574 research outputs found
In Vivo Reflectance Confocal Microscopy for Non-Melanocytic Malignant Skin Tumours
No full textNon-melanoma skin cancer (NMSC) is a major health problem because of its high incidence in the Caucasian population, as well as its related potential morbidity and mortality. Reflectance confocal microscopy is a non-invasive technique that allows the visualization of the skin at a nearly histological resolution, improving significantly the early diagnosis of NMSC. This tool is also important in the management of NMSC therapy and in the post-treatment follow-up. In this chapter, we provide a review of the reflectance confocal microscopy criteria for the diagnosis of NMSC
Dermoscopy for Benign Melanocytic Skin Tumors
No full textIn this chapter, we present the dermoscopic clues of the main categories of nevi, making a brief mention of their clinical and histopathological features. Not only junctional, dermal and compound nevi are described, but also congenital, blue, Spitz–Reed, Meyerson’s, desmoplastic, balloon, targetoid hemosiderotic, and sclerosing nevus are described
In Vivo Reflectance Confocal Microscopy for Mucous Membranes
No full textReflectance confocal microscopy (RCM) is an advanced noninvasive diagnostic technique that allows tissue imaging in vivo, contributing to a more accurate diagnosis of skin cancers. Recently, the RCM devices dedicated to the skin have also been applied to perform “virtual biopsies” of the oral, genital, and ocular mucosa, sensitive areas where noninvasive imaging techniques are of high interest to spare biopsies and excisions. In this chapter, RCM features of healthy mucosa are described as well as most important features to distinguish melanosis from melanoma. Besides being useful for the diagnosis, RCM may be helpful to identify the area to be biopsied in case of large or multifocal mucosal lesions and may be regarded as a complementary technique for noninvasive assessment of treatment efficacy
Volte di laterizio in folio: una tecnica di consolidamento
No full textLe volte sono costruzioni in pietre che l’arte ha immaginato per supplire ai soffitti ed alle coperture in legno, onde rendere gli edifici più durevoli e guarentirli dagl’incendi.
[...] Colla parola volta s’intende una costruzione composta di molte pietre di taglio, pietrami, mattoni od altre materie modellate, disposte o riunite in modo da sostenersi per coprire uno spazio (Giovanni Rondelet, “Trattato dell’arte di edificare” Tomo II, I parte Libro III “Stereotomia” Sezione III “Costruzione ed apparecchio delle volte piane”, 1831).
Nell’edilizia del passato ancora in uso i piani delle abitazioni sono spesso costituiti da volte sottili in laterizio, costruite con mezzane in folio disposte a spinapesce o a filari longitudinali paralleli ai muri di imposta. Il gesso, utilizzato per la rapidità della presa, garantiva il celere avanzamento della costruzione senza l’ausilio di centine complete.
Le volte a padiglione ribassato, dette “a specchio”, erano spesso completate all’estradosso da frenelli, lunette o unghie, anch’esse costruite in folio, che, avvicinandosi alla quota del pavimento, riducevano il peso del riempimento e contribuivano alla statica con la loro rigidezza.
Nell’edilizia attuale questa tecnica non trova più applicazioni, che sono invece riscontrabili molto frequentemente fino alla Seconda Guerra Mondiale, ma è sostituita dai solai a intradosso piano che comportano tecniche costruttive più semplici ed economiche con minori ingombri e senza spinte.
Le volte in laterizio, nelle numerose varietà tipologiche spesso molto ardite, rappresentano quindi una fondamentale componente dell’edilizia storica tuttora in uso e destano ammirazione per la loro perfezione tecnica, rivelandosi degne di conservazione e adeguamento alle attuali necessità in termini di impiego e di sicurezza.
Questo lavoro vuol dare un contributo all’utilizzo sicuro di questo particolare patrimonio edilizio, rendendolo anche idoneo a carichi concentrati o eccentrici e non vulnerabile dagli effetti dell’acqua sul gesso di connessione. A tale scopo viene qui presentata una tecnica, per molti aspetti innovativa, applicata ad un caso specifico di recente attuazione.
Si analizza inizialmente la funzione statica dei diversi elementi costruttivi componenti la volta e, successivamente, si valuta, in termini quantitativi, il miglioramento statico apportato dall’intervento di rinforzo sia alla volta stessa, sia alle pareti di imposta sia al comportamento scatolare dell’edificio
Surgical treatment of degenerative spondilolistesi: simple decompression without fusion.
No full text
Clinical usefulness of proximal ulnar and radial fracture-dislocation comprehensive classification system (PURCCS): prospective study of 39 cases.
No full textBackground: Complex fracture-dislocations of the proximal ulna and radius represent a challenge even for expert orthopaedic surgeons. A new comprehensive classification, the proximal ulnar and radial fracture-dislocation comprehensive classification system (PURCCS), was recently proposed. The aim of this study was to analyze the clinical usefulness of this classification in a large series of patients.
Materials and methods: We studied 38 patients (39 elbows) with a mean age of 56 years. All patients were classified with the PURCCS by use of standard radiography, computed tomography, and intraoperative fluoroscopy. Surgical treatment was performed according to the PURCCS therapeutic algorithm. Patients were followed up for a mean of 23 months. The clinical evaluation was performed with the Mayo Elbow Performance Score and Index (MEPS and MEPI); the Disabilities of the Arm, Shoulder, and Hand (DASH) score; and the modified American Shoulder and Elbow Surgeons (m-ASES) score.
Results: Each pattern of fracture-dislocation in our series finds its position within the PURCCS. At the last follow-up, the mean MEPS, DASH score, and m-ASES score were 91.2, 14.9, and 83.9, respectively. The mean extension, flexion, pronation, and supination were 19 degrees, 136 degrees, 81 degrees, and 79 degrees, respectively. According to the MEPI, 72%, 20%, and 8% of cases were rated excellent, good, and fair, respectively. Two patients with elbow stiffness underwent a reoperation, with final satisfactory results.
Conclusion: The PURCCS helps identify the main lesions of each injury pattern; the associated therapeutic algorithm helps select correct surgical strategies. This study showed that the clinical results were satisfactory in the majority of cases, with few major complications and reinterventions. The PURCCS is a comprehensive classification that may contribute to the surgical management of these difficult fracture-dislocations. (C) 2013 Journal of Shoulder and Elbow Surgery Board of Trustees
Glucocorticoids: Systemic
No full textCorticosteroids (CSs) play a major role in the dermatological treatment due to their potent anti-inflammatory and immunosuppressive properties. They are used as first line in most autoimmune bullous dermatoses, autoimmune connective tissue diseases, neutrophilic dermatoses and vasculitis. Systemic CSs are usually administered orally, but intravenous and intramuscular preparations are also available. CSs differ in their relative anti-inflammatory and mineralocorticoid effects and duration of ACTH suppression. CSs with minimal mineralocorticoid effects and an intermediate half-life are usually selected to decrease sodium retention and reduce adverse effects. Adverse effects are mainly due to the alteration of electrolyte and water balance, the inhibition of tissue repair process, the activation of gluconeogenesis, the increase of infection risk, the inhibition of the secretion of ACTH and the risk of growth retardation in children. Prednisolone is commonly the oral medication of choice because it has a sufficiently prolonged action to ensure the sustained effectiveness of a single daily dose, has minimal mineralocorticoid activity and is biologically active, differently from other CSs that need to be transformed into their active forms in the liver. The daily dose of prednisone varies depending on the severity of the dermatological condition and ranges from 0.5 to 2 mg/kg/day. A single daily dose is preferable, given in the morning when there is maximal adrenocortical cortisol secretion. Treatments that last longer than 4 weeks should not be stopped abruptly to avoid acute adrenal insufficiency and a flare of the dermatological condition. In conclusion CSs provide an effective response for several dermatological conditions and dermatologists should be aware of their therapeutic properties and their side effects to prevent serious complications
Hacia la preparación de la vida adulta. La dimensión pedagógica de los Centros de Apoyo a los Estudiantes con Discapacidad
No full textDesde la década de los noventa, han sido varios los pronunciamientos internacionales por la promoción de una perspectiva inclusiva, que han colocado el tema en la educación terciaria entre sus directrices y acciones. La inclusión terciaria se refiere a los derechos humanos, indicando que la persona con discapacidad debe ser considerada como un ciudadano de pleno derecho y, por lo tanto, titular de los derechos fundamentales durante toda su vida. En este sentido, la Universidad desempeña un papel fundamental en el apoyo, no solo del camino educativo de los jóvenes con discapacidad, sino también de su entrada en la vida adult
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