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Partial Splenic embolization in the treatment of hypersplenism
No full textCASE PRESENTATION: A 30-year-old woman with a history of hepatitis B virus-related cirrhosis presented to our institution. In 2013, she underwent transarterial chemoembolization for hepatocellular carcinoma, followed by liver transplantation in August 2014. After surgery, the patient developed portal hypertension and hypersplenism. Partial splenic embolization was proposed.
PROCEDURE DESCRIPTION: From a right femoral access, we catheterized the splenic artery to perform diagnostic angiography using a 5-F (1.67-mm) sheath and a 4-F (1.33-mm) cobra catheter. We then decided to go distally to the peripheral intrasplenic branches to perform a more selective embolization. A torqueable DirexionTM Microcatheter and a Fathom®-16 Guidewire were easily advanced through a tortuous splenic branch to perform superselective catheterization of three vessels supplying the upper middle third of the spleen. Subsequently, we embolized those branches using microcoils. After embolization, the patient developed transient abdominal pain, which remitted with administration of pain relief medication.
FOLLOW-UP AND DISCUSSION: A postembolization CT scan demonstrated a successful embolization with evidence of partial devascularization of the spleen, with minimal perisplenic and perihepatic fluid and the absence of major complications. The patient showed significant reduction of portal pressure and was discharged a few days later. She was still in good clinical condition at follow-up
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
Trattamento Percutaneo della litiasi biliare: esperienza di un unico centro
No full textScopo: La gestione dei pazienti con litiasi biliare è volta a risolvere le colangiti e le infezioni biliari croniche. L’approccio percutaneo (PA) è attualmente indicato come alternativa efficace agli approcci endoscopici o chirurgici.
Materiale e metodi: E’ stato collezionato un database prospettico di pazienti sottoposti ad PA per litiasi biliare. Sono stati inclusi 104 pazienti trattati dal 2000 al 2015; 13 pazienti sono stati esclusi per una sottostante stenosi maligna. Dei restanti 91 pazienti, 38 (Gruppo A) avevano solo calcoli biliari e 53 (Gruppo B) avevano calcoli e stenosi biliare (BS). I nostri obiettivi sono stati: la valutazione del tasso di successo della procedura, l’efficacia a breve e lungo termine e la sicurezza del PA nei due gruppi e nella intera popolazione.
Risultati: Sono stati eseguiti 511 trattamenti, con una mediana di 5 trattamenti per paziente. Il tempo intercorso tra il primo trattamento e la rimozione finale del drenaggio è stato significativamente più lungo nel Gruppo B (p=0.039). Durante un follow-up medio di 38 mesi, la mediana di intervallo libero da calcoli biliari è stata di 21 mesi (intervallo di confidenza 95%: 14.1-28.7). La mediana di recidiva è stata più corta nei pazienti con stenosi biliare, sebbene non significativa (p=0.174). L'approccio percutaneo è stato più efficace nel lungo periodo nei pazienti del Gruppo A e non è stato più necessario nel 68.4% di questi pazienti rispetto al 35.8% dei pazienti nel Gruppo B (p=0.003).
Conclusioni: Il trattamento con approccio percutaneo per la pulizia dei calcoli biliari è una procedura efficace con elevati tassi di successo nei pazienti con calcoli biliari; tuttavia, la coesistenza di stenosi biliare condiziona l’efficacia a lungo termine
Perirenal ultrasound abnormality: When to think at Xantogranulomatous Erdheim-Chester disease
No full textTransarterial Chemoembolization and Radioembolization for Unresectable Intrahepatic Cholangiocarcinoma—a Systemic Review and Meta-Analysis
No full textPurpose: Intrahepatic cholangiocarcinoma (ICC) has a poor prognosis, when unresectable; therefore, intra-arterial therapies (IAT) such as trans-arterial chemoembolization (TACE) and trans-arterial radioembolization (TARE) have been employed. With the present systematic review and meta-analysis, we aimed to analyse published studies to understand if one IAT can be superior to the alternative. Materials and methods: A systematic search of PubMed and Web of Science databases was performed for articles published until 1 March 2020 relevant to IAT for ICC. Overall survival was the primary end point. Occurrence of clinical adverse events and tumour overall response were secondary outcome measures. Results: A total of 31 articles (of 793, n.1695 patients) were selected for data extraction, 13 were on TACE (906 patients) and 18 were on TARE (789 patients). Clinical and tumour characteristics showed moderate heterogeneity between the two groups. The median survival after TACE was 14.2 months while after TARE was 13.5 months (95%C.I.: 11.4–16.1). The survival difference was small (d = 0.112) at 1 year and negligible at 2 years (d = 0.028) and at 3 years (d = 0.049). The radiological objective response after TACE was 20.6% and after TARE was 19.3% (d = 0.032). Clinical adverse events occurred in 58.5% after TACE, more frequently than after TARE (43.0%, d = 0.314). Conclusion: In conclusion, IATs are promising treatments for improving outcomes for patients with unresectable ICC. To date, TACE and TARE provide similar good outcomes, except for adverse events. Therefore, the decision about techniques is determined by ability to utilize these resources and patient specific factors (liver function or lesion dimension)
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