The phlebological surgery in elderly patients

The pathogenesis of the lower limbs varicose veins in the elderly patients is the same one as in the juvenile and adult age. What changes is the severity of the clinical picture, because the disease is a chronic pathology and it is aggravated with the passing of the years in absence of prophylaxis and missed or inadequate therapy. Equally the surgical operations on the superficial venous system of the elderly patients from a technical point of view are the same that are practiced in other ages of life. What changes is the anaesthesiological risk, which is increased, because other chronic pathologies are frequently associated with the old ones. Currently both the use of techniques of peripheral anesthesia, as the blocks of the lower limbs nervous trunks, and the introduction of poor toxic anesthetics for the heart in therapeutical practice allow in an inci¬sive way to submit elderly people to surgical procedures. Above all the out-patient hemodynamic surgery of the superficial chronic venous insufficiency, which requires a careful and meticulous instrumental investigation aimed surgical gestures, but simple, effective, of brief duration, has convinced many surgeons of the possibility to operate on the varicose patients of a more and more advance age. On the other hand the rapid postoperative mobiliza¬tion of those sick, in absence of immediate complica¬tions, means that they can be discharged from the hospital on the same day of the operation. This undoubtedly involves positive reflexes on the sanitary expense and it increases at the same time the compliance in terms of motivation and acceptance of the proposed procedure. The elderly patient, perhaps more than the younger adult, once informed of the new anaesthesiological and surgical techniques, gladly gives his consent to the inter¬vention, pleased to return to his own house and tquickly return to his daily occupations. How much I dictate you is translated in our experi¬ence, that is carried out near the Phlebological Center of the Siena University, in a progressive increase in the last 5 years both in absolute terms (223) and percen¬tages (12%) of the number of subjects older than sixty¬five years old that have been submitted to surgical operations for the venous disease. Of all 223 patients, males are 68 and females are 155; 144of them have an age between 66 and 70 years, 73 belonging to the eighty years of life and 6 subject to the ninty. All patients have been operated in Day Hospi¬tal admission. No mortality has been found. Local post-operative complications was encountered in 1,8% of the cases

Ameloblastoma plexiforme del maxilar: manejo quirúrgico y protético. A propósito de un caso

El ameloblastoma es un tumor odontógeno benigno de derivación epitelial, de elevada invasión local, crecimiento intermitente y con alta probabilidad de recidiva. Puede dividirse en los siguientes tipos histológicos: folicular, plexiforme, acantomatoso, a células basales y granulares. El ameloblastoma folicular es el subtipo histológico más común. Se manifiesta prevalentemente durante la tercera, cuarta y quinta década de vida, sin predilección para el sexo, aun así se puede encontrar en cualquier grupo de edad incluyendo niños. La mayoría de los ameloblastomas se encuentra sobretodo en mandíbula (al nivel del ángulo y rama). Las características clínicas, incluso si complementadas con radiografías y muestras histológicas, no son útiles a la hora de predeterminar el comportamiento biológico y por lo tanto el pronóstico de un ameloblastoma individual. Los autores presentan un caso localizado de ameloblastoma plexiforme localizado en la parte posterior del maxilar de un hombre de 30 años; el término "plexiforme" se refiere al aspecto de anastomosis de los islotes del epitelio odontógeno, en contraste con el tipo «folicular». En este artículo se discuten importantes aspectos de la patología, del tratamiento quirúrgico y protésico. En conclusión, es necesaria una cooperación estricta a largo plazo de un grupo de clínicos, patólogos, cirujanos y prostodoncistas, para ofrecer el mejor tratamiento individualizado en cada caso. The ameloblastoma is a clinically persistent benign tumor derived from odontogenic epithelium, locally invasive, intermittent in growth and with high a probability of recurrence. The following histologic patterns may be distinguished: follicular, plexiform, spindle cell, acanthomatous, basal cell type and granular cell. The follicular ameloblastoma is the most common histologic tipe. The majority of patients are in 3th, 4th and 5th decade, but can be found in any age group including children. The majority of ameloblastomas are observed in the mandible (mostly angle or ramus). Clinical features, even if combined with radiology or histology findings, are not useful when trying to determine the biological behaviour and therefore the prognosis of an individual ameloblastoma. The authors report a case of plexiform ameloblastoma in the posterior maxilla, in male 30 year old otherwise healthy; the term "plexiform" refers to the appearance of anastomosing islands of odontogenic epithelium in contrast to a follicular pattern. Important questions on pathology, surgical and prosthetic therapy are discussed in this paper. In conclusion, a close cooperation of clinicians, pathologists, surgeons and prosthesists is necessary and very important over a long period of time for the best management of each individual case

Analysis of cadmium root retention for two contrasting rice accessions suggests an important role for oshma2

Two rice accessions, Capataz and Beirao, contrasting for cadmium (Cd) tolerance and root retention, were exposed to a broad range of Cd concentrations (0.01, 0.1, and 1 M) and analyzed for their potential capacity to chelate, compartmentalize, and translocate Cd to gain information about the relative contribution of these processes in determining the different pathways of Cd distribution along the plants. In Capataz, Cd root retention increased with the external Cd concentration, while in Beirao it resulted independent of Cd availability and significantly higher than in Capataz at the lowest Cd concentrations analyzed. Analysis of thiol accumulation in the roots revealed that the different amounts of these compounds in Capataz and Beirao, as well as the expression levels of genes involved in phytochelatin biosynthesis and direct Cd sequestration into the vacuoles of the root cells, were not related to the capacity of the accessions to trap the metal into the roots. Interestingly, the relative transcript abundance of OsHMA2, a gene controlling root-to-shoot Cd/Zn translocation, was not influenced by Cd exposure in Capataz and progressively increased in Beirao with the external Cd concentration, suggesting that activity of the OsHMA2 transporter may differentially limit root-to-shoot Cd/Zn translocation in Capataz and Beirao

New methodologies to analyze and study the Hellenistic-Roman quarter in Agrigento

The Agrigento: insula III Project began in 2016 thanks to an agreement between the Parco Archeologico e Paesaggistico Valle dei Templi di Agrigento and DiSCi - Bologna University; it aims to document an entire sector of the Hellenistic-Roman quarter, in a three-year period. The main goal is to start a systematic study of private housing from the Archaic period to Late Antiquity and, at the same time, provide a critical understanding of the town planning scheme in this part of the town, which still lacks a modern archaeological and topographical documentation. The interpretation of the previous documentation is the starting point, along with new mapping with laser scanning and a systematic campaign of geophysical investigations to obtain a BIM. As the Bologna University tradition teaches, modern technologies can answer precise historical and archaeological questions: what are the primary phases of the town map? Which one is the starting module of each lot and what are the changes in different ages? Is it possible to reconstruct the original architecture of Hellenistic houses? What is the relationship between this quarter and the rest of the town? The integration of traditional investigational techniques with more recent ones is the methodological assumption of the project, in order to solve the analysis of the complex stratigraphy of the setting, which was inhabited for at least a millennium, from the Archaic to the Middle Ages

Brown rotting fungus closely related to Pseudomerulius curtisii (Boletales) recorded for the first time in South America.

In the region of Santa Maria, Southern Brazil, we have analyzed morphologically and molecularly some interesting brown-rotting mushroom specimens closely related to Pseudomerulius curtisii. Except for minor differences in morphology and ITS sequence similarity, collections have corresponded to P. curtisii by basidiospore size and shape, the kind of hyphal system, the macromorphology, the slightly unpleasant pungent spicy smell turning stronger upon drying and, particularly, by the highly supported and closely related clade after phylogenetic analysis. Perhaps due the rarity in nature, morphological data are not abundant in literature and appears to be somewhat incomplete to discordant for the species, so we provide a more detailed description and illustrations from collected specimens

The management of atrophies classified as V class according to Cawood & Howell by piezo-electric surgery

Introducción: Los casos analizados presentaban atrofias severas (V clase según Cawood y Howell) (1), que se caracterizan por presentar una densidad de la cresta transversal inferior a 4 mm y vertical inferior a 6 mm; ello hace pensar en la posibilidad de una rehabilitación implanto-soportada. Objetivo: Evaluación de la rehabilitación de pacientes afectados por severa atrofia del maxilar superior clase V según Cawood y Howell) (1) rehabilitados con elevación del seno maxilar e injerto de hueso autólogo. Materiales y métodos: Estudio longitudinal a partir de una muestra de 32 pacientes, con atrofia maxilar severa y edentulismo parcial o total. En todos los pacientes se ha colocado un injerto con técnica de reconstrucción onlay mono o bicortical y se ha adoptado la cirugía piezoeléctrica para realizar el elevación del seno, el cual podía ser mono o bilateral, de hueso autólogo procedente de la cresta ilíaca anterior. Seguimiento realizado durante 2 años. Resultados: A los dos años del control final, el 94,05% de todos los implantes colocados tras la intervención de elevación se presentan osteointegrados y cargados protésicamente. La cresta ilíaca anterior resulta ser la zona idónea para la extracción medular, necesaria para la elevación del seno. Las posibilidades de supervivencia del implante son realmente elevadas si se espera el tiempo clínico necesario para la recuperación y la integración del injerto. El éxito de todas las intervenciones de elevación del seno maxilar se debe a la adopción de la cirugía piezoeléctrica, que permite efectuar la incisión de entrada y realizar el desprendimiento de los tejidos con un traumatismo mínimo para la membrana de Schneider. La integridad de la membrana y la utilización de bone-chips de origen autólogo no ha hecho necesario recurrir a la utilización de membranas reabsorbibles, simplificando así el procedimiento quirúrgico. La utilización de la cresta ilíaca anterior como zona donante, permite disponer de abundante tejido óseo cortical, necesario para colocar los onlay y para reconstruir el defecto óseo. Introduction: Valutation of rehabilitated patients by sinus lift in upper jaw and by autologous bone graft from iliac crest. Materials and methods: Rehabilitation of 32 patients with severe atrophies of upper jaw and partial or total edentulism by positioning of mono- or bicortical onlay with piezosurgery to obtain a sinus lift mono- or bilateral by autologous bone grafts from anterior iliac crest. Results: 94.05% of successes after a two years follow-up. Conclusions: Respecting of timing surgery, a correct use of the piezosurgery technique and of the autologous bone graft from anterior iliac crest let a successful implantological rehabilitation. Moreover the iliac crest is a very good donor site of bone tissue for the management of severe atrophies in the upper jaw. An accidental laceration of Schneider's membrane was observed in filling phase in the 5.26% of cases

Painful constipation: a neglected entity?

Functional chronic constipation is a common symptom in daily clinical practice. Although the definition of constipation may be variable, there is usually agreement that (at least for research purposes) the definition given by the Rome Committee are useful. However, some blind spots or hidden angles remain, even in the more thorough classifications; among these, there is painful constipation, a poorly defined yet clinically encountered entity. The present article reviews the current knowledge about painful constipation, trying to put together the scarce data available, and to frame it in the more general context of chronic constipation