75 research outputs found
Questione di feeling? La legittimazione delle tecnologie digitali nel social work durante la pandemia.
No full textThe pandemic has forced many social workers to adopt various digital technologies to overcome the limitations of lockdown and maintain relationships with service users and colleagues. Reactions to this change have been ambivalent: on the one hand, many social workers have appreciated the advantages and innovations that digital technologies can offer but, on the other hand, other practitioners have expressed a strong mistrust of their appropriateness for social work. Based on an empirical research conducted with seventy-five social workers, the article offers an analysis of the steps that have progressively led to the acceptance or rejection of digital technologies, highlighting the main issues on which professionals have questioned themselves. The challenge that remains open is to understand whether the adoption of digital technologies can enrich the repertoire of resources and tools available to professionals and organisations, or whether it corresponds to a fallback to be abandoned
Effectiveness of the CardioPain initiative in reducing inappropriate NSAID prescriptions in pain therapy among high cardiovascular risk patients: an informative Italian survey
No full textNon-steroidal anti-inflammatory drugs (NSAIDs) and COX-2 inhibitors (COXIBs) may be associated with increased cardiovascular (CV) risk and mortality in CV patients. After the release of Note 66 by Agenzia Italiana del Farmaco (AIFA) to reduce inappropriate prescribing of NSAIDs and COXIBs, the CARDIOPAIN initiative was started in Italy to include such recommendations into the hospital discharge letter of patients with high CV risk. We evaluated the effect of the CARDIOPAIN initiative on the prescription of analgesic drugs by general practitioners (GPs)
Intra-site spatial analysis to understand past foodways: the case of the Early Holocene occupation at Takarkori (SW Libya).
No full textProspective pilot study evaluating the effectiveness of electrochemotherapy using reduced dosages of intravenous bleomycin
No full textBackground: Electrochemotherapy (ECT) is currently used to treat cutaneous and subcutaneous tumors of different histotypes. ECT combines cytotoxic drugs and the application of high-intensity electric pulses to increase cell permeability. In 2006, a multicenter European project (ESOPE, European Standard Operating Procedures of Electrochemotherapy) defined the guidelines for ECT application. To date, a revision of the first SOP is required. The International Network for Sharing Practices on Electrochemotherapy (InspECT) database was established to improve the clinical application of ECT. The objective of this study was to evaluate the effectiveness of ECT using reduced dosages of i.v. bleomycin (BLM). Methods: Lowering of the dose of BLM is advised e.g. in patients with impaired renal function. As patients treated with ECT were registered prospectively in a common database (InspECT registry) we decided to investigate efficacy and side effects when a lower dose of BLM was used. 57 patients, uploaded by 7 European centres, were treated by ECT with respectively 7.500, 10.000 and 13.500 IU/m2 of BLM, instead of the standard 15.000 IU/m2, because of renal dysfunction. Results: We enrolled 57 patients with 147 skin lesions. Diagnosis distribution of primary tumour was: 38.6% melanoma, 22.8% squamous cell carcinoma, 17.5% basal cell carcinoma, 7% breast cancer, 7% Kaposi sarcoma, 7.1% other. Per-tumor response at 60 days was as follows: CR, 70.1%, PR, 16.3%. Per-patient response was as follows: CR, 57.9%, PR, 21.1%. Only 2 patients (4%) experienced flu-like symptoms, 1 patient (2%) nausea and 22 patients (39%) referred pain, mostly mild. Conclusions: According to the data of this pilot study, the use of dose of BLM lower than those recommended by SOP, seems to be effective. Our results suggest that also patients with renal failure may benefit from ECT treatment with a reduced BLM dose. These findings need prospective confirmations on wider cohorts of patients
Water and air ozone treatment as an alternative sanitizing technology
No full textAims. We investigated the effectiveness of ozone (aqueous and gaseous) treatment as an alternative sanitizing technology to common conventional disinfectants in reducing the microbial contamination of both water and air. Methods. Ozone was added for 20 minutes to a well-defined volume of water and air by the system named "Ozonomatic®". The effectiveness of ozonation was determined by counting CFU/m3 or ml of bacteria present in samples of air or water collected before (T0) and after (T1) the addition of ozone and comparing the microbial load of different bacteria present in ozonized and non-ozonized samples. Results. When the ozonisation equipment was located at 30 cm from the surface of the water in the bath tub in which the bacteria investigated were inoculated, the treatment was able to reduce the total microbial load present in the aerosol by 70.4% at a temperature of 36°C for 48 hours. Conversely, at 22°C for 5 days, only a modest decrease (9.1%) was observed. Escherichia coli and Pseudomonas aeruginosa were completely eliminated. A 93.9% reduction was observed for Staphylococcus aureus, followed by Streptococcus faecalis (25.9%). The addition of ozone to water was able to almost eliminate Staphylococcus aureus (98.9% reduction) and also to exert a strong impact on Legionella pneumophila (87.5% reduction). Streptococcus faecalis and Pseudomonas aeruginosa showed a decrease of 64.2% and 57.4%, respectively. Conversely, only a 26.4% reduction was observed for the bacterium Escherichia coli. This study showed that the addition of ozone in the air exerted a modest reduction on microbial load at 36°C, whereas no effect was observed at 22°C. Conclusions. Aqueous and gaseous ozone treatments were effective against microbial contaminants, reducing the CFU of the microorganisms studied. These results confirm the efficacy of the ozone disinfection treatment of both water and air; particularly, it constitutes an extremely promising alternative, allowing the possibility to reuse contaminated water
Core stability; aspetti anatomo-funzionali e implicazioni nella prevenzione degli infortuni agli arti inferiori e al rachide lombare: scoping review
No full textINTRODUZIONE: Il core è definibile come il nucleo del nostro corpo, il principale elemento stabilizzante la colonna vertebrale e in quanto tale è direttamente implicato nella esecuzione di movimenti precisi e controllati delle estremità. Da queste premesse nasce l’ipotesi che la core stability sia un fattore di prevenzione per gli infortuni al rachide lombare e agli arti inferiori
OBIETTIVI: Riportare le evidenze presenti in letteratura riguardo l’ipotesi che il rinforzo della muscolatura del core possa ridurre la possibilità di lombalgia e di lesioni agli arti inferiori
METODI: La ricerca è avvenuta nelle principali banche dati, PubMed, PEDro e Cochrane Library e si è avvalsa del confronto con esperti. La ricerca sulle banche dati online è terminata il 15 settembre 2021 e sono stati considerati sia studi primari che secondari
RISULTATI: Sono stati selezionati dalle banche dati 43 articoli di interesse che sono inerenti all’anatomia del core e alla core stability come fattore preventivo degli infortuni al rachide lombare e agli arti inferiori. Ci sono evidenze riguardo il fatto che le componenti della core stability siano correlate agli infortuni agli arti inferiori negli sportivi
CONCLUSIONE: La core stability è un concetto multidimensionale che risulta pertanto difficile da valutare in maniera completa. Molti studi forniscono evidenze per le quali il core risulti un fattore potenzialmente preventivo nelle lesioni del rachide lombare e degli arti inferiori; esso è direttamente implicato nella stabilità del rachide e nella cinematica degli arti inferiori. L’allineamento posturale, in particolare del bacino, è correlato all’attivazione dei muscoli del core, motivo per cui risulta fondamentale una valutazione posturale che preceda la fase di rinforzo muscolare del “nucleo”. Servono ulteriori studi che definiscano in maniera univoca le componenti della core stability e indaghino ulteriormente la sua relazione con gli infortuni al rachide lombare e agli arti inferior
Myocardial damage following cardiac surgery: Comparison between single-dose Celsior cardioplegic solution and cold blood multi-dose cardioplegia
No full textMyocardial protection during cardiac surgery can be accomplished by different cardioplegic solutions. The aim of this study was to assess myocardial damage after heart valve surgery performed with myocardial protection of a single dose of Celsior cardioplegia or with repeated cold blood cardioplegia. After the stratification of 139 valvular patients by means of matching according to cross-clamp and cardiopulmonary bypass time, 32 patients were retained for comparison (16 patients received Celsior and 16 patients received cold blood cardioplegia). Creatine kinase-MB (CK-MB) and cardiac troponin I (cTnI) release were evaluated until six days after the operation. Pre-operative characteristics were similar in both groups. In the Celsior group, CK-MB and cTnI values were significantly higher from the first up to the sixth post-operative day. Peak cTnI values were 19.4±13.4 and 9.7±7 ng/mL (p=0.01) in the Celsior and the Cold Blood group, respectively. Peak CK-MB values were 79.6±58.8 and 45.9±20.6 U/L (p=0.07) in the Celsior and the Cold Blood group, respectively. Cold blood cardioplegia reduces perioperative myocardial damage compared to the Celsior solution in elective cardiac valve operations. © The Author(s) 2013
A Simple Analytical Model of the Nocturnal Low-Level Jet over the Great Plains of the United States
No full textA simple analytical model including both diurnal thermal forcing over sloping terrain (the "Holton" mechanism) and diurnally varying boundary layer friction (the "Blackadar" mechanism) is developed to account for the observed amplitude and phase of the low-level jet (LLJ) over the Great Plains and to understand better the role of each mechanism. The present model indicates that, for the pure Holton mechanism (time-independent friction coefficient), the maximum southerly wind speed v(max) occurs (depending on the assumed friction coefficient) between sunset and midnight local standard time, which is earlier than the observed after-midnight maximum. For the pure Blackadar mechanism (time-independent thermal forcing), the present model shows that v(max) generally occurs later (closer to sunrise) than observed and has a strong latitudinal dependence. For both mechanisms combined, the present model indicates that v(max) occurs near to the observed time, which lies between the time obtained in the pure Holton mechanism and the time obtained in the pure Blackadar mechanism; furthermore, v(max) is larger (and closer to that observed) than in each one considered individually. The amplitude and phase of the LLJ as a function of latitude can be obtained by the combined model by allowing for the observed latitude-dependent mean and diurnally varying thermal forcing.Meteorology & Atmospheric SciencesSCI(E)[email protected]
Activation of the receptor activator of the nuclear factor-κB ligand pathway during coronary bypass surgery: Comparison between on- and off-pump coronary artery bypass surgery procedures
No full textObjectives: The receptor activator of the nuclear factor kappa-B (NF-κB) ligand (RANKL), its membrane receptor RANK and its decoy receptor osteoprotegerin (OPG) are all members of the tumour necrosis factor family involved in bone metabolism and immune response. We evaluated the activation of the OPG/RANKL/RANK pathway in patients undergoing cardiac surgery with and without cardiopulmonary bypass (CPB). Methods: Twenty consecutive patients undergoing elective coronary artery surgery were enrolled in the study and assigned either to the on-pump or to the off-pump group. Pre- and postoperative serum levels of OPG and RANKL were evaluated by enzyme-linked immunosorbent assay; gene expression of OPG, RANKL, RANK and NF-κB p50 subunits were determined by real-time polymerase chain reaction in peripheral blood T-cells and monocytes. Results: Serum levels of OPG significantly increased after surgery in both groups, whereas serum levels of RANKL did not differ over time. T-cells from the on-pump group showed increased gene expression of OPG, RANKL and RANK after the intervention, whereas no mRNA variation for these genes was detected in T-cells from off-pump patients. Gene expression of p50 subunit increased in T-cells and monocytes from both groups. Conclusions: Cardiac surgery induces the activation of the OPG/RANKL/RANK pathway; both on- and off-pump procedures are associated with increased postoperative OPG serum levels and up-regulation of the NF-κB p50 subunit. © The Author 2013. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery
Pump blood processing, salvage and re-transfusion improves hemoglobin levels after coronary artery bypass grafting, but affects coagulative and fibrinolytic systems
No full textCell saving systems are commonly used during cardiac operations to improve hemoglobin levels and to reduce blood product requirements. We analyzed the effects of residual pump blood salvage through a cell saver on coagulation and fibrinolysis activation and on postoperative hemoglobin levels. Thirty-four elective coronary artery bypass graft (CABG) patients were randomized. In 17 patients, residual cardiopulmonary bypass (CPB) circuit blood was transfused after the cell saving procedure (cell salvage group). In the other 17 patients, residual CPB circuit blood was discarded (control group). Activation of the coagulative, fibrinolytic and inflammatory systems was evaluated pre-operatively (Pre), 2 hours after the termination of CPB (T0) and 24 hours postoperatively (T1), measuring prothrombin fragment 1.2 (PF 1.2), plasmin-anti-plasmin (PAP), plasminogen activator inhibitor-1 (PAI-1) and interleukin-6 (IL-6). The cell salvage group of patients had a significant improvement in hemoglobin levels after processed blood infusion (2.7 ± 1.7 g/dL vs 1.2 ± 1.1 g/dL; p=0.003). PF1.2 levels were significantly higher after infusion (T0: 1175 ± 770 pmol/L vs 730 ± 237 pmol/L; p=0.037; T1: 331 ± 235 pmol/L vs 174 ± 134 pmol/L; p=0.026). Also, PAP levels were higher in the cell salvage group, although not significantly (T0: 253 ± 251 ng/mL vs 168 ± 96 ng/mL; p: NS; T1: 95 ± 60 ng/mL vs 53 ± 32 ng/mL; p: NS). No differences were found for PAI-1, IL-6, heparin levels or for red blood cell (RBC) transfusions. The cell salvage group of patients had increased chest tube drainage (749 ± 320 vs 592 ± 264; p: NS) and fresh frozen plasma transfusion rate (5 (29%) pts vs 0 pts; p<0.04). Pump blood salvage with a cell saving system improved postoperative hemoglobin levels, but induced a strong thrombin generation, fibrinolysis activation and lower fibrinolysis inhibition. These conditions could generate a consumption coagulopathy. © The Author(s) 2012
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