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USL
Arezzo, Italy

Giani I.,USL | Mistrangelo M.,University of Turin | Fucini C.,University of Florence
Techniques in Coloproctology | Year: 2013

The Italian society of colo-rectal surgery (SICCR) is dedicated to improving the study, prevention and management of the diseases of the colon, rectum and anus. One of the aims of the society is to establish guidelines to the treatment of these diseases. These guidelines are based on the international literature and on the best available evidence. Clinical practice guidelines are one of the most important instruments to provide therapeutic decision-making support, based on the best scientific evidence available at the time. Guidelines are advisory and not prescriptive, susceptible to continual variations secondary to innovations and new scientific evidence. These guidelines are a guide for all colo-rectal surgeons and physicians who approach anal cancer. © Springer-Verlag Italia 2012. Source


Chisci G.,University of Siena | Chisci C.,USL | Chisci V.,University of Rome Tor Vergata | Chisci E.,University of Ferrara
International Journal of Oral and Maxillofacial Surgery | Year: 2013

Many intraoperative complications occurring during third molar surgery are described in the literature. Unilateral trochlear nerve palsy secondary to dental anaesthesia is a rare complication. We report the case of a 36-year-old healthy man, ASA I classification, requiring upper third molar extraction. Articaine 1:200,000 epinephrine for right posterior superior alveolar (PSA) nerve block was administered locally in the mucobuccal fold above the upper third molar. A few minutes after PSA nerve block the patient experienced double-vision. The patient was subsequently visited by an ophthalmologist and the condition was diagnosed as transient unilateral vertical diplopia due to temporary paralysis of the superior oblique muscle as a result of the anaesthetic solution involving the IV cranial nerve. The authors report this unusual case and discuss the possible anatomical pathways that might explain this rare phenomenon. © 2013 International Association of Oral and Maxillofacial Surgeons. Source


Maremmani A.G.I.,University of Pisa | Rovai L.,University of Pisa | Bacciardi S.,University of Pisa | Massimetti E.,University of Pisa | And 6 more authors.
Heroin Addiction and Related Clinical Problems | Year: 2015

Introduction: No room is currently being allocated in the literature to correlations between patients’ craving for heroin and their actual addictive behaviours, due to the fact that research is focused instead on risk behaviours leading to infectious diseases and the risks being incurred through overdoses. Methods: An expert panel open to rehabilitated patients built an inventory to assess craving behaviours in heroin use disorder patients. We administered it to a sample of 114 ‘typical respondents’, with the aim of testing the value of the various items in the inventory in demonstrating their discriminative effect, their reliability, and the existence of behavioural clusters. We tested the sensitivity of our inventory (its preliminary construct validity) by comparing groups each of which could be expected to be prone to a different type of craving. Results: The inventory demonstrated good internal consistency (reliability) across the sample. This high level of internal consistency suggests that the items measure the craving construct. Preliminary split-test data showed acceptable agreement for the subset of items examined. Preliminary construct validity was established through significant association in the expected direction observed for the utilized variables in identifying the modalities of heroin use. Preliminary factor analysis suggests that this inventory is unidimensional. Conclusions: The inventory appears to qualify as a tool that may be able to evaluate craving in patients with heroin use disorder through their addictive behaviours. © Icro Maremmani. Source


Muiesan M.L.,University of Brescia | Salvetti M.,University of Brescia | Amadoro V.,University of Rome La Sapienza | Di Somma S.,University of Rome La Sapienza | And 15 more authors.
Journal of Cardiovascular Medicine | Year: 2015

Severe acute arterial hypertension is usually defined as 'hypertensive crisis', although 'hypertensive emergencies' or 'hypertensive urgencies', as suggested by the Joint National Committee and the European Society of Hypertension, have completely different diagnostic and therapeutic approaches. The prevalence and demographics of hypertensive emergencies and urgencies have changed over the last four decades, but hypertensive emergencies and urgencies are still associated with significant morbidity and mortality. Different scientific societies have repeatedly produced up-to-date guidelines; however, the treatment of hypertensive emergencies and urgencies is still inappropriate, with potential clinical implications. This review focuses on hypertensive emergencies and urgencies management and treatment, as suggested by recent data. © Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. Source


Mancuso M.,Neurological Rehabilitation Unit | Rosadoni S.,Neurological Rehabilitation Unit | Capitani D.,Neurological Rehabilitation Unit | Bickerton W.L.,University of Birmingham | And 16 more authors.
Neurological Sciences | Year: 2015

Hemispatial neglect due to right parieto-temporo-frontal lesions has a negative impact on the success of rehabilitation, resulting in poor functional gain. Recent research has shown that different types of neglect can impact in a different way on rehabilitation outcomes. The availability of a sensitive test, useful for distinguishing egocentric and allocentric forms of neglect, may be clinically important as all current clinical instruments fail to distinguish between these forms of disturbance, yet they differentially predict outcome. The Apples Test is a new instrument useful to evaluate both egocentric and allocentric forms of neglect. In order to establish Italian norms for this diagnostic instrument the test was administered to a sample of 412 healthy people of both genders (201 M and 211 F), aged from 20 to 80 years enrolled from 14 different rehabilitation centers in Italy. Based on the data, we established pathological performance cut-offs for the accuracy score (total omission errors), the asymmetry score for egocentric neglect (omission error difference), the asymmetry score for allocentric neglect (commission error difference) and execution time. The usefulness of the Apples Test for diagnostic purposes is illustrated by presenting three patients with different forms of neglect (egocentric, allocentric and mixed neglect). © 2015, Springer-Verlag Italia. Source

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