3,945 research outputs found
Left main bronchial sleeve resection with total lung parenchymal preservation: a tailored surgical approach
No full textBronchial sleeve resection is an uncommon thoracic surgical procedure. Under specific conditions, patients can be selected to undergo a sleeve resection of the main bronchus with complete parenchymal preservation. The left main bronchus is longer than the contralateral bronchus, therefore left endobronchial tumours can be localized at the proximal end of the bronchus or distally, near the secondary carina. Bronchial anastomosis in these 2 situations requires different approaches. We present the surgical technique of left main bronchus resection with complete preservation of lung parenchyma through a hemi-clamshell incision (proximal tumour) or posterolateral thoracotomy (distal tumour)
Três contos de Thomas Hardy: tradução comentada de cadeias de significantes, hipotipose e dialeto
No full textTese (doutorado) - Universidade Federal de Santa Catarina, Centro de Comunicação e Expressão. Programa de Pós-Graduação em Estudos da TraduçãoEsta tese se insere na área de tradução comentada de textos literários e se baseia na minha tradução para o português dos contos "The withered arm", "Barbara of the House of Grebe" e "An imaginative woman", do escritor inglês Thomas Hardy (1840-1928), tendo como intuito propor uma discussão a respeito de algumas questões de tradução de prosa, a saber, a cadeia de significantes, hipotipose e dialeto. A tradução é precedida por um estudo prévio sobre o autor e sobre os aspectos mais importantes de sua obra e por uma apreciação da ficção de Hardy traduzida no Brasil. Em seguida, apresento os contos traduzidos e os respectivos comentários da traduçãoThe area of research of this thesis is literary translation with commentary and it is based on my own translation into Portuguese of the short stories #The withered arm#, #Bárbara of the House of Grebe#, and #An imaginative woman# by Thomas Hardy (1840-1928). In the commentaries, I draw attention to some matters in prose translation, such as underlying networks of signification, hypotyposis, and dialect. My translation is preceded by a study on the writer and on the most important aspects of his work, and by an analysis of Hardy#s fictional work translated into Brazilian Portuguese. Finally, I present the translation of the short stories and the commentaries on the translatio
sj-docx-1-tam-10.1177_17588359241236451 – Supplemental material for Resected EGFR-mutated non-small-cell lung cancers: incidence and outcomes in a European population (GFPC Exerpos Study)
No full textSupplemental material, sj-docx-1-tam-10.1177_17588359241236451 for Resected EGFR-mutated non-small-cell lung cancers: incidence and outcomes in a European population (GFPC Exerpos Study) by Jean-Bernard Auliac, Pascal-Alexandre Thomas, Olivier Bylicki, Florian Guisier, Hubert Curcio, AlainVegnenègre, Aurelie Swalduz, Marie Wislez, Jacques Le Treut, Chantal Decroisette, Victor Basse, Lionel Falchero, Gonzague De Chabot, Diane Moreau, Eric Huchot, Audrey Lupo Mansuet, Helene Blons, Christos Chouaïd and Laurent Greillier in Therapeutic Advances in Medical Oncology</p
La revue a reçu…
No full textDOUNIÈS Thomas. Réformer l’éducation civique ? Enquête du ministère à la salle de classe. Rennes : Presses universitaires de Rennes, 2021, 258 p. DUPONT Pascal (dir.). L’enseignement de l’oral en contexte francophone : pratiques et outils de formation. Toulouse : Presses universitaires du Midi, 2020, 198 p. FONTAINE Alexandre (dir.). Penser la circulation des savoirs scolaires dans l’espace transatlantique. Émigration, transferts, créations (xviii-xxe siècles). Lormont : Le Bord de l’eau, 202..
The modifying factors that help improve anterior cruciate ligament reconstruction rehabilitation: A narrative review
No full textBackground: : The goal of a rehabilitation programme after anterior cruciate ligament (ACL) reconstruction is to manage a patient's goals and expectations (i.e., returning to physical activities and sports) while minimizing the risk of new injury, particularly a new ACL injury. Although general rehabilitation programmes have been proposed, some factors can lead to adapting each programme to each patient. Objective: : To describe how different variables, including surgical techniques, sports participation, psychosocial and contextual factors can modify the rehabilitation programme. Methods: : We performed a narrative review with input from experts in the field (level of evidence 5). Conclusions: : Modifying factors of the ACL rehabilitation programme are related to the initial lesion or surgery, to sports, or to psychological or social aspects. Regarding the type of graft, the rehabilitation is mainly different in the early postoperative phase; the other phases are not graft-based but rather goal-based rehabilitation. Depending on the meniscal or cartilage repair, the rehabilitation protocol will initially take priority over the anterior cruciate ligament reconstruction protocol. The ACL reconstruction rehabilitation programme should meet the requirements of the anticipated sports, to optimize the athlete's ability to return to the expected level and minimize the risk of reinjury. Psycho-social and contextual factors must also be considered in rehabilitation care to individualize and optimize each patient's programme. (C) 2021 Elsevier Masson SAS. All rights reserved
Lymph node dissection during sublobar resection: why, when and how?
No full text1st International Conference on Sublobar Resections for Lung Cancer, Paris, FRANCE, JAN, 2018International audienceAppropriate lymph node (LN) assessment is a hallmark of surgical quality of curative intent operations for non-small cell lung cancer (NSCLC). Even in the era of extensive pre-treatment workup including routine PET-scanning and brain imaging, and selective invasive LN evaluation, unexpected LN metastases are found at surgery in more than 10% of patients with a cT1aN0 tumor. Systematic lymphadenectomy minimizes the risk of leaving tumor-LN behind and thus the risk of an incomplete resection, and provides the most truthful pTNM, which is decisive in directing adjuvant chemotherapy. Removal of interlobar, hilar, and mediastinal LNs is necessary during sublobar resection, as it is during lobectomy. In addition, segmental LNs should be dissected at both the resected and nonresected lobar segments, because the lymphatic flow from the resected segment can go directly to the neighboring segmental LNs to join the lymphatic network at the roots of the lobar bronchi, especially for tumors in anteriorly located segments. Finally, several anatomical studies described direct lymphatic vessels from the lower lobes into the upper lobar bronchi LN rendering also advisable clearance of the upper lobar LN in case of lower lobe NSCLC. Given that intralobar LN dissection is impossible within the remaining lobe after wedge resection, omission of segmental and intralobar LN retrieval may also explain the high incidence of loco-regional recurrence observed after wedge resection. Thus, segmentectomy should be preferred to wedge resection as the recommended type of sublobar resection
Semelhança e morte: máscaras mortuárias em Mallarmé e Blanchot
No full textTese (doutorado) - Universidade Federal de Santa Catarina, Centro de Comunicação e Expressão, Programa de Pós-Graduação em Literatura, Florianópolis, 2014.Esta tese de doutorado em Literatura analisa a imagem e a semelhança como condições essenciais na experiência literária de Stéphane Mallarmé e Maurice Blanchot, mais especificamente nas obras Igitur e Thomas l'Obscur, procurando compreendê-las como máscaras mortuárias na literatura, fato esse permitido pela noção blanchotiana de "meio absoluto", relacionado ao devir-imagem da linguagem na literatura.Résumé : Cette thèse de doctorat en littérature analyse lrimage et la ressemblance comme des conditions essentiels dans lrexpérience littéraire de Stéphane Mallarmé et Maurice Blanchot, surtout dans les oeuvres Igitur et Thomas l?Obscur, en essayant de comprendre les masques mortuaires dans la littérature, ce qui est permis par la notion blanchotienne de Rmilieu absolur, par rapport au devenir-image du langage dans la littérature
3D statistical shape models of human bones : their construction using a finite element registration algorithm, formulation on Hilbert spaces, and application to medical image analysis
No full textStatistical shape models have become a widely used tool in computer vision and medical image analysis. They are constructed from a representative set of example shapes and represent the normal shape variations of a class of objects,
in our case of human bones. The foundation of statistical shape models is the concept of correspondence. In order to draw meaningful statistical conclusions and to build a generative model from the example shapes, we should compare and relate only corresponding parts of the shape. The task of establishing correspondence between shapes and images is known as the registration problem and is one of the fundamental problems of computer vision. To approximate a solution of the registration problem for our bone shapes, we propose a new registration algorithm, which is formulated as a continuous minimization problem, whose solution is sought with a state of the art finite element method.
Once the shapes have been brought into correspondence, a statistical shape model can be built. We present a formulation of the shape model on general Hilbert
spaces, which incorporates all associated models which can be constructed in a similar way, like models of shape, color, intensity, deformations etc. Which of
these models is used depends only on the choice of the Hilbert space. Because this includes the choice between continuously defined models and models based on
any kind of discretization method, we can easily integrate the statistical model into our registration method and its finite element discretization. This inclusion of class-specific prior knowledge into makes the registration more
robust against outliers and damaged data sets.
Finally, we show how the statistical models can be applied to a number of practical problems from medical image analysis and surgery planning, like the fitting of the model to novel shapes or images, the design of optimized medical implants or the automatic repositioning of fractured bones
Intérêts et limites du clampage endovasculaire de l'aorte thoracique en situation de choc hémorragique non contrôlé lié à un traumatisme abdominal sur un modèle animal
No full textLa traumatologie est la première cause de mortalité chez les sujets de moins de 40 ans dans les pays industrialisés. Le choc hypovolémique lié à une hémorragie du tronc est une cause fréquente de décès, à la fois sur les lieux de l’accident mais également pendant la prise en charge pré-hospitalière et intra-hospitalière. L’existence d’un hémopéritoine est un facteur de sous estimation du traumatisé grave.Le contrôle lésionnel, mieux connu sous les anglicismes « damage control ressucitation » et « damage control surgery », est le paradigme moderne de la prise en charge du choc hémorragique d’origine traumatique. Il comprend une mise en condition minimaliste privilégiant la réalisation d’une hémostase chirurgicale précoce et rapide, suivie d’une réanimation intensive associant transfusion massive, réchauffement et optimisation de la coagulation. Le traitement chirurgical exhaustif des lésions traumatiques est différé au delà de la période d’instabilité.Chez le blessé hémorragique agonique, la thoracotomie de ressuscitation avec clampage de l’aorte thoracique est une pratique courante mais dont les bases factuelles ne sont pas bien établies. En revanche en pathologie artérielle, la voie d’abord endovasculaire a très largement fait preuve de son efficacité.Nous avons émis l’hypothèse qu’un clampage aortique endovasculaire de l’aorte thoracique par voie rétrograde est possible et que cette technique améliore le profil hémodynamique dans le territoire myocardique et cérébral tout en augmentant la survie en cas de choc hémorragique lié à un traumatisme abdominal.Nos résultats suggèrent que cette technique de sauvetage est efficace, même s’il semble exister des limites corrélées à la durée de l’ischémie/reperfusion viscérale et médullaire.Trauma is the leading cause of mortality in industrialized countries for people aged below 40 years. Fifty percent of the pre hospital and in hospital mortality from severe blunt and penetrating abdominal traumas is due to an hemorrhagic shock. Peritoneal bloody effusion is the main reason to under estimate the seriousness of trauma.Damage control resuscitation (DCR) and damage control surgery (DCS) typify the current paradigm of hemorrhagic torso trauma management. Damage control includes a basic pre operative management before a short surgical control of bleeding followed by intensive resuscitation care based on massive blood transfusion, palliation of hypothermia and correction of biological coagulation disorders. According to this strategy, the curative surgical treatment is postponed until the patient has been stabilized.Some authors have reported on the efficacy of resuscitation thoracotomy with aortic crossclamping in the emergency room in patients with severe abdominal trauma . However, the end results of such a procedure are contrasted and its use is still debated. More recently, endovascular approach has emerged in the management algorithm of some vascular emergencies. We hypothesized that an endovascular retrograde occlusion of the thoracic aorta would be a safe and efficient to preserve hemodynamic profile in cardiac and cerebral area, and to improve survival in case of uncontrolled hemorrhagic shock caused by an abdominal trauma.Our results sustain this hypothesis, even if its benefits seem time-limited, according to the medullar and visceral side-effects of ischemia/reperfusion
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