Clinical audit; freehand renal biopsy, still a suitable method?

Introduction: Freehand renal biopsy represents a valid alternative to the most widespread ultrasonography-guided technique, although some concerns can derive from the possible increased complication rate and lower adequacy rate. Objectives: In the present audit study, efficacy of freehand method have been established through the analysis of 328 consecutive renal biopsies in 322 patients, instead the safety of the procedure was assessed in 196 patients. Patients and Methods: We retrospectively reviewed hospital databases of all patients who underwent a percutaneous renal biopsy over an 18 years’ period at Santa Marta and Santa Venera hospital in Acireale. Results: The procedure led to a definitive diagnosis in the majority of cases (98.48%), being uninformative only in 5 out of 328 cases (1.52%). Comparing these results against a Proforma, resulting from analysis of best literature reports for the items studied, adverse event rates were similar. Conclusion: Freehand renal biopsy resulted a good option to obtain renal tissue, without serious side effects. We argue about safety and we prefer to reserve this invasive procedure to selected cases, avoiding renal biopsy if biochemical and instrumental data allow a definitive diagnosis as well as in high risk patients. Our policy protects patients from the adverse effects that can result from kidney biopsy

ELEMENTI DI SCIENZE MOTORIE E SPORTIVE 2

IL VOLUME SI ARTICOLA IN DUE PARTI. NELLA PRIMA PARTE: LO SPORT, LE REGOLE E IL FAIRPLAY; NELLA SECONDA PARTE: RELAZIONE CON L'AMBIENTE NATURALE E TECNOLOGIC

ELEMENTI DI SCIENZE MOTORIE E SPORTIVE 1

iL TESTO SI ARTICOLA IN QUATTRO PARTI. NELLA PRIMA PARTE GLI ARGOMENTI TRATTATI SONO LO SPORT, LA SOCIETA' E LO STATO; NELLA SECONDA PARTE SI PARLA DI PERCEZIONE DI SE' E LO SVILUPPO DELLE CAPACITA' MOTORIE; NELLA TERZA PARTE: LOSPORT E IL FAIR PLAY; NELLA QUARTA - SALUTE, BENESSERE E PREVENZION

Sperimentazione di tecnologie low cost 3D per la divulgazione delle collezioni museali - Experimentation of low cost 3D technologies for the dissemination of museum collections

La ricerca è tesa a esplorare potenzialità e limiti di dispositivi a basso costo per l’acquisizione 3D al fine di valutare l’applicabilità per la digitalizzazione del patrimonio museale, per la maggior parte non fruibile dai visitatori. La sperimentazione è stata condotta su alcuni oggetti delle collezioni del Museo Civico Castello Ursino di Catania. The research explores the potentialities and weaknesses of a newly released low cost device for 3D acquisition to understand its effective usability for the digitization of museum collections, often not visible by visitors. The testbed has been carried out on specimens of the collections of the Civic Museum Castello Ursino in Catania

COVID-19 Vaccine and Death: Causality Algorithm According to the WHO Eligibility Diagnosis

The current challenge worldwide is the administration of anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines. Even if rarely, severe vascular adverse reactions temporally related to vaccine administration have induced diffidence in the population at large. In particular, researchers worldwide are focusing on the so-called “thrombosis and thrombocytopenia after COVID-19 vaccination”. This study aims to establish a practical workflow to define the relationship between adverse events following immunization (AEFI) and COVID-19 vaccination, following the basic framework of the World Health Organization (WHO). Post-mortem investigation plays a pivotal role to support this causality relationship when death occurs. To demonstrate the usefulness and feasibility of the proposed workflow, we applied it to two exemplificative cases of suspected AEFI following COVID-19 vaccination. Based on the proposed model, we took into consideration any possible causality relationship between COVID-19 vaccine administration and AEFI. This led us to conclude that vaccination with ChAdOx1 nCov-19 may cause the rare development of immune thrombocytopenia mediated by platelet-activating antibodies against platelet factor 4 (PF4), which clinically mimics heparin-induced autoimmune thrombocytopenia. We suggest the adoption of the proposed methodology in order to confirm or rule out a causal relationship between vaccination and the occurrence of AEFI

The risks associated with percutaneous native kidney biopsies: a prospective study

The known risks and benefits of native kidney biopsies are mainly based on the findings of retrospective studies. The aim of this multicentre prospective study was to evaluate the safety of percutaneous renal biopsies and quantify biopsy-related complication rates in Italy

Effects of guidelines on adeno-tonsillar surgery on the clinical behaviour of otorhinolaryngologists in Italy

<p>Abstract</p> <p>Background</p> <p>Several guidelines on adeno-tonsillar disease have been proposed in recent years and some discrepancies in relation both to clinical manifestations and indications for surgical treatment have emerged. The aim of the study was to verify what influence (adeno)-tonsillectomy guidelines have had on the clinical behaviour of ENT specialists in Italy. Our study is a retrospective and multi-centre case series with chart review.</p> <p>Methods</p> <p>The survey involved 14,770 children, aged between the ages of 2 and 11, who had undergone adeno-tonsillar surgery between 2002 and 2008 in fourteen Italian tertiary and secondary referral centres. Anova test was used for the statistical analysis, assuming p < 0.05 as the minimum statistical significance value.</p> <p>Results</p> <p>The frequency of adeno-tonsillar surgeries did not change significantly (p>0.05) during the study period and following the Italian policy document publication. Overall, adeno-tonsillectomy was the most frequent intervention (64.1%), followed by adenoidectomy (31.1%) and tonsillectomy (4.8%). The indications for surgery did not change significantly for each of the operations (p>0.05), with the exception of adeno-tonsillectomy in case of feverish episodes due to acute recurrent tonsillitis ≥ 5 without nasal obstruction (decreased p= 0.010) , even when the feverish episodes due to acute recurrent tonsillitis were < 5 over the last year. Nasal obstruction was associated with feverish episodes due to acute recurrent tonsillitis in 65.2% of operated cases, while otitis media had been diagnosed in 43.3% of the patients studied.</p> <p>Conclusions</p> <p>The recommendations first developed in Italy in a 2003 policy document and then resumed in guidelines in 2008, were not implemented by ENT units involved in the survey. The study highlights the fact that the indications for adeno-tonsillar operations are based on the overall clinical presentation (comorbidity) rather than on a single symptom. Guidelines are necessary to give coherent recommendations based on both the findings obtained through randomized controlled trials and the data collected from observational studies.</p

Manual of Cardio-oncology Cardiovascular Care in the Cancer Patient

This concise and handy manual provides straightforward, up-to-date guidance for cardiologists and other practitioners on the management of cancer patients with cardiac problems, whether they be due to the cancer itself or to antineoplastic treatment. Detailed attention is devoted to the various forms of cardiotoxicity associated with chemotherapy and radiotherapy. The drugs commonly responsible for each toxicity are identified and clear advice is offered on monitoring techniques and treatment approaches. In addition, the issue of cardiotoxicity due to cancer treatment in particular patient groups \u2013 children, the elderly, and those with pre-existing cardiac disease \u2013 is addressed separately, with guidance on when and how antineoplastic (and/or cardiological) treatments should be modified. Further sections describe the correct responses to cardiac problems secondary to the cancer itself, including thromboembolic disorders and electrolyte imbalances, and the diagnosis, treatment, and follow-up of cardiac tumors. A closing section considers how to improve cooperation between oncologists, cardiologists, and general practitioners to ensure that cancer patients\u2019 cardiovascular needs are met in a multidisciplinary approach