138 research outputs found

    Le Otto Città dell’Anima: La «Lampada delle Luci» (Misbāh al-Arwāh) di Shams ad-dīn Bardasīrī, un mi‘rāj persiano del XIII secolo

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    Il lavoro si concentra sulla seconda parte del poema mistico-didattico persiano Mishbāh al-Arwāh (La Lampada degli Spiriti), a lungo attribuito a Awhad al-dīn di Kerman ma opera in realtà di Shams al-dīn Muhammad b. Il-Tughān Bar dasīrī morto intorno al 1220. Lungo ca. 1100 versi il poema si divide in due parti. Nella prima il maestro Mu‘īn al-dīn Saffār impartisce una serie di lezioni all’allievo e io narrante, che coincide con l’Autore dell’opera, fornendoci in sostanza un compendio di insegnamenti e dottrine sufi all’altezza del XIII sec. riguardanti una congerie di argomenti (dalla cosmologia alle scienze naturali, dalla Resurrezione alla vita devota, dal rapporto allievo-maestro al ruolo di Iblis nel mondo ecc.) e il Maestro occupa interamente la scena; nella seconda parte del poema viene invece descritto il viaggio dei due attraverso le “otto città dell’anima” – dai gradi più bassi (l’ “inferno”) a quelli più elevati (il “paradiso”) – ad contemplanda mysteria animae, e il discepolo interloquisce vivacemente con il suo Maestro che è un po’ mutatis mutandis il “Virgilio” del Mishbāh al-Arwā

    Influence of the conditions of sensitization on the characteristics of p-DSCs sensitized with asymmetric squaraines

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    The effect of the conditions of sensitization on the photoelectrochemical performance of p-type dye-sensitized solar cells (p-DSCs) with screen-printed nickel oxide (NiO) photocathodes is analyzed. The dye-sensitizers employed in the present study are asymmetric squaraines. The conditions of sensitization differ for the relative concentration of the anti-aggregating agentCDCA(chenideoxycholic acid) with respect to the concentration of the dye-sensitizer. The co-adsorption of CDCA onto NiO electrode brings about a decrease in the surface concentration of the anchored dye as well as a blueshift of the characteristic wavelengths of optical absorption of the asymmetric squaraines considered here. Beside this, the employment of CDCA as co-adsorbent reduces the overall conversion performance of the resulting squaraine-sensitized p-DSCs with consequent diminution of the short-circuit current density. This result is ascribed to the acid action of CDCA toward the amminic nitrogen of the squaraines. Quantum efficiency spectra show that CDCA acts as a quencher of the intrinsic photoelectrochemical activity of NiO. Moreover, CDCA does not interfere with the mechanism of charge injection effectuated by the photoexcited squaraines. The photoelectrochemical impedance spectra was analyzed employing a model of equivalent circuit developed for semiconducting nanostructure electrodes

    efficacy of the inside out tramsobturator tension free vaginal tape tvt abbrevo for the treatment of stress urinary incontinence after a 12 month follow up

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    The aim of this study was to evaluate the efficacy of the inside-out tension-free vaginal tape transobturator approach or TVT-Obturator system (TVT-ABBREVO) in women with stress urinary incontinence (SUI). This is a prospective single arm study of women with SUI who underwent a TVT-ABBREVO procedure. The inclusion criterion was a diagnosis of SUI urodynamically proven without detrusor over activity. SUI was defined as involuntary urine leakage with stress in the absence of detrusor over activity with or without intrinsic sphincter deficiency. Before, and 12 months after surgery women received urodynamic test, pelvic examination, and a personal interview using the Urogenital Distress Inventory (UDI) and the Incontinence Impact Questionnaire (IIQ). The primary outcome was the incidence of incontinency through cough stress test during the urodynamic exam. A total of 90 women were included in the analysis. Our analysis showed that the incidence of incontinence through cough stress test during the urodynamic exam was significantly less 12 months after the intervention (100% vs 3%; P-value =0.001). Moreover, we found a significantly improvement of the quality of life measured by UDI score (13±4.5 vs 7.3±2.2 points; P-value 0.01) and IIQ score (14±5.7 vs 8.1 vs 3.1 points; P-value 0.02). No intraoperative complications were noticed. TVT-ABBREVO significantly reduced the incidence of stress urinary incontinence. In the authors' experience, this technique resulted technically simple and provided high objective and subjective long-term efficacy, a clinically meaningful improvement in patient quality of life, and an excellent safety profile

    Sinus Floor Elevation with Modified Crestal Approach and Single Loaded Short Implants: A Case Report with 4 Years of Follow-Up

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    Tooth extraction is usually followed by bone reduction. In the maxillary posterior region, this remodelling combined with sinus pneumatisation and periodontal defects may lead to a reduced basal bone height available for implant placement. Sinus floor elevation can be performed with different surgical techniques. Crestal approach has demonstrated to be effective, less invasive, and associated with a reduced morbidity. This article reports a modified sinus floor elevation by means of rotary, noncutting instruments, addition of xenograft, and 2 short-threaded implant placements. The aim of the study was to evaluate the implant’s success and intrasinus radiographical bone gain after 4 years of functional loading. The premolar implant site presented a starting basal bone height of 6 mm, while the molar site was of 2 mm. In the first surgical step, sinus floor elevation was performed mesially and the implant was inserted, and distally only sinus floor elevation was performed. After 6 months, the mesial implant was uncovered and the second implant was inserted; 4 months later, the second fixture was uncovered, and both fixtures were loaded with single provisional screw-retained crowns and later with single screw-retained porcelain fused to metal crowns. Implants integrated successfully, and crestal bone remodelling did not exceed the smooth collar. Bone gain was 3 mm for the mesial implant and more than 5 mm for the distal one

    Efficacy of methylergometrine during the early puerperium: a randomized double-blind placebo-controlled clinical trial

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    OBJECTIVE: To determine if oral methylergometrine administration during the first 10 d following spontaneous vaginal delivery has any beneficial effect on the increase of hemoglobin levels. METHODS: This was a parallel group double-blind placebo-controlled clinical trial conducted at single center university hospital in Italy. Participants were puerperal women, who delivered singleton gestation with spontaneous vaginal delivery at term. Participants were randomized into a 1:1 ratio to receive either 0.125 mg methylergometrine per os twice a day or placebo for 10 d. Hemoglobin levels were recorded on the day of delivery and after 10 d. The primary outcome was the variation in hemoglobin levels between the first and the 10th day of treatment. RESULTS: From December 2012 to October 2015, 220 agreed to take part in the study, underwent randomization, and were enrolled and followed-up. Of the randomized women, 110 (50%) were randomized to the methylergometrine group and 110 (50%) to the placebo group. No women were excluded after randomization or lost to follow-up (100%). We found no significant difference in the median variation of hemoglobin levels between the intervention and the placebo group Conclusions: The use of 10 d oral methylergometrine in puerperal women was not associated with any benefit in the variation of hemoglobin levels from delivery to 10 d after delivery. Key Message Methylergometrine in puerperal women was not associated with any benefit

    Incidence of uterine rupture in second-trimester abortion with gemeprost alone compared to mifepristone and gemeprost

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    OBJECTIVES: To compare uterine rupture rates in women having a medical abortion receiving gemeprost alone to those receiving mifepristone plus gemeprost. STUDY DESIGN: We reviewed the records of women undergoing medical abortion at 13 0/7-23 6/7 weeks from January 2007 to December 2014 at a single center in Italy. Prior to January 2011, we used gemeprost 1 mg vaginally every 3 h up to a maximum of five doses. After January 2011, we added mifepristone 200 mg orally 24 h prior to the same gemeprost protocol. The primary outcome of the study was the incidence of uterine rupture. We compared the outcome between women receiving gemeprost alone with the combination of gemeprost and mifepristone. RESULTS: One thousand and sixty-one (58.5%) and 753 (41.5%) women underwent medical abortion in the gemeprost-alone and the gemeprost/mifepristone groups, respectively. Five (0.47%) uterine ruptures occurred in the gemeprost and four uterine ruptures occurred in the gemeprost/mifepristone groups, respectively (0.53%) (p=.89). All uterine ruptures occurred in women with prior cesarean delivery. CONCLUSIONS: We rep orted no difference in the incidence of uterine rupture between the gemeprost-alone and gemeprost and mifepristone groups. IMPLICATIONS: Uterine rupture is a rare complication of second-trimester medical abortion with gemeprost. Use of mifepristone prior to gemeprost does not affect this risk

    Carbamazepine transbuccal delivery: the histo-morphological features of reconstituted human oral epithelium and buccal porcine mucosae in the transmucosal permeation

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    Transbuccal drug delivery is an attractive way of administration since several well-known advantages are provided, especially with respect to peroral management. Carbamazepine (CBZ) is an anticonvulsant which is useful in controlling neuropathic pain, and it is currently administered by peroral route, although its absorption and bioavailability is limited due to various factors. The oral cavity could be an interesting site for transbuccal CBZ delivery due to two properties: slow administration of constant low drug doses and less dose-related side effects. However, in transbuccal absorption a major limitation could be the low permeability of the mucosa which results in low drug bioavailability; thus the aptitude of the drug to penetrate the buccal mucosa has to be assessed by using tissue models resembling human normal mucosa. In our experience, CBZ well permeates mucosal membranes. In order to assess the efficacy of CBZ transbuccal delivery and to verify the reliability of these tissues in permeability testing before and after the passage of CBZ, the histo-morphological features of reconstituted human oral (RHO) epithelium (E) and buccal porcine mucosae were investigated. Significant histological changes due to CBZ passage were observed both in RHO-E and porcine mucosa. The main findings detected in RHO samples were cellular swellings with a signet ring-like appearance, nuclear swelling, prominent nucleoli lined against the nuclear membrane and the presence of keratohyalin granules. The most striking finding regarding porcine buccal mucosa was a cytoplasmic vacuolization, mainly involving the basal layer

    Immersion in water during labor and delivery

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    Objective: Immersion in water during labor and delivery has been studied as an alternative form of obstetric care. The aim of this study was to evaluate obstetrics and neonatal outcomes of women intending to use immersion in water for labor and delivery. Methods: This was a retrospective observational study conducted at a single center in Italy from January 2004 to January 2016. The clinical records of pregnant women intending to use immersion in water for labor and delivery were collected in a dedicated database and included in the study. Only the women who underwent immersion in water starting from the first stage of labor were included in the study. Inclusion criteria were women with uncomplicated singleton gestations and cephalic presentation at or later than 37 weeks of gestation, and with spontaneous onset of labor. The primary outcome of the study was the percentage of women who had both labor and delivery in water. Results: 389 women met the inclusion criteria and were included in the study. 256 (66%) were nulliparous, and 133 (34%) were multiparous. Out of the 389 women intending to use immersion in water for labor and delivery, 278 (71.5%) had labor and delivery in the water, 31 (8.0%) labor in water and delivery on land, and 80 (20.5%) had the first stage of labor in water, and the second stage and delivery on land. The incidence of perineal lacerations was 61.4%. Conclusion: The vast majority of the women who set out to labor and delivery in water achieve their aim

    Endometrial scratch injury before intrauterine insemination: is it time to re-evaluate its value? Evidence from a systematic review and meta-analysis of randomized controlled trials

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    OBJECTIVE: To assess the impact of endometrial scratch injury (ESI) on the outcomes of intrauterine insemination (IUI) stimulated cycles. DESIGN: Systematic review and meta-analysis. SETTING: Not applicable. PATIENT(S): Infertile women undergoing one or more IUI stimulated cycles. INTERVENTION(S): Randomized controlled trials (RCTs) were identified by searching electronic databases. We included RCTs comparing ESI (i.e., intervention group) during the course of IUI stimulated cycle (C-ESI) or during the menstrual cycle preceding IUI treatment (P-ESI) with controls (no endometrial scratch). The summary measures were reported as odds ratio (OR) with 95% confidence-interval (CI). MAIN OUTCOME MEASURE(S): Clinical pregnancy rate, ongoing pregnancy rate, multiple pregnancy rate, ectopic pregnancy rate, miscarriage rate. RESULT(S): Eight trials were included in the meta-analysis, comprising a total of 1,871 IUI cycles. Endometrial scratch injury was associated with a higher clinical pregnancy rate (OR 2.27) and ongoing pregnancy rate (OR 2.04) in comparison with the controls. No higher risk of multiple pregnancy (OR 1.09), miscarriage (OR 0.80), or ectopic pregnancy (OR 0.82) was observed in patients receiving ESI. Subgroup analysis based on ESI timing showed higher clinical pregnancy rate (OR 2.57) and ongoing pregnancy rate (OR 2.27) in patients receiving C-ESI and no advantage in patients receiving P-ESI. CONCLUSION(S): Available data suggest that ESI performed once, preferably during the follicular phase of the same cycle of IUI with flexible aspiration catheters, may improve clinical pregnancy and ongoing pregnancy rates in IUI cycles. Endometrial scratch injury does not appear to increase the risk of multiple pregnancy, miscarriage, or ectopic pregnancy

    Uterine fibroid size modifications during pregnancy and puerperium: evidence from the first systematic review of literature

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    PURPOSE: The influence of pregnancy on uterine fibroid size still remains an unsolved dilemma. Basing on current knowledge, physicians are not able to inform patients about the likelihood of uterine fibroids to modify their size during pregnancy. Study aim was to summarize available evidence concerning the size modifications of uterine fibroids during each trimester of pregnancy and during puerperium. METHODS: The review was reported following the PRISMA guidelines and registered in PROSPERO (registration number: CRD42017071117). A literature search was conducted in electronic database (PubMed, Embase, Sciencedirect, the Cochrane library and Clinicaltrials.gov) until July 2017. All studies evaluating fibroids' changes during pregnancy and puerperium by ultrasound or magnetic-resonance-imaging were included. Descriptive characteristics of studies and patients were collected. The modifications of uterine fibroid diameter and volume were the outcome measures. RESULTS: Concerning the first trimester of pregnancy, all authors reported a significant growth of uterine fibroids. Contradictory evidence was found about uterine fibroid modifications during the second and third trimesters, mainly supporting a slowdown during mid pregnancy and a subsequent size reduction during late pregnancy. Concerning the overall modifications during pregnancy and puerperium, poor evidence quality suggests that uterine fibroids do not modify their volume/slightly enlarge during pregnancy and subsequently reduce in size during puerperium. CONCLUSIONS: Uterine fibroids seem to be subject to a non-linear trend of modifications during pregnancy and puerperium, which may vary from myoma to myoma. Adequate evidence supports uterine fibroid systematic enlargement during the first trimester of pregnancy, while inconsistent evidence is available about the changes of uterine fibroids during second and third trimesters. In addition, the overall modifications of myomas during pregnancy and puerperium remain unclear
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