Progettazione di un laboratorio EMC pre-compliance per controlli elettronici

Questa tesi si pone lo scopo di progettare un laboratorio di misure e prove EMC pre-compliance per controlli elettronici, considerando: normative vigenti, caratteristiche dei prodotti, esigenze aziendali, strumentazione, spazio disponibile/necessario, rumore di fondo, impianto elettrico, mobilio. In appendice ci sono le guide riassuntive alle prove EMC prese in esameope

L’inconsistenza della diagnosi di cancro duttale in situ

Background: Classifying ductal carcinoma in situ (DCIS) remains problematical for interpretation of specified histological features and field selection where morphology is heterogeneous. Emphasis is placed on the role of intraductal proliferative lesions as risk factors of variable magnitude in subsequent development of invasive breast carcinoma. The present study is designed to investigate the relative contribution of diagnostic and treatment paradigms on the lack of consistency in the analysis of these lesions. Materials and methods: A cohort of in situ lesions of the breast was reviewed according to ductal intraepithelial neoplasia (DIN) classification adopted by the World Health Organization (WHO). In this retrospective study 458 patients with DIN diagnosed by core needle biopsy had undergone conservative or radical surgical treatment and SLNB in cases of DIN1C-DIN3. Results: Breast conservative surgery was the definitive treatment in 80% of cases. All the SLNs sampled showed 1.2 % (4/336) positivity of metastatic or micrometastatic nodal involvement by H&E stain while the IHC assessment for cytokeratin showed 4.5% (15/336) positivity. Conclusions: The widely recognised variation in the growth pattern of DCIS makes difficult to identify uniform indications for clinical procedure. Although the incidence of metastases in patient with initial diagnosis of DIN is considered to be low, SLNB remains an attractive option to guarantee oncological safety. In patients at high risk occult invasion does occur and without lymphatic analysis, undertreatment is possible

How future surgery will benefit from SARS-COV-2-related measures: a SPIGC survey conveying the perspective of Italian surgeons

COVID-19 negatively affected surgical activity, but the potential benefits resulting from adopted measures remain unclear. The aim of this study was to evaluate the change in surgical activity and potential benefit from COVID-19 measures in perspective of Italian surgeons on behalf of SPIGC. A nationwide online survey on surgical practice before, during, and after COVID-19 pandemic was conducted in March-April 2022 (NCT:05323851). Effects of COVID-19 hospital-related measures on surgical patients' management and personal professional development across surgical specialties were explored. Data on demographics, pre-operative/peri-operative/post-operative management, and professional development were collected. Outcomes were matched with the corresponding volume. Four hundred and seventy-three respondents were included in final analysis across 14 surgical specialties. Since SARS-CoV-2 pandemic, application of telematic consultations (4.1% vs. 21.6%; p < 0.0001) and diagnostic evaluations (16.4% vs. 42.2%; p < 0.0001) increased. Elective surgical activities significantly reduced and surgeons opted more frequently for conservative management with a possible indication for elective (26.3% vs. 35.7%; p < 0.0001) or urgent (20.4% vs. 38.5%; p < 0.0001) surgery. All new COVID-related measures are perceived to be maintained in the future. Surgeons' personal education online increased from 12.6% (pre-COVID) to 86.6% (post-COVID; p < 0.0001). Online educational activities are considered a beneficial effect from COVID pandemic (56.4%). COVID-19 had a great impact on surgical specialties, with significant reduction of operation volume. However, some forced changes turned out to be benefits. Isolation measures pushed the use of telemedicine and telemetric devices for outpatient practice and favored communication for educational purposes and surgeon-patient/family communication. From the Italian surgeons' perspective, COVID-related measures will continue to influence future surgical clinical practice

Progettazione di un laboratorio EMC pre-compliance per controlli elettronici

Questa tesi si pone lo scopo di progettare un laboratorio di misure e prove EMC pre-compliance per controlli elettronici, considerando: normative vigenti, caratteristiche dei prodotti, esigenze aziendali, strumentazione, spazio disponibile/necessario, rumore di fondo, impianto elettrico, mobilio. In appendice ci sono le guide riassuntive alle prove EMC prese in esam

Isoniazid-induced Takayasu arteritis remission

A 75-year-old man was admitted because of fever, unproductive cough, neck pain and upper limb claudication. The patient was febrile and hypotensive, and a cardiac systolic ejection murmur was heard. Blood tests showed normochromic anemia, elevated erythrocyte sedimentation rate, C-reactive protein, fibrinogen, and alpha-2 and beta-2 globulins. In order to investigate neck pain, an ultrasound examination of the carotid arteries was performed which showed a carotid intima-media thickness reaching the maximum value of 2.3 mm in both carotid arteries. Ultrasound examination of the temporal artery and its rami demonstrated wall thickening, both in the common superficial temporal artery and its frontal and parietal rami. A temporal artery biopsy was performed and was consistent with Takayasu arteritis. A positive interferon-\u3b3 release assay revealed latent tuberculosis infection and isoniazid 300 mg every 24 hours was commenced. Neither corticosteroids nor other drugs were prescribed at that time. Two weeks later, ultrasound examination showed a significant reduction in the thickening of all investigated arteries. To our knowledge, this is the first case of isoniazid-induced Takayasu arteritis remission. We believe that isoniazid deserves further investigation regarding its potential immunomodulatory properties

Laparoscopic sleeve gastrectomy for morbid obesity and Klinefelter syndrome: clinical report on two patients, with long-term follow-up

Klinefelter syndrome (KS) can appear as a wide spectrum of clinical manifestations, with no guidelines for appropriate treatment. We present the first study of bariatric surgery (BS) with a 48-month follow-up, for the management of two patients affected by obesity and KS

Comparative study of oncoplastic versus non-oncoplastic breast conserving surgery in a group of 211 breast cancer patients

Breast conserving surgery (BCS) followed by radiotherapy is the standard of care for most patients with early breast cancers; however, the aesthetic outcomes of this procedure is not always desirable. Oncoplastic breast surgery is an innovative approach that aims at the safe and effective treatment of the cancerous lesion while achieving the best possible aesthetic outcome. The aim of this study was to evaluate and compare oncoplastic and non-oncoplastic procedures

A 25-Year-Old Woman With Long-Lasting Abdominal Pain and Spleen Abscess

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Contrast-Enhanced Mammography-Guided Biopsy: Preliminary Results of a Single-Center Retrospective Experience

Background: CEM-guided breast biopsy is an advanced diagnostic procedure that takes advantage of the ability of CEM to enhance suspicious breast lesions. The aim pf this paper is to describe a single-center retrospective experience on CEM-guided breast biopsy in terms of procedural features and histological outcomes. Methods: 69 patients underwent the procedure. Patient age, breast density, presentation, dimensions, and lesion target enhancement were recorded. All the biopsy procedures were performed using a 7- or 10-gauge (G) vacuum-assisted biopsy needle. The procedural approach (horizontal or vertical) and the decubitus of the patient (lateral or in a sitting position) were noted. Results: A total of 69 patients underwent a CEM-guided biopsy. Suspicious lesions presented as mass enhancement in 35% of cases and non-mass enhancement in 65% of cases. The median size of the target lesions was 20 mm. The median procedural time for each biopsy was 10 ± 4 min. The patients were placed in a lateral decubitus position in 52% of cases and seated in 48% of cases. The most common approach was horizontal (57%). The mean AGD was 14.8 mGy. At histology, cancer detection rate was 28% (20/71). Conclusions: CEM-guided biopsy was feasible, with high procedure success rates and high tolerance by the patients

Nodal status assessment in breast cancer: strategies of clinical grounds and quality of life implications

Even in the era of gene-expression profiling, the nodal status still remains the primary prognostic discriminant in breast cancer patients. The exclusion of node involvement using noninvasive methods could reduce the rate of axillary surgery, thereby preventing from suffering complications. However, lymphatic mapping with sentinel node biopsy (SNB) is one of the most interesting recent developments in surgical oncology. Optimization of procedure could be implemented by dual mapping injection site skills, resection of all hot or blue nodes through tracer combination, and improvement in atypical drainage patterns mapping. This anatomical analysis suggests safety measures in patients with high probability of node metastasis through a renewed interest in surgical management. The perspective of a guided axillary sampling (GAS) could represent a potential development of recent anatomical and functional acquisitions, offering a dynamic technique shared according to clinical and anatomical disease parameters. Furthermore, the surgical staging procedures may adopt a conservative approach through the evaluation of upper arm lymphatics, thus defining a functional model aimed at the reduction of short- and long-term adverse events. Quality results in breast cancer surgery need to generate oncological safety devoid of complications through renewed clinical experience