Prognostic differences between VAP caused by Acinetobacter baumannii and VAP caused by other microorganisms

Nosocomial infection, in particular pneumonia, is an important risk factor for hospital mortality and morbidity. Acinetobacter baumannii is a common multi-resistant microorganism responsible of Ventilator Associated Pneumonia (VAP). Currently Colistin is a rescue therapy for this pathogen. The purpose of this study is to compare the outcome of VAP caused by Acinetobacter baumannii and VAP by other microorganisms in critical patients. Comorbidity, prognostic scores, mortality and eradication frequency did not turn out significantly different between the two study groups. Colistin safety was tested

Pediatric Endoscopic Pilonidal Sinus Treatment, a Revolutionary Technique to Adopt in Children with Pilonidal Sinus Fistulas: Our Preliminary Experience

This study aimed to report our preliminary experience with pediatric endoscopic pilonidal sinus treatment (PEPSiT). PATIENTS AND METHODS: We retrospectively reviewed the reports of 15 patients, 6 girls and 9 boys, with an average age of 16 years (range 13-18) with noninfected pilonidal sinus disease who underwent PEPSiT in our institution over an 18-month period. Four cases were redo-procedures, for recurrence of disease after open excision repair. Surgical outcomes of sinus healing, recurrence of disease, postoperative pain, hospital stay, analgesic requirements, and patient satisfaction levels were evaluated and a comparison analysis with classic open repair was performed. RESULTS: All procedures were performed under subarachnoid spinal anesthesia. We always adopted a fistuloscope, an endoscopic forceps, and a monopolar electrode to remove the hairs and to heal the fistula. The average length of surgery was 28.5 minutes (range 26-41). No intraoperative or postoperative complications were reported. The average pain score evaluated using Visual Analogue Scale (VAS) pain scale during the first 48 postoperative hours was 3.2 (range 2-5). The average analgesic requirement was 22 hours (range 16-28). The average hospital stay length was 28 hours (range 22-48). They changed dressing daily, by applying a topical solution of eosin 2% and a silver sulfadiazine spray. At 1 month postoperatively, the external openings were closed in all patients and no recurrence was recorded at a mean follow-up of 6 month. PEPSiT was associated with a significantly shorter, painless, and better outcome compared to open technique. CONCLUSION: On the basis of our preliminary experience, we believe that PEPSiT is a promising technique for surgical treatment of pilonidal sinus in children. It is technically easy and quick to perform, with a short and painless hospital stay, without recurrences in our series. It allows operated patients an early return to full daily activities without restrictions that happen for the classic treatment

Concept riqualificazione aree facoltà architettura politecnico di Milano. supervisor: santiago quesada

(From curators) The MIAW.2/forests program ///Day 1 Salutations Alessandro Balducci, Vice Rector of the Politecnico di Milano - Gianni Scudo, Vice Dean of the School ʻArchitettura e Societàʼ - Ilaria Valente, President School ʻArchitettura e Societàʼ Master of Sciences in Architecture Course - Emilio Genovesi, Councillorship of Culture, Expo, Fashion and Design, Comune di Milano - Richard Haag, Professor Emeritus University of Washington, Seattle // Opening Lecture ʻStick-Chartsʼ by Christine Dalnoky, Atelier Christine Dalnoky (France) // Workshops opening ///Day 2 MIAW Open Lectures Morning Sessions Françoise Akinosho / Maja Leonelli - MIAW Open Lectures Afternoon Sessions Anders Berensson + Ulf Mejergren (Visiondivison) / Drew Seskunas and Brice Delarue (Zirkumflex) ///Day 3 MIAW Open Lectures Morning Sessions Marialena Nikolopoulou / Marta Bottero and Chiara DʼAlpaos - MIAW Afternoon Open Lectures Sessions Giovanni Attili / Santiago Quesada ///Day 4 MIAW Open Lectures Morning Sessions Duilio Forte (AtelierFORTE) / Andre Dekker (Observatorium) ///Day 5 MIAW.2 Final and Farewell Party at the Politecnico di Milano Leonardo Campus /// The 2011 MIAWers are:/// 1 Rachele Albini / Giada Albonico / Jacopo Biasio / Sara Caramaschi / Elisa Carraro / Desislava Dimitrova / Cristina Gatti / Elisa Gulino / Mariya Hasamova / Nina Mikhailova / Ottavia Molatore / Joao Molinar / Azadeh Moradiasr / Mohyedin Navabzadeh Navabi / Giuseppe Maria Palermo / Riccardo Somaini / Bogdan Stojanovic /// 2 Andra Elena Apostolescu / Valentina Armenti / Dana Baranes / Sofia Chicherina / Guadalupe Ciocoletto / Marina Franzi / Gulin Keskin / Somayeh Khoshdelmishamandani / Gabriella Milo / Filippo Minora / Ayca Ozbank / Priyank Dipakbhai Parmar / Elena Piazza / Nicolò Rota / Pietro Spazzini / Paolo Volpetti / Tamara Zarkovic / Maia Zheliazkova /// 3 Kalina Andreeva / Giacomo Ardesio / Giulia Cascella / Filippo Cima / Carolina Luísa De Sá E Brito / Alaleh Emami / Michele Gerli / Anna Chiara Leardini / Marina Meloni / Navid Moshfeghi / Alexandra Nita / Rohit Perla / Gabriele Tomassini /// 4 Alessia Albini / Laura Beltrami / Giuseppe Biscottini / Lorenzo Campini / Angela Charalambous / Michela Di Noia / Reza Kamyabi / Ivana Lilikj / Jacopo Marcolini / Behnam Meimandpour / Surajkumar Nandakumar / Sophia Theologou / Ofelia Vera / Marco Zanini / Alice Cristina Jola Zingales / Riccardo Zocche /// 5 Fabio Bonaventura / Mattia Bravin / Matteo Calati / Lia Crupi / Serena DʼAndrea / Maria Grubova / Ketaki Kadam / Maria Korobitsyna / Aly Mohamed Mohamed Ahmed El Sayed / Mattia Morandi / Haitham Nabil Mohamed Mousa / Ozge Noyan / Arlinda Sheqiri / Ceren Sipahioglu / Paula Stefan / Claudio Valcamonico /// 6 Alessandra D'Apolito / Chrysafina Geronta / Bernardo Gonzalez De Cossio Paez / Rajesh Gupta / Sona Keresztesová / Federico Montagna / Maria Nickolova / Parsa Pahlavan / Raluca-Mihaela Serdaru / Alexandra Shatskaya /// 7 Elena Alexandrova / Chrystalla Argyrou / Tijana Djordjevic / Gloria Ferrari / Priscilla Gazzellini / Deborah Gotti / Francesco Ernst Lupic / Giulia Marcosano / Lara Mondonico / Veronica Notaro / Savia Palate / Caterina Pilar Palumbo / Ilaria Pedrini / Andrea Perletti / Giulia Repetti / Aster Sittoni / Gulcin Tanil / Matteo Tressi / Erica Ubbiali / Ayman Wagdy Mohamed Ibrahim /// 8 Giada Bonatti / Matteo Chelazzi / Alberto DʼOspina / Serena Di Nocera / Katarzyna Dudycz / Nenad Duric / Filip Durickovic / Francesca Fabiana Fochi / Andrea Guaiti / Daniela Iallorenzi / Americo Iannazzone / Mickeal Milocco / Gabriele Motta / Andreea Onu / Patrizio Pelosi / Marta Petrov / Olga Shishova / Jue Wang /// 9 Constantina Agroti / Arezoo Akbarvand / Glykeria Anaxagorouglyka / Stefano Arrighi / Nicolò Bianchi / Giulia Borghi / Miruna-Luiza Caragheorgheopol / Daniele Cremaschi / Vedat Ali Dalokay / Matteo Gobbi / Seyedeh Golkoo Hooshmand Ziafi / Daniele Iori / Berk Kangoz / Katarzyna Krol / Georgios Kyriazis / Lorenza Manfredi / Abdulkadir Eren Ozturk / Amanda Parisi De Marchi / Isha Rathod / Negin Salamat / Marina Serratine Paul / Alessia Tosini / Maria Vassileva / Ege Yuksek /// 10 Stefan Andelkovic / Mirko Andolina / Pietro Bodria / Alessandro Danesi / Irene De Donatis / Claudia De Flumeri / Corinna Del Bianco / Joris Katkecivius / Claudia Mainardi / Federico Marcantognini / Jenni Mazzoni / Luca Menegaldo / Milena Meregalli / Emanuele Migliorosi / Sara Moriggia / Manuele Mossoni / Claudia Praderio / Filippo Tiozzo / Arianne Veloce / Francesca Zanotto MIAW.2/forestsThe 2nd Milano International Architectural Workshop of the Politecnico di Milanoʼs School of ʻArchitettura e Societàʼ programmes, playing with the metaphor of forests, aimed to generate 10 new visions to explain nowadays living and its next future in the spirit of green design, resilience, recycling, and ethical consciousness.MIAW.2 took place from September 26th to September 30th 2011 involving more than 100 students supervised by 15 international tutors working on 10 different workshop themes with the target to enrich the Politecnico di Milanoʼs Leonardo Campus environscape with light installations.This catalogue shows the MIAW.2/forests resul

Concept riqualificazione aree facolt\ue0 architettura politecnico di Milano. supervisor: santiago quesada

(From curators) The MIAW.2/forests program ///Day 1 Salutations Alessandro Balducci, Vice Rector of the Politecnico di Milano - Gianni Scudo, Vice Dean of the School \u2bbArchitettura e Societ\ue0\u2bc - Ilaria Valente, President School \u2bbArchitettura e Societ\ue0\u2bc Master of Sciences in Architecture Course - Emilio Genovesi, Councillorship of Culture, Expo, Fashion and Design, Comune di Milano - Richard Haag, Professor Emeritus University of Washington, Seattle // Opening Lecture \u2bbStick-Charts\u2bc by Christine Dalnoky, Atelier Christine Dalnoky (France) // Workshops opening ///Day 2 MIAW Open Lectures Morning Sessions Fran\ue7oise Akinosho / Maja Leonelli - MIAW Open Lectures Afternoon Sessions Anders Berensson + Ulf Mejergren (Visiondivison) / Drew Seskunas and Brice Delarue (Zirkumflex) ///Day 3 MIAW Open Lectures Morning Sessions Marialena Nikolopoulou / Marta Bottero and Chiara D\u2bcAlpaos - MIAW Afternoon Open Lectures Sessions Giovanni Attili / Santiago Quesada ///Day 4 MIAW Open Lectures Morning Sessions Duilio Forte (AtelierFORTE) / Andre Dekker (Observatorium) ///Day 5 MIAW.2 Final and Farewell Party at the Politecnico di Milano Leonardo Campus /// The 2011 MIAWers are:/// 1 Rachele Albini / Giada Albonico / Jacopo Biasio / Sara Caramaschi / Elisa Carraro / Desislava Dimitrova / Cristina Gatti / Elisa Gulino / Mariya Hasamova / Nina Mikhailova / Ottavia Molatore / Joao Molinar / Azadeh Moradiasr / Mohyedin Navabzadeh Navabi / Giuseppe Maria Palermo / Riccardo Somaini / Bogdan Stojanovic /// 2 Andra Elena Apostolescu / Valentina Armenti / Dana Baranes / Sofia Chicherina / Guadalupe Ciocoletto / Marina Franzi / Gulin Keskin / Somayeh Khoshdelmishamandani / Gabriella Milo / Filippo Minora / Ayca Ozbank / Priyank Dipakbhai Parmar / Elena Piazza / Nicol\uf2 Rota / Pietro Spazzini / Paolo Volpetti / Tamara Zarkovic / Maia Zheliazkova /// 3 Kalina Andreeva / Giacomo Ardesio / Giulia Cascella / Filippo Cima / Carolina Lu\uedsa De S\ue1 E Brito / Alaleh Emami / Michele Gerli / Anna Chiara Leardini / Marina Meloni / Navid Moshfeghi / Alexandra Nita / Rohit Perla / Gabriele Tomassini /// 4 Alessia Albini / Laura Beltrami / Giuseppe Biscottini / Lorenzo Campini / Angela Charalambous / Michela Di Noia / Reza Kamyabi / Ivana Lilikj / Jacopo Marcolini / Behnam Meimandpour / Surajkumar Nandakumar / Sophia Theologou / Ofelia Vera / Marco Zanini / Alice Cristina Jola Zingales / Riccardo Zocche /// 5 Fabio Bonaventura / Mattia Bravin / Matteo Calati / Lia Crupi / Serena D\u2bcAndrea / Maria Grubova / Ketaki Kadam / Maria Korobitsyna / Aly Mohamed Mohamed Ahmed El Sayed / Mattia Morandi / Haitham Nabil Mohamed Mousa / Ozge Noyan / Arlinda Sheqiri / Ceren Sipahioglu / Paula Stefan / Claudio Valcamonico /// 6 Alessandra D'Apolito / Chrysafina Geronta / Bernardo Gonzalez De Cossio Paez / Rajesh Gupta / Sona Keresztesov\ue1 / Federico Montagna / Maria Nickolova / Parsa Pahlavan / Raluca-Mihaela Serdaru / Alexandra Shatskaya /// 7 Elena Alexandrova / Chrystalla Argyrou / Tijana Djordjevic / Gloria Ferrari / Priscilla Gazzellini / Deborah Gotti / Francesco Ernst Lupic / Giulia Marcosano / Lara Mondonico / Veronica Notaro / Savia Palate / Caterina Pilar Palumbo / Ilaria Pedrini / Andrea Perletti / Giulia Repetti / Aster Sittoni / Gulcin Tanil / Matteo Tressi / Erica Ubbiali / Ayman Wagdy Mohamed Ibrahim /// 8 Giada Bonatti / Matteo Chelazzi / Alberto D\u2bcOspina / Serena Di Nocera / Katarzyna Dudycz / Nenad Duric / Filip Durickovic / Francesca Fabiana Fochi / Andrea Guaiti / Daniela Iallorenzi / Americo Iannazzone / Mickeal Milocco / Gabriele Motta / Andreea Onu / Patrizio Pelosi / Marta Petrov / Olga Shishova / Jue Wang /// 9 Constantina Agroti / Arezoo Akbarvand / Glykeria Anaxagorouglyka / Stefano Arrighi / Nicol\uf2 Bianchi / Giulia Borghi / Miruna-Luiza Caragheorgheopol / Daniele Cremaschi / Vedat Ali Dalokay / Matteo Gobbi / Seyedeh Golkoo Hooshmand Ziafi / Daniele Iori / Berk Kangoz / Katarzyna Krol / Georgios Kyriazis / Lorenza Manfredi / Abdulkadir Eren Ozturk / Amanda Parisi De Marchi / Isha Rathod / Negin Salamat / Marina Serratine Paul / Alessia Tosini / Maria Vassileva / Ege Yuksek /// 10 Stefan Andelkovic / Mirko Andolina / Pietro Bodria / Alessandro Danesi / Irene De Donatis / Claudia De Flumeri / Corinna Del Bianco / Joris Katkecivius / Claudia Mainardi / Federico Marcantognini / Jenni Mazzoni / Luca Menegaldo / Milena Meregalli / Emanuele Migliorosi / Sara Moriggia / Manuele Mossoni / Claudia Praderio / Filippo Tiozzo / Arianne Veloce / Francesca Zanotto MIAW.2/forestsThe 2nd Milano International Architectural Workshop of the Politecnico di Milano\u2bcs School of \u2bbArchitettura e Societ\ue0\u2bc programmes, playing with the metaphor of forests, aimed to generate 10 new visions to explain nowadays living and its next future in the spirit of green design, resilience, recycling, and ethical consciousness.MIAW.2 took place from September 26th to September 30th 2011 involving more than 100 students supervised by 15 international tutors working on 10 different workshop themes with the target to enrich the Politecnico di Milano\u2bcs Leonardo Campus environscape with light installations.This catalogue shows the MIAW.2/forests resul

Two decades of experience with laparoscopic varicocele repair in children: Standardizing the technique

Summary Background Controversy still exists about the indications and the gold standard approach for varicocele treatment in pediatric population. Objective The authors report their 23 years of experience in laparoscopic varicocele repair in the pediatric population. Study design We retrospectively evaluated the data of 345 consecutive patients who underwent laparoscopic left varicocelectomy from January 1993 to December 2015. Average patient age was 12.5 years (range 8e17). Seven out of 345 patients (2%) had a recurrent varicocele, and five out of 345 patients (1.4%) had a varicocele on a single testis. In 335/345 patients (97.1%) we performed a Palomo procedure, and in 10/345 patients (2.9%) an artery-sparing Palomo procedure. After 2010, in 105/ 345 patients (30.4%) we performed a lymphatic sparing procedure using isosulfan blue injection preoperatively. Results All procedures were completed in laparoscopy (Figure), without conversions or intraoperative complications. The average operative time was 17 min (range 14e45) for the Palomo procedure and 26 min (range 18e50) for arterysparing Palomo. In 45/345 patients (13%) we performed additional procedures. We recorded 4/345 (1.3%) recurrences/ persistences in patients undergoing Palomo, while we recorded 1/10 (10%) recurrence/persistence after artery-sparing Palomo. On 230 Palomo procedures performed in the pre-isosulfan blue era, we recorded 25 cases of hydrocele (10.8%), 13 of these were treated with transcrotal puncture and 12 required surgical operation. The last 105 patients undergoing isosulfan blue injection had no postoperative hydrocele. We also reported 10 other complications (I grade Clavien-Dindo) such as umbilical granuloma or instrumental problems. Discussion Analyzing the international literature of the last 25 years, most papers focused on the minimally invasive treatment of pediatric varicocele. There are several reasons to perform laparoscopic repair of pediatric varicocele. First of all, it is technically easy to perform, the average operative time is very short, and it has excellent outcome in regard to varicocele persistence/ recurrence. In addition it has a very low complication rate, and in particular adopting the intradartoic/intratesticular isosulfan blue injection before surgery we recorded no postoperative hydrocele. Conclusion On the basis of our 23 years of experience with varicocele repair, we clearly believe that laparoscopic Palomo lymphatic sparing varicocelectomy should be considered the standard of care for the treatment of pediatric patients with varicocele. Laparoscopic varicocelectomy is technically easy and quick to perform, painless, and scarless, with a recurrence rate of about 1%. The use of a preoperative injection of isosulfan blue completely eliminates postoperative hydrocele formation