Laparoscopic Appendectomy in Italy: An Appraisal of 26,863 Cases

Objective: To evaluate the practice of laparoscopic appendectomy (LA) in Italy. Methods: On behalf of the Italian Society of Young Surgeons (SPIGC), an audit of LA was carried out through a written questionnaire sent to 800 institutions in Italy. The questions concerned the diffusion of laparoscopic surgery and LA over the period 1990 through 2001, surgery-related morbidity and mortality rates, indications for LA, the diagnostic algorithm adopted prior to surgery, and use of LA among young surgeons (<40 years). Results: A total of 182 institutions (22.7%) participated in the current audit, and accounted for a total number of 26863 LA. Laparoscopic surgery is performed in 173 (95%) institutions, with 144 (83.2%) routinely performing LA. The mean interval from introduction of laparoscopic surgery to inception of LA was 3.4 ± 2.5 years. There was an emergent basis for 8809 (32.8%) LA procedures (<6 hours of admission); 10314 (38.4%) procedures were performed on an urgent basis (<24 hours of admission); while 7740 (28.8%) procedures were elective. The conversion rate was 2.1% (561 cases) and was due to intraoperative complications in 197 cases (35.1%). Intraoperative complications ranged as high as 0.32%, while postoperative complications were reported in 1.2% of successfully completed LA. The mean hospital stay for successfully completed LA was 2.5 ± 1.05 days. The highest rate of intraoperative complications was reported as occurring during the learning curve phase of their experience (in their first 10 procedures) by 39.7% of the surgeons. LA was indicated for every case of suspected acute appendiceal disease by 51.8% of surgeons, and 44.8% order abdominal ultrasound (US) prior to surgery. A gynecologic counseling is deemed necessary only by 34.5% surgeons, while an abdominal CT scan is required only by 1.5%. The procedure is completed laparoscopically in the absence of gross appendiceal inflammation by 83%; 79.8% try to complete the procedure laparoscopically in the presence of concomitant disease; while 10.4% convert to open surgery in cases of suspected malignancy. Of responding surgeons aged under 40, 76.3% can perform LA, compared to 47.3% surgeons of all age categories. Conclusions: The low response rate of the present survey does not allow us to assess the diffusion of LA in Italy, but rather to appraise its practice in centers routinely performing laparoscopic surgery. In the hands of experienced surgeons, LA has morbidity rates comparable to those of international series. The higher diagnostic yield of laparoscopy makes it an invaluable tool in the management algorithm of women of childbearing age; its advantages in the presence of severe peritonitis are less clear-cut. Surgeons remain the main limiting factor preventing a wider diffusion of LA in our country, since only 47.3% of surgeons from the audited institutions can perform LA on a routine basis.

Evidence for the Confraternity of S. Pietro Martire at San Zanipolo, Venice

This conference paper looks at evidence of 15th- and 16th-century saints' images on carved door frames at the church of S. Zanipolo (SS Giovanni e Paolo) in Venice, using them to help locate and reconstruct the history of the 'albergo' of the confraternity dedicated to St Peter Martyr and St Vincent Ferrer. Suggestions are made concerning the possible relationship of confraternity buildings outside a church to altars dedicated to the same saint(s) within that church.

Direct Sensing in Liquids Using Whispering-Gallery-Mode Droplet Resonators

Liquid droplets suspended by the tip of a thin wire, a glass capillary, or a needle form high-Q optical resonators, thanks to surface tension. Under gravity equilibrium conditions, the maximum drop diameter is approximately 1.5 mm for paraffin oil (volume ∼ 0.5 μL) using, for instance, a silica fiber with 250 μm thickness. Whispering gallery modes are excited by a free-space near-infrared laser that is frequency locked to the cavity resonance. The droplet cavity serves as a miniature laboratory for sensing of chemical species and particles.

Alegoría: su pertinencia en la predicación y uso en "La novena maravilla"

En este artículo se focaliza el recurso de la alegoría como método exegético en la composición de los sermones panegíricos de Juan Espinosa Medrano (Perú, siglo XVII). Se traza el recorrido de la alegoría (y las humanidades en general) en relación –siempre tensa– con el cristianismo a lo largo de su historia; y se llega a la Contrarreforma y el uso exacerbado del método en la predicación barroca; particularmente en la oratoria sagrada de Espinosa Medrano, quien abarca elementos diversos y extraídos de distintas fuentes (filosofía natural, mitología clásica, tradición emblemática, relatos bíblicos), a los que hace funcionar como signos de otra verdad mayor, la sagrada. Si bien las preceptivas sagradas impulsaban una predicación más llana y simple, la profusión de alegorías mitológicas, que el autor resemantiza según su interés de guiar la interpretación, pueden explicarse por varias circunstancias, motivos de estudio en este trabajo.

Relation of the work of the artist Antonio Lopez with the photography. Methods of a teacher rejected as a professor

In 1966 the artist Antonio Lopez was rejected for the chair in “Preparatorio de colorido” (Preparatory Colouring) by the San Fernando School of Fine Arts where he himself presented his work Nevera de hielo (Ice Box). After 5 years as a “stand in” for this post he left the Institution. This article analyzes the circumstances and proof of a decade where there appears to be evidence of a definite change in his work, more toward Realism, uncomfortable in a system that maintained with difficulty the traditional academic model copy, and incompatible with, in those years was imposed by Spain. At the same time his relation with photography conditioned by the theoretical thoughts of the artist, and his work methods also are analyzed in this article.

Some thoughts on Juan Antonio Ramírez´s iconologic-paranoid method for the study of Dali´s works

In 1990, Juan Antonio Ramírez made known his iconological paranoiac method to the academic world. It is a system devised to study Dalí´s work, born of happy matrimony between the catalonian artist´s critical paranoiac method and the first iconographic school of Warburg and Panofsky. What, at first sight, seemed to be an extravagant methodology with little academic credibility, turned out to be, by going forward in time, an effective research method when analyzing Dali´s initial works. It is no wonder that, at the beginning of XXI century, this hybridization between Dalí´s and Panofsky’s methods, were regarded as a strange and nonsensical idea. Nevertheless, twenty years after, blatant examples have been noted, which endorse the advantages of this new system for “iconographic” study. As usual, this new contribution by Juan Antonio Ramirez to art history methodology is called upon to have a successful future survival, in forthcoming generations. This article, attempts to analyze this method, inquiring into the validity, effectiveness and practical utility.