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Orecchio S.,University of Palermo | Amorello D.,University of Palermo | Carollo C.,Istituto Mediterraneo per i Trapianti e Terapie Ad Alta Specializzazione
Microchemical Journal | Year: 2012

Because Platinum Group Elements have found widespread use in catalytic converters in cars and as chemotherapeutic agent, interest in the development of reliable analytical methods is carried out in order to monitor these analita in humans to protect the citizen's health.Considering that information on the levels of many trace elements in biological matrices is scarce and for many non-essential elements, baseline levels in the population, and especially in those particularly exposed to the risk are lacking, in this paper we optimize an analytical method for biological matrices, using a voltammetric technique to measure the concentration of Pt in blood and perfusate.The amount of Pt recovered from the blood and perfusate samples spiked with analita was observed to be meanly of 95% with 5-6% of R.S.D. These results indicated that proposed method for the determination of platinum in biological materials is accurate and reproducible.The amounts of platinum found in the blood samples of common ranged citizen were similar to quantification limit while in the patients the concentration ranged from 1.5 to 360 μg/L, in perfusate ranged from 0.7 to 9700 μg/l. The concentrations of Pt of populace and in patients before of infusion are in agreement with the level measured in the blood of unexposed patients.The proposed analytical method permits to determine the amount of Pt in the perfusate and subsequently absorbed by the target organs in order to determine the dose and timing of treatment and to avoid overdoses with related undesired effects. © 2011 Elsevier B.V. Source


Muriana C.,University of Palermo | Piazza T.,University of Palermo | Vizzini G.,Istituto Mediterraneo per i Trapianti e Terapie Ad Alta Specializzazione
Knowledge-Based Systems | Year: 2016

Interest in the field of performance assessment of health care structures has grown in recent decades. In fact, the possibility of determining overall performances of health care structures plays a key role in the optimization of resource allocation and investment planning, as it contributes to reducing the uncertainty of future performance. In this context, key performance indicator (KPI) tools have been developed to assess the performance of health care structures from process, organizational, cost, financial, and output points of view. In practice, they are periodically calculated, and the effect of several KPIs on the overall performance of health care structures is determined by management through human judgment or software that provides synthetic dashboards. Given their non-stationary nature, performance assessment and forecasting are generally tackled by employing adaptive models, but these approaches cannot reflect the holistic nature of performance itself, nor take into account the impact of KPIs on the overall performances. In order to overcome these shortcomings, this study presents an expert system whose engine relies on fuzzy sets, in which the input-output relations and correlations have been modeled through inference rules based on time-series trends. The focus is on the financial performance assessment of a health care structure, such as a hospital. The approach is of an interdisciplinary kind, as several indicators were taken as inputs that relate to output, process, and cost KPIs, and their impact on the output measure, which is of a financial kind (namely the total reimbursement). The output measure calculated by the expert system was then compared with that predicted using only adaptive forecasting models, and the error with respect to the actual value was determined. Results showed that measures determined by fuzzy inference, able to effectively model actual input-output relations, outperform those of adaptive models. © 2016 Elsevier B.V. All rights reserved. Source


Busuttil R.W.,University of California at Los Angeles | De Carlis L.G.,General Surgery and Abdominal Transplantation | Mihaylov P.V.,General Surgery and Abdominal Transplantation | Gridelli B.,Istituto Mediterraneo per i Trapianti e Terapie Ad Alta Specializzazione | And 2 more authors.
American Journal of Transplantation | Year: 2012

Until the present time, the first experimental liver transplant which led to the development of human liver transplantation is attributed to C. Stuart Welch who performed a heterotopic transplant in the canine species in 1955. In 1956, Jack Cannon is credited with the first animal orthotopic liver transplant although the species was not disclosed. This report is intended to set the historical record straight by acknowledging that Vittorio Staudacher in 1952 was the first to perform a liver transplant in a large animal model. © Copyright 2012 The American Society of Transplantation and the American Society of Transplant Surgeons. Source


D'Anna C.,National Research Council Italy | Cigna D.,National Research Council Italy | Costanzo G.,National Research Council Italy | Ferraro M.,National Research Council Italy | And 4 more authors.
Life Sciences | Year: 2015

Background Lung fibroblasts are crucial for the integrity of alveolar structure. Cigarette smoking, the major risk factor for chronic obstructive pulmonary disease, impairs the repair functions of lung fibroblasts. Aims The study simultaneously assessed for the first time cell cycle, p53, p21, p38, ERK 1/2 and IL-8. Main methods Primary foetal lung fibroblasts (HFL-1) and primary lung fibroblasts from former (n = 5) and current (n = 5) smokers with/without cigarette smoke extracts (CSEs) and inhibitors of p38 and ERK1/2 were studied for cell cycle events and for marker expression by flow-cytometry, western-blot analysis and ELISA. Key findings CSE exposure did not induce caspase 3 cleavage or DNA laddering but reduced S phase, and increased G1 and G2/M in HFL-1. Furthermore CSE increased: p53 and p21 expression; p38 and ERK 1/2 pathway activation; and IL-8 release. Inhibitors of p38 and ERK 1/2 reversed the effects of CSE on cell cycle and on IL-8 release. ERK 1/2 inhibitor was able to reverse the effects of CSE on p21 expression. Primary lung fibroblasts from current smokers had higher ERK 1/2 activation in comparison to normal primary fibroblasts and higher percentage of cells in G1 phase and lower percentage of cells in S phase in comparison to former smoker fibroblasts. Significance Cigarette smoke may affect the reparative potential of lung fibroblasts altering the expression of p53 and p21 and the progression of the cell cycle to S phase. All these events are promoted by the activation of pro-inflammatory pathways. © 2015 Elsevier Inc. Source


Bertolini G.,Centro Of Ricerche Cliniche Per Le Malattie Rare Aldo E Cele Dacco | Boffelli S.,Centro Of Ricerche Cliniche Per Le Malattie Rare Aldo E Cele Dacco | Malacarne P.,Servizio di Anestesia | Peta M.,I Servizio Anestesia e Rianimazione | And 9 more authors.
Intensive Care Medicine | Year: 2010

Purpose: To appraise the end-of-life decision-making in several intensive care units (ICUs) and to evaluate the association between the average inclination to limit treatment and overall survival at ICU level. Design: Prospective, multicenter, observational study, lasting 12 months. Setting: Eighty-four Italian, adult ICUs. Patients: Consecutive patients (3,793) who died in ICU or were discharged in terminal condition, in 2005. Measurements: Data collection included patient description, treatment limitation and decision-makers, involvement of patients and relatives in the decision, and organ donation. A logistic regression model was used to identify predictors of treatment limitation and develop a measure of the inclination to limit treatment for each ICU. This was compared with the standardized mortality ratio, an index of the overall performance of the unit. Results: Treatment limitation preceded 62% of deaths. In 25% of cases, nurses were involved in the decision. Half the limitations were do-not-resuscitate orders, with the remaining half almost equally split between withholding and withdrawing treatment. Units less inclined to limit treatments (odds ratio <0.77) showed higher overall standardized mortality ratio (1.08; 95% confidence interval: 1.04-1.12). Limitations: The voluntary nature of participation, with self-selected ICUs from a self-selected independent network. Conclusions: Treatment limitation is common in ICU and still principally a physician's responsibility. Units with below-average inclination to limit treatments have worse performance in terms of overall mortality, showing that limitation is not against the patient's interests. On the contrary, the inclination to limit treatments at the end of life can be taken as an indication of quality in the unit. © 2010 Copyright jointly held by Springer and ESICM. Source

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