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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
Rare extragonadal teraratomas in children: complete tumor excision as a reliable and essential procedure for significant survival. Clinical experience and review of the literature
No full textBACKGROUND:
Extragonadal teratomas are rare tumors in neonates and infants and can sometimes show unusual, distinctive feature such as an unusual location, a clinical sometimes acute, presentation and a "fetiform" histotype of the lesion. We have extrapolated, from our entire experience of teratomas, 4 unusual cases, mostly operated as emergencies; 2 of them were treated just after birth. Aim of this paper is to report the clinical and pathological findings, to evaluate the surgical approach and the long-term biological behaviour in these cases, in the light of survival and current insights reported in the literature.
MATERIAL AND METHODS:
The Authors reviewed the most significant (Tables I and II) clinical, laboratory, radiologic, and pathologic findings, surgical procedures, early and long-term results in 4 children, 1 male and 3 females (M/F ratio: 1/3), suffering from extragonadal teratomas, located in the temporo-zygomatic region of the head (Case n. 1, Fig. 1), retroperitoneal space (Case n. 2, Fig. 2) ,liver (Case n. 3, Figg. 3-5), kidney (Case n. 4, Fig. 6, 7), respectively. Of the 4 patients, 2 were treated neonatally (1 T. of the head, 1 retroperitoneal T.) A prenatal diagnosis had already been made in 2 of the 4 patients, between the 2nd and 3rd trimester of pregnancy, All the infants were born by scheduled caesarean section in a tertiary care hospital and were the immediately referred to thew N.I.C.Us. Because of a mostly acute clinical presentation, the 4 patients were then referred to the surgical unit at different ages: 7 days, 28 days, 7 months, and 4 years respectively. The initial clinical presentation (Table II) was consistent with the site of the mass and/or its side effects. The 2 newborns (Case 1 and 2) both with a prenatally diagnosed mass located at the temporozygomatic region and in the abdominal cavite respectively, already displayed, at birth a mass with a tendency to further growth. The symptoms and signs described to the primary care physician by the parents of the 2 patients suffering from intra-abdominal tumours (Cases n. 3, 4) were: swelling of the epigastrium and left hypochondrium due to a progressively growing hard mass, without impairment of the general, conditions in case n.3 (teratoma of the liver),while recurrent abdominal pain lasting for the 5 months was described in case n.4(retroperitoneal teratoma), followed by the development of an evident hard mass occupying the entire abdomen. In this case the symptoms suddenly worsened, with acute pain extending to the entire abdomen, high fever (>39° C), polypnea, anemia, deterioration of the general conditions and a rapid further enlargement of the mass. Antibiotic therapy was ansuccessful. The young child underwent a radiologic investigation (Fig. 6) that showed a large calcified mass in the left retroperitoneal space, associated with pleural effusion, In all the patients except for the Case n. 3, emergency surgical management was required and, in accordance with recommended practice, the procedure was complete exeresis.
RESULTS (TABLE I):
All the 4 patients had an uneventful postoperative course. Clinical surveillance and tests of AFP and other markers were scheduled every 6 months for the first years and annually thereafter. At the current date they are alive, disease-free and have not suffered any recurrence with a follow-up as reported in Table I, of 7 years in case n. 2; 23 years in case n. 1; 42 years in case n. 3 and 36 years in case n. 4.
CONCLUSIONS:
Some extragonadal teratomas of childhood of may rarely arise in the solid organs (liver, kidney), in the retroperitoneal space or the cranio-facial region, and also show unique histotype childhood characteristics ("fetiform") which distinguish them from more common cases. Being congenital tumours, prenatal diagnosis by US scan is extremely important in order to organize proper perinatal care in appropriate facilities where it is possible to define the diagnosis and carry out emergency surgery. An emergency procedure is frequently dictated both by complications related to the mass eddect and by the need to define the histology of the whole mass rather than just small biopsy specimens, Some teratomatas can hide more or less extensive islands of immaturity signs of malignant transformation that are clinically evident. It should be remembered that high serum levels of alpha-fetoprotein and calcficationof the imaging study, that are usually pathognomonic elements for fiagnosis, nay be lacking in abdominal lesions. Moreover, some additional specific diagnostic problems can be faced by either the radiologist (differential diagnosis from acquired or congenital cystic lesions, identification of the primary site of origin in the liver kidney or retroperitoneal space). Or the histopathologist (exclusion of renal metastasis of a primary gonadal teratomas of a glomerular and tubular differentiation a Wilm's tumour). The prognosis is generally benign, although the AIEOP guideline pointed out that high levels of circulating markers, including AFP, in children affected by mature or immature teratomas, could indicate rhe presence of micro-foci of YST, marking them out as at high risk. The UKCCSG II and the SFOP indicates AFP values exceeding 10,000 ng/ml as the threshold identifying a group of patients with a severe prognosis. The treatment indicated is early, complete exeresis, followed by a careful, exstensive, microscopic examination, associated, if necessary, with adjuvant chemotherapy. Finally, to improve the prognosis, close, long-term clinical, laboratory and imaging surveillance is necessary, at shorter intervals during the first 5 years after the exeresis and annually thereafter
Il diverso approccio di Francia e Italia nella fusione dei territori regionali
No full textIl saggio ricostruisce il diverso approccio costituzionale al tema della fusione delle regioni fra l’ordinamento francese e quello italiano, dalla «non rilevanza» del dissenso dei territori e delle comunità in Francia alle garanzie procedurali e ai limiti all’accorpamento forzato delle regioni italiane per effetto dell’efficacia permanente del principio costituzionale autonomist
L’autonomia finanziaria regionale alla prova: il diritto alla salute tra Stato e Regioni
No full text
L’influenza dell’evoluzione dell’Unione Europea sulla Presidenza del consiglio e sul suo Presiden-te nel nuovo secolo: dal Trattato di Nizza al secondo governo Conte
No full textObiettivo di questo lavoro è quello di analizzare non tanto l’evoluzione del ruolo del Presidente del Consiglio quanto di analizzare gli effetti della successione nel tempo di una serie di leggi che hanno inciso direttamente sulle competenze, sui rapporti con le altre istituzioni esterne e quindi in definitiva sul ruolo del Presidente del Consiglio. Si cercherà di verificare se, a Costituzione invariata, solo le leggi elettorali incidano sull’evoluzione dei poteri del Presidente del Consiglio, ovvero se vi siano state altre leggi che, parimenti, possano influire su di essi o, ancora, se occorra indirizzarsi verso fattori esogeni all’organo che, indirettamente, determinano un nuovo riadattamento al sistema.
A questo riguardo, il carattere intergovernativo dell’organizzazione europea e l’espansione dei poteri in quella sede esercitati dai rispettivi governi hanno sicuramente esercitato un’influenza significativa sul riconoscimento di un’autonomia di decisione del Presidente del Consiglio, così da garantirgli spesso un’emancipazione dalle decisioni del proprio Consiglio, che si è manifestata in numerose e diverse fasi della vita governativa, con conseguente europeizzazione della forma di governo di numerosi Stati e sicuramente anche dell’Italia
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
Unusual presentation of sacro-coccygeal teratomas and associated malformation in children- clinical experience and review of the literature
No full textBACKGROUND:
Sacrococcygeal teratomas are the most common and best known extragonadal teratomas in neonates and infants, but they sometimes present unique, distinctive features unlike those commonly described, that can be considered exceptional and noteworthy.
MATERIAL AND METHODS:
The Authors reviewed the most significant (Table I, II) clinical, laboratory, radiological and pathologic findings, surgical procedure, and early and long-term results in 5 children, 2 males and 3 females, suffering from sacrococcygeal teratomas. Four of 5 patients were observed and managed in the neonatal age. A prenatal diagnosis had already been made in 2 of them between the 2nd and 3rd trimester of pregnancy. Two patients were also suffering from the Currarino syndrome associated with Hirschsprung's disease and other, multiple malformations and a cloacal anomaly with anal imperforation, respectively. This last developmental anomaly had been prenatally suspected at US scanning, which had demonstrated a severe sacral anomaly and a large abdominal mass with perineal extension and dilated bowel loops. All the infants were born by scheduled caesarean section in a tertiary care hospital and were then referred to the N.I.C.Us. because of a mostly acute clinical presentation, except for case N°4, who was referred at the age of 3.3 years. Laboratory and radiologic investigations confirmed the clinical diagnosis of teratoma on the basis of elevated AFP values and imaging findings. All patients underwent emergency surgical management, in accordance with recommended practice, consisting of complete exeresis of the tumor, including coccygectomy, in 3 of the 5 children.
RESULTS:
Of the 5 patients, the female newborn affected by the Currarino syndrome, associated with persistence of the common cloacal canal and anal imperforation, died two days after surgery, of cardiovascular and respiratory complications. All the other patients had an uneventful postoperative course. Two years after the first exeresis at birth, relapse was observed in case N° 3, with a malignant component, YST, anticipated by elevated AFP values but negative physical signs and a benign cystic imaging pattern. After adjuvant chemotherapy she underwent a second complete exeresis. So far, 3 years after the second surgery and 5 years after the diagnosis and first treatment, no local recurrence or distant metastases have occurred. The other 3 patients are also all alive, disease-free and with no signs of relapse or distant metastasis, after a follow-up ranging from 2 years to 28 years. None of the 3 cases treated for sacrococcygeal teratoma, operated in 1985, 1984 and 2006, have ever developed functional sequelae such as ano-rectal and/or bladder dysfunction or hypotonia of the lower limbs.
CONCLUSIONS:
From this review of our selected cases and in the light of literature reports, we can draw the following conclusions. Some sacrococcygeal teratomas may have unique characteristics distinguishing them from more common cases, especially those included in the Currarino Syndrome, with or without an association with other malformations such as Hirschsprung's Disease and Cloacal anomalies. Being congenital tumors, prenatal diagnosis by US scan is extremely important in order to decide either for an anticipated delivery or to perform, in critical fetuses, prenatal treatment within highly specialized facilities, or to organize proper perinatal care, always in appropriate facilities where it is possible to define the diagnosis and carry out emergency surgery. An emergency procedure is frequently dictated both by complications related to the mass effect, and by the need to define the histology of the whole mass rather than just small biopsy specimens. Some sacrococcygeal teratomas can hide more or less extensive islands of immaturity or signs of malignant transformation that are clinically evident. The prognosis is generally benign, although AIEOP (Associazione Italiana Ematologia Oncologica Pediatrica) 2004 guidelines pointed out that high levels of circulating markers, including AFP, in children affected by mature or immature teratomas would indicate the presence of micro-foci of YST, marking them out as at high risk. The UKCCSG II (Children UK Cancer Study Group) and the SFOP (Société Française d'Oncologie Pédiatrique) indicated AFP values exceeding 10,000 ng / ml as the threshold identifying a group of patients with severe prognosis. The treatment indicated is early, complete exeresis, followed by a careful, extensive microscopic examination associated, if necessary, with adjuvant chemotherapy, that is indicated before surgery only in infiltrating primary malignant teratomas. Sacrococcygeal teratomas are commonly considered as lesions at particular risk, in which the coccyx must always be removed together with the mass and overlying skin, taking particular care of the deep pelvic fascia to prevent functional disorders of the bladder and anal canal, as well as any motor alterations of the lower limbs, usually due to iatrogenic lesions of the subfascial nerve structures. There is a ananimous consensus that to improve the prognosis, close, long-term clinical, laboratory and imaging surveillance is essential at shorter intervals during the first 5 years after the exeresis and annually thereafter. In newborns or infants suffering from congenital malformations associated with teratomas, definitive surgical correction, if indicated, must obviously be postponed to a proper time, especially in patients with multiple malformations or needing adjuvant chemotherapy, unless a complication arises or the repair cannot be delayed
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