1,721,079 research outputs found
Contrast-Enhanced Ultrasound (CEUS) in Nephrology
No full textContrast-enhanced ultrasound (CEUS) represents one of the most interesting and promising examples of imaging application in clinical practice. Ultrasound contrast media are defined as “blood pool” agents because they remain confined into blood vessels without reaching the excretory tract. They are classified into first and second generation depending on the gas in microbubbles. When the ultrasound beam hits microbubbles in the blood flow, their compressible gas cores oscillate in response to the high-frequency sonic energy field. The microbubbles reflect a unique echo that stands in stark contrast to the surrounding tissue due to the orders of magnitude mismatch between microbubble and tissue echogenicity. Both contrast generations are characterised by an excellent safety profile, with rare hepatic and central nervous system side effects and absent nephrotoxicity thanks to their predominant pulmonary clearance. The clinical utility of CEUS, which is widely recognised in the study of liver diseases, is also becoming relevant to the pathology of other organs, such as genitourinary system, gastrointestinal tract, peripheral vascular system, spleen and lymph nodes, and breast, lung, and endocrine and exocrine glands. Possible applications of CEUS in nephrology include renal ischemia, differential diagnosis of cystic and solid lesions, follow-up of ablative therapies, kidney trauma, kidney transplant, inflammatory diseases, renal artery stenosis, and vesicoureteral reflux
Surgical therapy: possible one-step solutions
No full textOne step-solution in management of female to mal
Surgery in complications: ileal vaginoplasty
No full textIleal vaginoplasty for surgical complication
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
Characterization of Focal Liver Lesions with Contrast-specific US Modes and a Sulfur Hexafluoride–filled Microbubble Contrast Agent: Diagnostic Performance and Confidence
Full text linkPURPOSE: To assess whether characterization of solid focal liver lesions could be improved by using ultrasonographic (US) contrast-specific modes after sulfur hexafluoride–filled microbubble contrast agent injection, as compared with lesion characterization achieved with preliminary baseline US.
MATERIALS AND METHODS: Four hundred fifty-two solid focal hepatic lesions that were considered indeterminate at baseline gray-scale and color Doppler US were examined after microbubble contrast agent injection performed by using low-acoustic-power contrast-specific modes during the arterial (10–40 seconds after injection), portal venous (50–90 seconds after injection), and late (100–300 seconds after injection) phases. Two readers independently and retrospectively reviewed baseline and contrast material–enhanced US scans and classified each depicted lesion as malignant or benign according to standard diagnostic criteria. Sensitivity, specificity, accuracy, and positive and negative predictive values and areas under the receiver operating characteristic curve (Az) were calculated by considering histologic analysis (317 patients) or contrast-enhanced helical computed tomography followed by serial US 3–6 months apart (135 patients) as the reference standards.
RESULTS: Different contrast enhancement patterns were observed according to lesion characteristics. During the late phase, benign lesions were predominantly hyper- or isoechoic relative to the adjacent liver parenchyma, whereas malignant lesions were predominantly hypoechoic. Review of the contrast-enhanced US scans after baseline image review yielded significantly improved diagnostic performance (P < .05). Overall diagnostic accuracy was 49% before versus 85% after review of the contrast-enhanced scan for reader 1 and 51% before versus 88% after review of the contrast-enhanced scan for reader 2. Diagnostic confidence—that is, the Az—was 0.820 before versus 0.968 after review of the contrast-enhanced scan for reader 1 and 0.831 before versus 0.978 after review of the contrast-enhanced scan for reader 2.
CONCLUSION: The use of contrast-specific modes with a sulfur hexafluoride contrast agent led to improved characterization of solid focal liver lesions
Ethical issues for the practitioner work in transgender care
No full textAll treatment decisions involve the tacit decision to treat or to withhold treatment. Although often not expressed, the “not to treat” side of the analysis of risks versus benefits is quite important and should be explored in patients with gender identity dysphoria (GID) and its variants. The availability of somatic treatments as accepted interventions for the overall management of GID raises a number of bioethical issues. The medical literature rarely is as rife with affect as when this issue is discussed by those who oppose the application of surgical treatments as part of the treatment plan for gender transmutation
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
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