102,094 research outputs found
Transplantation during the COVID-19 pandemic. Nothing noble is accomplished without danger
No full textThe global health crisis due to the fast spread of coronavirus disease (COVID-19) has caused major disruption in all aspects of healthcare. Transplantation is one of the most affected sectors, as it relies on a variety of services that have been drastically occupied to treat patients affected by COVID-19. With this report from two transplant centers in Italy, we aim to reflect on resource organization, organ allocation, virus testing and transplant service provision during the course of the pandemic and to provide actionable information highlighting advantages and drawbacks.To what extent can we preserve the noble purpose of transplantation in times of increased danger? Strategies to minimize risk exposure to the transplant population and health- workers include systematic virus screening, protection devices, social distancing and reduction of patients visits to the transplant center. While resources for the transplant activity are inevitably reduced, new dilemmas arise to the transplant community: further optimization of time constraints during organ retrievals and implantation, less organs and blood products donated, limited space in the intensive care unit and the duty to maintain safety and outcomes
Pathways of Self-Determination: A Constructivist Grounded Theory Study of Slut-shaming Vulnerability in a Group of Young Adults
No full textSlut-shaming is a sexual stigmatization that consists in a form of discrimination
against those who do not respect gender stereotypes of external appearance and/
or sexual behaviors and attitudes. Individuals may also be exposed to slut-shaming
merely due to fortuitous elements unrelated to the sexual dimension. Slut-sham ing is perpetrated through ostracism, rejection and sexual stigmatization and may
have negative efects on psychophysical well-being. The primary aim of the pre sent study is to explore the victimization of young adults through slut-shaming. A
sample of thirty-six participants (aged 19–28) was recruited and focus groups and
interviews were conducted to explore participants’ slut-shaming experiences. Con structivist grounded theory was employed to understand how young adults deal with
slut-shaming and analyze sociocultural factors involved in slut-shaming dynamics.
Several individual, social and cultural factors are involved in sexual stigmatization
processes. A core set of 6 categories related to slut-shaming exposure was identifed:
exposure to slut-shaming, antecedents of slut-shaming, socio-cultural context facili tating slut-shaming, LGBTQIA+and slut-shaming, negative efects of slut-sham ing, and reactions to slut-shaming. Results emphasized that, even if young adults
showed a generally high level of awareness of sexual discrimination and stigmati zation processes, slut-shaming victimization is not uniformly experienced by them.
Young adults’ narratives seem to show conficting feelings and thoughts regarding
the possible strategies that could be employed to deal with slut-shaming exposure and pervasive internal and external forms of oppression
The effects of mandatory preclinical education on exposure to injuries as reported by Italian nursing students: A 15-year case-control, multicentre study
No full textContext: Patients with advanced illnesses show the highest prevalence for pressure injuries. In the palliative care setting, the ultimate goal is injury healing, but equally important is wound maintenance, wound palliation (wound-related pain and symptom management), and primary and secondary wound prevention.
Objectives: To describe the course of healing for pressure injuries in a home palliative care setting according to different end-points, and to explore patient and caregiver characteristics and specific care activities associated with their achievement.
Methods: Four-year retrospective chart review of 669 patients cared for in a home palliative care service, of those 124 patients (18.5%) had at least one pressure injury with a survival rate less than or equal to six months.
Results: The proportion of healed pressure injuries was 24.4%. Of the injuries not healed, 34.0% were in a maintenance phase, whereas 63.6% were in a process of deterioration. Body mass index (P = 0.0014), artificial nutrition (P = 0.002), and age <70 years (P = 0.022) emerged as predictive factors of pressure injury complete healing. Artificial nutrition, age, male caregiver (P = 0.034), and spouse (P = 0.036) were factors significantly associated with a more rapid pressure injury healing. Continuous deep sedation was a predictive factor for pressure injury deterioration and significantly associated with a more rapid worsening.
Conclusion: Pressure injury healing is a realistic aim in home palliative care, particularly for injuries not exceeding Stage II occurring at least two weeks before death. When assessing pressure injuries, our results highlight the need to also pay attention to artificial nutrition, continuous deep sedation, and the caregiver's role and gender
Lapatinib activity in a patient with encephalic metastases from trastuzumab-resistant her-2 positive breast cancer
No full textA 42-year-old woman with right breast cancer cT4dN2M0 HR +, HER2 +, undergoes mastectomy with axillary lymphadenectomy after neoadjuvant chemotherapy. During adjuvant treatment with trastuzumab and hormone therapy, the patient develops multiple symptomatic encephalic metastases. She undergoes panencephalic radiotherapy and begins chemotherapy with capecitabine and lapatinib. After three months of well tolerated therapy, an important volumetric response of encephalic metastases is observed, with regression of neurological symptoms
The effects of mandatory pre-clinical education on exposure to injuries as reported by Italian nursing students: a 15-year case-control, multi-centre study.
No full textTransanal endoscopic video-assisted (TEVA) resection of early rectal lesions using a SILS port A single center experience
No full textAIM: Transanal Endoscopic Video Assisted (TEVA) excision using a Single Incision Laparoscopic Surgery SILSTM-Port represents a safe and complete technique to remove benign lesions of the rectum not treatable by endoscopy and malignant rectal lesions at early stage. It is a valid alternative to transanal endoscopic microsurgery (TEM), to conventional transanal surgery and to transabdominal resection.
METHODS: In our operating Unit we performed a resection of 8 voluminous adenoma in the rectal ampulla with SILSTM-Port.
RESULTS: The mean age of the patients was of 51.1 years, the mean BMI was 23. There were not intra or post-operative complications nor conversions to conventional transanal excision or major resective surgery. The postoperative course was normal. The average time of hospitalization was 3 days.
CONCLUSIONS: TEVA is easier to perform than TEM and does not require a long training and specific and expensive material as the TEM does. TEVA might go to replace completely TEM
Role of videofluorography with water siphon test in otolaryngologic presentations of GERD
No full textIn recent years digital videofluorography (VFG) with water siphon test (WST) has been proposed just for diagnosing hiatal hernia and/or gastroesophageal reflux.
PATIENTS AND METHODS:
Fifteen patients undergone Laparoscopic Nissen (LN) for complicated GERD associated to hiatal hernia, were referred for VFG and WST in order to evaluate the functional results of surgery. At one-month videofluorographic control thirteen patients had just a minimal prolonged esophageal transit time but only six of these had an early postoperative dysphagia, whereas at six months control the prolonged esophageal transit time was present in three patients two of which complained a very light dysphagia. One patient at one month control had a severe dysphagia, her videofluorography showed a very prolonged esophageal transit time and she had to redo surgery. She had a complete resolution of dyspagia and at the six months videofluorographic control she had a normal esophageal and esophagogastric transit time. One patient, underwent surgery in another hospital, complained a persistent and moderate dysphagia and at one month videofluorografic control was evident a malposition of wrap around the upper part of the stomach and a WST positive for reflux and at six months control clinical finding was worst. He will be evaluated for further endoscopic or surgical treatment.
CONCLUSIONS:
In our experience we believe that VFG is a valid test to identificate the postoperative outcomes giving the surgeons a visual evaluation of their work
The Nexus of Hyperparathyroidism and Thyroid Carcinoma: Insights into Pathogenesis and Diagnostic Challenges—A Narrative Review
No full textThis review investigates the intricate relationship between hyperparathyroidism (HPT) and thyroid carcinoma (TC), aiming to elucidate their coexistence, potential pathogenetic mechanisms, and clinical implications. A systematic search strategy, employing the MeSH terms 'Hyperparathyroidism' and 'Thyroid Carcinoma', spanned publications from 2013 to 2023 across the PubMed, Web of Science, and Scopus databases. Fifteen selected articles were analyzed. Studies unanimously confirm the notable association between primary hyperparathyroidism (PHPT) and thyroid nodules/cancer, with incidences ranging from 2.8% to 47.1%. Key findings reveal a predilection for papillary thyroid carcinoma (PTC) in this association, showcasing varying tumor characteristics and gender disparities. Lower preoperative serum parathyroid hormone (PTH) levels are a potential risk factor for thyroid cancer in PHPT patients. Diverse surgical approaches and tumor characteristics between PHPT and secondary hyperparathyroidism (SHPT) cases were noted. Moreover, this review underscores the scarcity of definitive guidelines in managing concurrent PHPT and thyroid conditions, advocating for comprehensive assessments to enhance diagnostic accuracy and refine therapeutic interventions. Rare coincidental associations, as highlighted by case reports, shed light on unique clinical scenarios. In essence, this review amalgamates evidence to deepen the understanding of the interplay between HPT and TC, emphasizing the need for further research to elucidate underlying mechanisms and guide clinical management
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