279 research outputs found
La tassa di concessione governativa per l'iscrizione nel registro delle imprese: storia e problematiche
No full textTeaching adults to read better and faster : results from an experiment in Burkina Faso
No full textTwo cognitively oriented methods were tested in Burkina Faso to help illiterates learn to read more efficiently. These were (a) speeded reading of increasingly larger word units and (b) phonological awareness training to help connect letters to speech. Learners were given reading tests and a computerized reaction time test. Although the literacy courses were shortened by the arrival of rains and government delays, the piloted methods helped adults read better than those in the standard"control"classes. Learners enrolled in the experimental classes performed better on the outcome tests than did learners enrolled in control classes. Ninety percent of the possible comparisons between treatment classes and control classes favored classes receiving treatments, and 72 percent of the measurements in favor of treatments were statistically significant. The evidence suggests that phonological awareness training is particularly effective in situations where the training period was short, and that rapid reading was more advantageous in longer training situations. Overall, the results are indicative of the potential that scientifically backed methods have in making adult literacy instruction more effective. However, due to the short duration of the classes (3-4 months) learners apparently did not receive sufficient practice to consolidate skills. Literacy skills may still be prone to being forgotten if readers do not learn to read automatically and if opportunities to read are few.Curriculum&Instruction,Teaching and Learning,Nonformal Education,Primary Education,ICT Policy and Strategies,Nonformal Education,ICT Policy and Strategies,Primary Education,Teaching and Learning,Curriculum&Instruction
Recurrent sacrococcygeal pilonidal disease: the efficacy of minimal subcutaneous excision of the sinus and unroofing of pseudocystic cavity
No full textI pazienti sottoposti a intervento chirurgico per malattia pilonidale sono ad alto rischio di sviluppare una recidiva. La nostra analisi prospettica è stata eseguita per valutare l’esito del trattamento della malattia pilonidale recidiva, mediante escissione sottocutanea minima del tramite fistoloso e della cute sopra la cisti, con Recurrent pilonidal disease guarigione per seconda intenzione. 48 pazienti consecutivi con precedente asportazione chirurgica di malattia pilonidale e attuale recidiva, sono stati sottoposti a chirurgia da gennaio 2009 a dicembre 2016, in anestesia locale. L’età dei pazienti (42 maschi e 6 femmine) al momento della nostra osservazione era di 28.5 ± 10.2 anni, il BMI di 26.3 ± 6.8. Il numero medio di interventi precedenti al nostro era di 2.02 ± 1.14. RISULTATI: Il tempo medio operatorio è stato di 18.2 ± 5.5 minuti. Tutti i pazienti sono stati dimessi da 2 a 4 ore dopo l’intervento chirurgico, con un tempo medi di guarigione di 22.8 ± 15.3 giorni. Abbiamo registrato, nel periodo di follow up, solo 4 recidive (8.32%), tutte ritrattate con la medesima procedura operatoria e portate a guarigione completa. I risultati del questionario cosmetico, che ha valutato la soddisfazione e la contentezza del paziente, hanno mostrato che il 96% dei pazienti era completamente soddisfatto e tutti i pazienti raccomandavano l’intervento chirurgico ad altri. L’analisi di Kaplan-Meier ha dimostrato che in 7 anni di follow-up l’85% dei pazienti è andato incontro a guarigione in assenza di recidiva. CONCLUSIONI: La nostra semplice procedura appare sicura e facilmente riproducibile, consentendo un elevato successo chirurgico nel trattamento della malattia pilonidale recidiva.Patients undergoing surgery for recurrent pilonidal disease are at high risk of developing re-recurrence. The present prospective analysis was performed to evaluate the outcome for recurrent pilonidal disease treatment with a technique that provides a minimal subcutaneous excision of fistula and of the skin above the cyst, with secondary healing of wounds. METHODS: 48 consecutive patients with previous surgical excision and recurrent pilonidal disease underwent surgery from January 2009 to December 2016, under local anaesthesia. The age of the patients (42 males and 6 females) at the time of our observation was 28.5 ± 10.2 years, the BMI of 26.3 ± 6.8. The average number of interventions prior to our was 2.02 ± 1.14. RESULTS: The mean operative time was 18.2 ± 5.5 minutes. All patients were discharged 2 to 4 hours after surgery, with an average healing time of 22.8 ± 15.3 days. We recorded, in the follow-up period, only 4 relapses (8.32%), all retreated with the same surgical procedure and brought to complete healing. The results of the cosmetic questionnaire, which assessed patient satisfaction and contentment, showed that 96% of patients were completely satisfied and all patients recommended surgery to others. Kaplan-Meier analysis showed that in 7 years of follow-up, 85% of patients healed without recurrence. CONCLUSIONS: Our simple procedure appears to be safe and easily reproducible, allowing a high surgical success in the treatment of recurrent pilonidal disease. KEY EORDS: Excision, Healing, Recurrent sacrococcygeal pilonidal disease
INTRODUZIONE ALLO STATUTO DELL'O.N.U.
No full textIl contributo analizza lo Statuto dellOnu alla luce dell'evoluzione della comunità internazionale dopo la seconda guerra mondiale e l'impatto che questo ha avuto sull'evoluzione del diritto internazionale pubblico contemporaneo
CHOROIDAL METASTASIS FROM LUNG ADENOCARCINOMA: A RARE CASE REPORT
No full textThe choroid is the most common site for intraocular metastatic disease. Orbital metastasis as metastatic site of lung adenocarcinoma is very rare and in literature a very exiguos number of cases is present. This is a case report of a wiìoman with history of lung adenocarcinoma and, after surgery, detection of a choroidal mass described as lung metastasis, responding to Gefinitib therapy. However a biopsy was non performed. After two years there was a great dimension decrement of the lung metastasis but she is still suffering from recurrent pleural effusion, with pleural thickening biopsied and diagnosed as recurrence disease
Bayesian variable selection in modelling geographical heterogeneity in malaria transmission from sparse data : an application to Nouna Health and Demographic Surveillance System (HDSS) data, Burkina Faso
No full textQuantification of malaria heterogeneity is very challenging, partly because of the underlying characteristics of mosquitoes and also because malaria is an environmentally driven disease. Furthermore, in order to assess the spatial and seasonal variability in malaria transmission, vector data need to be collected repeatedly over time (at fixed geographical locations). Measurements collected at locations close to each other and over time tend to be correlated because of common exposures such as environmental or climatic conditions. Non- spatial statistical methods, when applied to analyze such data, may lead to biased estimates. We developed rigorous methods for analyzing sparse and spatially correlated data. We applied Bayesian variable selection to identify the most important predictors as well as the elapsing time between climate suitability and changes in entomological indices.; Bayesian geostatistical zero-inflated binomial and negative binomial models including harmonic seasonal terms, temporal trends and climatic remotely sensed proxies were applied to assess spatio-temporal variation of sporozoite rate and mosquito density in the study area. Bayesian variable selection was employed to determine the most important climatic predictors and elapsing (lag) time between climatic suitability and malaria transmission. Bayesian kriging was used to predict mosquito density and sporozoite rate at unsampled locations. These estimates were converted to covariate and season-adjusted maps of entomological inoculation rates. Models were fitted using Markov chain Monte Carlo simulation. The results show that Anophele. gambiae is the most predominant vector (79.29%) and is more rain-dependant than its sibling Anophele. funestus (20.71%). Variable selection suggests that the two species react differently to different climatic conditions. Prediction maps of entomological inoculation rate (EIR) depict a strong spatial and temporal heterogeneity in malaria transmission risk despite the relatively small geographical extend of the study area. CONCLUSION: Malaria transmission is very heterogeneous over the study area. The EIR maps clearly depict a strong spatial and temporal heterogeneity despite the relatively small geographical extend of the study area. Model based estimates of transmission can be used to identify high transmission areas in order to prioritise interventions and support research in malaria epidemiology
ROUTINARY USE OF FIBRIN SEALANTS TO PREVENT PROLONGED AIR LEAK IN THORACIC SURGERT: OUR EXPERIENCE
No full textIntroduction: prolonged air leak (PAL) is one of the most common postoperative complications after lung surgery. It is associatred with increased significant morbidity, lower quality of life, longer hospital stay and higher hospital costs. Since its great clinical and economic burden, it is important to establish the feasibility and the effectiveness of the routinary preventive use of a fibrin sealant in order to reduce the incidence of prolonged air leaks. Patients and methods: this is a randomized study on 189 adult patients - 118 men (62,4%) and 71 women (37,6%) aged from 39 to 87 y.o. (mean age 68,3 y.o.) - who underwent lung surgery (lobectomy or bilobectomy) with intraoperatory detection of air leakage, from January 2013 to December 2017, at Department of Thoracic Surgery in "Ospedale Maggiore Carlo Alberto Pizzardi" (Bologna, Italy) and Department of Thoracic Surgery in "Paolo Giaccone" Teaching Hospital (Palermoo, Italy). Patients were randomnly assigned to the "Glue" arm (90 patients) or the "Control" group (99 patients). We only used stapler or manual suture to acheve aerostasis. In addition, we used a fibrin sealant ("glue") to cover the suture line on patients in the "glue" arm. The primary endpoints were incidence of prolonged air leaks, days with chest tube and mean hospital stay. Results: in the "Glue" arm we experienced ONLY 1 prolonged air leak (1,1%), while in the "Control group) there were 8 leaks. (8,1%). Patients kept chest tube for average 4,15 days in the "Glue" arm and 4,45 days in the "control" group. The mean hospital stay was average 7,4 days for the 2Glue" arm, while 9.1 days in the "control" group. Conclusions: according to our experience it seems that the routinary preventive use of a fibrin sealant results in a lower incidence of prolonged air leaks, a shorter hospital stay with lower hospital costs, representing a cost-effective, feasible and effective system to decrease morbility and mortality among surgical patients
RESECTION OF A GIANT MEDIASTINAL LEIOMYOSARCOMA
No full textABSTRACT Primary leiomyosarcomas of the lung are rare tumors. We report a case of 49-year-old female with history of cough, breathless at rest, right sided chest pain. Chest CT showed a huge (16 cm) mediastinal mass located on the right mediastinum encasing the right main pulmonary artery and infiltrating the main right bronchus and pericardium. The tumor was resected with combined pericardiectomy and pnemonectomy via hemiclamshell incision. This surgical access provided an adequate exposure of the chest “blind zones” and it allowed a radical and safe surgical resection of lung, pleura, pericardium and diaphragm. The final diagnosis showed a low grade differentiation leiomyosarcoma
POSTOPERATIVE COMPLICATIONS,PAIN AND QUALITY OF LIFE AFTER THORACOSCOPIC OF THOREACOTOMIC LOBECTOMY FOR LUNG CANCER
No full textAim: Thoracoscopic lobectomy is superior to thoracotomy, but the evidence for this assumption is low. We present a comparison between thoracotomy and thoracoscopy in term of postoperative complications, mortality, postoperative, hospital stay and quaklity of life. Patients and methods: This is a rectrospective analysis of 224 lobectomies in 24-months. 128 patients (57.1%) were operated by thoracotomy; 96 patients (42.9%) by videothoracoscopy. Results: Major complications were observed in 4/128 (3.1%) in thoracotomy group and in 1/96 (16.7%) thoracoscopy. Thoracoscopy patients had a shorter hospital stay. Conclusion: our study shows an advantage of thorascopy over thoracotomy but furher studies are needed
CT-GUIDED TRANSTHORACIC NEEDLE BIOPSY: ADVANTEGES IN HISTOPATHOLOGICAL AND MOLECULAR TESTS
No full textAim: The present study aimed to demonstrate that computed tomography-guided transthoracic needle biopsy (TTNB) is a safe procedure that gives a more accurate pre-operative tissue diagnosis for peripheral lung nodules than transthoracic needle aspiration, obtaining suitable samples for molecular test in lung adenocarcinomas. Patients and methods: Between December 2016 and March 2018 at Thoracic Surgery Department of the University of Palermo - Policlinico Paolo Giaccone Hospital, TTNB was performed in 42 patients with computed tomography-detected peripheral lung nodules > 10 mm, using 16-18 -Gauge tru-Cut needles. Results: With TTNB, we have estimated an accuracy for tissue diagnosis of 97,6%. At the molecular test, EGFR overexpression and ALK mutation resulted positive for 12/23 patients with lung adenocarcinoma. Conclusion: TTNB has showed a low rate of complications and it is adoptable as standard diagnostic procedure for peripheral lung nodules
- …
