5 results
THE HARMONIC STUDY: COST-EFFECTIVENESS EVALUATION OF THE USE OF THE ULTRASONIC SCALPEL IN TOTAL THYROIDECTOMY
- Matteo Ruggeri, Rossella Dibidino, Marco Marchetti, Celestino Pio Lombardi, Marco Raffaelli, Americo Cicchetti
-
- Journal:
- International Journal of Technology Assessment in Health Care / Volume 28 / Issue 3 / July 2012
- Published online by Cambridge University Press:
- 14 September 2012, pp. 259-264
-
- Article
- Export citation
-
Background: Total thyroidectomy (TT) can be performed either with the traditional technique or using the ultrasound scalpel. Here, the use of the ultrasound scalpel is investigated in order to assess cost-effectiveness from an hospital, third party payer and societal perspective.
Methods: A randomized controlled trial was conducted at the University Hospital A. Gemelli in Rome. Data refer to 198 patients, randomized to either surgery with the ultrasound scalpel (n = 96) or traditional (n = 102) and followed for 3 months after hospital discharge. Operation time (OT) and resource consumption were recorded. Main clinical outcome investigated was quality of life (evaluated with EQ-5D).
Results: A shorter operation time (traditional: 76.36 vs ultrasound: 54.16 minutes, p < 0.001) was observed. 3 months after surgery, differences in QoL were significant (0.91 vs 0.84, p = 0.002). Concerning the hospital perspective, ultrasound scalpel allows savings of 119 EUR per patient. From a societal perspective, ultrasound scalpel is also related to lower medical resource consumption during a 3 month follow-up after discharge (traditional: 129.03 EUR vs ultrasound: 107.82 EUR) and lower non-medical resource utilization (transport/hotels costs traditional:535.51 EUR vs ultrasound: 342.77 EUR. No statistical difference was found in productivity losses up to 3 months (traditional: 377.71 EUR vs ultrasound: 385.51 EUR).
Conclusion: Allowing an overall saving of 325.36 EUR per patient, Ultrasound scalpel should be adopted for TT procedures in the “A.Gemelli” University hospital.
Physical weed control in processing tomatoes in Central Italy
- Michele Raffaelli, Marco Fontanelli, Christian Frasconi, Francesca Sorelli, Marco Ginanni, Andrea Peruzzi
-
- Journal:
- Renewable Agriculture and Food Systems / Volume 26 / Issue 2 / June 2011
- Published online by Cambridge University Press:
- 11 January 2011, pp. 95-103
-
- Article
- Export citation
-
Tomato is a very important vegetable crop in Italy. Improving the means of production for processing organic tomatoes could help guarantee better profits for farmers and, at the same time, enhance environmental management and safeguard consumers’ health. Weed control, in particular within crop rows, is one of the main problems in organic farming, and thus also for the organic cultivation of tomato. The aim of this study was to develop innovative strategies and equipment for effective physical weed control in processing tomatoes. A conventional weed management system incorporating herbicides was compared with an alternative system relying exclusively on physical control during three growing seasons (2006–2008) on a farm located near Pisa, Italy. The crop was transplanted mechanically onto paired rows. The conventional strategy consisted of three different chemical treatments, two post-transplanting PTO-powered rotary hoe passes and several hand-weeding treatments on the paired rows. The alternative system included a stale seedbed technique (performed by a rolling harrow pass and one flaming treatment), two post-transplanting precision hoeing treatments and several hand-weeding treatments. All the machines for the alternative system were adjusted and set up for processing tomatoes transplanted in paired rows. Each physical treatment (mechanical and thermal) within the alternative system allowed an ‘instantaneous’ (just before/just after) weed control from 50 to 100%, while the alternative strategy as a whole achieved values of weed dry biomass at harvest ranging from 22 to 126 g m−2. However, the alternative system required a total labor input that averaged 50% higher than the conventional strategy. The conventional system had on average more effective weed control than the alternative system, but both strategies controlled weeds effectively. Weed biomass at harvest averaged 36 and 68 g m−2 for conventional and alternative strategies, respectively. On the other hand, the alternative system generally led to a significant increase in fresh crop yield (+13% average yield for the 3 years).
Physical weed control in protected leaf-beet in central Italy
- Michele Raffaelli, Marco Fontanelli, Christian Frasconi, Marco Ginanni, Andrea Peruzzi
-
- Journal:
- Renewable Agriculture and Food Systems / Volume 25 / Issue 1 / March 2010
- Published online by Cambridge University Press:
- 15 January 2010, pp. 8-15
-
- Article
- Export citation
-
Leaf-beet is a typical and very important protected cultivation crop in central Italy. In leaf-beet protected cultivation, weed control is one of the most important problems because of its fairly long crop cycle (approximately 4–5 months). The aim of this research was to set up an efficient non chemical weed control strategy performed with innovative machines built and set up by the University of Pisa. A two-year (2006–2007) ‘on-farm’ experimental trial was carried out in Crespina (PI). A conventional weed management technique (consisting of one pre-transplanting chemical treatment) was compared with an innovative physical weed control strategy in an organic production system (consisting of using a stale seedbed technique, in several post-emergence precision hoeing and in-row hand-weeding treatments). In the conventional technique, leaf-beet was manually transplanted, while it was sown with a precision pneumatic planter in the organic system. All innovative machines for physical weed control were adjusted and set up for the protected cultivation. Similar yields were recorded for the two systems in this two-year trial. Total labor time (for weed management and crop planting) was appreciably lower in the conventional system in the first year of the experiment (−67%), while in the second year, some improvement in the physical weed control techniques decreased labor needs with respect to the conventional technique (−40%). Weed dry biomass at harvest was significantly lower in the organic cropping system (on average −50%).
Innovative strategies for on-farm weed management in organic carrot
- Andrea Peruzzi, Marco Ginanni, Marco Fontanelli, Michele Raffaelli, Paolo Bàrberi
-
- Journal:
- Renewable Agriculture and Food Systems / Volume 22 / Issue 4 / December 2007
- Published online by Cambridge University Press:
- 04 December 2007, pp. 246-259
-
- Article
- Export citation
-
Weed management is often the most troublesome technical problem to be solved in organic farming, especially in poorly competitive crops like vegetables. A four-year (2000–2003) series of trials was established to assess the possibility of adopting an innovative non-chemical weed management system in organic carrot grown on the Fucino plateau, i.e., the most important carrot-growing area in Italy. The system utilized for physical weed control was based first on a false seedbed technique followed by pre-sowing weed removal, performed with a special 2 m wide 6-row spring-tine harrow. Prior to crop emergence, a pass with a flame weeder equipped with four 50 cm wide-open flame burners was also performed. Post-emergence weed control consisted of one or more hoeing passes with a purpose-designed 11-tine precision hoe equipped with spring implements (torsion weeders and vibrating tines), in addition to hand weeding. This innovative system was applied to a novel planting pattern (sowing in ten individual rows within 2 m wide beds) and compared to the standard management system of the area (sowing within 2 m wide beds but in five bands, use of spring-tine harrowing and flame weeding pre-emergence and of traditional hoeing post-emergence). The new system was tested in different commercial farms including both early and late-sown carrot. Assessments included machine operative characteristics, labor time, weed density and biomass, crop root yield and yield quality, and economic data (physical weed control costs and crop gross margin). Compared to the standard system, the innovative system usually resulted in reduced labor time (from 28 to 40%) and total costs for physical weed control (on average −416 € ha−1). Use of the precision hoe resulted in intra-row weed reduction ranging from 65 to 90%, which also led to a marked reduction in the labor required for hand weeding. In 2001 the two systems did not differ in terms of yield and yield quality, whereas in 2002 and 2003 the innovative system showed a higher mean density of carrot plants (from 28 to 55%), root yield (from 30 to 42%), and gross margin (from 40 to 100%). Carrot yield was higher in farms which adopted an early sowing whereas root commercial quality was somewhat variable between systems and years. In general, results obtained with the innovative management system look very promising.
Xenogeneic transplantation of human spermatogonia
- Marcos M. Reis, Ming C. Tsai, Peter N. Schlegel, Miriam Feliciano, Ricciarda Raffaelli, Zev Rosenwaks, Gianpiero D. Palermo
-
- Article
- Export citation
-
In the last 3 years, several studies have shown that xenogeneic transplantation of rodent spermatogonia is feasible. The treatment of infertile patients with spermatogenic arrest using the injection of immature germ cells has yielded only poor results. We attempted to establish a complete spermatogenetic line in the testes of mutant aspermatogenic (W/Wv) and severe combined immunodeficient mice (SCID) transplanted with germ cells from azoospermic men. Spermatogenic cells were obtained from testicular biopsy specimens of men (average age of 34.3 ± 9 years) undergoing infertility treatment because of obstructive and non-obstructive azoospermia. Testicular tissue was digested with collagenase to promote separation of individual spermatogenic cells. The germ cells were injected into mouse testicular seminiferous tubules using a microneedle (40 μm inner diameter) on a 10 ml syringe. To assess the penetration of the cell suspension into the tubules, trypan blue was used as an indicator. Mice were maintained for 50 to 150 days to allow time for germ cell colonisation and development prior to them being killed. Testes were then fixed for histological examination and approximately 100 cross-sectioned tubules were examined for human spermatogenic cells. A total of 26 testicular cell samples, 16 frozen and 10 fresh, were obtained from 24 men. The origin of the azoospermia was obstructive (OA) in 16 patients and non-obstructive (NOA) in 8 patients. The concentration of spermatogenic cells in the OA group was 6.6 × 106 cells/ml, and 1.3 ? 106 cells/ml in the NOA group (p < 0.01). The different spermatogenic cell types were distributed equally in the OA samples, ranging from spermatogenia to fully developed spermatozoa, but in the NOA group the majority of cells were spermatogonia and spermatocytes. A total of 23 testes from 14 W/Wv mice and 24 testes from 12 SCID mice were injected successfully, as judged by the presence of spermatogenic cells in histological sections of testes removed immediately after the injection. However, sections from the remaining testes examined up to 150 days after injection showed tubules lined with Sertoli cells and xenogeneic germ cells were not found. The reason why the two strains of mouse used as recipients did not allow the implantation of human germ cells is probably due to interspecies specificity involving non-compatible cell adhesion molecules and/or immunological rejection.