1,721,039 research outputs found
Miomectomia laparoscopica
No full textI leiomiomi (o fibromi) uterini sono la neoplasia uterina più comune e colpiscono fino al 30% delle donne in età fertile, con riscontro istologico nei campioni post-isterectomia fino al 77% dei casi. Si tratta di lesioni estrogeno-dipendenti le cui dimensioni tendono ad aumentare durante la gravidanza e a ridursi nell’età post-menopausale. Nel 20-50% dei casi sono asintomatici e non richiedono alcun trattamento, ma follow-up regolari. Nei restanti casi, i fibromi possono causare sintomi correlati alle loro dimensioni e alla loro localizzazione, quali sanguinamenti uterini anomali (menometrorragie o spotting), anemizzazione secondaria, sintomi da compressione (dolore pelvico, stipsi o pollachiuria). I fibromi hanno, inoltre, un impatto negativo sulla fertilità e si associano a complicanze ostetriche, quali aborti spontanei, parti pretermine, ritardi di crescita e malpresentazioni fetali. Nelle donne che desiderano conservare l’utero e quindi nelle pazienti in cerca di gravidanza, la miomectomia costituisce l’intervento chirurgico di scelta per l’asportazione dei miomi uterini sintomatici. La miomectomia può essere eseguita per via laparoscopica, laparotomica o isteroscopica a seconda della posizione, della dimensione e del numero dei leiomiomi. L’approccio laparoscopico è spesso preferito a quello laparotomico, in quanto associato ad un inferiore tasso di complicazioni postoperatorie, ridotto dolore postoperatorio, migliore risultato estetico e ospedalizzazione più breve. Inoltre, la laparoscopia sembra avere il vantaggio di provocare meno aderenze post-operatorie rispetto alla laparotomia che sono spesso origine di sintomatologie algiche e disfunzionali. La miomectomia laparoscopica è stata descritta per la prima volta come tecnica chirurgica da Semm e Mettler nel 1977, ma solo a partire dagli anni novanta il numero di pazienti trattate con questa tecnica è aumentato notevolmente. Infatti, a causa del sempre maggior numero di donne che desiderano un intervento chirurgico che conservi la fertilità e dei rapidi progressi tecnologici per migliorare la chirurgia mini-invasiva, compreso lo sviluppo della piattaforma robotica nel 2005, la miomectomia laparoscopica o robot-assistita è sempre più spesso l’intervento chirurgico di scelta per le donne sintomatiche affette da fibromatosi uterina. L’approccio laparoscopico, tuttavia, richiede una lunga learning curve per il chirurgo, in particolare per la sutura della breccia uterina e per la morcellazione dei miomi asportati. La miomectomia laparoscopica risulta essere ad oggi una tecnica sicura e riproducibile, diffusa in tutto il mondo, con eccellenti risultati. Recenti dati, infatti, riportano un basso tasso di complicanze associate a questa procedura e basse percentuali di conversioni laparotomiche
Practical fundamentals of retroperitoneal spaces for safe pelvic surgery: possible answers to difficult questions
No full textSeparate works report a strong association between knowledge of pelvic anatomy and surgical competency (Lentz, 2001). The ability to manage several surgical procedures is considerably influenced by the level of training in anatomy and the ability to identify key anatomical structures (Arraez-Aybar, 2010). The importance of applied anatomy is suggested also by a 7-fold increase in claims made to UK Medical Defence Organizations between 1995 and 2000 (Waterston, 2005).
The most easily identifiable anatomical structures are pelvic organs and blood vessels. Instead, retroperitoneum, nerves and lymphatics are the least identifiable. Furthermore, whilst laparoscopy has become the standard of gynaecological surgical care, ability to identify pelvic structures at laparoscopy was found less than both laparotomy (Sgroi, 2014).
Preliminary data of ongoing multi-centric study conducted by Bologna University, assessing through a survey necessity and level of training of retroperitoneal anatomy among gynaecologists, have provided an overview of the poor knowledge and confidence of surgeons with this topic. Most of gynaecologists sustain retroperitoneal anatomy as an essential topic in their work, but they perceive limitations in their anatomical knowledge and training.
Recognizing retroperitoneal structures is essential for management of complex surgery (i.e. deep endometriosis, oncology), but can be also crucial for so-called “every-day” surgery (Cruikshank, 1987; Gingold and Falcone, 2016; Sharma, 2014).
We aim by this chapter to provide practical, basic knowledge about the retroperitoneal pelvic anatomy, referring to other chapters the dissertation of the remaining anatomical topics
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
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
Author-wise bibliometric analysis based on entropy.
No full textAuthor-wise bibliometric analysis based on entropy.</p
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