Open and / or laparoscopic surgical treatment of liver hydatic cysts

Hydatid disease is a severe parasitic disease with a widely ranging distribution. In the human being the liver is the most frequent organ affected. 1 The treatment should be individualized to the morphology, size, number and location of the cysts, that is why a variety of surgical operations have been advocated from complete resection like total pericystectomy or partial hepatectomy to laparoscopy to a minimally invasive procedures like percutaneous aspiration of cysts to conservative drug therapy. 3-4 This study compares laparoscopic versus open management of the hydatid cyst of liver the surgical approach to liver echinococcosis is still a controversial issue and shows our results of surgical treatment of liver hydatid cysts during a 3-years period

Interactive simulator for e-Learning environments: a teaching software for health care professionals

There is an established tradition of cardiovascular simulation tools, but the application of this kind of technology in the e-Learning arena is a novel approach. This paper presents an e-Learning environment aimed at teaching the interaction of cardiovascular and lung systems to health-care professionals. Heart-lung interaction must be analyzed while assisting patients with severe respiratory problems or with heart failure in intensive care unit. Such patients can be assisted by mechanical ventilatory assistance or by thoracic artificial lung. "In silico" cardiovascular simulator was experimented during a training course given to graduate students of the School of Specialization in Cardiology at \u27Sapienza\u27 University in Rome. The training course employed CARDIOSIM(C): a numerical simulator of the cardiovascular system. Such simulator is able to reproduce pathophysiological conditions of patients affected by cardiovascular and/or lung disease. In order to study the interactions among the cardiovascular system, the natural lung and the thoracic artificial lung (TAL), the numerical model of this device has been implemented. After having reproduced a patient\u27s pathological condition, TAL model was applied in parallel and hybrid model during the training course. Results obtained during the training course show that TAL parallel assistance reduces right ventricular end systolic (diastolic) volume, but increases left ventricular end systolic (diastolic) volume. The percentage changes induced by hybrid TAL assistance on haemodynamic variables are lower than those produced by parallel assistance. Only in the case of the mean pulmonary arterial pressure, there is a percentage reduction which, in case of hybrid assistance, is greater (about 40%) than in case of parallel assistance (20-30%). At the end of the course, a short questionnaire was submitted to students in order to assess the quality of the course. The feedback obtained was positive, showing good results with respect to the degree of students\u27 learning and the ease of use of the software simulator

A Survey of Telecardiology Projects in Italy.

It is estimated that in Italy there are about three million people affected by chronic heart failure. Cardiology is the health care field currently getting the largest benefits from telemedicine. Transmission, using wireless devices, makes possible to achieve virtual hospitalization: it is possible to anticipate the time of discharging and the patient can be remotely controlled by the central station in the ICU of the department of Medicine. Teleconsulting (i.e. a distance consulting between physicians) is applied in telecardiology, it allows the realization of a consulting between cardiology departments and remote services in the same hospital or among far-away hospitals. In this paper some of the most significant cardiac telemonitoring projects in Italy are described. Also reported, the projects involving the applications of implantable cardiac devices which can be controlled remotely. In conclusion, we sketch out the future prospects of telecardiology research and its applications in Italy

A Survey of Telecardiology Projects in Italy

It is estimated that in Italy there are about three million people affected by chronic heart failure. Cardiology is the health care field currently getting the largest benefits from telemedicine. Transmission, using wireless devices, makes possible to achieve virtual hospitalization: it is possible to anticipate the time of discharging and the patient can be remotely controlled by the central station in the ICU of the department of Medicine. Teleconsulting (i.e. a distance consulting between physicians) is applied in telecardiology, it allows the realization of a consulting between cardiology departments and remote services in the same hospital or among far-away hospitals. In this paper some of the most significant cardiac telemonitoring projects in Italy are described. Also reported, the projects involving the applications of implantable cardiac devices which can be controlled remotely. In conclusion, we sketch out the future prospects of telecardiology research and its applications in Italy

The role of very low calorie ketogenic diet in sympathetic activation through cortisol secretion in male obese population

Adipose tissue is considered an endocrine organ, and its excess compromises the immune response and metabolism of hormones and nutrients. Furthermore, the accumulation of visceral fat helps to increase the synthesis of cortisol. The hypothalamus-pituitary-adrenal (HPA) axis is a neuroendocrine system involved in maintaining homeostasis in humans under physiological conditions and stress, and cortisol is the main hormone of the HPA axis. It is known that a stress-induced diet and cortisol reactivity to acute stress factors may be related to dietary behavior. In obesity, to reduce visceral adipose tissue, caloric restriction is a valid strategy. In light of this fact, the aim of this study was to assess the effects of a commercial dietary ketosis program for weight loss on the sympathetic nervous system and HPA axis, through evaluation of salivary cortisol and GSR levels. Thirty obese subjects were recruited and assessed before and after 8 weeks of Very Low Calorie Ketogenic Diet (VLCKD) intervention to evaluate body composition and biochemical parameters. Salivary cortisol levels and GSR significantly decreased after dietary treatment; in addition, body composition and biochemical features were ameliorated. The VLCKD had a short-term positive effect on the SNS and HPA axes regulating salivary cortisol levels. Finally, the effects of the VLCKD on the SNS and HPA axis may lead to more individualized treatment strategies that integrate obesity and stress and support the usefulness of such therapeutic interventions in promoting the reduction of the individual disease burden

The role of rural development policy in supporting agroforestry systems in EU

PresentationA financial support (Measure 222) was introduced in the EU Rural Development Programmes (RDPs) 2007-2013 aimed at promoting the establishment of agroforestry systems on arable lands. The objectives of the paper are to: i) assess the implementation rate of the Measure 222 in EU27 during the period 2007-2013; ii) identify the main reasons and constraints that affected the farmers’ interest in the Measure 222, iii) highlight the perspectives in the next RDPs 2014-2020. The data on RDPs monitoring were obtained from the European Network for Rural Development (http://enrd.ec.europa.eu) and analyzed. The study compared the financial resources allocated to implement the Measure 222 with: i) the resources allocated to implement other forestry Measures; ii) the effective expenditures invested in establishing new agroforestry systems. The output indicators (number of beneficiaries and hectares under new agroforestry systems) were also analyzed in relation to their expected target. The Measure 222 was poorly applied across EU27: only few EU Regions have allocated resources to the Measure 222 and only 3.4% of these resources has been effectively invested to create new agroforestry systems on arable lands. Moreover, only 2.3% of the expected beneficiaries has been targeted and 2.1% of the expected hectares has been realized. The main constraints that have hampered the success of the Measure 222 in EU27 are reported. The new Regulation (EU Reg. 1305/2013) in support of rural development 2014-2020 states that: i) agroforestry systems comprise the combination between forestry plantations and agriculture on the same land; ii) grants should cover the establishment costs (up to 80% of the expenses) and the maintenance costs with an annual premium for 5 years; iii) beneficiaries should be not limited to farmers but may include also Municipalities and Associations. This new grant scheme should raise farmers and land owners interest in agroforestry systems

Lesioni non palpabili della mammella: la Mammotome-biopsy nella gestione preoperatoria del cancro della mammella

Premessa: Il tumore del seno è nei paesi occidentali al primo posto per frequenza nelle donne e la sua incidenza è in costante crescita. Grazie soprattutto alla diffusione dello screening mammografico e ad una maggiore consapevolezza del problema, negli ultimi anni è aumentata la diagnosi delle cosiddette lesioni “non palpabili”; parimenti si è assistito ad un importante sviluppo delle metodiche diagnostiche di tipo mininvasivo. Alla tradizionale citologia con ago sottile si sono affiancate infatti varie procedure bioptiche percutanee; tali metodiche microistologiche hanno quasi del tutto sostituito la biopsia chirurgica escissionale e l’esame intra-operatorio al congelatore. Pazienti e metodo: Nella nostra Divisione di Chirurgia Generale, Vascolare e Mininvasiva, dal dicembre 1999 al settembre 2004 abbiamo eseguito, in collaborazione con il servizio di Radiologia, 214 biopsie su guida ecografia utilizzando la vacuum-assisted biopsy (Mammotome® ) con ago 11-Gauge. I risultati ottenuti per ciò che concerne l’accuratezza diagnostica, la quantità e qualità delle informazioni ottenute, il significato delle stesse nella eventuale gestione chirurgica, il discomfort globale per la paziente sono stati analizzati e discussi nel presente lavoro. Risultati: Delle 214 biopsie eseguite con tecnica Mammotome, nell’89,3% dei casi si è trattato di lesioni clinicamente non palpabili, con un diametro medio di 8 mm. L’età media delle pazienti era di 57,6 anni (range 31-88). La positività per patologia maligna è stata di 90 casi (42%). Nei casi di iperplasia duttale atipica e radial scar (6%) è stata effettuata l’exeresi chirurgica della lesione che ha confermato nel 100% dei casi la precedente diagnosi bioptica. Il 19% delle pazienti sottoposte a biopsia Mammotome era stato precedentemente sottoposto ad un prelievo citologico con ago sottile. Confrontando i risultati delle due metodiche, l’attendibilità diagnostica della seconda risulta essere significativamente superiore (p<0,05) come pure il numero di informazioni ottenute (istotipo, invasività, grading, recettori ormonali, etc.); il discomfort legato alla procedura, valutato in termini di dolore (VAS), è risultato inferiore a quello del prelievo con ago sottile (p<0,05). L’unica complicanza della biopsia Mammotome è rappresentata dall’ematoma nella sede del prelievo (8% dei casi). Il numero dei falsi negativi è stato di un caso, dovuto ad un non corretto centraggio del bersaglio. Conclusioni: Allo stato attuale in presenza di una lesione non palpabile della mammella la scelta della metodica diagnostica (agobiopsia o Mammotome) è legata al sospetto radiologico nella prospettiva di un eventuale intervento chirurgico. La biopsia con Mammotome nelle lesioni non palpabil

Infectious Disease Ontology

Technological developments have resulted in tremendous increases in the volume and diversity of the data and information that must be processed in the course of biomedical and clinical research and practice. Researchers are at the same time under ever greater pressure to share data and to take steps to ensure that data resources are interoperable. The use of ontologies to annotate data has proven successful in supporting these goals and in providing new possibilities for the automated processing of data and information. In this chapter, we describe different types of vocabulary resources and emphasize those features of formal ontologies that make them most useful for computational applications. We describe current uses of ontologies and discuss future goals for ontology-based computing, focusing on its use in the field of infectious diseases. We review the largest and most widely used vocabulary resources relevant to the study of infectious diseases and conclude with a description of the Infectious Disease Ontology (IDO) suite of interoperable ontology modules that together cover the entire infectious disease domain

USE OF CAGED MUSSEL MYTILUS GALLOPROVINCIALIS IN AN ECOTOXICOLOGICAL APPROACH TO ASSESS ENVIRONMENTAL IMPACT IN OFF-SHORE ACTIVITIES

Abstract Mediterranean mussels, Mytilus galloprovincialis, are well recognized bioindicator organisms which can be easily caged in investigated areas to assess the impact of anthropogenic activities. In this work a monitoring protocol was developed for off-shore installations in the Adriatic sea. Integration of chemical analyses with a wide range of biomarkers analysed in mussels caged at 2 platforms, allowed to evaluate the biological disturbance and confirmed the utility of the ecotoxicological approach for monitoring off-shore activities. Keywords : Bio-indicators, Adriatic Sea. Several environmental issues are associated with the off-shore oil and gas industry, from the impact caused during installation to various form of disturbance related to daily ship traffic, extraction activities, maintenance of structures and, finally, decommissioning of old platforms. During the last year a monitoring protocol with caged mussels, Mytilus galloprovincialis, has been developed, to evaluate the potential ecotoxicological effects caused from the off-shore platform &quot;Giovanna&quot; in the Adriatic sea. Obtained results allowed to exclude marked biological disturbance and demonstrated the suitability of this approach. In this respect considering &quot;Giovanna&quot; as model platform, the monitoring protocol with caged mussel has been extended including also another off-shore installation, the &quot;Emilio&quot; platform. In this work native mussels were collected on a seasonal basis from a reference site on the Adriatic coast (Portonovo, Ancona) and transplanted for 4-6 weeks in both the sampling area and to the investigated platform &quot;Giovanna&quot; (42 • 46&apos; 060N, 14 • 27&apos; 750E) and Emilio (42 • 56&apos; 305 N; 14 • 13&apos; 915 E). After the translocation period, mussels were recovered dissected tissues frozen in liquid nitrogen and maintained at -80 • C until analyses. Chemical analyses on trace metals (arsenic, cadmium, chromium, copper, iron, mercury, manganese, nickel, lead, zinc) in mussels tissues An overall evaluation of results confirmed the absence of marked biological effects caused by the activities of &quot;Giovanna&quot; platform, as already demonstrated during the previous monitoring project. More variations were observed in mussels translocated to &quot;Emilio&quot;, i.e. higher activities of glutathione S-transferases, catalase and peroxisomal proliferation decrease of oxyradical scavenging capacity toward hydroxyl and peroxyl radicals and lysosomal destabilization (inhibition of neutral red retention time), indicating an onset of impairment condition in the organisms. Compared to mussels transplanted at the reference site, those from &quot;Emilio&quot; platform did not exhibit more elevated concentrations for the various metals and only for zinc and cadmium an higher bioavailability was detected close to the platform, suggesting the influence of galvanic anodes for cathodic protection. The overall results of this work confirmed the utility of using caged mussels as an additional contribution for monitoring off-shore activities and provided an ecotoxicological protocol based on cellular biomarkers for the early detection of biological disturbance

Bringing onco‐innovation to Europe’s healthcare systems. The potential of biomarker testing, real world evidence, tumour agnostic therapies to empower personalised medicine

Rapid and continuing advances in biomarker testing are not being matched by uptake in health systems, and this is hampering both patient care and innovation. It also risks costing health systems the opportunity to make their services more efficient and, over time, more economical. The potential that genomics has brought to biomarker testing in diagnosis, prediction and research is being realised, pre‐eminently in many cancers, but also in an ever‐wider range of conditions— notably BRCA1/2 testing in ovarian, breast, pancreatic and prostate cancers. Nevertheless, the implementation of genetic testing in clinical routine setting is still challenging. Development is impeded by country‐related heterogeneity, data deficiencies, and lack of policy alignment on standards, approval—and the role of real‐world evidence in the process—and reimbursement. The acute nature of the problem is compellingly illustrated by the particular challenges facing the development and use of tumour agnostic therapies, where the gaps in preparedness for taking advantage of this innovative approach to cancer therapy are sharply exposed. Europe should already have in place a guarantee of universal access to a minimum suite of biomarker tests and should be planning for an optimum testing scenario with a wider range of biomarker tests integrated into a more sophisticated health system articulated around personalised medicine. Improving healthcare and winning advantages for Europe’s industrial competitiveness and innovation require an appropriate policy framework—starting with an update to outdated recommendations. We show herein the main issues and proposals that emerged during the previous advisory boards organised by the European Alliance for Personalized Medicine which mainly focus on possible scenarios of harmonisation of both oncogenetic testing and management of cancer patients