Assessing appropriateness for elective colorectal cancer surgery: clinical, oncological, and quality-of-life short-term outcomes employing different treatment approaches

Purpose In recent years, colorectal cancer surgery has benefitted from new techniques such as laparoscopy and robotic surgery. However, many treatment disparities exist among different centers for patients affected by the same kind of tumors. Methods Forty-five (41%) open (OCO) vs. 30 (28%) laparoscopic (LCO) vs. 34 (31%) robotic-assisted (RCO) colectomies and 34 (40%) open (ORR) vs. 52 (60%) robotic (ROR) rectal resections performed during a 15-month period, in elective setting, were compared. Patients presenting contraindications for minimally invasive procedures were excluded from the study, so that all the enrolled patients were suitable for either of the surgical procedures. Results Overall morbidity rates were similar among groups. Perioperative mortality was nil. No significant differences were noted as for total number of lymph nodes harvested between arms. Mean time (days) to first bowel movement to gas was 3.3 vs. 2.3 vs. 2.6 for OCO, LCO, and RCO, respectively (p<0.001), and 3.3 vs. 2.0 for ORR and ROR, respectively (p=0.003). Among several European Organization in Research and Treatment of Cancer QLQ-C30 functional scales considered only physical functioning was significantly better at 30 days for RCO vs. OCO (96.3\ub110 RCO vs. 85.5\ub112.6 OCO; p=0.015). Robotic surgery was much more expensive in comparison to open as well as laparoscopic procedures. Conclusions Laparoscopic and robotic surgeries for colorectal cancer present both the same advantages in comparison to open procedures in terms of faster recovery. However, our data do not seem to support the routine use of RCO as a cost-effective procedure

An integrated assessment of vulnerability to glacial hazards

The Rio Santa valley in the Cordillera Blanca, Peru, has been repeatedly affected by severe glacial flood disasters in the past decades. The continuing high rate of glacier retreat has led to the formation and rapid growth of a large number of glacial lakes. Due to the risk of lake outburst floods, downstream communities are confronted with serious hazards. The regional capital of Huaraz is one of the major sites exposed to these hazards. Mainly due to a lack of resources, no systematic evaluation of the existing hazards and related risks has been performed so far, nor have adequate warning systems been installed. Strict financial limitations make a prioritization of mitigation measures a necessity. Vulnerability assessments are an effective tool to this end. In this article, we present a method to measure the vulnerability of Huaraz to hazards from glacial lake outbursts integrating both physical (ie hazards-related) and socioeconomic factors. The difficulty of quantifying socioeconomic variables and its combination with physical factors, as well as a lack of corresponding concepts, is a challenge for measuring vulnerability. The resulting map shows a high vulnerability for several parts of Huaraz. The results of this study thus make an important contribution to effectively addressing the identified protection deficit and to efficiently assigning the limited resources in the context of a developing country. However, this article also shows the strong need for more vulnerability research integrating both physical and social science components and related theoretical frameworks to be readily applied in practice

Iustiniani Augusti Digesta seu Pandectae. Digesti o Pandette dell'Imperatore Giustiniano - Traduzione italiana. (vol. II (libri 4-11), a cura di Sandro Schipani

Antonio Saccoccio ha fatto parte del gruppo di revisione dei testi tradott

Iustiniani Augusti Digesta seu Pandectae. Digesti o Pandette dell'Imperatore Giustiniano - Traduzione italiana. (vol. II (libri 4-11), a cura di Sandro Schipani

Antonio Saccoccio ha fatto parte del gruppo di revisione dei testi tradott