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Syncope in Prinzmetal’s variant angina
Nicola Parenti,Fabrizio Mucci,Tiziano Lenzi
Emergency Care Journal , 2006, DOI: 10.4081/ecj.2006.2.7
Abstract: Syncope is a very common disease in Emergency Department. Prinzmetal’s variant angina has an high prevalence in Italy. It could begin as a syncope. Early diagnosis of both is important because their prognosis is sometimes unfavourable. During initial evaluation, physical and instrumental exams aren’t often diagnostic. On the contrary, the history is often useful. If there is a diagnostic hypothesis of cardiac syncope, ECG monitoring, also for 48-72 hours, is fundamental.
Emergency clinical path of ST Elevation Acute Myocardial Infarction
Tiziano Lenzi,Nicola Parenti,Cesare Antenucci,Mauro Metalli
Emergency Care Journal , 2007, DOI: 10.4081/ecj.2007.4.21
Abstract: ST Elevation Acute Myocardial Infarction (STEMI) represents a clinical condition that witnessed a new therapeutic progress in the last years, from thrombolysis era to primary percutaneous coronary intervention (PPCI) era. New European and North American guidelines and the Consensus document produced from Italian Cardiologist Federation (FIC) with Emergency Physicians (SIMEU) and Territorial System of Emergency 118 (SIS 118) require clinical and organized pathway with the involvement of Cardiologist, in and out hospital Emergency Physicians and 118. Main aim is to develop a network able to give to all patients the best treatment in the shortest time. The efficiency and functionality of these pathways must be verified through evaluation systems. The Imola’s experience confirms as the network can be put into practice and that it’s possible to analyse and to develop models of improvement.
Can a course modify the quality of triage in ER?
Nicola Parenti,Andrea Zardi,Roberta Manfredi,Diego Sangiorgi
Emergency Care Journal , 2009, DOI: 10.4081/ecj.2009.3.16
Abstract: All international Societies of Emergency Medicine have developed and promote courses on triage methods and guidelines, given their fundamental role in improving initial evaluation of patients in Emergency Department settings. However, as far as we know, few studies analyse the effect of triage courses on the allocation of priority codes. Since 2001, the Intra-Hospital Triage Guidelines have been implemented in Imola, where they are disseminated and illustrated in two-day courses. In this study, we analysed the effect of a two-day triage course on the quality of priority code allocation to patients evaluated at our ER. The Triage Guidelines course appears to improve two of the quality indicators analysed: observance of documentation standards and compliance with Triage Guidelines.
Precocious puberty in Turner Syndrome: report of a case and review of the literature
Improda Nicola,Rezzuto Martina,Alfano Sara,Parenti Giancarlo
The Italian Journal of Pediatrics , 2012, DOI: 10.1186/1824-7288-38-54
Abstract: Introduction Turner Syndrome (TS) is caused by monosomy or structural abnormalities of the X chromosome, with a prevalence of about 1/2000 females live birth. Most important clinical features of TS are short stature and gonadal failure. Approximately one third of girls with TS may undergo spontaneous puberty. Here we report on the case of a girl with a rare 45X0/47XXX mosaic TS exhibiting a precocious puberty. Case report The patient was diagnosed with TS at the age of 4 years, upon a diagnostic work-up for dysmorphic features. Chromosome analysis revealed a mosaic karyotype (45X0/47XXX). She presented with normal height and normal growth velocity so that Growth Hormone (GH) therapy was not started. She was referred to our Department at the age of 7 years and 10 months, because of vaginal bleeding. A physical examination revealed a Tanner stage III for breast and Tanner stage III for pubic hair development. Height and weight were within the normal range for age. Psychological evaluation showed moderate global developmental delay, together with emotional and social immaturity and reading difficulties. The growth rate was accelerated. Her bone age was 10 years. Pelvic ultrasound demonstrated increased size for age of both the uterus and the ovaries, with bilateral ovarian follicles. GnRH stimulation test revealed pubertal response of gonadotropins (peak LH 22.5 mIU/ml). MRI of the brain was normal. These clinical, radiologic and laboratory findings were consistent with a diagnosis of idiopathic central precocious puberty; therefore, GnRH analog therapy was started, in order to slow pubertal progression and to preserve adult stature. Furthermore, GH treatment was added to further improve adult height. Conclusion Our case highlights the possibility of precocious puberty as an atypical clinical feature of TS. Thus, precocious puberty may occur in TS girls when a dosage compensation by the cell line with more than two X chromosomes allows normal ovarian function. GnRH analog therapy in addition to GH treatment should be recommended in TS girls with precocious puberty in order to slow pubertal progression and to preserve adult stature.
Reliability and effectiveness of a 4-level emergency triage
Nicola Parenti,Maria Letizia Bacchi Reggiani,Diego Sangiorgi,Tiziano Lenzi
Emergency Care Journal , 2008, DOI: 10.4081/ecj.2008.5.30
Abstract: Italian guidelines require a 4-level in hospital triage based on an acuity scale measurement, but they don’t suggest common guidelines neither which triage models to adopt. Thus each hospital developed own triage guidelines based on consensus. But, to our knowledge, there aren’t data on the reliability and predictive validity of triage systems adopted by Italian Emergency Department. Also in the ED of Imola, a triage working group developed Guidelines on triage in 2001. In this study we measured the reliability and predictive validity of the Imola Triage Guidelines (LGTI).
Triage Emergency Method Version 2 (TEM v2). A new triage within hospital method
Nicola Parenti,Vito Serventi,Rossella Miglio,Stefano Masi
Emergency Care Journal , 2011, DOI: 10.4081/ecj.2011.3.27
Abstract: Our aim was to check if TEM v1, a new four-level in-hospital triage with good inter- and intra-rater reliability, reaches a large consensus among Italian triage experts. Finally we tried to improve the model and to create a new model: TEM v2. A 2 round modified Delphi study was conducted including 25 triage experts. The predetermined consensus level was considered 80%. Total return rate was 72% (18/25), the return rate for round one and two was 92% (23/25) and 78% (18/23) respectively. After the first round, a set of 11 questions was sent with the new TEM v2. Eight items of round 2 reached more than 80% of consensus. Using the Delphi technique we developed from TEM v1, the new triage tool TEM v2 which reached a large consensus among a panel of triage experts. This is, to our knowledge, the first Italian study which uses the Delphi technique to reach consensus on a triage system and to improve it.
Historia, importancia y aplicaciones del método de lectura de paramentos
Parenti, Roberto
Informes de la Construccion , 1995,
Abstract: After for over ten years of experimentations into architecture studies carried out by a tool settled in archaeological research, in Italy we draw up a balance dual we determine new outlines of research that apply at differented disciplinary limits. Nevertheless we have to insist because the connection between archaeologist and architect engaged in the restoration field, tend towards a more strict collaboration. In the best situations the research is getting on, but we should make didactically comprehensible the principles and the capacity of the tools, so that it might be used by many operators, because the architectural heritage, either monumental one or a simple dwelling, it is like an enormous recorder that records a large amount of data. Those data must be understood by the operators, with an easy and useful tool, if we don't want lose the amount of remark and will change them into progress of knowledge. Después de más de diez a os de experimentación sobre el análisis arquitectónico con un instrumento creado para la investigación arqueológica, en Italia se ha conseguido un balance y se han definido nuevas líneas de investigación que se refieren a campos especializados muy diferentes. No obstante se debe insistir en que, en los casos más atentos al avance de la investigación científica, la relación entre arqueólogos y arquitectos ocupados de la restauración se orienta hacia una colaboración cada vez más integrada. En las actuaciones ejemplares, la investigación continúa; pero, mientras, es preciso hacer didácticamente comprensibles los criterios y capacidades de este instrumento, con el fin de que puedan valerse de él muchos más investigadores, ya que el patrimonio arquitectónico, ya sea un monumento o la vivienda más modesta, es como un enorme registro que recoge en su estructura una gran cantidad de datos. Datos que la mayor parte de los investigadores deben poder descodificar con criterios uniformes y transmisibles, si queremos que no se pierda la gran masa de observaciones y que se conviertan en las informaciones necesarias para que avancen nuestros conocimientos.
Dalla stratigrafia all’archeologia dell’architettura. Alcune recenti esperienze del laboratorio senese
Parenti, Roberto
Arqueología de la Arquitectura , 2002,
Abstract: The author presents three lines of investigation, developed in the University of Siena by the study of some hundreds of historical buildings. The study of depositional processes and products allows us to interpret the dynamics of depositional environments and to establish a chronological framework.This time framework is provided by different aspects of stratigraphy and allows us to interpret building activities in terms of dynamic evolving environments. The record of buildings activities and climatic-pollution processes through historical time is held in these walls along with evidence of the different lime mortars. Our aim is to calibrate the “tools” that could be used to connect the analysis of lime mortar to building activities. Lime mortars could be considered as a perfect dating material for the historical building activities, because it must be freshly prepared every time you need it (it couldn’t be reused), even for the smallest intervention. With the help of a computer we will obtain a rectified photography as simulation where a virtual model works as a mathematics formula. So that we would say that, with the virtual reality,we can either “rebuild” an outline of a building in a precise moment of its history, or we can examine and study all the theories related with the analysis of the material structure, and, eventually,we might understand either the theories will be right or not. L’autore presenta tre delle linee di ricerca sviluppate dal Laboratorio senese, risultato della prassi operativa su alcune centinaia di edifici. La prima è una riflessione sulla complessità del processo di formazione del deposito stratificato, sulle strategie da seguire nell’esecuzione dell’indagine e sulla necessità di un ‘progetto conoscitivo’ preliminare all’indagine stessa. La seconda linea di ricerca affronta lo studio delle malte. L’obiettivo è quello di calibrare gli strumenti che possono essere impiegati per ricorrere all’analisi delle malte nell’identificazione delle attività edilizie. Le malte possono considerarsi come il perfetto fossile guida per le attività dell’edilizia storica, poiché devono essere preparate al momento del loro utilizzo (non possono essere reimpiegate), anche per i più piccoli interventi. L’ultima parte del contributo tratta della fotografia rettificata, grazie alla quale è possibile simulare un modello virtuale dell’edificio, “ricostruendolo” nelle sue varie fasi costruttive, e attraverso il quale studiare e verificare tutte le operazioni di analisi della struttura materiale.
Elachista bassii Parenti, a new species of Elachistidae from Nepal and Elachista crocogastra Meyrick in Madagascar (Lepidoptera: Elachistidae)
U. Parenti
SHILAP Revista de Lepidopterología , 2006,
Abstract: Se describe una nueva especie de Elachistidae, Elachista bassii, del norte de Irán, mientras Elachista crocogastra Meyrick es el primer representante de esta familia se alado de Madagascar.
Notes on the bionomy of Elachista cingillella (Herrich-Sch ffer, 1855) and Elachista geminatella (Herrich-Sch ffer, 1855) (Lepidoptera: Elachistidae)
U. Parenti
SHILAP Revista de Lepidopterología , 2005,
Abstract: La cría en el laboratorio ha permitido obtener datos sobre la biología y los primeros estadios, larva y pupa, de Elachista cingillella (Herrich-Sch ffer) y Elachista geminatella (Herrich-Sch ffer).
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