Long term compensatory sweating results after sympathectomy for palmar and axillary hyperhidrosis

Endoscopic thoracic sympathectomy is currently the best treatment for primary upper extremity hyperhidrosis, but the potential for adverse effects, particularly the development of compensatory sweating, is a concern and often precludes surgery as a definitive therapy. This study aims to evaluate long-term results of two-stage unilateral versus one-stage bilateral thoracoscopic sympathectomy

Salvage resection of advanced mediastinal tumors

The surgical treatment of locally advanced mediastinal tumors invading the great vessels and other nearby structures still represent a tricky question, principally due to the technical complexity of the resective phase, the contingent need to carry out viable vascular reconstructions and, therefore, the proper management of pathophysiologic issues. Published large-number series providing oncologic outcomes of patients who have undergone extended radical surgery for invasive mediastinal masses are just a few. Furthermore, the wide variety of different histologies included in some of these studies, as well as the heterogeneity of chemo and radiation therapies employed, did not allow for the development of clear oncologic guidelines. Usually in the past, surgical resections of large masses along with the neighbouring structures were not offered to patients because of related morbidity and mortality and limited information available on the prognostic advantage for long term. However, in the last decades, advances in surgical technique and perioperative management, as well as increased oncologic experience in this field, have allowed radical exeresis in selected patients with invasive tumors requiring resections extended to the surrounding structures and complex vascular reconstructions. Such aggressive surgical treatment has been proposed in association or not with adjuvant chemo- or radiotherapy regimens, achieving encouraging oncologic results with limited morbidity and mortality in experienced institutions. Congestive heart failure or impending cardiovascular collapse due to the compression by the large mass are the most frequent immediately lifethreatening problems that some of these patients can experience. In this setting, medical palliation is usually ineffective and an aggressive salvage surgical treatment may remain the only therapeutic option

Flow-volume curve analysis for predicting recurrence after endoscopic dilation of airway stenosis

The flow-volume curve is a simple test for diagnosing upper airway obstruction. We evaluated its use to predict recurrence in patients undergoing endoscopic dilation for treatment of benign upper airway stenosis

First Italian Consensus Conference on VATS Lobectomy for NSCLC

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A Review of Radioactive Wastes Production and Potential Environmental Releases at Experimental Nuclear Fusion Facilities

The development of experimental nuclear fusion facilities and the systems connected to them currently involves the operation (or advanced design) of some large plants in the national territory. Devices such as neutron generators and plasma focus systems are also included. The machines developed to test the main components of these systems such as neutral beam generators (Neutral Beam Injector) and the experimental plants for thermonuclear fusion, mainly in the Tokamak configuration (toroidal geometry), are in the list. These applications are characterized by high neutron fluxes of high energy (typically 2.5 and 14 MeV from deuterium-deuterium and deuterium-tritium fusion reactions, respectively). They involve the production of radionuclides in the components of the machines and in the fluids used for targets' cooling and in the primary containments. In many cases, the atmosphere of the rooms containing these structures is activated and may be affected by the dispersion of powders that are more or less radioactive. The present work addresses the issues mentioned so far, taking into consideration the real cases relating to the devices and the facilities in operation, under construction, and in the advanced design phase. The conclusions highlight the critical aspects related to the management of these types of waste, as well as the low or very low environmental impact, from a radiological point of view, of the examined facilities

Estilos de liderazgo de las microempresarias del sector comercio en los distritos de San Isidro y Miraflores

Las mujeres se encuentran en desventaja en el emprendimiento de negocios, esta brecha de género se ve incrementada aún más en negocios ya consolidados. Los estilos de liderazgo aplicados por las dueñas de los negocios inciden en la productividad y desarrollo de los negocios. Sin embargo, no existe información precisa sobre los estilos de liderazgo que aplican, por lo que el objetivo de la presente investigación fue justamente identificar el estilo de liderazgo predominante. Sobre los resultados obtenidos se podrán hacer estudios posteriores que determinen la efectividad del estilo de liderazgo. La investigación describe el estilo de liderazgo que predomina en las mujeres microempresarias del sector comercio en los distritos de San Isidro y Miraflores mediante el estudio de las características de las dueñas del negocio; características del negocio; y características del liderazgo que aplican las dueñas del negocio; todo ello a través de la recolección de información sobre las microempresarias de estos dos distritos con mayor densidad empresarial de Lima. El estudio utiliza el paradigma cualitativo basado en estudios de caso de diez microempresarias del sector comercio de los distritos de San Isidro y Miraflores. Los resultados muestran, como principal conclusión, el predominio del estilo de liderazgo Transformacional, debido a que en todas las microempresarias entrevistadas, se identificó que presentan seis características personales (Carisma, Interactividad, Creatividad, Orientado a las Personas, Ética, Coherencia) de las siete características personales del liderazgo Transformacional (Carisma, Interactividad, Creatividad, Orientado a las Personas, Ética, Coherencia, Visión)Women are in disadvantage in entrepreneurship, this gender gap is further increased in already established businesses. Leadership styles applied by business owners influence productivity and business development. However, there is no precise information about the leadership styles they apply, so the objective of the present research was precisely to identify the predominant style of leadership. On the results obtained can be made later studies that determine the effectiveness of the style of leadership. The research describes the style of leadership that prevails in women microentrepreneurs of the trade sector in the districts of San Isidro and Miraflores by studying the characteristics of the owners of the business; business characteristics; and leadership characteristics applied by the owners of the business; all through the gathering of evidence of the microentrepreneurs of these two districts with greater business density in Lima. The study uses the qualitative paradigm based on case studies of ten women microentrepreneurs of the districts of San Isidro and Miraflores. The results show the predominance of the Transformational leadership, because in all the microentrepreneurs interviewed were identified six personal characteristics (Charisma, Interactivity, Creativity, People Orientation, Ethics, Coherence) of the seven personal characteristics of Transformational leadership (Charisma, Interactivity, Creativity, People Orientation, Ethics, Coherence, Vision)Tesi

Unidirectional endobronchial valves for management of persistent air-leaks. Results of a multicenter study

Background: To evaluate the efficacy of Endo-Bronchial Valves in the management of persistent air-leaks (PALs) and the procedural cost. Methods: It was a retrospective multicenter study including consecutive patients with PALs for alveolar pleural fistula (APF) undergoing valve treatment. We assessed the efficacy and the cost of the procedure. Results: Seventy-four patients with persistent air leaks due to various etiologies were included in the analysis. In all cases the air leaks were severe and refractory to standard treatments. Sixty-seven (91%) patients underwent valve treatment obtaining a complete resolution of air-leaks in 59 (88%) patients; a reduction of air-leaks in 6 (9%); and no benefits in 2 (3%). The comparison of data before and after valve treatment showed a significant reduction of air-leak duration (16.2±8.8 versus 5.0±1.7 days; P<0.0001); chest tube removal (16.2±8.8 versus 7.3±2.7 days; P<0.0001); and length of hospital stay (LOS) (16.2±8.8 versus 9.7±2.8 days; P=0.004). Seven patients not undergoing valve treatment underwent pneumo-peritoneum with pleurodesis (n=6) or only pleurodesis (n=1). In only 1 (14%) patient, the chest drainage was removed 23 days later while the remaining 6 (86%) were discharged with a domiciliary chest drainage removed after 157±41 days. No significant difference was found in health cost before and after endobronchial valve (EBV) implant (P=0.3). Conclusions: Valve treatment for persistent air leaks is an effective procedure. The reduction of hospitalization costs related to early resolution of air-leaks could overcome the procedural cost

The inhibition of 45A ncRNA expression reduces tumor formation, affecting tumor nodules compactness and metastatic potential in neuroblastoma cells

open16noWe recently reported the in vitro over-expression of 45A, a RNA polymerase IIItranscribed non-coding (nc)RNA, that perturbs the intracellular content of FE65L1 affecting cell proliferation rate, short-term response to genotoxic stress, substrate adhesion capacity and, ultimately, increasing the tumorigenic potential of human neuroblastoma cells. In this work, to deeply explore the mechanism by which 45A ncRNA contributes to cancer development, we targeted in vitro and in vivo 45A levels by the stable overexpression of antisense 45A RNA. 45A downregulation leads to deep modifications of cytoskeleton organization, adhesion and migration of neuroblastoma cells. These effects are correlated with alterations in the expression of several genes including GTSE1 (G2 and S phaseexpressed- 1), a crucial regulator of tumor cell migration and metastatic potential. Interestingly, the downregulation of 45A ncRNA strongly affects the in vivo tumorigenic potential of SKNBE2 neuroblastoma cells, increasing tumor nodule compactness and reducing GTSE1 protein expression in a subcutaneous neuroblastoma mouse model. Moreover, intracardiac injection of neuroblastoma cells showed that downregulation of 45A ncRNA also influences tumor metastatic ability. In conclusion, our data highlight a key role of 45A ncRNA in cancer development and suggest that its modulation might represent a possible novel anticancer therapeutic approach.openPenna, Ilaria; Gigoni, Arianna; Costa, Delfina; Vella, Serena; Russo, Debora; Poggi, Alessandro; Villa, Federico; Brizzolara, Antonella; Canale, Claudio; Mescola, Andrea; Daga, Antonio; Russo, Claudio; Nizzari, Mario; Florio, Tullio; Menichini, Paola; Pagano, AldoPenna, Ilaria; Gigoni, Arianna; Costa, Delfina; Vella, SERENA LUISA; Russo, Debora; Poggi, Alessandro; Villa, Federico; Brizzolara, Antonella; Canale, Claudio; Mescola, Andrea; Daga, Antonio; Russo, Claudio; Nizzari, Mario; Florio, Tullio; Menichini, Paola; Pagano, Ald

The Impact of Company Grade Officer Self-Sacrificial Behavior on Subordinate Assessments of Leader Charisma

Newly commissioned officers in the U.S. Army are taught to lead their soldiers from the front and to voluntarily make personal sacrifices in the service of the nation. Although this facet of military culture is seen as critical to the integrity of the force, there are few research studies describing the impact of leader self-sacrifice in the U.S. Army. Research evolving from the transformational leadership literature indicates that civilian leaders who engage in self-sacrificial behavior are viewed as more charismatic than their counterparts and that this perception is particularly pronounced in crisis situations. The current study extended this research to a military population utilizing a quantitative experimental research design. Respondents were randomly assigned to written vignettes that manipulated leader self-sacrifice and the combat environment and then provided assessments of the company grade officer\u27s attributed charisma. Currently serving enlisted and commissioned officers in the California Army National Guard (n = 218) took part in the research, and ANOVA test results indicated that both self-sacrifice and the experience of combat significantly increase perceptions of a company grade officer\u27s attributed charisma. No significant interaction was found between leader self-sacrifice and combat. This study indicated that the self-sacrificial leadership model may have broad applicability across organizations and provides strong support for the Army\u27s emphasis on selfless service. This research can spur positive social change by fostering a more aspirational form of leadership within the Army that builds the psychological resilience of soldiers and results in stronger teams