1,721,093 research outputs found
Lo strumento della confisca tra istanze nazionali e prospettive di integrazione nello spazio di giustizia europeo
No full textThe aricle analizes the framework decision 2005/212 and its impact in the relevant national case -law.
On this basis it highlights the necessity of reforms as raccomanded in the proposal of directive 2012/0036
Diagnostic Accuracy of Endocervicoscopy in Identifying and Grading Cervical Intraepithelial Neoplasia Lesion
No full textIntroduction: Colposcopy represents the second step of the diagnostic approach of cervical intraepithelial lesions. Limits of colposcopy in studying cervix are essentially related to cervical anatomy. Nowadays, endocervical courettage is the standard technique to examine endocervix. Endocervicoscopy is a new imaging technique for the diagnostic work-up of endocervix in patients with cervical intraepithelial neoplasia (CIN). Objective: To evaluate endocervicoscopy accuracy to identify and grade cervical intraepithelial lesion in comparison to other procedures employed into the diagnostic workup of cervical pathology. Methods: A total of 634 women who performed colposcopy, endocervicoscopy and cytological or histological sampling were included in a retrospective study. The agreement between the endocervicoscopic and the colposcopic impressions, minor and major changes, and between these imaging techniques and histological diagnosis was assessed for the entire cohort. χ2 test and k statistic were used in the statistical analysis. Results: The extension of the lesion resulted significantly greater at endocervicoscopy than at colposcopy. We showed a statistically significant association between colposcopy and endocervicoscopy findings. Overall, the correlation of minor or major findings between colposcopy and endocervicoscopy was statistically significant with a p value for all parameters <0.0001. Description of mosaic/punctuation, cuffed crypt (gland) openings and ridge sign showed a high k value (k = 0.68 [95% CI 0.64-0.73], k = 0.80 [95% CI 0.75-0.85], k = 0.78 [95% CI 0.64-0.90], respectively). The sensitivity (70.1%) and the specificity (77.0%) of endocervicoscopy for all CIN lesions were lower than colposcopy. Conclusion: Endocervicoscopy turned out to be a good method to identify and grade CIN lesions in a subset of patients where colposcopy was not satisfactory. It allowed us to overcome one of the limits of colposcopy in the evaluation of the squamo-columnar junction and to establish the real extension of the lesion into cervical cancer
Distribution and peroxidative oxidation of 2-t-butyl-4-methoxyphenol in rat tissues after a single intraperitoneal dose
No full textThe distribution of 2-t-butyl-4-methoxyphenol (BHA) and its conversion to 2,2'-dihydroxy-3,3'-di-t-butyl-5,5'-dimethoxydiphenyl (di-BHA) in rat tissues at different times (1-96 hr) following the intraperitoneal administration of a single dose of BHA (32 mg kg-1 body weight) were monitored by gas chromatography-mass spectrometry (GC/MS) analysis of both compounds. High BHA levels were found in the intestine and liver persisting up to 24 hours (5.5-20.7 and 1.8-3.3 micrograms g-1 wet weight, respectively). In these tissues, values of the area under the experimental concentration curve (AUC0-24) were 285 and 49 times higher, respectively, than those observed in plasma (945 ng mL-1 hr), AUC0-24 values in kidney, spleen, erythrocytes, and brain were 2-7 times higher, whereas values below those found in plasma were observed in lung and muscle. The metabolite di-BHA could be detected in the intestine, kidney, and spleen, amounting to 5-8% of BHA. These findings indicate that rat intestine is capable of transforming in vivo BHA into di-BHA even when the former compound is administered intraperitoneally and that this capacity is shared by the kidney and spleen
Uterine arteries prophylactic occlusion balloon placement in pregnancies with placenta praevia
No full textIntroduction: To evaluate the feasibility of uterine arteries prophylactic occlusion balloon placement (POBP) to reduce hemorrhagic complications associated with placenta praevia. Material and methods: A retrospective analysis was carried out from January 2014 to November 2018. Only women with a diagnosis of placenta praevia and gestational age at delivery between 33 and 40 weeks were included. All women were diagnosed using transvaginal ultrasound scan (TVS) and confirmed with magnetic resonance imaging (MRI). All women underwent uterine arteries POBP before caesarean delivery (CD). All patients underwent clinical and instrumental follow-up with semestral outpatient TVS for 2 years after the surgery. Results: Forty-eight pregnant women were recruited and analyzed. 32/48 patients (66%) had positive anamnesis for previous CDs. Mean blood loss was 510 ± 222 mL. 15/48 patients (31.6%) were supported with RBC concentrate transfusion. In 10 (20.8%) cases, an intrauterine haemostatic balloon (Bakri-Balloon, Cook Medical, Spencer, USA) was used to control the intra-operative hemorrhage. Hysterectomy was performed in eight cases (16.6%). No cases of hemodynamic instability or urinary complications were reported. No postoperative complications occurred. During follow-up, no long-term complications were observed and nine patients had a successful pregnancy. Conclusions: Uterine arteries POPB is a promising technique that may be adopted in women with placenta praevia to prevent hemorrhagic complications
A rare case of isolated rectal laceration during parturition: consideration of the controversial role of the episiotomy and literature review
No full textBackground: Rectal laceration without sphincter lesion during childbirth is an unusual presentation. Like all the other severe lacerations during parturition, if left undiagnosed and untreated could hesitate in serious short and long term complications. Episiotomy once considered a routine procedure in nulliparous and a safeguard against severe tissue trauma nowadays is undergoing criticism and his effectiveness reconsidered. Currently, a policy of “selective” use of episiotomy is recommended only when an impending risk of lacerations is identified. When, according to this proposal, in the absence of risk factors episiotomy is not performed and complications occur, the medicolegal implication could arise. Case: A 29-year-old primigravida was admitted with spontaneous onset of labor at 41 weeks after an uncomplicated pregnancy. During the second stage of labor a spurt of siero- hemorrhagic fluid was noted trough the anus. In absence of recognized risk factor episiotomy was not performed. A healthy 3650 grams female was born in a fair condition. Rectal examination immediately after delivery revealed a longitudinal laceration with un undamaged sphincter. The rectal tear was repaired and recovery was uneventful. Conclusions: In our as in the other cases here reviewed a severe laceration occurred unexpectedly and unpreventably in patients where, according to a selective regime, episiotomy was not performed. In this setting, if severe short and long term complications ensued, especially in nulliparous, the decision to withhold episiotomy could be a source of medicolegal issues. Therefore a detailed informed consent is necessary to offer to patients a full disclosure on the role of episiotomy, its recent indications as well as the possible complications stemming from both executing or withholding this procedure
Fortini dopo Fortini: un percorso
No full textL'articolo propone una ricognizione della fortuna di Franco Fortini nella poesia italiana del secondo Novecent
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