RESUMO
The initial phases of COVID-19 emergency in Italy highlighted the technical delay that the national health system has accumulated in health services digitalization. Italian hospitals rapidly applied a demand systems for virtual health services based on tele-triage, tele-consultation and tele-visits procedures. This led, in the following months, the integration of virtual healthcare services applicable to the Azienda Ospedaliero Universitaria Pisa (AOUP). In particular, BCure system represents an important technological investment for the remote management of care protocols and the analysis of the complete use of health services. This is a unique system for sharing information between specialists, general practitioners and patients.
Assuntos
COVID-19 , Atenção à Saúde , Serviço Hospitalar de Emergência , Hospitais de Ensino , Humanos , Itália , SARS-CoV-2RESUMO
The poor vaccination coverage among health-care workers in a hospital, resulted from a self-administered questionnaire, showed the necessity to improve educational efforts and to promote vaccination campaign.
Assuntos
Pessoal de Saúde , Programas de Imunização , Doenças Profissionais/prevenção & controle , Feminino , Humanos , Itália , Masculino , Inquéritos e QuestionáriosRESUMO
The diagnostic value of radioisotopic cerebral angioscintigraphy (R.A.) and of Doppler CW (D.C.W.) techniques to identify stenosis of the internal carotid artery in its extracranial course was studied in 97 patients with ischaemic lesions (50 T.I.A. and 47 Complete Stroke). The results of R.A. and D.C.W. were compared with those of contrast carotid-angiography (C.A.). C.A. revealed stenosis above 50% or complete occlusion in 22% of cases, whereas D.C.W. and R.A. showed flow reduction in 27% and 48% of the cases respectively. In T.I.A., C.A. positivity went down to 8%; D.C.W. to 16%; and R.A. to 34%. In "Complete Stroke" positivity was 36% for C.A.; 41% for D.C.W.; and 62% for R.A. There was a high number of false positive findings with D.C.W. (8) but even more with R.A. (27). False negative findings occurred only in two cases with R.A. These data confirm the diagnostic value of these two noninvasive techniques to identify haemodynamically carotid stenosis. The use of both methods can reduce error due to false negativity. The rather marked frequency of false positivity, particularly with reference to R.A. doesn't affect the diagnostic value of the two methods.
Assuntos
Angiografia Cerebral/métodos , Transtornos Cerebrovasculares/diagnóstico , Ultrassonografia , Auscultação/instrumentação , Reações Falso-Negativas , Reações Falso-Positivas , Humanos , Ataque Isquêmico Transitório/diagnósticoRESUMO
The Authors take into consideration some important forms of vascular and tumoral pathology of neurosurgical interest which can affect pregnant women. Some criteria of urgency or delay of the surgical treatment are proposed in the attempt of saving the mother's and the foetus' life.
Assuntos
Encefalopatias/cirurgia , Complicações na Gravidez/cirurgia , Neoplasias Encefálicas/cirurgia , Hemorragia Cerebral/cirurgia , Transtornos Cerebrovasculares/cirurgia , Tomada de Decisões , Feminino , Humanos , Gravidez , RiscoAssuntos
Revascularização Cerebral , Ataque Isquêmico Transitório/diagnóstico , Anticoagulantes/uso terapêutico , Aspirina/uso terapêutico , Artéria Carótida Externa/cirurgia , Artéria Carótida Interna/cirurgia , Humanos , Ataque Isquêmico Transitório/tratamento farmacológico , Ataque Isquêmico Transitório/cirurgia , MicrocirurgiaRESUMO
Post-traumatic thrombosis of the middle cerebral artery (MCA) is uncommon: only 39 cases were found in the literature. In the present report, eight cases of post-traumatic MCA thrombosis are analyzed and compared with other reported cases. The symptoms can be easily confused with those of expanding intracranial hematoma. Although ancillary noninvasive diagnostic methods are helpful, cerebral angiography confirms the diagnosis. The morbidity and mortality rates are high, and treatment has been mainly supportive. The low mortality in the present study may be related to the absence of severe head or other trauma. Possible cerebral revascularization procedures are also discussed.
Assuntos
Artérias Cerebrais , Traumatismos Craniocerebrais/complicações , Embolia e Trombose Intracraniana/etiologia , Adulto , Idoso , Criança , Feminino , Humanos , Embolia e Trombose Intracraniana/diagnóstico por imagem , Embolia e Trombose Intracraniana/terapia , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios XAssuntos
Terapia a Laser , Animais , Odontologia , Oftalmopatias/cirurgia , Feminino , Gastroenteropatias/cirurgia , Doenças dos Genitais Femininos/cirurgia , Humanos , Nefropatias/cirurgia , Hepatopatias/cirurgia , Neoplasias/cirurgia , Doenças do Sistema Nervoso/cirurgia , Ortopedia , Otorrinolaringopatias/cirurgia , Dermatopatias/cirurgia , Doenças Torácicas/cirurgiaRESUMO
The authors report their experience in six cases of head surgery for the simultaneous reconstruction of skin, bone and dura mater. They recommend the use of teflon as a dural substitute and the autogenous bone opercolum, boiled to have it free from cancer cells or infection.
Assuntos
Transplante Ósseo , Crânio/cirurgia , Cirurgia Plástica , Idoso , Assepsia/métodos , Dura-Máter/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Politetrafluoretileno , Retalhos Cirúrgicos , Transplante AutólogoAssuntos
Craniossinostoses/cirurgia , Criança , Feminino , Humanos , Lactente , Métodos , Técnicas de SuturaRESUMO
The Authors have investigated the significance and the limits of the directional Doppler method in a group of subjects affected by internal carotid obstruction in various sites and degree. On the basis of the obtained results the Authors point out how this method represents a concrete progress in the field of non invasive diagnosis of the insufficiency of this artery.