Acute Hemorrhagic Edema of Infancy

Acute Hemorrhagic Edema of Infancy is a small vessel leucocytoclastic vasculitis affecting young infants. It is characterized by large, target-like, macular to purpuric plaques predominantly affecting the face, ear lobes and extremities. Non-pitting edema of the distal extremities and low-grade fever may also be present. Extra-cutaneous involvement is very rare. Although the lesions have a dramatic onset in a twenty-four to forty-eight hour period, usually the child has a non-toxic appearance. In most cases there are no changes in laboratory parameters. The cutaneous biopsy reveals an inflammatory perivascular infiltrate. It is a benign and auto-limited disease, with complete resolution within two to three weeks leaving no sequelae in the majority of cases. No recurrences are described. We report a case of a 42-day old girl admitted at our hospital with Acute Hemorrhagic Edema of Infancy.info:eu-repo/semantics/publishedVersio

CFD characterization of flow regimes inside open cell foam substrates

This is the author accepted manuscript. The final version is available from the publisher via the DOI in this record.In this work a combination of micro-CT, image-based modeling and CFD has been applied to investigate the pressure drop in open-cell foams. The analysis covers a range of flow regimes and is aimed at determining the effects of important morphological parameters on the pressure drop. The adoption of micro-CT technology along with detailed CFD modeling allows the investigation of phenomena occurring in real foam micro-structures. Moreover, by means of image processing tools, the geometry can be artificially modified in order to investigate the effects of mathematical transformation of the geometrical parameters of a real foam, one parameter at a time, e.g. varying pore size without affecting the porosity. Non-dimensional coefficients have been defined for the analysis of the results, with the purpose of describing the pressure drop as a function of the Reynolds number. The proposed formulation allows us to relate the permeability properties of an open-cell foam to its morphology alone, without any dependence on the properties of the fluid adopted or on the effective characteristic dimension of the foam micro-structure (pore or cell size). Comparison with experimental results available in the literature is also provided for one of the cases studied

O Hospital e o Adolescente Uma Visão Num Hospital Pediátrico

Com o objectivo de conhecer as opiniões e expectativas dos adolescentes acerca das condições de atendimento hospitalar, os autores aplicaram um auto-questionário, de resposta facultativa e anónima, aos utentes desse grupo etário em Março de 1995. Obtiveram-se 207 respostas no ambulatório e 33 no internamento; apenas 17% frequentavam a consulta pela primeira vez e, 26% utilizavam-na há mais de 5 anos; 64% dos inquiridos já tinham internamentos anteriores dos quais 78% neste hospital. Em caso de necessidade de internamento 59% preferia o hospital pediátrico e, 56,5% gostaria de uma consulta específica para o seu grupo etário. Quanto às condições de internamento 88,8% desejava ter apenas jovens da sua idade na enfermaria e, sublinham a importância da sua privacidade. Concluem pela necessidade de melhorar as condições de atendimento e internamento e promover a discussão sobre o funcionamento de unidades hospitalares para adolescentes

Atypical presentation of infantile hypertrophic pyloric stenosis

A estenose hipertrófica do piloro (EHP), no pequeno lactente, é uma causa conhecida de vómitos não biliosos que se apresenta habitualmente entre a terceira e sexta semana de vida. Com o desenvolvimento dos métodos de imagem a apresenta- ção clássica tornou-se rara. É apresentado o caso de um lactente de quatro meses internado por má progressão ponderal e vómitos intermitentes, não biliosos desde a segunda semana de vida. Apresentava alcalose metabólica hipoclorémica e excreção urinária de potássio elevada, o que levou a considerar outros diagnósticos, para além de EHP excluída aos dois meses por ecografia abdominal normal. Este caso relembra que embora rara, a EHP deve ser considerada em lactentes com mais de seis semanas de vida

Acute hemorragic edema of infancy

info:eu-repo/semantics/publishedVersio

Uniportal pure robotic-assisted thoracic surgery—technical aspects, tips and tricks

The uniportal access for robotic thoracic surgery presents itself as a natural evolution of minimally invasive thoracic surgery (MITS). It was developed by surgeons who pioneered the uniportal video-assisted thoracic surgery (U-VATS) in all its aspects following the same principles of a single incision by using robotic technology. The robotic surgery was initially started as a hybrid procedure with the use of thoracoscopic staplers by the assistant. However, due to the evolution of robotic modern platforms, the staplers can be nowadays controlled by the main surgeon from the console. The pure uniportal robotic-assisted thoracic surgery (U-RATS) is defined as the robotic thoracic surgery performed through a single intercostal (ic) incision, without rib spreading, using the robotic camera, robotic dissecting instruments and robotic staplers. There are presented the advantages, difficulties, the general aspects and specific considerations for U-RATS. For safety reasons, the authors recommend the transition from multiportal-RATS through biportal-RATS to U-RATS. The use of robotic dissection and staplers through a single incision and the rapid undocking with easy emergent conversion when needed (either to U-VATS or to thoracotomy) are safety advantages over multi-port RATS that cannot be overlooked, offering great comfort to the surgeon and quick and smooth recovery to the patient.info:eu-repo/semantics/publishedVersio

Dilution versus pollution in watercourses affected by acid mine drainage: a graphic model for the Iberian Pyrite Belt (SW Spain)

The aim of this study was to chemically characterize the water quality impacts of the 88 acid mine drainage (AMD) generating mines in the Spanish sector of the Iberian Pyrite Belt (IPB). This was necessary because the Water Framework Directive of the European Union and the hydrological plans of the Tinto, Odiel, and Piedras river basins require that water quality be improved enough to allow at least some of the rivers in the IPB to sustain healthy fish populations by 2027. The results indicate a clear decrease in metals, arsenic, and sulfate concentrations and increased pH between the AMD-sources and the river channels.info:eu-repo/semantics/publishedVersio

Geneshot: search engine for ranking genes from arbitrary text queries

The frequency by which genes are studied correlates with the prior knowledge accumulated about them. This leads to an imbalance in research attention where some genes are highly investigated while others are ignored. Geneshot is a search engine developed to illuminate this gap and to promote attention to the under-studied genome. Through a simple web interface, Geneshot enables researchers to enter arbitrary search terms, to receive ranked lists of genes relevant to the search terms. Returned ranked gene lists contain genes that were previously published in association with the search terms, as well as genes predicted to be associated with the terms based on data integration from multiple sources. The search results are presented with interactive visualizations. To predict gene function, Geneshot utilizes gene–gene similarity matrices from processed RNA-seq data, or from gene–gene co-occurrence data obtained from multiple sources. In addition, Geneshot can be used to analyze the novelty of gene sets and augment gene sets with additional relevant genes. The Geneshot web-server and API are freely and openly available from https://amp.pharm.mssm.edu/geneshot

A multicenter study on the appropriateness of hospitalization in obstetric wards: application of Obstetric Appropriateness Evaluation Protocol (Obstetric AEP)

The cross-sectional study has been based on the implementation of the Obstetric Appropriateness Evaluation Protocol (OAEP) in seven hospitals to determine inappropriate hospital admissions and days of stay. The outcomes were: inappropriateness of admission and "percentage of inappropriateness" for one hospitalization. A total number of 2196 clinical records were reviewed. The mean percentage of inappropriateness for hospitalization was 22%. The percentage of inappropriateness for the first 10 d of hospitalization peaked in correspondence of the fourth (42%). The logistic regression model on inappropriated admission reported that emergency admission was a protective factor (OR = 0.4) and to be hospitalized in wards with 6530 beds risk factor (OR = 5.12). The second linear model on "percentage of inappropriateness" showed that inappropriated admission and wards with 6530 beds increased the percentage (p < 0.001); whereas the admission in Teaching Hospitals was inversely associated (p < 0.001). The present study suggests that the percentage of inappropriate admission depends especially on the inappropriate admission and the large number of beds in obstetric wards. This probably indicates that management of big hospitals, which is very complex, needs improving the processes of support and coordination of health professionals. The OAEP tool seems to be an useful instrument for the decision-makers to monitor and manage the obstetric wards. \ua9 2014 Informa UK Ltd. All rights reserved

Disinvestment in healthcare: an overview of HTA agencies and organizations activities at European level

BACKGROUND: In an era of a growing economic pressure for all health systems, the interest for "disinvestment" in healthcare increased. In this context, evidence based approaches such as Health Technology Assessment (HTA) are needed both to invest and to disinvest in health technologies. In order to investigate the extent of application of HTA in this field, methodological projects/frameworks, case studies, dissemination initiatives on disinvestment released by HTA agencies and organizations located in Europe were searched. METHODS: In July 2015, the websites of HTA agencies and organizations belonging to the European network for HTA (EUnetHTA) and the International Network of Agencies for HTA (INAHTA) were accessed and searched through the use of the term "disinvestment". Retrieved deliverables were considered eligible if they reported methodological projects/frameworks, case studies and dissemination initiatives focused on disinvestment in healthcare. RESULTS: 62 HTA agencies/organizations were accessed and eight methodological projects/frameworks, one case study and one dissemination initiative were found starting from 2007. With respect to methodological projects/frameworks, two were delivered in Austria, one in Italy, two in Spain and three in U.K. As for the case study and the dissemination initiative, both came from U.K. The majority of deliverables were aimed at making an overview of existing disinvestment approaches and at identifying challenges in their introduction. CONCLUSIONS: Today, in a healthcare context characterized by resource scarcity and increasing service demand, "disinvestment" from low-value services and reinvestment in high-value ones is a key strategy that may be supported by HTA. The lack of evaluation of technologies in use, in particular at the end of their lifecycle, may be due to the scant availability of frameworks and guidelines for identification and assessment of obsolete technologies that was shown by our work. Although several projects were carried out in different countries, most remain constrained to the field of research. Disinvestment is a relatively new concept in HTA that could pose challenges also from a methodological point of view. To tackle these challenges, it is necessary to construct experiences at international level with the aim to develop new methodological approaches to produce and grow evidence on disinvestment policies and practices