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  • 1
    Electronic Resource
    Electronic Resource
    The Effect of Multiple Blood Conservation Techniques on Donor Blood Exposures in Adult Coronary and Valve Surgery Performed with a Membrane Oxygenator: A Multivariate Analysis on 1310 Patients. (1995)
    Oxford, UK : Blackwell Publishing Ltd
    Journal of cardiac surgery 10 (1995), S. 0 
    Details
    ISSN: 1540-8191
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The object of the study was to retrospectively evaluate protective and risk factors for receiving donor blood products and red cell transfusions after coronary and valve surgery performed with a hollow-fiber oxygenator and with multiple blood-saving techniques. During the period of January 1991 to June 1993, 1310 patients underwent primary coronary and valve surgery using a hollow-fiber oxygenator at our institution; the mean age of this population was 61 ±10 years; 977 patients were men (74.6%). Of these patients, 73.5% (963/1310) underwent coronary, 21.5% (281/1310) valve, and 5% (66/1310) combined surgery. Two hundred seventy-six (21.1%) needed donor blood product transfusions, while 153 (11.7%) patients underwent red cell transfusions. Significant risk factors for homologous blood product exposure after multivariate logistic regression analysis were, in order of importance: (1) postoperative blood loss (O.R. = 1.0009 per mL, p = 0.0000); (2) cardiopulmonary bypass (CPB) time (O.R. = 1.008 per min, p = 0.0001); (3) age at intervention (O.R. = 1.031 per calendar year, p = 0.0026); and (4) reoperation for bleeding (O.R. = 1.71, p = 0.0078). Protective factors were: (1) male gender (O.R. = 0.56, p = 0.0000); (2) preoperative withdrawal of autologous blood (O.R. = 0.66, p = 0.0018); and (3) a preoperative hematocrit greater than 34% (O.R. = 0.76, p = 0.005). When considering risk factors only for donor red cell exposure, multivariate regression analysis identified the following risk factors: (1) reoperations for bleeding (O.R. = 2.04, p = 0.0002); (2) postoperative blood losses (O.R. = 1.0007 per mL, p = 0.0005); (3) CPB time (O.R. = 1.0075 per min, p = 0.0008); and (4) age at intervention (O.R. = 1.03 per calendar year, p = 0.0160). Protective factors were: (1) intraoperative “high-dose” aprotinin administration (O.R. = 0.61, p = 0.0024); and (2) preoperative donation if autologous blood (O.R. = 0.65, p = 0.0093); and (3) intraoperative withdrawal of autologous blood by phlebotomy (O.R. = 0.67, p = 0.0114). Applying multiple blood-saving techniques, coronary and valve procedures can now be performed with a low incidence of postoperative donor blood products and red cells exposures; autologous blood predonation and aprotinin administration were highly effective in reducing postoperative transfusion needs.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8191.1995.tb00603.x
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    Paper (German National Licenses)
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  • 2
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    Outcomes and cost analysis of laparoscopic versus open appendectomy for treatment of acute appendicitis: 4-years experience in a district hospital (2014)
    BioMed Central
    Details
    Publication Date: 2014-03-20
    Description: Background: Laparoscopic appendectomy is not yet unanimously considered the "gold standard" in the treatment of acute appendicitis because of its higher operative time, intra-abdominal abscess risk, and costs compared to open appendectomy. This study aimed to compare outcomes and cost of laparoscopic and open appendectomy in a district hospital. Methods: A retrospective analysis of 230 patients who underwent appendectomy at the Division of General Surgery of the Civil Hospital of Ragusa, Italy, from May 2008 to May 2012 was performed. The variables analyzed included patients data (age, gender, previous abdominal surgery, preoperative WBC count, duration of symptoms, ASA risk score), rate of uncomplicated or complicated appendicitis, operative time, postoperative complications, length of hospital stay, and total costs. The patients were divided in two groups according to the surgical approach and compared for each variable. The results were analyzed using the t Student test for quantitative variables, and the Chi-square test with Yates correction and Fisher exact test for categorical. Results: Laparoscopic appendectomy was performed in 139 patients, open appendectomy in 91. Two cases (1.4%) were converted to open procedure and included in the laparoscopic group data. Patient data and rate of complicated appendicitis were similar in the two study groups. There was no statistical difference (p = 0.476) in the mean operative time between the laparoscopic (52.2 min; range, 20-155) and open appendectomy (49.3 min; range, 20-110) groups. The overall incidence of minor and major complications was significantly lower (p = 0.006) after laparoscopic appendectomy (2.9%, 4 cases) than after open appendectomy (13.2%, 12 cases); rate of intra-abdominal abscess were similar. The length of hospital stay was significantly shorter (p = 0.001) in laparoscopic group (2.75 days; range, 1-8) than in open group (3.87 days; range, 1-19). The mean total cost was 2282 Euro in laparoscopic group and 2337 Euro in open group, with a no significant difference of 55 Euro (p = 0.812). Conclusion: Laparoscopic appendectomy is associated with fewer complications, shorter hospital stay, and similar operative time, intra-abdominal abscess rate, and total costs, compared with open appendectomy. Therefore, laparoscopic appendectomy can be recommended as preferred approach in acute appendicitis.
    Electronic ISSN: 1471-2482
    Topics: Medicine
    Published by BioMed Central
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    PAPER CURRENT
  • 3
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    Progettazione e realizzazione di una nuova interfaccia di comunicazione per i blog INGVterremoti, INGVvulcani e INGVambiente (2022)
    Istituto Nazionale di Geofisica e Vulcanologia
    Details
    Publication Date: 2022-06-07
    Description: AA. VV., (2020). Progetto “Sale Operative Integrate e Reti di monitoraggio del futuro: l’INGV 2.0”. Report finale. Editors: L. Margheriti, F. Cirillo, F. Guglielmino, M. Moretti. Misc. INGV, 57: 1186, https://doi.org/10.13127/misc/57
    Description: Nel 2012, a seguito della sequenza sismica in Emilia Romagna, l’INGV decise di migliorare la sua comunicazione sulla sismicità in corso creando un blog di informazione sui terremoti. L’esigenza di avere un prodotto di immediato utilizzo orientò la scelta sulla piattaforma Wordpress119, così da poter sfruttare i vantaggi del cloud e di un hosting affidabile. In effetti, nei primi giorni di pubblicazione, il blog “INGVterremoti120” (Figura 1) ebbe milioni di visualizzazioni di pagina senza nessuna interruzione del servizio. Negli anni successivi il blog si è consolidato come punto di riferimento della comunicazione della ricerca sui terremoti e dell’informazione in emergenza sismica, arrivando a superare ventuno milioni di visualizzazioni di pagina con una media annua di oltre un milione di visualizzazioni. Sulla scia del successo di INGVterremoti, nel 2018 sono stati aperti altri due blog, uno per ciascun Dipartimento, sulla stessa piattaforma: “INGVambiente121” e “INGVvulcani122” (Figura 1), con le stesse modalità del primo anche se con finalità leggermente diverse. In particolare il blog INGVambiente, che non offre informazioni legate alle emergenze e alla comunicazione delle stesse, ha come scopo principale la divulgazione di tematiche care al Dipartimento Ambiente con la pubblicazione regolare di un post a settimana. In modo simile a INGVterremoti, il blog INGVvulcani pubblica articoli relativi allo stato di attività dei vulcani in Italia e nel mondo e approfondimenti sulla ricerca vulcanologica del Dipartimento Vulcani e sul monitoraggio vulcanico effettuato dall’Osservatorio Vesuviano e dall’Osservatorio Etneo. Grazie al continuo e tempestivo aggiornamento sull’attività in corso, è diventato riferimento costante per i cittadini dell’area napoletana, di quella etnea e delle Isole Eolie. Nel 2012, per realizzare il blog INGVterremoti fu scelto un tema gratuito presente in Wordpress chiamato “Mystique”, molto utilizzato in quel periodo. Il tema prevedeva un’interfaccia molto semplice che riportava in homepage gli ultimi articoli pubblicati in ordine cronologico. La pagina era completata da una serie di widget sul lato destro per interagire con i post pubblicati attraverso i Tag e le Categorie degli articoli e per i collegamenti a informazioni esterne (feed terremoti, social media, link siti web, ecc.). Un menù in alto nella Home conteneva l’informazione statica, composta da una serie di pagine e sottopagine. Nel 2018, per i nuovi blog di INGVvulcani e INGVambiente fu, invece, scelto il tema “Apostrophe 2” con un’interfaccia simile al tema “Mystique” ma all’epoca più moderna e attuale. Anche in questi blog la disposizione della Home prevedeva una serie di widget sulla destra e le pagine dell’informazione statica nel menù.
    Description: Published
    Description: 175-178
    Description: 3TM. Comunicazione
    Description: N/A or not JCR
    Keywords: blog INGVterremoti ; blog INGVambiente ; blog INGVvulcani ; 05.09. Miscellaneous
    Repository Name: Istituto Nazionale di Geofisica e Vulcanologia (INGV)
    Type: article
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    PAPER (OA)
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