1,721,654 research outputs found
Editorial Comment on "Evaluation of the Treatment of Congenital Penile Curvature including Psycho-Sexual Assessment"
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Simplification of classification and surgical expertise in the delayed treatment of traumatic posterior urethral injuries
No full textTelerehabilitation after total knee replacement in Italy: cost-effectiveness and cost-utility analysis of a mixed telerehabilitation-standard rehabilitation programme compared with usual care
Full text linkOBJECTIVES: To assess cost-effectiveness and cost utility of telerehabilitation (TR) versus standard rehabilitation (SR) after total knee replacement (TKR). DESIGN: Markov decision modelling of cost-effectiveness and cost-utility analysis based on patient-level and secondary data sources employing Italian National Health Service (NHS; Ita-NHS) and Society perspectives. SETTING: Primary care units (PCUs) in Italy. PARTICIPANTS: Patients discharged after TKR. INTERVENTIONS: Mixed SR-TR service (10 face-to-face sessions and 10 telesessions) versus SR (20 face-to-face sessions) PRIMARY AND SECONDARY OUTCOME MEASURES: The incremental cost per additional knee flexion range of motion (ROM) and per QALY gained by SR-TR compared with SR. Second, we considered the probability of being cost-effective and the probability of being more effective and less expensive. RESULTS: TR appears to be the cost-effective in the base case and in all of the considered scenarios, but is no longer more effective and less expensive if transportation costs are excluded. Comparing SR-TR with SR, the incremental cost-effectiveness ratio (ICER) adopting the Ita-NHS perspective for the base case was -€117/ROM gained. The cost-effectiveness probability for SR-TR was 0.98 (ceiling ratio: €50/ROM), while the joint probability of being more effective and less expensive was 0.87. Assuming that TR would increase health-related quality of life (HRQOL) utilities by 2.5%, the ICER adopting Ita-NHS perspective is -€960/QALY (cost-effectiveness probability: 1; ceiling ratio: €30 000/QALY). All the performed sensitivity analyses did not change the conclusions, but if transportation costs were excluded, the probability for SR-TR of being more clinically effective and less expensive reduced to 0.56. CONCLUSIONS: The analysis suggested SR-TR to be cost-effective, even less expensive and more effective if the PCUs provide ambulance transportations. However, the uncertainty related to TR costs, HRQOL and long-term clinical outcomes raises important topics for future research, which should be addressed to confirm our estimates. TRIAL REGISTRATION NUMBER: ISRCTN45837371
Phosphodiesterase Type 5 (PDE5) Inhibitors in Erectile Dysfunction: The Proper Drug for the Proper Patient
No full textIntroduction. Erectile dysfunction (ED) is a very common multidimensional disorder affecting men worldwide. Physical illness, reaction to life stresses, or an unhappy couple relationship influence clinical outcome. Phosphodiesterase type 5 (PDE5) inhibitors are recognized as efficacious and well tolerated, and are the first-line treatment for ED. Sildenafil, tadalafil, and vardenafil are the most widely used and studied PDE5 inhibitors. Data acquired during a routine diagnostic workup for ED should be taken into account when choosing the best PDE5 inhibitor for the individual patient, creating an individualized treatment plan, and going beyond "experience-based" subjective opinion and unfounded ideas and prejudice regarding currently available drugs. Aim. As the process of matching a given patient's profile to any selected PDE5 inhibitor often relies more on physician's personal convictions than on solid evidence, the aim of this review is to identify the main clinical, demographic, and relational factors influencing the choice of the PDE5 inhibitor to be used for the treatment of ED. Methods. A systematic literature search and current treatment guidelines were evaluated in a systematic manner. Main Outcome Measures. The main clinical, cultural, and demographical factors to be considered for the treatment of ED have been identified. Results. Main factors influencing the choice of the treatment for ED have been described. A short list of items that may help in choosing the right PDE5 inhibitor for the treatment of different patients in daily clinical practice has been prepared. Conclusions. The simple algorithms prepared should be a useful tool to be used in daily practice, which may help in choosing the right treatment for each subject affected by ED. Corona G, Mondaini N, Ungar A, Razzoli E, Rossi A, and Fusco F. Phosphodiesterase type 5 (PDE5) inhibitors in erectile dysfunction: The proper drug for the proper patient. J Sex Med 2011;8:3418-3432
Progetto di un sistema per il controllo e l'interfacciamento con l'utente di un'unità meccanica complessa
No full textTecniche di controllo ed acquisizione dati per prove di oscillazione forzata in galleria del vento
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“A buon intenditor poche parole”. Qualche riflessione sulla comunicazione istituzionale per le comunità con background migratorio
No full textLa necessità di un ammodernamento della comunicazione istituzionale che ne possa migliorare la comprensibilità è ancora pressante. Di particolare rilievo è l’impatto positivo che questo processo linguistico può avere per l’inclusione delle comunità con background migratorio. Si tratta di una evoluzione cruciale, necessaria anche per colmare il divario ancora esistente tra la lingua parlata di tutti i giorni e la lingua utilizzata nella comunicazione istituzionale scritta. In questo contributo si intende analizzare la leggibilità e comprensibilità di alcuni testi redatti da istituzioni italiane. Il nostro studio sottolinea che molti aspetti problematici, evidenziati nella letteratura sul linguaggio burocratico italiano, sono presenti anche nei testi istituzionali rivolti agli stranieri. L’analisi segnala che le istituzioni mostrano un basso grado di consapevolezza circa i bisogni e le aspettative comunicative degli immigrati, ma anche circa le funzioni sociali che la lingua italiana dovrebbe svolgere in una società plurilingue e interculturale
Hydrological behavior of ash-fall pyroclastic soil mantled slopes of the Sarno Mountains (Campania - Southern Italy)
No full textThe instability of ash-fall pyroclastic deposits that mantle mountain ranges around the Mount Somma-Vesuvius (Campania, southern Italy) are well known to represent a main geological hazard due to their frequent involvement in shallow flow-like landslides, triggered by high-intensity and prolonged rainfall. In such a geomorphological framework, which is similar to other mountain areas that surround volcanic centers of the world, the comprehension of hydrological dynamics occurring into pyroclastic deposits is a key factor for assessing and modelling the landslide hazard. Despite the general relevance of hydrological analysis in studying shallow landslides, this type of approach is particularly significant for pyroclastic soils due to their special hydrological properties and complex stratigraphic settings. Along with this goal, in a test area of the Sarno Mountains, upslope of a debris flow source area, a monitoring station was installed to assess hydrological processes that predispose and lead to landslide triggering. Monitoring data, covering about three hydrological years (Dec. 2010 - Dec. 2013), showed a regime of pore pressures always ranging in unsaturated conditions. Marked seasonal and interannual variations of pore pressure were observed at different depths with respectively delayed and damped dynamics. These observations were correlated to rainfall patterns and the evapotranspiration regime, which is concentrated during the activity period of the existing deciduous forest. Results of this approach allow understanding hydrological processes at slope scale, to set and calibrate numerical models for estimating rainfall thresholds by a deterministic approach as well as to assess landslide hazard
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