1,720,971 research outputs found
Long term sequelae after 1,311 primary inguinal hernia repairs
No full textBackground: Aim of this study was to analyze long-term sequelae, risk factors, and satisfaction after inguinal hernia primary repair. Methods: A postal questionnaire was mailed to all patients operated between January 1997 and December 2004 for inguinal hernia repair. Patients who had a lump in the groin and patients who experienced chronic problems were invited for a physical examination. Patients who reported having chronic pain were asked to fill out the short-form McGill Pain Questionnaire (SF-MPQ). Results: Chronic pain was present in 18.1% of cases. The strongest risk factors were presence of recurrence, use of heavyweight mesh, and age younger than 66 years. By means of the SF-MPQ, we found that the pain reported by most patients was sensory-discriminative in quality, with "tender" and "aching" being the most common descriptors used. About 71.3% of replies used descriptors typical of nociceptive pain, 8.9% of neuropathic pain, and 19.8% of nociceptive plus neuropathic. Chronic pain was severe in 2.1% of patients and interfered with normal activities, work, and exercise. The cumulative recurrence rate was 2.1%. There was a strong correlation between lump and recurrence. Patients declared themselves satisfied with the result of the operation in 93.1% of cases. Due to chronic pain, 6.5% of patients were unsatisfied. Conclusions: This study demonstrates that the main problem after inguinal hernia repair remains chronic pain, which was the primary reason of dissatisfaction. The SF-MPQ is feasible and easy to administer to all patients and provides important information about qualitative features of the pain
Analysis of post-surgical pain after inguinal hernia repair : a prospective study of 1,440 operations
No full textBackground: Pain remains a significant clinical problem after inguinal hernia repair. We prospectively assessed post-surgical pain following herniorrhaphy in 1,440 operations with the aim of describing the characteristics and identifying predisposing factors for pain. Methods: Pain quality was assessed with the short-form McGill Pain Questionnaire (SF-MPQ); pain character was estimated as either nociceptive or neuropathic in nature. Results: A total of 38.3% of replies reported pain (acute or chronic), and 18.7% reported chronic pain. Independent risk factors for pain were young age, BMI >25, day surgery, and use of Radomesh. In patients with chronic pain, independent risk factors were young age, BMI >25 and use of Radomesh. Analysis of the SF-MPQ revealed that the pain reported by most patients was sensory-discriminative in quality. The most common descriptors were tender and aching. Patients with chronic pain reported more intense pain and used sensory descriptors of greater mean intensity than patients with acute pain. A total of 73.9% of replies used descriptors typical of nociceptive pain, 6.5% used descriptors typical of neuropathic pain and 19.6% used nociceptive plus neuropathic descriptors. Patients considered to have nociceptive pain used significantly more sensory descriptors than those considered to have neuropathic pain. By contrast patients with neuropathic pain used more affective descriptors than those with nociceptive pain. Neuropathic pain was reported as more difficult to treat with analgesics than nociceptive pain and neuropathic plus nociceptive pain. Conclusions: Our study confirms that herniorrhaphy frequently produces chronic pain, which can reduce quality of life. The SF-MPQ is a useful instrument to administer to all patients and provides important information about qualitative properties of the pain
Rendez-vous endolaparoscopico nel trattamento della calcolosi colecisto-coledocica
No full textPremessa
Molti studi hanno dimostrato l’efficacia del rendez-vous endo-laparoscopico nel trattamento in un unico tempo della coledocolitiasi associata alla litiasi della colecisti.
Scopo dello studio
Scopo del presente studio è l’analisi della tecnica del rendez-vous in pazienti con litiasi colecisto-coledocica in termini di effica-cia, fattibilità, morbilità e mortalità.
Metodi
Dal 1998 al 2008, sono stati sottoposti consecutivamentea a rendez-vous endo-laparoscopico 37 pazienti, 22 donne e 15 uomini con un’età media di 63 anni (range: 33-82). Il rendez-vous consiste nell’effettuare, nella medesima seduta operatoria, video-laparo-colecistectomia, colangiografia intra-operatoria, colangio-pancreatografia retrograda endoscopica (CRPE), eventuale papillosfinterotomia endoscopica e bonifica della via biliare principale.
Risultati
La mortalità intra- e post-operatoria è stata nulla. Nessun intervento ha richiesto la conversione open. La durata mediana dell’intervento è stata di 150 minuti (range: 65-270). Complicanze intra-operatorie minori si sono verificate in 6 pazienti (16,2%), ma non hanno determinato né conversione, né prolungamento della durata dell’intervento. Complicanze post-operatorie maggiori si sono verificate nel 10,8% dei casi (2 sanguinamenti della papilla e 2 fistole biliari), guariti con terapia conservativa e con una degenza mediana di 16 giorni. Si sono verificate 2 pancreatiti acute lievi (5,4%), trattate conservativamente e con risoluzione completa del quadro patologico. Considerando globalmente tutti i pazienti, la degenza post-operatoria mediana è stata di 5 giorni. Ad un follow-up mediano di 60 mesi (range: 6-72), tutti i pazienti sono in buone condizioni generali.
Conclusioni
Il rendez-vous endo-laparoscopico rappresenta una tecnica valida ed efficace nel trattamento della calcolosi colecisto-coledocica, con un successo del 97,3% nella nostra esperienza. Permette in un unico tempo la risoluzione della duplice patologia. Il limite della metodica è rappresentato dalle difficoltà logistico-organizzative, soprattutto quando la coledocolitiasi è accertata intra-operatoriamente
TRAITEMENT CHIRURGICAL DU REFLUX GASTRO-OESOPHAGIEN PAR COELIOSCOPIE : ETAT DE L’ART
No full textLe reflux gastro-œsophagien est une pathologie fréquente et pose un problème de santé publique en raison de sa prévalence élevée, de son évolution chronique et du recours fréquent à un traitement. Le traitement peut être médical ou chirurgical. La fundoplicature représente le traitement chirurgical de choix; elle a pour but d'entourer le bas de l'œsophage d'un anneau d'estomac pour former une valve antireflux. Actuellement, la voie d'abord de référence est la laparoscopie qui améliore de manière importante les suites opératoires, en les rendant en particulier moins douloureuses, tout en réduisant la durée d'hospitalisation et en raccourcissant la période de convalescence. Le point encore à débattre est le choix de la technique chirurgicale entre la fundoplicature totale de Nissen ou Nissen-Rossetti et la fundoplicature postérieure selon Toupet. Dans la littérature la plus récente, les deux techniques semblent être comparables en termes de résultats. La plus faible morbidité de la technique de Toupet peut être contrebalancée par la meilleure efficacité à long terme de l'intervention de Nissen. Il nous semble que la fundoplicature totale selon Nissen est plus efficace en termes de contrôle du reflux à long terme que la fundoplicature partielle. Dans notre série, le taux de dysphagie sévère est acceptable et la plupart des patients sont satisfaits
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
TRAITEMENT CHIRURGICAL DU REFLUX GASTRO-OESOPHAGIEN PAR COELIOSCOPIE : ETAT DE L’ART
No full textLe reflux gastro-œsophagien est une pathologie fréquente et pose un problème de santé publique en raison de sa prévalence élevée, de son évolution chronique et du recours fréquent à un traitement. Le traitement peut être médical ou chirurgical. La fundoplicature représente le traitement chirurgical de choix; elle a pour but d'entourer le bas de l'œsophage d'un anneau d'estomac pour former une valve antireflux. Actuellement, la voie d'abord de référence est la laparoscopie qui améliore de manière importante les suites opératoires, en les rendant en particulier moins douloureuses, tout en réduisant la durée d'hospitalisation et en raccourcissant la période de convalescence. Le point encore à débattre est le choix de la technique chirurgicale entre la fundoplicature totale de Nissen ou Nissen-Rossetti et la fundoplicature postérieure selon Toupet. Dans la littérature la plus récente, les deux techniques semblent être comparables en termes de résultats. La plus faible morbidité de la technique de Toupet peut être contrebalancée par la meilleure efficacité à long terme de l'intervention de Nissen. Il nous semble que la fundoplicature totale selon Nissen est plus efficace en termes de contrôle du reflux à long terme que la fundoplicature partielle. Dans notre série, le taux de dysphagie sévère est acceptable et la plupart des patients sont satisfaits
Rendez-vous endolaparoscopico nel trattamento della calcolosi colecisto-coledocica
No full textPremessa
Molti studi hanno dimostrato l’efficacia del rendez-vous endo-laparoscopico nel trattamento in un unico tempo della coledocolitiasi associata alla litiasi della colecisti.
Scopo dello studio
Scopo del presente studio è l’analisi della tecnica del rendez-vous in pazienti con litiasi colecisto-coledocica in termini di effica-cia, fattibilità, morbilità e mortalità.
Metodi
Dal 1998 al 2008, sono stati sottoposti consecutivamentea a rendez-vous endo-laparoscopico 37 pazienti, 22 donne e 15 uomini con un’età media di 63 anni (range: 33-82). Il rendez-vous consiste nell’effettuare, nella medesima seduta operatoria, video-laparo-colecistectomia, colangiografia intra-operatoria, colangio-pancreatografia retrograda endoscopica (CRPE), eventuale papillosfinterotomia endoscopica e bonifica della via biliare principale.
Risultati
La mortalità intra- e post-operatoria è stata nulla. Nessun intervento ha richiesto la conversione open. La durata mediana dell’intervento è stata di 150 minuti (range: 65-270). Complicanze intra-operatorie minori si sono verificate in 6 pazienti (16,2%), ma non hanno determinato né conversione, né prolungamento della durata dell’intervento. Complicanze post-operatorie maggiori si sono verificate nel 10,8% dei casi (2 sanguinamenti della papilla e 2 fistole biliari), guariti con terapia conservativa e con una degenza mediana di 16 giorni. Si sono verificate 2 pancreatiti acute lievi (5,4%), trattate conservativamente e con risoluzione completa del quadro patologico. Considerando globalmente tutti i pazienti, la degenza post-operatoria mediana è stata di 5 giorni. Ad un follow-up mediano di 60 mesi (range: 6-72), tutti i pazienti sono in buone condizioni generali.
Conclusioni
Il rendez-vous endo-laparoscopico rappresenta una tecnica valida ed efficace nel trattamento della calcolosi colecisto-coledocica, con un successo del 97,3% nella nostra esperienza. Permette in un unico tempo la risoluzione della duplice patologia. Il limite della metodica è rappresentato dalle difficoltà logistico-organizzative, soprattutto quando la coledocolitiasi è accertata intra-operatoriamente
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
- …
