74 research outputs found
Potentialities of X-ray fluorescence analysis in numismatics: the case study of pre-Roman coins from Cisalpine Gaul
Compositional and microstructural characterization of Celtic silver coins from northern Italy using neutron diffraction analysis
Robotic total gastrectomy with intracorporeal robot-sewn anastomosis. A novel approach adopting the double-loop reconstruction method
Gastric cancer constitutes a major health problem. Robotic
surgery has been progressively developed in this field. Although the
feasibility of robotic procedures has been demonstrated, there are
unresolved aspects being debated, including the reproducibility of
intracorporeal in place of extracorporeal anastomosis.
Difficulties of traditional laparoscopy have been described and there
are well-known advantages of robotic systems, but few articles in
literature describe a full robotic execution of the reconstructive phase
while others do not give a thorough explanation how this phase was run.
A new reconstructive approach, not yet described in literature, was
recently adopted at our Center.
Robotic total gastrectomy with D2 lymphadenectomy and a socalled
‘‘double-loop’’ reconstruction method with intracorporeal robotsewn
anastomosis (Parisi’s technique) was performed in all reported
cases.
Preoperative, intraoperative, and postoperative data were collected
and a technical note was documented.
All tumors were located at the upper third of the stomach, and no
conversions or intraoperative complications occurred. Histopathological
analysis showed R0 resection obtained in all specimens. Hospital
stay was regular in all patients and discharge was recommended starting
from the 4th postoperative day. No major postoperative complications
or reoperations occurred.
Reconstruction of the digestive tract after total gastrectomy is one of
the main areas of surgical research in the treatment of gastric cancer and
in the field of minimally invasive surgery.
The double-loop method is a valid simplification of the traditional
technique of construction of the Roux-limb that could increase the
feasibility and safety in performing a full hand-sewn intracorporeal
reconstruction and it appears to fit the characteristics of the robotic
system thus obtaining excellent postoperative clinical outcome
Compositional and microstructural characterization of Celtic silver coins from northern Italy using neutron diffraction analysis
Abstract The silver coinage of Celtic tribes settled in northern Italy (IV–I century B.C.) is a topic characterized by several issues, such as chronology, attributions and relationships between emissions produced in different periods. In order to provide numismatists with new data, several specimens, belonging to different typologies, have been analysed with neutron diffraction technique to overcome surface alteration and to provide bulky compositional and structural information of the coins. Measurements performed with the INES diffractometer at the ISIS facility provided essential data for numismatics research. A clear silver debasement occurring between the first and latter emissions has been traced, due to inflation processes which can be related with the increasing power of Roman Republic in the Cisalpine region. Moreover, compositional data enabled for the first time to identify internal evolutions inside typologies defined by numismatists. The silver loss has also been used to establish a relative chronology between different emissions. Other parameters such as texture index, residual strains and grain dimensions have been useful to understand technical aspects of minting procedures during Iron Age
A targeted approach to genetic counseling in breast cancer patients: the experience of an Italian local project.
Aims and backgroundPatients with hereditary breast cancer (BC) may benefit from genetic counseling and testing for detection of causative mutations, definition of therapeutic and preventive strategies, and identification of at-risk relatives. Italy has few oncogenetic centers and genetic evaluation of all patients with BC is not feasible. Moreover, lack of uniformity in the selection of patients generates inappropriate referral to the geneticist. We designed a model that may represent a reproducible way to select patients at risk for hereditary BC, with the aims of rationalizing access to genetic centers and improving clinical management and surveillance.MethodsThe genetic unit of a Cancer Center and the Departments of Oncology from 2 public Hospitals in Milan were involved in the project. After training sessions at the genetic unit, operators from the 2 hospitals evaluated all patients with BC attending a first oncologic visit, through a specific interview. Patients considered at risk of hereditary BC at..
X-ray tomography of large wooden artworks: The case study of "Doppio corpo" by Pietro Piffetti
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Sensitivity and specificity of in vivo COVID-19 screening by detection dogs: Results of the C19-Screendog multicenter study
Trained dogs can recognize the volatile organic compounds contained in biological samples of
patients with COVID-19 infection. We assessed the sensitivity and specificity of in vivo SARS-CoV-
2 screening by trained dogs.
We recruited five dog-handler dyads. In the operant conditioning phase, the dogs were taught to
distinguish between positive and negative sweat samples collected from volunteers’ underarms in
polymeric tubes. The conditioning was validated by tests involving 16 positive and 48 negative
samples held or worn in such a way that the samples were invisible to the dog and handler. In the
screening phase the dogs were led by their handlers to a drive-through facility for in vivo screening
of volunteers who had just received a nasopharyngeal swab from nursing staff. Each volunteer who
had already swabbed was subsequently tested by two dogs, whose responses were recorded as
positive, negative, or inconclusive. The dogs’ behavior was constantly monitored for attentiveness
and wellbeing.
All the dogs passed the conditioning phase, their responses showing a sensitivity of 83-100% and a
specificity of 94-100%. The in vivo screening phase involved 1251 subjects, of whom 205 had a
COVID-19 positive swab and two dogs per each subject to be screened. Screeningsensitivity and
specificity were respectively 91.6-97.6% and 96.3-100% when only one dog was involved, whereas
combined screening by two dogs provided a higher sensitivity. Dog wellbeing was also analysed:
monitoring of stress and fatigue suggested that the screening activity did not adversely impact the
dogs’ wellbeing. This work, by screening a large number of subjects, strengthen recent findings that
trained dogs can discriminate between COVID-19 infected and healthy human subjects and introduce
two novel research aspects: i) assessement of signs of fatigue and stress in dogs during training and
testing, and ii) combining screening by two dogs to improve detection sensitivity and specificity.
Using some precautions to reduce the risk of infection and spillover, in vivo COVID-19 screening by
a dog-handler dyad can be suitable to quickly screen large numbers of people: it is rapid, non-
invasiveand economical, since it does not involve actual sampling, lab resources or waste
management, and is suitable to screen large numbers of people
Prescription appropriateness of anti-diabetes drugs in elderly patients hospitalized in a clinical setting: evidence from the REPOSI Register
Diabetes is an increasing global health burden with the highest prevalence (24.0%) observed in elderly people. Older diabetic adults have a greater risk of hospitalization and several geriatric syndromes than older nondiabetic adults. For these conditions, special care is required in prescribing therapies including anti- diabetes drugs. Aim of this study was to evaluate the appropriateness and the adherence to safety recommendations in the prescriptions of glucose-lowering drugs in hospitalized elderly patients with diabetes. Data for this cross-sectional study were obtained from the REgistro POliterapie-Società Italiana Medicina Interna (REPOSI) that collected clinical information on patients aged ≥ 65 years acutely admitted to Italian internal medicine and geriatric non-intensive care units (ICU) from 2010 up to 2019. Prescription appropriateness was assessed according to the 2019 AGS Beers Criteria and anti-diabetes drug data sheets.Among 5349 patients, 1624 (30.3%) had diagnosis of type 2 diabetes. At admission, 37.7% of diabetic patients received treatment with metformin, 37.3% insulin therapy, 16.4% sulfonylureas, and 11.4% glinides. Surprisingly, only 3.1% of diabetic patients were treated with new classes of anti- diabetes drugs. According to prescription criteria, at admission 15.4% of patients treated with metformin and 2.6% with sulfonylureas received inappropriately these treatments. At discharge, the inappropriateness of metformin therapy decreased (10.2%, P < 0.0001). According to Beers criteria, the inappropriate prescriptions of sulfonylureas raised to 29% both at admission and at discharge. This study shows a poor adherence to current guidelines on diabetes management in hospitalized elderly people with a high prevalence of inappropriate use of sulfonylureas according to the Beers criteria
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