Disfunção aguda devido a uma trombose da prótese da válvula mitral mecânica

Um homem de 64 anos recebeu uma prótese mecânica CarboMedics de 31 mm para refluxo mitral grave. Após quatro dias, o paciente apresentou-se com fadiga e dispnéia em repouso. Estudos do Doppler ecocardiografia transtorácica e transesofágica confirmaram uma disfunção na mobilidade do folheto da válvula protética devido à trombose e uma operação de emergência foi feita. O pós-operatório transcorreu sem intercorrências. Este é um caso incomum de disfunção grave devido à trombose de uma prótese mitral mecânica em um paciente tomando anticoagulantes orais e calciparinaAn 64-year-old man received a 31-mm CarboMedics mechanical prosthesis for severe mitral regurgitation. After four days the patient presented fatigue and dyspnoea with rest; transthoracic and transesophageal Doppler echocardiographic study confirmed a failing mobility of prosthetic valve leaflet from thrombosis and an emergency operation was done. The postoperative course was uneventful. This is an unusual case of acute dysfunction from thrombosis of a mechanical mitral valve prosthesis in a patient on oral anticoagulant therapy and calciheparin

Bonus bebè e assegno di maternità: convergenza tra Corti e Carte in nome della solidarietà

Il lavoro esamina il dialogo tra Corte Costituzionale e Corte di giustizia in merito allo sviluppo delle politiche sociali nazionali e vincoli europe

Left Main Coronary Artery Stent Misadventure

Coronary artery bypass grafting has long been the standard of care for patients with left main coronary artery (LMCA) disease. Lately, percutaneous coronary intervention (PCI) has become a suitable alternative for these patients, but the procedure may be challenging. We describe 2 cases of LMCA PCI failure requiring surgical intervention

Intensive hyperglycemia control reduces postoperative infections after open heart surgery

Background: Diabetes mellitus increases the risk of infections in patients undergoing cardiac surgery. We hypothesized that intensive perioperative hyperglycemia control by intravenous insulin infusion reduces postoperative infections in all patients undergoing open heart surgical procedures. Methods: Sixty diabetics patients who underwent CABG operation (Group 1) were compared with fifty-five patients who underwent other cardiac surgery (Group 2) between January 2004 and March 2005. A continuous infusion of insulin was used in all these patients. Results: There were no 30-day mortalities in either group. There was no difference in the incidence of infections between the two groups: in Group 1, 3 (5%) patients were diagnosed to have postoperative infection (superficial sternal wound infections in 1 (1.66%) and lung infection in 2 (3.33%) patients); postoperative infection occurred in only 2 patients (3.63%) in Group 2, 1 superficial sternal wound infections (1.81%) and 1 lung infection (1.81%). Conclusions: Our analysis indicates that continuous intravenous insulin infusion improves outcome and reduces postoperative infections in patients undergoing CABG as well as those undergoing other cardiac surgery procedures.

Mission analysis and guidance and control for the SpEye inspection CubeSat

The space community is moving forward with the development of in-orbit servicing and removal technologies to enable the circular economy in space and improve future space missions’ scientific and commercial return and space environment exploitation. The application of nanosatellites to carry out proximity operations presents an additional opportunity to support various novel and cost-effective distributed mission architectures. The SpEye CubeSat mission, funded by the Agenzia Spaziale Italiana in the framework of the Alcor Program, aims at demonstrating inspection and rendezvous guidance navigation and control capabilities of a nanosatellite in close-proximity of the satellite carrier in a low Earth orbit environment. This paper focuses on the design of the SpEye mission and on the guidance and control strategies to enable its technological demonstrations. Particular attention is placed on the safety aspects of trajectory design, considered of paramount importance for the robust autonomous operations of a low-cost CubeSat in proximity to another satellite

SpEye – Space Eye

Space Eye (SpEye) is a two-satellite technology (Free Flyer and Carrier Target) demonstration mission for the in-flight validation of critical technologies and techniques related to advanced on-orbit inspection and formation-flying techniques, applicable to future operational nano-satellite capabilities and operations

STUDIO RETROSPETTIVO SUI CONSUMI DI SODIO OXIBATO E SULLA TIPOLOGIA DI PAZIENTI DEL SERT DI TERMINI IMERESE

In questo studio è stato preso in considerazione il consumo annuale di sodio oxibato della Farmacia Territoriale, dal 2009 al 2012, da parte del Ser.T di Termini Imerese. Si è voluto, inoltre, indagare sulla tipologia di pazienti ambulatoriali per avviare un successivo progetto di informazione e prevenzione rivolto alle scuole. Materiali e metodi: I dati relativi ai consumi sono stati estrapolati dal programma di magazzino della farmacia, mentre i dati relativi ai pazienti sono stati ricavati dal Sistema Informativo Sanitario del Ministero della Salute consultabile dai dipendenti del Ser.T. Risultati: La richiesta di sodio oxibato è cresciuta dal 2009 al 2011 per diminuire nel 2012 (60, 89, 99 e 38 flaconi consegnati rispettivamente nel 2009, 2010, 2011 e 2012). Anche il numero di pazienti è aumentato fino al 2011subendo una contrazione nel 2012 (27 pazienti nel 2009, 34 nel 2010, 38 nel 2011 e 34 nel 2012). Erano principalmente uomini (83,4% maschi; 17,6% femmine) di età superiore ai 20 anni. Di questi solo alcuni sono stati sottoposti a trattamento farmacologico (12 soggetti nel 2009, 16 nel 2010, 26 nel 2011 e 18 nel 2012) per un numero totale di 96 trattamenti. Le bevande alcoliche di uso prevalente sono risultate superalcolici e vino nel 2009 e nel 2010; nel 2011 e 2012 invece si è riscontrato un notevole aumento dei bevitori di birra. Un numero limitato di soggetti faceva uso concomitante di sostanze stupefacenti e psicotrope. Conclusioni: L’alcolismo è un problema di rilevanza sociale. Da ciò nasce l’esigenza di intraprendere campagne di informazione e prevenzione e l’età di ricovero al Ser.T superiore ai 20 anni ci indica come il target ottimale possa essere proprio quello degli adolescenti e dei loro tutori. La collaborazione tra figure professionali diverse quali il farmacista, lo psicologo, il medico, lo psichiatra, il tossicologo e il docente universitario potrebbe costituire un valido aiuto finalizzato alla prevenzione dei rischi legati all’abuso di alcool. In quest’ottica il farmacista potrebbe divenire una figura chiave nel promuovere stili di vita corretti e salutari

Inter-society consensus for the use of inhaled corticosteroids in infants, children and adolescents with airway diseases

Background: In 2019, a multidisciplinary panel of experts from eight Italian scientific paediatric societies developed a consensus document for the use of inhaled corticosteroids in the management and prevention of the most common paediatric airways disorders. The aim is to provide healthcare providers with a multidisciplinary document including indications useful in the clinical practice. The consensus document was intended to be addressed to paediatricians who work in the Paediatric Divisions, the Primary Care Services and the Emergency Departments, as well as to Residents or PhD students, paediatric nurses and specialists or consultants in paediatric pulmonology, allergy, infectious diseases, and ear, nose, and throat medicine. Methods: Clinical questions identifying Population, Intervention(s), Comparison and Outcome(s) were addressed by methodologists and a general agreement on the topics and the strength of the recommendations (according to the GRADE system) was obtained following the Delphi method. The literature selection included secondary sources such as evidence-based guidelines and systematic reviews and was integrated with primary studies subsequently published. Results: The expert panel provided a number of recommendations on the use of inhaled corticosteroids in preschool wheezing, bronchial asthma, allergic and non-allergic rhinitis, acute and chronic rhinosinusitis, adenoid hypertrophy, laryngitis and laryngospasm. Conclusions: We provided a multidisciplinary update on the current recommendations for the management and prevention of the most common paediatric airways disorders requiring inhaled corticosteroids, in order to share useful indications, identify gaps in knowledge and drive future research

Notulae to the Italian alien vascular flora: 14

In this contribution, new data concerning the distribution of vascular flora alien to Italy are presented. It includes new records, confirmations, and status changes for Italy or for Italian administrative regions. Nomenclatural and distribution updates, published elsewhere, and corrections are provided as Suppl. materia