44 research outputs found
Applicabilità delle tariffe a forcella all'appalto di servizi di trasporto
No full textL'articolo commenta un'importante sentenza della Corte costituzionale sulla legge n. 162 del 1993 e, in particolare, sull'applicabilità del sistema delle tariffe a forcella a contratti diversi da quello di trasporto e, dunque, al contratto di appalto di servizi che abbiano per oggetto attività di trasporto. La nota ricostruisce il senso della legge n. 162 del 1993 e si interroga sulla possibilità di attribuire natura di norme di interpretazione autentica ad alcune disposizioni della stessa legge
Applicabilità delle tariffe a forcella all'appalto di servizi di trasporto
No full textL'articolo commenta un'importante sentenza della Corte costituzionale sulla legge n. 162 del 1993 e, in particolare, sull'applicabilità del sistema delle tariffe a forcella a contratti diversi da quello di trasporto e, dunque, al contratto di appalto di servizi che abbiano per oggetto attività di trasporto. La nota ricostruisce il senso della legge n. 162 del 1993 e si interroga sulla possibilità di attribuire natura di norme di interpretazione autentica ad alcune disposizioni della stessa legge
Beyond the skin: disease parameters in pemphigus
No full textPemphigus represents a group of rare autoimmune bullous diseases that affect the skin and mucous membranes. This group has a chronic course leading to high morbidity and mortality. Because of the painful chronic-recurring blisters and/or erosions on skin and mucosa, pemphigus can impair quality of life (QOL). Therapeutic modalities, anxiety and depression can also have an additional negative impact in the QOL of the pemphigus patients. Since the nature and course of the pathology and the fact that pemphigus worsens the quality of life of affected patients, scoring systems to objectively evaluate the clinical activity of the disease and to correlate that with the QOL are needed. Nowadays the most used global scales to assess the clinical activity of pemphigus are the Autoimmune Bullous Skin Disorder Intensity Score (ABSIS), the Pemphigus Disease Area Index (PDAI) and the Pemphigus Visual Activity Scale (PVAS). To evaluate the patient's generic QOL the most used score is the Dermatology Life Quality Index (DLQI), but all the sponsered clinical trials in pemphigus are using ABQOL this rather than DLQI
Casera Staulanza, Zoldo Alto, e Forcella Pecol, Selva di Cadore: Campagne 2011 e 2012
No full textIl contributo riporta i risultati delle ricerche degli anni 2011 e 2012 presso le aree di Casera Staulanza e Forcella Pecol. Nella prima località è stata rinvenuta una stazione riferibile all'Epigravettiano recente, oggetto di ricerca estensiva negli anni a seguire. Nella seconda i numerosi sondaggi effettuati hanno evidenziato come gli interventi antropici avvenuti in epoca recente abbiano cancellato ogni evidenza in situ di frequentazioni preistoriche, di cui erano state rinvenute le tracce in superficie
Fate of primary determinate and indeterminate target vessel endoleaks after fenestrated-branched endovascular aortic repair
No full textObjective: The aim of this study was to investigate the outcomes of primary determinate and indeterminate target vessel endoleaks (TVELs) after fenestrated-branched endovascular aortic repair (F-BEVAR). Methods: We conducted a single-center retrospective study (2014-2023) on F-BEVAR for thoracoabdominal (TAAAs) or pararenal aortic aneurysms (PRAAs). TVELs were classified as "primary" if present at the first postoperative computed tomography angiogram. Endoleaks were defined "determinate" (dELs) if the cause (type Ic or IIIc) and implicated target vessel were identifiable and "indeterminate" (iELs) if contrast enhancement was detectable at the level of fenestrations/branches without any evident source. Endoleaks involving multiple inflows (type II and target vessels) were defined as "complex" (cELs). Endpoints were endoleak spontaneous resolution, 1-year aneurysm sac failure to regress (>5 mm diameter decrease), and 4-year endoleak-related secondary interventions. Kaplan-Meier estimates and Cox regression were used for the analysis. Results: There were 142 patients with JRAAs/PRAAs (n = 85; 60%) or TAAAs (n = 57; 40%), with 513 target arteries incorporated through a fenestration (n = 294; 57%) or directional branch (n = 219; 43%). Fifty-nine primary TVELs (12%) were identified in 35 patients (25%), a dEL in 20 patients (14%) and iEL in 15 (11%); 22 (15%) had a determinate or indeterminate cEL. Overall spontaneous resolution rate was 75% (95% confidence interval [CI], 51%-87%) at 4 years. cELs (odds ratio [OR], 5.00; 95% CI, 1.10-49.4; P 6 months, and persistent forms were associated with sac failure to regress at 1 year (OR, 1.72; 95% CI, 1.03-12.59; P = .040). Overall freedom from endoleak-related reinterventions was 85% (95% CI, 79%-92%) at 4 years, 92% (95% CI, 87%-97%) for those without primary TVELs and 62% (95% CI, 46%-84%) for those with any primary TVEL (P < .001). In particular, cELs (hazard ratio, 1.94; 95% CI, 1.4-18.81; P = .020) were associated with an increased need for reintervention. In case a secondary intervention was needed, iEL or cEL had an increased risk for multiple secondary procedures (hazard ratio, 2.67; 95% CI, 1.22-10.34; P = .034). Conclusions: Primary TVELs are frequent after F-BEVAR, and a clear characterization of the endoleak source by computed tomography angiogram is not possible in 40% of patients. Most primary TVELs spontaneously resolve, but during follow-up, patients with any primary TVEL experience a worsened freedom from endoleak-related reinterventions that is mostly driven by persistence of cELs and post-BEVAR iELs. Multiple secondary procedures may be required in case of iELs or cELs
Effect of narrow paravisceral aorta on target vessels instability after fenestrated and branched endovascular aortic repair
No full textObjective: To investigate the effect of narrow paravisceral aorta (NPA) on target vessel instability (TVI) after fenestrated-branched endovascular aortic repair. Methods: We conducted a single-center retrospective study (2014-2023) of patients treated by fenestrated-branched endovascular aortic repair for thoracoabdominal aortic aneurysms (TAAA) or pararenal aortic aneurysms. The paravisceral aorta was defined as the aortic segment limited by the diaphragmatic hiatus proximally and the emergence of lower renal artery distally, and was considered "narrow" in case of a minimum inner diameter of 30° was significantly associated with TVI in FEVAR (HR, 3.21; 95% CI, 1.03-48.70; P = .036), being the result mostly driven by target vessel occlusion. In BEVAR, a NPA diameter of 25 mm (hazard ratio [HR], 3.02; 95% CI, 1.01-36.33; P = .040) and NPA severe calcification (HR, 1.70; 95% CI, 1.00-22.42; P = .048) were associated with a higher chance for TVI. Conclusions: FEVAR and BEVAR are both feasible in cases of NPA and provide satisfactory target vessels durability. The use of outer branches should be avoided in cases with an inner aortic diameter of 25 mm or moderate to severe NPA calcifications. In FEVAR, bridging stent patency may be negatively influenced by NPA of 30°
Cadmium accumulation in neuronal cells leads to essential metals imbalance and zinc transporters dysregulation
No full text: The heavy metal cadmium (Cd), a natural element of the Earth's crust released into the environment through both natural processes and anthropogenic activities, is ranked 7th on the ATSDR Substance Priority List of hazardous substances. Its low excretion rate from human body and its long biological half-life (10-30 years) lead to Cd heavy accumulation in organisms. Although Cd carcinogenicity is well recognized, the neurotoxicity and damage to the nervous system still require further investigation. The interference with essential element homeostasis, referred as dyshomeostasis, is one of Cd neurotoxic mechanisms and its interference on specific ions balance could play a key role in the process of neurodegenerative diseases. In this study Cd possible impact on the balance of essential elements was evaluated in human neural SH-SY5Y cells, by exposing the target cells to low Cd concentrations (0.1-5μM) for 24h, 48h and 6 days. Cd accumulates inside the cells in a time and dose dependent manner with dysregulation of both zinc and iron homeostasis and induction of heme oxygenase 1 expression. Moreover, zinc transporters ZnT1 and ZnT2 are upregulated, while the iron transporter DMT1 is downregulated. In conclusion our data show that even low, sublethal cadmium concentrations are effective in inducing dyshomeostasis of essential metals involved in important neuronal functions
Impact of Carotid Stent Design on Embolic Filter Debris Load During Carotid Artery Stenting
No full textBackground: The carotid stent design may influence the risk of embolization during carotid artery stenting. The aim of the study was to assess this risk by comparing the quantity of embolized material captured by filters during carotid artery stenting, using different stent designs. Methods: We conducted a single-center retrospective study of patients undergoing carotid artery stenting for asymptomatic carotid stenosis >70% (2010-2022) in a tertiary academic hospital (Padua University Hospital, Italy). Carotid stents were classified according to their design as open-cell (OCS), closed-cell (CCS), or micromesh stents (MMS). A distal filter protection was used in all patients, and the amount of captured embolized particles was semiautomatically analyzed using a dedicated software (Image-Pro Plus, Media Cybernetics). Primary end point was embolic filter debris (EFD) load, defined as the ratio of the filter area covered by particulate material to the total filter area. Secondary end points were 30 days major stroke and death. Results: Four-hundred-eighty-one carotid artery stentings were included; 171 (35%) using an OCS, 68 (14%) a CCS, and 242 (50%) a MMS. Thirty-days mortality was 0.2% (n=1) and major stroke rate was 0.2% (P=0.987). Filters of patients receiving MMS were more likely to be free from embolized material (OCS, 30%; CCS, 13%; MMS, 41%; P15 mm (OC, 10.2±15.3; CC, 8.6±12.4; MM, 8.2±13.6; P<0.001), and preoperative ipsilateral asymptomatic ischemic cerebral lesion (OCS, 12.9±16.8%; CCS, 8.7±19.5%; MMS, 5.4±9.7%; P<0.001). After multivariate linear regression, use of MMS was associated with lower EFD load (P=0.038). Conclusions: The use of MMS seems to be associated with a lower embolization rate and EFD load, especially in hypoechogenic and long plaques and in patients with a preoperative evidence of asymptomatic ischemic cerebral lesion
Lactobacillus casei Shirota daily intake improves NK cytotoxicity in smokers in a randomized controlled trial
No full textA case study of a ’policy network’ for the promotion of migrant health: the Italian Society of Migration Medicine (SIMM)
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