Does the continuation of low-dose acetylsalicylic acid during the perioperative period of thyroidectomy increase the risk of cervical haematoma? A 1-year experience of two Italian centers

Background: A growing number of patients taking antiplatelet drugs, mainly low-dose acetylsalicylic acid (ASA) (75–150 mg/day), for primary or secondary prevention of thrombotic events, are encountered in every field of surgery. While the bleeding risk due to the continuation of these medications during the perioperative period has been adequately investigated in several surgical specialties, in thyroid surgery it still needs to be clarified. The main aim of this study was to assess the occurrence of cervical haematoma in patients receiving low-dose acetylsalicylic acid, specifically ASA 100 mg/day, during the perioperative period of thyroidectomy. Methods: Patients undergoing thyroidectomy in two high-volume thyroid surgery centers in Italy, between January 2021 and December 2021, were retrospectively analysed. Enrolled patients were divided into two groups: those not taking ASA were included in Group A, while those receiving this drug in Group B. Univariate analysis was performed to compare these two groups. Moreover, multivariate analysis was employed to evaluate the use of low-dose ASA as independent risk factor for cervical haematoma. Results: A total of 412 patients underwent thyroidectomy during the study period. Among them, 29 (7.04%) were taking ASA. Based on the inclusion criteria, 351 patients were enrolled: 322 were included in Group A and 29 in Group B. In Group A, there were 4 (1.24%) cervical haematomas not requiring surgical revision of haemostasis and 4 (1.24%) cervical haematomas requiring surgical revision of haemostasis. In Group B, there was 1 (3.45%) cervical haematoma requiring surgical revision of haemostasis. At univariate analysis, no statistically significant difference was found between the two groups in terms of occurrence of cervical haematoma, nor of the other early complications of thyroidectomy. At multivariate analysis, the use of low-dose ASA did not prove to be an independent risk factor for cervical haematoma. Conclusions: Based on our findings, we believe that in patients receiving this drug, either for primary or secondary prevention of thrombotic events, its discontinuation during the perioperative period of thyroidectomy is not necessary

End-to-end numerical simulator of the Shadow Position Sensor (SPS) metrology subsystem of the PROBA-3 ESA mission

PROBA-3 - PRoject for OnBoard Autonomy is an ESA mission to be launched in 2022 where a spacecraſt is used as an external occulter (OSC-Occulter Spacecraſt), to create an artificial solar eclipse as observed by a second spacecraſt, the coronagraph (CSC-Coronagraph Spacecraſt). The two spacecraſts (SCs) will orbit around the Earth, with an highly elliptic orbit (HEO), with the perigee at 600 Km, the apogee at about 60530 Km and an eccentricity of 0.81. The orbital period is of 19.7 hours and the precise formation flight (within 1 mm) will be maintainedforabout6hours overthe apogee, in ordertoguarantee the observation ofthe solarcoronawith the required spatial resolution. The relative alignment ofthe two spacecraſts is obtained bycombining information from several subsystems. One ofthe most accurate subsystem (with accuracy >0.5 mm) is the Shadow Position Sensors (SPS), composed by eight photomultipliers installed around the entrance pupil of the CSC. The SPS will monitor the penumbra generated by the occulter spacecraſt, whose intensity will change according to the relative position ofthe two satellites. A dedicated algorithm has been developed to retrieve the displacementof the spacecraſts fromthe measurements ofthe SPS. Several tests are requiredin ordertoevaluate the robustness of the algorithm and its performances/results for different possible configurations. A soſtware simulator has been developed for this purpose. The simulator includes the possibility to generate synthetic 2-D penumbra profile maps or analyze measured profiles and run different versions ofthe retrieving algorithms, including the “on-board” version. In order to import the “as built” algorithms, the soſtware is coded using Matlab

Shedding light on typical species : implications for habitat monitoring

Habitat monitoring in Europe is regulated by Article 17 of the Habitats Directive, which suggests the use of typical species to assess habitat conservation status. Yet, the Directive uses the term “typical” species but does not provide a definition, either for its use in reporting or for its use in impact assessments. To address the issue, an online workshop was organized by the Italian Society for Vegetation Science (SISV) to shed light on the diversity of perspectives regarding the different concepts of typical species, and to discuss the possible implications for habitat monitoring. To this aim, we inquired 73 people with a very different degree of expertise in the field of vegetation science by means of a tailored survey composed of six questions. We analysed the data using Pearson's Chi-squared test to verify that the answers diverged from a random distribution and checked the effect of the degree of experience of the surveyees on the results. We found that most of the surveyees agreed on the use of the phytosociological method for habitat monitoring and of the diagnostic and characteristic species to evaluate the structural and functional conservation status of habitats. With this contribution, we shed light on the meaning of “typical” species in the context of habitat monitoring

Acute diverticulitis management: evolving trends among Italian surgeons. A survey of the Italian Society of Colorectal Surgery (SICCR)

Acute diverticulitis (AD) is associated with relevant morbidity/mortality and is increasing worldwide, thus becoming a major issue for national health systems. AD may be challenging, as clinical relevance varies widely, ranging from asymptomatic picture to life-threatening conditions, with continuously evolving diagnostic tools, classifications, and management. A 33-item-questionnaire was administered to residents and surgeons to analyze the actual clinical practice and to verify the real spread of recent recommendations, also by stratifying surgeons by experience. CT-scan remains the mainstay of AD assessment, including cases presenting with recurrent mild episodes or women of child-bearing age. Outpatient management of mild AD is slowly gaining acceptance. A conservative management is preferred in non-severe cases with extradigestive air or small/non-radiologically drainable abscesses. In severe cases, a laparoscopic approach is preferred, with a non-negligible number of surgeons confident in performing emergency complex procedures. Surgeons are seemingly aware of several options during emergency surgery for AD, since the rate of Hartmann procedures does not exceed 50% in most environments and damage control surgery is spreading in life-threatening cases. Quality of life and history of complicated AD are the main indications for delayed colectomy, which is mostly performed avoiding the proximal vessel ligation, mobilizing the splenic flexure and performing a colorectal anastomosis. ICG is spreading to check anastomotic stumps' vascularization. Differences between the two experience groups were found about the type of investigation to exclude colon cancer (considering the experience only in terms of number of colectomies performed), the size of the peritoneal abscess to be drained, practice of damage control surgery and the attitude towards colovesical fistula

Differential host utilisation by different life history stages of the fish ectoparasite Argulus foliaceus (Crustacea: Branchiura)

Contains fulltext : 72168.pdf (publisher's version ) (Open Access

La distribuzione diatopica di alcuni predicati complessi sardi

AbstractThe aim of this paper is to examine the diatopic variation of some Sardinian complex predicates, mainly from a morphosyntactic (and, secondarily, a semantic) perspective. I will discuss (i) the distribution of Camp(idanese)ai/ Log(udorese)-Nu(orese)àere a+ inf(initive), lit. ‘to have to’ + inf., and of the agglutinated and univerbated forms of Log.-Nu.dèvere/dèppere+ inf., lit. ‘must’ + inf., both constructions expressing (different types of) future time reference; (ii) the diffusion of person and number in the modal complex predicate Camp.fai/ Log.-Nu.fàghere/fàchere a+ inf., lit. ‘to do to’ + inf., with the sense of ‘being able/allowed to do something’; (iii) cases of double accusative marking of clitic pronouns expressingcausee/beneficiaryandundergoer, and agreement between these pronouns and the past participle of ‘make’/‘let’ in the causative constructions Camp.fai/ Log.-Nu.fàghere/fàchere+ inf., lit. ‘to make’ + inf., and Camp.lassai/ Log.-Nu.lassare/(dassare)+ inf., lit. ‘to let’ + inf.; (iv) the ongoing diffusion of the reiterative and/or purposive values of Camp.torrai a/po/ Log.-Nu.torrare a/pro+ inf., lit. ‘to return to’ + inf.; (v) the ongoing diffusion of the aspectual complex predicate Camp.(am)megai/ Log.-Nu.(am)megare de/a+ inf., conveying progressive aspect, according to Blasco Ferrer (1991; 2002) and my data. In conclusion, I will argue that isoglosses of morphosyntactic variation of Sardinian complex predicates seem to be more ‘conservative’ (in the sense of Virdis 1988) and to englobe wider and more homogenous areas, if compared to phonological isoglosses.</jats:p

A trustworthy mechanochemical route to isocyanides

Isocyanides are hardly produced, dramatically sensitive to purification processes, and complex to handle as synthetic tools. Notwithstanding, they represent one of the most refined and valuable compounds for accessing sophisticated and elegant synthetic routes. A unique interest has always been addressed to their production, though their synthetic pathways usually involve employing strong conditions and toxic reagents. The current paper intends to provide a conceptually innovative synthetic protocol for mechanochemical isocyanide preparation, simultaneously lowering the related reagents' toxicity and improving their purification in a straightforward procedure.</jats:p

A trustworthy mechanochemical route to isocyanides

Isocyanides are hardly produced, dramatically sensitive to purification processes, and complex to handle as synthetic tools. Notwithstanding, they represent one of the most refined and valuable compounds for accessing sophisticated and elegant synthetic routes. A unique interest has always been addressed to their production, though their synthetic pathways usually involve employing strong conditions and toxic reagents. The current paper intends to provide a conceptually innovative synthetic protocol for mechanochemical isocyanide preparation, simultaneously lowering the related reagents' toxicity and improving their purification in a straightforward procedure