1,720,996 research outputs found
Totally Cervical Thymoma from the Orthotopic Thymus
No full textTotally cervical thymoma is extremely rare and usually arises from ectopic thymic tissue. We report a case of a B1 thymoma localized in the neck, misdiagnosed for a decade as a thyroid nodule. Fine needle aspiration biopsy led to a preoperative suspicion of the correct diagnosis. The tumor was resected intact through a cervical collar incision, along with the upper thymic horn from which it originated. A pathogenetic hypothesis was formulated
Locally invasive thyroid cancer. Options for a treatment
No full textLocal invasion to neighbor organs by thyroid cancer is an important prognosticator and requires different therapeutic approach. Which one is the possible best treatment option and results are evaluated in this study. A single-institution experience in thyroid cancer invading the airway is evaluated retrospectively (1990-2016). Facts regarding patients' demographics, disease history, comorbidities, condition at first evaluation and reason for referral are analyzed. Hospital records and treatment details are extracted from charts and Institutional folders. Therapeutic indication and treatment option details are assessed. A total of 2203 thyroid cancer patients undergoing evaluation and treatment are found in the Institutional records. According to the current staging system, T4a cancers are 309. Airway has been compromised in 144 cases. All patients have been referred after receiving indicative workup imaging or airway-related symptoms. Well-differentiated histology is reported in 97; non-differentiated pattern is described in the remaining ones. Airway endoscopy is performed in all patients prior to every treatment planned. In 37 cases, the airway is found to get benefit from resection with curative intent; stenting has been indicated in 41 cases while tracheostomy has been performed in 44 cases as permanent treatment option. Rigid bronchoscopy is apparently a mandatory preliminary step for patients undergoing resection and reconstruction of a segmental airway tract. Tracheostomy is performed when the disease could not be submitted to exeresis or when the tumor biology shows a tumultuous disease. Forty patients had a stable symptoms relief after stenting. The rate of patients presenting with respiratory symptoms due to thyroid cancer infiltrating the airway is decreasing thank to screening programs and the greater attention to early detection. When possible, the segmental resection and reconstruction of the compromised airway produces good outcome and represents a surgical subspecialty requiring a multidisciplinary approach with specific technical competences. Stenting and tracheotomy are end-stage treatment with possible stable outcome for highly variable time span
Short term prospective evaluation of microalbuminuria after thoracic surgery
No full textOBJECTIVE
Micro-albuminuria (MA) is associated with a generalized increase in systemic vascular permeability and a sensitive marker of endothelial dysfunction. Several studies documented its rapid increase and its adverse prognostic significance after trauma, pancreatitis, ischemia reperfusion injury, and surgery. However, little is known about MA and its potential implication after thoracic surgery. We performed a prospective study to serially assess MA after thoracic surgery.
METHODS
Design: short-term prospective observational pathophysiology driven study. Setting: thoracic surgery unit. Patients: 80 consecutive patients. Outcome measures: MA in first-void urine samples before thoracic surgery and in postoperative day 1, 3 and 7.
RESULTS
Mean age was 63 years [60 to 65], 67% were male, and the most common comorbidities were COPD (55), hypertension (38), and diabetes (9). Sixty-four patients underwent standard thoracic surgery (55 lobectomies, 4 pneumonectomies and 5 thymectomies) and 16 VATS resections. Preoperative MAU level was normal, mean 0.61 mg/dl ([0.48 to 0.79]) while on postoperative day 1 we observed a seven fold increase (4.45 mg/dl [3.50 to 5.65] p<0.001). An even larger increase was observed in patients with diabetes and hypertension (8.95 mg/dl [1.54 to 52.09]; p<0.001 and 5.852 mg/dl [4.04 to 8.46]; p<0.001 respectively). On postoperative day 1 we did not find significant MAU differences between categories defined by type of surgery. Average MAU was normal and close to baseline level on postoperative day 7, however 45% of patients submitted to open procedures still had MAU greater than baseline level.
CONCLUSIONS
Our study showed that MAU might be and early marker of increased vascular permeability in thoracic surgery patients. As expected a larger increase was observed in diabetics and hypertensives. A wider proportion of patients undergoing VATS compared to open thoracic surgery recovered baseline MAU within 7 days. Persistence of MAU seems associated with the severity of surgical stress
Forgotten goiter: our experience
No full textForgotten goiter is a rare disease that is defined as a mediastinal thyroid mass after total thyroidectomy. Massard, a French school author, was the first to us this term. According to literature the incidence is between 2-16%. The authors recorded their experience about four cases. Patients age is 46-56 years and three of them were female: case n. 1 was an incidental finding, case n. 2 had cervicobrachialgia, case n. 3 had persistent hyperthyroidism and case n. 4 had thyroid cancer metastases in laterocervical nodes. The time gap between thyroidectomy and reintervention was average 10 years. Diameter of masses is between 8-10 cm. Cervicotomy was enough to carry out in one case, cervicotomy and sternotomy were used in two patients. In one case it was necessary to carry out a cervicosternotomy and right posterolateral thoracotomy because the mass reached the Barety loggia and paraesofageal area. We used new devices for hemostasis and intraoperative nerve monitoring. Cases of permanent hypoparathyroidism, permanent recurrent laryngeal nerve paralysis or hemorrhage were not recognized. The surgery is mandatory after diagnosis. The choice of the type surgery way is conditioned by the relationships that the pathological tissue has with the mediastinal structures and exact location in that area. Surgical management for forgotten goiter in specialized centers is associated with low morbility
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
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