1,198 research outputs found
Le idee e le tecniche. Saper costruire
No full textIl contributo traccia un quadro di sintesi sull'arte del costruire nell'impero bizantino, con riferimento ai principali protagonisti - professionisti delle costruzioni e maestranze -, ai saperi da essi applicati e tramandati, e alle tecniche dispiegate per la realizzazione delle più importanti imprese costruttive dell'epoca
Five-Year Outcomes of Endovascular Aortic Repair With the TREO Abdominal Endograft
No full textPurpose: Newer generation abdominal endografts, including Treo (Terumo Aortic, Sunrise, Florida), have shown optimal safety and effectiveness in treating abdominal aortic aneurysms (AAAs), even with hostile anatomy over the short- and mid-term. The durability of such results, however, is still a controversial issue, due to the paucity of long-term data. Our aim is to show the long-term outcomes of endovascular aortic repair of both standard and hostile AAAs with the Treo endograft on a cohort of patients treated between 2016 and 2017. Methods: We analyzed the postoperative follow-up of 37 consecutive patients who have undergone endovascular aortic repair (EVAR) with the Treo Endograft between 2016 and 2017, whose baseline clinical conditions, operative data, and short-term outcomes had been published in 2018. All patients were followed up by computed tomography angiography (CTA) at 6 and 12 months and 5 years postoperatively. Primary endpoints were aortic-related mortality, type I-III endoleak (EL), and reintervention rate. Secondary endpoints were the rates of type II ELs and aneurysm sac regression. Results: Of 37 patients, 27 had at least one criterion of anatomic hostility and 11 were performed outside the device-specific instructions for use (IFU). In the perioperative period, we observed 100% technical success, with no perioperative mortality. Over a mean follow-up of 5.5 years (66 months), 3 patients (8.1%) were lost to follow-up and 3 (8.1%) died of non-aortic causes (overall survival: 91.9%). One type IA EL of an AAA with a hostile neck (but within the IFU) and a type III EL of an AAA with standard anatomy were observed and treated by endovascular relining (overall reintervention rate: 5.5%). Four type II ELs were associated with aneurysm sac stability over time and are still under surveillance. Mean aneurysm shrinkage was 11.25 +/- 8.30 mm. Conclusion: The optimal results of the Treo Endograft in terms of complication and reintervention rates reported over the mid-term by the current literature (ITA-ENDOBOOT registry) are maintained on the long term, both in case of hostile and friendly aortic anatomy, with a satisfactory shrinkage rate of the aneurysm sac. Clinical Impact The innovative characteristics of Treo and its short-term results are well-known and reported. The present case series contributes to the scientific validation of a new-generation abdominal aortic endograft over the long-term, focusing especially on its performance in treating AAAs with hostile anatomy. Its 5-years outcomes confirm the optimal results already reported over the short- and mid-term
Giulia Veronica Varisco
No full textThe headword explains the biography and the contribution of the author Giulia Varisco to the children's literatur
Robust Gamma regression models for the analysis of health care cost data
No full textAbstract: The population-mean cost of patients with certain pathologies is the parameter of interest for allocating health resources. It generally depends upon a number of covariates and the presence of outliers yields difficulties in the estimation procedure. Recent research in parametric robust techniques proposed the use of robust estimating equations via M-estimation for the Gamma model [2] and a class of high efficiency and high breakdown point estimators [14] extended to the case of generalized log-gamma regression [12]. In the present work, we compared results obtained by the two parametric robust procedures with the standard GLM (Generalized Linear Model) Gamma with log link, both in a simulation study and in a cardiovascular trial. The robust procedures outperformed the GLM Gamma in the contaminated simulation scenario and in the real dataset the significance of some covariates changed between the three estimators, with a better ability of the Log Gamma Robust in isolating the outliers driving these changes
Lexicon for an Affective Archive
No full textTo study an archive or archival materials is to encounter an affective and critical practice involved in the construction of memory. Lexicon for an Affective Archive, edited by Giulia Palladini and Marco Pustianaz, is an international collection of these encounters, offering glimpses into the intimate relations inherent in finding, remembering (or imagining), and creating an archive. Bringing together voices from a variety of fields across the humanities, performance studies, and contemporary art, and engaging in a multidisciplinary analysis, this beautifully designed and fully illustrated volume advances the idea of an “affective archive” as a useful conceptual tool—a tool which contributes to an understanding of an expanded notion of an archive and its central role in contemporary visual and performing arts
Emergent physician modified carotid fenestrated TEVAR for the treatment of a complicated acute type nonA-nonB aortic dissection with undetected multiorgan malperfusion
No full textComplicated acute nonA-nonB dissection with malperfusion is associated with a high in-hospital mortality up to 67%. Therefore, rapid identification and treatment are critical for clinical outcomes. We report the urgent treatment of a complicated subacute aortic dissection treated with a physician-modified-endograft (PMEG) fenestrated-TEVAR (f-TEVAR) for the left common carotid artery (LCCA). A 49-year-old male patient with acute non-A non-B aortic dissection with complete true lumen collapse and associated mesenteric and renal ischemia, was referred to another vascular center for abdominal pain and received exclusively medical treatment. After 15 days of persistent pain, the patient self-referred to our center and was treated with endovascular repair. The proximal entry tear was located at the level of the left subclavian artery: a PMEG f-TEVAR was performed with fenestration for LCCA in conjunction with carotid-subclavian bypass. In addition, spot stenting of the left renal artery was performed to resolve renal malperfusion. The final angiography showed satisfactory result. The patient soon reported significant pain relief. Follow-up at 30-days was satisfactory, with no need for further intervention. A physician-modified fenestrated-TEVAR can be used in emergency setting to treat acute non-A-non-B aortic dissection in conjunction with multiorgan malperfusion, with satisfactory results even after initial delayed treatment
Mini-Surgical Access Prevents Local Complications and Reduces Costs in Endovascular Aortic Repair
No full textBackground: This study aims to propose a minimally invasive surgical approach to the common femoral artery in endovascular aortic repair and assess its value by a single-center retrospective study including 118 patients.Methods: Between 2017 and 2022, all patients receiving endovascular treatment for thoracic and abdominal aortic aneurysms in our center had the anterior wall of the common femoral artery exposed, through a 23 cm transverse groin incision, instead of a complete surgical cutdown. We access the artery with a purse-string suture, held tight with a tourniquet. After procedure completion, we tie the purse-string closing the arteriotomy. We retrospectively analyzed the cohort of all consecutive patients treated with endovascular aortic repair in this period and recorded primary and assisted technical success, operative time, in-hospital length of stay, access failure, and access-related complications, comparing the results with the current literature.Results: All procedures were successful, with no perioperative mortality. Primary technical success was achieved in 116 patients; 2 required adjunctive procedures. No access failure or access-related complications (thrombosis, groin hematoma, lymphocele, wound dehiscence, or infection) occurred. Two accesses required conversion to complete femoral artery exposure and endarterectomy. Operatory time and length of in-hospital stay were comparable to the outcomes of the major studies reporting on percutaneous access, saving the costs of the closure devices.Conclusions: Minimally invasive surgical access is safe and feasible for endovascular aortic procedures. Compared to the costs of percutaneous access found in literature, it is cost-effective. It can be chosen whenever the percutaneous approach is not feasible or at a high risk of complications
Trust and trustworthiness in the villain’s dilemma: collaborative dishonesty with conflicting incentives?
No full textWrong-doers may try to collaborate to achieve greater gains than would be possible alone. Yet potential collaborators face two issues: they need to accurately identify other cheaters and trust that their collaborators
do not betray them when the opportunity arises. These concerns may be in tension, since the people who
are genuine cheaters could also be the likeliest to be untrustworthy. We formalise this interaction in the
‘villain’s dilemma’ and use it in a laboratory experiment to study three questions: what kind of information
helps people to overcome the villain’s dilemma? Does the villain’s dilemma promote or hamper cheating
relative to individual settings? Who participates in the villain’s dilemma and who is a trustworthy collaborative cheater? We find that information has important consequences for behaviour in the villain’s dilemma.
Public information about actions is important for supporting collaborative dishonesty, while more limited
sources of information lead to back-stabbing and poor collaboration. We also find that the level of information, role of the decision maker, and round of the experiment affect whether dishonesty is higher or lower
in the villain’s dilemma than in our individual honesty settings. Finally, individual factors are generally
unrelated to collaborating but individual dishonesty predicts untrustworthiness as a collaborator
Endovascular-First Approach for Symptomatic Carotid Artery Stenosis in a COVID-19 Positive Patient: Expected and Unexpected Advantages
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