Evaluation of Clinical Outcome after Laparoscopic Antireflux Surgery in Clinical Practice: Still a Controversial Issue

Background. Laparoscopic antireflux surgery has shown to be effective in controlling gastroesophageal reflux (GERD). Yet, a universally accepted definition and evaluation for treatment success/failure in GERD is still controversial. The purpose of this paper is to assess if and how the outcome variables used in the different studies could possibly lead to an homogeneous appraisal of the limits and indications of LARS. Methods. We analyzed papers focusing on the efficacy and outcome of LARS and published in English literature over the last 10 years. Results. Symptoms scores and outcome variables reported are dissimilar and not uniform. The most consistent parameter was patient's satisfaction (mean satisfaction rate: 88.9%). Antireflux medications are not a trustworthy outcome index. Endoscopy and esophageal manometry do not appear very helpful. Twenty-four hours pH metry is recommended in patients difficult to manage for recurrent typical symptoms. Conclusions. More uniform symptoms scales and quality of life tools are needed for assessing the clinical outcome after laparoscopic antireflux surgery. In an era of cost containment, objective evaluation tests should be more specifically addressed. Relying on patient's satisfaction may be ambiguous, yet from this study it can be considered a practical and simple tool

The Master in International Health of Parma University: a possible model of sanitary cooperation with developing Countries

The Master in “International Health and Medicine for Cooperation with Developing Countries” was established by CUCI, based on the evaluation that many health facilities and hospitals in the low-middle income Countries are not properly equipped to face daily emergencies. The objective of the Master’s program is to train doctors with multi-sector skills, necessary to operate in healthcare ambulatories, hospitals and medical districts, characterized by poor infrastructures and management systems, that are typical in areas of high-poverty, facing cases of emergencies of various entities. The Italian Ministry of Foreign Affairs and International Cooperation is funding a number of scholarships for the best candidates classified in the final selection rating and residing in African Countries. The Course is also open to Italians who wish to extend their professional skills in order to work in resource-constrained settings. The Master course lasts one year and includes lectures, seminars, videoconferencing and internships both at the University Hospital of Parma and in other Structures / Laboratories. The final work includes a scientific section and a project work for future collaboration with the Countries from which the doctors come from. Besides the various fields of medicine, other important themes are addressed in the course, like guidelines for hospital managements, health cooperation, development, prevention strategies. Why this Master could be a model of sanitary cooperation? The WHO and the Geneva Foundation for Medical Education and Research provide scientific support and they are involved in the teaching programme; the physicians formed in the course, once back in their Countries, are expected to facilitate training of the local staff (physicians, nurses and auxiliary personnel) and to continue collaboration; the project allows strengthening of partnerships with other Universities, Ministries, local and international Associations, NGO. The feedback of the participants who have attended the previous editions will also be discussed

Challenges of Meeting Surgical Needs in the Developing World

The burden of surgical conditions and diseases is increasing in low-income and middle-income countries, but the capacity to meet the demands they present is not following pace. Ongoing initiatives, such as brief visits by surgeons from advantaged countries, sending surgical residents to spend time in a developing country as part of their training, or ships weighing anchor offshore and offering some limited on-shore or on-board services, have not proven successful. More comprehensive and sustainable solutions include the development of local training programs, better retention of trainees with adequate incentives particularly in rural areas, and engaging government and professional associations, as well as academic institutions, to develop and implement policies to address local training needs

Variabilidade genética e evolução do gênero Calibrachoa (Solanaceae)

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The zCOSMOS 10k-Bright Spectroscopic Sample

We present spectroscopic redshifts of a large sample of galaxies with I_(AB) < 22.5 in the COSMOS field, measured from spectra of 10,644 objects that have been obtained in the first two years of observations in the zCOSMOS-bright redshift survey. These include a statistically complete subset of 10,109 objects. The average accuracy of individual redshifts is 110 km s^(–1), independent of redshift. The reliability of individual redshifts is described by a Confidence Class that has been empirically calibrated through repeat spectroscopic observations of over 600 galaxies. There is very good agreement between spectroscopic and photometric redshifts for the most secure Confidence Classes. For the less secure Confidence Classes, there is a good correspondence between the fraction of objects with a consistent photometric redshift and the spectroscopic repeatability, suggesting that the photometric redshifts can be used to indicate which of the less secure spectroscopic redshifts are likely right and which are probably wrong, and to give an indication of the nature of objects for which we failed to determine a redshift. Using this approach, we can construct a spectroscopic sample that is 99% reliable and which is 88% complete in the sample as a whole, and 95% complete in the redshift range 0.5 < z < 0.8. The luminosity and mass completeness levels of the zCOSMOS-bright sample of galaxies is also discussed

Epidemiology and Microbiology of Skin and Soft Tissue Infections: Preliminary Results of a National Registry

Skin and soft tissue infections (SSTIs) represent a wide range of clinical conditions characterized by a considerable variety of clinical presentations and severity. Their aetiology can also vary, with numerous possible causative pathogens. While other authors previously published analyses on several types of SSTI and on restricted types of patients, we conducted a large nationwide surveillance programme on behalf of the Italian Society of Infectious and Tropical Diseases to assess the clinical and microbiological characteristics of the whole SSTI spectrum, from mild to severe life-threatening infections, in both inpatients and outpatients. Twenty-five Infectious Diseases (ID) Centres throughout Italy collected prospectively data concerning both the clinical and microbiological diagnosis of patients affected by SSTIs via an electronic case report form. All the cases included in our database, independently from their severity, have been managed by ID specialists joining the study while SSTIs from other wards/clinics have been excluded from this analysis. Here, we report the preliminary results of our study, referring to a 12-month period (October 2016–September 2017). During this period, the study population included 254 adult patients and a total of 291 SSTI diagnoses were posed, with 36 patients presenting more than one SSTIs. The type of infection diagnosed, the aetiological micro-organisms involved and some notes on their antimicrobial susceptibilities were collected and are reported herein. The enrichment of our registry is ongoing, but these preliminary results suggest that further analysis could soon provide useful information to better understand the national epidemiologic data and the current clinical management of SSTIs in Italy

Mass and environment as drivers of galaxy evolution in SDSS and zCOSMOS and the origin of the Schechter function

We explore the inter-relationships between mass, star-formation rate and environment in the SDSS, zCOSMOS and other surveys. The differential effects of mass and environment are completely separable to z ~ 1, indicating that two distinct processes are operating, "mass-quenching" and "environment-quenching". Environment-quenching, at fixed over-density, evidently does not change with epoch to z ~ 1, suggesting that it occurs as large-scale structure develops in the Universe. The observed constancy of the mass-function shape for star-forming galaxies, demands that the mass-quenching of galaxies around and above M*, must be proportional to their star-formation rates at all z < 2. We postulate that this simple mass-quenching law also holds over a much broader range of stellar mass and epoch. These two simple quenching processes, plus some additional quenching due to merging, then naturally produce (a) a quasi-static Schechter mass function for star-forming galaxies with a value of M* that is set by the proportionality between the star-formation and mass-quenching rates, (b) a double Schechter function for passive galaxies with two components: the dominant one is produced by mass-quenching and has exactly the same M* as the star-forming galaxies but an alpha shallower by +1, while the other is produced by environment effects and has the same M* and alpha as the star-forming galaxies, and is larger in high density environments. Subsequent merging of quenched galaxies modifies these predictions somewhat in the denser environments, slightly increasing M* and making alpha more negative. All of these detailed quantitative relationships between the Schechter parameters are indeed seen in the SDSS, lending strong support to our simple empirically-based model. The model naturally produces for passive galaxies the "anti-hierarchical" run of mean ages and alpha-element abundances with mass.Comment: 66 pages, 19 figures, 1 movie, accepted for publication in ApJ. The movie is also available at http://www.exp-astro.phys.ethz.ch/zCOSMOS/MF_simulation_d1_d4.mo

VizieR Online Data Catalog: EELGs out to z~1 in zCOSMOS (Amorin+, 2015)

Star formation rates have been computed from Hα or Hβ luminosity (IMF from Chabrier et al. (2003PASP..115..763C) and assuming a theoretical ratio Hα/Hβ=2.82) following Kennicutt (1998ApJ...498..541K). Uncertainties in SFR account for the propagation of errors in line fluxes and reddening. Gas-phase metallicity has been derived using four methods: (1) the direct method (Hagele et al., 2008MNRAS.383..209H); (2) the Te-Z correlation (This work); (3) the N2 calibration (Perez-Montero & Contini, 2009MNRAS.398..949P); and (4) the R23 calibration (McGaugh, 1991ApJ...380..140M) scaled to the direct method using the linear relation presented by Lamareille et al. (2006, Cat. J/A+A/448/893 and 2006A&A...448..907L, see also Perez-Montero et al., 2013A&A...549A..25P). In all cases, 1σ uncertainties in metallicity account for the propagated errors in line fluxes and reddening. (2 data files)