1,721,173 research outputs found
Second Surgery for Recurrence of Malignant Pleural Mesothelioma after extrapleural Pneumonectomy.
No full textBACKGROUND:
Extrapleural pneumonectomy is a treatment option for malignant pleural mesothelioma (MPM), but disease recurrence is common. Among different therapeutic options for recurrence, we have found no reports for second surgical procedures.
METHODS:
We retrospectively evaluated the types and outcomes of surgical management of solid recurrences of MPM, in a series of 74 patients treated with extrapleural pneumonectomy over a 20-year period.
RESULTS:
Of 57 patients for whom follow-up data were available, 11 patients experienced recurrent disease in the form of a solid mass, 1.5 to 12 years after the initial treatment; 8 of these patients had sufficiently good clinical conditions to undergo a second surgery with curative intent. Chest wall resection was performed in 4 cases of parietal recurrence, radical retroperitoneal resection was done in 3 cases of retroperitoneal relapse, and segmental resection of the remaining lung was done in one case of pulmonary metastasis. In this latter case, although computed tomographic images showed a solid mass, at surgery the disease was found to have a serosal nature, precluding the possibility of a curative surgery. Median survival after the second surgery was 14.5 months (range, 6 to 29); no association between survival and site of recurrence, age or disease-free interval was found.
CONCLUSIONS:
In this series, the second surgery did not offer the expected survival benefit of curative treatment strategies and should therefore be considered palliative. Second surgery may be a treatment option in a subset of patients who experience a solid recurrence of MPM that is symptomatic or near vital organs and who cannot undergo additional radiotherapy
Determination of buprenorphine and norbuprenorphine in hair by GC-MS
No full textBuprenorphine is a synthetic derivative of thebaine used as a substitute of heroin in detoxification programs. Buprenorphine was introduced for this application in May 2000 in Italy and its use for this therapeutic purpose has increased by over than 30% in three years. The aim of this study was to extend the method routinely applied in our laboratory to detect heroin metabolites, cocaine and amphetamines also to buprenorphine (BPR) and its metabolite norbuprenorphine (norBPR) in order to monitor BPR administration in detoxification programs as well as to detect drug abuse during detoxification. The analytical procedure was as follows: after a washing-step with methanol, hair was finely cut and incubated in HCl 0.1N (45°C, overnight). Nalorphine was chosen as internal standard. Purification of analytes was executed by solid phase extraction (Bond Elut Certify) which provided recoveries higher than 80% for both BPR and norBPR; purified extract was derivatised with N-methyl, N-trimethylsilyl trifluoroacétamide (MSTFA) and the analysis was performed by GC-MS in SIM mode. Ions monitored were: m/z 450, 482, 506 for BPR, m/z 468, 500, 524 for norBPR and m/z 455. 414, 324 for internal standard (underlined ions were used as quantifiers). Method validation was performed by: evaluation of accuracy and precision; analysis of seven drug-free hair samples; testing of linearity (0-0.5 ng/mg, n = 5). Intra-day (n = 7) and inter-day (n = 3 on 5 different days) precision were better than 8.8%for both analytes and accuracy better than 15%. The limit of detection was 0.005 ng/mg and the limit of quantitation was 0.01 ng/mg. This method was applied to hair samples collected from patients in withdrawal treatment programmes and demonstrated its good applicability in routine analysis
Erratum: A randomised trial of target-vessel versus multivessel revascularisation in ST-elevation myocardial infarction: Major adverse cardiac events during long-term follow-up (Heart (2010) 96 (662-7))
No full textN/
A direct screening procedure for diuretics in human urine by liquid chromatography-tandem mass spectrometry with information dependent acquisition
No full textBackground: Diuretics are a class of compounds largely used for either therapeutic (edemas, hypertension, etc.) or illegal (doping) purposes. Probably owing to the substantial variety of their chemical structures, which makes them hardly extractable from a biological matrix in a single procedure, a quite short list of screening methods can be retrieved in the literature.
Methods: This work presents a screening procedure for 24 diuretics based on the direct injection of urine (after 50 folds dilution) in a LC-ESI-MS/MS system (Applied Biosytems 4000 QTrap). Two information dependent acquisitions (IDA), one in positive, one in negative ionization, allowed the acquisition of one selected reaction monitoring transition for each compound, which, when a significant peak was found, triggered the acquisition of the enhanced product ion (EPI) spectrum.
Results and conclusions: EPI spectra were stored in a library and the procedure was able to recognize by library matching various diuretics in real positive samples. The limits of detection were comprised between 0.002 and 0.25 mg/l and ion suppression was not found to significantly influence the analysis
Long-term outcome of percutaneous exclusion of huge saphenous vein graft aneurysms using peripheral covered-stents as alternative to surgical repair
No full textGiant vein graft aneurysms occur infrequently after coronary artery bypass graft surgery and are most often detected incidentally during coronary angiography for suspected angina or as a mediastinal mass on chest radiographs. Hereby, we describe the percutaneous treatment of a huge right coronary artery saphenous vein bypass graft aneurysm by using peripheral stent-graft. Twelve months after the procedure, the aneurysm was completely sealed at computed tomographic angiography with a good distal run-off in the bypass graft. Different strategies adopted and the feasibility as well as the long-term outcomes of this technique are described thoroughly
ST-segment elevation myocardial infarction with concomitant multiple coronary arteries thromboses in a young patient with hyperhomocysteinaemia
No full textST-segment elevation myocardial infarction with concomitant multiple coronary arteries thromboses in a young patient with hyperhomocysteinaemi
Ethyl glucuronide in hair: sensitivity, specificity, and factors potentially influencing its performance
No full text
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
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