The Historical Development of the Port of Livorno (Italy) and Its New Port Plan 2010 in Advanced Stage of Elaboration

The geographical location makes the port of Livorno one of the most important in Italy. The port, in fact, benefits of an extended network of roads and rails connecting it with the rest of Italy, and central and southern Europe as well. The history of Livorno and its port is inextricably linked to that of Pisa and Florence, and to the complexity of events that determined the political set-up of the region along several centuries. Looking at the new port plan of Livorno has made it necessary an extensive overview of the history of both the port, and of its planning. This analysis has allowed: to understand the reason for the different choices made in the past for the development of the port, highlighting, when necessary, the errors made; to identify the strengths and weaknesses of the existing port infrastructure; to identify the works needed to boost the port in the European context. The purpose of this paper is to provide a summary of the analysis performed for the implementation of the new Livorno port plan 2010 and show how the port planning in Italy is often conditioned by hundreds of centuries of history

Single-center experience in the treatment of visceral artery aneurysms

Background: Visceral artery aneurysms (VAAs), although rare, represent a life-threatening disease with high mortality rates. With the more frequent use of diagnostic tests, there has been an incidental detection of these lesions which are mostly asymptomatic. It follows that surgeons are increasingly called to decide on the most appropriate management of VAAs between an open surgical or endovascular approach and among the different endovascular options currently available. The aim of this retrospective study was to evaluate the results of open surgery and interventional endovascular strategies of visceral artery aneurysms with respect to technical success, therapy-associated complications, and postinterventional follow-up in the elective and emergency situation. Methods: From January 1992 to January 2017, 125 open surgical or endovascular interventions for VAA were performed at our institution. Once the VAA was diagnosed and the indication for treatment was assessed, the preoperative diagnostic work-up consisted of contrast computed tomography (CT) or magnetic resonance imaging (MRI) and, in some patients, digital subtraction angiography. Follow-up included clinical and duplex ultrasound scan (DUS) and contrast-enhanced ultrasound to assess the treated vessel patency and organ perfusion after 1, 6, and 12 months, and yearly thereafter. CT or MRI controls were also performed at 1 year of follow-up and only when DUS was not diagnostic or showed a complication thereafter. After the first 5 years of follow-up, the status of the patient was obtained by a structured telephone survey. Results: The treatment option was endovascular in 56 of 125 cases (44.8%). Technical success was 98.3%. In one case, the procedure was interrupted for the extensive dissection of the afferent vessel. Twenty-six patients were treated by coil embolization while 29 with covered stenting. The endovascular approach was in emergency in two cases (3.6%). In the endovascular group, mortality was nil. Complications occurred in 5 cases (8.9%): 1 subacute intestinal ischemia caused by superior mesenteric artery dissection, 2 aneurysm reperfusion, 1 stent thrombosis, and 1 massive splenic hematoma. In 69 (55.2%) cases, surgical treatment was preferred, with 24 VAA resections and 45 arterial reconstructions. In 20 cases (29%), open surgery was performed in emergency conditions. In the surgical group, 8 emergency patients (40%) died intraoperatively. The mortality after elective surgical interventions was nil. Complications after surgery were 4 graft late thrombosis (5.8%): asymptomatic in three cases and requiring splenectomy in one. Conclusions: There is no overall consensus regarding the indications for treatment of VAA. Currently in emergent setting, the endovascular approach should be considered as the first choice because of its reduced invasiveness, faster way to access and bleeding control; this accounts for the lower morality of the interventional therapy than open surgery. Endovascular approach is effective for elective repair of VAAs, but procedure-related complications may occur in a not negligible number of patients. Given comparable mortality rates and low procedure-related complication rate, surgical approach still has space in the elective management of VAAs, especially for aneurysms unsuitable or challenging for the endovascular option in patients with low surgical risk. The size, location, and morphology of VAAs, systemic or local comorbidities, and specific anatomical situations such as previous abdominal surgery should dictate treatment choice

Nellix endovascular aortic sealing endoprosthesis late explantation for concomitant type I endoleak and stent frames proximal caudal migration

Endovascular aneurysm sealing (EVAS) using the Nellix™ System was introduced in clinical practice with the aim of reducing the incidence of complications such as migration, endoleaks, and reinterventions after conventional endovascular aneurysm repair (EVAR). Although, initial efficacy data on this device have been encouraging, EVAS has also demonstrated to undergo adverse events. Herein, we report a case of Nellix graft explant due to endobags shrinkage after air bubble reabsorption leading to proximal type I A endoleak and stent migration. The focus of this article is on the importance of a more assiduous surveillance of this new device, in particular in those cases with air into the endobags immediately after the procedure; this surveillance should be aimed to timely identify complications which can otherwise lead to consequences that require open conversion

Effects of ambient temperature, humidity, and other meteorological variables on hospital admissions for angina pectoris.

BACKGROUND: Seasonal peaks in cardiovascular disease incidence have been widely reported, suggesting weather has a role. DESIGN: The aim of our study was to determine the influence of climatic variables on angina pectoris hospital admissions. METHODS: We correlated the daily number of angina cases admitted to a western Sicilian hospital over a period of 12 years and local weather conditions (temperature, humidity, wind force and direction, precipitation, sunny hours and atmospheric pressure) on a day-to-day basis. A total of 2459 consecutive patients were admitted over the period 1987-1998 (1562 men, 867 women; M/F - 1:8). RESULTS: A seasonal variation was found with a noticeable winter peak. The results of Multivariate Poisson analysis showed a significant association between the daily number of angina hospital admission, temperature, and humidity. Significant incidence relative ratios (95% confidence intervals/measure unit) were, in males, 0.988 (0.980-0.996) (p = 0.004) for minimal temperature, 0.990 (0.984-0.996) (p = 0.001) for maximal humidity, and 1.002 (1.000-1.004) (p = 0.045) for minimal humidity. The corresponding values in females were 0.973 (0.951-0.995) (p < 0.017) for maximal temperature and 1.024 (1.001-1.048) (p = 0.037) for minimal temperature. CONCLUSIONS: Environmental temperature and humidity may play an important role in the pathogenesis of angina, although it seems different according to the gender. These data may help to understand the mechanisms that trigger ischemic events and to better organize hospital assistance throughout the year

Surface doping in T6/ PDI-8CN2 Heterostructures investigated by transport and photoemission measurements

In this paper, we discuss the surface doping in sexithiophene (T6) organic field-effect transistors by PDI-8CN2. We show that an accumulation heterojunction is formed at the interface between the organic semiconductors and that the consequent band bending in T6 caused by PDI-8CN2 deposition can be addressed as the cause of the surface doping in T6 transistors. Several evidences of this phenomenon have been furnished both by electrical transport and photoemission measurements, namely the increase in the conductivity, the shift of the threshold voltage and the shift of the T6 HOMO peak towards higher binding energies.Comment: 5 pages, 5 figure