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Surgical treatment of thoracoabdominal aortic aneurysms
No full textTorakoabdominalna aneurizma aorte (TAAA) je degenerativna bolest aorte u kojoj dolazi do postupnog proširenja njenog promjera za 50% više od normalnih granica. TAAA čine oko 2% ukupnog broja aneurizama aorte te su ujedno i najrjeđe. Čimbenici rizika koji ubrzavaju razvoj aneurizme uključuju: arterijsku hipertenziju, koronarnu bolest, šećernu bolest, muški spol, starije od 70 godina, bijela rasa, pušenje, kroničnu opstruktivnu plućnu bolest te bubrežno zatajenje. Prema Crawfordovoj klasifikaciji modificiranoj prema Safiju dijelimo ih na 5 tipova. TAAA većinom su asimptomatske te se najčešće otkriju slučajno tijekom kliničkog pregleda. Pacijenti sa simptomatskom TAAA većinom se prezentiraju s oštrom i konstantnom boli u području abdomena, u leđima, prsima, u slabinama ili u preponama. Pretrage koje se koriste za početno postavljanje dijagnoze TAAA su nativni rendgenogram i ultrazvuk, dok se u preoperativnoj obradi najčešće koristi MSCT aortografija s kontrastom. Otvorena je rekonstrukcija zlatni standard liječenja TAAA, no povezuje se s visokim operativnim mortalitetom i perioperativnim komplikacijama. Endovaskularni i hibridni pristup predstavljaju alternativne opcije za visokorizične pacijente. TEVAR označava endovaskularni postupak postavljanja torakalnog aortnog stent-grafta, dok su BEVAR/FEVAR oblici totalnog endovaskularnog popravka TAAA koji ne zahtijevaju ni torakotomiju ni laparotomiju. Hibridni popravak TAAA kombinacija je otvorenog i endovaskularnog pristupa.Thoracoabdominal aortic aneurysm (TAAA) is a degenerative aortic disease in which the diameter of the aorta gradually expands by more than 50% of its normal limits. TAAA make 2% of total number of aortic aneurysms and are the rearest. Risk factors associated with accelerated development of aneurysms are hypertension, coronary disease, diabetes, male gender, age over 70 years, caucasian descent, smoking, chronic obstructive pulmonary disease and renal failure. According to Safi’s modification of Crawford TAAA classification there are 5 types of TAAA. They are mostly asymptomatic and discovered during physical examination. Patients with symptomatic TAAA usually experience sharp and constant pain in their abdomen, back, chest, loins or groins. Initial diagnostic tests include RTG and ultrasound while MSCT aortography with contrast is mostly used in preoperative assessment. Open repair is the gold standard treatment of TAAAs but it is associated with high rates of operative mortality and perioperative complications. Endovascular and hybrid treatment provide alternative options for high-risk patients. TEVAR is an endovascular procedure during which an aortic stent-graft is placed in the thoracic aorta while BEVAR/FEVAR are types of total endovascular aneurysm repair that do not require neither thoracotomy nor laparotomy. Hybrid TAAA repair is a combination of open and endovascular approach
Surgical and endovascular treatment of vascular compression syndrome
No full textSindromi kod kojih je krvna žila pritisnuta ili uklještena drugim okolnim strukturama nazivaju se sindromima vaskularne kompresije. Po etiologiji se mogu podijeliti na stečene i kongenitalne, ali također i na sindrome nastale kompresijom mekog tkiva, kostiju, arterija, ligamenata, fibroznog tkiva, mišića i ostalih struktura koje pritišću vaskularne strukture. U ovom radu opisani su sindrom gornjeg otvora prsišta, sindrom orašara, anomalije koronarnih arterija, sindrom aduktornog kanala, Eagle sindrom, sindrom hipotenarnog čekića, May-Thurnerov sindrom, Dunbarov sindrom, sindrom lateralnog pazušnog otvora te sindrom kompresije poplitealne arterije. Simptomi se razlikuju zbog anatomske strukture koja je zahvaćena te variraju od boli, edema, bljedila do hematurije i aritmija. Patofiziološki mehanizam oštećenja započinje ozljedom i odgovorom endotela krvne žile zbog dugotrajne kompresije strukture na vanjski dio krvne žile. Komplikacije koje se mogu javiti su stenoza, poststenotička dilatacija, aneurizma te okluzije. Dijagnoza se postavlja na temelju anamneze, fizikalnog pregleda te neke od slikovnih dijagnostičkih metoda, ovisno koju strukturu želimo prikazati. Bitno je isključiti druge uzroke kompresije kao što su tumorske mase ili limfadenopatija jer im je incidencija veća, nego kod ovih sindroma. Vrlo često se koriste ultrazvučne metode u početnoj dijagnostičkoj obradi. Liječenje ovih sindroma može biti konzervativno, endovaskularno ili se pak mogu koristiti metode otvorene kirurgije jer je najčešće potrebno ukloniti uzrok kompresije kako bi došlo do poboljšanja. Kirurško liječenje komplikacija koje su nastale uslijed dugog djelovanja kompresije na žilu također je prisutno. Moderne metode dekompresije uključuju i laparoskopsku tehniku te robotski asistiranu kirurgiju, čija je primjena sve učestalija. Endovaskularne tehnike uključuju katetersku trombolizu, perkutanu mehaničku trombektomiju i perkutanu transluminalnu angioplastiku, dok se u otvorenoj kirurgiji najčešće koriste premosnice, trombektomija, trombendarterektomija, embolektomija i plastika zakrpom.Syndromes where a blood vessel is pressed or entrapped by other surrounding structures are called vascular compression syndromes. By etiology, they can be divided into acquired and congenital, but also into syndromes caused by compression of soft tissue, bones, arteries, ligaments, fibrous tissue, muscles and other structures that exert compression on vascular structures. This paper describes upper thoracic outlet syndrome, Nutcracker syndrome, coronary artery anomalies, adductor canal syndrome, Eagle syndrome, Hypothenar hammer syndrome, May-Thurner syndrome, Dunbar syndrome, Quadrilateral Space Syndrome and popliteal artery compression syndrome. Symptoms differ due to the anatomical structure that is affected and vary from pain, edema, pallor to hematuria and arrhythmias. The pathophysiological mechanism of damage begins with the injury and response of the blood vessel endothelium, due to long-term compression of the structure on the outer part of the blood vessel. Complications that can occur are stenosis, post-stenotic dilation, aneurysm and occlusion. The diagnosis is based on history, physical examination and one of the imaging diagnostic methods, depending on which structure we want to review. It is important to rule out other causes of compression such as tumor masses or lymphadenopathy because they have higher incidence. Ultrasound methods are very often used in the initial diagnostic process. The treatment of these syndromes can be conservative, endovascular, or open surgery methods can be used, because it is usually necessary to remove the cause of compression for improvement. Surgical treatment of complications caused by the long-term effect of compression on the vessel is also present. Modern methods include laparoscopic technique and robot-assisted surgery, the use of which is becoming more frequent. Most frequently employed endovascular techniques are catheter thrombolysis, percutaneous mechanical thrombectomy and percutaneous transluminal angioplasty, while open surgery usually involves bypass, thrombectomy, thrombendarterectomy, embolectomy and patch angioplasty
Surgical treatment of thoracic aortic disease
No full textAneurizma torakalne aorte (engl. thoracic aortic aneurism, TAA) označava lokalno proširenje aorte koje najčešće nastaje kao posljedica ateroskleroze i tada se naziva degenerativna aneurizma aorte, a njezin razvoj uvjetovan je složenom interakcijom genetskih čimbenika, stanične neravnoteže i promjene hemodinamskih čimbenika. U Republici Hrvatskoj se godišnje dijagnosticira oko 50 slučajeva TAA. Tijekom posljednjih desetljeća je primijećen porast incidencije TAA, što se smatra posljedicom mnogobrojnih čimbenika, kao što su napredak u tehnici slikovne dijagnostike i starenje populacije. Čimbenicima rizika za ubrzavanje razvoja aneurizme smatraju se bijela rasa, dob iznad 60 godina, muški spol, kronična opstruktivna plućna bolest, hipertenzija, pušenje i naslijeđe. TAA se češće pojavljuje u mlađih pacijenata koji boluju od raznih bolesti vezivnoga tkiva i u pacijenata s obiteljskom TAA i disekcijom. Otvorena rekonstrukcija je nekada bila uobičajen i klasičan način liječenja bolesti torakalne aorte, a danas se za liječenje te patologije preferira torakalni endovaskularni postupak postavljanja stent-grafta (engl. thoracic endovascular aortic reconstruction, TEVAR). Tijekom otvorene rekonstrukcije torakalne aorte vaskularnim se hvataljkama privremeno prekine krvotok kroz aneurizmu, ona se otvori, iz nje se izljušti tromb, podvežu se svi ogranci aneurizme (interkostalne arterije) i distalni krvotok se rekonstruira umetanjem dakronskoga ili teflonskoga transplantata između proksimalnog i distalnog zdravog dijela aorte. Indikacije za operaciju aneurizme aorte dijelimo na vitalne, apsolutne i relativne, a vitalne indikacije za operaciju aneurizme aorte su postojanje rupture, odnosno zadržane rupture aneurizme aorte i simptomatske aneurizme aorte koja je predznak rupture. Predoperativna obrada u kirurškom liječenju bolesti torakalne aorte sastoji se od uzimanja detaljne anamneze, provođenja fizikalnog pregleda i analize laboratorijskih nalaza, EKG-a i radioloških nalaza. S posebnom pozornošću se prije operacije trebaju analizirati srčana, plućna i bubrežna funkcija pacijenta. Najčešće komplikacije otvorene operacije torakalne aorte su: akutno bubrežno zatajenje i ishemija kralješnične moždine, a rezultat su privremene ishemije tijekom operacije. Postupci kojima se smanjuje rizik nastanka postoperativnih komplikacija su: distalna aortna perfuzija, intraoperacijska i postoperacijska drenaža cerebrospinalnog likvora i hipotermija. TEVAR je endovaskularni postupak postavljanja aortnog stent-grafta u torakalnu aortu. TEVAR ima manji mortalitet i morbiditet u usporedbi s kirurškim pristupom, a neke od komplikacija zahvata su oštećenje periferne vaskulature, ishemijski moždani udar i „popuštanje“ (engl. endoleak).Thoracic aortic aneurysm (TAA) is a local aortic dilatation that most often occurs as a result of atherosclerosis and is then called a degenerative aortic aneurysm. It´s development is conditioned by a complex interaction of genetic factors, cellular imbalance and changes in hemodynamic factors. In the Republic of Croatia, about 50 cases of TAA are diagnosed annually. An increase in the incidence of TAA has been observed in recent decades, which is considered to be the result of many factors, such as advances in imaging techniques and population aging. Risk factors for accelerating the development of aneurysms are caucasian descent, age over 60 years, male gender, chronic obstructive pulmonary disease, hypertension, smoking and heritage. TAA occurs more frequently in younger patients suffering from various connective tissue diseases and in patients with familial TAA and dissection. Open reconstruction was once a common and classic way of treating thoracic aortic disease and today thoracic endovascular aortic reconstruction (TEVAR) is preffered. During open thoracic aortic reconstruction, blood flow through the aneurysm is temporarily interrupted with vascular forceps, the aneurism is opened, thrombus is peeled off, all branches of the aneurysm are ligated and the distal blood flow is reconstructed by inserting a dacron or teflon graft between the proximal and distal healthy part of the aorta. Indications for aortic aneurysm surgery are divided into vital, absolute and relative. Vital indications for aortic aneurysm surgery are the existence of a rupture, delayed rupture of an aortic aneurysm and symptomatic aortic aneurysm which is a sign of rupture. Preoperative evaluation in the surgical treatment of thoracic aortic disease consists of taking a detailed medical history, conducting a physical examination, and analyzing laboratory findings, ECG, and radiological findings. The patient's cardiac, pulmonary, and renal function should be analyzed with special care prior to surgery. The most common complications of open thoracic aortic surgery are: acute renal failure and spinal cord ischemia, resulting from temporary ischemia during surgery. Procedures that reduce the risk of postoperative complications are: distal aortic perfusion, intraoperative and postoperative drainage of cerebrospinal fluid and hypothermia. TEVAR is an endovascular procedure for placing an aortic stent-graft in the thoracic aorta. TEVAR has a lower mortality and morbidity compared to the surgical approach and some of the complications of the procedure are damage to the peripheral vasculature, ischemic stroke and endoleak
Surgical treatment of thoracoabdominal aortic aneurysms
No full textTorakoabdominalna aneurizma aorte (TAAA) je degenerativna bolest aorte u kojoj dolazi do postupnog proširenja njenog promjera za 50% više od normalnih granica. TAAA čine oko 2% ukupnog broja aneurizama aorte te su ujedno i najrjeđe. Čimbenici rizika koji ubrzavaju razvoj aneurizme uključuju: arterijsku hipertenziju, koronarnu bolest, šećernu bolest, muški spol, starije od 70 godina, bijela rasa, pušenje, kroničnu opstruktivnu plućnu bolest te bubrežno zatajenje. Prema Crawfordovoj klasifikaciji modificiranoj prema Safiju dijelimo ih na 5 tipova. TAAA većinom su asimptomatske te se najčešće otkriju slučajno tijekom kliničkog pregleda. Pacijenti sa simptomatskom TAAA većinom se prezentiraju s oštrom i konstantnom boli u području abdomena, u leđima, prsima, u slabinama ili u preponama. Pretrage koje se koriste za početno postavljanje dijagnoze TAAA su nativni rendgenogram i ultrazvuk, dok se u preoperativnoj obradi najčešće koristi MSCT aortografija s kontrastom. Otvorena je rekonstrukcija zlatni standard liječenja TAAA, no povezuje se s visokim operativnim mortalitetom i perioperativnim komplikacijama. Endovaskularni i hibridni pristup predstavljaju alternativne opcije za visokorizične pacijente. TEVAR označava endovaskularni postupak postavljanja torakalnog aortnog stent-grafta, dok su BEVAR/FEVAR oblici totalnog endovaskularnog popravka TAAA koji ne zahtijevaju ni torakotomiju ni laparotomiju. Hibridni popravak TAAA kombinacija je otvorenog i endovaskularnog pristupa.Thoracoabdominal aortic aneurysm (TAAA) is a degenerative aortic disease in which the diameter of the aorta gradually expands by more than 50% of its normal limits. TAAA make 2% of total number of aortic aneurysms and are the rearest. Risk factors associated with accelerated development of aneurysms are hypertension, coronary disease, diabetes, male gender, age over 70 years, caucasian descent, smoking, chronic obstructive pulmonary disease and renal failure. According to Safi’s modification of Crawford TAAA classification there are 5 types of TAAA. They are mostly asymptomatic and discovered during physical examination. Patients with symptomatic TAAA usually experience sharp and constant pain in their abdomen, back, chest, loins or groins. Initial diagnostic tests include RTG and ultrasound while MSCT aortography with contrast is mostly used in preoperative assessment. Open repair is the gold standard treatment of TAAAs but it is associated with high rates of operative mortality and perioperative complications. Endovascular and hybrid treatment provide alternative options for high-risk patients. TEVAR is an endovascular procedure during which an aortic stent-graft is placed in the thoracic aorta while BEVAR/FEVAR are types of total endovascular aneurysm repair that do not require neither thoracotomy nor laparotomy. Hybrid TAAA repair is a combination of open and endovascular approach
Surgical treatment of carotid body tumors
No full textKarotidno tjelešce kemoreceptorski je organ smješten u adventiciji karotidne bifurkacije, odgovoran za održavanje homeostaze pO2, pCO2 i pH. Tumori karotidnog tjelešca pripadaju skupini rijetkih tumora i mogu se podijeliti na tri tipa; sporadični, obiteljski i hiperplastični. Najčešće se očituju kao bezbolne tvorbe na lateralnoj strani vrata, koje u uznapredovaloj fazi mogu uzrokovati neurološke simptome i simptome lokalne kompresije. Temelj dijagnostike je ultrazvuk, a CTA, MRA i DSA koriste se u prijeoperacijskoj obradi. Shamblinova klasifikacije dijeli tumore u tri skupine na temelju odnosa tumora s karotidnim arterijama. Zlatni standard liječenja je subadventicijska resekcija; radioterapija i opservacija alternativne su opcije. Kirurška resekcija danas je praćena niskim mortalitetom, ali još uvijek se veže uz značajan rizik neurovaskularne ozljede. Uspješnost operacije može se potencirati primjenom prijeoperacijske devaskularizacije putem embolizacije, ugradnje stenta ili prijeoperacijske radioterapije.The carotid body is a chemoreceptor organ found in adventitia of carotid bifurcation responsible for maintaining homeostatis of pO2, pCO2 i pH. Carotid body tumors belong to the group of rare tumors and can be divided into three types: sporadic, familial and hyperplastic. They most often present as painless mass on the lateral side of the neck and can, in advanced stages, cause neurological symptoms and symptoms of local compression. The base for diagnosis is ultrasound,while CT, MR and angiography are used in preoperative assesment. Shamblin's classification divides these tumors into three groups based on the relationship of the tumor to the carotid arteries. The gold standard of treatment is subadventricular resection; radiotherapy and observation are alternative options. Surgical resection today is accompanied with low mortality, but is still associated with a significant risk of neurovascular injury. The success of the operation can be enhanced by preoperative devascularization, stent implantation or preoperative radiotherapy
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe 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
Surgical and endovascular treatment of vascular compression syndrome
No full textSindromi kod kojih je krvna žila pritisnuta ili uklještena drugim okolnim strukturama nazivaju se sindromima vaskularne kompresije. Po etiologiji se mogu podijeliti na stečene i kongenitalne, ali također i na sindrome nastale kompresijom mekog tkiva, kostiju, arterija, ligamenata, fibroznog tkiva, mišića i ostalih struktura koje pritišću vaskularne strukture. U ovom radu opisani su sindrom gornjeg otvora prsišta, sindrom orašara, anomalije koronarnih arterija, sindrom aduktornog kanala, Eagle sindrom, sindrom hipotenarnog čekića, May-Thurnerov sindrom, Dunbarov sindrom, sindrom lateralnog pazušnog otvora te sindrom kompresije poplitealne arterije. Simptomi se razlikuju zbog anatomske strukture koja je zahvaćena te variraju od boli, edema, bljedila do hematurije i aritmija. Patofiziološki mehanizam oštećenja započinje ozljedom i odgovorom endotela krvne žile zbog dugotrajne kompresije strukture na vanjski dio krvne žile. Komplikacije koje se mogu javiti su stenoza, poststenotička dilatacija, aneurizma te okluzije. Dijagnoza se postavlja na temelju anamneze, fizikalnog pregleda te neke od slikovnih dijagnostičkih metoda, ovisno koju strukturu želimo prikazati. Bitno je isključiti druge uzroke kompresije kao što su tumorske mase ili limfadenopatija jer im je incidencija veća, nego kod ovih sindroma. Vrlo često se koriste ultrazvučne metode u početnoj dijagnostičkoj obradi. Liječenje ovih sindroma može biti konzervativno, endovaskularno ili se pak mogu koristiti metode otvorene kirurgije jer je najčešće potrebno ukloniti uzrok kompresije kako bi došlo do poboljšanja. Kirurško liječenje komplikacija koje su nastale uslijed dugog djelovanja kompresije na žilu također je prisutno. Moderne metode dekompresije uključuju i laparoskopsku tehniku te robotski asistiranu kirurgiju, čija je primjena sve učestalija. Endovaskularne tehnike uključuju katetersku trombolizu, perkutanu mehaničku trombektomiju i perkutanu transluminalnu angioplastiku, dok se u otvorenoj kirurgiji najčešće koriste premosnice, trombektomija, trombendarterektomija, embolektomija i plastika zakrpom.Syndromes where a blood vessel is pressed or entrapped by other surrounding structures are called vascular compression syndromes. By etiology, they can be divided into acquired and congenital, but also into syndromes caused by compression of soft tissue, bones, arteries, ligaments, fibrous tissue, muscles and other structures that exert compression on vascular structures. This paper describes upper thoracic outlet syndrome, Nutcracker syndrome, coronary artery anomalies, adductor canal syndrome, Eagle syndrome, Hypothenar hammer syndrome, May-Thurner syndrome, Dunbar syndrome, Quadrilateral Space Syndrome and popliteal artery compression syndrome. Symptoms differ due to the anatomical structure that is affected and vary from pain, edema, pallor to hematuria and arrhythmias. The pathophysiological mechanism of damage begins with the injury and response of the blood vessel endothelium, due to long-term compression of the structure on the outer part of the blood vessel. Complications that can occur are stenosis, post-stenotic dilation, aneurysm and occlusion. The diagnosis is based on history, physical examination and one of the imaging diagnostic methods, depending on which structure we want to review. It is important to rule out other causes of compression such as tumor masses or lymphadenopathy because they have higher incidence. Ultrasound methods are very often used in the initial diagnostic process. The treatment of these syndromes can be conservative, endovascular, or open surgery methods can be used, because it is usually necessary to remove the cause of compression for improvement. Surgical treatment of complications caused by the long-term effect of compression on the vessel is also present. Modern methods include laparoscopic technique and robot-assisted surgery, the use of which is becoming more frequent. Most frequently employed endovascular techniques are catheter thrombolysis, percutaneous mechanical thrombectomy and percutaneous transluminal angioplasty, while open surgery usually involves bypass, thrombectomy, thrombendarterectomy, embolectomy and patch angioplasty
Interleukin 1 beta in inner carotid artery atherosclerosis
No full textMoždani je udar po učestalosti drugi uzrok smrtnosti u svijetu i Republici Hrvatskoj. Jedan od mehanizama njegova nastanka ishemija je područja opskrbe unutarnje karotidne arterije uzrokovana stenozom na mjestu odvajanja od zajedničke unutarnje karotidne arterije. Zahvat koji se u vaskularnoj kirurgiji provodi u liječenju ove bolesti je karotidna endarterektomija (engl. carotid endarterectomy, CEA) kojom se mehanički odstranjuje plak iz arterije. CEA se u asimptomatskih bolesnika (koji su bez neurološkog ispada unazad 6 mjeseci) vrši kao prevencija moždanog udara, ali i sama nosi određeni rizik od akutnog moždanog udara i smrti. Prema važećim preporukama Europskog društva za vaskularnu kirurgiju (engl. European Society for Vascular Surgery, ESVS) iz 2023. g. kirurško se liječenje u asimptomatskih bolesnika preporučuje kod onih sa stenozom između 60-99 % uz povišen klinički ili radiološki utvrđen rizik od moždanog udara. Ipak, postoje asimptomatski bolesnici sa stenozom nižeg stupnja koji u nekom trenutku pretrpe moždani udar uzrokovan karotidnom stenozom, a koje je teško unaprijed probrati. Kako bi se taj probir potkrijepio dodatnim medicinskim nalazima, znanstvena zajednica traga za biljezima iz krvi koji bi u kombinaciji s postojećim metodama pokazali koji bi pacijenti s nižim stupnjem stenoze imali koristi od CEA-e. Ovo istraživanje prikazalo je obećavajući potencijal IL-1 beta u dijagnostici, ali i liječenju karotidne stenoze te je i svojevrstan poticaj za usmjeravanje daljnjih istraživanja u smjeru spomenutog biljega u kontekstu karotidne stenoze.Stroke is the second leading cause of death worldwide and in the Republic of Croatia. One of its pathogenetic mechanisms is the ischaemia of the inner carotid artery area caused by stenosis of its origin – the bifurcation of the common carotid artery. One of the modalities of its treatment is the procedure called carotid endarterectomy (CEA) performed by vascular surgeons in which the atherosclerotic plaque is mechanically removed. It is, among other cases, indicated in patients with asymptomatic carotid stenosis (those who haven't suffered from a neurological incident in the past 6 months) as a prevention of stroke, although it carries the risk of stroke and death. By the European Society for Vascular Surgery’s newest guidelines, CEA is indicated when asymptomatic patents have stenosis 60-99% with at least one clinical or radiological risk factor for stroke. However, some asymptomatic patients with lower stenosis also develop stroke, which is currently impossible to predict. In order to screen the patients with lower stenoses that could benefit from CEA, the scientific community is in search for blood biomarkers that show the ability of identifying those patients, together with the existing methods. This research shows promising potential of IL-1 beta in both diagnostics and treatment of carotid stenosis and also presents encouragement in further investigations on IL-1 beta in the context of carotid stenosis
Variations on the Author
Get PDF“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
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