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Morbimortalidad del traumatismo de recto extraperitoneal
Barillaro, Guillermo;Gatica, Sandra;Escudero, Ezequiel;Jimenez, Lorena;Martini, Mariano;
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (S?o Paulo) , 2008, DOI: 10.1590/S0102-67202008000100002
Abstract: background: extraperitoneal rectal injuries represent 3 to 5% of all traumatisms and abdominal injuries, and they are highlighted by their high morbidity/mortality presented if not early and appropriately diagnosed and treated. nowadays there is not a consensus related to an optimal surgical management. aim: to relate the experience in treating this disease, evaluating factors that influence mortality and morbidity. methods: it consisted in a descriptive retrospective study where it was reviewed handbooks of all extraperitoneal rectal trauma patients operated between january 1998 and december 2007. the abdominal trauma rate, the interval between trauma and surgery and the initial surgery's type were related to infectious complications and mortality. results: there were evaluated 13 patients: 5 injured by firearms, 5 autoimpalament and 3 by closed trauma. the abdominal trauma mean rate of infected and dead was more than 25. 61% of patients (n=8) underwent surgery before 8 hours. the infection rate was 61.5% and 90% of infected patients required additional surgeries. the series' mortality was 38.5% (5 patients). in patients operated after 8 hours there was perirectal infection in 80% of them, and 80% of mortality regardless of surgery performed type. conclusions: the delay over 8 hours in treating and the abdominal trauma rate over 25 were the main factors associated with perirectal infection and mortality in this series. absence of presacral drainage and distal rectal wash were correlated with increased incidence of perirectal infection.
Surgical site infections in Italian Hospitals: a prospective multicenter study
Nicola Petrosillo, Cecilia MJ Drapeau, Emanuele Nicastri, Lorena Martini, Giuseppe Ippolito, Maria Moro, ANIPIO
BMC Infectious Diseases , 2008, DOI: 10.1186/1471-2334-8-34
Abstract: In 2002, a one-month, prospective national multicenter surveillance study was conducted in General and Gynecological units of 48 Italian hospitals. Case ascertainment of SSI was carried out using standardized surveillance methodology. To assess potential risk factors for SSI we used a conditional logistic regression model. We also reported the odds ratios of in-hospital and postdischarge SSI.SSI occurred in 241 (5.2%) of 4,665 patients, of which 148 (61.4%) during in-hospital, and 93 (38.6%) during postdischarge period. Of 93 postdischarge SSI, sixty-two (66.7%) and 31 (33.3%) were detected through telephone interview and questionnaire survey, respectively. Higher SSI incidence rates were observed in colon surgery (18.9%), gastric surgery (13.6%), and appendectomy (8.6%). If considering risk factors for SSI, at multivariate analysis we found that emergency interventions, NNIS risk score, pre-operative hospital stay, and use of drains were significantly associated with SSI occurrence. Moreover, risk factors for total SSI were also associated to in-hospital SSI. Additionally, only NNIS, pre-operative hospital stay, use of drains, and antibiotic prophylaxis were associated with postdischarge SSI.Our study provided information on risk factors for SSI in a large population in general surgery setting in Italy. Standardized postdischarge surveillance detected 38.6% of all SSI. We also compared risk factors for in-hospital and postdischarge SSI, thus providing additional information to that of the current available literature. Finally, a large amount of postdischarge SSI were detected through telephone interview. The evaluation of the cost-effectiveness of the telephone interview as a postdischarge surveillance method could be an issue for further research.Surgical site infections (SSI) remain a major clinical problem in terms of morbidity, mortality [1], length of stay and hospital costs [2-4]. Nearly 60% of SSI diagnosis, ranging from 21 to 100%, [5-9] occur after hospita
Gratitude, or the Positive Side of the Relationship with Patients. Development and First Validation of New Instruments: A Scale of Gratitude Perceived by Operators and a Scale of Support Offered by the Gratitude Expressed by Their Patients  [PDF]
Mara Martini, Daniela Converso
Psychology (PSYCH) , 2014, DOI: 10.4236/psych.2014.56067

The relationship with patients/users is a crucial dimension for helping professionals. It is nevertheless mostly analyzed in its negative connotation, that’s to say as a possible cause, for example, of the burnout syndrome, while very few are research works that take into account the positive side of the relationship, as a resource more than a problem, and even fewer are the instruments to measure it. The aim of the present work is the development and the analysis of the characteristics of a scale to measure the gratitude expressed by patients perceived by operators and of a scale to measure the perception of support that gratitude by patients/customers offers to relieve the fatigue of daily commitment and return significance to their work. The two scales were developed and then integrated into a questionnaire including items regarding the negative side of the relationship (exceeding requests from patients) and the Customer-initiated support scale (Zimmermann et al., 2011). The questionnaire was filled in by 267 nurses in Piedmont, Italy. Descriptive analyses on each item, exploratory factor analysis, Cronbach’s alpha, analysis of variance, and bivariate correlations were conducted. Both scales show a one-factor solution. The independent sample t-tests highlighted differences between men and women and between people who have families to care for and people who do not. Bivariate correlations signalled a positive relationship between both the gratitude scales and the Customer-initiated support; no relationships are evident with the scale of exceeding request from patients. A limitation of the work is the dimension of the sample: a more extensive administration of the questionnaire is currently in progress that will also permit to more deeply investigate the factorial structure of the scales. The scales will allow filling a gap in measuring a central work issue for helping professions.

Transition Process in the Western Balkans: How Much Successful Is This Story?  [PDF]
Skuflic Lorena
Intelligent Information Management (IIM) , 2010, DOI: 10.4236/iim.2010.23029
Abstract: The last enlargement of the European Union put Western Balkans countries into focus of integration, and thus the countries became an area where future integration is expected. Future enlargement of the European Union depends on the success of the previous EU accession, as well as on the achieved results of the transition process in the Western Balkans, since these countries are not on the same level as the developed European countries or new member states. The region contains small countries that are at different stages on their road towards membership. Transition is a comprehensive process of economic and political reforms that creates many shocks in the economy, and when this process occurs in a politically unstable and war environment, as the case being with the Western Balkans, the results may be very unfavorable. Formal agreements improved the relations between these countries and the European Union, thereby had an influence on risk reduction and increased business transparency, resulting in a growing interest of foreign investors for the region. Despite increased investments in the region and rapid economic growth, Western Balkan countries have only 21 (Albania) and 52% (Croatia) of the average European Union Gross Domestic Product (GDP) per capita, indicating the need for faster implementation of reforms and individual involvement of countries into the process of European integration. There is a significant development gap between Western Balkan countries, so observing the region as a whole and applying a singular strategy in the sense of its economic leveling and the process of EU accession would have a negative impact on Croatia, as the most developed country of the region.
Molecular Epidemiology of a Pseudomonas aeruginosa Hospital Outbreak Driven by a Contaminated Disinfectant-Soap Dispenser
Simone Lanini,Silvia D'Arezzo,Vincenzo Puro,Lorena Martini,Francesco Imperi,Pierluca Piselli,Marco Montanaro,Simonetta Paoletti,Paolo Visca,Giuseppe Ippolito
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0017064
Abstract: Pseudomonas aeruginosa infection represents a main cause of morbidity and mortality among immunocompromised patients. This study describes a fatal epidemic of P. aeruginosa that occurred in a hematology unit in Italy.
Hospital Cluster of HBV Infection: Molecular Evidence of Patient-to-Patient Transmission through Lancing Device
Simone Lanini, Anna Rosa Garbuglia, Vincenzo Puro, Mariacarmela Solmone, Lorena Martini, William Arcese, Alessandro Nanni Costa, Piero Borgia, Pierluca Piselli, Maria Rosaria Capobionchi, Giuseppe Ippolito
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0033122
Abstract: Introduction In western countries the transmission of hepatitis B virus (HBV) transmission through multi-patients lancing devices has been inferred since early ‘90s, however no study has ever provided biological evidence which directly link these device with HBV cross-infection. Here we present results of an outbreak investigation which could associate, by molecular techniques, the use of lancing device on multiple patients with HBV transmission in an Italian oncohematology unit. Methods The outbreak investigation was designed as a retrospective cohort study to identify all potential cases. All cases identified were eventually confirmed through molecular epidemiology techniques. Audit of personnel including extensive review of infection control measures and reviewing personnel's tests for HBV was done identify transmission route. Results Between 4 May 2006 and 21 February 2007, six incident cases of HBV infection were reported among 162 patients admitted in the oncohematology. The subsequent molecular instigation proved that 3 out 6 incident cases and one prevalent cases (already infected with HBV at the admission) represented a monophyletic cluster of infection. The eventual environmental investigation found that an identical HBV viral strain was present on a multi-patients lancing device in use in the unit and the inferential analysis showed a statistically significant association between undergoing lancing procedures and the infection. Discussion This investigation provide molecular evidence to link a HBV infection cluster to multi-patients lancing device and highlights that patients undergoing capillary blood sampling by non-disposable lancing device may face an unacceptable increased risk of HBV infection. Therefore we believe that multi-patients lancing devices should be banned from healthcare settings and replace with disposable safety lancets that permanently retract to prevent the use of the same device on multiple patients. The use of non-disposable lancing devices should be restricted to individual use at patients' home.
IL-1 inhibition in autoinflammatory diseases
Alberto Martini
Arthritis Research & Therapy , 2012, DOI: 10.1186/ar3711
Abstract: Muckle-Wells Syndrome, Familial Cold Autoinflammatory Syndrome and Chronic Infantile Neurological Cutaneous and Articular Syndrome are IAS due to mutations in a single gene, CIAS1 (cold-induced autoinflammatory syndrome 1, or NALP-3), encoding a protein called cryopyrin which is an essential component of an intracellular multiprotein complex named inflammasome, that play a crucial role in the production and secretion of interleukin (IL)-1 These diseases are characterized by excessive production of IL-1 and have a dramatic response to IL-1 inhibition.More recently, IL-1 inhibition has also been shown to be effective in another AID (TNF-receptor associated periodic syndrome or TRAPS) as well as in other conditions such as systemic juvenile idiopathic arthritis and recurrent idiopathic pericarditis. This has suggested that also these two last diseases may represent autoinflammatory conditions.
Fibrinogen metabolic responses to trauma
Wenjun Martini
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine , 2009, DOI: 10.1186/1757-7241-17-2
Abstract: Coagulation complications are significant contributors to morbidity and mortality in trauma patients [1,2]. Mortality in patients with severe injuries and coagulopathy is found to be four times greater than in patients with injuries alone [3]. Trauma-related coagulopathy is associated with hypoperfusion due to tissue injury and blood loss, hemodilution from resuscitation with crystalloid and/or colloid solutions, progressive hypothermia and the development of acidosis. Since the recognition of the lethal triad of hypothermia, acidosis, and coagulopathy over a decade ago [1,2], a great deal of effort has been made to elucidate possible mechanisms contributing to trauma related coagulopathy as well as to search for effective treatments [4-7]. Recent data suggest that fibrinogen availability may play an important role in the survival of patients. The purpose of this article is to review recent findings that have been made concerning clotting protein fibrinogen metabolism and availability following trauma-related events, including hemorrhage, resuscitation, hypothermia and acidosis.As the precursor of clot formation, fibrinogen plays an important role in coagulation function. Fibrinogen deficiency is associated with uncontrolled bleeding and compromised survival [8-12]. Thus, regulation of fibrinogen availability is critical to survival in trauma patients.As an acute phase protein, fibrinogen is synthesized in the liver and released into the circulation. It is catabolized through normal protein degradation, the coagulation process, and other unknown pathways. At any moment, fibrinogen availability is delineated by the dynamic balance of synthesis and breakdown. Mathematically, fibrinogen availability can be expressed as:Where [fibrinogen] is the initial fibrinogen concentration (mg/dL); synthesis is the amount of fibrinogen (mg) produced in a unit of time (hour); and breakdown rate is the amount of fibrinogen (mg) consumed in a unit of time (hour).The importance of init
Imparare a raccontarsi, raccontarsi per imparare
Ornella Martini
m@gm@ , 2010,
Abstract: Questo contributo costituisce un’ulteriore occasione per riflettere su un ambito centrale della mia attività didattica e di ricerca intorno e dentro le logiche e le modalità comunicative in Rete: Internet come luogo nel quale si offrono molteplici e significative opportunità di plasmare la propria, meglio le proprie, identità attraverso la partecipazione e la condivisione, soprattutto con la scrittura.
Brugada syndrome; an organic syndrome
B Martini
Iranian Cardiovascular Research Journal , 2007,
Abstract: -
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