169,766 research outputs found
Premise to implement a grading system to evaluate the sanitary level in food service establishments in Milan, Italy
Get PDFThe regulatory framework of the official controls on food safety, the criteria and methods from the planning of interventions in the field of official control to the management of information flows, and the standards described in the operation manual of the local competent authorities drafted by the Lombardy Region (2011) were evaluated. A questionnaire consisting of n. 10 questions with multiple answers draft in partnership with EPAM (the Association of Provincial Public Retail and catering businesses in Milan) to n. 107 Food service establishments of Milan shows that 92% of managers approve the introduction of a grading system. The regulatory framework is planned to support the implementation of risk assignment, unfortunately the attribution of risk category of retail and catering businesses is still different among regions
Valutazione non invasiva mediante TC multislice delle sindromi coronariche acute senza sopraslivellamento del tratto ST
No full textScopo: Il quadro clinico dei pazienti con sindrome coronaria acuta (SCA) può essere atipico, con enzimi miocardiospecifici normali ed elettrocardiogrammi non diagnostici. Una percentuale dei pazienti (2-8%) con SCA giunti in pronto soccorso, viene erroneamente dimessa. Spesso i pazienti con angina instabile (UA) o infarto miocardico senza sopraslivellamento del tratto ST (NSTEMI) possono presentare malattia coronarica multivasale o lesioni critiche dei rami principali prossimali; è importante quindi una stratificazione del rischio per la scelta del timing terapeutico ottimale. Scopo del nostro studio è stato quello di valutare il ruolo della TCMS nella stratificazione del rischio di questi pazienti, confrontando tale tecnica con un’analisi clinica, biochimica e di funzionalità miocardica.
Materiali e Metodi: Sono stati arruolati nello studio 47 pazienti consecutivi (34 maschi, 13 femmine; età media 63.3 ± 11,6 anni) con NSTEMI (94%) o UA (6%). E’ stata effettuata una valutazione clinico-anamnestica, biochimica, elettrocardiografica ed ecocardiografica. Entro 12 ore dall’ingresso tutti i pazienti sono stati sottoposti ad esame TCMS 64-strati e suddivisi in monovasali, bivasali, trivasali, con patologia e del tronco comune e con stenosi < 50%. Successivamente tutti i pazienti sono stati sottoposti ad esame coronarografico.
Risultati: La TCMS ha mostrato una sensibilità nell’identificare malattia coronarica del 97%, una specificità dell’83%, un valore predittivo negativo dell’83%, un valore predittivo positivo del 97% ed un’accuratezza diagnostica del 95%. Un solo paziente con malattia coronarica, con un’importante componente vasospastica, non è stato identificato alla TCMS. La concordanza della TCMS con l’esame coronarografico nell’identificazione di pazienti monovasali, bivasali, trivasali, con malattia del tronco comune e con stenosi < 50% è stata rispettivamente dell’83%, 81%, 82%, 78%, 80%. Nessuno dei parametri clinici, biochimici, elettrocardiografici ed ecocardiografici ha invece mostrato una correlazione con l’estensione della malattia coronarica. Il 58% delle lesioni culprit aveva una componente lipidica, l’11% calcifica, il 30% mista. La TCMS ha identificato la lesione culprit della SCA nell’86% dei casi (densità media della placca: 76 ± 41 HU, densità minima: 50,9 ± 29 HU) e il vaso responsabile nel 92%.
Conclusioni: La TCMS è risultata affidabile nella stratificazione del rischio di pazienti con NSTEMI e UA, avendo correlato con l’estensione della malattia, avendo identificato i pazienti con malattia coronarica nel 97% dei casi e avendo identificato e caratterizzato la lesione responsabile. I dati clinici, elettrocardiografici, enzimatici ed ecocardiografici invece non si sono dimostrati utili strumenti nella stratificazione del rischio in tale gruppo di pazienti.Rationale and Objectives: Clinical presentations in acute coronary syndrome (ACS) are sometimes atypical consisting in normal initial cardiac enzymes and nondiagnostic electrocardiogram. Previous studies have found that between 2% and 8% of patients with ACS who present to the emergency department are inappropriately discharged home. Unstable angina and non-ST elevation myocardial infarction (NSTEMI) patients have usually multivessel disease or proximal coronary vessel disease and a non invasive coronary evaluation could be useful for risk stratification and for an optimal therapeutic strategy timing. The aim of our study was to evaluate multislice computed tomography (MSCT) role in risk stratification of ACS without ST elevation, comparing this technique with a clinical, biochemical and echocardiographic analysis.
Materials and Methods: Forty-seven consecutive patients (34 male, 13 female; mean age: 63.3 ± 11,6 years) admitted because of ACS [NSTEMI (94%), UA (6%)] were enrolled. All patients underwent a clinical, biochemical, electrocardiographic, echocardiographic evaluation. Sixty-four MSCT coronary angiography was performed in all patients within 12 hours of acute event. In a patient-based analysis all subjects were divided in 5 groups: 1-vessel, 2-vessels, 3-vessels, left main and non significant disease. Selective coronary angiography was performed within 12 hours after MSCT.
Results: Sensitivity, specificity, negative predictive value, positive predictive value and accuracy of MSCT for detecting coronary artery disease (CAD) were 97%, 83%, 83%, 97% and 95%, respectively. Only one patient with CAD and a vasospastic component was non identified by MSCT. MSCT correlation with coronary angiography in the identification of 1-vessel, 2-vessels, 3-vessels, left main and non significant disease patients was respectively 83%, 81%, 82%, 78%, 80%. Clinical, biochemical, electrocardiographic, echocardiographic parameters were not able to correlate with CAD severity and extension. Culprit lesion composition was lipidic in 58% of cases, calcified in 11%, mixed in 30%. MSCT identified ACS culprit lesion in 86% of patients (mean plaque density 76 ± 41 HU, minimum plaque density 50,9 ± 29 HU) and culprit vessel in 92% of cases.
Conclusions: In the majority of cases, MSCT definitively and non invasively establishes or excludes CAD as the cause of chest pain. Our results show that 64-slice CT is an accurate non invasive technique to detect CAD in NSTEMI/UA patients, useful for risk stratification, assessing CAD extension and culprit lesion composition. Clinical, biochemical, electrocardiographic, echocardiographic parameters resulted not useful in risk stratification in this group of patients
Photoelectrochemical Behaviour and XPS Characterization of a (Ti,Al,V)O2 Film Obtained by non Conventional Anodic Oxidation of a Commercial Ti-Al-V Alloy.
No full textValidation study on new isothermal container for hot ready to eat food in catering establishments: Preliminary results
Get PDFThe production methods, in particular the cook-serve method, applied in high production catering establishments, even if inserted in a correct spatial design, it is affected by time-temperature flows characterized by inadequate designed moments during which critical points can be observed. The aim of this study was to evaluate, at a preliminary stage, how the new technologies can support the supply chain and production processes in catering establishments. To this end, a specific passive and active heat storage system was tested: "Polibox Smart Heater (R)" (PX SH), which makes an isothermal expanded polypropylene container an advanced maintainer for ready to eat food. The experimental design was divided into four different experiments, during which the functionality of the isothermal containers was evaluated, and thermal-tightness tests were carried out. The results showed that the PX SH containers, containing a heat accumulator, are temperature maintainers, which guarantee thermal stability (>65 degrees C), according to the current standard (UNI EN 12571:1999). In conclusion, the production chain of catering establishments should use innovative technologies such as PX SH, in order to benefit from performance consistent with the safety, hygiene and sensory criteria
[Diabetes worsens the clinical manifestations and prognosis of concurrent cardiovascular and kidney disease]
No full textNumerous studies have shown a marked increase in the incidence of diabetes mellitus worldwide. Diabetes mellitus is currently considered equivalent to coronary artery disease in terms of prognostic risk stratification, and its high prevalence makes this clinical condition the first cause of end-stage renal disease requiring chronic hemodialysis or kidney transplant. Even if chronic kidney disease remains the ''Cinderella of the cardiovascular profile'', the presence of microalbuminuria is closely related to a high risk of development of coronary artery disease. The same risk factors that impair heart function are also harmful to the kidney, and the common pathophysiological features of the two systems are at the origin of a new subspecialty, cardionephrology. A crucial task of cardiologists and nephrologists is the early identification of high risk patients with concurrent cardiovascular and kidney disease. The utilization of simple screening methods such as assessment of microalbuminuria and glomerular filtration rate by family doctors may help in establishing prevention strategies directed towards cardiovascular risk and progression of kidney disease. In conclusion, early stratification of cardiovascular risk, coupled with primary prevention strategies aimed at the general population, is warranted to obtain a significant reduction of kidney and cardiovascular disease and of the need for chronic hemodialysis treatment. This strategy is safe and cost-effective in comparison with the costs of chronic dialysis of patients affected by chronic kidney disease
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Accuracy of thin-slice computed tomography in the detection of coronary stenoses
No full textAim Our aim was to investigate the accuracy of multislice spiral computed tomography (MSCT) in the detection of significant (>50%) coronary stenosis using a scanner equipped for 16 x 0.625 mm collimation. Methods In 64 patients (59 mate, mean age 58 5 years) with suspected coronary artery disease, MSCT (GE Light Speed-16, collimation: 16 x 0.625 mm) was performed 20 5 days before coronary angiography (CAG). Only angiographic segments > 1.5 mm were considered for analysis. Results In all patients, MSCT was carried out without complications. Three patients were excluded from the analysis. Of 729 angiographic segments, 613 (84%) were judged evaluable by MSCT. Considering only the segments judged evaluable, the sensitivity was 89%, specificity 98%, positive predictive value 90%, and negative predictive value 98%. Including all segments in the analysis (evaluable and nonevaluable), sensitivity was 78%. Conclusions Using a scanner with a collimation of 16 x 0.625 mm, our study confirms the potential role of MSCT in the detection of significant coronary stenosis with a sensitivity of 89% and a very high specificity (98%). Exclusion criteria and less than full evaluability of the coronary arteries must still be considered limitations of the method. (C) 2004 The European Society of Cardiology. Published by Elsevier Ltd. All rights reserved
Correlations between personality factors and coronary artery disease: From type A behaviour pattern to type D personality
No full textDuring the last 50 years, many studies have analysed the correlations between personality factors, behavioural pattern, personality type, psychiatric disorders and coronary artery disease (CAD). Although consistent evidence of causal association between CAD and major depressive disorders does exist, the role and importance of personality factors and character traits in CAD development and manifestations are still debatable. We reported the most important studies from the literature on type A behaviour pattern (TABP), the first correlated to CAD. After the initial enthusiasms, large clinical trials raised doubts about the role of TABP as CAD risk factor. We reported subsequent researches aimed at extracting from TABP components predisposing to atherosclerosis, such as hostility and anger. Finally, we analysed a recent personality type (type D) introduced in 1995 and identified as a negative prognostic factor in CAD patients. © 2008 Italian Federation of Cardiology
Mitomycin C in highly myopic eyes - Author reply
No full textOphthalmology. 2005 Feb;112(2):208-18; discussion 219.
Mitomycin C modulation of corneal wound healing after photorefractive keratectomy in highly myopic eyes.
Gambato C, Ghirlando A, Moretto E, Busato F, Midena E.
SourceRefractive Surgery Service and Antimetabolite Therapy Research Unit, Department of Ophthalmology, University of Padova, Padova, Italy.
Abstract
PURPOSE: To evaluate the role of topical mitomycin C in corneal wound healing (CWH) after photorefractive keratectomy (PRK) in highly myopic eyes.
DESIGN: Prospective, double-masked, randomized clinical trial.
PARTICIPANTS: Seventy-two eyes of 36 patients affected by high (>7 diopters) myopia.
METHODS: In each patient, one eye was randomly assigned to PRK with intraoperative topical 0.02% mitomycin C application, and the fellow eye was treated with a placebo. Postoperatively, mitomycin C-treated eyes received artificial tears (3 times daily, tapered in 3 months), whereas the fellow eye was treated with fluorometholone sodium 2% and artificial tears (3 times daily, tapered in 3 months).
MAIN OUTCOME MEASURES: Uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA), contrast sensitivity, manifest refraction, and biomicroscopy. Contrast sensitivity was determined using the Pelli-Robson chart. Corneal confocal microscopy documented CWH.
RESULTS: Mean follow-up was 18 months (range, 12-36). No side effects or toxic effects were documented. At 12-month follow-up examination, UCVAs (logarithm of the minimum angle of resolution) were 0.4+/-0.48 and 0.5+/-0.53 (P = .03) in mitomycin C-treated eyes and corticosteroid-treated eyes, respectively. At 1 year, corneal haze developed in 20% of corticosteroid-treated eyes, versus 0% of mitomycin C-treated eyes. At 12, 24, and 36 months, corneal confocal microscopy showed activated keratocytes and extracellular matrix significantly more evident in untreated eyes (Ps = 0.004, 0.024, and 0.046, respectively).
CONCLUSION: Topical intraoperative application of 0.02% mitomycin C can reduce haze formation in highly myopic eyes undergoing PRK.
Comment in
Ophthalmology. 2006 Feb;113(2):357; author reply 357-8
Development and electroanalytical investigation of a novel rectifying semiconductor/polymer interface
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