1,720,973 research outputs found
Prevention of post-thrombotic syndrome: Role of fibrinolysis in proximal deep vein thrombosis
No full textBACKGROUND: Deep vein thrombosis (DVT) of the lower limbs is a relatively common clinical condition, with an incidence estimated at 1-2 cases per 1000 inhabitants per year. Post-thrombotic syndrome (PTS) is a chronic complication which particularly affects patients with proximal DVT (ilio-femoral); it significantly impacts upon patients' quality of life and it also has major health-economic implications. METHODS: We report our experience with ultrasound accelerated thrombolysis EKOS system in treatment of patients affected by proximal DVT. RESULTS: In our experience, we treated three cases of proximal DVT adopting ultrasound accelerated thrombolysis with EKOS system. Technical success rate was 100% in absence of embolic or hemorrhagic complications. The mean follow-up was 18 months: there were no thrombotic recurrences and none of the three patients had clinical signs of PTS. Loco-regional thrombolysis applied in selected cases of proximal DVT, unlike traditional therapy with oral anticoagulants, is able to ensure a rapid resolution of the thrombotic process, thus limiting valvular damage, that underlies the development of PTS. In recent years new techniques like mechanical, pharmaco-mechanical and ultrasound enhanced thrombolysis were developed. They allow a further reduction in both duration of treatment and drugs dose used, compared to pharmacological thrombolysis alone and also lead to an overall costs' reduction. CONCLUSIONS: In conclusion, from both a review of the literature and our own experience, pharmacological thrombolysis has proven to be a safe and effective technique in the treatment of proximal DVT, in order to prevent the development of PTS; nevertheless, it appears appropriate that those techniques are reserved to highly selected patients and practiced in centers with adequate experience and resources
Venous thoracic outlet syndrome: Single center five years experience
No full textBACKGROUND: Patients with thoracic outlet syndrome. can present neurogenic, venous, and/o arterialsymptoms due to compression of the neurovascular structures by the scalene muscle, first rib, or fibrous bands. METHODS: Twenty-six patients underwent decompressive surgery of the thoracic outlet via the supraclavicular approach. The indication for operation was compression of the subclavian artery in 7 instances (5 females and 2 males, aged 44±9), axillo-subclavian venous thrombosis in 6 instances (5 females and 1 male, aged 22±4), and brachial plexus irritation in 13 instances (9 females and 4 males, aged 35±6). Operation consisted of resection of the anterior scalene and medial aspect of the middle scalene muscles and brachial plexus neurolysis for neurogenic indication, with first rib resection reserved for vascular complications. RESULTS: Clinical evaluation including a history and physical examination followed by catheter-based venography to confirm or exclude the diagnosis and allowing for immediate treatment using thrombolysis. After thrombolysis, to prevent early recurrent thrombosis, patients should be maintained with systemic anticoagulation and surgery should be performed earlier in patients with severe residual SCV stenosis. CONCLUSIONS: Early diagnosis and thrombolytic therapy followed by operative first-rib resection produces the most favorable long-term outcome for the patients
Biosynthetic graft failure to replace infected infrainguinal bypass as developing infection due to Morganella morganii leading to disrupture of the anastomosis. Case report
No full textIntroduction Biosynthetic prosthesis has become the trend to carry out arterial reconstruction in infected sites since considered to be resistant to infection. Late graft occlusion is the only complication reported in literature so far. We report a case of biosynthetic graft infection which led to early detachment of the femoral anastomosis of a femoral-popliteal above-knee bypass. Material A 76-year-old man developed groin infection 3 months later after performing an ePTFE femoral-popliteal above-knee bypass for critical limb ischemia. He was re-admitted for groin infection involving the vascular structures. Explantation of the existing bypass and its replacement with a biosynthetic graft (omniflow II) was performed. Detachment of the proximal anastomosis occurred 6 days later leading to groin haematoma. Consequently, retroperitoneal access was performed for clamping the external iliac artery so as to control haemorrhage followed by explantation of the biosynthetic graft. An external iliac-popliteal above-knee bypass was tailored in order to save the limb and it was performed using a transobturator approach avoiding the infected site. In both cases bacterial cultures resulted positive for Morganella Morganii. The groin wound was treated separately with negative pressure medication healing definitively within 20 days and after 3-month follow-up the bypass was still patent. Conclusion This is the first report of biosynthetic graft infection used for infrainguinal reconstruction leading to haemorrhage due to anastomosis disrupture. Using an extra-anatomical access for providing blood inflow to the leg avoiding the infected site and treating safely the groin wound with VAC therapy revealed to be a valid approach
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
Retroperitoneal access for Abdominal aortic aneurysms: A single center experience
No full textBACKGROUND: Abdominal aortic aneurysms (AAA) may be treated through different surgical techniques. In this endovascular era, surgery remains a mainstay in the management of this disease, especially in patients unsuitable for EVAR. The purpose of this study was to compare retrospectively the postoperative outcomes and survival rates of the transperitoneal and the retroperitoneal approach for the abdominal aortic aneurysm repair in our Unit. METHODS: A retrospective analysis of 840 consecutive patients affected by AAA who were electively admitted in our unit from 1996 to 2011 was performed. Five hundred and sixty patients underwent surgical treatment, 193 through a transperitoneal approach (TP group) and 367 by a retroperitoneal approach (RP group). Short and long-term postoperative outcomes were compared in the two groups. RESULTS: The RP group was characterized by significantly fewer ICU admissions and fewer respiratory and cardiac postoperative complications. Canalization and oral feeding occurred earlier and the mean length of hospital stay for the RP group was shorter compared with that for the TP group. Twelve months survival rate in the RP group was significantly higher comparing with the TP group. Similarly higher survival rates were also observed at 180 months follow-up. CONCLUSIONS: In our study the repair of AAA through a retroperitoneal approach was associated with positive outcomes particularly in high-risk patients. It represents a valid therapeutic option especially in subjects not suitable for endovascular procedures. Surgical training and competence should be maintained to ensure the selection of the appropriate therapy for each patient
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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