La terapia a pressione topica negativa: analisi comparativa e valutazione dei costi d'impiego

Scopo della tesi: Con questo elaborato mi propongo di valutare tutti gli aspetti che caratterizzano la terapia a pressione topica negativa. Svolgendo una ricerca tra la le evidenze, analizzerò la validità di questo presidio in termini di efficacia e inoltre cercherò di mettere a confronto questo sistema con l'utilizzo delle medicazioni avanzate, rilevandone vantaggi e svantaggi nell'ambito dell'organizzazione sanitaria. Inoltre, in seguito alla spending review approvata in ambito sanitario dal nostro Governo, mi permetto di valorizzare l'utilizzo di questo sistema a domicilio piuttosto che in ambito ospedaliero, indagando soprattutto sulla risposta psico-fisica del paziente trattato con TNP a noleggio domiciliareope

“Pero las madres terribles / levantaron la cabeza” : Un topos de la mujer imaginario en la literatura de la Edad de Plata

En diversos textos literarios producidos en España en las tres primeras décadas del siglo XX se observa la recurrencia de un modelo de representación de la mujer ligado a los estereotipos fatales que proliferan en la imaginería artística desde finales de la centuria anterior. Se trata de la mujer “fálica” —usurpadora del poder viril— en función de madre que seduce y fagocita al hijo, o bien convierte al hombre en instrumento desechable de su exclusivo instinto generatriz. Previsible contracara de esa fantasía ominosa es la versión sublimada de la autoinmolación femenina y la figura de la mater dolorosa. Se examina esta temática en obras de Miguel de Unamuno, Federico García Lorca y Cipriano de Rivas Cherif.Centro de Estudios de Teoría y Crítica Literari

State-of-the-art of small-scale biomass gasification systems: An extensive and unique monitoring review

Abstract During the last few years, there has been an increasing interest in small-scale biomass gasification in Central and Northern Europe. Since 2011, almost fifty small-scale biomass gasification plants have been authorized and built in the South Tyrolean region (Italy), and most of them are currently operating. Within this framework, an extensive survey was performed by means of questionnaires to the plant owners for assessing the biomass and char flows in the region. Moreover, a comprehensive monitoring campaign was carried out onsite on representative plants of almost all the available operating technologies. For each of the monitored plants, the feedstock and the gasification products were characterized and their fluxes quantified, leading to energy and mass balances. This allowed collecting an extended set of data and drawing up a unique overview of the reference values for the ranges of operation of small-scale biomass gasification systems currently available in the European market, in terms of equivalence ratio, dry gas composition and heating value, specific electricity production, and conversion efficiencies. Moreover, samples of chars were deeply characterized, providing an insight into possible utilization pathways for the valorization of this by-product that is currently disposed of, representing an economical and environmental burden

Prácticas de lectura y prácticas de escritura: diálogos epistemológicos

En este trabajo nos propusimos realizar una analítica de las prácticas de lectura y escritura en la universidad a través de un recorrido teórico experiencial que atendiera a la posibilidad de visibilizar y enunciar las condiciones epistémicas que determinan las producciones características en el ámbito de las Ciencias Sociales y las Humanidades. Realizamos un estudio de los discursos y las condiciones que configuran y habilitan ese juego relacional conforme a cierta representación de lo que se considera primordial y/o constitutivo en la relación con los textos; y, paralelamente, un archivo de memorias de experiencias de transmisión que dan cuenta de las modalidades de constitución de este juego relacional, con el propósito de  interrogar los diferentes modos de relación con el conocimiento desde perspectivas que habilitan otras problematizaciones al considerar que las prácticas de lectura y escritura no constituyen unos movimientos meramente funcionales a la apropiación de conocimientos sino que en ellas se juegan, con modalidades específicas, los procesos de constitución subjetiva propios de los espacios institucionales de formación

A comparison between 18F-FDG PET/CT imaging and biological and radiological findings in restaging of hepatoblastoma patients

Background. In this study we retrospectively evaluated if 18F-FDG-PET/CT provided incremental diagnostic information over CI in a group of hepatoblastoma patients performing restaging. Procedure. Nine patients (mean age: 5.9 years; range: 3.1–12 years) surgically treated for hepatoblastoma were followed up by clinical examination, serum α-FP monitoring, and US. CI (CT or MRI) and PET/CT were performed in case of suspicion of relapse. Fine-needle aspiration biopsies (FNAB) were carried out for final confirmation if the results of CI, PET/CT, and/or α-FP levels were suggestive of relapse. PET/CT and CI findings were analyzed for comparison purposes, using FNAB as reference standard. Results. α-FP level was suggestive of disease recurrence in 8/9 patients. Biopsy was performed in 8/9 cases. CI and PET/CT resulted to be concordant in 5/9 patients (CI identified recurrence of disease, but 18F-FDG-PET/CT provided a better definition of disease extent); in 4/9 cases, CI diagnostic information resulted in negative findings, whereas PET/CT correctly detected recurrence of disease. 18F-FDG-PET/CT showed an agreement of 100% (8/8) with FNAB results. Conclusions. 18F-FDG-PET/CT scan seems to better assess HB patients with respect to CI and may provide incremental diagnostic value in the restaging of this group of patients

Operator learning curve for transradial liver cancer embolization: implications for the initiation of a transradial access program

PURPOSEWe aimed to analyze transradial access (TRA) learning curve on patients undergoing hepatic chemoembolization, investigating the relationship between procedural volumes and various benchmarks of procedural success.METHODSWe enrolled 60 consecutive patients who received two unilobar hepatic chemoembolizations within a 4-week interval performed by a single interventional radiologist, highly-trained in conventional transfemoral access (TFA) procedures, but without any previous practical experience in TRA procedures and with a preliminary 2-day theoretical training only. Consecutive patients were prospectively enrolled and analyzed in 3 groups: A (cases 1 to 20), B (cases 21 to 40), and C (cases 41 to 60). All patients underwent one hepatic chemoembolization using TRA and the other one using TFA in random order. All TFA procedures performed by the same operator in the same series of patients were considered as the control group. Primary endpoint was to analyze the relationship between TRA procedure operator experience and benchmarks of procedural success, to define the optimal procedural learning curve.RESULTSTechnical success was obtained in all patients, with a crossover rate (radial to femoral access) of 0%. An association between incremental TRA operator experience (in terms of performed procedures) and decrease of preparation, puncture, fluoroscopy, and total examination times was observed. Similarly, inverse associations between incremental TRA operator experience and contrast medium (CM) volumes (P < 0.001) and radiation dose (RD) values (in terms of RAK - Reference Air Kerma) (P < 0.001) were also observed. Compared with TFA, CM volumes and RD values were significantly higher only in group A (cases 1–20). Procedure success remained high in all TRA groups and no significant association between TRA incremental experience and postprocedural outcomes was found. Higher postprocedural complaints at the access route and more limitations in performing basic activities were recorded after TFA vs. TRA (P < 0.001).CONCLUSIONTRA catheterizations can be safely performed in patients treated for liver cancer embolization after a relatively short training in controlled conditions and with a better performance in comparison with TFA. Operator proficiency improves with greater TRA experience, with a threshold needed to overcome the learning curve represented by about 20 procedures

Anastrozole-related acute hepatitis with autoimmune features: a case report

<p>Abstract</p> <p>Background</p> <p>Two cases of acute hepatitis occurring during treatment with anastrozole have previously been reported, but the underlying mechanisms of liver injury are still uncertain. We report the case of anastrozole-related acute hepatitis with some autoimmune features.</p> <p>Case presentation</p> <p>A 70-year-old woman developed acute hepatitis associated with serum antinuclear antibodies during anastrozole treatment; after drug withdrawal, liver function parameters rapidly improved and serum auto-antibodies were no longer detectable.</p> <p>Conclusions</p> <p>Anastrozole-induced hepatotoxicity is a very rare event. Drug-drug interactions or metabolically-mediated damage might be involved, with a possible role of individual susceptibility. Our report suggests that an immune-mediated mechanism may also be considered in anastrozole-related liver injury.</p