Acute Dacryocystitis with Empyema of the Lacrimal Sac: Is Immediate Endoscopic Dacryocystorhinostomy Justified?

Objectives. To evaluate the efficacy of endoscopic dacryocystorhinostomy (Endo-DCR) in the treatment of acute dacryocystitis with lacrimal sac empyema (ADLSE). Design. Case series with chart review. Setting. Academic tertiary center. Patients. The study included 26 consecutive patients who underwent Endo-DCR for ADLSE between August 2005 and December 2013. Main Outcome Measures. The success of the procedure was defined as complete complaint relief and DCR patency. Data on the time from referral to surgery, postoperative complications, and revision surgery are also reported. Results. The present patient series included 4 males (15.4%) and 22 females (84.6%) (mean age, 66 years). The mean time between referral and surgery was 0.88 days and the mean follow-up time was 29 months. All patients showed immediate relief from symptoms, with no ADLSE recurrences. Complete success was achieved in 25 (96.2%) cases; the only failure was in a patient who had previously undergone radioiodine treatment. In this case, revision Endo-DCR was not successful. The only perioperative complication (3.8%) was epistaxis in a patient who required revision surgery under general anesthesia. The definitive success rate was 96.2% after primary and revision surgery. Conclusions. Endo-DCR enables rapid resolution of ADLSE with a very high success rate. Immediate surgery may reduce the risk of skin fistulization and/or orbital complications. DCR shrinkage and lacrimal obstruction are unlikely with Endo-DCR since the procedure is performed on an enlarged sac. The main advantage of Endo-DCR, compared with external DCR, is the absence of a skin incision in an inflamed and infected field

Dataflow/Actor-Oriented language for the design of complex signal processing systems

International audienceSignal processing algorithms become more and more complex and the algorithm architecture adaptation and design processes cannot any longer rely only on the intuition of the designers to build efficient systems. Specific tools and methods are needed to cope with the increasing complexity of both algorithms and platforms. This paper presents a new framework which allows the specification, design, simulation and implementation of a system operating at a higher level of abstraction compared to current approaches. The framework is base on the usage of a new actor/dataflow oriented language called CAL. Such language has been specifically designed for modelling complex signal processing systems. CAL data flow models expose the intrinsic concurrency of the algorithms by employing the notions of actor programming and dataflow. Concurrency and parallelism are very important aspects of embedded system design as we enter in the multicore era. The design framework is composed by a simulation platform and by Cal2C and CAL2HDL code generators. This paper described in details the principles on which such code generators are based and shows how efficient software (C) and hardware (VHDL and Verilog) code can be generated by appropriate CAL models. Results on a real design case, a MPEG-4 Simple Profile decoder, show that systems obtained with the hardware code generator outperform the hand written VHDL version both in terms of performance and resource usage. Concerning the C code generator results, the results show that the synthesized C-software mapped on a SystemC scheduler platform, is much faster than the simulated CAL dataflow program and approaches handwritten C versions

A 3-dimensional transnasal endoscopic journey through the paranasal sinuses and adjacent skull base: a practical and surgery-oriented perspective

An endoscopic approach through the transnasal corridor is currently the treatment of choice in the management of benign sinonasal tumors, cerebrospinal fluid leaks, and pituitary lesions. Moreover, this approach can be considered a valid option in the management of selected sinonasal malignancies extending to the skull base, midline meningiomas, parasellar lesions such as craniopharyngioma and Rathke cleft cyst, and clival lesions such as chordoma and ecchordosis. Over the past decade, strict cooperation between otorhinolaryngologists and neurosurgeons and acquired surgical skills, together with high-definition cameras, dedicated instrumentation, and navigation systems, have made it possible to broaden the indications of endoscopic surgery. Despite these improvements, depth perception, as provided by the use of a microscope, was still lacking with this technology. The aim of the present project is to reveal new perspectives in the endoscopic perception of the sinonasal complex and skull base thanks to 3-dimensional endoscopes, which are well suited to access and explore the endonasal corridor. In the anatomic dissection herein, this innovative device came across with sophisticated and long-established fresh cadaver preparation provided by one of the most prestigious universities of Europe. The final product is a 3-dimensional journey starting from the nasal cavity, reaching the anterior, middle, and posterior cranial fossae, passing through the ethmoidal complex, paranasal sinuses, and skull base. Anatomic landmarks, critical areas, and tips and tricks to safely dissect delicate anatomic structures are addressed through audio comments, figures, and their captions

Ricerca del migliore compromesso delle caratteristiche meccaniche degli acciai per utensili a caldo dopo bonifica. Comportamento della tenacità per effetto dei tempi prolungati alle temperature di nitrurazione

La bonifica degli acciai per utensili a caldo rende stabile il comportamento termomeccanico dovuto allo stressa cui sono sottoposti i componenti per pressocolata o stampaggio a caldo. L’interesse di questo studio è rivoltoa tutti i margini di miglioramento industrialmente applicabili tramite trattamento termico per ottenere unaresa ed una performance che rispettino le attese anche a fronte di differenti stati di fornitura del materiale.Utensili e stampi, dopo trattamento termico e finitura, sono spesso nitrurati. Indipendentemente dal metodo, lanitrurazione sottopone il pezzo a temperature site nell’intervallo della fragilità da rinvenimento con più lunghepermanenze. L’indagine è stata anche condotta con lo scopo di verificare in che modo ed in quale misura siainfluenzata la tenacità di un materiale bonificato con durezza e resilienza caratteristiche di uno stampo dipressocolata simulando la tipica temperatura e i tempi adottati per la nitrurazion

Adherence to the Mediterranean Diet: Impact of Geographical Location of the Observations

The Mediterranean diet has emerged as a comprehensive lifestyle, including specific foods and meal composition and a set of behavioural and social features. Adherence to the Mediterranean diet has been shown to promote health and reduce the prevalence of chronic diseases. The actual implementation of the Mediterranean diet is affected by several sociocultural factors as well as geographical components. Indeed, the geographical location, such as a specific country or different areas in a country and specific latitude and climate, appears to be an important factor that may strongly affect the implementation of the Mediterranean diet or some of its principles as well as the adherence to it. Another dynamic component affecting personal nutritional choices, also regarding adherence to the Mediterranean diet and its principles, is the individual life-long trajectory of food preference and nutrition habits and awareness. In this review, we discuss the current evidence on the impact of geographical location on adherence to the Mediterranean diet

A System-on-a-chip for Multimedia Stream Processing and Communication

SCI-STI-M