168 research outputs found
Colecistectomia laparoscopica nella colecistite acuta: timing e outcome
No full textLa colecistite acuta è una malattia comune con alta prevalenza e notevoli costi sociali. Colpisce circa il 10-25% della popolazione adulta e circa il 20% di questi svilupperà complicazioni che richiedono un intervento chirurgico. Negli ultimi 25 anni si è registrato un aumento della prevalenza della patologia. Tale aumento è ascrivibile all’aumento dei fattori predisponenti (soprattutto nei paesi occidentale) e ad un aumento della longevità (essendo la litiasi della colecisti e le sue complicanze una malattia dell’anziano). Sebbene sia una patologia benigna, è oggi una malattia che influisce significativamente sui costi sociali, sia diretti (i costi sanitari per l’ospedalizzazione e per le cure) sia indiretti (la convalescenza e le giornate lavorative perse con conseguente diminuzione della produttività). Le complicanze legate all’evoluzione della malattia comportano un aumento della degenza ma anche un aumento delle complicanze post-operatorie. In numerosi studi in letteratura possiamo trovare come l’intervento chirurgico in urgenza aumenti il tasso di complicanze post-operatorie. Tali numeri rimangono alti anche in questi anni di miglioramento della tecnologia a supporto del chirurgo. Con il nostro studio abbiamo pensato di raccogliere dati sulle colecistectomie eseguite per litiasi della colecisti (sia in elezione che in urgenza) di due centri universitari (il Policlinico Sant’Orsola di Bologna e l’Ospedale Umberto I di Roma – La Sapienza) e quelli di un centro ospedaliero dell’AUSL di Bologna (Ospedale di Bentivoglio). Il DB condiviso ha permesso di poter indagare in primo luogo i fattori responsabili della conversione e delle morbidità post-operatorie, l’incidenza dell’età sugli outcome operatori ed il timing di intervento. Tutti questi dati sono stati poi raccolti ed analizzati. Siamo giunti alla conclusione che non esistono fattori modificabili che possano in qualche modo “evitare” le complicanze post-operatorie. Esistono invece alcuni fattori modificabili, come il timing (già indicato dalle Tokyo Guideline 2018) e la gravità della patologia (la colecistite acuta gangrenosa). Pertanto dopo un primo periodo di analisi retrospettiva abbiamo utilizzato un algoritmo di Learning Machine per poter determinare quali colecisti debbano essere operate subito e quali possano beneficiare del “raffreddamento” Nei prossimi anni, implementando l’algoritmo e aumentando i casi clinici, potremmo definire se tale algoritmo possa aiutare i clinici nella giusta scelta
Samuele R. Bacchiocchi and Family
No full textSeventh-day Adventist author and theologian, Samuele R. Bacchiocchi and his wife and their children at a graduation ceremony at Pontifical University
IDENTIFYING PATIENTS WITH RIGHT ILIAC FOSSA PAIN AT VERY LOW RISK OF APPENDICITIS: PROSPECTIVE, MULTICENTRE VALIDATION AND CALIBRATION OF RISK SCORES
No full textsd920/FIJI-macros-for-IHC-and-SHG-analysis: Batch Split Channels (3 channels)
No full textThis macro allows to split channels for Z-stack .tiff files and save them in a new folder in batch mode.
Author: Samuele Di Carmine, [email protected]
Version 1.0
July 13, 2021
//License: BSD3
Copyright 2021 Samuele Di Carmine, Imperial College Londo
Samuele R. Bacchiocchi
No full textSamuele R. Bacchiocchi was a Seventh-day Adventist author and theologian best known for his work on the Sabbath in Christianity, particularly in the historical work "From Sabbath to Sunday," based on his doctoral thesis from the Pontifical Gregorian University. Bacchiocchi defended the validity of the Feasts of the Lord, situated in Leviticus 23. He wrote two books on the subject. He was also known within the Seventh-day Adventist church for his opposition to rock and contemporary Christian music, jewelry, the celebration of Christmas and Easter, certain dress standards, and alcohol. This photograph was taken during a graduation ceremony from Pontifical University
Laparoscopic repair for perforated peptic ulcer: our experience, a comparison with the open approach and a review of the literature.
No full textBackgrounds:
The incidence of perforated peptic ulcers has decreased during the last decades but the optimal treatment for these patients remains controversial. At the same time, a laparoscopic approach to this condition has been adopted by an increased number of surgeons.
Therefore, this study wants to evaluate the postoperative results of the laparoscopic treatment of perforated peptic ulcer performed in one Italian center with extensive experience in laparoscopic surgery.
Methods:
This retrospective study includes 94 patients who were operated for perforated peptic ulcer peritonitis at “St. Orsola Hospital - Emergency Surgery Unit - University of Bologna” from May 2014 to December 2019. The patients’ charts were reviewed for demographics, surgical procedure, complications, and short-term outcomes.
Results:
The diagnosis was made clinically and confirmed by the presence of gas under diaphragm on abdominal X-ray. All patients underwent primary suture repair with or without omentopexy. Boey score 0 or 1 was found in 66 (70%) patients, Boey 2 or 3 in 28 (30%) patients. The operative time was between 35 and 255 minutes, with a mean of 93 minutes. The overall median hospital stay was 9.5 (1-60) days. Post-operative complications occurred in 19 (20%) patients and 18 (19%) patients died.
Conclusions:
Perforated peptic ulcer is a severe condition that requires early hospital admission and immediate surgery. Laparoscopy in experienced centers and for selected patients is safe, associated with optimal outcomes and should be the preferred approach
RIGHT SIDED DIVERTICULITIS IN EMERGENCY AND ELECTIVE SETTINGS: A SINGLE CENTRE EXPERIENCE
No full textIntroduzione
Right sided colonic diverticulitis is a rare condition in Western countries while is common in Asian ones. In most cases, right colonic diverticulitis mimicks an acute appendicitis and it is often diagnosed when explorative laparoscopy excludes the presence of appendicits. We report our experience in the treatment of right-side diverticulitis.
Pazienti e metodi
From September 2011 to May 2015 170 patients underwent surgical intervention for diverticular disease in our unit, both in emergency or elective setting. Pre- intra- and postoperative data of patients were prospectively registered. Uni and multivariate analysis was performed both for factors associated with postoperative morbidity and conversion to laparotomy. Statistical analysys was performed with SPSS v. 13.0. Significance was considered for p value < 0.05.
Risultati
17 patients (10%) was affected by right colonic diverticulitis and only 3 of them (17.6%) came from Asian countries. Male/female ratio was 1:1 with mean age of 5115 years, statistically lower respect to our cohort of patients with left side diverticulitis (6714 years; P<0.001). In 16 cases (94,1%) a surgical exploration was performed due to clinical and laboratoristic diagnosis of acute appendicitis. Only one patient underwent elective surgery for recurrent episodes of acute diverticulitis that required two hospital admissions. In 9 cases (52.9%) the disease was localized in the ascending colon while in the other 8 patients there was a caecal diverticulitis. 12 patients (70.6%) had Hinchey 1-2, in one case there were a generalized purulent peritonitis and in one case we found hemoperitoneum from diverticular bleeding. 13 patients (76.5%) underwent colonic resection with anastomosis while in the other 4 cases a diverticulectomy was performed with no postoperative events. Surgical interventions were performed with mini-invasive approach in 13 patients (76.5%) with a conversion rate of 29.4% (5 patients). Mean postoperative stay was 9 11 days. Overall postoperative morbidity rate was 12.6% (3 patients) according Calvien Dindo Classification. There was no postoperative in-hospital mortality. We also performed multivariate analysis to identify factors predicting overall, surgical ad medical complications but we did not find any significant factor. Also the logistic regression to identify factor predicting conversion from laparoscopic to open approach failed to find an independent variable.
Conclusioni
In our experience, right side colonic diverticulitis is a rare but not irrelevant condition also in Caucasian young individuals. Clinical and laboratoristic features of right diverticulitis can mimick other pathological contidion as acute appendicitis and often is misdiagnosed. Patients with acute right colonic diverticulitis can be treated safely with colonic resection and anastomosis. In selected cases isolated diverticulectomy can be an adequate approach
Small bowel obstruction due to metastasis of cutaneous melanoma: 7-years after primary diagnosis.
No full textAim of study: Metastatic involvement of the small bowel by melanoma is rare. The average time from the excision of the primary cutaneous melanoma to the occurrence of intestinal metastases tends to be between 3 and 5 years; one case of recurrence after 15 years is described.
The most common kind of lesion is polypoid: this can cause intussusception and intestinal occlusion. We report a case of intestinal occlusion by an ileal metastasis of a melanoma occurred 7 years earlier.
Materials and Methods: Case Report: The patient was a 57-year-old female who was admitted to our hospital for persistent abdominal pain and sub-occlusion. The patient's past medical history included cutaneous malignant melanoma 7 years before and lobular breast adenocarcinoma 10 years before. During the previous three months, she had intermittent abdominal pain and a weight loss of about 7 kg. Abdominal-US, EGDS and colonoscopy were all negative for pathologic findings. During the hospital stay, a CT enterography revealed lower intestinal intussusception, and enlarged lymph nodes both in the abdominal cavity and in the retroperitoneum. Intraoperatively we found an ileal invagination due to a polypoid mass of the ileal tract. Segmental ileal resection was performed; wide mesenteric lymph node dissection was not possible because of large and extended retroperitoneal lymphadenopathies. Histological examination showed epithelioid and spindle tumor cells with obvious cytoplasmic melanin deposition. Immunohistochemical staining revealed that tumor cells were positive for S-100, HMB-45 and vimentin, confirming the diagnosis of melanoma.
Main results and conclusions: Appearance of GI metastases is reported up to 15 years after the inital diagnosis of melanoma. Reported clinical signs and symptoms generally include chronic abdominal pain, occult or gross bleeding and, as in this case, weight loss. Aspecificity of symptoms may impede early diagnosis and treatment of the disease. As in this case, where curative surgery is impossible because of the extent of disease, metastatic tumor resection or GI tract bypass surgery is recommended to relieve symptoms or avoid future complications. Early diagnosis of metastases requires adequate imaging (CT) and prolonged follow up
The Impact of the COVID-19 Emergency on Local Vehicular Traffic and Its Consequences for the Environment: The Case of the City of Reggio Emilia (Italy)
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Open AccessArticle
The Impact of the COVID-19 Emergency on Local Vehicular Traffic and Its Consequences for the Environment: The Case of the City of Reggio Emilia (Italy)
by Samuele Marinello 1,*OrcID,Francesco Lolli 1,2 andRita Gamberini 1,2OrcID
1
En&Tech Interdepartmental Center, University of Modena and Reggio Emilia, 42124 Reggio Emilia, Italy
2
Department of Sciences and Methods for Engineering, University of Modena and Reggio Emilia, 42122 Reggio Emilia, Italy
*
Author to whom correspondence should be addressed.
Sustainability 2021, 13(1), 118; https://doi.org/10.3390/su13010118
Received: 3 December 2020 / Revised: 21 December 2020 / Accepted: 22 December 2020 / Published: 24 December 2020
(This article belongs to the Special Issue 8th World Sustainability Forum—Selected Papers)
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Abstract
The COVID-19 health emergency has imposed the need to limit and/or stop non-essential economic and commercial activities and movement of people. The objective of this work is to report an assessment of the change in vehicle flows and in air quality of a specific study area in the north of Italy, comparing the periods February–May 2020 and February–May 2019. Circulating vehicles have been measured at nine characteristic points of the local road network of the city of Reggio Emilia (Italy), while atmospheric pollutant concentrations have been analysed using data extracted from the regional air quality monitoring network. The results highlight a rapid decline in the number of vehicles circulating in 2020 (with values of up to −82%). This has contributed to a reduction in air concentrations of pollutants, in particular for NO2 and CO (over 30% and over 22%, respectively). On the other hand, O3 has increased (by about +13%), but this is expected. Finally, the particulate matter grew (about 30%), with a behaviour similar to the whole regional territory. The empirical findings of this study provide some indications and useful information to assist in understanding the effects of traffic blocking in urban areas on air quality
Laparoscopic repair for perforated peptic ulcer: our experience, a comparison with the open approach and a review of the literature.
No full textBackgrounds:
The incidence of perforated peptic ulcers has decreased during the last decades but the optimal treatment for these patients remains controversial. At the same time, a laparoscopic approach to this condition has been adopted by an increased number of surgeons. Therefore, this study wants to evaluate the postoperative results of the laparoscopic treatment of perforated peptic ulcer performed in one Italian center with extensive experience in laparoscopic surgery.
Methods:
This retrospective study includes 94 patients who were operated for perforated peptic ulcer peritonitis at “St. Orsola Hospital - Emergency Surgery Unit - University of Bologna” from May 2014 to December 2019. The patients’ charts were reviewed for demographics, surgical procedure, complications, and short-term outcomes.
Results:
The diagnosis was made clinically and confirmed by the presence of gas under diaphragm on abdominal X-ray. All patients underwent primary suture repair with or without omentopexy. Boey score 0 or 1 was found in 66 (70%) patients, Boey 2 or 3 in 28 (30%) patients. The operative time was between 35 and 255 minutes, with a mean of 93 minutes. The overall median hospital stay was 9.5 (1-60) days. Post-operative complications occurred in 19 (20%) patients and 18 (19%) patients died.
Conclusions:Perforated peptic ulcer is a severe condition that requires early hospital admission and immediate surgery. Laparoscopy in experienced centers and for selected patients is safe, associated with optimal outcomes and should be the preferred approach
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