Attualità e sviluppi della lotta ai tumori nella Provincia di Trento

Il sistema sanitario, in questi ultimi anni, è sottoposto ad una forte pressione per la necessità di un rinnovamento della propria organizzazione che porti ad un continuo miglioramento della qualità dei servizi offerti al cittadino e nel contempo riesca a contenere i costi gestionali e delle prestazioni. L’information technology (IT) sta giocando un ruolo chiave in questo processo evolutivo del sistema sanitario e l’interesse della comunità scientifica internazionale verso l’utilizzo di applicazioni quali la telemedicina, la cartella clinica digitale, reti telematiche territoriali, sistemi di supporto alla diagnosi, ecc, è rappresentato dal numero crescente di pubblicazioni scientifiche apparse in questi ultimi anni sulle maggiori riviste internazionali. Gli aspetti legati allo sviluppo, all’introduzione ed all’utilizzo di tecnologie informatiche (in particolare della telemedicina) in oncologia, pur rappresentando un ambito di ricerca relativamente nuovo, stanno riscuotendo un notevole interesse grazie alle potenzialità che le applicazioni telematiche avanzate possono offrire nel processo di miglioramento della cura del paziente oncologico. Dal 1997 sono attivi in Trentino due progetti di tele-oncologia, che partendo dalla raccolta e dall’analisi dei fabbisogni degli utenti medici, attraverso la progettazione e l’implementazione di sistemi tecnologici adeguati, hanno come comune obiettivo la valutazione degli effetti (positivi e negativi) che accompagnano l’introduzione dell’IT in oncologia. L’attività di ricerca si distingue per i due progetti e per tipologia di utente e per funzionalità delle applicazioni. Il primo progetto (Teleconsulto oncologico) finanziato dal Ministero della Sanità, si rivolge ai medici ospedalieri degli ospedali centrali e periferici coinvolti nella cura oncologica, mentre il secondo (Teleformazione e teleconsulto in sanità: verso un management integrato del paiente oncologico) finanziato dalla EU, si rivolge agli specialisti oncologi dell’ospedale centrale e ai medici di medicina generale (MMG) operanti sul territorio provinciale. Gli obiettivi specifici sono rispettivamente di verificare se strumenti telematici opportunamente introdotti possano contribuire a migliorare il livello della qualità di cura oncologica negli ospedali periferici e di favorire un miglioramento della comunicazione fra medicina di I e II livello per avviare un processo di gestione integrata sul territorio del paziente oncologico. Entrambi questi progetti pongono il Trentino a livello di eccellenza nella ricerca tecnologica internazionale sia per quanto riguarda l’introduzione di applicazioni telematiche avanzate in oncologia, che nell’individuazione e definizione dei conseguenti cambiamenti di natura organizzativo-culturale, che coinvolgono gli utenti diretti (pazienti, medici, personale sanitario, ecc) e le istituzioni pubblich

The 20th Century Wall Paintings in the Chapel of the Fallen in Parma Cathedral (Italy): Scientific Investigations for a Correct Conservation Project

In this work, we present a diagnostic study carried out on 20th century wall paintings in the Chapel of the Fallen of the Great War in the Cathedral of Parma (Italy). The Chapel was painted in the two-year period of 1921–1922 and has been recently restored. The paintings were investigated in order to study the technique used by the painter, Biagio Biagetti (Porto Recanati, 1877–Macerata, 1948) and their state of conservation. A total of twelve micro-fragments of the painting layers were sampled and investigated using different techniques. Raman spectroscopy revealed the large amount of different pigments used for each hue, many of them being synthetic materials. SEM/EDS analysis showed that the mortar was an aerial lime obtained from calcium carbonate mixed with a small amount of clay. Organic materials were identified by FTIR spectroscopy. GC/MS investigations revealed lipid and proteinaceous materials in the examined specimens; the lipid fraction, however, is not attributable to the presence of drying oils. From the determination of the amino acid content, it became apparent that the proteinaceous fraction is due to the combination of egg and animal glue; this allowed us to infer the use of “a secco” techniques, confirming the visual impressions of the restorer. The results obtained have contributed to the definition of the conservation project in its various phases

Information Technology in Pathology: from Telemicroscopy application up to date

Given the rapidly increasing number of ancillary technologies available to the medical community, there is a growing opportunity for their application, to address specific challenges. The development of new technologies for pathology such as robotic microscopes, and the availability of increasingly more powerful technologies for medical application is having profound impact in the research/diagnostic field in surgical Pathology [Wein_1]. In particular robotic microscopy in tandem with digital imaging stand for powerful technology to support and improve research studies and routine work in pathology field. Robotic microscopes let each microscope movement (x, y stage movements, objectives turret changes, auto-focus system, etc.) be controlled by local and/or remote computers and at the same time, images taken by video and/or photo-cameras mounted on the microscope, can be processed. The first application area where robotic microscopy has been strongly engaged was teleconsultation (remote diagnosis as first or second opinion), as reported by a considerable number of recent studies [Wolf, Dunn]. The system that we developed in our lab as telepathology application for remote frozen section service was designed to address specific constraints given by local orography and regional network [Dem_1]. This system, called STeMiSy (Static TeleMicroscopy System), has been used between a district general hospital and the central hospital in Trento during the last year. Moreover these technologies allow to manage histo-pathological glass slides as sets of digital data, thanks to completely automated systems, that acquire, store and manage digital images of the tissue on a slide. Digital representation of entire slide has been named in literature virtual slide [Wein_2][Saltz] and virtual case [Dem_2]. A virtual case is composed of a collection of digital images entirely representing a histological/cytological slide at all magnification levels, supplemented by all relevant clinical data. In comparison to glass slides it offers some advantages arising from its digital nature. Virtual case can be: a) reproduced in an indefinite number of identical copies stored in several different archives without any loss of sample technical quality in time, b) viewed and discussed simultaneously by many different distant users for different purposes without any times restriction, c) implemented with additional clinical and pathological data. This kind of approach can be considered the common basis for multiple purposes in the fields of teleconsultation, education, research (quantitative pathology), and quality control and proficiency tests [Dem_3]. Doubtless information technology through the introduction of robotic microscope, digital imaging and data mining techniques is becoming a essential component in Pathology and will arise more and more importance in every Pathology department in the next year

Casa-based simulated learning environment emphasizing Evidence Based Medicine

The rapid and constant development of medical knowledge, the distance of educational courses location, that prevents physicians from participation due to daily clinical practice duties, etc. make it more and more difficult to medical professional keeping itself competent. We have designed an educational tool that can constitute an alternative to the residential courses, allowing to give continuity to the education in oncology domain without space and time limitations, differentiating and personalizing the formative course on the basis of learner. Learning takes place most effectively when the learner is engaged and actively involved in decision-making. The most important session of our tool is focused on case-simulations. The virtual cases have been created on real patients data, treated according to the therapeutic strategies based on medical evidence, that are currently considered as valid. The data collection, planned through the experimentation phase in the next few months, will provide precise information in oncology education on the effectiveness of a case-simulation based tool emphasizing evidence medicin

Characterization of Waxes in the Roman Wall Paintings of the Herculaneum Site (Italy)

A multi-analytical approach is proposed for the detection and quantitative characterization of waxes in wall paintings from the Vesuvian area, in particular in the House of the Skeleton, the House of the Deer and the House of the two Atriums in Herculaneum (Italy). Different types of waxes, of animal, vegetable, mineral and artificial origin, were investigated, as reference materials, by Fourier transform infrared (FTIR) spectroscopy, Raman spectroscopy and gas chromatography coupled with mass spectrometry (GC/MS). The obtained results were compared with those found on samples from the wall paintings of Herculaneum. By non-destructive techniques, Raman and FTIR spectroscopies, waxes were generally found in the wall painting fragments investigated. A more quantitative characterization by GC/MS analysis, performed on three representative samples on the three houses, allowed highlighting the features of beeswax. In addition to beeswax, candelilla wax and an artificial wax, compatible with the formulated candelilla wax, were also detected. The presence of candelilla, a vegetable wax introduced in Europe after the sixteenth century, suggests maintenance works probably carried out with the aim of preserving the original colors of the paintings. In addition, by Raman and FTIR spectroscopies hematite and Egyptian blue pigments were identified. Calcite, aragonite and gypsum were also detected

Characterization of Waxes in the Roman Wall Paintings of the Herculaneum Site (Italy)

A multi-analytical approach is proposed for the detection and quantitative characterization of waxes in wall paintings from the Vesuvian area, in particular in the House of the Skeleton, the House of the Deer and the House of the two Atriums in Herculaneum (Italy). Different types of waxes, of animal, vegetable, mineral and artificial origin, were investigated, as reference materials, by Fourier transform infrared (FTIR) spectroscopy, Raman spectroscopy and gas chromatography coupled with mass spectrometry (GC/MS). The obtained results were compared with those found on samples from the wall paintings of Herculaneum. By non-destructive techniques, Raman and FTIR spectroscopies, waxes were generally found in the wall painting fragments investigated. A more quantitative characterization by GC/MS analysis, performed on three representative samples on the three houses, allowed highlighting the features of beeswax. In addition to beeswax, candelilla wax and an artificial wax, compatible with the formulated candelilla wax, were also detected. The presence of candelilla, a vegetable wax introduced in Europe after the sixteenth century, suggests maintenance works probably carried out with the aim of preserving the original colors of the paintings. In addition, by Raman and FTIR spectroscopies hematite and Egyptian blue pigments were identified. Calcite, aragonite and gypsum were also detected