Cell therapy in patients with critical limb ischemia

Critical limb ischemia (CLI) represents the most advanced stage of peripheral arterial obstructive disease (PAOD) with a severe obstruction of the arteries which markedly reduces blood flow to the extremities and has progressed to the point of severe rest pain and/or even tissue loss. Recent therapeutic strategies have focused on restoring this balance in favor of tissue survival using exogenousmolecular and cellular agents to promote regeneration of the vasculature.These are based on stimulation of angiogenesis by extracellular and cellular components. This review article carries out a systematic analysis of the most recent scientific literature on the application of stem cells in patients with CLI. The results obtained from the detailed analysis of the recent literature data have confirmed the beneficial role of cell therapy in reducing the rate of major amputations in patients with CLI and improving their quality of life

Feasibility of inguinal hernioplasty under local anaesthesia in elderly patients.

BACKGROUND: The aim of this study is to evaluate the feasibility and the safety of hernioplasty under local anaesthesia in elderly patients with significant comorbidity. METHODS: A total of 218 patients underwent inguinal hernia repair with mesh between June 2009 and July 2012. Presence of comorbid conditions and complications were compared between patients younger and older than 70 years. RESULTS: Hernia repair in older patients were more likely associated with comorbid conditions than in their younger counterparts ( hypertension: 25% vs 8.16%; cardiovascular diseases: 50% vs 22%; benign prostatic hypertrophy 60% vs 30%). The most common postoperative complications in both groups were recurrence, wound infection, urinary retention. There was a slightly higher rate of complication in elderly group. CONCLUSIONS: Inguinal hernia repair with local anaesthesia is quite safe and results in a good success rate in elderly patients despite a higher rate of comorbidity typical of this kind of patient

Organizational models in robotica assisted surgery

The development and diffusion of minimally-invasive surgery has been possible due to the application of new technologies, including robotics, which has only recently been introduced in this field. The aim of the study was to propose a series of guidelines regarding the organizational and didactic requirements for ensuring high operative standards for the diffusion of robotic surgery. Problems concerning installation of the robotic system, disposition of the operating room, and standardization of surgical procedures are discussed. To exemplify these aspects, the phases of a robotic cholecystectomy are described. The essential requirements for the creation of training and research centers for robotic surgery are outlined. In addition, the ideal course of training for the surgeon of the third millennium is delineated. In the near future, robotic technique is destined to play an increasingly important role, both in general surgery and in the surgical specialties. The development of special centers for the diffusion and teaching of robotic surgery, therefore, is an objective to be pursued

Peripheral blood mono-nuclear cells implantation in patients with Peripheral Arterial Disease: a pilot study for clinical and biochemical outcome of neoangiogenesis.

BACKGROUND: Substantial progresses in the management of peripheral arterial disease (PAD) have been made in the past two decades. Progress in the understanding of the endothelial-platelet interaction during health and disease state has resulted in better antiplatelet drugs that can prevent platelet aggregation, activation and thrombosis during angioplasty and stenting. A role in physiological and pathological angiogenesis in adults has been recently shown in bone marrow–derived circulating endothelial progenitors (BM-DCEPs) identified in the peripheral blood. These findings have paved the way for the development of therapeutic neovascularization techniques using endothelial progenitors. METHODS: This pilot study includes five patients, aged 60 to 75, with a history of claudication and recruited from September 2010 to February 2011 at the A.O.U. Federico II of Naples. PBMNCs have been implanted three times in the limb with the worst ABI value in all the patients included in the study. The clinical follow up was performed during the subsequent 12 months from the beginning of the treatment. RESULTS: In four patients there was a regression of ulcerative lesions. One patient’s condition improved after the first implantation but later did not respond to the further treatments. All patients achieved a pain relief as judged by the numeric pain scale. Pain relief remained satisfactory in three patients for one year. Pain gradually returned to the pre-treatment level in two patients. All patients referred an ameliorating in their quality of life expressed even by an improvement in claudication free walking distance. These improvements are reflected also by intra-arterial digital subtraction angiography (IADSA) that shows an improvement of arterial vascularization. CONCLUSIONS: The data from this study suggest an efficacy of BM-DCEPs implantation in terms of improvement of the vascularization and quality of life in patients affected by Peripheral Arterial Disease. Nevertheless a double-blind placebo-controlled study is needed to confirm our findings

Verifying for Compliance to Data Constraints in Collaborative Business Processes.

Production processes are nowadays fragmented across different companies and organized in global collaborative networks. This is the result of the first wave of globalization that, among the various factors, was enabled by the diffusion of Internet-based Information and Communication Technologies (ICTs) at the beginning of the years 2000. The recent wave of new technologies possibly leading to the fourth industrial revolution – the so-called Industry 4.0 – is further multiplying opportunities. Accessing global customers opens great opportunities for organizations, including small and medium enterprises (SMEs), but it requires the ability to adapt to different requirements and conditions, volatile demand patterns and fast-changing technologies. Regardless of the industrial sector, the processes used in an organization must be compliant to rules, standards, laws and regulations. Non-compliance subjects enterprises to litigation and financial fines. Thus, compliance verification is a major concern, not only to keep pace with changing regulations but also to address the rising concerns of security, product and service quality and data privacy. The software, in particular process automation, used must be designed accordingly. In relation to process management, we propose a new way to pro-actively check the compliance of current running business processes using Descriptive Logic and Linear Temporal Logic to describe the constraints related to data. Related algorithms are presented to detect the potential violations

LTL Model Checking for Security Protocols

Most model checking techniques for security protocols make a number of simplifying assumptions on the protocol and/or on its execution environment that prevent their appli-cability in some important cases. For instance, most tech-niques assume that communication between honest princi-pals is controlled by a Dolev-Yao intruder, i.e. a malicious agent capable to overhear, divert, and fake messages. Yet we might be interested in establishing the security of a pro-tocol that relies on a less unsecure channel (e.g. a confiden-tial channel provided by some other protocol sitting lower in the protocol stack). In this paper we propose a general model for security protocols based on the set-rewriting for-malism that, coupled with the use of LTL, allows for the specification of assumptions on principals and communica-tion channels as well as complex security properties that are normally not handled by state-of-the-art protocol analysers. By using our approach we have been able to formalise all the assumptions required by the ASW protocol for optimistic fair exchange as well as some of its security properties. Be-sides the previously reported attacks on the protocol, we report a new attack on a patched version of the protocol. 1