1000 resultados para Monti, Ricardo
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Pós-graduação em Serviço Social - FCHS
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Abstract Introduction Hydronephrosis, reflux and renal failure are serious complications that occur in patients with neurogenic bladder associated with myelomeningocele. When the bladder compliance is lost, it is imperative to carry out surgery aimed at reducing bladder storage pressure. An ileocystoplasty, and for patients not suitable for intermittent catheterization, using the Mitrofanoff principle to form a continent stoma and the subsequent closure of the bladder neck, can be used. We report here, for the first time to the best of our knowledge, an association between two previously described techniques (the Mitrofanoff principle and the technique of Monti), that can solve the problem of a short appendix in obese patients. Case presentation A 33-year-old male Caucasian patient with myelomeningocele and neurogenic bladder developed low bladder compliance (4.0 mL/cm H2O) while still maintaining normal renal function. A bladder augmentation (ileocystoplasty) with continent derivation principle (Mitrofanoff) was performed. During surgery, we found that the patient's appendix was too short and was insufficient to reach the skin. We decided to make an association between the Mitrofanoff conduit and the ileal technique of Monti, through which we performed an anastomosis of the distal stump of the appendix to the bladder (with an antireflux valve). Later, the proximal stump of the appendix was anastomosed to an ileal segment of 2.0 cm that was open longitudinally and reconfigured transversally (Monti technique), modeled by a 12-Fr urethral catheter, and finally, the distal stump was sutured at the patient's navel. After the procedure, a suprapubic cystostomy (22 Fr) and a Foley catheter (10 Fr) through the continent conduit were left in place. The patient had recovered well and was discharged on the tenth day after surgery. He remained with the Foley catheter (through the conduit) for 21 days and cystostomy for 30 days. Six months after surgery he was continent with good bladder compliance without reflux and fully adapted to catheterization through the navel. Conclusion The unpublished association between the Mitrofanoff and Monti techniques is feasible and a very useful alternative in urologic cases of derivation continent in which the ileocecal appendix is too short to reach the skin (i.e., in obese patients).
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La tesi può intendersi schematicamente suddivisibile in quattro macrosettori: il primo concerne un excursus storico-giuridico sulla nascita ed evoluzione dei Monti di Pietà, nonché delle Casse di Risparmio; il secondo macrosettore si riferisce peculiarmente alla profonda trasformazione e riorganizzazione delle Banche Pubbliche in Società per Azioni e alla conseguente nascita delle Fondazioni Bancarie, con l'approfondimento delle problematiche attinenti alla loro natura giuridica, e con il richiamo alle sentenze nn. 300 e 301/2003 della Corte Costituzionale; il terzo prende in esame il ruolo delle Fondazioni nella prospettiva della operatività del principio di sussidiarietà orizzontale; infine, nell'ambito del quarto macrosettore ci si è soffermati sulla struttura organizzativa delle Fondazioni, sul loro regime fiscale e sul tema dell'attività d'impresa delle stesse.
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Un rilievo laserscanner della Grotta dell'Orso, vicino al Ponte di Veja (Monti Lessini) ha consentito di descrivere in dettaglio questo sistema carsico e trarre alcune conclusioni dal punto di vista morfometrico e speleogenetico.
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Lo scopo del lavoro è stato quello di ipotizzare e comprendere la speleogenesi del sistema carsico del Ponte di Veja, nel Parco Regionale dei Monti Lessini. È stato eseguito un primo rilevamento geomorfologico dell'intero sistema carsico con annessi campionamenti. Il sito è caratterizzato dalla struttura principale dell'arco e dal connesso sistema di grotte. L'arco rappresenta il resto di un antico soffitto della grotta più grande crollato probabilmente durante il Pleistocene, che forma attualmente una dolina. La grotta su cui si basa la gran parte delle ipotesi è la Grotta dell'Orso (grotta A) che è attraversata in parte da un dicco basaltico.
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The Alburni Massif is the most important karstic area in southern Italy and It contains about 250 caves. Most of these caves are located on the plateau, between 1500 m a.s.l. and 700 m a.s.l., and only a few reach the underground streams that feed the springs and the deep aquifer. The main springs are Grotta di Pertosa-Auletta (CP1) and Auso spring (CP31), both located at 280 m a.s.l., the first on the south-eastern margin whereas the second on south-west margin, and the springs present in Castelcivita area, the Castelcivita-Ausino system (CP2) and Mulino di Castelcivita spring (CP865), located at 60 m a.s.l.. Some other secondary springs are present too. We have monitored Pertosa-Auletta’s spring with a multiparameter logger. This logger has registered data from November 2014 to December 2015 regarding water level, electric conductivity and temperature. The hydrodynamic monitoring has been supported by a sampling campaign in order to obtain chemical water analyses. The work was done from August 2014 to December 2015, not only at Pertosa but also at all the other main springs, and in some caves. It was possible to clarify the behavior of Pertosa-Auletta’s spring, almost exclusively fed by full charge conduits, only marginally affected by seasonal rains. Pertosa-Auletta showed a characteristic Mg/Ca ratio and Mg2+ enrichment, as demonstrated by its saturation index that always showed a dolomite saturation. All other spring have characteristic waters from a chemical point of view. In particular, it highlights the great balance between the components dissolved in the waters of Mulino’ spring opposed to the variability of the nearby Castelcivita-Ausino spring. Regarding the Auso spring the variable behavior in terms of discharge and chemistry is confirmed, greatly influenced by rainfall and, during drought periods, by full charge conduits. Rare element concentrations were also analyzed and allowed to characterize further the different waters. Based on all these data an updated hydrogeological map of the Alburni massif has been drawn, that defines in greater detail the hydrogeological complexes on the basis of lithologies, and therefore of their chemical characteristics.
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En el presente trabajo partimos de una clara ponderación de la escritura epistolar como espacio gnoseológico que surge de la relación entre Ricardo Palma y Miguel de Unamuno, entre los años 1903 y 1913. Por tanto se inscribe, asimismo, en el campo de estudio de las relaciones culturales entre España y América. Como consecuencia, nuestro propósito principal no supone un abordaje solamente intratextual sino intertextual de la obra de Palma y la de Unamuno, en aquellos textos en los que se cruzan, ya sea bajo la forma de prólogos, comentarios o sencillamente en el intercambio epistolar. En marco esbozado, leemos una serie de problemáticas que se ocupan de la historia, la literatura y la lengua.
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Una experiencia vivida y comentada por el propio Suspisiche -pintor del litoral santafecino- y la frecuentación de los textos saerianos abren la posibilidad de este trabajo que pretende un acercamiento al cruce de lenguajes entre las obras de ambos. Cada uno desde su propia estética genera un espacio que trasciende la referencialidad para convertirse en una poética, pero también en una verdadera cosmovisión. Las obras de Saer van develando su concepción de la literatura y del mundo, concepción según la cual la realidad es huidiza, imposible de aprehender. Esta certeza conduce su proceso de escritura. aporta sus tópicos recurrentes que no son más que la insistencia desesperada por comunicar las propias percepciones. De la pintura de Suspisiche, dijo el crítico Taverna Irigoyen: "es un paisaje que pareciera entregársele fácilmente, y cuando lo va a hacer suyo, a penetrarlo, se convierte en un espejismo inatrapable". ¿Cómo resuelven ambos. en la superficie textual. esa desconfianza en la posibilidad de instaurar sus universos? Por el camino del lenguaje, por la experimentación con que pueden transformar, superponer, reiterar, hasta crear un significado. Nuestro trabajo trata de demostrar cómo ambos evolucionan hacia la esencialidad que se logra por la progresiva supresión de lo accesorio, el abandono del pintoresquismo y una praxis que exige técnicas cada vez más rigurosas. Para el/o ese analiza el proceso de productividad de esos espacios que envuelven el trayecto vital del hombre y son uno con él, no por afinidades psicologistas. a la manera romántica, sino fatalmente, por impregnación. por simbiosis, por acoplamiento. No es el hombre el que se apropia del paisaje. es el espacio el que lo contiene. y permite al artista. desde adentro. una mirada que no es sólo recreación estética. sino ideología. en el sentido de visión del mundo.
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Fil: Arpini, Adriana.