1,720,981 research outputs found
Timing and pharmacological support in the surgical treatment of multiple perianal fistulas in Crohn's Disease
Full text linkWe present a case report on the management of a young woman affected by Crohn's Disease ever since childhood, complicated by complex, multiple perianal fistulas. In literature, there is increasing evidence to support the treatment of perianal fistulas using a combined association of medical and surgical strategies. In the case of our patient, the choice of surgery in association with pharmacological treatment was supported by the consideration of the fact that intervening during a quiescent phase of the disease, from the symptomatic, clinical-biohumoral and endoscopic standpoint, would have reduced the risk of complications and thus promoted healing. (www.actabiomedica.it)
Hernioplasty in elderly high-risk adults: efficacy of fibrin glue.
No full textGroin hernia surgery is common; the
lifetime risk of undergoing surgery for groin hernia is 27%
in men and 3% in women. Elective groin hernia repair is
considered a low-risk procedure, with fewer than one
death per 10,000 operations. By contrast, emergency
repair of hernia is associated with significant morbidity
and mortality; in elderly adults with groin hernias, early
elective surgery is preferre
Hernioplasty in Elderly High-Risk Adults: Efficacy of Fibrin Glue
Full text linkBackground:
Risk factors as cirrhosis, diabetes, coagulopathies, advanced age, have often been considered a contraindication to perform an inguinal hernioplasty. The aim of this study was to establish whether fibrin glue application to fix the mesh during a Lichtenstein inguinal hernioplasty is useful to prevent complications in high risk patients.
Methods:
From March 2004 to September 2009, 87 high risk patients underwent hernioplasty using fibrin glue to fix mesh prosthesis. Patients were evaluated for immediate and late postoperative pain, presence of haematomas and seromas, infiltration of ascitic fluid, and wound complications.
Results:
Among our patients (mean age 73.6±12.4 years) 38 (44%) had diabetes, 33 (38%) had coagulopathies and 16 (18%) had liver cirrhosis (2 C Child’s grade). During a follow-up period ranging from 12 to 24 months, no complications nor significant post-operative pain were observed.
Conclusions:
This preliminary observational study indicates that fibrin glue application can be considered a very useful way to obtain good results by open hernioplasty in high risk patients
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
Lower extremity arterial reconstruction for critical limb ischemia in diabetes.
Full text linkBackground: The impact of diabetes mellitus on the technical and clinical outcomes of infrainguinal arterial reconstruction
(IAR) for critical limb ischemia (CLI) remains controversial. This study analyzed the outcome of IAR in diabetic patients
with CLI over a 17-year period.
Methods: Details on all consecutive patients undergoing primary IAR at our institution were stored prospectively in
a vascular registry from 1995 to 2011. Demographics, risk factors, indications for surgery, inflow sources and outflow
target vessels, types of conduit, and adverse outcomes were analyzed. Postoperative surveillance included clinical examination,
duplex scans, and ankle-brachial index measurements in all patients at discharge, 1 and 6 months after surgery,
and every 6 months thereafter. End points were patency, limb salvage, survival, and amputation-free survival rates, and
were assessed using Kaplan-Meier life-table analysis. The c2 or Fisher exact, Student t, and log-rank tests were used to
establish statistical significance.
Results: Overall, 1407 IARs were performed in 1310 patients with CLI by the same surgeon, 705 (50.2%) in 643 diabetic
patients and 702 in 667 nondiabetic patients. Autogenous vein conduits were used in 87% of the IARs. There were no
perioperative deaths. Diabetic patients had significantly more major (16.7% vs 11.8%; P [ .02) and minor complications
(9.7% vs 6.5%; P [ .02) than nondiabetic patients. At 5 and 10 years, there were no significant differences between
diabetic and nondiabetic patients in the rates of primary patency (65% and 46% vs 69.5% and 57%; log-rank test, P[.09),
secondary patency (76% and 60% vs 80% and 68%; log-rank test, P [ .20), limb salvage (88% and 76% vs 91% and 83%;
log-rank test, P [ .12) survival (51% and 34% vs 57% and 38%; log-rank test, P [ .41), or amputation-free survival
(45.5% and 27% vs 51% and 29%; log-rank test, P [ .19). The type of conduit did not affect patency or limb salvage rates
in either group.
Conclusions: Diabetic patients receiving IAR for CLI can have the same survival and amputation-free survival rates as
nondiabetic patients. Their comparable technical and clinical outcomes strongly demonstrate that diabetics with CLI
can expect the same quantity and quality of life as nondiabetics with CLI, and aggressive attempts at limb salvage in
patients with diabetes mellitus, including distal and foot level bypass grafting, should not be discouraged
Midline abdominal wall incisional hernia after aortic reconstruction: a prospective study
Full text linkBackground and Purpose. To evaluate rate of formation of midline abdominal wall incisional hernia (MAIH) after elective open repair of abdominal aortic aneurysm (AAA) and revascularization for aortoiliac occlusive disease (AOD).
Methods. AAA and AOD patients operated electively via a primary midline abdominal incision at our institution over a decade were entered in this prospective study. Patients who had already undergone midline laparotomy or had an MAIH after previous celiotomy were excluded. Patients were examined for MAIH 6-monthly for 2 years, then yearly.
Results. We included 1,065 patients who underwent aortic reconstructive surgery (412 with AAA and 653 with AOD). The follow-up (mean ± standard deviation) was 6.4 ± 3.8 years (range, 0.5–12.7). Wounds were closed with a suture length-to-wound length (SL:WL) ratio of at least 4:1 in 58% (239 of
653) of AAA patients and 66% (431 of 653) of AOD patients (P = .01). There were 124 (11.6%) MAIHs, with an incidence of 12.4% (51 of 412) in the AAA group and 11.2% (73 of 653) in the AOD group (P = .62), and 3 (0.4%) wound infections (all among the AOD patients), none of which
resulted in MAIH. At multivariate analysis, a SL:WL ratio of <4:1 was the only independent predictor of MAIH in AAA (P = .004) and AOD patients (P < .001).
Conclusion. AAA and AOD patients had a similar incidence of MAIH, which seems related to the wound closure technique. A SL:WL ratio of at least 4:1 is recommended. Further clinical studies are required to determine possible technical and perioperative variables that may be modified to decrease the
incidence of MAIH development after aortic reconstructive surgery
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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