A novel identification procedure from ambient vibration data for buildings of the cultural heritage

Ambient modal identification, also known as Operational Modal Analysis (OMA), aims to identify the modal properties of a structure based on vibration data collected when the structure is under its operating conditions, i.e., no initial excitation or known artificial excitation. This procedure for testing and/or monitoring historic buildings, is particularly attractive for civil engineers concerned with the safety of complex historic structures. However, since the external force is not recorded, the identification methods have to be more sophisticated and based on stochastic mechanics. In this context, this contribution will introduce an innovative ambient identification method based on applying the Hilbert Transform, to obtain the analytical representation of the system response in terms of the correlation function. In particular, it is worth stressing that the analytical signal is a complex representation of a time domain signal: the real part is the time domain signal itself, while the imaginary part is its Hilbert transform. A 3DOF numerical example will be presented to show the accuracy of the proposed procedure, and comparisons with data from other methods assess the reliability of the approach

Minimally Invasive Treatment of Acute Intrahepatic Fluid Collections With Acute Biliary Pancreatitis

BACKGROUND: Peripancreatic fluid collection suggests the anatomical-clinical scenario of necrotizing acute pancreatitis. However, intrahepatic fluid collection is a rare occurrence with fewer than 30 cases being reported in the medical literature. We describe 2 cases of intrahepatic fluid collection in 2 patients with acute biliary pancreatitis and discuss the therapeutic possibilities. CASE REPORTS: The first case report is that of a 68-year-old female with a diagnosis of acute biliary pancreatitis with several necrotizing fluid collections and a large infected intrahepatic collection in the left lobe. The patient was successfully treated by percutaneous US/CT guided drainage. The second case report is that of a 72-year-old female with a diagnosis of acute biliary pancreatitis with several peripancreatic fluid collections and a voluminous intrahepatic fluid collection in the left lobe that caused epigastric pain. This patient was also successfully treated with percutaneous US/CT guided drainage. CONCLUSION: Intrahepatic fluid collection in the course of acute biliary pancreatitis is a rare occurrence. The therapeutic approach is the same as that for pancreatic and peripancreatic fluid collections. In case of infection, the patient undergoes percutaneous US/CT guided drainage. This therapeutic procedure can be added to the therapeutic program for necrotizing acute biliary pancreatitis together with ERCP/ES and videolaparocholecystectomy (VLC)

Umbilical Port-Site Complications in Laparoscopic Cholecystectomy: Role of Topical Antibiotic Therapy

Abstract BACKGROUND AND OBJECTIVES: Umbilical port-site infections after video-laparoscopic cholecystectomy (VLC) are frequent complications. The aim of this prospective randomized study was to verify the validity of topical rifamycin for prevention of post-VLC umbilical infections. METHODS: From September 2006 to April 2007, 48 patients with uncomplicated cholelithiasis who underwent VLC were enrolled in the study. Enrolled patients were randomized into 2 groups. The first group of 24 patients was treated with topical rifamycin to the umbilicus. The second group of 24 patients was not treated with rifamycin. RESULTS: Postoperative umbilical pain with a need for analgesics, presence of signs of inflammation of the umbilical wound, dehiscence of the umbilical skin sutures, and the presence of incisional umbilical hernia on the 60th postoperative day were statistically significantly better in the rifamycin group compared with the control group. CONCLUSIONS: Topical administration of rifamycin to the umbilicus in the pre-, intra- and postoperative periods was a rapid, safe, and economic way to reduce infective complications after VLC

Current Approaches in the Minimally Invasive Surgical Treatment of Adrenal Tumors

The use of imaging modalities and minimally invasive surgery plays an important role in the current management of adrenal tumors. Ultrasonography frequently allows for the incidental diagnosis of adrenal masses. The most frequent adrenal pathologies encountered are hypercortisolism (Cushing’s syndrome), primary hyperaldosteronism (Conn’s syndrome), and pheochromocytomas. Clinical presentation of these adrenal tumors can often be non-specific, or such lesions may present as “incidentalomas” in patients who undergo imaging for clinical reasons unrelated to the adrenal glands. Adrenal malignancy is suggested by morphologic characteristics found on imaging studies: increased size, irregular borders, local invasion, and large necrotic areas. The risk of malignancy increases for larger adrenal masses. Minimally invasive surgery has become the initial choice for the treatment of adrenal tumors with retroperitoneal and transperitoneal approaches. This chapter describes the surgical indications and compares the various minimally invasive surgical approaches for the therapeutic management of adrenal masses

Acute Cholecystitis: Diagnostic Pitfall and Timing of Treatment

Objective: Cholelithiasis represents a very frequent health problem with higher prevalence in developed countries. The aim of this chapter is to underline, also by submitting our surgical experience, some diagnostic deceptions and the timing of treatment

Stapled hemorrhoidopexy: no more a new technique

Haemorrhoidal disease affect between 4.4% and 36.4% of the general population. The common symptoms are: bleeding, prolapse, pain, discharge, itching and hampered anal hygiene. There is no correlation between specific symptoms and anatomic grading. Apparently severe looking haemorrhoids can cause relatively few symptoms. Open haemorrhoidectomy, as described by Milligan, has been accepted worldwide as the best choice for treatment of symptomatic haemorrhoids. In 1998, Longo proposed a procedure for haemorrhoidectomy with minimal postoperative pain, no perianal wound requiring postoperative wound care and a relatively short operative time. His technique presented a new notion for treating haemorrhoids as he proposed circumferential rectal mucosectomy that results in mucosal lifting (anopexy). His aim was not excision of the haemorrhoidal tissue but rather restoring anatomical and physiological aspects of the haemorrhoidal plexus. The grading system described by Goligher, is the most commonly used and is based on objective findings and patient history. Stapled hemorrhoidopexy is performed for grade III and IV, for grade II in case of major bleeding. In lithotomy position and spinal anesthesia and after taking all aseptic precautions, the procedure of stapled hemorrhoidectomy was performed according to Longo’s technique. After this surgical procedure, the need to manually reduce prolapse will have been cured in approximately 90% of patients and the overall preoperative symptoms will be much reduced in the great majority. There should be no anal pain. Bowel habits should have returned to a normal pattern without urgency. One year follow-up or longer 11% of patients had remaining or recurrent prolapse, the reintervention rate is about 10%

Gastroduodenal Lesions Associated with Portal Hypertension: An Extensive Review

The block of the portal flow by obstacles in prehepatic, hepatic or posthepatic site and alterations of the splanchnic blood flow are the pathological conditions that lead to portal hypertension. The portal hypertension can cause also others gastroduodenal lesions, potentially hemorrhagic, in addition to esophageal varices commonly developed and habitual source of bleeding in these patients. The gastroduodenal lesions associated with portal hypertension, usually encountered in the clinical practice, are portal hypertensive gastropaty, gastric antral vascular ectasia, gastric and duodenal ulcer, isolated gastric varices. The pathophysiology and clinical, diagnostic and therapeutic features of these lesions are examined