132 research outputs found
Charcoal Suspension Tattoo: A New Technique for Intraoperative Detection of Small Tumors of the Parotid Gland
No full textAbstract
OBJECTIVE:
The current surgical trend in the treatment of pleomorphic adenomas of the parotid gland is to limit the extent of resection. This raises the need to correctly identify the mass within the normal parenchyma so as to avoid dissecting the entire superficial lobe of the gland. We describe ultrasound-guided tattooing as a technique to facilitate identification and excision of parotid pleomorphic adenomas.
METHODS:
We reviewed 23 consecutive patients with pleomorphic adenoma of the parotid gland. All patients underwent ultrasound-guided tattooing of the lesions with a charcoal suspension. Baseline tumor and patients' characteristics, major and minor complications, and subjective tolerance to the procedure were recorded. We assessed the number of intralesionally marked masses and the percentage of intraoperatively detected marked lesions.
RESULTS:
The injection was well tolerated. No major complications were recorded. In 2 cases (9%), a transient increase in lesion size was observed. No other minor complications were encountered. Charcoal was found inside the tumor in 19 cases (83%). In 4 cases (17%), it was found in the tissues above the lesion. Twenty-three lesions were intraoperatively detected (100%) and dissected.
CONCLUSION:
Charcoal suspension tattooing is safe and well tolerated for the detection of small pleomorphic adenomas during parotid surgery
El diario de Augusto Monterroso: La letra E
No full textIn El diario de Augusto Monterroso: La letra E (in Assunta Polizzi, Parole discorsi testi nelle culture ispaniche, a cura di, Palermo, Flaccovio, 2007, pp.21-36) the author reflects on the genre of the journal within the framework of the ‘modern’, halfway between the existential testimony and an exercise in writing; fiction and confession.
The paper examines the journal of Augusto Monterroso, La letra E, a text focusing on the image of a writer continually searching for adequate forms of expression and his doubts on the very act of writing. La letra E thus ends up being a further testimony to the commitment of the writer to the written word and –at the same time- to his clear intention to pinpoint the modalities of the literary journal as genre, and consequently one of the forms, whether sophisticated or not, of lie, fiction and masking
Surgical treatment of neglected hip fracture in children with cerebral palsy: Case report and review of the literature
No full textCase. A clinical case of a 15-year-old cerebral palsy child with a Sandhu type 2 neglected femoral neck fracture is presented. The patient was treated using cannulated screws and cancellous bone graft augmented with mesenchymal stem cells. At 6 months after the surgery complete fracture healing was observed. Conclusion. To early diagnose this fractures, it is mandatory to perform a comprehensive clinical and radiological evaluation including also a second level imaging. The use of cannulated screws with cancellous bone graft and MSCs is a viable treatment option in these patients.Case. A clinical case of a 15-year-old cerebral palsy child with a Sandhu type 2 neglected femoral neck fracture is presented. The patient was treated using cannulated screws and cancellous bone graft augmented with mesenchymal stem cells. At 6 months after the surgery complete fracture healing was observed.Conclusion. To early diagnose this fractures, it is mandatory to perform a comprehensive clinical and radiological evaluation including also a second level imaging. The use of cannulated screws with cancellous bone graft and MSCs is a viable treatment option in these patients
Pituitary dysfunction and its association with quality of life in traumatic brain injury
No full textBACKGROUND:
Traumatic brain injury (TBI) is a major cause of death and disability and may cause transient or persistent, isolated or multiple hypopituitarism in a variable percentage of cases.
OBJECTIVES:
The primary aim of this study was to determine the incidence of isolated and multiple anterior pituitary hormone deficiency in subjects with TBI in a single institution. The secondary aim was to determine a correlation between pituitary deficiency and quality of life (QOL) after TBI.
METHODS:
Thirty-five patients, aged between 18 and 63 years, were evaluated 6months to 5 years after TBI. We evaluated the QOL by SF-12(®) questionnaire and measured serum basal GH, IGF1, LH, FSH, testosterone (in males), 17-β-estradiol (in women), PRL, fT4 and TSH. In patients with low IGF1, a GHRH + Arginine test was performed.
RESULTS:
Single or multiple pituitary failure was found in 13 patients (37%). Low testosterone was found in 7 males, low FSH and/or LH in 4, low IGF1 in 7 patients. Hypogonadotropic hypogonadism and GH insufficiency assessed by GHRH + Arginine test were found respectively in 3 and 2 patients. One patient displayed a concomitant GH insufficiency and low TSH level. Twenty six patients showed a reduction in QOL. A correlations between altered QOL and hormonal deficiency was not observed.
CONCLUSIONS:
Isolated or multiple hypopituitarism resulting from TBI are frequent. Alterations in QOL and pituitary function resulting from TBI are not associated
Charcoal suspension tattoo: new tool for the localization of malignant laterocervical lymph nodes
No full textWe present a retrospective study to evaluate safety and effectiveness of ultrasound (US)-guided tattooing with charcoal of suspicious laterocervical lymph nodes. When an open biopsy of a laterocervical lymph node is needed, the choice of the lymph node to excise and examine is fundamental to avoid rebiopsy. Surgeons tend to choose the most surgical approachable enlarged lymph node that does not always correspond to the one with worst echographic aspect. We present 16 cases of patients with laterocervical adenopathy with inconclusive or non-adequate results at fine needle aspiration cytology addressed to open biopsy. Those patients underwent US-guided preoperative injection of a charcoal suspension inside the lymph node to excise to mark it, and then excisional biopsy was performed. Sixteen marked lesions (100 %) were detected intraoperatively and dissected. The injected charcoal was detected intraoperatively in all cases. In 14 patients (87, 5 %) it was inside the lesion; in two cases (12, 5 %), the charcoal suspension was found in the tissues above the lesion. The procedure was well tolerated in all cases. No major procedure-related complications were encountered. US-guided charcoal tattooing is a new, safe, well-tolerated, and easy-to-perform technique for the marking of US suspicious laterocervical lymph nodes. This preliminary study shows a high technical success rate (76 %) and high percentage of intraoperative detection of marked lesions (100 %) with a low rate of complications
IL DIRITTO DEL LAVORO NELLE IMPRESE SOCIALMENTE RESPONSABILI
No full textThe author starts from CSR definition as it is set by the Green Paper of the European Commission, where great importance is given to labour issures, in order to examine how it affects labour law and if, how and how much labour relationships may change in companiers voluntarily involvede in it. The expert in labour law is conscious of the importance of the change takin place, especially when the tespect of rules is connected to social and environmental sustainability targets, but he/she is also conscious of the risk of bargaining a lowe workers' protection
"Vuoti" e "pieni": la retribuzione e la parità di trattamento nell'ordinamento dell'Unione europea
No full textThe Author envisages the topic of pay from an Eu perspective by verifying how the exclusion of competence, which is still stated by the Treaties, combines with the principle of equal pay for women and men, which was already enshrined in the Treaty of Rome. The analyseis leads to interesting considerations. Firsto of all, the issue seems to run the blind track of competence exclusion not only beacause of a choice of non interfering with its determination, except for the equality principle, but also because the issue reaches an European dimension when referring to trans-national phenomena (such as, posting of workers and right to minimum wage). Most of all, this highlights the key role of equal tratment and of the prohibitions of discriminations, which have been progressively extended to a plurality of factors protected by the legal system and to the so called atypical jobs. The analysis of the proposal for a directive on GPG raises the critical aspects that collective bargaining implies. In fact, if pay is the typical subject of collective bargaining and if the systems of classification and professional placement are ones of its closest corollaries, the GPG is its direct outcome. This perspective necessarily implies the topic of the limits to contractual autonomy stemming from fundamental principles. The general rehearsals on this matter can be found in the "contracto on inserimento", as the law itself permits an exemption from the equal treatment principle. The point of arrival, at the moment, is represented by the omnivorous exception of art. 8 of the financial act of September 2011
Galdós, el periodismo y la escritura. Reflexiones a partir del cuento "El artículo de fondo"
No full textGaldós was experiencing in his formation and in his first stage of production the narrative space of the press. The short story “El artículo de fondo” was published in 1871 in Revista de España, in 1879, in three installments in El Océano and reappears in 1889 in a collection of brief narrative texts that accompany his Torquemada en la hoguera. This study tries to focus, on the one hand, the variants introduced by the author, especially in the last edition, in order to evaluate the process of maturation of galdosian writing. On the other hand, taking into account the essentially heterotextual consistency of this short story, it try to put it in relation to the pluritextual narrative texture, which the newspaper macrotexts emblematically reflects.Galdós da a conocer por primera vez el cuento “El artículo de fondo” en 1871 en la publicación periódica Revista de España (XIX, 3, 427-440). Bastante años después, volverá a editarlo en una colección de textos de narrativa breve que acompañan su Torquemada en la hoguera (Madrid, La Guirnalda y Episodios y Episodios Nacionales, 1889), advirtiendo a su amigo Clarín en una carta que las «antiguallas» que presentaba el volumen, sacadas del olvido por voluntad ajena al autor, no merecían la pena de una lectura. Sin embargo, Galdós tuvo que empeñarse en la revisión, por lo menos del texto que aquí nos interesa, si consideramos las variantes introducidas, las elisiones y las ampliaciones que la segunda edición del cuento presenta ya sólo a través de una rápida collatio y a partir del incipit. Siguiendo esta pista, no mencionada en los escasos estudios que la crítica galdosiana ha dedicado a “El artículo de fondo” y que hemos podidos consultar, y enfocando la consistencia esencialmente heterotextual del cuento, se ha ido hilvanando una serie de reflexiones acerca del interés de Galdós por los procesos de construcción del texto, del tejido narrativo pluritextual, conjunto de piezas da variada naturaleza verbal y genérica, que el macrotexto del periódico emblemáticamente refleja. Galdós iba experimentando en su formación y en su primera etapa de producción precisamente el espacio narrativo de la prensa, instalado en lo sustancial de la narración diversificada por registros y dispositivos informativos, entre los cuales los visuales, de la actualidad. De ahí, la hipótesis de este estudio que intenta enfocar, más allá de la incontrovertible parodia del periodista costumbrista o serial que el cuento elige come sujeto, las estrategias de trasvase de la realidad en el texto, una realidad siempre multifacética que necesita la yuxtaposición de piezas verbales y de perspectivas singulares, según los rasgos del discurso periodístico y del periódico como sistema textual complejo
Accuracy of the Anatomage Table in detecting extranodal extension in head and neck cancer: a pilot study
No full textPurpose: To assess whether the three-dimensional reconstructions of preoperative computed tomography (CT) scans are helpful for establishing extranodal extension (ENE) in head and neck carcinoma. Approach: Patients with a histological diagnosis of ENE ( pENE + ) were considered "cases" and patients with negative histological examination for ENE ( pENE - ) were considered "controls." Cases and controls were divided into two groups: a major nodes (MaN) group (lymph nodes on CT > 15 mm ) and a minor nodes (MiN) group (lymph nodes on CT ≤ 15 mm ). The preoperative CT scans were uploaded to the Anatomage Table and were randomly and blindly provided to the radiologist for assessment. The findings at the Anatomage Table were compared with those of CT and magnetic resonance imaging (MRI) scans. Results: Analysis of data from the MaN group showed that the Anatomage Table had a higher percentage of concordance with histopathological examination (90%) than the CT and MRI scans. The Anatomage Table had 100% sensitivity in identifying all pENE + patients, associated with a lower specificity. The negative predictive value of 100% allowed identification of pENE - patients. In the MiN group, on the other hand, sensitivity was lower, related to a high number of false-negative results. Conclusions: The Anatomage Table could represent a useful tool for preoperatively establishing the extranodal extension of cervical lymph node metastasis
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