1,354,263 research outputs found
The open abdomen: indications and techniques
No full textThis book offers an overview of acute care surgery around the world, focusing on the four main branches of this novel subdiscipline: trauma, general emergencies, critical care, and rescue surgery. The book’s primary goal is to provide a general view of acute care surgery, while addressing the most important issues in depth.
The content is divided into three parts, the first of which is dedicated to the general organization of trauma centers, including the composition of modern trauma teams. Protocols of activation and action for the trauma team, as well as damage control procedures both in the emergency room and in the surgical theatre, are described. The book also addresses the development of a trauma registry, together with the quality assessment process that can be applied.
In turn, the second part describes the principal protocols for making diagnoses, with special attention to circumstances such as unstable hemodynamics, neurological deterioration, normal vital signs, and penetrating injuries. The book subsequently deals with the most important aspects of trauma to the abdomen, chest, and pelvis, with notes on both surgical and intensive care issues. Practical descriptions of how to treat principal injuries to various organs are also provided.
Finally, the third part of the book is dedicated to the most frequent general surgical emergencies and rescue surgical approaches, and includes information on diagnostic support with point of care ultrasound and endoscopic advanced techniques. Presenting cutting-edge strategies, this book will be of interest to professionals involved in surgical and intensive care for emergency conditions, such as colonic perforations, obstructions, acute pancreatitis, biliary tree stones, and caustic injuries
NK cell and ILC heterogeneity in colorectal cancer. New perspectives from high dimensional data
No full textInnate lymphoid cells (ILCs) and tissue-resident natural killer (NK) cells ensure immunity at environmental interfaces and help maintain barrier integrity of the intestinal tract. This wide range of innate lymphocytes is able to provide fast and potent inflammatory responses that, when deregulated, have been associated with pathogenesis of inflammatory bowel disease (IBD) and colorectal cancer (CRC). While the presence of tumor-infiltrating NK cells is generally associated with a favorable outcome in CRC patients, emerging evidence reveals distinct roles for ILCs in regulating CRC pathogenesis and progression. Advances in next generation sequencing technology, and in particular of single-cell RNA-seq approaches, along with multidimensional flow cytometry analysis, have helped to deconvolute the complexity and heterogeneity of the ILC system both in homeostatic and pathological contexts. In this review, we discuss the protective and detrimental roles of NK cells and ILCs in the pathogenesis of CRC, focusing on the phenotypic and transcriptional modifications these cells undergo during CRC development and progression
LATE POST-TRAUMATIC DIAPHRAGM RUPTURE IN A POLYTRAUMATIZED PATIENT: A CASE STUDY
No full textCase History: 50 years old male with traumatic brain, chest and skeletal injuries after a car crash, transferred from a peripheral hos- pital to our ED. A Total Body CT-Scan was performed. After the positioning of a trans-skeletal traction of the left leg and 12 h of observation in our ED, he was admitted to the floor with the diagnosis of: ‘‘Head Trauma, Small Left Pneumothorax, Multiple costal frac- tures, Pulmonary Contusions, Pneumomediastinum, Sternal Fracture, Left Acetabulum Fracture’’.
19 days after the trauma the patient underwent a reduction and fixa- tion of the acetabulum fracture without complications.
23 days after the trauma suddenly occurred a change in the clinical condition of the patient.
Clinical Findings: The patient appeared lethargic but aroused by oral stimulation, dyspnoeic, the hemodynamic was stable, no fever. At the clinical examination, the ventilation of the left hemithorax was remarkably reduced if compared to the contralateral; the patient reported pain to the palpation of the epigastrium and the bowel sounds were reduced.
Investigation/Results: Firstly a Chest X-Ray was performed: it showed the presence of the gastric bubble in the left thoracic sec- tion. Afterwards a Chest and Abdomen CT-scan was performed. Diagnosis: Late post-traumatic rupture of the left diaphragm (lacer- ation of 8-10 cm) with thorax herniation of the upper 3/4th of the stomach and of the omentum, associated with a massive left pneu- mothorax with shift of the mediastinum.
Therapy and Progressions: An emergency surgery for the reparation of the diaphragm rupture with a laparotomy approach was performed, followed by the positioning of a pleural drainage.
Comments: Although unexpected it is necessary to consider a late diaphragmatic injury in a patient involved in a car crash where there is the possibility of a traumatic-related increase of the abdomen pressure
Going Beyond Counting First Authors in Author Co-citation Analysis
No full textThe 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
Intima-media thickness in patients with psoriatic arthritis : a case-control study
No full textFil: Perrotta, F. M. University of Rome. Dipartimento di Medicina Interna e Specialità Mediche; ItaliaFil: Scarno, A. University of Rome. Dipartimento di Medicina Interna e Specialità Mediche; ItaliaFil: Carboni, A. University of Rome. Dipartimento di Medicina Interna e Specialità Mediche; ItaliaFil: Cardini, F. University of Rome. Dipartimento di Medicina Interna e Specialità Mediche; ItaliaFil: Montepaone, M. University of Rome. Dipartimento di Medicina Interna e Specialità Mediche; ItaliaFil: Lubrano, E. Università del Molise. Dipartimento di Medicina e di Scienze per la Salute; ItaliaFil: Spadaro, A. University of Rome. Dipartimento di Medicina Interna e Specialità Mediche; Itali
Variations on the Author
No full text“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
No full textWe 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
Assessment of subclinical atherosclerosis in ankylosing spondylitis: correlations with disease activity indices
No full textThe aim of the study was to evaluate atherosclerosis in ankylosing spondylitis (AS) through the assessment of morphological and functional measures of subclinical atherosclerosis. Twenty patients [M/F=12/8, age (median/range) 43.5/28-69 years; disease duration (median/range) 9.7/1-36) years] with AS classified according to modified New York criteria and twenty age and sex related healthy controls with negative past medical history for cardiovascular events were enrolled in the study. In all patients and controls, the intima-media thickness (IMT) of common carotid artery, carotid bulb and internal carotid artery, and the flow-mediated dilatation (FMD) of non-dominant arm brachial artery were determined, using a sonographic probe Esaote GPX (Genoa, Italy). Furthermore, we assess the main disease activity and disability indices [bath ankylosing spondylitis disease activity index, ankylosing spondylitis disease activity score-eritrosedimentation rate (ASDAS-ESR), ASDAS-C-reactive protein (CRP), bath ankylosing spondylitis metrology index, bath ankylosing spondylitis functional index) and acute phase reactants. Plasmatic values of total cholesterol, low-density lipoprotein, high-density lipoprotein, triglyceride and homocysteine were carried out in all twenty patients. IMT at carotid bulb was significant higher in patients than in controls (0.67 mm vs 0.54 mm; P=0.03). FMD did not statistically differ between patients and controls (12.5% vs 15%; P>0.05). We found a correlation between IMT at carotid bulb and ESR (rho 0.43; P=0.04). No correlation was found between FMD and disease activity and disability indices. This study showed that in AS patients, without risk factors for cardiovascular disease, carotid bulb IMT, morphological index of subclinical atherosclerosis, is higher than in controls
[Arterial hypertension and cardiovascular risk: need for a combined strategy of intervention].
No full textFinasteride, 1 mg daily administration on male androgenetic alopecia in different age groups: 10-year follow-up
No full textFinasteride 1 mg is indicated for the treatment of men with androgenetic alopecia (AGA). However, more than 5 years efficacy and safety has not been previously reported. To assess the efficacy over 10 years in different age groups of men with AGA. 118 men, between 20 and 61 years, with AGA receiving finasteride (1 mg/day), were enrolled in this uncontrolled study. Efficacy evaluation was assessed with standardized global photographs at T0, T1, T2, T5, T10. Statistical analysis was made using frequency tables and evaluating the chi-square index with its p-value. Better improvements are observed in patients older than 30 years (42.8% aged between 20 and 30 years did not improve also after 10 years) or with higher AGA grades (58.9% for AGA grade IV and 45.4% for AGA grade V had the first improvement just after 1 year). In 21% of cases, the treatment continuation beyond 5 years provided better results. Side effects were referred by 6% of the patients; nevertheless, some of them went on with treatment because of the great results. In our opinion, the result after the first year can help in predicting the effectiveness of the treatment. Its efficacy was not reduced as time goes on; in fact, a big proportion of subjects unchanged after 1 year, improved later on, maintaining a positive trend
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