42 research outputs found
Exploring the role of surgical margins and reoperation in basal cell carcinoma recurrence: a study of 3036 cases
No full textIntroduction: Basal cell carcinoma (BCC) is the most common type of skin cancer globally, with its prevalence increasing due to chronic ultraviolet (UV) radiation exposure. Although surgical excision remains the cornerstone of treatment, achieving optimal outcomes requires a careful balance between complete tumor removal and the preservation of cosmetic appearance. Objective: This study aims to investigate the relationship between excision margins, reoperation rates, and BCC recurrence through a retrospective analysis of 3036 surgical excisions. Methods: Conducted at the Department of Plastic Surgery in Trieste, Italy, this study includes data from 2037 patients treated between 2014 and 2018. Excision procedures adhered to standardized hospital protocols. Tumor characteristics, excision margins, and involved anatomical sites were analyzed. Results: The study demonstrated an equal gender distribution (51.02% women), with the nodular subtype (45.85%) being the most common. The head was the most frequently affected site (54.74%). A complete excision rate of 93.3% was achieved, but incomplete excisions were more common in head and neck locations and certain histological subtypes. Surgical reinterventions were primarily performed for high-risk BCCs, significantly reducing recurrence rates (0.52%). Conclusion: Reoperation, especially for high-risk BCCs, should be prioritized over conservative management to minimize recurrence. Narrow excision margins were associated with higher recurrence rates, highlighting the importance of adequate margin clearance. This study enhances understanding of the complex interplay between excision techniques, reoperation, and long-term outcomes in BCC management
Development of a Digital Application Program Based on an Institutional Algorithm Sustaining the Decisional Process for Breast Reconstruction in Patients with Large and Ptotic Breasts: A Pilot Study
No full textBackground/Objectives: Immediate implant-based breast reconstruction is an established option for selected patients undergoing mastectomy. However, patients with large and ptotic breasts present specific reconstructive challenges, often requiring tailored approaches to minimize complications and optimize aesthetics. This pilot study aimed to evaluate the clinical feasibility and effectiveness of a mobile application developed to support intraoperative decision-making based on an institutional algorithm for breast reconstruction. It is also important to underline that this pilot study was exploratory in nature and primarily aimed at assessing feasibility and adherence to an app-based decision pathway, rather than comparative efficacy. Methods: We conducted a prospective observational study from October 2023 to December 2024 at the University Hospital of Sassari. Female patients with large and ptotic breasts undergoing immediate implant-based reconstruction were included. A mobile app, developed using MIT App Inventor 2, implemented our institution’s algorithm and guided surgeons through both preoperative and intraoperative decision-making. Surgical options included subpectoral, prepectoral with autologous fascial flaps, or prepectoral with acellular dermal matrix (ADM) reconstruction, depending on flap thickness and fascia integrity. Results: Sixteen patients (21 reconstructed breasts) were included. Surgical planning and execution followed app-generated recommendations in all cases, with no intraoperative deviations. Subpectoral reconstruction was performed in six patients, prepectoral with ADM in eight, and prepectoral with fascial flaps in two. The app was rated positively by all surgeons and facilitated consistent decision-making. Conclusions: The proposed mobile application, described in this pilot study, proved to be a feasible and effective decision-support tool for implant-based breast reconstruction in patients with challenging anatomy. It standardized surgical choices, supported training, and has the potential to enhance reproducibility and safety in complex reconstructive procedures
Electrospun Collagen-Coated Nanofiber Membranes Functionalized with Silver Nanoparticles for Advanced Wound Healing Applications
No full textComplex wounds pose a significant healthcare challenge due to their susceptibility to infections and delayed healing. This study focuses on developing electrospun polycaprolactone (PCL) nanofiber membranes coated with Type I collagen derived from bovine skin and functionalized with silver nanoparticles (AgNPs) to address these issues. The collagen coating enhances biocompatibility, while AgNPs synthesized through chemical reduction with sodium citrate provide broad-spectrum antimicrobial properties. The physical properties of the membranes were characterized using scanning electron microscopy (SEM) and atomic force microscopy (AFM). Results showed the formation of nanofibers without defects and the uniform distribution of AgNPs. A swelling test and contact angle measurements confirmed that the membranes provided an optimal environment for wound healing. In vitro biological assays with murine 3T3 fibroblasts revealed statistically significant (p ≤ 0.05) differences in cell viability among the membranes at 24 h (p = 0.0002) and 72 h (p = 0.022), demonstrating the biocompatibility of collagen-coated membranes and the minimal cytotoxicity of AgNPs. Antibacterial efficacy was evaluated against Staphylococcus aureus (SA), Pseudomonas aeruginosa (PA), and Vancomycin-resistant Enterococcus (VRE), with the significant inhibition of biofilm formation observed for VRE (p = 0.006). Overall, this novel combination of collagen-coated electrospun PCL nanofibers with AgNPs offers a promising strategy for advanced wound dressings, providing antimicrobial benefits. Future in vivo studies are warranted to further validate its clinical and regenerative potential
Trasformazioni geometriche e figure dell'architettura
No full textThe volume examines a controversial architectural treatise written at the end of the 17th century by the Spanish mathematician and polygrapher Juan Caramuel de Lobkowitz. The work, entitled Architectura Civil Recta y Obliqua, is often remembered by historians in relation to the debate that binds its author to an illustrious project: that of the Berninian colonnade in St. Peter's square. The goal of the research is to highlight, through direct and systematic reading of the work and its unusual drawings, the contributions that Caramuel had the opportunity to draw from the geometric and mathematical research of his time, in a sort of anastylosis of the Caramelian aesthetic, allowing a rigorous reading of his peculiar designed architectures
Availability and quality assessment of Clinical Practice Guidelines on Orthoplastic surgery treatment of open fractures of the lower limb using AGREE II tool: a systematic review
No full textIntroduction: Orthoplastic surgery, which combines orthopedic and plastic surgery principles, plays a crucial role in the treatment of open fractures of the lower limb. Clinical Practice Guidelines (CPGs) are valuable tools for standardizing and improving patient care. Objective: To assess the availability and quality of international CPGs for orthoplastic treatment of open fractures of the lower limb. A secondary objective was to provide a detailed analysis of the specific recommendations by comparing them among different CPGs. Methods: A systematic review was conducted in 2023 according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines across major medical databases and gray literature. Inclusion criteria focused on guidelines specific to orthoplastic surgery for lower limb open fractures. The Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool, a widely accepted instrument for guideline assessment, was utilized to evaluate the methodological rigor and transparency of the selected guidelines. Results: Three orthoplasty CPGs have been identified, 2 of which were judged reliable according to the AGREE II methodology. Orthoplastic recommendations are no more than 7 per CPG. Consistent agreement was observed on the timing of debridement, the importance of early fixation, and definitive coverage. Conclusion: CPGs are critical to set up clinical pathways that are safe and evidence-based. Only 3 international CPGs address orthoplastic treatment of open lower limb fractures, 2 of which are judged reliable according to methodology. Therefore, it becomes essential to develop and disseminate high-quality, evidence-based guidelines, which are critical to improving patient outcomes and standardizing clinical practice worldwide
Fantasie onomaturgiche e iconiche : Sciascia, Laterza, le "parrocchie", i "pretini", i "notabili"
No full textTra i rapporti che Leonardo Sciascia instaurò con numerosi editori italiani, spicca quello con la Laterza, anche per essere legato alla pubblicazione del suo primo scritto in prosa, Le parrocchie di Regalpetra. Di tale rapporto, documentato dalla recente pubblicazione del carteggio tra Vito Laterza e Sciascia, il saggio ritaglia i contenuti relativi alla realizzazione editoriale dialettica dell'opera - in particolare di alcuni aspetti paratestuali della mise en page - attraverso l'esame della corrispondenza tra autore ed editore circa il titolo e l'illustrazione di copertina. Queste scelte furono fondamentali per connotare l'opera all'interno della collana I libri del tempo, innovativa nel panorama editoriale italiano degli anni 1950, che aveva bisogno di manifestare al lettore la coerenza delle opere ricevute e il suo carattere culturale.Entre les relacions que Leonardo Sciascia va establir amb nombroses editorials italianes, destaca la de Laterza, en part per estar vinculada a la publicació del seu primer escrit en prosa, Le parrocchie di Regalpetra. D'aquesta relació, documentada per la recent publicació de la correspondència entre Vito Laterza i Sciascia, l'assaig desgrana els continguts relacionats amb la redacció dialèctica de l'obra -particularment de certs aspectes paratextuals de la mise en page- a través de l'examen de la correspondència entre autor i editor sobre el títol i la il·lustració de portada. Aquestes eleccions van ser fonamentals per connotar l'obra dins de la sèrie I libri del tempo, innovadora en el panorama editorial italià de la dècada de 1950, que necessitava manifestar al lector la coherència de les obres rebudes i el seu caràcter cultural.Among the relationships Leonardo Sciascia established with numerous Italian publishers, the one with the Laterza stands out, partly for being linked to the publication of his first prose writing, Le parrocchie di Regalpetra. Of that relationship, documented by the recent publication of the correspondence between Vito Laterza and Sciascia, the essay carves out the contents related to the dialectical editorial making of the work - particularly of certain paratextual aspects of the mise en page - through the examination of the correspondence between author and publisher regarding the title and cover illustration. These choices were fundamental to connote the work within the series I libri del tempo, innovative in the Italian publishing scene of the 1950s, that needed to manifest to the reader the coherence of the works received and its cultural character.Entre las relaciones que Leonardo Sciascia estableció con numerosos editores italianos, destaca la de Laterza, en parte por estar vinculada a la publicación de su primera escritura en prosa, Le parrocchie di Regalpetra. De esa relación, documentada por la reciente publicación de la correspondencia entre Vito Laterza y Sciascia, el ensayo detalla los contenidos relacionados con la realización editorial dialéctica de la obra -particularmente de ciertos aspectos paratextuales de la puesta en página- a través del examen de la correspondencia entre autor y editor sobre el título y la ilustración de la portada. Estas elecciones fueron fundamentales para connotar el trabajo dentro de la serie I libri del tempo, innovadora en la escena editorial italiana de la década de 1950, que necesitaba manifestar al lector la coherencia de las obras recibidas y su carácter cultural
Inkjet printing of flexible organic electrodes for tissue engineering applications
No full textDissertação (mestrado) - Universidade Federal de Santa Catarina, Centro Tecnológico, Programa de Pós-graduação em Ciência e Engenharia de Materiais, Florianópolis, 2012A tecnologia de impressão por jato de tinta vem demonstrando ser capaz de imprimir todos os materiais necessários para a fabricação de circuitos integrados, apresentando baixos custos de fabricação quando comparada às técnicas convencionais utilizadas com silício. Com o advento da eletrônica orgânica, uma ampla gama de materiais tornou-se disponível e a fabricação de dispositivos com propriedades únicas com a interface biológica é agora possível. Um exemplo importante é a utilização de eletrodos metálicos revestidos com polímeros condutores implantados no sistema nervoso central, proporcionando estimulação elétrica aos neurônios. Este trabalho relata a fabricação de dispositivos orgânicos biocompatíveis por meio da tecnologia de impressão por jato de tinta, utilizando-se uma nova combinação de materiais. Os dispositivos foram fabricados sobre um substrato de Parileno C (PaC), um polímero flexível e biocompatível. As linhas condutoras foram impressas utilizando-se uma tinta de nanopartículas de prata, enquanto os sítios ativos foram impressos usando-se uma tinta de poli (3,4-etilenodioxitiofeno)/poliestireno sulfonado (PEDOT: PSS). Para isolar o dispositivo final foi utilizada uma tinta de poliimida para imprimir uma espessa película sobre o dispositivo, deixando pequenas janelas abertas sobre os sítios ativos de PEDOT:PSS. Caracterização elétrica do dispositivo final e avaliação de sua interface com a biologia (testes de cultura de células) foram realizadas. Os resultados mostram que um dispositivo biocompatível e de baixo custo pode ser produzido por escrita direta sem quaisquer técnicas de pre-patterning ou de auto-alinhamento, utilizando-se tintas orgânicas. Abstract : Inkjet printing has been demonstrated to be able to print all materials required for integrated circuits at low costs when compared to conventional silicon processing. With the advent of organic electronics, a wide range of materials became available and the fabrication of devices with unique properties for interfacing with biology is now possible. One important example is the use of conducting polymer coatings on metal electrodes that are implanted in the central nervous system, which provides electrical stimulation of neurons. This work reports on the fabrication of biocompatible organic devices by means of inkjet printing with a novel combination of materials. The devices were fabricated on Parylene C (PaC), a biocompatible, flexible polymer substrate. The contact tracks were printed using a silver nanoparticle ink, while the active sites were inkjet printed using a poly (3,4-ethylenedioxythiophene)/polystyrene sulfonate (PEDOT:PSS) solution. To insulate the final device, a polyimide ink was used to print a thick film, leaving small opened windows upon the active sites. Electrical characterization of the final device and evaluation of its interface with biology (cells culture assays) were performed. The results show that inexpensive and biocompatible devices can be produced by direct writing without any pre-patterning or self-alignment techniques using organic inks
Diminishing benefits of urban living for children and adolescents' growth and development
No full textThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was <1.1 kg m–2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified.publishedVersionInstitutt for idrettsmedisinske fag / Department of Sports Medicin
Long-term and recent trends in hypertension awareness, treatment, and control in 12 high-income countries: an analysis of 123 nationally representative surveys
No full textBackground Antihypertensive medicines are effective in reducing adverse cardiovascular events. Our aim was to compare hypertension awareness, treatment, and control, and how they have changed over time, in high-income countries.Methods We used data from people aged 40-79 years who participated in 123 national health examination surveys from 1976 to 2017 in 12 high-income countries: Australia, Canada, Finland, Germany, Ireland, Italy, Japan, New Zealand, South Korea, Spain, the UK, and the USA. We calculated the proportion of participants with hypertension, which was defined as systolic blood pressure of 140 mm Hg or more, or diastolic blood pressure of 90 mm Hg or more, or being on pharmacological treatment for hypertension, who were aware of their condition, who were treated, and whose hypertension was controlled (ie, lower than 140/90 mm Hg).Findings Data from 526 336 participants were used in these analyses. In their most recent surveys, Canada, South Korea, Australia, and the UK had the lowest prevalence of hypertension, and Finland the highest. In the 1980s and early 1990s, treatment rates were at most 40% and control rates were less than 25% in most countries and age and sex groups. Over the time period assessed, hypertension awareness and treatment increased and control rate improved in all 12 countries, with South Korea and Germany experiencing the largest improvements. Most of the observed increase occurred in the 1990s and early-mid 2000s, having plateaued since in most countries. In their most recent surveys, Canada, Germany, South Korea, and the USA had the highest rates of awareness, treatment, and control, whereas Finland, Ireland, Japan, and Spain had the lowest. Even in the best performing countries, treatment coverage was at most 80% and control rates were less than 70%.Interpretation Hypertension awareness, treatment, and control have improved substantially in high-income countries since the 1980s and 1990s. However, control rates have plateaued in the past decade, at levels lower than those in high-quality hypertension programmes. There is substantial variation across countries in the rates of hypertension awareness, treatment, and control. Copyright (C) 2019 The Author(s). Published by Elsevier Ltd
