1,720,959 research outputs found
The use of cilostazol in patients with peripheral arterial disease: results of a national physician survey
No full textBACKGROUND: Although international guidelines recommend cilostazol as first-line therapy for peripheral arterial disease (PAD) because it improves the symptoms and quality of life, it remains an underused agent for amputation-free survival. The objective of this study was to evaluate the practice among Italian physicians of the use of cilostazol in patients suffering from peripheral arterial disease (PAD). METHODS: For the present study, a cross-sectional survey was carried out. Physicians specialized in the medical and/or surgical treatment of PAD and who prescribe cilostazol regularly were invited to a phone interview. A nationally-representative probability sample of hospital-based physicians who diagnose and treat patients with PAD was randomly selected among the members of the Italian Physicians' Association. RESULTS: Out of a total of 641 physicians contacted, 250 of them (39%) accepted to take part in this survey. Reasons of survey refusal were the non-attitude to prescribe cilostazol (45%), or unspecified motivations (16%). Among the 250 physicians participating the survey: 120 were vascular surgeons, 80 internal medicine doctors, 50 angiologists. Cilostazol was suggested in 79% of patients with symptomatic intermittent claudication, and in 30% of patients who had undergone revascularization. The majority of physicians stated to prescribe cilostazol at recommended dosage of 100 mg bid (46.4%). The principal reason to suggest a reduced drug dosage was to limit early side effect at the time of treatment onset, but the increase to the full dose of cilostazol is suggested by 91.3% of interviewed within 4 weeks. Sixty-three percent of physicians affirmed to prescribe cilostazol as a continuous treatment for a mean of 4 months, while a lifelong treatment was suggested by 17.6% of participants. CONCLUSIONS: Among physicians who habitually prescribe cilostazol adherence to the recommended drug dosage and length of treatment is high. The prescription of cilostazol is particularly appreciated in patients with symptomatic intermittent claudication, even before any noninvasive diagnosis of PAD, and before any invasive therapy. Finally a relevant number of physicians regularly prescribe cilostazol also after revascularization, advocating the anti-restenotic properties of the drug
Endovascular treatment of popliteal aneurysm
No full textAlthough traditional surgical repair by aneurysm exclusion and bypass is still considered the gold standard in the treatment of popliteal artery aneurysms (PAAs), the endovascular repair (ER) has been gaining great interest in the last decades. ER offers several advantages over open bypass, including lower morbidity and mortality, and faster functional recovery, but some concerns about migration, occlusion, or fracture remain when a stent graft is deployed across a joint that undergo constant flexion. This review summarizes the current evidence on ER for PAAs. Level I evidence is still very limited, while the majority of published data come from retrospective studies. Moreover the heterogeneity of PAA morphology seems to play a major role in the outcomes after popliteal endografts placement, so that many anatomical criteria should be taken into account to determine which patient is best treated endovascularly. In conclusion, while it is unlike that endovascular treatment may displace open surgical bypass in the near future, it indeed does provide a feasible option for selected patients with high surgical risk and good anatomical features
Carotid artery stenting renaissance: is it safe and effective using new materials?
No full textData from randomized controlled trials (RCTs) demonstrated significant differences between carotid artery stenting (CAS) and carotid endarterectomy (CEA) in terms of early neurological outcomes (from 0 to 30 days), although mid- and long-term neurological results are indistinguishable. CAS in symptomatic standard risk patients is coupled with a higher risk of any stroke, and death or any stroke at 30 days, while the rates of disabling or major stroke do not vary remarkably between treatments. Since the micro-embolization through the stent struts is the primary suspected cause of suspected early postoperative neurological complications (i.e., non-disabling stroke), surgical technology has focused on the production of a new generation of stents with a double layer of mesh to reduce the "free area" of the cells, and on new cerebral protection devices. Another major determinant of early negative outcomes is believed to be the intraluminal manipulation occurring during carotid engagement from the aortic arch, the crossing maneuvers at the level of the culprit lesion and vessel trauma during angioplasty. To address these subject matters, new embolic protection devices and innovative strategies have been developed, consequently. This review is designed to furnish the current status of CAS results, to update the ongoing RCTs comparing CAS vs. CEA outcomes, and to recapitulate the features and clinical outcomes for a new carotid stent design, the so called "mesh-stents", and new embolic protection tools
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
Abdominal aortic aneurysm
No full textEndovascular repair of abdominal aortic aneurysms has become a milestone in the treatment of patients with abdominal aortic aneurysm. Technological improvement allows treatment in more and more complex cases. This review summarizes all grafts available on the market. A complete review of most important trial on this topic is provided to the best of our knowledge, and technical tips and tricks for standard cases are also included
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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