Anesthesiologic effects of transperitoneal versus extraperitoneal approach during robot-assisted radical prostatectomy: results of a prospective randomized study

To compare the effects of CO(2) insufflation on hemodynamics and oxygen levels and on acid-base level during Robot-Assisted Radical Prostatectomy (RARP) with transperitoneal (TP) versus extra-peritoneal (EP) accesses

AN ANALYSIS OF THE COUNTRY-OF-ORIGIN EFFECT ON THE HRM POLICIES AND PRACTICES OF FINNISH MNCs OPERATING IN ITALY

There is considerable debate in the literature as to the determinants of human resource policies and practices of foreign subsidiaries. Are these representatives of global emerging best practices and pointing to a convergence of Human Resource Management systems? Are they shaped by the cultural and institutional constraints of the host country? Or are they subject to country-of-origin effect? This study makes a significant contribution by examining the role of country-of-origin effect in the Italian subsidiaries of Finnish Multinational Corporations (MNCs); with the aim of exploring if and how it manifests itself and what are the main factors that strengthen or moderate this effect. Its originality lies in the approach, which takes into account both the cultural and institutional backgrounds of the studied countries. A questionnaire (adaptation of the CRANET questionnaire) was sent to all Finnish subsidiaries in Italy and survey data was complemented by four mini case studies. Findings have confirmed the presence of a marked country-of-origin effect in many HR areas (e.g. use of written strategies; selection; T&D) with a localised approach being used in other areas (e.g. Pay and Benefits; E.R. and flexibility) and an ‘integrated’ approach in the case of Appraisals. It has also emerged that a high degree of control is exerted by the Parent Company on the management of strategic employees while management of lower-level employees is entirely delegated to local managing directors, pointing towards a ‘dual’, mainly polycentric or regiocentric internationalisation strategy. Nevertheless internationalisation strategy per se is not sufficient in explaining why some less strategic areas of HR were found to also be subject to country-of-origin effect. When exploring the elements that influence this effect; factors identified by previous theoretical models have been confirmed and it has emerged that, in the case of countries characterised by great cultural and institutional distance, the relational context (and perception gaps in particular) may play a vital role in moderating the amount of control and autonomy exerted by HQs and host country managers respectively and hence will also influence the amount of similarity of local HR practices to the Parent Country’s. No indication of either final or directional convergence has been observed

Sobre la ciencia de aprender a ayudarse libremente por la acción recíproca de los hombres unos sobre los otros

A garantia à livre associação pacífica é um dos esteios das liberdades individuais. Ao investigar a natureza do individualismo e a reação da sociedade democrática a essa pulsão, Alexis de Tocqueville nota que “dificilmente se tira um homem de si mesmo para interessá-lo pelo destino de todo o Estado”. (...). Mas, se é preciso fazer passar uma estrada junto do seu domínio, ele verá desde o primeiro olhar que existe uma relação entre essa pequena questão pública e os seus maiores negócios privados e descobrirá (...) o estreito laço que une aqui o interesse particular ao interesse geral. É nessa arena, por vezes conflituosa, que surgem as práticas da advocay e do lobby. The assurance of peaceful free association is one of the stays of individual freedom. When investigating the nature of individualism and the democratic society’s reaction to this compulsion, Alexis de Tocqueville notes that “it is difficult to remove an individual from him/herself so as to make him/her become interested in the destinies of the entire State”. (...). But if it is necessary to build a road next to his/her property, he/she will see at a first glance that there is a relation between this minor public issue and his/her major private business, and will discover (...) the tight knot that in this case joins private interest with general interest. It is in this scenario, which is often conflictive, that the practices of advocacy and lobbying arise.La garantía de libre asociación pacífica es un factor incondicional de las libertades individuales. Al investigar la naturaleza del individualismo y la reacción de la sociedad democrática a esa unidad, Alexis de Tocqueville señaló que “difícilmente un hombre sale de si mismo para interesarse por el destino de todo el estado. (...). Pero si es necesario hacer pasar una carretera cerca de su propiedad, verá a primera vista que hay una relación directa entre este pequeño asunto público y sus mayores negocios privados y descubrirá (...) el estrecho vínculo que une aquí el interés particular al interés general”. Es en este campo, a veces conflictivo, donde surgen las prácticas de advocacy, y de lobby

Virginity And Intellectual Construction: The Function Of Virginity Within The Early English Novel

This project situates the state of virginity as both a narrative and mode of behavior within Samuel Richardson\u27s novel Pamela. By challenging the supposition that feminine virginity in eighteenth-century novels is presented as both an intellectual and physical disability, this thesis allows for a reconsideration of how virginity functions in the early novel. I place virginity in three distinct and yet simultaneous modes of thinking that contributed to the conflicting and contradictory images of women that were available to purchase in print: virginity as moral intelligence and form of resistance; virginity as an intellectual disability, and the loss of virginity as intellectually enabling. These three modes of thinking and, in turn, behavior, allow for the state and site of virginity to be bound intrinsically with the textual production and social constructions that were used during the eighteenth century. The ways in which women were portrayed and constructed in narratives such as Pamela signified that textual inscription was not merely being enacted upon paper materials, but rather on women\u27s bodies themselves

Peripheral primitive neuroectodermal tumor of seminal vesicles: is there a role for relatively aggressive treatment modalities?

A 50 year old white man received an incidental ultrasound diagnosis of hypoechoic mass interesting the right seminal vesicle. A CT scan showed the presence of a 7.8 cm roundish cyst, originating from the right seminal vesicle. He had been followed by the removal of the right seminal vesicle and both the cystic lesion. The histological findings of the specimen documented the presence of small round cells compatible with Ewing's sarcoma/PPNET. The patient received also adjuvant chemotherapy and radiation treatment. After 10 years, the follow-up is still negative

Il trattamento endourologico retrogrado della calcolosi cistinica multirecidivante: caso clinico paradigmatico

Presentiamo un caso clinico di calcolosi cistinica multirecidivante paradigmatico. Il paziente giungeva alla nostra osservazione dopo multipli trattamenti endourologici in altra sede con una situazione litiasica complessa: portatore di nefrostomie bilaterali e di stent ureterale destro venivano evidenziati calcoli multipli renali bilaterali e grosse calicificazioni ureterali, a destra a ridosso dello stent e a sinistra per un tratto di oltre 5 cm. Il trattamento endourologico retrogrado eseguito in più tempi, associato a una adeguata terapia medica per la cistinuria, ha portato a una bonifica completa. Riteniamo che il trattamento endourologico retrogrado rappresenti la modalità più adeguata per risolvere la calcolosi cistinica multirecidivante, al quale deve necessariamente essere associata la terapia farmacologica della cistinuria. Risulta altresi mandatario un trattamento in tempi brevi e una permanenza di eventuali endoprotesi ureterali per il tempo strettamente necessario, allo scopo di evitare calcificazioni degli stessi anche con formazioni litiasiche di ossalato di calcio. Ottenuta la bonifica, è consigliabile che anche i controlli vengano effettuati inizialmente secondo scadenze ravvicinate per poter risolvere eventuali recidive prima che raggiungano dimensioni tali da richiedere trattamenti più complessi

Renal colic, where is it headed? An observational study

Aim: In the last thirty years, the treatment for renal and ureteral calculi has undergone profound variations. The objective of this study has been to evaluate the existence of parameters which can affect the spontaneous expulsion of a symptomatic ureteral stone in a reasonably brief period of time and to identify whether certain parameters such as sex, age, the location and dimension of the stone, the presence of dilation in the urinary tract together with the administered therapy, can be used for a correct clinical management of the patient. Methods: In a period of 9 months, 486 cases of renal colic were registered at emergency department. Results: The cases of renal colic due to ureteral calculus were 188 (38.7%). The patients' charts, complete of all data and therefore, valid for this research, resulted to be 120 (64%). In the presence of a symptomatic ureteral stone, the correct approach must first of all, focalize on the dimension of the calculus itself; less importance instead, is given to the location, as reported in other studies, the presence of hydroureteronephrosis, sex and the side. Conclusion: In the cases when the pain symptoms cannot be solved by means of the administration of analgesics, it is then reasonable to take into consideration an immediate endourological treatment. If the pain symptoms are promptly solved, an attentive wait of 4 weeks should be considered reasonable in order to allow spontaneous expulsion of the calculus

Wunderlich's syndrome: Three cases of acute spontaneous renal bleeding, conservately treated

Wunderlich's syndrome is a clinical condition defined as a spontaneous renal bleeding of non traumatic origin, contained within the Gerota's fascia. Wunderlich's syndrome is rare. Spontaneous bleeding of kidney tumors, either benign or malignant, represents the more common causes. Classically it presents with acute flank pain, tender palpable mass and clinical hemodynamic deterioration. These symptoms are defined as the Lenk's classic triad. We present three cases of spontaneous renal bleeding