Climate change disclosures: An examination of Canadian oil and gas firms

The purpose of this paper is to examine: (1) to what extent Canadian oil and gas firms haveadhered to the Canadian Institute of Chartered Accountant proposed guidelines respecting climatechange disclosures in their annual reports, and (2) whether the disclosures of these firmscan be influenced by their media visibility, the presence and operating characteristics of an environmentalcommittee within the board of directors, their ownership structure, their auditfirms, their political exposure and media visibility. The results show that the level of disclosureis very low; however, when the board of directors has an environment committee, the level ofdisclosure is higher. This is also the case for firms having significant political exposure andstrong media visibility, and for those with a widely held ownership structure. Whether or notthe audit firm is one of the Big Four, does not make any difference in the level of disclosure. Copyright © www.iiste.or

The Use Of Selective Filtration Of Monocytes From Peripheral Blood In Patients With Vascular Ulcers Promotes Healing. A Pilot Study In A High Volume Vascular Surgery Centre

Introduction: Monocytes have a documented action to promote the healing of trophic lesions through the regenerative action of the transformation of M1 macrophages into M2 macrophages, with multilineage potential comparable to that of mesenchymal stem cells (MSC). Patients affected by peripheral artery disease in Rutherford 5 and 6 stage may be considered suitable. The monocytes can be harvested from peripheral venous blood and injected both in peri-arterial leg areas and in ulcerative lesions. Methods: From 2015 to 2018, 200 procedures were performed in our centre for obstructive arterial disease of the lower limbs, causing PAD. Twelve (12) patients were considered non-revascularisable (5.5%). This was a first therapeutic approach in 7/12 (58.3%), while it was proposed as a therapeutic alternative in patients already subjected to previous operations and / or revascularisation attempts in 5 (41.6%). Demographic and clinical features are collected. An informed consent was obtained in all patients. In 72.5% three or four cycles were performed. All patients followed post-operative medical therapies and adjuvant medications during the months following treatment. Results: Comorbidities included hypertension in 91%, CRC in 63%, dyslipidaemia in 90%, cardiopathy in 72%, COPD in 63%, diabetes in 20%, smoking in 55% (of which 50% ex-smokers) at median follow up of 18 months DS (+/- 7 months) the survival rate was 81.8% (ES 0,11) the limbs savage was 51.1% (ES 0,15). Amputation rate was respectively: minor 45.5% and major 9%. Considering minor amputation as a limb salvage, this percentage increased to 83.4%. Four deaths unrelated to therapy were observed. The pain with VAS score measurement varied from reduction in 36.3% to disappearance in 27.2%. Data regarding TCp02 has increased : a post-operative median level in the examined patients was 24.8 mmHg T2. Conclusion: The filtration procedure with mononuclear cells is safe and must be applied selectively. In high volume centres it is possible to evaluate candidate patients for this type of intervention. Additional procedures must be associated to complete the therapeutic procedure. Due to the increasing complexity and comorbidity of patients, careful selection is required; a multidisciplinary approach and accurate patient follow up is needed. Multicentre studies with multiple cases are needed to validate the Results

Pulmonary embolism: Successful treatment of floating thrombus in SFJ after vena cava filter insertion and surgical thrombectomy

The floating venous thrombus in the common femoral vein has a high potential risk for pulmonary embolization. Clinical treatments, using anticoagulants or fibrinolytic, open thrombectomies, or thrombectomies by endovascular devices have all been used. Our case describe an obese patient affected by floating thrombus coming from GSV and diving in comm

An unusual complication after endovascular aneurysm repair for giant abdominal aortic aneurysm with aortocaval fistula: High bilirubin levels

Abdominal aortic aneurysm has among its rare complications the aortocaval fistula. It is observed in less than 1% of all abdominal aortic aneurysms and represents 3%–7% of clinical presentation in case of rupture. A male patient was presented to the emergency department with pulsating mass with continuous vascular systo-diastolic bruit, located in the lower part of abdomen with the back pain radiating anteriorly in lower abdomen. After diagnosis of abdominal aortic aneurysm with aortocaval fistula, a trimodular Endurant endograft was placed. Migration of the endoprosthesis was treated with Endoanchor and endovascular aneurysm sealing device. In the postoperative course, the patient had jaundice due to high bilirubin levels, cholestasis and increased hepatocyte cytolysis: aspartate aminotransferase and alanine aminotransferase. The treatment with appropriate continuous filtration rapidly reduced bilirubin values and the patient gradually improved

C-peptide: a predictor of cardiovascular mortality in subjects with established atherosclerotic disease

Aim: Insulin resistance and type 2 diabetes are independent risk factors for cardiovascular diseases. Levels of C-peptide are increased in these patients and its role in the atherosclerosis progression was studied in vitro and in vivo over the past years. To evaluate the possible use of C-peptide as cardiovascular biomarkers, we designed an observational study in which we enrolled patients with mono- or poly-vascular atherosclerotic disease. Methods: We recruited 431 patients with stable atherosclerosis and performed a yearly follow-up to estimate the cardiovascular and total mortality and cardiovascular events. Results: We performed a mean follow-up of 56months on 268 patients. A multivariate Cox analysis showed that C-peptide significantly increased the risk of cardiovascular mortality [Hazard Ratio: 1.29 (95% confidence interval: 1.02-1.65, p<0.03513)] after adjustment for age, sex, diabetes treatment, estimated glomerular filtration rate and known diabetes status. Furthermore, levels of C-peptide were significantly correlated with metabolic parameters and atherogenic factors. Conclusion: C-peptide was associated with cardiovascular mortality independently of known diabetes status in a cohort of patients with chronic atherosclerotic disease. Future studies using C-peptide into a reclassification approach might be undertaken to consider its potential as a cardiovascular disease biomarker

Laparoscopic management of a giant hiatal hernia with gastric volvulus: a case report

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Cervical manipulation and cerebrovascular ischemia. A rare but dangerous association. Monocentric experience in a high CEA volume center and literature review.

Abstract Background: A correlation between stroke and cervical manipulation in the neck is reported in the literature with increasing frequency, and each new publication seems to rekindle the debate. The manipulations in the cervical region is potentially dangerous for arterial vessels. The aim of this work is to analyze the incidence of these events in the experience of a center with high volume surgery, in which emergency interventions are performed for acute cerebrovascular Ischemia. Methods: Data were collected regarding patients undergoing carotid endarterectomy surgery for neurological symptoms of cerebrovascular insufficiency over a seven-year period. Results: The intervention was conducted urgently in 66 cases for acute symptoms (7.6%) with a median symptom interval / CEA: 39.4 ± 5.4 h) in 32 cases for hemispheric transient ischemic attack, while in 34 for minor stroke. Only in 1 case (1.5%) did a condition of severe spondyloarthrosis of the cervical spine occur in acute carotid plaque in C4-C5. In another case (1.5%) a cervical trauma caused by beatings is documented. Conclusions: Manipulations of the neck and cervical spine can rarely cause or contribute to worsening neurological symptoms, however they should always be considered

Successful conversion strategy in patient submitted to EVAR demanding open surgery: comparative analysis 1997-2011 vs 2012-2020

: Late open conversion in our center has been reviewed in the past 8 years, comparing 1997-2011 (first period group A) with 2012-2020 (second period group B). A retrospective analysis of patients treated at our centre by standard EVAR for infrarenal aortic aneurysm requiring late open conversion between January 1997 and February 2020 was performed. All stent grafts were implanted according to their current IFU all patients. The data concerning intra and postoperative complications were collected. Post-operative evaluated data include: ICU (Intensive Care Unit) stay, major peri-operative (&lt;30 days) complications, in hospital mortality, length of hospital stay, 30-days mortality, and mid-term outcomes. Between January 2012 and February 2020 (group B), in our institution 8 patients previously treated by stent graft with endoleak underwent open surgery. The incidence of conversions and the 30-day mortality rate were compared with that of previous years, from January 1997 to December 2011 (group A). 481 patients submitted to EVAR in a second part of the analysis have been considered, 8 patients underwent late open conversion (1.7%) (Group B) due to endoleak. Among January 1997 and December 2011 overall 268 EVAR were performed; during this first study period, surgical conversion had been performed in 14 patients (5.2%) (Group A). The average time from EVAR to open conversion was four years (range 12-88 months) in Group B, and it was 30 months (range 1-82 months) in Group A. In most cases, in both group A and group B the proximal aortic cross-clamping were infrarenal. After the emergent procedure in Group B (12.5%), we have observed a death, whereas three patients died in Group A in urgent situations (21.4%). The more frequent indication for open surgery is the Endoleak type 1 and migration in the two considered periods. Adherence with current IFU and the technical progress in endoprosthesis design maintain lower rate incidence. In most cases, open surgery for prostheses that require explantation can be performed with infrarenal clamping. Partial removal of the endoprosthesis in selected cases makes open conversion easier and appears durable. The results are unfair by numerous comorbidities; in both periods, urgent graft removal seems to elevate both mortality and morbidity, compared to elective surgery

Conventional vs. extended D2 lymphadenectomy in gastric cancer patients: less is more?—more or less

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Chapter Sentinel-2 e campionamenti in situ per il monitoraggio delle acque marine dell’Abruzzo: primi risultati

In this study, the estimate of chlorophyll "a" and the dispersion of sediment in the sea, calculated from Sentinel-2, was compared with real data acquired in situ by a multiparametric probe, along the Abruzzo coast. The ultimate goal is to optimize parameters and algorithms to be able to derive concentration maps of chlorophyll and suspended solids from satellite, taking advantage of the high time frequency and high spatial resolution of the detections. This information is of particular relevance for aquaculture activities, for monitoring water quality and for analyzing sedimentary processes