40 research outputs found
Domain sensor: a new device to capture complete experimental discrete data
No full textA new measurement device is presented. Extreme design care is devoted to achieve a closer relation between the structure of the mathematical description and the finite-resolution properties of physical detectors that characterize any real measurement process, than previous attempts described in scientific and technical literature. In fact, experimental data are captured by means of a pair of active sensors, placed at a relative fixed distance, working in a coupled arrangement. The presented device operates in a discrete variable domain. Beyond the operational advantages in term of simplicity and computational speed, it agrees with the results of biological observation which reveals that highly structured data always come from coupled transducing bio-elements. A numerical example is presented: an optimal computational precision level can be selected according to the required output precision. Furthermore, it can be showed that for that required precision, the output discrete data set is consistent under inversion transformation
La compra pública d’innovació com instrument facilitador per a l’adopció de les innovacions basades en valor al sector salut
No full textCompra pública; Innovació; Sector de la salutCompra pública; Innovación; Sector de la saludPublic procurement; Innovation; Health sectorHablamos de innovación cuando una necesidad identificada por los profesionales, por los usuarios o por el mismo sistema de salud crea una demanda de transformación de los servicios sanitarios adecuada para un particular contexto médico, práctico o social y pone en marcha los recursos necesarios, bien para desarrollar nuevas tecnologías, nuevos productos y servicios, nuevos modelos organizativos y procesos, nuevas competencias de los profesionales y de los pacientes, o bien para mejorar lo que ya existe. La Compra pública precomercial (CPP), la compra pública de tecnología innovadora (CPTI), la asociación para la innovación, o la inclusión de elementos innovadores en los procedimientos de compra, diálogos competitivos, concursos de diseño, etc. son instrumentos facilitadores para las innovaciones basadas en valor en el sector salud.Parlem d’innovació quan una necessitat identificada pels professionals, pels usuaris o pel mateix sistema de salut crea una demanda de transformació dels serveis sanitaris adequada per a un particular context mèdic, pràctic o social i posa en marxa els recursos necessaris, o bé per desenvolupar noves tecnologies, nous productes i serveis, nous models organitzatius i processos, noves competències dels professionals i dels pacients, o bé per millorar el que ja existeix. La Compra pública precomercial (CPP), la compra pública de tecnologia innovadora (CPTI), l'associació per a la innovació, o la inclusió d'elements innovadors en els procediments de compra, diàlegs competitius, concursos de disseny, etc. són instruments facilitadors per a les innovacions basades en valor al sector salutWe talk about innovation when a need identified by professionals, by users or by the health system itself creates a demand for transformation of health services suitable for a particular medical, practical or social context and sets in motion the necessary resources, either for develop new technologies, new products and services, new organizational models and processes, new skills to professionals and patients, or to improve what already exists. The precommercial public purchase (CPP), the public purchase of innovative technology (CPTI), the association for innovation, or the inclusion of innovative elements in purchasing procedures, competitive dialogues, design competitions, etc. they are facilitating instruments for value-based innovations in the health sector
Waste not, want not: Report of a completely calcified C1-C2 juxtafacet cyst and literature review
No full textBackground: Calcified juxtafacet cysts in the cervical spine are extremely rate. Such symptomatic cysts commonly cause neck pain, radiculopathy, or even myelopathy. MR and CT studies typically document cord/ root compression. On occasion, some of these cysts will spontaneously regress, while many others may warrant surgical removal. Case Description: A 70-year-old male presented with a 2-year history of a progressive tetraparesis. The preoperative MR/CT studies showed a C1-C2 left extradural mass occupying more than half of the spinal canal. On MR, it was homogeneously hypointense on both T1- and T2-weighted images, while the CT showed a calcified cyst. Intraoperative and histopathological findings documented a calcified cervical juxtafacet cyst (i.e. ganglion subtype) that was fully excised without sequelae. Conclusion: C1-C2 juxtafacet cervical cyst should be considered when a patient presents with myelopathy due to a calcified MR/CT documented paraspinal lesion contributing to significant cervical cord/root compression
Platelet function tests: a comparative review
No full textRita Paniccia,1,2 Raffaella Priora,1,2 Agatina Alessandrello Liotta,2 Rosanna Abbate1,2 1Department of Experimental and Clinical Medicine, Thrombosis Center, University of Florence, Florence, Italy; 2Department of Heart and Vessels, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy Abstract: In physiological hemostasis a prompt recruitment of platelets on the vessel damage prevents the bleeding by the rapid formation of a platelet plug. Qualitative and/or quantitative platelet defects promote bleeding, whereas the high residual reactivity of platelets in patients on antiplatelet therapies moves forward thromboembolic complications. The biochemical mechanisms of the different phases of platelet activation – adhesion, shape change, release reaction, and aggregation – have been well delineated, whereas their complete translation into laboratory assays has not been so fulfilled. Laboratory tests of platelet function, such as bleeding time, light transmission platelet aggregation, lumiaggregometry, impedance aggregometry on whole blood, and platelet activation investigated by flow cytometry, are traditionally utilized for diagnosing hemostatic disorders and managing patients with platelet and hemostatic defects, but their use is still limited to specialized laboratories. To date, a point-of-care testing (POCT) dedicated to platelet function, using pertinent devices much simpler to use, has now become available (ie, PFA-100, VerifyNow System, Multiplate Electrode Aggregometry [MEA]). POCT includes new methodologies which may be used in critical clinical settings and also in general laboratories because they are rapid and easy to use, employing whole blood without the necessity of sample processing. Actually, these different platelet methodologies for the evaluation of inherited and acquired bleeding disorders and/or for monitoring antiplatelet therapies are spreading and the study of platelet function is strengthening. In this review, well-tried and innovative platelet function tests and their methodological features and clinical applications are considered. Keywords: platelets, method, point-of-care testing, laboratory assessment, bleeding, thrombosi
Peripheral facial palsy following ventriculoperitoneal shunt. The lesson we have learned
No full textThe most frequent complications after shunt surgery are infective and obstructive. Other types are less common, and eventually occur due to technical errors during brain ventricular puncture, opening the intraperitoneal cavity or the tunnelling of the catheter between the two points. Although rare, there are well-reported complications related to the poor positioning of the distal catheter, with perforation of organs and tissues. We report a very rare case of a male patient with normal pressure hydrocephalus submitted to ventriculoperitoneal shunt. During tunnelling of the shunt stylet, a peripheral facial palsy due to injury to the extra cranial segment of the facial nerve occurred. To the best of our knowledge this is the second case described in Literature. The patient and the surgeon should be aware of this very rare but possible complication in shunt surgery being careful to the course of the facial nerve in the mastoid region
Rapid malignant progression of an intraparenchymal choroid plexus papillomas
No full textBackground: Choroid plexus tumors (CPTs) are rare neoplasms accounting for only 0.3-0.6% of all brain tumors in adults and 2-5% in children. The World Health Organization (WHO) classification describes three histological grades: grade I is choroid plexus papilloma (CPP), grade II is atypical papilloma, and grade III is the malignant form of carcinoma. In adults, CPTs rarely have a supratentorial localization. Case Description: Here we report a very rare case of an intraparenchymal parietal CPP with a rapid histological transition from grade I to grade III WHO in a 67-year-old man, in <7 months. Conclusion: Because of the rarity of these oncotypes, descriptions of each new case are useful, mostly to consider this diagnostic entity in extraventricular brain tumors of adults, despite an unusual location
Minimally Invasive Management of Spontaneous Supratentorial Intracerebral Lobar Hemorrhages by a “Homemade” Endoscopic Strategy: The Evangelical Doctrine of “Venite ad Me” Allied to the Legacy of King Leonida
No full textBackground: Although the incidence of intracerebral hemorrhage (ICH) has appeared to be increasing over the years, its prognosis remains dismal. No consensus has yet been reached regarding the management of ICH; however, minimally invasive surgery should limit, if not avoid, intraoperative parenchymal damage. Therefore, we have presented a novel, modified “homemade” approach aimed to shorten the operative time and minimize the corticectomy and brain manipulation. Methods: From 2008 to 2017, 53 patients (32 men and 21 women; mean age, 63.8 years) were admitted to our neurosurgery department and surgically treated for a lobar ICH. A modified suction tube, coupled with the endoscope light source, was used. Clot evacuation was performed under loupe magnification without the use of the microscope or endoscope. The light source of the latter was only used to provide light in the working cavity. Results: The mean hematoma volume was 69.2 mL (range, 40–100) preoperatively and 12.1 mL (range, 0–20) postoperatively, with a mean clot evacuation of 84.3% (range, 60%–100%). The mean postoperative Glasgow coma scale score was 11.6, with an improvement of 14% from the admission score (mean, 9.2). Conclusions: The results from our clinical series have shown the effectiveness of endoscopic clot evacuation in surgical ICH. In addition, we have demonstrated an efficient technique that can be used in urgent cases and in less-developed areas owing to its reduced demand on resources and its shorter learning curve. The outcomes were good and comparable to those with the classical endoscopic approach
Alterations of haemorheological parameters in patients with Peripheral Arterial Disease
No full textPeripheral arterial disease (PAD), is a common manifestation of systemic atherosclerosis. Advances on the development of such vascular disease have described with a number of novel risk factors. Hyperviscosity, due to alterations of blood cells and plasma components, may play a role on the pathogenesis of the disease. Aim of this study was to evaluate the possible association between hemorheological variables and PAD. The hemorheological variables [whole blood viscosity (WBV), erythrocyte deformability index (DI), plasma viscosity (PLV)] were analyzed in 90 patients and in 180 healthy subjects. WBV and PLV were measured by a Rotational Viscosimeter and DI by a filtrometer. DI and PLV were significantly different in patients as compared to controls. To investigate the possible association between these parameters and the disease we divided the study population into tertiles. At the univariate analysis, we found a significant association between the highest tertiles of PLV, of DI and the disease. A model adjusted for traditional risk factors showed an association between highest tertiles of PLV and PAD. After adjustment for confounding parameters highest tertiles of PLV remained to be significantly associated with the disease. Our data indicate that an alteration of plasma viscosity may modulate the predisposition to PAD
