101,958 research outputs found
Nuovi dati dalla ricerca archeologica per la ricostruzione del paesaggio storico delle Colline Metallifere massetane
No full textIn this paper the research team of the University of Siena (Medieval Archaeology section), together with the Superintendency for Tuscany, will present new data collected on the area of the Colline Metallifere through recent archaeological researches. The chronological research focus is on early and late medieval landscapes, reconstructed through ongoing extensive excavations as well as through archaeological surveys. The project proposes a reconstruction of the medieval historical landscape, with a specific indepth on the exploitation of important local natural resources, particularly silver ores, and their influence on economical policy and settlement patterns
Archeologia e chimica per il patrimonio minerario (Ar.Chi.Min.). Un nuovo approccio multidisciplinare allo studio dei contesti archeominerari del comprensorio massetano
No full textThe «Ar.Chi.Min.» project intends to improve the archaeological, historical and scientific knowledge of the Colline Metallifere mining fields (south-west Tuscany), developing a multi-disciplinary approach to investigate ancient mining settlements and/or archaeo-industrial findings. The analysis of archaeological and geological evidences, together with chemical analysis of residual ores, mine tails and finds, were used to produce a framework about possible pre-industrial economic exploitation of mined ores. The study has mainly focus on the exploitation of copper, lead and silver sulfides. Recent surveys and documentary researches have also highlighted the importance of the local alum bodies exploitation, both for the medieval and the first modern age
His-bundle pacing to treat an unusual case of chest pain after pacemaker implant
No full textA 63-year-old man with hypertension and 3-vessel coronary artery disease previously treated with coronary artery bypass graft was admitted to our emergency room complaining of chest pain. He had undergone pacemaker implant 5 months before due to paroxysmal advanced atrioventricular block. Electrocardiography and troponin testing were unremarkable. Echocardiography and chest X-ray ruled out lead displacement and perforation. Interrogation showed normal parameters [right atrium: impedance 550 Ohm bipolar, sensing 2.4 mV bipolar; threshold 0.50 V/0.4 ms bipolar; right ventricle (RV): impedance 580 Ohm bipolar, sensing > 25 mV bipolar; threshold 1.5 V/0.4 ms bipolar and 0.4 V/0.4 ms unipolar]. Pain was evoked only during RV pacing. An electrophysiology study demonstrated painful RV pacing from multiple sites. We hypothesized that pain was associated with pacing-induced dyssynchrony. His-bundle pacing (HBP) was considered as a solution. We achieved HBP with a bipolar fixed-screw catheter connected to a cardiac resynchronization therapy pacemaker generator. During HBP above threshold (4.00 V/1.00 ms) the patient did not complain of any pain. He was discharged 3 days later pain-free with His-bundle lead amplitude set at 5.00 V/1.00 ms. After 6 months the patient was asymptomatic, with the device showing normal functioning. This is the first clinical experience of painful RV pacing treated with HBP. Learning objective: Painful right ventricular pacing in the absence of perforation is a rare but potentially underdiagnosed condition. Ventricular dyssynchrony could represent the underlying mechanism. Physiological electromechanical activation achieved via His-bundle pacing could represent an effective therapeutic option
Il disegno e la geometria come strumenti per antropizzare il paesaggio
No full textla ricerca mostra il ruolo della geometria per il posizionamento delle città intorno a Lecce. Grazie alla ricerca si può chiarire il senso di appartenenza di un territorio e definire meglio l'area di appartenenza di un paesaggio culturale, quello leccese
La città ed il territorio nella strategia difensiva spagnola del XVI secolo: l’esperienza dell’ingegnere militare Giovanni Battista Antonelli.
No full textGiovanni Battista Antonelli, ingegnere militare ed idraulico di origine e formazione italiana, svolge la sua carriera professionale a partire dalla seconda metà del Cinquecento al servizio della Corona spagnola, con l’incarico della protezione delle frontiere dell’intero Regno di Spagna. Il disegno complessivo della difesa che l’ingegnere propone, già anticipato in uno degli scritti del suo trattato intitolato Epitomi delle fortificazioni moderne (1560-61), viene attuato principalmente sulle coste della penisola iberica, che soffrivano in quel periodo di frequenti e reiterati attacchi da parte dei corsari. Nell’ottica di questa strategia difensiva la città ha valore di fondamentale avamposto militare al pari di un baluardo, gli insediamenti portuali ne rappresentano le porte di ingresso e le torri disseminate nelle coste assolvono la funzione di garitte per l’avvistamento. Il territorio, dal canto suo, è considerato come una grande città fortificata alla moderna, in cui il Mar Mediterraneo può essere considerato il fosso ed i presidi Nord-Africani e i possedimenti italici i rivellini. Questo interessante sistema è stato studiato attraverso l’analisi della documentazione archivistica e tramite gli strumenti del disegno e del rilievo, nella volontà di documentare e valorizzare un patrimonio storico e architettonico
Transvenous removal of pacing and ICD leads: single italian referral center experience.
No full textIntroduction: Device related complications are rising the need of Transvenous Lead Removal (TLR). Transvenous extraction of Pacing (PL) and Defibrillating Leads (DL) is a highly effective technique. Aim of this report is to analyse the longstanding experience performed in a single Italian Referral Center.
Methods: since January 1997 to December 2014, we managed 2250 consecutive patients (1718 men, mean age 65.3 years) with 4114 leads (mean pacing period 71.8 months, range 1-576). PL were 3328 (1582 ventricular, 1391 atrial, 355 coronary sinus leads), DL were 786 (765 ventricular, 6 atrial, 15 superior vena cava leads). Indications to TLR were infection in 83% (systemic 28%, local 55%) of leads. We performed mechanical dilatation using a single polypropylene sheath technique (Cook Vascular - Leechburg PA, USA) and if necessary, other intravascular tools (Catchers and Lassos, Osypka, Grentzig-Whylen, G); an Approach through the Internal Jugular Vein (JA) was performed in case of free-floating leads or failure of the standard approach.
Results: Removal was attempted in 4105 leads because the technique was not applicable in 9 PL. Among these, 4019 leads were completely removed (97.9%), 44 (1.1%) partially removed, 42 (1.0%) not removed. Among 4020 exposed leads, 625 were removed by manual traction (15.5%), 2998 by mechanical dilatation using the venous entry site (74.6%), 32 by femoral approach (FA) (0.8%) and 279 by JA (7.0%). All the free-floating leads were completely removed, 25.8% by FA and 74.2% by JA. Major complications occurred in 13 cases (0.6%): cardiac tamponade (12 cases, 2 deaths), hemotorax (1 death).
Conclusions: our experience shows that in centers with wide experience, TLR using single sheath mechanical dilatation has a high success rate and a very low incidence of serious complications. TLR through the Internal Jugular Vein increases the effectiveness and safety of the procedure also in case of free-floating or challenging leads
Simultaneous penile and signet ring cell bladder carcinoma in renal transplant recipient: a first case
No full textThe incidence and prevalence of cancer increase with time after transplantation. Therefore, a risk-adapted screening process is very important in order to identify low-grade malignancies early in their development. This provides the opportunity to initiate appropriate immunosuppressive regimens depending on the tumor type and stage of development. The first case presented is one of a 65-year-old patient with a double genitourinary carcinoma (penis and bladder). The patient received kidney transplantation 7 years prior to this event. After adequate surgical treatment (partial amputation of the penis for squamous cell carcinoma and complete transurethral resection of bladder adenocarcinoma), the patient was noted to be free of tumor recurrence and had functioning renal graft with a 2-year follow-up
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