Single port laparoscopic appendectomy: are we pursuing real advantages?

Single port appendectomy, due to its cosmetic appeal and to a technique similar to classic laparoscopic appendectomy, is provoking an increasing number of publications and case series to explore its feasibility and effective improvements for patients with acute appendicitis. The margins for improvement are not so large, as laparoscopic appendectomy is, after 20 years from its beginning, still debated. A literature search has been accomplished to investigate the outcomes of the operation. 23 case series or retrospective comparisons with classic laparoscopy have been found. The numbers and low quality of the published data do not permit to draw evidence based conclusions. Still, trends seem to evidence an increase in complications especially in complicated appendicitis, which suggests caution in its dissemination outside clinical trials

Un codice arabo in caratteri ebraici dalla Trapani degli Abbate (Vat. ebr. 358)

The manuscript Vat. ebr. 358 contains the Arabic text written in Hebrew script of paragraphs VI-X of the first part of the medical encyclopedia Kitāb kāmil al-ṣinā ͑a al-ṭibbiyya (‘The perfect book of the medical art’). The work was composed before 367/977-978 by ͑Alī ibn al- ͑Abbās al-Majūsī (d. 384/994 [?]). This article claims the place of production of the manuscript to be Trapani (Ṭrābaniš) in Sicily. The city is explicitly mentioned in the colophon that was copied on Adar 26, 5053 (March 13, 1293). This article expands our knowledge of the circulation of Arab medical science among Sicilian Jews (13-15th c.).El manuscrito Vat. ebr. 358 contiene el texto árabe escrito en caracteres hebreos de los apartados VI-X de la primera parte del Kitāb kāmil al-ṣinā ͑a al-ṭibbiyya (‘El libro perfecto del arte medico’). Esta última es la enciclopedia médica compuesta antes de 367/977-978 por ͑Alī ibn al- ͑Abbās al-Majūsī (m. 384/994 [?]). En el presente artículo se apunta, por primera vez, al lugar de producción del manuscrito, Trapani (Ṭrābaniš) en Sicilia. La ciudad aparece mencionada explícitamente en el colofón del manuscrito copiado el 26 de adar 5053 (13 de marzo 1293). Con este artículo se pretende contribuir al estudio de la circulación del conocimiento médico árabe entre los judíos sicilianos durante los siglos XII a XV

Influence of Constriction, Wall Tension, Smooth Muscle Activation and Cellular Deformation on Rat Resistance Artery Vasodilator Reactivity

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Rilevazione statistica della diffusione e della conoscenza di sostanze dopanti, integratori e dell' Exercise Addiction

I benefici derivanti dalla pratica dell'esercizio fisico sono stati ampiamente documentati. Tuttavia, l’eccessivo ricorso alla attività fisica può condurre alla messa in atto di pattern compulsivi di allenamento che possono evolversi in una vera e propria patologia: l' exercise addiction. Studi recenti suggeriscono l'espansione di due fenomeni: il doping amatoriale e l'abuso di integratori per lo sport. Sono stati somministrati 686 test. I partecipanti allo studio sono stati scelti tra studenti di scuola media superiore, studenti universitari e frequentatori di ambienti sportivi. Il 42,5% degli intervistati dichiara di assumere sostanze per migliorare le prestazioni sportive e quindi di doparsi. Il 30,23% assume integratori. Una percentuale compresa tra il 35 e l'88,35 % dichiara di non conoscere le sostanze proposte.Il 15,8% dei rispondenti è a “rischio” di exercise addiction, il 71,7% è classificato come “sintomatico”. E' stata infine indagata quale possibile correlazione potesse esserci tra le variabili in esame. La statistica test X2 evidenzia che non vi è alcuna associazione , in altre parole non sembra esserci relazione tra il rischio di dipendenza dall' esercizio fisico e l'assunzione di sostanze. L'analisi dei dati raccolti suggerisce invece che vi sia un'espansione del fenomeno del doping in ambiente amatoriale e che vi sia una scriteriata e incongrua assunzione di integratori per lo sport. La presente ricerca suggerisce che occorre compiere interventi immediati sia a livello di informazione che di prevenzione , in cui al farmacista sia affidato un ruolo di primo piano

Del árabe al hebreo. El nacimiento de la ginecología hebrea medieval y el Canon de la medicina de Ibn Sīnā

The aim of this essay is to show that the Zikhron ha-ḥolayim ha-hovim be-klei ha-herayon (An account of the diseases of the organs of pregnancy) –a short Hebrew treatise on the conditions of male and female sexual organs, written in Castile at the turn of the 12th century– is an epitome of funūn 20 and 21 of Book III from Ibn Sīnā’s Canon of Medicine, drawn directly from Arabic some decades prior to the first known Hebrew translation. With this in mind, the only manuscript copy from the Hebrew treatise so far identified and several Hebrew and Latin witnesses of the Canon have been collated. Moreover, its production has been analyzed in the context of the movements of translation, appropriation and transmission of medical knowledge that occurred in multicultural and multilingual Castile between the 12th and the 14th centuries. The essay also examines the position of the Zikhron within the Hebrew corpus of literature on women’s health care, as well as its late circulation in the 15th century, prompted by the new interest on gynaecology shown by male medical authors and their audiences.Este artículo pretende demostrar que el Zijrón ha-ḥolayim ha-hovim be-klé ha-herayón (Memoria de las enfermedades que afectan a los órganos de la reproducción) –un breve tratado anónimo dedicado a las enfermedades de los órganos genitales de hombres y mujeres, escrito en hebreo en Castilla a fines del siglo xii o principios del XIII– es un epítome de los funūn 20 y 21 del Libro III del Canon de la medicina de Ibn Sīnā, realizado directamente desde la lengua árabe varias décadas antes de su primera traducción conocida al hebreo. Para ello se ha llevado a cabo el cotejo preliminar del único manuscrito en que se conserva el tratado y varios testigos en hebreo y latín del Canon, y se ha analizado su producción en el contexto de los movimientos de traducción, apropiación y difusión de conocimiento médico de la Castilla multicultural y plurilingüe de los siglos XII al XIV. También se ha examinado el lugar que ocupa el Zijrón en el corpus hebreo dedicado al cuidado de la salud femenina, y se ha indagado sobre su difusión en el siglo XV, en el marco del nuevo interés que despertó la ginecología entre los autores y consumidores de literatura médica de la Europa bajomedieval

Sensitivity and specificity of mastoid vibration test in detection of effects of vestibular neuritis [Sensibilità e specificità del test della vibrazione mastoidea nella individuazione degli esiti della neurite vestibolare]

Aim of this study was to determine sensitivity and specificity of the mastoid vibration test in patients who had suffered an attack of vestibular neuritis. Results were compared with the caloric test and two bedside tests of vestibular function (head shaking test and head thrust test). Results are reported in 28 patients who had a residual vestibular deficit 6 months after acute neuritis and in 25 healthy subjects. Mastoid vibration nystagmus was evoked in 21 patients but not in controls. In these patients, mastoid vibration test had a sensitivity of 75% and specificity of 100%. Since one patient had inverted mastoid vibration nystagmus, specificity of identification on the pathological side was 95%. Sensitivity of the test increased with increasing severity of the vestibular lesion. Indeed, mastoid vibration nystagmus was induced in 93% of patients with caloric paralysis and in 58% of those with caloric paresis. Nystagmus could usually be modulated or elicited by stimulation of either mastoid. In the few patients in whom mastoid vibration nystagmus was elicited only from one side, or when there was a clear difference in intensity of the nystagmus induced on the two sides, the stimulated side was more often the affected side. Four patients still showed spontaneous nystagmus. The caloric test was abnormal in 26/28 patients (93%) with paralysis in 16 and paresis in 12; 71% of patients had a head shaking induced nystagmus: 64% had an asymmetrical response in head thrust test. In conclusion, mastoid vibration test was overall more sensitive than head thrust test. Mastoid vibration test was slightly less sensitive than head shaking test in patients with severe residual deficit and more sensitive in patients with partial deficit. Mastoid vibration test, a valid, low cost clinical screening test for rapid detection of asymmetrical vestibular function, does not cause patient discomfort. It is suggested that this test be included in the diagnostic workup of all patients with suspected vestibular dysfunction

Aspirin causes endothelium-dependent vasodilation of resistance arteries from non-gravid and gravid rats

Abstract Objective The objective of this study was to understand the effect of acetylsalicylic acid (aspirin) on resistance arteries from mesentery and uterus. During pregnancy, the uterine vasculature undergoes consistent growth to provide sufficient uteroplacental blood flow, a process whose failure is associated with pregnancy complications characterized by high uterine vascular resistance. Methods Uterine arcuate (UA) and mesenteric arteries (MA; diameter Results Aspirin dilated both UA and MA in a dose dependent manner. Pregnancy increased aspirin vasodilation in MA and UA from mid-gravid rats, an effect that was reduced in vessels from late gravid animals at concentrations >10−7 M. Further, uterine vasodilation was significantly reduced when the endothelium was removed (p  Conclusion This is the first study to show a direct vasodilatory effect of aspirin on rat uterine artery that is mediated by a combination of cellular – primarily endothelial - mechanisms. Our results in UA suggest that the use of aspirin may be effective in enhancing uteroplacental blood flow, while its vasodilation effect on MA may lower peripheral resistance

Bartolomeo e Giuseppe Lagumina e gli studi storici e orientali in Sicilia fra Otto e Novecento

[Italiano]: L’orientalismo siciliano, così come quello spagnolo, rappresenta una significativa eccezione che scardina i paradigmi proposti da Edward Said centrati soprattutto sull’esperienza franco-britannica del XIX sec., un’esperienza fortemente segnata dalla fascinazione, o dalla repulsione, per l’alterità e l’esotico. Già a partire dal XVI sec. l’interesse riguardo gli studi orientali in Sicilia dimostra inequivocabilmente che esiste una diversa e concreta esperienza europea all’interno della quale s’immaginano la presenza arabo-islamica ed ebraica come componenti, a volte problematiche, della propria storia nazionale. Il volume intende mettere a fuoco il clima culturale della Palermo fra Otto e Novecento, maturato sull’onda lunga degli interessi per il mondo arabo e orientale aperti dall’opera di Michele Amari (1806-1889). Centro della riflessione è la vita e l’opera di Bartolomeo Lagumina (1850-1931), personaggio emblematico, la cui produzione scientifica si dispiega in un periodo della storia dell’orientalismo italiano dominato dalle figure di Ignazio Guidi (1844-1935) e Carlo Alfonso Nallino (1872-1938), studiosi dalla forte personalità scientifica, con i quali Lagumina ebbe rapporti oscillanti fra il riconoscimento e la negazione. Ispettore del Museo Nazionale di Palermo, docente di ebraico e poi di arabo, prima presso il Seminario e poi all’Università di Palermo, ma anche canonico della Cattedrale di Palermo e infine vescovo di Agrigento, Bartolomeo Lagumina è un trait d’union tra ambienti culturali differenti, lontani e spesso opposti. La sua attività scientifica tocca ambiti distinti, dall’epigrafia e la numismatica arabo-sicule allo studio di importanti testi arabi ed ebraici (il Codice Martiniano dell’abate Vella, la Cronaca di Cambridge, il Libro della Palma di Abū Ḥātim al-Sijistānī, le lettere di r. ‘Ovadya da Bertinoro), giungendo fino al riordino delle principali collezioni orientali palermitane (il medagliere della Biblioteca Comunale e il catalogo dei codici orientali della Biblioteca Nazionale di Palermo). Insieme al fratello Giuseppe (1855-1931), Bartolomeo Lagumina crea il Codice diplomatico dei Giudei di Sicilia, uno strumento di lavoro, a lungo indispensabile, che raccoglie oltre mille documenti relativi alla storia delle comunità ebraiche di Sicilia, da Gregorio Magno fino all’espulsione del 1492-93. Il suo impegno culturale non coinvolge direttamente soltanto la città di Palermo ma anche Agrigento, dove Bartolomeo ebbe poi modo di curare il restauro della Cattedrale e il riordino delle collezioni diocesane al tempo del suo vescovato. Oltre a delineare la temperie di un’epoca il volume intende proporre un bilancio dell’attività scientifica di Bartolomeo e Giuseppe Lagumina, attualizzando e discutendo al contempo i frutti del loro lavoro ./[English]: Sicilian Orientalism, like the Spanish one, constitutes a significant exception to the paradigms proposed by Edward Said, which have been primarily based on the Franco-British experience of the nineteenth century, an experience strongly characterized by the fascination, or repulsion, for the otherness and the exotic. The interest aroused by Oriental studies in Sicily as early as the sixteenth century unequivocally demonstrates the existence in Europe of a different, concrete experience, which construes the Arab-Islamic and Jewish presence as an integral, and sometimes problematic, component of national history. This book focuses on the cultural climate in Nineteenth and Twentieth century Palermo, in the long wave of the interest in the Arab and Oriental world created by the work of Michele Amari (1806-1889). The discussion is centered on the life and work of Bartolomeo Lagumina (1850-1931), an emblematic character, whose scientific production unfolds in a period of the Italian Orientalism dominated by the figures of Ignazio Guidi (1844-1935) and Carlo Alfonso Nallino (1872-1938), scholars with a strong scientific personality, and toward whom Lagumina had a relationship wavering between respect and lack of recognition. Bartolomeo Lagumina, who was inspector of the Museo Nazionale of Palermo, professor of Hebrew and then of Arabic, first at the Palermo Seminary and then at the University of Palermo, and also canon of the Cathedral of Palermo and finally Bishop of Agrigento, has been a trait d’union between different, distant and often opposite cultural environments.He was scientifically active in several areas, from Arabic-Sicilian epigraphy and numismatics to the study of important Arabic and Hebrew texts (abbot Vella’s Codex Martinianus, the Cambridge Chronicle, the Book of the Palm by Abū Ḥātim al-Sijistānī, the letters of r. ‘Ovadya of Bertinoro), to the reorganisation of the main oriental collections of Palermo (the numismatic collection of the Biblioteca Comunale and the catalog of the oriental codices of the Biblioteca Nazionale of Palermo). Together with his brother Giuseppe (1855-1931), Bartolomeo Lagumina created the Codice diplomatico dei Giudei di Sicilia, a long-indispensable work that collects over a thousand documents about the history of the Jewish communities in Sicily, from Saint Gregory the Great to the expulsion of 1492-93. His cultural activity directly involved not only the city of Palermo but also Agrigento, where Bartolomeo as bishop oversaw the restoration of the Cathedral and the reorganization of the diocesan collections. In addition to outlining the climate of an era, this book will make a balanced assessment of the scientific activity of Bartolomeo and Giuseppe Lagumina, updating and discussing the results of their work

Resorbable Mesh Cranioplasty Repair of Bilateral Cerebrospinal Fluid Leaks Following Pediatric Simultaneous Bilateral Auditory Brainstem Implant Surgery

OBJECTIVE: To present a child with cochlear nerve deficiency (CND) who received simultaneous bilateral simultaneous auditory brainstem implants (BS-ABI) and subsequently presented with bilateral cerebrospinal fluid (CSF) leaks unresponsive to standard treatments. To propose a novel rigid retrosigmoid cranioplasty for treating and preventing CSF leaks in children at high risk for this complication. PATIENT: A 3.5-year-old child with CND, vertebral defects, anal atresia, cardiac defects, tracheo-esophageal fistula, renal anomalies, and limb abnormalities, coloboma, heart defect, atresia choanae, retarded growth and development, genital abnormality, and ear abnormality, Arnold Chiari malformation, previous treated tracheo-esophageal fistula underwent BS-ABI. Postoperatively, the child had recurrent bilateral retroauricular fluid collections. A standard revision procedure revealed breaches in the dural closure, migration of the auditory brainstem implantation (ABI) receiver stimulator on both sides and was unsuccessful in stopping the leak. INTERVENTIONS: Bilateral repair with free fat grafting filling the craniectomy space and two absorbable meshes of poly-L-D-lactic (PLDL) acid stabilized with PLDL pins on the surrounding cranium, one to stabilize the fat graft and one to fix the ABI receiver stimulators inside the subperiosteal pockets. MAIN OUTCOME MEASURE: CSF leak recurrence, postoperative computed tomographic (CT) scans, intra- and postoperative simultaneous electrically evoked auditory brainstem responses (EABRs). Subjective and objective assessment of ABI function. RESULTS: No postoperative CSF leaks at 60 days follow-up. EABRs and consistent behavioral responses obtained at initial mapping on both sides. CONCLUSIONS: The use of BS-ABI likely contributed to bilateral CSF leaks requiring revision surgeries in this child. Simultaneous bilateral craniotomies can put patients at risk for CSF leak. A novel cranioplasty technique employed finally proved successful in stopping the CSF leak in this case