1,721,001 research outputs found
Does prophylactic bronchoalveolar lavage during surgery reduce post-operative pulmonary complications?
No full textReducing post-operative complications from lung surgery is critical. We explored if intra-operative bronchioalveolar lavage would reduce post-operative respiratory complications such atelectasis, pneumonia, and mucous plugging. BAL is well-researched as a diagnostic tool but its use as a protective procedure is not well studied. We conducted a retrospective cohort study of 291 patients who underwent routine BAL intraoperatively during lung surgery in the last 3 years as well as a comparison group of 215 patients who did not receive intra-operative BAL. This group of 506 patients fit the inclusion criteria of having undergone lung resection. Exclusion criteria were as follows: lack of one-lung ventilation, concurrent other surgery. All the surgeries took place at Health Sciences Centre in Winnipeg. 34.9% (n = 75) of patients in control group and 37.1% (n = 108) of the cases had some type of post-operative complication as classified by the Ottawa TM&M. Narrowing down to only respiratory complications (pulmonary and pleural), 20.5% (n = 44) of controls and 25.5% (n = 73) of cases had complications. When looking at only pulmonary complications, 7.4% (n = 16) of the controls and 9.6% (n = 28) of the cases had pulmonary complications. We saw that patients who received BAL prophylactically had a similar incidence of pulmonary complications compared to the control group (9.6% and 7.4% respectively). However, multivariable analysis shows that current smokers benefited greatly from prophylactic BAL where there was a reduction in pulmonary complications
NT-proBNP as a predictor of postoperative atrial fibrillation after thoracic surgery
No full textBackground: Postoperative atrial fibrillation following lung resection is associated with increased morbidity and mortality. The extent of pulmonary resection and preoperative N terminal pro-BNP (NT-proBNP) levels have been suggested as contributing factors in the development of postoperative atrial fibrillation. This study aims to determine if a relationship exists between the extent of lung parenchyma resected and perioperative changes in serum NT-proBNP levels.
Methods: We conducted a prospective cohort study enrolling patients aged ≥55 years undergoing pulmonary resection with no documented history of atrial fibrillation. Baseline NT-proBNP levels were measured preoperatively (PRE), in the post-anesthesia care unit (PACU), and on postoperative day 1 (POD1). The weight and volume of lung resection was determined from pathological review of the surgical specimen. Statistical analysis utilized repeated measure regression models with NT-proBNP as the outcome, incorporating measurement time (PRE/PACU/POD1), the extent of lung resection, and their interaction as predictor variables. Trajectory plots were generated to assess NT-proBNP changes after surgery and Spearman correlations were used to determine the relationship between NT-proBNP and extent of resection at each time point.
Results: 105 patients were enrolled, and 102 patients were analyzed. Postoperative atrial fibrillation occurred in 5 (4.9%) cases. Relative to PRE NT-proBNP measurements, the change in NT-proBNP levels at PACU and POD1 was -0.5 ± 37.9 pg/mL (p=0.905) and 320 ± 472.5 pg/mL (p <0.0001), respectively. No relationship between NT-proBNP and the extent of lung resection, defined using multiple outcomes, was demonstrated across all measurement times.
Conclusions: Lung resection was followed by a near four-fold elevation in NT-proBNP levels from baseline on the first postoperative day. However, there was no relationship between
perioperative elevations in NT-proBNP and the extent of lung resection.October 202
Invasive adenocarcinoma with bronchoalveolar features: A population-based evaluation of the extent of resection in bronchoalveolar cell carcinoma
No full text
Does geography influence the treatment and outcomes of colorectal cancer in the province of Manitoba?
No full textBackground: Colorectal cancer (CRC) is the third most common cancer in Manitoba. We sought to determine if regional differences exist for treatments, wait times, and quality measures for Manitobans with CRC.
Methods: A population-based historical cohort analysis for patients diagnosed with CRC between 2004 and 2006 was undertaken using administrative databases.
Results: 2086 patients were diagnosed with Stage I-IV CRC between 2004 and 2006. Diagnosis wait times and treatment wait times were longer in Winnipeg than rural Manitoba. There were no differences between Winnipeg and rural Manitoba in rates of total colonic examination, adequate lymphadenectomy, and consultations with oncologists. Rural patients with rectal cancer experienced higher local recurrence and mortality rates than urban patients.
Conclusion: This study establishes population-based benchmarks for the quality of CRC therapy in Manitoba. Minimal geographic differences exist for quality measures. For rectal cancer local recurrence, rural patients represent an important area for quality improvement initiatives.October 201
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
The impact of mean arterial pressure on functional outcome post-acute spinal cord injury: a systematic review of animal models and human clinical data
No full textThe occurrence of hypotension has been shown to be associated with worse outcomes after traumatic injury, including severe head injury. To our knowledge, a prospective controlled assessment of the effects of hypotension on acute spinal cord injury (ASCI) in humans has not been performed. Animal models of ASCI have been created in laboratory and data is extrapolated to the clinical setting, suggesting that hypotension contributes to secondary injury after ASCI by reducing spinal cord blood flow and perfusion.Given the lack of conclusive evidence on the topic, we set out to perform a comprehensive review of the pertinent evidence, first of the animal models on which the current guidelines are based, followed by a review of the human clinical data which is available. The goal was to assess the merit of the current guidelines and ascertain the correct target MAP immediately after ASCI as well as the duration for which this MAP must be targeted.October 201
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
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe 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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