2 resultados para Vulnerability curve

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Objective. Minimally invasive video-assisted thyroidectomy (MIVAT) is a technically demanding procedure and requires a surgical team skilled in both endocrine and endoscopic surgery. A time consuming learning and training period is mandatory at the beginning of the experience. The aim of our report is to focus some aspects of the learning curve of the surgeon who practices video-assisted thyroid procedures for the first time, through the analysis of our preliminary series of 36 cases. Patients and methods. From September 2004 to April 2005 we selected 36 patients for minimally invasive video-assisted surgery of the thyroid. The patients were considered eligible if they presented with a nodule not exceeding 35mm in maximum diameter; total thyroid volume within normal range; absence of biochemical and echographic signs of thyroiditis. We analyzed surgical results, conversion rate, operating time, post-operative complications, hospital stay, cosmetic outcome of the series. Results. We performed 36 total thyroidectomy. The procedure was successfully carried out in 33/36 cases. Post-operative complications included 3 transient recurrent nerve palsies and 2 transient hypocalcemias; no definitive hypoparathyroidism was registered. All patients were discharged 2 days after operation. The cosmetic result was considered excellent by most patients. Conclusions. Advances in skills and technology have enabled surgeons to reproduce most open surgical techniques with video-assistance or laparoscopically. Training is essential to acquire any new surgical technique and it should be organized in detail to exploit it completely.

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Urban retrofit is becoming increasingly established as one of the most effective solutions to contain the energy consumption of the existing building stock, to reduce vulnerability to natural and man-made risk and generally improve the quality of built space. However, the planning of retrofit interventions at urban scale should take account of the actual feasibility of measures lest they remain only on paper. This contribution supplies an overview of the many issues related to the subject of urban regeneration, proposing a procedure to identify practical interventions to minimize costs and maximize benefits, in terms of energy efficiency, an increase in resilience and improvement in the quality of the building stock. This procedure was applied to a case study of a neighborhood in the city of Naples, a high-density urban area which is particularly vulnerable to volcanic and seismic risk, and to risks due to climate change.