1,720,975 research outputs found
Rapidly fatal outcome of Covid-19 after successful emergency surgery during pandemic outbreak in Northern Italy
No full textIntroduction: A pandemic outbreak of novel coronavirus, named SARS-CoV-2 and responsible of Coronavirus Disease 2019 (COVID-19), has rapidly spread from China to Europe, being Northern Italy the first focus outside Asia. Little is known about the evolution of SARS-CoV-2 infection in patients undergoing surgery. Presentation of case: Here we report the first confirmed case of early postoperative SARS-CoV-2 infection in a patient recovering after Hartmann's procedure for acute diverticulitis. After an otherwise unevenful postoperative course, on post-operative day 8, the patient suddenly presented hyperpyrexia and cough, rapidly evolving to respiratory failure and death 36 h after symptoms onset. CT-scan identified bilateral, diffuse, interstitial pneumonitis and oropharyngeal swab test confirmed the presence of SARS-CoV-2. A previous contact with the partner, developing the same symptoms, remained unrecognized until ICU admission. Discussion: During a pandemic outbreak, the early identification of SARS-CoV-2 infection of an inside patient initially considered to be infection-free has a pivotal importance not only for the prompt patient's management, but also to avoid infection spreading to other patients and hospital personnel.In the reported case, a more precise information to the patient regarding the imperative necessity to inform the medical personnel of any person of his entourage presenting, at any time, any tell-tale sign, symptom or examination which may be attributed to COVID-19, may have had allowed to anticipate patient's isolation and examinations and procedures aimed at identifying such an infection. Conclusion: Persistent hyperleucocytosis and increased CRP serum level in spite of uneventful postoperative course were the only, aspecific markers of an ongoing SARS-CoV-2 infection before symptoms’ onset, and should be considered in future clinical practice in order to adopt the prompt and appropriate patient management and limit COVID-19 contagion in surgical units
Prognostic value of the OESIL risk score in a cohort of Emergency Department patients with syncope.
No full textThe aim of this paper was to assess short and long term prognostic value of the OESIL risk score (ORS), a risk stratification rule for syncope which consider abnormal ECG, age > 65, history of cardiovascular diseases, lack of prodromal symptoms to identify patients at higher risk of mortality (ORS≥2) to be admitted. Methods: This is a prospective cohort study in which syncopal recurrences, readmission for other reasons, major therapeutic procedures, cardiovascular events, death for any reason, were assessed in a group of 200 syncopal patients at both 1 month and 1 year after discharge from an Emergency Department Observation Unit. Results: Multinomial logistic regression analysis showed that ORS ≥2 is not associated with any endpoint, except major procedures. Conversely, ORS≥3 was a strong predictor of at least 1 adverse event within 1 month and severe outcomes within 1 year, particularly for non-syncopal readmission (P<0.005), major procedures (P<0.002), cardiovascular events (P<0.023), and death for any cause (P<0.022). Conclusion: Our patient group was significantly older than the ORS derivation cohort (72.4±15.1 vs. 59.5±24.3 yrs) and mostly above the age considered as 1 point in the ORS, so it is rather understandable that only a more restrictive cut-off might be advantageous for identifying high risk patients. On the evidence of a progressive ageing of patients presenting at the EDs, we suggest to use a 33 ORS threshold when deciding for admission
Transplant Renal Artery Stenosis: A Case Report of Functional Recovery Six Months After Angioplasty
No full textTransplant renal artery stenosis (TRAS) is a common vascular complication after kidney transplantation, leading to worsening or refractory hypertension, deterioration in renal function, and possible cause of graft loss. Early diagnosis and an appropriate treatment are crucial for organ preservation. Endovascular treatment, including percutaneous transluminal angioplasty and stent implantation, is considered the first-line therapy for TRAS. Here we report the case of a 69-year-old woman with end-stage renal disease for chronic kidney disease not biopsy proven, who underwent a kidney transplant from expanded criteria donors on December 2018. Postoperative course was characterized by delayed graft function. Doppler ultrasonography (US) showed an increase of peak systolic velocity at the origin of the renal artery, and parvus-tardus waveform in periferic graft arteries and an abdominal computed tomography scan confirmed a stenosis at the origin of the main renal artery (TRAS). The patient underwent a percutaneous transluminal angioplasty. It was not possible to place a stent at the particular location of the stenosis at the anastomosis. Despite the improvement of the graft's perfusion, monitored with Doppler US, the patient showed a very poor improvement in renal function and remained on hemodialysis for months. A percutaneous needle biopsy reported a normal renal parenchyma and excluded acute rejection. During this period, the patient received immunosuppressive therapy. About 6 months after the transplant, the patient had an unexpected and slow renal function recovery until she was weaned completely from hemodialysis
Becoming adult at home. The central role of familiar responsibility in the development of adulthood.
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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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