1,721,060 research outputs found
Functional recovery and patient-reported outcomes after surgery
No full textThis manuscript centers on what surgeons, patients, and hospital administrations want and need to know about the crucial role of functional recovery and patientsâ reported outcome measure, above all in the elderly population. From all angles, it is clear that elderly patients are unique and their cancer care should be individualized and approached in a multidisciplinary fashion. Evaluation of patient fitness to undergo surgery should be undertaken in the elective and emergent settings. If patients are deemed fit for treatment, they should be offered the appropriate treatment, regardless of their age. This includes proceeding with surgery and/or chemotherapy and utilizing minimally invasive techniques, when appropriate. In addition, quality of life should be a priority in the care of elderly patients and patient-reported outcomes should be assessed and reported
Recurrent Small Bowel Obstruction in an Adolescent Patient
Full text linkA 14-year-old adolescent boy with a body mass index of 14.0 kg/m2was admitted to the emergency department with a 1-year medical history of recurrent epigastric pain associated with bilious vomiting. All episodes spontaneously resolved in 8–12 hours from onset. An abdominal computed tomography (CT) scan with intravenous contrast was performed during an acute episode. The CT scan was suggestive for superior mesenteric artery syndrome (SMAS). The first therapeutic approach is aimed at restoring ideal body weight. Our patient’s clinical manifestation progressively resolved after weight gain, and he was free from all symptoms 1 year after the diagnosis. The surgical option with duodenal bypass should only be considered when conservative treatment fails
Reduced duration of stay after elective colorectal surgery during the peak phase of COVID-19 pandemic: A positive effect of infection risk awareness?
No full textBackground: While elective surgery was shut down in most settings during the 2019 novel coronavirus
pandemic, some referral centers were designated as surgery hubs. We sought to investigate how the
pandemic scenario impacted the quality of a long-established enhanced recovery protocol colorectal
surgery program in 2 referral centers, designated as colorectal surgery hubs, located in the epicentral
Italian regions hardest hit by the pandemic.
Methods: We compared short-term outcomes of patients undergoing major colorectal surgery with a
long-established enhanced recovery protocol during the coronavirus disease 2019 outbreak occurred in
2020 (group A) with the correspondent timeframe of 2019 (group B). Primary outcomes were morbidity
and mortality, duration of stay, and readmission rate.
Results: One hundred and thirty-six patients underwent major colorectal surgery in group A and 173 in
group B. Postoperative complications and readmission rate were comparable between the 2 groups.
Oncologic case-log was predominant in group A compared with group B (73.5 vs 61%; P 1⁄4 .01). A
significantly shorter overall duration of stay was found in group A (P < .001). Uncomplicated patients of
group A had a shorter duration of stay when compared with uncomplicated patients of group B (P 1⁄4
.008).
Conclusion: Under special precautionary measures, major colorectal surgery can be undertaken on
elective basis even during coronavirus disease 2019 pandemic with reasonable results. A reduction of
duration of stay within a long-established enhanced recovery protocol colorectal surgery program was
observed during the coronavirus disease 2019 pandemic occurred in 2020 in comparison with the
correspondent timeframe of the previous year without compromising short-term outcomes. The
pandemic uncovered the positive impact of patients’ commitment to reducing duration of stay as the
empowered risk awareness likely promoted their compliance to the enhanced recovery protoco
Clinical application of faecal calprotectin in ulcerative colitis patients
No full textFaecal calprotectin (FC) is the most relevant noninvasive biomarker for monitoring inflammatory status, response to treatment and for predicting clinical relapse in ulcerative colitis (UC). The aim of this study was to evaluate the role of FC in predicting both clinical/endoscopic activity and clinical relapse in a large UC patient cohort.Objective Faecal calprotectin (FC) is the most relevant noninvasive biomarker for monitoring inflammatory status, response to treatment and for predicting clinical relapse in ulcerative colitis (UC). The aim of this study was to evaluate the role of FC in predicting both clinical/endoscopic activity and clinical relapse in a large UC patient cohort. Patients and methods A two-phase prospective study was carried out. In the first phase, the relationship between FC and clinical/endoscopic activity was evaluated. In the second phase, a cohort of asymptomatic patients with endoscopic mucosal healing was followed up using clinical and FC level determinations. Results One hundred and twenty-one UC patients were enrolled. The FC concentrations were directly correlated with both clinical and endoscopic activity (r= 0.76 and 0.87, respectively, P>0.05) and were capable of differentiating between different degrees of endoscopic severity (P> 0.01). An FC cut-off value of 110 ìg/g was highly predictive (95%) of endoscopic activity. Seventy-four patients in clinical remission with mucosal healing were followed up for a year or until relapse and 27% developed a clinical relapse. The FC concentration of nonrelapsed patients (48 μg/g) versus relapsed patients (218 μg/g) was significantly different (P> 0.01). An FC cut-off value of 193 μg/g had an accuracy of 89% in predicting clinical relapse. High FC levels were associated with clinical relapse using survival analysis and multivariate analysis. Conclusion Our data strongly support the use of FC for staging the activity of disease, predicting relapse and leading decisionmaking in a UC setting
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
Immediate versus early (24-hours) urinary catheter removal after elective minimally invasive colonic resection: study protocol for a randomized, multicenter, non-inferiority trial
Full text linkEnhanced Recovery After Surgery (ERAS) represents the standard of care in colorectal surgery. Among ERAS items, early removal of urinary catheter (UC) is considered a key issue, though adherence to this specific item still varies among centers. UC placement allows for monitoring of post-operative urinary output but relates to an increased risk of urinary tract infection (UTI), reduced mobility, and patient's discomfort. Several studies investigated the role of early UC removal specifically looking at the rate of acute urinary retention (AUR) but most of them were retrospective, single-center, underpowered, cohort studies. The main purpose of this study is to compare the rate of AUR after immediate (at the end of the surgery) versus early (within 24 h from the completion of surgery) removal of UC in patients undergoing minimally invasive colonic resection (MICR). The secondary outcomes focus on goals that could be positively impacted by the immediate removal of the UC at the end of the surgery. In particular, the rate of UTIs, perception of pain, time-to-return of bowel and physical functions, postoperative complications, and length of hospital stay will be measured
Possible Gender-Related Modulation by the ROCK1 Gene in Colorectal Cancer Susceptibility
No full textAIM:
In view of accumulating evidence supporting a pivotal role of the Rho/ROCK pathway in cancer, we investigated Rho-kinase polymorphisms as potential susceptibility factors in colorectal cancer (CRC) in a representative sample of the Italian population.
METHODS:
DNA obtained from the peripheral blood samples of 137 CRC patients and 141 healthy controls was genotyped for four ROCK1 (rs35996865; rs73963110; rs2127958; rs288980) and five ROCK2 (rs12692437; rs7563468; rs35768389; rs17463896; rs16857265) selected single nucleotide polymorphisms.
RESULTS:
None of the allelic variants of the nine selected markers was associated with the occurrence of CRC or with the development of regional lymph node metastasis. By contrast, the ROCK1 rs35996865 G variant allele was significantly more frequent in male patients (p = 0.028) than in the control group.
CONCLUSION:
This finding is, at present, the first that points to a possible gender-related modulation by the ROCK1 gene in CRC susceptibility
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