1,721,011 research outputs found
Single Access Videothoracoscopic Biopsy and Talc Pleurodesis in Patients With Malignant Pleural Effusion
No full textAim-Background: Recurrent pleural effusion is frequently observed in clinical experience and malignancy is one of the most frequent causes. Although it is generally necessary to prevent the recurrence of effusion in patients with disseminated neoplastic disease, in others, a diagnosis is required. The aim of this study was to determine the efficacy and safety of biopsy and pleurodesis by a single access videothoracoscopic approach. Methods: We report a consecutive series of 20 patients (12 men, 8 women, aged 39 to 83 years) who underwent single access videothoracoscopy with pleural biopsy and talc pleurodesis for recurrent pleural effusion. In all cases, indication for the procedure was a recurrent pleural effusion, suspicious for malignancy.
Videothoracoscopy was performed under general anaesthesia. For pleurodesis, an average of 8g of sterile talc powder was used. A six-month follow-up was completed for all patients, and efficacy was judged by clinical examination and chest X-ray.
Results: Diagnosis was obtained in all cases. In five cases, the diagnosis was a pleural involvement by breast cancer metastasis, and in four cases, a primary lung cancer was detected. Eight were mesotheliomas and one a parapneumonic collection. In two cases, an unknown-malignancy recurrent pleural effusion was observed. No deaths, talc-induced ARDS or malignant
invasion of the scar occurred, but only a postoperative empyema and two subcutaneous emphysemas treated successfully without further operation. Conclusions: Single access videothoracoscopic pleural biopsy and talc pleurodesis is a safe and effective
method for the diagnosis and treatment of malignant pleural effusions
Indicazioni, tecniche, complicanze e risultati della sleeve lobectomy
No full textObiettivo. Gli Autori analizzano la loro casistica in rapporto ai dati della letteratura per valutare i risultati funzionali che tali interventi possono offrire rispetto alle tecniche tradizionali.
Metodi. Dal 1986 al 2000 sono state eseguite 66 sleeve lobectomy, in 49 casi l'intervento è stato eseguito con criteri di elezione e in 17 di necessità funzionale. Sono state associate 3 sleeve vascolari e 5 plastiche vascolari tangenziali. La disparità di calibro è stata corretta con sezioni oblique sul bronco intermedio secondo Merendino. Nel caso del reimpianto dell'intermedio sul principale sinistro si è resa necessaria una jet ventilation ad alta frequenza. Le anastomosi sono state ricoperte con ampi lembi pleurici peduncolati. In 3 casi è stata praticata una miectomia extramucosa dell'esofago medio-toracico associata, in 1 caso, a resezione mucosa con successiva sutura diretta.
Risultati. La morbilità è stata del 34,5% (21% fibrillazione atriale, 7,5% complicanze parenchimali, 4,5% complicanze anastomotiche e 1,5% mediastinite). La mortalità a 30 giorni è stata del 6% (emottisi massiva 3 casi e insufficienza respiratoria 1 caso). Il pTNM dei 57 pazienti sopravvissuti è stato in 35 casi IB, in 6 IIB e in 16 IIIA. Il follow-up ha evidenziato sopravvivenza a 5 anni del 62% per lo stadio IB e del 24% per lo stadio IIIA.
Conclusioni. Sulla base della loro esperienza, con una mortalità postoperatoria e un tasso di complicanze sovrapponibili ai dati della letteratura, gli Autori ritengono che la sleeve lobectomy, pur presentando delle problematiche postoperatorie che richiedono un controllo clinico più prolungato, siano da preferire agli interventi tradizionali per i vantaggi funzionali che offrono ai pazienti con cancro polmonare
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
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
Cystic pancreatic tumor treated by distal spleno-pancreatectomy with occasional diagnosis of neuroendocrine tumor: case report
No full textINTRODUCTION: Cystic and neuroendocrine pancreatic neoplasms are quite rare tumors which diagnosis is often difficult due to their non specific symptomatology and limited diagnostic accuracy of conventional diagnostic instruments. Their treatment is still controversial.
CASE REPORT: A young woman is admitted with abdominal pain and dyspepsia. Instrumental diagnosis reveals a cystic pancreatic lesion which seems to be malignant as CEA of pancreatic liquid is increased. The patient undergoes distal spleno-pancreatectomy and postoperative histological examination found IPMN associated with MCN and furthermore there was occasional diagnosis of a small neuroendocrine tumor in the pancreatic tail.
DISCUSSION: A correct diagnostic approach is indispensable for a correct therapeutic approach. Radical surgical treatment is indicated in all cases of main- and branch duct IPMN and in case of MCN with signs of malignant transformation. Surgical treatment is also the gold standard for pancreatic neuroendocrine tumors if they are singular and in M0 stage.
CONCLUSIONS: In case of cystic and neuroendocrine neoplasms of the pancreas the preoperative diagnostic approach is often not enough to obtain a definite diagnosis. Review of literature and this case report show that a definite diagnosis can only be done after postoperative histological examination. Recent prospective studies suggest the possibility for a follow up instead of surgical treatment for some neuroendocrine tumors
Echo-guided foam sclerotherapy treatment of venous malformation involving the sciatic nerve
No full textPrimary sciatic nerve varices (SNV) lie within the sciatic nerve possibly causing chronic venous disease and sciatic pain as well. We report a series of 12 consecutive patients affected by symptomatic SNV. All of them were treated by echo-guided Tessari foam sclerotherapy (EGFSCL). Mean follow up lasted two years. Reflux through the sciatic veins, as the connected superficial varicose veins, disappeared in the entire cohort and only minor complications have emerged. EGFSCL seems to be both safe and effective, so representing a reliable and minimally invasive treatment
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