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Biomedical subjects

G Orsi

Publications and source records attributed to G Orsi.

14 recordsLinked to original sources
PubMed2001

The VEPSY updated project: virtual reality in clinical psychology.

Many of us grew up with the naive assumption that couches are the best used therapeutic tools in psychotherapy. But tools for psychotherapy are evolving in a much more complex environment than a designer's chaise lounge. In particular, virtual reality (VR) devices have the potential for appearing soon in many consulting rooms. The use of VR in medicine is not a novelty. Applications of virtual environments for health care have been developed in the following areas: surgical procedures (remote surgery or telepresence, augmented or enhanced surgery, and planning and simulation of procedures before surgery); preventive medicine and patient education; medical education and training; visualization of massive medical databases; and architectural design for health care facilities. However, there is a growing recognition that VR can play an important role in clinical psychology, too. To exploit and understand this potential is the main goal of the Telemedicine and Portable Virtual Environment in Clinical Psychology--VEPSY Updated--a European Community-funded research project (IST-2000-25323, http://www.vepsy.com). The project will provide innovative tools-telemedicine and portable-for the treatment of patients, clinical trials to verify their viability, and action plans for dissemination of its results to an extended audience-potential users and influential groups. The project will also develop different personal computer (PC)-based virtual reality modules to be used in clinical assessment and treatment. In particular, the developed modules will address the following pathologies: anxiety disorders; male impotence and premature ejaculation; and obesity, bulimia, and binge-eating disorders.

Adult↗
PubMed2000

[Spigelian hernia: 3 case reports].

Spigelian hernia is an uncommon hernia of the abdominal wall, often not easily diagnosed. Three cases of Spigelian hernia are reported. In the first patient it was an incidental discovery, in the second one hernia was complicated by strangulation of the small bowel, in the third patient hernia was symptomatic without complications. In all the patients, in their previous clinical history, an operation for hernia or other abdominal pathologies was observed. These patients were treated surgically, using direct reconstruction of the abdominal wall in two cases, while a non-absorbable mesh was positioned in the preperitoneal space in the third patient. The anatomopathological and clinical features of Spigelian hernia are described and the problems in diagnosis discussed; in addition, the importance of surgical cure in incidental hernia is underlined.

Aged↗
PubMed1998

On the integration of healthcare emergency systems in Europe: the WETS project case study.

The European Union (EU) is characterized by a large number of different emergency healthcare (EHC) systems. In this situation, a common policy for healthcare emergency handling is largely prevented and is a cause of an increase of the costs associated with such systems all over Europe. There is, hence, a need for a homogenization and integration of healthcare emergency systems in Europe. This turns out to be difficult because of the ethical, political, legal, and technological differences and peculiarities of the European scenario and the large investments that would be needed in this sector. The process of integration passes through the identification of the main functionalities--driven by the user needs in their real life conditions--along with the technologies that are best fitted for supporting them. In this paper, several aspects related to these problems are analyzed and a real case study, drawn from the Project "Worldwide Emergency Telemedicine Services" (WETS), supported by the European Commission (DG-XIII), is presented. Within WETS, several pilot sites (in Italy, Spain, Greece, Denmark, and Iceland) consider different aspects of the integration of healthcare emergency systems with particular focus on the sharing of solutions that "traditionally" belong to different environments (i.e., land, air, and sea). The involvement of important hospitals, ship companies, airlines, and emergency health institutions allows us to devote a large part of this two-year project (1998-1999) to validate and demonstrate the results of the development phase in real-life conditions. Some more concrete details are given for the Italian pilot site, where the authors operate.

Emergency Medical Services↗
PubMed1998

[Hepatic incidentaloma. A case report of cholangiocarcinoma].

The finding of incidentalomas is becoming increasingly frequent during the course of routine diagnostic tests. At the hepatic level, the preclinical diagnosis of primary tumours has enabled a growing number of patients to undergo surgery with reduced operating trauma and greater oncological radicality. The authors report a case of cholangiocarcinoma whose pre-clinical diagnosis enabled its resection in spite of the patient's advanced age.

Aged↗
PubMed1997

Medical emergency aid through telematics: design, implementation guidelines and analysis of user requirements for the MERMAID project.

MERMAID is an EU financed telemedicine project with global reach and 24-hour, multilingual capability. It aspires to provide a model for the provision of health care services based on the electronic transmission of medical information, via ISDN based videoconferencing. This model will not be limited to medical diagnostics but it will encompass all cases where the actual delivery of health care services involves a patient who is not located where the provider is. Its implementation requires the commissioning of an expensive telecommunications infrastructure and the exploration of a number of solutions. In fact, all categories of telemedical applications (audio and video conferencing, multimedia communications, flat file and image transfer with low, medium and high bandwidth data requirements) will be considered while the full range of network choices (Digital land lines, Cellular/Wireless, Satellite and Broadband) will be tested in terms of cost/performance tradeoffs that are inherent to them and the developmental stage each of these options occupies in their in its life cycle. Finally, out that MERMAID utilises advanced land based line transmission technologies to aid the remote patient by making available the specialist care that is best suited in the particular case.

Emergency Medical Services↗
PubMed1992

Seasonal trend of fog water chemical composition in the Po Valley.

Fog frequency in the Po Valley, Northern Italy, can be as high as 30% of the time in the fall-winter season. High pollutant concentrations have been measured in fog water samples collected in this area over the past few years. The combined effects of high fog occurrence and high pollutant loading of the fog droplets can determine, in this area, appreciable chemical deposition rates. An automated station for fog water collection was developed, and deployed at the field station of S. Pietro Capofiume, in the eastern part of the Po Valley for an extended period: from the beginning of November 1989 to the end of April 1990. Time-resolved sampling of fog droplets was carried out during all fog events occurring in this period, and chemical analyses were performed on the collected samples. Statistical information on fog occurrence and fog water chemical composition is reported in this paper, and a tentative seasonal deposition budget is calculated for H+, NH4+, NO3- and SO4(2-) ions. The problems connected with fog droplet sampling in sub-freezing conditions are also addressed in the paper.

Journal Article↗
PubMed1988

Parameter extraction from heart rate and arterial blood pressure variability signals in dogs for the validation of a physiological model.

The paper describes an automatic procedure for improving the extraction of parameters in heart rate (HR) and arterial blood pressure (ABP) beat-to-beat variability signals. Auto- and cross-spectral analysis of such signals is carried out through parametric models and the distribution of the power of the spectra and the phase relationships are compared in various physiological situations induced in the dogs via drug infusion or surgical interventions which do influence the control mechanisms of HR and ABP. This "black-box" approach allows the obtention, directly from the processing of the above-mentioned signals, of the estimation of parameters relative to cardiovascular models, as the ones described by simple equations (Windkessel and Starling laws are introduced as examples). These parameters seem to validate significantly the capability of such models to describe the physiological interactions existing between the two considered signals. Applications may be foreseen both for research and clinical purposes.

Algorithms↗
PubMedDate not supplied

Medical emergency aid through telematics: design, implementation guidelines and analysis of user requirements for the MERMAID project.

MERMAID is an EU financed telemedicine project with global reach and 24-h, multilingual capability. It aspires to provide a model for the provision of health care services based on the electronic transmission of medical information, via ISDN based videoconferencing. This model will not be limited to medical diagnostics but it will encompass all cases where the actual delivery of health care services involves a patient who is not located where the provider is. Its implementation requires the commissioning of an expensive telecommunications infrastructure and the exploration of a number of solutions. In fact, all categories of telemedical applications (audio and video conferencing, multimedia communications, flat file and image transfer with low, medium and high bandwidth data requirements) are considered while the full range of network choices (digital land lines, cellular/wireless, satellite and broadband) are being tested in terms of cost/performance tradeoffs that are inherent to them and the developmental stage each of these options occupies in their in its life cycle. Finally, out that MERMAID utilises advanced land based line transmission technologies to aid the remote patient by making available the specialist care that is best suited in the particular case.

Computers↗
PubMedDate not supplied

[The rationale of laparoscopic treatment in acute appendiceal disease].

Notwithstanding its widely perceived advantages, laparoscopic appendectomy has not yet met with universal acceptance. The aim of the present work was to illustrate retrospectively the results of a case-control study of laparoscopic vs open appendectomy carried out at our institution. From Jan. 1993 to Dec. 1999 a total of 457 patients (M:F = 210:247; mean age 25.2 +/- 15 years) underwent emergency and/or urgent appendectomy. Among them, 254 (55.5%) were operated on laparoscopically, while 203 (44.5%) were treated by conventional surgery The choice of technique depended upon the availability or otherwise of a team expert in minimally invasive surgery. The laparoscopic technique conversion rate was 3.9% and was mainly due to the presence of dense intraabdominal adhesions. The major intraoperative complication rates were 0.39% and 0% in the laparoscopic and laparotomy groups, respectively (P = ns). Major postoperative complications occurred in 2 and 1%, respectively (P = ns). The postoperative mortality rates were 0.4% and 0.5% in the laparoscopy and laparotomy groups, respectively (P = ns). The reoperation rate was 1.1% in the laparoscopic group as against 0% in the open surgery group (P = ns). Minor postoperative complications were observed in 0.8% and 7.5% of patients in the laparoscopy and open surgery groups, respectively (P = 0.001) and consisted mainly of wound infections. Resumption of bowel function was significantly more rapid and the hospital stay significantly shorter in the laparoscopically treated patients. The greater diagnostic accuracy of laparoscopy allowed concurrent diseases to be diagnosed in 9% of laparoscopically treated patients with histologically proven appendicitis as against 1.5% of those treated by conventional surgery (P = 0.001). Similarly, among those patients with no evidence of gross and/or microscopic appendicitis, concurrent diseases were detected in 58.4% of the laparoscopic cases as against only 6% of the laparotomy cases (P = 0.0001). Despite the limitations of a retrospective investigation, on the basis of our experience we believe that laparoscopic appendectomy is as safe and effective as conventional surgery, presents a higher degree of diagnostic accuracy and makes for less trauma and a more rapid postoperative recovery. Such features make its use mandatory in female patients of child-bearing age referred for urgent abdominal and/or pelvic surgery.

Acute Disease↗
PubMedDate not supplied

Evaluation of extracranial carotid system with duplex scanner HR in hemiplegic patients.

The aim of this work is to study extracranial carotid lesions and their relation to some risk factors for atherosclerosis, in a large group of hemiplegic patients during rehabilitation treatment. The results indicate that in patients with stabilized ischemic stroke there is a high percentage of positive Duplex Scanner examination. However, the presence of negative patients with hemiplegia leads us, in this case, to look for a carotid lesion placed higher up. The high presence of bilateral atherosclerotic lesions also shows that atherosclerosis is not only a local process. The clinical event may be caused by the type of carotid lesion (as demonstrated by thrombosis or carotid lesions with superficial ulceration contralateral to the hemiplegia).

Carotid Artery Diseases↗