720,993 research outputs found
Is unilateral approach under local anesthesia for parathyroidectomy feasible? A systematic review of literature
No full textINTRODUCTION: Primary hyperparathyroidism (PHPT) is a common endocrine disease especially in postmenopausal women and in older adults, with elevated parathyroid hormone (PTH) levels by parathyroid glands. The main symptoms of PHPT are hypercalcemia, often associated with hypercalciuria, urolithiasis and bone demineralization that results in osteopenia or osteoporosis and increases overall fracture risk. Parathyroidectomy is today the only definitive treatment for patients to prevent worsening of symptoms. Minimally invasive targeted approach for parathyroidectomy can be offered to patients with well-localized disease, and combined with intraoperative PTH monitoring, the success rate reaches 95-97%; with short operative time, low complications rates and decreased hospital costs. To date, minimally invasive parathyroidectomy (MIP) can be performed under local anesthesia and most patients can be discharged on the same day of surgery or the following morning. The aim of this article is to summarize the current evidence of MIP under local anesthesia and its clinical outcomes to assess the effectiveness and safety of this procedure. EVIDENCE ACQUISITION: We searched PubMed, Embase, Cochrane and Web of Science databases from their date of inception until 30th May 2024. Inclusion criteria consisted in articles from any country written in English reporting MIP under local anesthesia related clinical outcomes in humans. RCTs, quasi-RCTs, cross-sectional studies, retrospective and prospective cohort studies, case-control studies were included. EVIDENCE SYNTHESIS: We identified 2 3 e ligible s tudies t hat i ncluded 2 470 a dults (mostly f emale asymptomatic) with PHPT; follow-up duration varied from six months to 24 months. All studies were screened for assessments of quality based on Newcastle-Ottawa Scale and the risk of bias based on ROBIN-I of the included studies. The operative time, number of conversions to general anesthesia, hospital stay and complications was respectively: 43.86 minutes, with 114 conversions to general anesthesia, mean hospitalization time was 16.83±8.62 hours and complications reported in 71 patients. Previously of surgery, the abnormal parathyroid gland is localized using multiplexed ion beam imaging (MIBI) plus ultrasound (US) in 12 studies, only MIBI in three studies, thallium-technetium scan plus US in three studies, single-photon-emission computed tomography (SPECT) plus US in one study and a combination of MIBI, US, SPECT, CT and magnet resonance in one study. The mean preoperative value of PTH and serum calcium was 277.44 pg/mL and 11.49 mg/dL respectively; while the mean postoperative value of PTH and serum calcium was 46.18 pg/mL and 9.11 mg/dL respectively. At the definitive histology the most of pathology is adenoma with 542 cases reported, followed by hyperplasia with 35 cases and only 20 cases of carcinoma. CONCLUSIONS: Focused mini-invasive parathyroidectomy under local anesthesia, guided by positive preoperative localization exams and accurate laboratory data, could be a feasible and effective surgical technique to cure primary hyperparathyroidism, with reduced operative time, a small surgical incision, shorter hospitalization stay and a lower occurrence of postoperative complications
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
Surgical margins in breast-conserving therapy: current trends and future prospects
No full textInadequate surgical margins represent a high risk for adverse clinical outcome in breast-conserving therapy (BCT) for early-stage breast cancer. The majority of studies report positive resection margins in 20% to 40% of the patients who underwent BCT. This may result in an increased local recurrence (LR) rate or additional surgery and, consequently, adverse effects on cosmesis, psychological distress, and health costs. In the literature, various risk factors are reported to be associated with positive margin status after lumpectomy, which may allow the surgeon to distinguish those patients with a higher “a priori” risk for re-excision. However, most risk factors are related to tumor biology and patient characteristics, which cannot be modified as such. Therefore, efforts to reduce the number of positive margins should focus on optimizing the surgical procedure itself, because the surgeon lacks real time intraoperative information on the presence of positive resection margins during breast-conserving surgery. This review presents the status of pre- and intraoperative modalities currently used in BCT. Furthermore, innovative intraoperative approaches, such as positron emission tomography, radio-guided occult lesion localization, and near-infrared fluorescence optical imaging, are addressed, which have to prove their potential value in improving surgical outcome and reducing the need for re-excision in BCT
Metaplastic carcinoma of the breast: Treatment, results and prognostic factors based on international literature
No full textMetaplastic carcinoma of the breast (MCB) is a rare form of cancer containing mixture of epithelial and mesenchymal elements in variable combinations. Few and conflicting clinical data are available in the literature addressing optimal treatment modalities, prognosis and outcome. A retrospective study was conducted to review all patients with MCB diagnosed and treated at Breast Unit of Azienda Ospedaliera "Santa Maria" Terni - Italy between 2001/2010. The aim is to describe patient's clinic pathologic features and to analyze treatment results. Six female patients were studied. The median age was 48 years (range 14/58). The median tumor size was 9 cm. (range 3/18 cm.). Two cases (33%) were identified as purely epithelial and 4 (67%) as mixed epithelial and mesenchymal metaplasia. Hormone receptors were positive in only 2 patients. Modified radical mastectomy performed in 3 patients and 5 underwent axillary node dissection. Adjuvant chemotherapy was given to all patients and postoperative radiotherapy to 4. Four patients relapsed with median time of relapse of 12 months. MCB is an aggressive form of breast cancer associated with poor outcome, high incidence of local recurrence and pulmonary metastases. The disease tends to be estrogen/progesterone receptor negative. Tumor size has an important impact on outcome. The best treatment approach is yet to be defined
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
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