Orsi L.,Private Practitioner |
Gristina G.R.,Italian Society of Anesthesia Analgesia and Intensive Care SIAARTI
Minerva Anestesiologica | Year: 2017
In January 2016 the Italian National Bioethics Committee (NBC) published a position statement entitled Deep and continuous palliative sedation in the imminence of death, related to the use of sedation and analgesia for relief from pain and psychological distress in dying patients. In this statement the Committee points out the clinical and ethical appropriateness of palliative sedation as a therapeutic procedure. As a result, today palliative sedation has to be considered useful, scientifically safe and reliable, and acknowledged as an integral part of good clinical practice. At the same time, the position statement, once and for all, makes clear that palliative sedation cannot and must not be equated with the practice of euthanasia. Thus, this document should be known by health professionals caring for dying patients not only in palliative as well as in intensive care settings, but it should be also considered as a milestone aimed to encourage and ease a widespread implementation of this procedure in all health care settings. © 2016 EDIZIONI MINERVA MEDICA.
Lange-Consiglio A.,University of Milan |
Rossi D.,Instituto Ospedaliero |
Tassan S.,Private practitioner |
Perego R.,University of Milan |
And 2 more authors.
Stem Cells and Development | Year: 2013
We have recently demonstrated that heterologous transplantation of horse amniotic membrane-derived mesenchymal cells (AMCs) can be useful for cell therapy applications in tendon diseases, and hypothesized that these cells may promote tendon repair via paracrine-acting molecules targeting inflammatory processes. To test this hypothesis, here we examined the immunomodulatory characteristics of AMCs and of their conditioned medium (AMC-CM) in vitro, and studied the potential therapeutic effect of AMC-CM in thirteen different spontaneous horse tendon and ligament injuries in vivo. Our results demonstrate that AMCs are capable of inhibiting peripheral blood mononuclear cell (PBMC) proliferation after allogenic stimulation either when cocultured in cell-to-cell contact, or when the two cell types are physically separated by a transwell membrane, suggesting that soluble factors are implicated in this phenomenon. Our hypothesis is further supported by the demonstration that PBMC proliferation is inhibited by AMC-CM. In our in vivo studies, no significant adverse effects were observed in treated tendons, and clinical and ultrasonographical evaluation did not reveal evidence of inappropriate tissue or tumor formation. Clinical outcomes were favorable and the significantly lower rate (15.38%) of reinjuries observed compared to untreated animals, suggests that treatment with AMC-CM is very efficacious. In conclusion, this study identifies AMC-CM as a novel therapeutic biological cell-free product for treating horse tendon and ligament diseases. © Copyright 2013, Mary Ann Liebert, Inc. 2013.
Ferriero G.,Scientific Institute of Veruno |
Vercelli S.,Scientific Institute of Veruno |
Sartorio F.,Scientific Institute of Veruno |
Munoz Lasa S.,Complutense University of Madrid |
And 4 more authors.
International Journal of Rehabilitation Research | Year: 2013
The aim of this study was to assess the reliability of a smartphone-based application developed for photographic-based goniometry, DrGoniometer (DrG), by comparing its measurement of the knee joint angle with that made by a universal goniometer (UG). Joint goniometry is a common mode of clinical assessment used in many disciplines, in particular in rehabilitation. One validated method is photographic-based goniometry, but the procedure is usually complex: the image has to be downloaded from the camera to a computer and then edited using dedicated software. This disadvantage may be overcome by the new generation of mobile phones (smartphones) that have computer-like functionality and an integrated digital camera. This validation study was carried out under two different controlled conditions: (i) with the participant to measure in a fixed position and (ii) with a battery of pictures to assess. In the first part, four raters performed repeated measurements with DrG and UG at different knee joint angles. Then, 10 other raters measured the knee at different flexion angles ranging 20-145 on a battery of 35 pictures taken in a clinical setting. The results showed that inter-rater and intra-rater correlations were always more than 0.958. Agreement with the UG showed a width of 18.2 [95% limits of agreement (LoA)=-7.5/+10.7 ] and 14.1 (LoA=-6.6/+7.5 ). In conclusion, DrG seems to be a reliable method for measuring knee joint angle. This mHealth application can be an alternative/additional method of goniometry, easier to use than other photographic-based goniometric assessments. Further studies are required to assess its reliability for the measurement of other joints. Copyright © Lippincott Williams & Wilkins.
Maina E.,Servizi Dermatologici Veterinari |
Maina E.,Ghent University |
Galzerano M.,Private practitioner |
Noli C.,Servizi Dermatologici Veterinari
Veterinary Dermatology | Year: 2014
Background: Perianal pruritus has been reported in dogs with anal sac disease but not in healthy dogs. Some authors describe it as typical of allergy, but there is little evidence in support of this. Hypothesis/Objectives: The aim was to investigate the association between perianal pruritus and canine atopic dermatitis (CAD), adverse food reaction (ARF) and other skin diseases in dogs. Animals: Two hundred and fifty privately owned dogs with skin disease and without anal sac disease. Methods: The presence or absence of perianal pruritus, macroscopic and cytological evaluation of the perianal skin surface and the macroscopic appearance of anal sac contents were assessed. Chi-square and Fisher's exact tests were performed to compare the frequency of perianal pruritus with the clinical diagnoses and with clinical and cytological parameters. Results: Perianal pruritus was seen in 39 of 75 dogs with CAD, in 29 of 57 dogs with ARF and in only 24 of 118 dogs with other conditions. The frequency of perianal pruritus in dogs with CAD and/or ARF was significantly higher than that in dogs with other diagnoses (P < 0.0001). No other disease was significantly associated with perianal pruritus. Perianal pruritus was significantly associated with signs of perianal alopecia, erythema, excoriations, lichenification and hyperpigmentation; it was not associated with the presence of bacteria or yeasts or with anal sac impaction. Conclusions and clinical importance: Perianal pruritus was seen more frequently in dogs with AFR/CAD than with other dermatological diseases. This is the first study to evaluate perianal pruritus in dogs with skin disease and without anal sac disease. © 2014 ESVD and ACVD.
Petersen R.F.,Statens Serum Institute |
Dalby T.,Statens Serum Institute |
Dragsted D.M.,Private practitioner |
Mooi F.,National Institute for Public Health and the Environment RIVM |
Lambertsen L.,Statens Serum Institute
Emerging Infectious Diseases | Year: 2012
We used multilocus variable-number tandem repeat analysis and multiple antigen sequence typing to characterize isolates of Bordetella pertussis strains circulating in Denmark during periods with and without pertussis vaccination coverage. Our results show substantial shifts in the B. pertussis population over time and a reduction in genetic diversity. These changes might have resulted from the introduction of pertussis vaccines in Denmark and other parts of Europe. The predominant strains currently circulating in Denmark resemble those in other European countries.
Mackness B.,Private Practitioner |
Mackness M.,Calle de lArgelagar
Panminerva Medica | Year: 2012
High-density lipoprotein (HDL) is protective against atherosclerosis development. Other than its central role in reverse cholesterol transport, HDL exhibits several other mechanisms by which it is protective. These include antioxidative, anti-inflammatory and antiapoptopic activities and the normalisation of vascular function. In light of the current view that oxidative modification of low-density lipoprotein (LDL) is essential for the initiation and progression of atherosclerosis, the antioxidative properties of HDL may be an important protective mechanism. HDL can retard the oxidation of LDL and limit its atherogenicity. Several proteins are present on HDL and the evidence that some of them metabolise lipid peroxidation products of phospholipids, cholesteryl esters and triglycerides associated with LDL and vascular cell membranes are discussed in this review.
Guimaraes T.,University of Porto |
Lopes G.,University of Porto |
Ferreira P.,University of Porto |
Leal I.,Private Practitioner |
Rocha A.,University of Porto
Animal Reproduction Science | Year: 2012
Cryopreservation of epididymal spermatozoa is a useful tool to preserve genetic material of valuable stallions after emergency castration or unexpected death. For that, testicles and epididymides are generally sent refrigerated to the laboratory. Collection of epididymal spermatozoa is a simple procedure that reduces the volume of the material to be shipped, and may improve the quality of the chilled epididymal sperm cells. In the present study we compared the characteristics of frozen/thawed epididymal spermatozoa after refrigeration of the epididymis or after direct refrigeration of the extended epididymal sperm cells. Ejaculated sperm samples were obtained from 10 healthy stallions with at least 15 days of sexual rest, before routine orchiectomies. Spermatozoa were recovered from the epididymal tail immediately after castration (EPI), after refrigeration of the epididymis for 24. h at 4. °C (EPI R) and recovered from epididymal tail immediately after castration and stored for 24. h at 4. °C (EPI RR). Total motility, straight-line velocity, percentage of rapid cells, viability and morphological defects were similar (p> 0.05) among different treatments, and post-thaw viability was higher (p< 0.05) in EPI than in the ejaculated sperm. The similarity of post-thaw parameters led us to conclude that immediate collection and refrigeration of the epididymal sperm cells or refrigeration of the whole epididymis are equally efficient as a means of transporting material for 24. h before cryopreservation of epididymal spermatozoa. © 2012 Elsevier B.V.
Collazo A.,Private Practitioner |
Austin A.,Barry University |
Craig S.L.,University of Toronto
Clinical Social Work Journal | Year: 2013
Although transgender clients seek services in a number of settings in which social workers practice, there is a dearth of scholarly literature available to guide effective clinical practice with this population. When transgender issues are included in the practice literature, the trend has been to consolidate the needs of transgender clients with those of the larger lesbian, gay, and bisexual community or to simply focus on increasing the comfort level of clinicians working with this population. This is concerning because transgender individuals represent a vulnerable subgroup of clients with unique and specific treatment needs related to the transition experience. Social workers play a critical role; they may serve transgender clients and their families in many ways: as advocate, educator, diagnostician, and individual, couples or family therapist. The purpose of this article is to identify several key components of trans-specific clinical practice and the role of social workers in supporting and facilitating client transition. Specifically, the authors will discuss: (a) relevant definitions and terminology, (b) emerging issues related to depathologizing the needs and experiences of transgender individuals, (c) the critical elements of trans-specific clinical assessment, and (d) clinical advocacy associated with the medical legal and social aspects of the transition process. Specific recommendations for trans-affirmative social work practice will be offered. © 2013 Springer Science+Business Media New York.
Riley III J.L.,University of Florida |
Gordan V.V.,University of Florida |
Ajmo C.T.,Private Practitioner |
Bockman H.,Private Practitioner |
And 2 more authors.
Community Dentistry and Oral Epidemiology | Year: 2011
Objectives: Few studies have examined dentists' subjective ratings of importance of caries risk factors or tested whether dentists use this information in treatment planning. This study tested several hypotheses related to caries risk assessment (CRA) and individualized caries prevention (ICP). Methods: Data were collected as part of a questionnaire entitled 'Assessment of Caries Diagnosis and Caries Treatment', completed by 547 practitioners who belong to The Dental Practice-Based Research Network (DPBRN), a consortium of participating practices and dental organizations. Results: Sixty-nine percent of DPBRN dentists perform CRA on their patients. Recently graduated dentists, dentists with busier practices, and those who believe a dentist can predict future caries were the most likely to use CRA. The association between CRA and individualized prevention was weaker than expected (r = 0.21). Dentists who perform CRA provide ICP to 57% of their patients, compared with 42% for dentists who do not perform CRA. Based on their responses to radiographic and clinical scenarios in the questionnaire, dentists who use CRA appear to use this information in restorative decisions. Conclusion: A substantial percentage of DPBRN dentists do not perform CRA, and there is not a strong linkage between its use and use of individualized preventive regimens for adult patients. More progress in the implementation of current scientific evidence in this area is warranted. © 2011 John Wiley & Sons A/S.
Clinical and radiological 12-year follow-up of full arch maxilla prosthetic restoration supported by dental implants positioned through guide Hapless surgery [Follow-up clinico e radiologico di una riabilitazione protesica di tipo full arch a supporto implantare eseguita con tecnica flapless computer-guidata]
Soardi C.M.,Private Practitioner |
Bramanti E.,Messina University |
Cicciu M.,Messina University
Minerva Stomatologica | Year: 2014
The computer-guided flapless surgery for implant placement using stereolithographic templates is going to be considered a daily practice technique. The advantages of this kind of surgery are related with its no flap opening, with the precision of the implant positioning and with the possibility of having a quick rehabilitation and low post-surgical discomfort. The introduction of digital planning programs has made it possible to place dental implants in preplanned positions and being immediately functionally loaded by using prefabricated prostheses. This case presented a 12-year follow-up of a maxillary prosthesis supported by dental implant immediately loading and positioned with the first kind of guided flapless surgery technique. Aim of this paper was to report how the guide surgery implant position technique can be considered a predictable and safe technique giving the surgeon excellent long-term results.