Fistola Artero-venosa Radio-Cefalica Distale per Emodialisi nel paziente anziano: Valutazione dei risultati ottenuti con l'utilizzo della Tecnica Microchirurgica

PREMESSA: Le linee guida raccomandano la fistola AV radio-cefalica autogena (RCAVF)come prima scelta per l'emodialisi. Preoccupazione è stata sollevata che questo potrebbe non essere appropriato nei pazienti anziani. METODO: Noi abbiamo seguito in modo prospettico 126 pazienti per tre anni. Dopo sistematica valutazione clinica ed ecografica, la RCAVF è stata creata utilizzando un microscopio operatore. La pervietà è stata valutata subito, a 1 settimana, a 1 mese e a 1 anno. I risultati sono stati registrati e stratificati in 2 gruppi: <70a e > 70a. RISULTATI: La RCAVF è stata creata nel 75% dei <70a e nel 70% dei >70a. L'incidenza di insuccesso immediato è stata 11% (<70a) e 13% (>70a). La pervietà primaria e secondaria ad 1 anno è stata 67% e 84% (<70a), 63% e 80% (>70a). CONCLUSIONI: La microchirurgia ha permesso la creazione di RCVAF in >70a con un rischio accettabile di fallimento e lievi differenze rispetto a <70a. L'età non deve precludere una creazione di RCAVF.

Trattamento delle lesioni osteocondrali di grado I e II mediante infiltrazione intra-articolare di fattori di crescita autologhi (plasma rich in platelets)

The use of Platelet-rich plasma (PRP), a platelet concentrate made of autogenous blood, is becoming use in the treatment of some orthopaedic diseases. The aim of this study is to assess the effect of PRP on articular cartilage defects in a rabbit model (10 subjects). Twenty osteochondral defects created in the femoropatellar groove, were in ten cases left untreated and in ten cases treated with autogenous PRP. PRP was obtained using a double centrifugation of the rabbit’s blood harvested before the operation. 30 days after the lesion was made in both knee, the left one in each rabbit was treated by a PRP injection, followed by other two injection at 45 and 60 days. Tissue specimens were assessed by macroscopic examination and histological evaluation, that showed a better healing of the lesions in the knee treated with PRP injections.

New catalytic processes for the upgrading of furfural and 5-hydroxymethylfurfural to chemicals and fuels

The demand of energy, fuels and chemicals is increasing due to the strong growth of some countries in the developing world and the development of the world economy. Unfortunately, the general picture derived sparked an exponential increase in crude oil prices with a consequent increase of the chemical, by-products and energy, depleting the global market. Nowadays biomass are the most promising alternative to fossil fuels for the production of chemicals and fuels. In this work, the development of three different catalytic processes for the valorization of biomass-derived has been investigated. 5-hydroxymethylfurfural oxidation was studied under mild reaction condition using gold and gold/copper based catalysts synthetized from pre-formed nanoparticles and supported onto TiO2 and CeO2. The analysis conducted on catalysts showed the formation of alloys gold/copper and a strong synergistic effect between the two metals. For this reason the bimetallic catalysts supported on titania showed a higher catalytic activity respect to the monometallic catalysts. The process for the production of 2,5-bishydroxymethyl furan (BHMF) was also optimized by means the 5-hydroxymethylfurfural hydrogenation using the Shvo complex. Complete conversion of HMF was achieved working at 90 °C and 10 bar of hydrogen. The complex was found to be re-usable for at least three catalytic cycles without suffering any type of deactivation. Finally, the hydrogenation of furfural and HMF was carried out, developing the process of hydrogen transfer by using MgO as a catalyst and methanol as a hydrogen donor. Quantitative yields to alcohols have been achieved in a few hours working in mild condition: 160 °C and at autogenous pressure. The only by-products formed were light products such as CO, CO2 and CH4 (products derived from methanol transformation), easily separable from the reaction solution depressurizing the reactor.