1,721,067 research outputs found
L’impresa sociale tra innovazione e sussidiarietà: l’esperienza dell’Osservatorio Economia Civile di Torino
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Personality and widowhood increase the risk for incident depression in the two years following the first acute coronary syndrome
No full textObjectives: Incident depression, occurring after an acute coronary syndrome (ACS) in never depressed patients, exerts a negative effect on the cardiac prognosis. Nonetheless only a few studies have evaluated the risk factor for incident depression and, particularly, no study have investigated the role of personality disorders. Therefore, the aim of this study is to verify if personality disorders represent a risk for incident depression in patients at their first ACS.Method: The study sample was selected among never depressed patients who were consecutively admitted to the Coronary Intensive Care Unit, from January 2009 to March 2012, for the first ACS. The study sample included 262 patients. The presence of depressive disorder was assessed with the Primary Care Evaluation of Mental Disorders (DSM-IV criteria), whereas its severity was evaluated with the Hospital Anxiety and Depression Scale. Evaluations were collected at baseline and at 1, 2, 4, 6, 9, 12 and 24 months of follow-up. Moreover, at baseline personality disorders were investigated with the Structured Clinical Interview for DSM-IV Axis II disorders.Results: Out of 262 subjects, a depressive disorder was diagnosed in 56 patients (21%). At baseline risk factors for incident depression were being widowed, having a distress reaction and narcissistic personality traits.Conclusion: Clinicians should keep in mind these characteristics when facing patients at their first ACS, given the detrimental effect of depression on cardiac prognosis. A psychological support should prevent the onset of incident depression in these patients
Laparoscopic and Robotic Surgery for Splenic Artery Aneurysm: A Systematic Review
No full textBackground: Splenic artery aneurysms (SAAs) are the most frequent visceral aneurysms, with a life-threatening risk in case of rupture. Our systematic review investigated the features of minimally invasive surgical approaches in vascular surgery for SAAs: robotic surgery and laparoscopy.
Methods: PubMed, EMBASE, and the Web of Science were systematically searched for robotic or laparoscopic surgery reports in SAA up to January 2020. The outcomes of the study were operative time, overall morbidity, intraoperative and postoperative complications, conversion rate, and length of hospital stay.
Results: A total of 40 studies (29 case reports, 8 case series, 1 randomized trial, 1 video, and 1 image), including 107 patients, were considered eligible for the review. Mean operative time was 164.2 ± 75.9 min (laparoscopy), 165 min (±75.6 min) and 150 min (±87.7 min) for robotic procedures. Four cases of conversion (4.8% of all laparoscopic procedures) were reported; no conversion in the robotic series was reported. Overall morbidity was 11.2%; the most common complications were postoperative spleen infarction and pancreatitis. Medium estimated blood loss was 105.2 mL (±239.5 mL) (robotic 186.6 (±202.4) mL, laparoscopic 63 (0-270) mL). Overall length of stay was 5.43 (±5.5) days (robotic 6.1 days and laparoscopic 5.5 days). Neither mortality nor reinterventions were observed in robotic and laparoscopic series.
Conclusions: In accordance with the available literature, laparoscopy and robotic surgery represent, in selected cases, a valid choice to treat SAAs. Multidisciplinary teams, comprehensive of vascular and general surgeons skilled in robotic and laparoscopic procedures, could permit to offer a tailored treatment for each patient. The rarity of this disease does not allow to perform randomized controlled trials; thus the possibility to reach definitive conclusions is currently precluded
Is it time to develop a robotic difficulty score system?
No full textConsiderations about the use of scores of difficulty in the practice of robotic liver resection
Does Age Affect Treatment of Depressive Disorders? A systematic review of antidepressants versus placebo studies
No full textSitus viscerum inversus and abdominal aortic aneurysm: A systematic review of a rare association
No full textSitus viscerum inversus (SVI) is a very rare condition in that abdominal and thoracic organs are located reversed. Abdominal aortic aneurysm (AAA) is a life-threatening pathology due to progressive aortic enlargement until the rupture. The association between SVI and AAA is very infrequent. The aim of this study is to identify the surgical procedures available to treat AAA in SVI. We performed a literature review of all studies about AAA in SVI patients, analyzing PubMed/MEDLINE, EMBASE, Web of Science (WOS), Google Scholar databases. The survey includes all publications until June 2023. The outcomes include demographic findings, type of surgical procedure, intraoperative and postoperative complications, follow-up. A total of 12 studies, including 12 patients, were considered eligible for the review. AAA mean size was 70.5 mm (range: 55–90 mm); the most common localization was in the infrarenal aortic portion. 6 studies reported data on elective surgery, and 6 on emergency procedures. In one case endovascular treatment was performed. No intraoperative complications are reported; 3 postoperative complications are registered. Medium follow-up period was 13.5 months (range: 3–60). According to the available literature, the treatment of AAA in SVI is feasible and does not show an incremented morbidity compared to patients with a normal visceral configuration. This treatment seems to be effective also in case of endovascular treatment. AAA treatment in SVI should be performed (especially in elective settings) in high volume centers where it is possible to bring on collaboration across different surgical specialists
Alexithymia and Cardiac Outcome in Patients at First Acute Coronary Syndrome
No full textBackground: This cohort study was aimed to verify whether subjects at their first acute coronary syndrome (ACS) were more alexithymic than healthy controls (HC) and whether alexithymia can predispose patients with coronary artery disease to new major adverse cardiac events (MACE) during a 24-month follow-up period.
Methods: The sample included 100 HC with no history of depression or ACS and 304 never depressed patients with a first-ever ACS. A total of 266 patients completed the 2-year follow-up.
Results: Patients and HC reported similar Toronto Alexithymia Scale (TAS-20) scores. During the follow-up, 69 (22.69%) patients developed incident depression and 57 (18.75%) developed a new MACE. In a proportional hazard model, developing a first-ever depressive episode, but not alexithymia (hazard ratio = 1.008, 95% confidence interval = 0.984-1.033; p = 0.500), was associated with almost 3 times the risk of a recurrent cardiac event.
Conclusion: Incident depression, but not TAS-20 scores, represented risk factor for MACE
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
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