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P Palma

Publications and source records attributed to P Palma.

At least 19 recordsLinked to original sources
PubMed2006

Evaluation of chemical and ecotoxicological characteristics of biodegradable organic residues for application to agricultural land.

The use of organic waste and compost as a source of organic matter and nutrients is a common practice to improve soil physico-chemical properties, meanwhile reducing the need for inorganic fertilisers. Official guidelines to assess sewage sludge and compost quality are mostly based on total metal content of these residues. Measurement of the total concentration of metals may be useful as a general index of contamination, but provides inadequate or little information about their bioavailability, mobility or toxicity when the organic residue is applied to the soil. However, ecotoxicity tests provide an integrated measure of bioavailability and detrimental effects of contaminants in the ecosystem. In the present study, three different types of biodegradable organic residues (BORs) have been considered: sewage sludge from municipal wastewater treatment (SS), compost from the organic fraction of unsorted municipal solid waste (MSWC), and garden waste compost (GWC). The BORs were subjected to chemical characterisation and total metal quantification (Cd, Cr, Cu, Ni, Pb and Zn), in order to verify their suitability for land application. Water leachability was determined through the DIN 38414-S4 method, while the modified BCR sequential extraction procedure was used for metal speciation. Ecotoxicity of the BORs was studied by direct and indirect bioassays. Direct toxicity bioassays were: plant growth tests with cress (Lepidium sativum L.) and barley (Hordeum vulgare L.), and earthworm (Eisenia fetida) mortality. On the other hand, indirect exposure bioassays, with leachate from the residues, took into account: luminescent bacteria (Vibrio fischeri), seed germination (L. sativum and H. vulgare) and Daphnia magna immobilization. As far as total metal concentration is concerned, with particular reference to Zn, SS resulted neither suitable for the use in agriculture nor compatible to be disposed of as an inert material into landfill, according to the Directive 1999/31/EC. Zinc in SS was mainly present in exchangeable form (28.5%), appearing as highly bioavailable. As a consequence, SS exhibited either high ecotoxicity effects with the indirect exposure bioassays or significant mortality with the earthworm bioassay. Total content of metals in MSWC allowed its classification as "stabilised biowaste", according to 2nd draft [DG Env.A.2. Working document of Biological treatment of biowaste - 2nd draft. Directorate-General Environment, Brussels, 12th February; 2001. accessed in:http://europa.eu.int/comm/environment/waste/facts_en.htm, at 10/09/2002] while leachate, on the basis of the concentration of these contaminants, could be classified as "inert waste". This residue showed significant ecotoxicity effects with direct exposure bioassays as well as with the luminescent bacteria bioassay. However, it resulted less toxic than SS. Finally, GWC could be classified as a Class 2 compost, with no detectable toxic effects on the organisms used in the bioassays, except for the luminescent bacteria. In this case, an EC(50) of 73.0% was observed. Considering the results, the use of a battery of toxicity test in conjunction with chemical analysis should be suggested, in order to correctly assess possible environmental risks deriving from disposal or land application of biodegradable organic residues.

Agriculture↗
PubMed2006

Hand-assisted laparoscopic sigmoid resection for diverticular disease: 100 consecutive cases.

BACKGROUND: Hand-assisted laparoscopic surgery (HALS) has been proposed as a useful alternative to conventional laparoscopic and open surgery. As compared with conventional laparoscopic surgery, it offers the advantages of tactile feedback, better exposure, and a shorter learning curve. There is increasing evidence that HALS retains the advantages of minimal-access surgery. The aim of this study was to analyze the feasibility as well as the short- and medium-term outcomes of HALS sigmoid resection for diverticular disease. METHODS: The study included 100 consecutive patients between July 1999 and August 2004. Data were prospectively recorded. Follow-up evaluation was performed by standardized telephone interview after a mean postoperative period of 19 months (range, 2-55 months). RESULTS: Two major intraoperative complications occurred: splenic laceration requiring splenectomy and ureteral injury requiring suture. There were only three conversions: one case of pararectal incision and two cases of extended lower Pfannestiel incision. There was no single case of conversion to midline laparotomy. One patient died postoperatively of myocardial infarction. The postoperative complications included intraabdominal hematoma (2%), anastomotic leakage (3%), wound infection (11%) and bladder dysfunction (1%). The reoperation rate was 5%. The median hospital stay was 8 days. In terms of satisfaction with the results, 97% of patients would choose HALS again. CONCLUSIONS: When used for diverticular disease, HALS sigmoid resection has a low intra- and postoperative complication rate. The satisfaction rate among patients is high. Even in technically difficult cases, conversion to midline laparotomy can be avoided.

Adult↗
PubMed2006

[Perianal and rectal impalement injuries].

Perianal impalement injuries with or without involvement of the anorectum are rare. Apart from a high variety of injury patterns, there is a multiplicity of diagnostic and therapeutic options. Causes of perianal impalement injury are gunshot, accidents, and medical treatment. The diagnostic work-up includes digital rectal examination followed by rectoscopy and flexible endoscopy under anaesthesia. We propose a new classification for primary extraperitoneal perianal impalement injuries in four stages in which the extension of sphincter and/or rectum injury is of crucial importance. Therapeutic aspects such as wound treatment, enterostomy, drains, and antibiotic treatment are discussed. The proposed classification encompasses recommendations for stage-adapted management and prognosis of these rare injuries.

Anal Canal↗
PubMed2006

[Female sexual function before and after treatment of urinary incontinence].

The prevalence of urinary incontinence is around 20% of healthy middle-aged women. Incontinence causes a negative impact on the quality of life and sexuality. From August 2002 to January 2004, 30 patients (mean age 43 years) with stress urinary incontinence (59%), overactive bladder (15%) and mixed incontinence (26%) answered the ICIQ-SF(International Consultation on Incontinence Questionnarie-Short Form) and FSFI (Female Sexual Function Index) questionnaires before and after treatment for urinary incontinence. The follow-up ranged from 12 to 53 months. Mean ICIQ score was 17 and 7 before and after treatment respectivelly (p<0,001). Overactive bladder showed the worst scores in all domains. The patients who underwent surgery increased their scores of desire (p=0,02), satisfaction (p=0,05) and total score (p=0,02). Thirteen patients which ICIQ was zero increased: desire (p<0,01), satisfaction (p=0,05) and total score (p=0,01). Urinary incontinence significantly affects the quality of life. Therefore sexual evaluation in incontinence patients is recommended.

Adult↗
PubMed2005

[Clinical applications of the comprehensive theory of urinary incontinence].

Currently, urinary incontinence cannot be treated without taking into consideration the comprehensive theory of urinary incontinence. According to this theory, stress incontinence, urge incontinence and alterations in bladder emptying result from alterations in the elements of suburethral support, ligaments and muscles of the pelvis floor. Alterations in the forces applied by muscles and ligaments to the fascia adjacent to the vaginal wall and the urethra cause the vesical neck and the urethra to open or close. Alterations in the forces applied to the vagina can also cause premature activation of the micturition reflex, triggering involuntary contractions of the detrusor muscle. Knowledge of the anatomic substrate of the upper, intermediate and lower layers of the pelvic floor and of the main pubourethral, urethropelvic and uterosacral ligamentous elements is essential before any surgical approach of incontinence can be attempted. Depending on the location of the fascial or ligamental muscle lesion and of the sensitivity of the local nerve endings, stress incontinence, urge incontinence, altered bladder emptying or combinations of these conditions can develop. There are 6 basic defects which should be systematically investigated: defect in the suburethral support ("Hammock"), tethered vagina syndrome, distended pubourethral ligaments, distended uterosacral ligaments and support of the vaginal apex, lesions of vaginal insertion of pubococcygeal muscles, lesions of the striated muscles of the pelvic floor levator plate.

Female↗
PubMed2005

[Transobturator correction of cystocele].

OBJECTIVE: We present our initial experience with the Perigee system for anterior vaginal wall prolapses repair. MATERIAL AND METHOD: 15 patients with anterior vaginal wall prolapse (mean age: 62 years old) underwent implanted with Perigee system which is composed by a mesh for correcting central defect and four self-attached horns for correcting lateral defect. The implanted procedure consist of four steps: 1) lateral vaginal wall dissection as far as isquiopubic branch; 2) performance of two upper marks at genitofemoral fold and two lower marks at 2 cm laterally and 3 cm lower; 3) insertion of the upper needles parallel to the isquiopubic branch and connection with the mesh's "arms" plus insertion of the lower needles vertically and connection with mesh's "legs"; 4) to adjust the mesh free tension. The system POP-Q was used as an objective measure of correction rate. RESULTS: Preoperatively, the point Aa was 0.09. After 6 weeks and three months postoperatively was -3.00 and -2.73 respectively. Preoperatively, the point Ba was 1.73. After 6 weeks and three months postoperatively was -2.82 and -2.82 respectively. No major complications were presented. No vascular damage or significant bleeding was observed. CONCLUSION: The transobturator correction of cystocele is an attractive alternative. The initial good outcome may be expected to be long lasting.

Adult↗
PubMed2005

[Correlation between urogenital prolapse and detrusor overactivity].

PURPOSE: To evaluate the urodynamic characteristics of a series of women with stress urinary incontinence presenting various rates of vaginal prolapse. METHODS: 92 female patients were included in this study, mean age was 48 years (range 29-75). All patients underwent urogynecologic physical examination (vaginal prolapse was graded) and complete urodynamic study in order to detect the presence of detrusor overactivity. Urodynamic terminology and measurements comply with the ICS (International Continence Society) standards. Statistical significance was established below 0.05. RESULTS: 65 women (70.6%) presented anterior vaginal prolapse and 31 (33.6%) posterior vaginal prolapse. Involuntary contractions of the detrusor muscle appeared in 13 patients (20%) who had an anterior vaginal prolapse and 6 women (19.3%) who had a posterior vaginal prolapse. The existence of involuntary contractions was not associated with the diagnosis of vaginal prolapse. CONCLUSION: Our study did not show any correlation between existence of vaginal prolapse and detrusor overactivity.

Adult↗
PubMed2005

[Rational treatment of nasal polyposis].

Despite the therapeutical advances of the last decade, nasal polyposis represents still a problem for rhinology, practitioners. A number of hypotheses have been formulated about its etiopathogenesis, but no one is confirmed, so that nowadays therapy continues to be only symptomatic and does not cure definitively the underlying pathology. Recurrences are frequent and discourage both the practitioner and the patient. Purpose of this paper is to illustrate Authors' therapeutical rationale aimed to reestablish nasal flow, reduce rhinorrhea, improve olfaction, decrease rhinosinusinusal infection rate and maintain as long as possible such a symptomatic improvement. These targets are best achieved by a combination of medical and surgical treatments in order to optimize the results and reduce the side-effects of both the therapeutical options. Moreover the treatment should be tailored on each patient and follow up should be careful and performed at regular interval. Authors reviewed the clinical records of patients who underwent surgery for nasal polyposis between 2002 and 2004 at Ospedale di Circolo e Fondazione Macchi, University of Insubria, Varese, Italy, with a minimum follow-up of 12 months. All patients underwent the complete set of diagnostic work-up. The choice between surgical or medical options was based on both the kind of the polyposis and the staging of the pathology. The therapy was as more "personalized" as possible, but a homogeneity of treatment was maintained. The results show that a correct "staging" of the patient allows an appropriate therapy and reduces recurrence rate. In conclusion, authors report their experience and propose a scheme of diagnostic work-up in order to define grading/staging of the pathology and establish a "tailored" therapeutic protocol aimed to control a pathology which is rarely definitively treated.

Adolescent↗
PubMed2004

Transanal endoscopic microsurgery: indications and results after 100 cases.

OBJECTIVE: Transanal endoscopic microsurgery (TEM), a minimally invasive technique has been employed in the excision of benign and well-selected malignant rectal tumours since June 1998. We present a prospective descriptive study and analyse the currently accepted indications. PATIENTS AND METHODS: Over a 4-year period 100 patients underwent TEM for treatment of rectal tumours located between 4 and 18 cm from the anal verge. RESULTS: TEM was performed in 71 cases for adenomas, 20 potentially curative excisions for pre-operative staged low-grade carcinoma, 3 palliative procedures for advance carcinoma, 5 carcinoids and 1 solitary ulcer. The local complication rate included wound breakdown in 7 patients, three of them requiring ileostomy. Conversion to laparotomy was performed in two patients. Five adenomas recurred and were successfully treated by TEM. Of the cancers, four patients required immediate salvage therapy by means of total mesorectal excision. Three patients underwent palliative TEM procedures combined with radiotherapy. A single cancer recurrence was treated by means of abdomino-perineal resection after radiotherapy. CONCLUSIONS: TEM appears to be an effective method of excising benign tumours and selected T1 carcinomas of the rectum. The superior exposure of tumours higher in the rectum combined with the greater precision of excision make this minimally invasive technique an attractive surgical approach.

Adenoma↗
PubMed2003

Small volume resuscitation with 7.5% hypertonic saline solution--treatment of haemorrhagic shock in the tropics.

Rapid intravenous injection of 4 mL/kg body weight of a 7.5% hypertonic sodium chloride solution immediately increases intravascular osmotic pressure and intravascular volume after haemorrhage. This 'small volume resuscitation' rapidly improves blood pressure and microcirculatory perfusion in patients with hypovolaemic shock after large blood losses. Pathophysiological findings as well as practical application approaches are described. Small volume resuscitation is an effective and economic method in the first-line treatment of acute haemorrhagic shock.

Adult↗
PubMed2002

Urinary tract infections: pathogenesis and related conditions.

This paper deals with main aspects of pathogenesis of urinary tract infection (UTI). Bacterial and host-related factors such as defense mechanisms and predisposing factors are described. Special aspects of UTI in elderly patients and during pregnancy are discussed. Recurrent cystitis and prophylactic measures are also reported.

Aged↗
PubMed2002

[Vascular injuries after extremity trauma].

The aim of the present examination was to analyse extremity trauma with additional vascular injuries. Between 1973-2000 78 patients with traumatic peripheral vascular injuries have been treated at the Surgical Department of the University Hospital of Mannheim. In addition to clinical examination Doppler-Duplex ultrasonography (cw-Doppler) was routinely performed. In selected cases either conventional or magnetic resonance angiography completed the diagnostic procedure. Vascular injuries to the upper extremities were found in 46.2 % (n = 36) whereas 53.8 % (n = 42) of the patients suffered from trauma of the lower extremities. The popliteal artery was affected in 28.2 % followed by the brachial artery with 23.1 %. 52.6 % of the patients had interposition of autologous vein for reconstruction. Only 7.7 % of the cases needed interposition of alloplastic material. In general the injured extremity was immobilised by external fixation, followed by secondary vascular reconstruction. An efficient trauma management reduced amputation rate as low as 2.6 %.

Adolescent↗
PubMed2001

Synthesis and insertion reactions of the cyclometalated palladium-alkyl complexes Pd(CH(2)CMe(2)-o-C(6)H(4))L(2). Observation of a pentacoordinated intermediate in the insertion of SO(2).

Palladacycles of the type 2, have been synthesized by treatment of the corresponding chloroalkylcomplexes Pd(CH(2)CMe(2)C(6)H(5))ClL(2) (L(2) = (PMe(3))(2), 2a, or 1,5-cyclooctadiene (cod), 2b) with suitable bases, or by simple ligand exchange reactions from the cyclooctadiene derivative 2b. The metallacycles 2 react with activated alkynes and with sulfur dioxide, giving rise to different insertion products.

Journal Article↗
PubMed2001

Micro-SPE method for sample introduction in capillary HPLC/MS.

A new solid-phase extraction on-line device for micro-HPLC is presented. This device optimizes the injection of very dilute samples into a packed capillary column. It consists of two capillary, reversed-phase, HPLC columns of different length that can be linked together as a single chromatographic column. The first segment, only 2 cm long is connected to the HPLC injector. When disconnected from the longer column, several milliliters of an aqueous sample can be passed through at a high flow rate for fast trapping. On the basis of the retention mechanism, all suitable compounds are focused on the short column head in a sharp band. As soon as the chromatographic column is recomposed, the trapped analytes are eluted and separated at the optimal flow rate and gradient conditions. Due to the high preconcentration factor, trace-level analysis can be performed successfully. Different classes of analytes of various polarities and molecular weights can be determined, depending on the stationary phase and on the detector used. Some pesticides belonging to different classes were chosen to evaluate the performance of the device using an electron ionization mass spectrometer as HPLC detector. A fungicide in an irrigation canal water was determined at a concentration level of 4.5 microg x L(-1).

Journal Article↗
PubMed2000

An efficient liquid chromatography--mass spectrometry interface for the generation of electron ionization spectra

The use of a new LC-MS interface (cap-EI), part of a Waters Integrity system, capable of generating EI spectra at micro flow rates is presented. The cap-EI interface relies on the production of a fine aerosol by means of a nebulizer and supported by a nitrogen jet. Sensitivity, response linearity, reproducibility, and LC compatibility of the interface were thoroughly examined using testosterone, caffeine, a mixture of antiinflammatory drugs, and 3,4-dihydroxybenzoic acid as test compounds. The interface is fully compatible with LC requirements such as high-water- and/or -buffer-content mobile phases. Reproducibility, high sensitivity in scan mode, as well, to produce library-searchable EI spectra, 2 orders of magnitude linearity, together with an intrinsic simplicity of the entire system are the key features of cap-EI interface.

Journal Article↗