Trattamento robotico dell'endometriosi profonda

UNIVERSITA’ DEGLI STUDI DI PISA FACOLTA’ DI MEDICINA E CHIRURGIA Dipartimento di Medicina clinica e Sperimentale (Settore scientifico disciplinare Ginecologia e Ostetricia) Direttore: Prof. Angiolo Gadducci Oggetto della tesi: “Trattamento robotico dell'endometriosi profonda” Relatore: Chiar.mo Prof. Angiolo Gadducci Candidato: Marilda Radomi ANNO ACCADEMICO 2013-201

The relationship between health care users’ demand and the health care system’s response: a research on change observed in the health care system, in the hospital and in the territory

The present research study aims at exploring the representation of the health service within a group of hospital physicians and nurses. The objective is to identify how the symbolic dynamic of hospital workers shapes their own praxis. The texts of interviews with 25 hospital workers have been subjected to Emotional Text Analysis (ETA). Five clusters emerge from the analysis where the topic of giving life and avoiding death is central and where the hospital assumes a thaumaturgical and basically omnipotent role. This is in conflict with recognizing the limitations of therapy. Only in the background the culture of curing the patients appears, characterized by aggressive reactivity towards the crisis which leads patients to emergency intervention because crises are ascribed to deviances frommedical prescription. Emergency intervention is ultimately the kind of intervention which the hospital believes it is capable to provide. Another problem is the lack of filters provided by bureaucratized general practitioners, whose cooperation would be essential, but who are supposed to have no longer the necessary relationship with their patients

La relazione che organizza il contesto sanitario: domanda dell’utenza e risposta dei servizi sanitari, nel territorio e nell’ospedale - The relationship which organizes the healthcare context: users’ demand and response of healthcare services, in the territory and the hospital

Our intent is to present citizens’ demand of health care services in Italy through a research structured in three studies. We used the Emotional Text Analysis (ETA) to lead the three s tudies: the first study regarded the citizens’expectations of the healthcare services, the second study regarded the point of view of the hospital personnel (medical doctors and nurses), the third regarded the point of view of the General Practitioners onthe health care services. These three studies are briefly presented. Data and outcome of an Assumed Similarity Test applied to all experimental subjects of the three studies in order to make a comparison among them, are also presented. The findings of the Emotional Text Analysis show that citizens, potential users of health services, center their requests on their individual subjectivity, and seek answers both to their suffering and to the feeling of alienation that characterizes the being sick feeling that makes them go to a medical doctor. For their part, general practitioners and hospital doctors immediately transform this subjective feeling in an objective medical diagnosis. Here a first gap emerges between patient’s demand and medical response, leavingthe possibility of an alliance on the diagnosis in order to jointly fight the disease. It has long been in place though a change that has expelled the patient also from sharing the diagnostic process, increasingly taken from self-centered dynamics within the healthcare system. This widens the gap between the request of the citizens and the response of the health services, that contributes to that conflictual growth to which defensive medicine gives a dysfunctional answer. The Assumed Similarity Test contributes to the interpretation of the health care dynamic identified in the Emotional Text Analysis; particularly in regard to the unfolding conflict, given by the hypothesis emerging from the data analysis, that a feeling of closeness for the hospital personnel goes along with an emotional stance of overpowering the othe

Gli Studi veterinari: dal Regio Istituto Superiore alla Facoltà di Medicina Veterinaria

In Sardegna l’orientamento di istituire una Scuola Veterinaria si fa strada per una serie di situazioni socio-economiche del territorio isolano, considerato che molte delle attività produttive gravitano attorno al comparto zootecnico, particolarmente attivo e vitale. In tale contesto non appare casuale la scelta politica e accademica di istituire un corso di formazione veterinaria presso l’Università di Sassari. In particolare il periodo, comprendente il lasso di tempo dei sette anni accademici, che va dall’avvio ufficiale dei corsi del Regio Istituto Superiore di Medicina Veterinaria (1928) fino alla trasformazione del Regio Istituto in Facoltà (1934), rappresenta un passaggio fondamentale dell’avvio dell’attività didattica e scientifica che ha raggiunto nel tempo punte di eccellenza contribuendo allo sviluppo della professione veterinaria in Sardegna

Lavoro di cura e innovazione tecnoscientifica: il caso della medicina personalizzata

In contemporary biomedicine, care practices are increasingly interlaced with research and development activities, leading to the emergence of new biomedical domains, such as personalized medicine. Personalized medicine involves the shaping of unprecedented relationships between clinical practice and technoscientific innovation processes, which need to be explored in their social and technological dimensions. In this article, based on ethnographic research carried out within an institute of care and research in Northern Italy, it will be analysed the reconfiguration of medical practice and health professions due to the increasing adoption of organizational strategies in support of the circulation of knowledge, biological materials and technologies between scientific laboratories and care settings. From the analytical point of view, a special attention it will be paid to the organizational arrangements performed by physicians and scientist in order to support the dialogue between research laboratories and care contexts, in which personalised medicine is shaped

On dynamic mutual information for bivariate lifetimes

We consider dynamic versions of the mutual information of lifetime distributions, with focus on past lifetimes, residual lifetimes and mixed lifetimes evaluated at different instants. This allows to study multicomponent systems, by measuring the dependence in conditional lifetimes of two components having possibly different ages. We provide some bounds, and investigate the mutual information of residual lifetimes within the time-transformed exponential model (under both the assumptions of unbounded and truncated lifetimes). Moreover, with reference to the order statistics of a random sample, we evaluate explicitly the mutual information between the minimum and the maximum, conditional on inspection at different times, and show that it is distribution-free. Finally, we develop a copula-based approach aiming to express the dynamic mutual information for past and residual bivariate lifetimes in an alternative way

Family doctors and clinical trials

There is a growing awareness that research in primary care is needed to provide excellent clinical and population-based care, to develop effective health systems and policies, and to educate future primary care professionals and researchers. The relevance of research undertaken in primary care is unquestionable: the results of researches conducted in other settings has limited relevance because primary care encounters health problems rarely managed in other sectors of health care (i.e. low probability of major acute disease and high prevalence of comorbidity). From legislative aspects to limits and difficulties of application, the article underlines the importance of research in primary care in the Italian context, where this kind of activity is almost absent. An example, concerning the Genova ASL 3, is reported to suggest strategies to promote and improve research as an integral component of family doctors skills

Canine Trypanosoma cruzi infection in the Bolivian Chaco

A cross-sectional study on Trypanosoma cruzi was carried out in 2013 to evaluate the role of dogs as possible source of infection for humans in two rural communities of the highly endemic Bolivian Chaco (Bartolo, Chuquisaca Department, n = 57 dogs; and Ivamirapinta, Santa Cruz Department, n = 48 dogs). Giemsa-stained thick and thin smears, rapid immunochromatographic test (ICT) (Chagas Quick test, Cypress Diagnostic, Belgium) and polymerase chain reaction for T. cruzi on dried blood spots were performed. All smears proved negative by microscopic examination, whereas 23/103 (22%) were positive by ICT and 5/105 (5%) blood samples contained T. cruzi DNA, evidencing the potential role of dogs in the domestic transmission of the parasite

Interaction between <i>Mycobacterium tuberculosis</i>, <i>Mycobacterium bovis</i>, <i>Mycobacterium avium</i> subspecies <i>paratuberculosis</i> with the enteric glia and microglial cells

Background We investigated the interaction of Mycobacterium avium subspecies paratuberculosis, M. bovis and M. tuberculosis and different glial cells (enteric glial and microglial cells) in order to evaluate the infecting ability of these microorganisms and the effects produced on these cells, such as the evaluation of cytokines expression. Results Our experiments demonstrated the adhesion of M. paratuberculosis to the enteroglial cells and the induction of IL-1A and IL-6 expression; M. tuberculosis and M. bovis showed a good adhesive capability to the enteric cell line with the expression of the following cytokines: IL-1A and IL-1B, TNF-α, G-CSF and GM-CSF; M. bovis induced the expression of IL-6 too. The experiment performed with the microglial cells confirmed the results obtained with the enteroglial cells after the infection with M. tuberculosis and M. bovis, whereas M. paratuberculosis stimulated the production of IL-1A and IL-1B. Conclusion Enteroglial and microglial cells, could be the target of pathogenic mycobacteria and, even if present in different locations (Enteric Nervous System and Central Nervous System), show to have similar mechanism of immunomodulation