Penetrating eye injuries at the workplace : case reports and discussion

We describe two recent cases of penetrating eye injury seen at Mater Dei Hospital, both resulting in a poor final outcome and illustrating the importance of wearing appropriate eye protection at the workplace. In case 1, injury was caused by a metal chip produced by a hammer and chisel that penetrated the sclera and lodged in the vitreous cavity, requiring vitrectomy and lens extraction and ultimately resulting in severe visual loss. In case 2, injury was caused by a shard released from an angle grinder disc that struck the orbit and caused severe disruption of the globe, which required enucleation. This is followed by a discussion on penetrating eye injuries, summarising the initial assessment and management of a suspected penetrating injury in the primary care setting and highlighting the need for urgent ophthalmic referral in cases where the nature of work was suggestive of high-speed projectiles, even where the trauma is seemingly trivial.peer-reviewe

A rare case of an idiopathic extraocular muscle abscess

Diplopia has a diverse range of ophthalmological, neurological, autoimmune, neoplastic and infectious causes. However it is very rare for an extraocular muscle abscess to occur. A skeletal muscle abscess usually occurs in the thigh and trunk muscles and is most commonly caused by Staphylococcus aureus.1 The purpose of this case report is to describe this condition we came across in our eye casualty department in a healthy teenager who presented with painful diplopia and this was due to a lateral rectus muscle abscess. Complete resolution of the diplopia occurred by 6 weeks from starting treatment. The possible aetiologies and possible complications of such a condition are then discussed. An idiopathic extraocular muscle abscess is a rare condition which should be included in the differential diagnosis of a patient presenting with painful double vision.peer-reviewe

Prader-Willi syndrome

Case regarding a three-year old girl, suffering from Prader-Willi Syndrome, a rare genetic disorder with characteristic, easily recognisable dysmorphic features. She was seen at Children’s Out-patients as part of a follow-up regimen, performed every three months. This consultation was held on the 3rd October, 2012 and another one was planned for the 5th of January, 2013. The clinical picture of developmental signs and symptoms are very characteristic and early diagnosis is beneficial for the anticipation of complications, reduction in unnecessary investigations and improved prognosis.peer-reviewe

A study of nano-particle based silane consolidants for Globigerina limestone

This STEPS funded study focuses on the application of hybrid and nanoparticle loaded hybrid silane consolidants for the treatment of 'Franka' type Globigerina Limestone. Consolidants act by gluing the deteriorated stone material to the underlying healthy stone (Dukes, 1972; Gutt, 1973; Alessandrini et al., 1975; Garrod, 2001). The consolidants evaluated in this work were a laboratory prepared hybrid silane based on a mixture of tetraethylorthosilicate (TEOS) and 3-(glycidoxypropyl) trimethoxysilane (GPTMS), the same hybrid consolidant loaded with silica nanoparticles and GPTMS-modified silica nanoparticles. In addition, a consolidant based on the hydrolysis product of TEOS was also tested. Prepared consolidants were applied to Globigerina Limestone test blocks by complete immersion. Untreated stone block were used as benchmarks. Following application of the consolidants, half of the treated limestone blocks were subjected to accelerated weathering. Non-weathered and weathered limestone blocks were then characterised by optical and electron microscopy and the stone colour before and after treatment with consolidants was assessed by a colorimetric technique. The pore size distribution before and after application of the different consolidant treatments was assessed by Mercury Intrusion Porosimetry. A water absorption by capillarity technique was also carried out to assess how the water uptake rate into the limestone alters with the different treatments. The mechanical properties of the consolidated limestone blocks were assessed by resistance to sodium sulfate crystallisation. Microscopy observations showed that the consolidants penetrated the stone to different extents depending on the consolidant and the method of application. The hybrid consolidant on its own led to yellowing of the limestone but the addition of nanoparticles to the hybrid (modified or not) appeared to help restore the original colour of the stone. The porosity of the limestone was only marginally affected by the different treatments but the somewhat hydrophobic nature of the consolidants led to a disruption in the capillary flow of water into the limestone.peer-reviewe

Valutazione d'impatto sociale: innovazione o ritorno al passato?

Metodi qualitativi e quantitativi, per misurare gli impatti di un processo sociale nel medio e lungo termine. Quello sulla valutazione d'impatto sociale è un decreto rivoluzionario, che per l'economista Maria Vella con i suoi principi riconduce al sistema dei valori connaturato al Terzo Settor

Prosperity thinking: azioni per dare forma al futuro

L'economista Maria Vella rilegge i temi affrontati nelle 18 edizioni delle Giornate di Bertinoro, che hanno saputo anticipare le grandi linee di pensiero che oggi ci portano a indicare nella prosperità inclusiva il frame dello svilupp

Il dae in ambito extraospedaliero: un intervento precoce può salvare la vita!

La realizzazione dell’elaborato di tesi arriva a fine del mio percorso di studi, percorso che mi ha fornito le conoscenze necessarie per prestare assistenza preventiva e curativa in ambito intra ed extraospedaliero. L’argomento trattato mi è stato suggerito dall’esperienza di tirocinio del terzo anno presso il Pronto Soccorso dell’ospedale di Feltre. L’arresto cardiaco è stato ampiamente trattato in letteratura, tuttavia rimane un argomento di notevole interesse e di studio in quanto interessa oltre 70.000 italiani all’anno con una prevalenza di eventi extraospedalieri. Se l’intervento non è tempestivo e veloce, le complicanze potenziali da arresto cardiaco sono notevolmente ingravescenti tempo dipendenti e possono portare alla morte del soggetto. Le difficoltà nel trattare l’arresto cardiaco sono ancora maggiori quando si presta assistenza sul territorio piuttosto che in ospedale che rappresenta un ambiente protetto. Il tempo che passa tra la chiamata al 118 e l’arrivo dei soccorsi sul posto, è mediamente di 10 minuti, tempo prezioso per salvare la vita di un paziente. È in questo scenario che si inserisce il tema della tesi proposta. Appare necessario introdurre ove possibile, qualche variante che permetta di velocizzare la catena della sopravvivenza. Con questo preciso scopo nasce l’idea delle postazioni salvavita, cioè garantire l’accesso più immediato possibile al primo soccorso. Dopo aver valutato il territorio feltrino, anche dal punto di vista socio-demografico, si sono individuati dei punti sensibili nel Progetto “Time is Life”, per la realizzazione di una rete di postazioni salvavita con l’obiettivo primario di aumentare le possibilità di sopravvivenza di un soggetto colto da arresto cardiaco.ope

Glances in Immunology of HIV and HCV Infection

Since the identification of HIV and HCV much progress has been made in the understanding of their life cycle and interaction with the host immune system. Despite these viruses markedly differ in their virological properties and in their pathogenesis, they share many common features in their immune escape and survival strategy. Both viruses have developed sophisticated ways to subvert and antagonize host innate and adaptive immune responses. In the last years, much effort has been done in the study of the AIDS pathogenesis and in the development of efficient treatment strategies, and a fatal infection has been transformed in a potentially chronic pathology. Much of this knowledge is now being transferred in the HCV research field, especially in the development of new drugs, although a big difference still remains between the outcome of the two infections, being HCV eradicable after treatment, whereas HIV eradication remains at present unachievable due to the establishment of reservoirs. In this review, we present current knowledge on innate and adaptive immune recognition and activation during HIV and HCV mono-infections and evasion strategies. We also discuss the genetic associations between components of the immune system, the course of infection, and the outcome of the therapies

Effetti collaterali delle carenze della sanità pubblica in Italia

La sanità pubblica subisce una continua erosione: nel prossimo decennio un terzo degli italiani non potrà più fare riferimento al medico di famiglia. Il SSN deve essere riorganizzato, sulla base di un modello multi-pilastro, con nuove regole ed operatori che possano garantire una risposta universale anche per le future generazioni. Non è più sufficiente limitarsi a garantire finanziamenti adeguati alla sanità pubblica, ma è necessario affidare in gestione il diritto alla salute dei cittadini al di fuori del SSN. Le Società di Mutualità Sanitaria (SMS) sono una risposta, a condizione che sappiano compattarsi e fare ret

Capitale umano vs capitale digitale: chi vince la sfida?

L’innovazione e la tecnologia sono improcrastinabili, ma occorre essere consapevoli che serve chi sappia accompagnarli ed è questa la grande scommessa del mondo del Terzo settor