197 research outputs found
Acute Cholecystitis: Diagnostic Pitfall and Timing of Treatment
No full textObjective: Cholelithiasis represents a very frequent health problem with higher prevalence in developed countries. The aim of this chapter is to underline, also by submitting our surgical experience, some diagnostic deceptions and the timing of treatment.
Methods: The presentation of 42 patients admitted in our institution (September 2012/September 2014) with the diagnosis of acute pancreatitis allows to identify two different clinical forms of acute biliary pancreatitis: the pancreatic pattern and biliary pattern. Moreover, the evaluation of another 42 patients observed in our institution (September 2014/September 2016) with acute cholecystitis should show our treatment program. Also, we added the analysis of our previous research, regarding acute cholecystitis, already published: difficult cholecystectomy, antegrade dissection in laparoscopic cholecystectomy, postoperative morbidity, laparoscopic approach in cirrhotics, finally the robotic experience.
Results: Clinical features, laboratory, and imaging exams should identify, into acute biliary pancreatitis, two clinical forms as biliary pattern and pancreatic pattern for different therapeutic approach. The treatment chosen for acute cholecystitis is early laparoscopic cholecystectomy within 24–72 hours. Severe, complicated acute cholecystitis can require urgent surgical intervention.
Conclusion: Acute cholecystitis encompasses clinical forms with various degree of severity and several clinical courses. The treatment is focused on early cholecystectomy with various and different management strategies, suitable to the specific pathological conditions
Current Approaches in the Minimally Invasive Surgical Treatment of Adrenal Tumors
No full textThe use of imaging modalities and minimally invasive surgery plays an important role in the current management of adrenal tumors. Ultrasonography frequently allows for the incidental diagnosis of adrenal masses. The most frequent adrenal pathologies encountered are hypercortisolism (Cushing’s syndrome), primary hyperaldosteronism (Conn’s syndrome), and pheochromocytomas. Clinical presentation of these adrenal tumors can often be non-specific, or such lesions may present as “incidentalomas” in patients who undergo imaging for clinical reasons unrelated to the adrenal glands. Adrenal malignancy is suggested by morphologic characteristics found on imaging studies: increased size, irregular borders, local invasion, and large necrotic areas. The risk of malignancy increases for larger adrenal masses. Minimally invasive surgery has become the initial choice for the treatment of adrenal tumors with retroperitoneal and transperitoneal approaches. This chapter describes the surgical indications and compares the various minimally invasive surgical approaches for the therapeutic management of adrenal masses
One stage surgery for synchronous liver metastasis from a neuroendocrine tumor of the colon. A case report
No full textINTRODUCTION: Neuroendocrine tumors (NETs) are a heterogeneous group of tumors. NET of colon represent less than 1% of colonic tumors. Synchronous liver metastases, present in 75-80%, are considered significant adverse prognostic indicators. Liver is the second commonest site for metastasis in patients with colorectal neuroendocrine tumors. Available treatment options include surgical resection, chemotherapy, biotherapy. Surgery is the gold standard for curative therapy and it is strictly related to the localization, the grade of tumor, and the stage of disease. CASE REPORT: We present a 64-year-old man with clinical carcinoid syndrome. Colonoscopy revealed ileocecal valve vegetating mass with negative biopsy. CT scans of thorax and abdomen showed a voluminous lesion (10 cm of diameter) of right liver. CEA, CA 19.9 and aFP were all normal. Only urinary 5HIAASerum 5-hydroxyindoleactic acid and blood Chromogranin A were positive. Surgical strategy was to treat the primary tumor and the liver synchronous metastasis in one stage surgery. DISCUSSION: Management of NETs liver metastases is challenging and requires aggressive therapy. Currently, there are many therapeutic options for metastatic NETs. Although complete surgical resection remains the optimal therapy and aggressive surgical resection increases the 5-year survival of NETs with sï¿1⁄2olitary liver metastasis to 100%. In this case, clinical status with doubt of carcinoid syndrome was essential for diagnosis and for subsequent surgical strategy with one stage surgery. CONCLUSION: Resection of the primary tumor, liver metastases, and local mesenteric lymph node metastases is thought to strictly promote long-term survival and quality of life. Typically, a multidisciplinary approach is a cornerstone for decision making while dealing with this aggressive disease
The novel the boy in the mirror as memory of Fernando Sabino
No full textThis article aims, through literary analysis, to show how the memory of author Fernando Sabino is present within the novel O Menino no Espelho (2010), seeking to identify the characteristics of the narrative literary genre. This research is of a qualitative nature, aiming to contribute to literary reading based on bibliographical analyzes of memories of the romance genre. Within the methodology, the object of analysis was the aforementioned book by Sabino. In this way, seeking to deepen the theme, bibliographical research, articles, books were used. Data collection took place through reading the work, bibliographical analysis and through records of subjects related to the research. In view of the data, the presence of Sabino's memory in the referred novel was identified. Thus, literary reading is one of the ways offered in this work to carry out an academic analysis. Theorists who supported the research: Fernando Tavares Sabino (2010), Angélica Maria Santos Soares (2007), Marisa Lajolo and Regina Zilberman (2011), Maria Clotilde Pires Bastos and Daniela Vitor Ferreira (2016), José Luiz Jobim (2012).Este artigo tem como objetivo, por meio da análise literária mostrar como a memória do autor Fernando Sabino se faz presente dentro do romance O Menino no Espelho (2010), buscando identificar as características do gênero literário narrativo. Esta pesquisa é de natureza qualitativa, visando contribuir com a leitura literária a partir de analises bibliográficas de memórias do gênero romance. Dentro da metodologia o objeto de análise foi o referido livro de Sabino. Desta forma, buscando o aprofundamento do tema, foram utilizadas a pesquisa bibliográfica, artigos, livros. A coleta de dados se deu por meio da leitura da obra, análise bibliográfica e através de fichamentos dos assuntos relacionados a pesquisa. Diante dos dados, identificou-se a presença de memória de Sabino no referido romance. Assim, a leitura literária é uma das formas oferecidas neste trabalho para se fazer uma análise acadêmica. Teóricos que deram embasamento a pesquisa: Fernando Tavares Sabino (2010), Angélica Maria Santos Soares (2007), Marisa Lajolo e Regina Zilberman (2011), Maria Clotilde Pires Bastos e Daniela Vitor Ferreira (2016), José Luiz Jobim (2012)
Geology and geological hazards field trip of Sabino Canyon : results of the July 2006 storms
No full textabstract: This field trip guide was created for a Project WET conference held in Tucson, Arizona, June, 2007. This guide discusses the general geology of the Santa Catalina Mountains in Sabino Canyon, and points out evidence of the July 2006 floods and debris flows. There are stops in the first few miles of canyon, and towards the end of the tram road, where the most spectacular debris flows are located.Open-file report (Arizona Geological Survey) ; 08-05Includes bibliographical references
Per una progettazione pedagogica partecipata. Generazione Z, rigenerazione urbana, educativa, culturale: un contributo nel segno del Service Learning
No full textThis essay argues for a participatory pedagogy centred on Generation Z that integrates civic education, urban regeneration and educational culture within a service-learning framework. It posits that civic participation and proactive engagement of the younger generations are fundamental prerequisites for social cohesion and democratic vitality. The author notes the European emphasis on promoting social responsibility and active citizenship among young people, particularly through initiatives outlined in the European Union Youth Strategy 2019-2027. The essay argues that while fostering a sense of community and solidarity is crucial, young people's increasing disengagement from political and social participation calls for a re-evaluation of traditional approaches to civic education. She suggests that a purely top-down approach to promoting civic engagement may be inadequate and may inadvertently reinforce feelings of alienation. Instead, the author argues for the need to cultivate a participatory civic and social culture that empowers young people to actively shape their political and social realities, thereby countering the risk of disengagement from decision-making processes
The apocryphal writer in the public debate: socio-political reflections in Sabino Ordas´ writings
No full text[ES] Sabino Ordás es una figura apócrifa ideada por los escritores
Juan Pedro Aparicio, Luis Mateo Díez y José María Merino. Su
creación aúna la atribución de una biografía ficticia junto a una serie
de escritos publicados, en su mayor parte, durante la Transición
española. Esta iniciativa de fabulación se adscribe al apócrifo en la
tradición del pensamiento político español, a la vez que conforma
un corpus de ideas exponente del leonesismo. Su obra subraya la
especificidad de la cultura leonesa, definida esta por la relación
entre las prácticas concretas, el paisaje y la historia. En su condición
de periodista, participa en el debate público con una reflexión
sociopolítica que aboga por la autonomía diferenciada para León
en el proceso de descentralización estatal. El reconocimiento de las
diversas culturas regionales bosqueja un concepto de nación como
identidad en la que confluyen dichas culturas regionales. Como
intelectual de su época, Sabino Ordás es un pensador que actualiza
la reflexión sobre el ser de España.[EN] Sabino Ordás is an apocryphal author created by Spanish
writers Juan Pedro Aparicio, Luis Mateo Díez and José María Merino.
This apocryphal model is made up with a given biography and
a set of writings. From the facts of his fictitious biography, Ordás
is linked to the history of Spanish political thought. On the other
hand, his writings show the relevance of culture to define a political
space. His political thought represents the updated current of
regionalism in the Spanish region of León since focus is granted on
particularities of León´s culture. This cultural regionalism aims at
a political recognition. Written in the times of Spanish transition to
democracy, such texts support the aspiration for political autonomy
for León. Sabino Ordas´s writings claimed for the recognition
of the different cultures and showed the reflection on Spain from
his conception of regionalism in León
La silloge epigrafica di Pietro Sabino : un riesame della tradizione manoscritta
No full textAltres ajuts: Questo contributo è stato realizzato in margine ai progetti di ricerca CCG2015/HUM-066 (UAH)This paper presents a new philological study of the manuscripts that contain the epigraphic collection of the humanist Pietro Sabino (15th c. ex.). The picture of the textual tradition that emerges from it differs widely from those proposed until now, and it features two consecutive recensions envisaged by its author. Moreover, the analysis allows us to shed light on the first diffusion of the collection, as well as on the chronology, interests and working method as regards Pietro Sabino's epigraphic studies
Riflessioni pedagogiche sulla continuità nel territorio: forme di partecipazione e Poli per l'infanzia
No full textThis paper, presented at the seminar "The pedagogy of the city in transition", explores pedagogical reflections on continuing education in the territory: forms of participation and policies for early childhood (0-6 years). The author highlights territorial elements and policies for early childhood within a research-action project focused on the 0-6 age group, emphasising the importance of the territorial context and the involvement of the community. While acknowledging regional references and existing research, the contribution is based on a perspective that sees the child not only as an individual in development, but also as a subject with rights and an inherent potential for agency within his or her family, social and institutional environment. It emphasises the active role of children in learning and care processes, recognising their capacity to exercise rights and express needs. Furthermore, it discusses the normative framework established by Law No. 107/2015 and subsequent decrees on the Integrated System of Education and Instruction from Birth to Six Years, highlighting the continuity of educational pathways and the diverse needs of children. The essay critically reflects on the challenges and opportunities in early childhood education, advocating for a pedagogical approach that acknowledges the complexity of childhood in contemporary society and promotes continuous training and research in this field
Un caso de escritura colaborativa a la luz de la estilometría: Sabino Ordás
No full textAt the end of the 1970s, specifically between November 1977 and November 1979, Juan Pedro Aparicio, José María Merino and Luis Mateo Díez began a collaborative writing adventure under the pseudonym Sabino Ordás. The aim of this work is to show how the traces of an author remain indelible, even despite the author's own will to hide. In this way, thanks to stylometry, we can detect the authorial responsibility of each of these three real authors in the different articles attributed to their common heteronym.A finales de los años 70, concretamente entre noviembre de 1977 y noviembre de 1979, Juan Pedro Aparicio, José María Merino y Luis Mateo Díez inician una aventura de escritura colaborativa bajo el pseudónimo de Sabino Ordás. En este trabajo se pretende mostrar cómo las huellas de un autor permanecen indelebles, aun a pesar de la voluntad de ocultación del propio autor. De este modo, gracias a la estilometría, podemos detectar la responsabilidad autorial de cada uno estos tres autores reales en los distintos artículos atribuidos a su común heterónimo
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