Gestione innovativa degli scarti di coltivazione e di lavorazione nella filiera delle erbe aromatiche (POLIECO2)

Le piante aromatiche contengono oli essenziali che conferiscono particolari aromi e vengono impiegati nella preparazione di bevande, profumi, cosmetici, prodotti per la casa ed il benessere oltre che in aromaterapia. I consumatori hanno cominciato ad associare le erbe aromatiche a cuochi di fama, a cibi raffinati, all’utilizzo in erboristeria, a tradizioni etniche ed hanno contribuito alla crescita del mercato, particolarmente del prodotto fresco che ha trovato spazio anche nella GDO. La produzione per il mercato fresco delle piante aromatiche richiede standard qualitativi elevati e questo determina abbondanti residui di coltivazione e lavorazione che rappresentano una materia prima ancora pregiata grazie a numerosi metaboliti che possono essere recuperati. Il progetto “Polieco2”, finanziato dalla misura 124 del PSR Regione Campania 2007-2013, si inserisce in tale contesto. L’obiettivo è il collaudo, l’adozione e la diffusione di innovazioni tecnologiche, di processo e organizzative nella fase precompetitiva in aziende agricole e commerciali che operano nel settore delle aromatiche per la GDO

Abstract W MP120: Minimally invasive subcortical parafascicular access for clot evacuation. A paradigm shift

Introduction: Spontaneous intracerebral hemorrhage (ICH) is common and causes significant mortality and morbidity. To date, intervention remains uncertain. Neurosurgical therapies for subcortical lesions have been limited by procedure-related injury to the cerebral cortex and adjacent subcortical brain regions. This is particularly relevant for eloquent cortex, therefore surgical therapy is often not performed. Hypothesis: We hypothesized that using an integrated systems approach for Minimally invasive Subcortical Parafascicular Access for Clot Evacuation (MiSPACE) consistently, could result in improved clinical outcomes and protection of eloquent tissue, especially if we focus on minimizing trauma to normal tissue. Methods: We report on this standardized technique incorporating 5 cores of MiSPACE 1) image interpretation and trajectory planning, 2) dynamic navigation, 3) a traumatic access (BrainPath, NICO Corp), 4) optics (Storz), and 5) resection (Myriad, NICO, Corp), wherein all surgeons have been trained through a CME course and have applied the surgical technique and approach in all 25 cases. Pathology, pre- and post-operative clinical and radiographic characteristics and clinical outcome at last follow-up were collected. Results and Conclusions: The cases presented illustrate successful application of the MiSPACE standardized systems approach. Mean pre-operative ICH volume was 47.2 and mean percentage of clot removal was 89%. Most importantly, significant recovery was observed in 89% of patients with no new deficits reported. MRI tractography obtained pre operatively illustrates how collateral tissue preservation can be achieved by trajectory planning. Using the same technique, the same equipment, in a standardized approach in dominant, eloquent cortex and subcortical regions (Table 1) this may lead to improved outcomes. Safety and feasibility studies are required to further assess this promising new therapeutic paradigm

The Safety and Feasibility of Image-Guided BrainPath-Mediated Transsulcul Hematoma Evacuation: A Multicenter Study.

BACKGROUND: Subcortical injury resulting from conventional surgical management of intracranial hemorrhage may counteract the potential benefits of hematoma evacuation. OBJECTIVE: To evaluate the safety and potential benefits of a novel, minimally invasive approach for clot evacuation in a multicenter study. METHODS: The integrated approach incorporates 5 competencies: (1) image interpretation and trajectory planning, (2) dynamic navigation, (3) atraumatic access system (BrainPath, NICO Corp, Indianapolis, Indiana), (4) extracorporeal optics, and (5) automated atraumatic resection. Twelve neurosurgeons from 11 centers were trained to use this approach through a continuing medical education-accredited course. Demographical, clinical, and radiological data of patients treated over 2 years were analyzed retrospectively. RESULTS: Thirty-nine consecutive patients were identified. The median Glasgow Coma Scale (GCS) score at presentation was 10 (range, 5-15). The thalamus/basal ganglion regions were involved in 46% of the cases. The median hematoma volume and depth were 36 mL (interquartile range [IQR], 27-65 mL) and 1.4 cm (IQR, 0.3-2.9 cm), respectively. The median time from ictus to surgery was 24.5 hours (IQR, 16-66 hours). The degree of hematoma evacuation was ≥90%, 75% to 89%, and 50% to 74% in 72%, 23%, and 5.0% of the patients, respectively. The median GCS score at discharge was 14 (range, 8-15). The improvement in GCS score was statistically significant (P \u3c .001). Modified Rankin Scale data were available for 35 patients. Fifty-two percent of those patients had a modified Rankin Scale score of ≤2. There were no mortalities. CONCLUSION: The approach was safely performed in all patients with a relatively high rate of clot evacuation and functional independence. ABBREVIATIONS: AVM, arteriovenous malformationCLEAR II, Clot Lysis Evaluating Accelerated Resolution of IVH Phase IIDTI, diffusion tensor imagingGCS, Glasgow Coma ScaleICH, intracranial hemorrhageIQR, interquartile rangeIVH, intraventricular hemorrhageMIS, minimally invasive surgeryMISPACE, minimally invasive subcortical parafascicular access for clot evacuationMISTIE, Minimally Invasive Surgery and rt-PA in Intracerebral Hemorrhage EvacuationmRS, modified Rankin Scale