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Preoperative radiofrequency ablation in painful osteolitic long bone metastases
No full textThis study aimed to determine whether Radiofrequency Ablation (RFA) followed by prophylactic internal fixation produces better palliation in terms of pain and reduces the need for blood transfusion more than radiotherapy and surgical stabilization (RT-SS). Patients with solitary long bone metastases and a pain score of 5 or more on the VAS scale were selected. Fifteen patients were treated with RFA and surgical stabilization (RFA-SS) and were compared with a matched group (15 subjects) treated by radiotherapy and surgical stabilization (RT-SS). A complete response in terms of pain relief at 12 weeks was documented in 20% (3/15) and 533% (8/15) of the subjects treated by RT-SS or RFA-SS, respectively (p = 0.027). The overall response rate at 12 weeks was 93.3% (14 patients) in the group treated by RFA-SS and 59.9% (9 patients) in the group treated by RT-SS (p = 0.048). Although recurrent pain was documented more frequently after RT-SS (26.6%) than after RFA-SS (6.7%) the difference did not reach statistical significance. The morbidity related to RT-SS did not significantly differ when the treatment was associated with RFA. We observed a reduction in blood transfusion, as 3 patients in the RT-SS group required a blood transfusion, versus none in the RFA-SS group. Our results suggest that RFA-SS is safe and is more effective than RT-SS; furthermore, RFA may become an option for patients with metastases of the long bones to prevent tumour dissemination and reduce intraoperative blood loss. The findings described here should serve as a framework around which to design future clinical trials
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
Related Articles Sciatica: treatment with intradiscal and intraforaminal injections of steroid and oxygen-ozone versus steroid only
No full textPURPOSE: To prospectively compare the clinical effectiveness of intraforaminal
and intradiscal injections of a mixture of a steroid, a local anesthetic, and
oxygen-ozone (O(2)-O(3)) (chemodiscolysis) versus intraforaminal and intradiscal
injections of a steroid and an anesthetic in the management of radicular pain
related to acute lumbar disk herniation.
MATERIALS AND METHODS: Medical Ethical Committee approval and informed consent
were obtained. One hundred fifty-nine patients (86 men, 73 women; age range,
18-71 years) were included and were randomly assigned to two groups.
Seventy-seven patients (group A) underwent intradiscal and intraforaminal
injections of a steroid and an anesthetic, and 82 patients (group B) underwent
the same treatment with the addition of an O(2)-O(3) mixture. Procedures were
performed with computed tomographic guidance. An Oswestry Low Back Pain
Disability Questionnaire was administered before treatment and at intervals, the
last at 6-month follow-up. Patients and clinicians were blinded as to which
treatment was performed. Results were compared with the chi(2) test.
RESULTS: After 6 months, treatment was successful in 36 (47%) patients in group A
and in 61 (74%) patients in group B. The difference was significant (P < .01).
CONCLUSION: Intraforaminal and intradiscal injections of a steroid, an
anesthetic, and O(2)-O(3) are more effective at 6 months than injections of only
a steroid and an anesthetic in the same sites
Magnetic resonance-guided focused ultrasound surgery treatment of non-spinal intra-articular osteoblastoma: feasibility, safety, and outcomes in a single-center retrospective analysis
No full textBackground: Interventional radiology, thanks to its low invasiveness and possibility to reduce the average time for the patients to come back to their normal activity, is becoming more and more promising and diffused in multiple fields. Employed without needles, MRgFUS is probably the less invasive techniques among the ones belonging to the field of interventional radiology. Purpose: To evaluate safety and effectiveness of MRgFUS in the treatment of a rare and benign, though disabling, bone lesion: intra-articular osteoblastoma. Materials and methods: A retrospective study was carried out on 6 patients (mean, 21 years) treated in the last 2 years with MRgFUS for symptomatic, histologically proved intra-articular osteoblastoma. The main inclusion criterion was the presence of a good acoustic window. The procedures consisted in MR-guided ablation, using high intensity ultrasound beams focused on the target lesion. Spinal anesthesia or peripheral nerve block was used. Clinical (based on pain and functional scales) and imaging follow-up studies were performed up to 1 year after treatment. Complications were recorded. Multiple linear regression and analysis of variance were used to assess correlations. Results: All the procedures were technically successful; no complications were observed. Painful symptomatology decreased of 88% at 6 months and 98% at 12 months (p < 0.0001), and was associated to functional improvement (p = 0.002). MRI and CT controls showed disappearance of all signs of disease and bone inflammation with a marked tendency to bone healing. Conclusion: This study shows the safety and effectiveness of MRgFUS in the treatment of intra-articular osteoblastoma with a good acoustic window
Evolution of the imaging features of osteoid osteoma treated with RFA or MRgFUS during a long-term follow-up: a pictorial review with clinical correlations
No full textInterventional radiology is today considered the first-line treatment for osteoid osteoma both in the form of needle-guided technique of ablation (Radiofrequency) and of needleless technique (magnetic resonance-guided focused ultrasound surgery). The follow-up study of the procedures is mainly clinical, since the disappearance of pain is consistent with the success of the procedure. However, due to the minimally invasive and innovative nature of the approach, interpretation of the follow-up imaging could be ambiguous and misleading. Aim of our review was to define the main findings on the imaging that can best describe the regular evolution of these types of treatment. In particular, four findings were considered: (1) bone marrow oedema; (2) reactive phenomena (perilesional inflammatory reaction for extra-articular lesions or synovial reaction for intra-articular lesions); (3) bone remodelling (disappearance of the nidus and bone healing); (4) ring sign (considered as the granulation tissue around the nidus treated). These findings were evaluated using MRI and CT with a follow-up study that lasted up to 24 months
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
Lesioni del legamento crociato anteriore negli atleti: valutazione e controlli clinico-diagnostici utilizzando apparecchio dedicato.
No full textINTRODUCTION: We investigated the MR signs of anterior cruciate ligament (ACL)
tears and tried to assess the patterns of both the acute and the chronic phases
since more MR examinations are currently performed of the knee joint in the hyper
and acute post-traumatic stage.
MATERIAL AND METHODS: December, 1994, through September, 1997, a hundred and 89
sportsmen with a history of hyper and acute knee trauma were submitted to MRI:
one hundred and four of them were followed-up for 3-6 months. The MR examinations
were performed with a dedicated unit (Artoscan, Esaote Biomedica, Genoa) using
T1-weighted SE, T2-weighted GE and Turbo ME sequences on the sagittal, coronal
and axial planes, respectively (3-5 mm slice thickness).
RESULTS: Of 189 patients examined in the hyper and acute post-traumatic stage,
101 had a complete ACL tear, 23 had a partial tear and 65 had an enlarged and
inhomogeneous ACL: Eighty-five patients underwent surgery, while the other 104
had 3-6 months' follow-up MRI. Twenty-four of the latter had a complete ACL tear,
20 had a partial tear and 60 had no MR finding of ACL interruption, with a more
or less inhomogeneous ligament.
DISCUSSION: ACL tears are difficult to demonstrate in the acute phase because of
perilesional swelling, synovitis and hemorrhage; high-contrast sequences on the
axial plane are therefore required. In the chronic stage, an uninterrupted ACL
does not necessarily imply that function is preserved, as well as the MR finding
of a deflected ligament does not necessarily imply altered biomechanics.
CONCLUSIONS: MRI of the knee joint is increasingly used to study hyper and acute
ACL tears thanks to the availability of dedicated units. The MR study of ACL
tears is not meant to refer the patients to surgery, which pertains to the
physical examination, but it allows to assess lesion severity and to show
associated injuries in other knee structures
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