1,720,959 research outputs found
Applications of indocyanine green-enhanced fluorescence in laparoscopic colorectal resections
No full textRecently, Indocyanine Green (ICG)-enhanced fluorescence has been introduced in laparoscopic colorectal surgery to provide detailed anatomical informations. The aim of our study is the application of ICG imaging during laparoscopic colorectal resections: to assess anastomotic perfusion to reduce the risk of anastomotic leak, to facilitate vascular dissection when vascular anatomy of tumor site is unclear, and to identify ureter to prevent iatrogenic injury. After the transection, 5 ml of ICG solution is intravenously injected. A Full HD IMAGE1S camera, switching to NIR mode, in few seconds provides a real-time angiography of colonic perfusion. After anastomosis, another bolus is injected to confirm the anastomotic perfusion. When the tumor is localized in difficult site, the fluorescence provides a real-time angiography of tumor area vascularization to perform the vascular dissection. When the tumor is tightly attached to the ureter, the ICG solution injection through the catheter allows ureter identification. From November 2016, 38 patients were enrolled: ten left colectomies, 22 right colectomies, three transverse resections, and three splenic flexure resections. In five cases, intraoperative angiography led to the identification of vascular anatomy. In one case the surgical strategy was changed. In one procedure, ureter identification allowed to prevent injury. Three postoperative complications that required surgical reoperation occured, of which one anastomotic leak, due to a mechanical problem. ICG-enhanced fluorescence imaging is a safe, cheap and effective tool to increase visualization during surgery. It can be employed also in small hospitals without learning curve. It is recommended to obtain additional information on anatomy and perfusion in colorectal surgery
Open surgical cholecystostomy under local anaesthesia as salvage therapy of acute cholecystitis during the 4th COVID-19 wave in Northern Italy: experience from a rural hospital
No full textThe COVID-19 pandemic outbreak delayed interventions of elective surgery worldwide. In Italy, the first western country to be affected, 410000 operations formerly planned were cancelled with the beginning of the first wave. Symptomatic cholelithiasis represents one of the most common, benign medical conditions in the world leading the affected patients to general surgeons'attention; in 0.5% of cases gallstones (symptomatic or not) can complicate with acute lithiasic cholecystitis (ALC) whose universally acknowledged treatment of choice is laparoscopic cholecystectomy. Delaying in surgery of ALC can increase the rate of complications like severe ALC, acute cholangitis and sepsis. The 4th wave of COVID 19 in Northern Italy induced further stress on the healthcare system. In fact, the occurrence of difficult communication and delays in ALC patients transfer between first and second level hospitals lead to the re-emergence of obsolete surgical procedures. In our rural hospital, in fact, a 92 years old patient affected with ALC and several comorbidities was treated with a successful emergency surgical procedure of transperitoneal cholecistostomy in lieu of a radiological transperitoneal approach. Such a choice was dictated by the absence of an interventional radiology unit in our hospital as well as the unavailability of patient transfer to our central referral hub (the hospital of Parma) due to hospital overcrowding secondary to the 4th wave of COVID 19 pandemic
Intussusception of the bowel in adult women due to bulky inflammatory fibroid polyp treated in emergency. A case report
No full text: Introduction: Intussusception represents a rare form of bowel obstruction in the adult, which is defined as the telescoping of a proximal segment of the gastrointestinal tract into the lumen of the adjacent distal segment of the GI tract Case Report: We report the case of a 50-year-old woman was admitted in our hospital with acute bowel obstruction. CT showed intestinal occlusion secondary to intussusception. the patient underwent emergency surgery. Surgery confirmed intussusception at the level of the distal ileum (about 30 cm from the ileocecal valve) due to a 3-4 oval mass of hard consistency that appeared to be suspicious for GIST. Was performed a resection of the ileal segment involved associated with oncologically radical lymphadenectomy. The histological examination reported benign ileal mesenchymal neoformation compatible with inflammatory fibroid polyp. Patient had a regular course Discussion: In adults, 90% of invaginations manifest as a result of an organic lesion caused by benign or malignant tumors. The clinical presentation in adults is generally chronic or nonspecific. The emergence of acute symptoms due to complete intestinal obstruction occours in fewer than 20% of patients. Abdominal computed tomography (CT) is the most sensitive radiologic method to confirm intussusception. As many cases are secondary to organic pathologies with malignant potential, surgical resection of the affected bowel segment with oncological procedures is the primary method of treatment Conclusion: Due to the fact that adult intussusception is often frequently associated with organic lesions, surgical intervention is necessary. Treatment usually requires formal resection of the involved bowel segment. (www.actabiomedica.it)
Treatment and management of 1,5 cm diameter appendiceal neuroendocrine tumors: a gray zone
No full textAppendiceal neuroendocrine tumours are rare and often diagnosed as incidentalomas after an appendectomy for acute appendicitis. Appendiceal tumours can cause appendiceal torsion, eventually resulting in acute appendicitis. In the international guidelines (NANTS and ENETS), tumour size is the main prognostic factor and is associated with os and lymph node relapse (LNM). Right hemicolectomy for tumours >2cm in diameter and simple appendicectomy for those <2cm, and linfadenectomy are generally recommended. Management of tumors between 1 and 2 cm, is still a matter of debate. With this case report we try to deepen this debate, about which clinical and surgical choice to undertake
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
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
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe 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
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe 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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