1,720,971 research outputs found
A rare case of isolated rectal laceration during parturition: consideration of the controversial role of the episiotomy and literature review
No full textBackground: Rectal laceration without sphincter lesion during childbirth is an unusual presentation. Like all the other severe lacerations during parturition, if left undiagnosed and untreated could hesitate in serious short and long term complications. Episiotomy once considered a routine procedure in nulliparous and a safeguard against severe tissue trauma nowadays is undergoing criticism and his effectiveness reconsidered. Currently, a policy of “selective” use of episiotomy is recommended only when an impending risk of lacerations is identified. When, according to this proposal, in the absence of risk factors episiotomy is not performed and complications occur, the medicolegal implication could arise. Case: A 29-year-old primigravida was admitted with spontaneous onset of labor at 41 weeks after an uncomplicated pregnancy. During the second stage of labor a spurt of siero- hemorrhagic fluid was noted trough the anus. In absence of recognized risk factor episiotomy was not performed. A healthy 3650 grams female was born in a fair condition. Rectal examination immediately after delivery revealed a longitudinal laceration with un undamaged sphincter. The rectal tear was repaired and recovery was uneventful. Conclusions: In our as in the other cases here reviewed a severe laceration occurred unexpectedly and unpreventably in patients where, according to a selective regime, episiotomy was not performed. In this setting, if severe short and long term complications ensued, especially in nulliparous, the decision to withhold episiotomy could be a source of medicolegal issues. Therefore a detailed informed consent is necessary to offer to patients a full disclosure on the role of episiotomy, its recent indications as well as the possible complications stemming from both executing or withholding this procedure
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
Adenomyosis: A potential cause of surgical failure in treating dyspareunia in rectovaginal septum endometriosis
Full text linkObjective: Dyspareunia can severely impact the quality of life of patients with endometriosis. This symptom is often linked to a specific form of deep infiltrating endometriosis, such as rectovaginal septum endometriosis. Despite the radicality of surgery, persistence and recurrence of symptoms post-surgery are not uncommon. The aim of the present study was to determine whether adenomyosis contributes to the failure of surgical interventions for dyspareunia in these patients. Methods: A retrospective single-cohort study was conducted at the at tertiary care gynecologic center of the University Federico II of Naples, using medical records from January 2020 to July 2023. The study included patients who underwent surgery for dyspareunia associated with rectovaginal endometriosis and had a definitive histologic diagnosis. Pain and sexual quality of life were assessed using the visual analog scale (VAS) and the sexual quality of life-female (SQoL-F) questionnaire, both before and 6 months after surgery. Patients with isolated rectovaginal endometriosis were compared to those with concurrent adenomyosis. Results: A total of 94 patients were included: thirty-five in group A (endometriosis with adenomyosis) and 59 in group B (isolated rectovaginal endometriosis). Histology confirmed deep infiltrating endometriosis (DIE) in all patients. Clinical characteristics such as age, BMI, abnormal uterine bleeding, and infertility, showed no significant differences between the groups. Multiparity was more common in group A (20%) compared to group B (5.1%) (P < 0.001). Pain VAS scores decreased significantly in both groups: from 7.11 to 5.40 in group A and from 7.34 to 3.31 in group B (both P < 0.001). Sexual quality of life (SQoL) scores improved significantly: from 42 to 57 in group A and from 41 to 66 in group B (both P < 0.001). Patients in group B showed a more significant improvement. Adjusted linear regression showed no significant association between parity and the severity of dyspareunia or sexual quality of life. Conclusion: Adenomyosis appears to reduce the effectiveness of surgical treatment for dyspareunia in patients with rectovaginal septum endometriosis. Comprehensive preoperative screening for adenomyosis is recommended to improve surgical outcomes and provide appropriate counseling. Future research should further explore the impact of adenomyosis on dyspareunia and the potential benefits of adjunctive medical therapies
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
EVALUATION OF OVARIAN ADHESION FORMATION AFTER LAPAROSCOPIC OVARIAN DRILLING BY SECOND-LOOK MINILAPAROSCOPY.
No full textObjective: To determine the incidence, site, and grade of ovarian adhesion formation after laparoscopic ovarian
drilling (LOD) and analyze the association between the number of punctures made and the incidence and grade
of adhesions, and evaluate the lateral distribution of the adhesions.
Design: Prospective clinical study.
Setting: University hospital endocrine and infertility center.
Patient(s): Ninety-six anovulatory infertile women with polycystic ovarian syndrome (PCOS) treated with
LOD.
Intervention(s): Women were randomized into two study groups of 48 women each, one treated with 6 punctures
on the left ovary and 12 on the right, and the other treated with 6 punctures on the right ovary and 12
on the left. A short-term second-look minilaparoscopy was performed to evaluate postsurgical adhesion formation.
Main Outcome Measure(s): [1] Evaluation of the incidence and grade (thin, dense, cohesive) of ovarian adhesions;
[2] comparative analysis of the incidence and grade of ovarian adhesions between ovaries treated with 6
and 12 punctures; and [3] comparative analysis of the incidence and grade of ovarian adhesions between the two
sides.
Result(s): Adhesion formation was detected in 54 of the 90 women (60%) and in 83 of the 180 ovaries treated
(46%). Dense adhesions were more likely to develop on the left ovaries to a statistically significant extent,
and independently of the number of ovarian punctures performed (odds ratio [OR] 1⁄4 4.34, 95% confidence
interval [CI] 1⁄4 1.72–10.94). Logistic regression analysis showed that the incidence of ovarian adhesions was
independent of both number of punctures (OR 1⁄4 1.05, 95% CI 1⁄4 0.58–1.88) and side (OR 1⁄4 1.37, 95%
CI 1⁄4 0.76–2.46).
Conclusion(s): The incidence of ovarian adhesion formation after LOD was high, and their extent and severity was
not influenced by the number of ovarian punctures; however, the left ovary appeared more prone to develop severe
adhesions than the contralateral one
CERVICAL FETAL FIBRONECTIN AS A PREDICTOR OF FIRST TRIMESTER PREGNANCY OUTCOME IN UNEXPLAINED RECURRENT MISCARRIAGE
No full textEvaluation of ovarian adhesion formation after laparoscopic ovarian drilling by second-look minilaparoscopy
No full textEditorial: Management of borderline ovarian tumor: The best treatment is a real challenge in the era of precision medicine
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