Preoperative digital three-dimensional planning for rhinoplasty

BACKGROUND: This report describes preoperative digital planning for rhinoplasty using a new three-dimensional (3D) radiologic viewer that allows both patients and surgeons to visualize on a common monitor the 3D real aspect of the nose in its inner and outer sides. METHODS: In the period 2002 to 2008, 210 patients underwent rhinoplasty procedures in the authors' clinic. The patients were randomly divided into three groups according to the type of preoperative planning used: photos only, a simulated result by Adobe Photoshop, or the 3D radiologic viewer. The parameters evaluated included the number of patients that underwent surgery after the first consultation, the number of patients who asked for a reintervention, patient satisfaction (according to a test given to the patients 12 months postoperatively), the surgical time required for a functional intervention, and the improvement in nasal function by postoperative rhinomanometry and subjective evaluation. RESULTS: Computer-aided technologies led to a higher number of patients deciding to undergo a rhinoplasty. Simulation of the postoperative results was not as useful in the postoperative period due to the higher number of reintervention requests. CONCLUSION: The patients undergoing rhinoplasties preferred new technologies in the preoperative period. The advantages of using the 3D radiologic viewer included improved preoperative planning, reduction in intraoperative stress, a higher number of patients undergoing surgery, reduction in postoperative surgical corrections, reduction in surgical time for the functional intervention, a higher rate of improvement in nasal function, a higher percentage of postoperative satisfaction, and reduced costs

Pharmacokinetics and pharmacogenetics of SSRIs during pregnancy : An observational study

Background: An involvement of selective serotonin reuptake inhibitors (SSRIs) in increasing the risk of malformations, neonatal withdrawal syndrome, has been suggested recently. Here, we aimed to investigate the contribution of individual pharmacogenetics of SSRI on infants' outcome. We also estimated the umbilical/maternal plasma SSRI concentration ratio in the pregnant women still on SSRI therapy at the time of delivery. Methods: Thirty-four pregnant women, referred to our hospital from January 2011 to July 2015, who were given SSRIs in the third trimester, and related children, were considered. The umbilical/maternal plasma SSRI concentration ratio was estimated in 15 mothers still on SSRI therapy at the time of delivery. For patients with pharmacokinetic analyses, blood samples were collected for pharmacogenetic analyses. Results: Nineteen newborns presented clinical signs possibly related to drug toxicity. A high umbilical/maternal plasma ratio of SSRI was observed in 10 of the 15 evaluated newborns. Five mothers were intermediate metabolizers and 1 a poor metabolizer for the major CYP enzyme involved in pharmacokinetic pathway. Conclusions: Individualized psychopharmacologic treatment that takes into account the mother's exposure to SSRI concentrations and eventually her genetic background may become the standard of care to maximize drug benefit and minimize risks to the newborn

DC Microgrid for Power Sharing Model: Control Techniques Analysis

In recent years, because of the energy crisis and fossil fuels depletion, Renewable Energy Sources (RES) are more and more deployed to meet the energy demand and their strategic importance is rising more than ever. Most of them are natively sources in DC, moreover many loads, such as electric vehicles and most electronic devices, are natively loads in DC too. The latest European directives introduced the concepts of Renewable Energy Communities (REC) and collective self consumption. These communities are increasingly attractive and, considering that the collective self consumption (as power sharing) can be easily applied when the community is based on a DC microgrid, this network topology is more and more developed and studied. In this paper, the authors want to investigate the possible control approaches suitable for the management of a DC microgrid designed to realize collective self-consumption through a power sharing model. A possible architecture for the DC microgrid is presented, highlighting the main elements which can be actively included in control algorithms and the main tasks to be pursued. Different control approaches are analysed and compared, highlighting the main benefits and limits of specific applications and configurations

Self-consumption Configurations Analysis

In the next it will be increasingly possible to produce energy closer to where it is consumed, extending the transformation of passive consumers into active consumers, either directly or through aggregations. Recent European Directives highlighted the role of the end users as active players of the system. An important aspect to be considered in this new system is how to share the electrical energy. The goal of the paper is to define possible rules that can be adopted in Italy and specify the concept of self consumption. This will be done by describing the electrical aggregate infrastructure that can be implemented in the European countries or could be in the next future and defining the differences between virtual self consumption and instantaneous self consumption