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Telemedical wound care is one of the possible applications of teledermatology. The treatment of pediatric wounds needs frequent and periodic assessments of their local status and adjustment of dressings choice.We present our experience using telemedicine in the successful assessment and treatment of 19 pediatric patients at the OPBG, Rome . Photographs with a digital camera were taken and sent weekly by mail to a wound care specialist in Rome. This allowed the expert to diagnose and evaluate the wounds periodically.In the shown cases, telemedicine allowed us to have an immediate evaluation and therapy adjustment. The quality of the images was good enough that the physician could regularly evaluate the status of the wound and immediately give his feedback to the parents. Of these 19, 13 patients (68%) experienced a wound resolution during the remote monitoring period. The satisfaction of the parents detected at 3, 6 and 12 months was found to be respectively 57%, 71%, 84%.Reducing transportation to the hospital to obtain a specialist advice, wound teleconsultation lowers health care costs and improve the quality of life for pediatric patients and their family, while still maintaining a high quality of pediatric wound care.

We studied the effect of Telehomecare (THC) in a group of cystic fibrosis (CF) patients.Forced Expiratory Volume in the first second (FEV1) was monitored at home, with the aim of an early recognition of the relapses of pulmonary infections. FEV1 was monitored for 4.5 years, using THC as a tool, in addition to the standard therapeutic protocol. 16 CF patients were followed by doctors experts in the treatment of CF, over a period of 4.5 years. We compared a control group among patients seen in the past for an identical period, matching for number, age, sex, respiratory function, bacterial colonization, O2 dependency, and complications. 16 CF patients with similar characteristics of age, degree of pulmonary involvement, bacterial colonization and O2 dependency. We calculated the annual mean values of FEV1 in both groups.Spirometry data showed a significant improvement in annual Fev1 mean values for the THC patients as compared to the control group.The data are encouraging for a possible role of Telemedicine as a tool for domestic assistance of patients affected by chronic diseases, such as CF. However, reliable data on the long-term effectiveness of the use of THC in the treatment of CF patients is still lacking. The time has come to obtain reliable data through a multicenter collaboration study, also in order to standardize the international Telemedicine protocols.

The Cystic Fibrosis (CF) Unit of Children's Hospital Bambino Gesù in Rome (Italy) has more than 25 years of experience in diagnosis and treatment of Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) related diseases. The CF Unit actively collaborates with the Transplantation Division for the follow-up of patients with CF who undergo lung transplantation, performed in our Unit since 1991. We present the case of a 19 year-old girl with CF, with severe respiratory failure for which it was subjected to two lung transplant. During the follow-up the remote monitoring has allowed the identification of an early episode of pulmonary relapse and graft-versus-host reaction even before the onset of symptoms, allowing an effective intervention and a complete recovery of lung function.

During the last two decades there have been several improvements on environmental acoustic qualification testing for launch and space vehicles. Direct field excitation (DFAX) tests using Multiple-Input-Multiple-Output (MIMO) control strategies seems to become the most cost-efficient way for component and subsystem acoustic testing. However there are still some concerns about the uniformity and diffusivity of the acoustic field produced by direct field testing. Lately, much of the documented progresses aimed to solve the non-uniformity of the field by altering the sound pressure level requirement, limiting responses and adding or modifying control microphones positions. However, the first two solutions imply modifying the qualification criteria, which could lead to under-testing, potentially risking the mission. Furthermore, adding or moving control microphones prematurely changes the system configuration, even if it is an optimal geometric layout in terms of wave interference patterns control. This research investigates the target definition as an initial condition for the acoustic MIMO control. Through experiments it is shown that for a given system configuration the performance of a DFAX test strongly depends on the target definition procedure. As output of this research a set of descriptors are presented describing a phenomenon defined as "Energy- sink".

Thyroglossal duct cysts are one of the most common congenital abnormalities of the cervical region. Complications of these swellings are rare, and among these, appearance of a carcinoma has also been noted. We present a case of papillary carcinoma arising in a thyroglossal duct cyst in 20-year-old woman with a swelling of about 4 cm, located at the middle region of the neck over the hyoid bone. Our patient was treated using a modified Sistrunk operation, in which thyroidectomy proved crucial for the correct diagnosis and continuation of appropriate treatment. Our case confirms the difficulty in distinguishing a primitive thyroglossal duct carcinoma from a synchronous metastatic papillary carcinoma of the thyroid. This dilemma often remains unresolved.Le cisti del dotto tireoglosso sono fra le più comuni anomalie congenite della regione cervicale. Le complicanze di queste tumefazioni sono rare e, fra queste, è stata descritta la comparsa di un carcinoma. Presentiamo un nuovo caso di carcinoma papillare insorto in una cisti del dotto tireoglosso in una giovane donna di 20 anni portatrice di una tumefazione di circa 4 cm, localizzata nella regione media del collo al di sopra dell'osso joide. La nostra paziente è stata trattata mediante l'operazione di Sistrunk, nella quale la tiroidectomia ha rappresentato uno step avanzato risultato cruciale per il raggiungimento di una corretta diagnosi e la continuazione di un appropriato protocollo terapeutico. Il nostro caso conferma la difficoltà nel distinguere un carcinoma del dotto tireoglosso primitivo da una metastasi sincrona di carcinoma papillare della tiroide. Questo dilemma spesso rimane irrisolto.