Archivio Istituzionale della Ricerca - Università degli Studi della Campania "Luigi Vanvitelli"
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Last-Minute Cancellations in Pediatric Ambulatory and Day Surgeries in Italy: Prevalence and Risk Factors
No full textBackground: Cancellation of pediatric day and ambulatory surgeries on the day of the procedure poses a significant challenge, impacting hospital resources and patient care. In Italy, ambulatory surgery is defined as a surgical/diagnostic procedure without hospitalization, and day surgery is defined as a surgical/diagnostic procedure with daytime hospitalization. Aims: To measure the rate and causes of cancellations on the day of the procedure in a tertiary pediatric hospital in Italy. Methods: We collected the data retrospectively from the electronic health record between January 2020 and March 2022 at Ospedale Pediatrico Bambino Gesù in Rome, Italy. The number of case cancellations were captured. The reasons for cancellation were categorized into three different buckets: anesthetic reasons, surgical reasons, and non-adherence to protocol. The reasons under each of these categories were further explored. We analyzed the difference in the rate of last-minute cancellations between ambulatory surgery and day surgeries to examine if different pathways produce different results. Results: A total of 4,600 procedures were scheduled and 183 were canceled (3.9% of total procedures). Surgical reasons contributed to most cancellations (49%), followed by anesthesia reasons (42%) and non-adherence to protocols (9%). Surgical reasons, including the need for post-operative hospitalization, were the primary causes for cancellation, often due to mismatches between pre-operative evaluations and the final decision-making process. Younger patients, particularly those prone to respiratory tract infections, were more likely to experience cancellations. Anesthetic reasons were also a significant factor but less prevalent than surgical ones. Conclusions: Using standardized treatment and diagnosis pathways can reduce the number of canceled procedures and optimize resources. A telephone re-assessment before the procedure and telemedicine can be useful strategies to further reduce the cancellation rate. Clinical Implications: The use of pediatric day surgery has significant advantages: minimizing last-minute canceled procedures means increasing patient comfort and reducing healthcare costs. Identifying the causes of cancellations on the day of the procedure allows one to improve the organizational system of the operating room
Transcatheter Pulmonary Valve Implantation in Congenital Heart Diseases: Current Advances and Future Prospectives
No full textPulmonary disfunction is frequent in repaired congenital heart diseases. Both pulmonary regurgitation and pulmonary stenosis are possible complications over time. In the past, the surgical approach was the only feasible management but exposed the patient to a redo-surgery with its consequent risks. Nowadays, the development of novel devices and techniques has made possible a transcatheter pulmonary valve implantation. The Melody Transcatheter Pulmonary Valve (TPV) (Medtronic Inc., Minneapolis, MN, USA) and the Edwards Sapien XT and S3 Transcatheter Heart Valve (Edwards Lifesciences LLC, Irvine, CA, USA) are balloon-expandable valvular bioprostheses approved for pulmonary position. Venus P-Valve (Venus Medtech, Shanghai, China) and Harmony TPV (Medtronic Inc., Minneapolis, MN, USA) are self-expandable pulmonary valves. Alterra Adaptive Prestent (Edwards Lifesciences LLC, Irvine, CA, USA) is an hourglass self-expandable stent that reduces the size of large right ventricular outflow tracts, creating a suitable landing zone to implant an Edwards Sapien S3 THV 29 mm. Novel stents and percutaneous valves are being planned and experimented with to widen the field of transcatheter approach. The aim of this review is to describe both the current approaches, strategies, and techniques as well as the future perspective to deal with the patients with significant pulmonary stenosis and/or regurgitation
La fin de vie en Italie entre la Cour constitutionnelle et le Parlement
No full textLa question de la fin de vie s’inscrit dans un cadre normatif où l’équilibre délicat des droits et
intérêts constitutionnels doit être établi par le pouvoir législatif. Néanmoins, en l’absence de dispositifs législatifs spécifiques, la résolution de cette question est principalement confiée à l’interprétation judiciaire, ce qui soulève des questions éthiques et juridiques complexes. En somme, la situation italienne constitue un exemple particulièrement pertinent pour approfondir cette question. En effet, dans ce pays, les juges sont fréquemment les premiers à se prononcer sur les dilemmes bioéthiques, et le législateur intervient en général postérieurement, bien que pas de manière systématique. Cette
dynamique est illustrée par le titre de cette contribution qui se concentre précisément sur la question
de la fin de vie en Italie, en analysant le rôle souvent supplétif de la Cour constitutionnelle face à
l’inaction du Parlement
Drivers of adolescent chasing behavior: The role of craving, decision-making, alcohol use, and gambling severity
No full textCraving and impaired decision-making are hallmark features of addiction, playing a prominent role in gambling disorder. These factors are central to loss-chasing behavior, a core diagnostic criterion of gambling dependence characterized by persistent attempts to recover prior losses. This study examines the interplay of craving, affective decision-making, decision-making styles, alcohol use, and gambling severity in chasing behavior among 272 Italian adolescents aged 14–19. Participants completed validated measures, including the South Oaks Gambling Screen-Revised for Adolescents (SOGS-RA), Iowa Gambling Task (IGT), General Decision-Making Style (GDMS), Gambling Craving Scale (GACS), and Alcohol Use Disorders Identification Test (AUDIT). Chasing behavior was assessed using a computerized task, with participants randomly assigned to either a Control or Loss condition. Regression and path analyses indicated that craving was the strongest predictor of both chasing initiation and persistence, while alcohol consumption was uniquely associated with greater chasing persistence. Conversely, a dependent decision-making style emerged as a protective factor, being associated with reduced engagement in chasing behavior. Notably, neither gambling severity (measured by the SOGS-RA) nor affective decision-making capacity (assessed via the IGT) predicted chasing outcomes. These findings suggest that chasing operates as an independent behavioral mechanism within gambling disorder, distinct from generalized gambling severity or neurocognitive decision-making deficits
Genitorialità omoaffettiva e miglior interesse del minore
No full textThe incidental question of constitutionality raised by the Court of Lucca provides an opportunity to re ect on the foundations of the prohibitions established by law n. 40 of 2004 and their degree of peremptoriness and non-derogability. These prohibitions express different fundamental principles and, in the absence of legislative intervention, the interpreter is called to engage a delicate balancing exercise in accordance with the axiological hierarchy of the legal system, in order to find solutions responsive to the particularities of individual cases and to avert breaches of fundamental rights.La questione di legittimità costituzionale sollevata dal Tribunale di Lucca è
l’occasione per ri ettere sui fondamenti dei divieti sanciti dalla l. n. 40 del 2004
e sul relativo grado di imperatività e inderogabilità. Diversi sono i princípi di cui
essi sono attuazione e, dinnanzi all’inerzia del legislatore, la giurisprudenza si
trova a svolgere un delicato bilanciamento, orientato dalla gerarchia assiologica
dell’ordinamento, al ne di giungere a soluzioni rispondenti alle istanze dei sin
goli casi concreti ed evitare ingiuste compromissioni dei diritti fondamentali delle
persone coinvolte
Precise measurement of the 7Be electron capture decay half-life in silicon carbide
No full textIn this work we present to our knowledge the most precise measurement of the 7Be electron capture decay half-life in a host material. A silicon carbide sample with ~8.62 × 1097Be atoms was measured for 83.5 d on an ultra-low background high purity Ge detector located deep underground in the Laboratori Nazionali del Gran Sasso, Italy. The result obtained for the decay half-life is T1/2 = 53.284 ± 0.016 d, which corresponds to an uncertainty of 0.3‰. Thanks to the high sensitivity achieved, this measurement is paving the way to further investigations on this process aiming to understand how environmental conditions may affect the decay half-life
Reconversion of the Sferisterio of Naples. From sporting tradition to a new urban market
No full textLow-cost optical fiber sensors for the portable detection of cortisol and E. coli
No full textDetection of biomarkers, as well as bacterial infection levels, plays an important role in clinical analysis. Development in research for fast, high-sensitivity, and selective sensors has a key role in decision-making during a health issue. Aligning to these features, low-cost biomarkers and bacteria population detection methods should be developed in order to make clinical trials more accessible to the whole of society. In this context, optical sensors based on surface plasmon resonance (SPR) phenomena have been intensively studied due to their easy functionalization and fast and amplified response. This work aimed at the optical detection of some analytes in aqueous solutions. SPR-based D-shape sensors employing gold-deposited polymer optical fibers (POF) were used in a portable platform to detect concentrations of cortisol, the stress hormone, and E. coli, a bacteria strain. The sensors showed good linearity in response to increasing cortisol concentrations, but were less consistent in detecting the E. coli bacteria. However, E. coli sensors possess a sensitivity of −0.38 ± 0.06 nm/log(CFU/mL), bearing a resemblance to the sensitivity obtained for cortisol sensors with −0.41 ± 0.04 nm/log(ng/mL). The biosensors had limits of detection (LODs) lower than those of existing literature, with E. coli detection of 3.72∼ × ∼10−7 CFU/mL, and cortisol detection of 1.73∼ × ∼10−4 pg/mL. Small topography profile differences of about 2.0-3.4 nm were found through atomic force microscopy (AFM), equivalent to the thickness of the used antibodies, suggesting they were deposited parallel to the gold surface. In the future, methods with the potential to assure antibody verticality should be explored