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din română în engleză din franceză în engleză din italiană în engleză engleză (monolingv) română (monolingv)
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Translation Volum: 1 days Completat: Oct 2016 Languages: din franceză în engleză
Medical article - Ciguatera fish poisoning
Pruritus, asthenia and paresthesia in a 51-year-old man
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Translation Volum: 2 days Completat: Oct 2016 Languages: din franceză în engleză
Vascular myeloproliferative neoplasm with normal cell blood count
Vascular myeloproliferative neoplasm with normal cell blood count: Exploration and medical management
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Translation Volum: 0 days Completat: Oct 2016 Languages: din italiană în engleză
Translation Italian to EnglishTJ353755-194237
Activity and efficacy of vinflunine in metastatic carcinoma of the bladder after failure of adjuvant treatment
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Translation Volum: 2 days Completat: Sep 2016 Languages: din italiană în engleză
Surveillance of severe cutaneous drug reactions- REACT-Lombardia
Surveillance of severe cutaneous drug reactions: Experience REACT-Lombardia
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Translation Volum: 350 pages Completat: Jun 2016 Languages: din franceză în engleză
PERSONALIZED MEDICINE
"...after forty years of private and hospital practice, this book answers the need to present the results of [doctor's] work together with French and foreign colleagues for developing a true terrain-based medicine, both preventive and curative, which takes into account the patient as a whole person."
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Translation Volum: 2 days Completat: Nov 2013 Languages: din franceză în engleză
Translation French to English P.O.: TJ111025-53745EU Project Tours
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Translation Romanian to English EU Project Pitesti
Application for European Green Capital 2016 Award
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Translation Volum: 1 days Completat: Jul 2013 Languages: din italiană în engleză
Translation Italian to English 2751 words CONDIZIONI GENERALI DI VENDITA
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Translation Italian English TJ79825-36789 QUANDO_E_PERCHÉ_CHIEDERE_L'UNZIONE_DE
Anointing of the sick - paper
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Translation Volum: 1 days Completat: Jun 2013 Languages: din italiană în engleză
Translation Italian -EnglishAN ITALIAN HOME
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Translation Italian to English12761 Parere Tecnico
din italiană în engleză: A strange case of Takotsubo syndrome after stress echocardiography with dipyridamole General field: Medical Detailed field: Terenuri = Imobiliare
Text sursă - italiană CASO CLINICO
Una donna di 81 anni è giunta alla nostra osservazione in Pronto Soccorso (PS) accusando dolore toracico irradiato agli arti superiori, insorto a riposo circa 6 h prima. Il dolore era ad andamento non costante ed associato a cefalea ed elevati valori pressori. La paziente era ipertesa e diabetica, in terapia con quinapril 20 mg/idroclorotiazide 12.5 mg/die e metformina 500 mgx 3/die. In anamnesi, inoltre, ateromasia carotidea ed un pregresso attacco ischemico transitorio, per cui assumeva aspirina 100 mg/die ed atorvastatina 10 mg/die. L’esame obiettivo era nella norma. L’ECG mostrava ritmo sinusale, onde T negative asimmetriche come da ipertrofia ventricolare sinistra (IVS), blocco di branca destra (reperto noto) (Figura 1A); all’ecocardiogramma, cinesi biventricolare conservata, ipertrofia del setto interventricolare basale (13 mm) del ventricolo sinistro (VS); insufficienza mitralica lieve, pericardio indenne. Esami ematochimici completi e due determinazioni della troponina (T0-T3: 0.01 ng/ml con cut-off di 0.04 ng/ml) risultavano nella norma.
Traducere - engleză CLINICAL CASE
An 81-year old woman came for consult to the Emergency Room (ER) complaining about chest pain radiating to upper limbs, which appeared at rest, about 6 h before. The pain was not constant and was associated with headache and high blood pressure. The patient was hypertensive and diabetic, undergoing therapy with quinapril 20 mg/hydrochlorothiazide 12.5 mg/day and metformin 500 mg x 3/day. In addition, she had a history of carotid atheromatosis and an episode of transient ischaemic attack, for which she was taking aspirin 100 mg/day and atorvastatin 10 mg/day. The physical exam was normal. The electrocardiogram showed sinus rhythm, asymmetric T-wave inversion suggesting left ventricular hypertrophy (LVH), right bundle branch block (known fact) (Figure 1A); the echocardiogram showed preserved biventricular kinetics, left ventricular (LV) hypertrophy of the basal segment of the interventricular septum (13 mm); mitral regurgitation, normal pericardium. Complete blood chemistry and two measurements of cardiac troponin (T0-T3): 0.01 ng/ml with 0.04 ng/ml cut-off) were within normal range.
din franceză în engleză: Injection intraveineuse d'adrénaline: attention au risque de dysfonction cardiaque iatrogène General field: Medical Detailed field: Terenuri = Imobiliare
Text sursă - franceză L'observation est celle d'une femme de 31 ans, G4P2 (deux grossesses par procréation médicale assistée avec stimulation ovarienne, deux fausses couches spontanées, la dernière 3 mois auparavant), ayant pour unique antécédent une torsion ovarienne droite ancienne. Une douleur abdominale localisée en fosse iliaque droite évoluant depuis 3 jours explique sa consultation aux urgences gynécologiques. Le bilan clinique, biologique et échographique ayant éliminé une cause gynéco-obstétricale, la patiente a été adressée aux urgences générales ou` une appendicite aigue¨ a été suspectée et l'indication de scanner injecté posée.
À l'injection de produit de contraste (PDC), elle a présenté un tableau brutal associant dyspnée laryngée (bronchospasme) et agitation évoquant au médecin urgentiste une réaction anaphylactique justifiant l'administration de polaramine en intraveineux puis d'adrénaline en boli intraveineux itératifs de 0,1 mg pour une dose totale cumulée de 0,8 mg. Dans les suites immédiates de l'injection, la patiente s'est plainte d'une douleur thoracique associée à une bradycardie à 45 battements par minute, une hypotension artérielle à 68/37 mmHg, nécessitant son transfert en réanimation. L'échographie transthoracique (ETT) réalisée a mis en évidence une dysfonction cardiaque globale du ventricule gauche (VG) avec une fraction d'éjection ventriculaire gauche (FeVG) effondrée à 20 %, une intégrale temps-vitesse mesurée à 13 cm, sans élévation des pressions de remplissage du ventricule gauche. L'ETT n'a pas retrouvé de signe d'obstruction des cavités droites, de trouble de la cinétique segmentaire ni d'épanchement péricardique pouvant évoquer une embolie pulmonaire, un infarctus du myocarde ou une péricardite. L'électrocardiogramme (ECG) a montré un sous-décalage du segment ST en V3-V4 sans autre anomalie, les dosages sériques de la troponine et de la Thyroid Stimulating Hormon (TSH) initiales étant normales.
Traducere - engleză This case involves a 31-year old woman, G4P2 (two pregnancies by Medically Assisted Procreation with ovarian stimulation, two spontaneous miscarriages, the last one, 3 months before), having as medical history only an old right ovarian torsion. Localized abdominal pain in the right iliac fossa evolving for the past 3 days explains her visit to the Gynaecology Emergency Department. Since the clinical examination, laboratory tests and ultrasound ruled out an obstetric-gynaecological cause, the patient was referred to the General Emergency Department where acute appendicitis was suspected and CT scan with contrast medium was indicated.
After administration of the contrast medium, she presented with a severe clinical picture associating laryngeal dyspnoea (bronchial spasm) and agitation, which led the emergency physician to suspect an anaphylactic reaction justifying administration of intravenous polaramine, then epinephrine in repeated intravenous boli of 0.1 mg, for a total cumulative dose of 0.8 mg. Immediately after the injection, the patient complained about chest pain associated with bradycardia at 45 beats per minute and arterial hypotension at 68/37 mmHg, requiring her transfer to the Intensive Care Unit. The transthoracic echocardiogram (TTE) performed identified left ventricular (LV) global cardiac dysfunction with a left ventricular ejection fraction (LVEF) dropped to 20%, time-velocity integral measured at 13 cm, without elevation of left ventricular filling pressure. The TTE did not find signs of obstruction in the right cavities, segmental kinetic disorder, or pericardial effusion suggesting pulmonary embolism, myocardial infarction or pericarditis. The electrocardiogram (ECG) showed depression of ST segment in V3-V4 without other abnormality, the initial serum troponin and the thyroid stimulating hormone (TSH) being normal.
din franceză în engleză: Locally advanced and metastatic cutaneous squamous cell carcinoma treated with cemiplimab General field: Medical Detailed field: Juridic (general)
Text sursă - franceză INTRODUCTION
Le carcinome spinocelluiaire cutané (cSCC) est le deuxième cancer cutané malin le plus fréquent, après le carcinome basocellulaire. Il touche les patients en moyenne à partir de 60 ans, généralement au niveau des zones photoexposées (1). Sa fréquence augmente entre 100 à 250 fois chez le patient immunodéprimé, notamment les patients greffés d'organe (1). La plupart des cSCC sont bien différenciés et se présentent comme des lésions isolées croûteuses hyperkératosiques, bien délimitées avec un halo légèrement inflammatoire. Ils se com portent de façon indolente et n'ont qu'un très faible potentiel métastasique. Plus rarement, on observe des cSCC mal différenciés qui se manifestent comme des lésions exophytiques charnues, érythémateuses et qui saignent facilement. Ceux-ci ont un profil de croissance beaucoup plus rapide et un risque métastatique bien plus élevé.
Le traitement des cSCC repose principalement sur une excision chirurgicale (2). Pour certaines lésions localement avancées et/ou métastatiques, la chirurgie et/ou la radiothérapie ne sont plus envisageables (–ge du patient, souhait du patient, techniquement difficile, trop mutilant, etc.), requérant alors des traitements systémiques. Les traitements systémiques pour le cSCC localement avancé et/ou métastatique (2, 3) sont des traitements chimiothérapeutiques, comme les platines, les taxanes, des traitements ciblés comme l'erlotinib et le cétuximab, ou, plus récemment, des immunothérapies comme le nivolumab et le cémiplimab (4, 5), tous deux des antagonistes PD1.
Traducere - engleză INTRODUCTION
Cutaneous squamous cell carcinoma (cSCC) is the second most common skin cancer after basal cell carcinoma. Commonly, it affects patients over 60 years of age, and generally involves photoexposed areas (1). Its incidence increases 100 to 250 times in immunocompromised patients, particularly organ transplanted patients (1). Most cSCCs are well differentiated and present as isolated, well circumscribed, hyperkeratotic, crusty lesions with a slightly inflammatory halo. It is indolent and has a very low metastatic potential. Less frequently, poorly differentiated cSCC can be observed, manifesting as exophytic, fleshy, erythematous, easily bleeding lesions. These latter have a faster growth profile and [are associated with] a much higher metastatic risk.
The treatment of cSCC is primarily based on surgical excision (2). For some locally advanced and/or metastatic lesions, surgery and/or radiotherapy are no longer possible (patient's age, patient's wish, technically difficult, too mutilating, etc.), in such case requiring systemic treatment. Locally advanced and/or metastatic cSCC is treated systemically (2, 3) by chemotherapy using platinum-based regimens, taxanes, target therapies, such as erlotinib and cetuximab, or, more recently, immunotherapy with nivolumab and cemiplimab (4, 5), both PD-1 antagonists.
din italiană în engleză: Diritto amministrativo General field: Legislaţie/Brevete Detailed field: Geografie
Text sursă - italiană Diritto amministrativo
PROGRAMMA DEL CORSO
– L’amministrazione e il diritto amministrativo nell’ordinamento costituzionale italiano.
– Le fonti del diritto amministrativo.
– La pubblica amministrazione; la sua organizzazione in generale; gli organi; gli uffici; il personale e il rapporto d’impiego (cenni).
– Lo Stato; le Regioni e gli enti territoriali; gli enti funzionali; le autorità indipendenti.
– L’attività amministrativa; l’attività autoritativa; l’attività negoziale; i servizi pubblici.
– Il procedimento amministrativo e il provvedimento amministrativo; l’inerzia dell’amministrazione.
– La validità e l’efficacia degli atti amministrativi; i vizi dell’atto amministrativo; la distinzione fra vizi di legittimità e vizi di merito.
– I procedimenti di secondo grado (annullamento d’ufficio, revoca, ecc.).
– L’attività contrattuale dell’amministrazione.
– I servizi pubblici.
– I beni pubblici.
– Le posizioni giuridiche soggettive (diritti soggettivi, interessi legittimi, ecc.).
– La responsabilità dell’amministrazione.
Traducere - engleză COURSE PROGRAMME
- Administration and administrative law in the Italian Constitution provisions.
- Basis of administrative law.
- Public administration; its general organization; administrative bodies; departments; personnel and employment relationship (overview).
- State; Regions and local government bodies; functional bodies; independent bodies.
- Administrative activity; authoritative activity; transaction activity; public services.
- Administrative procedure and administrative provision; administrative inertia.
- Validity and effectiveness of administrative measures; flaws of administrative measures; distinction between errors of law and error regarding merits.
- Second instance proceedings (official annulment, revocation, etc.).
- Contractual activity of the administration.
- Public services.
- Public goods.
- Subjective legal positions (subjective rights, legitimate interests, etc.).
- The responsibility of the administration.
din franceză în engleză: A rare and serious complication associated with acenocoumarol therapy: intra-alveolar haemorrhage General field: Medical Detailed field: Juridic (general)
Text sursă - franceză Patient et observation
Le patient est un homme g de 62 ans, hypertendu, ayant un antcdent de fibrillation auriculaire sous anti-vitamines K depuis 13 ans bien suivi. Il s'est prsent l'hpital dans un tableau de dyspne d'apparition brutale stade II NYHA, hmoptysie avec notion d'automdication par Ibuprofne depuis plusieurs jours. son admission, le patient tait apyrtique, tachypnique 28 cycles/min, tachycarde 126 bpm, une pression artrielle 134/79mmHg, saturation artrielle en oxygne 94% avec des rles crpitants diffus aux deux hmi champs pulmonaires. Au bilan biologique, nous avons not une anmie 7,8 g/dl hypochrome microcytaire, des globules blancs 10230/mm3, des plaquettes 260000/mm3, un INR incoagulable, une cratininmie 10,3 g/l estimant le dbit de filtration glomrulaire 77 ml/min/1,73 m2 (Formule MDRD simplifie), une albuminmie 34 g/l, protidmie 63g/l. L'examen de la bandelette urinaire s'est rvl ngatif sans hmaturie ni macroalbuminurie. Les taux sriques des p-ANCA, c-ANCA, Ac anti-MBG, AC anti-DNA ainsi que le facteur rhumatode se sont rvls ngatifs. L'chocardiographie transthoracique a montr une fonction ventriculaire normale et aucune valvulopathie. Le clich standard du thorax a rvl la phase dtat des opacits alvolaires bilatrales diffuses (Figure 1), ce qui nous a incit complter par une TDM thoracique retrouvant des lsions alvolaires multiples bilatrales (Figure 2). Enfin, une endoscopie bronchique avec lavage broncho-alvolaire (LBA) fut ralis retrouvant un liquide uniformment hmorragique avec cultures revenues striles.
Traducere - engleză Patient and case report
The patient is a 62-year old man, hypertensive, with a history of atrial fibrillation treated with vitamin K antagonists, properly followed for the past 13 years. He comes to the hospital presenting with dyspnoea of sudden onset classified as stage II according to New York Heart Association (NYHA) classification, haemoptysis with self-medication by Ibuprofen for the past few days. Upon admission, the patient was afebrile, tachypnoeic at 28 cycles/min, tachycardic at 126 bpm, blood pressure 134/79 mmHg, arterial oxygen saturation 94% with diffuse crackling sounds in both lung fields. Laboratory tests showed microcytic hypochromic anaemia at 7.8 g/dl, white blood cells count 10,230/mm3, platelet count 260,000/mm3, incoagulable INR, serum creatinine 10.3 g/l, estimated glomerular filtration rate 77 ml/min/1.73 m2) (simplified MDRD formula), serum albumin level 34 g/l, protidaemia 63 g/l. Urine test strip was negative without haematuria or microalbuminuria. Serum levels of pANCA, cANCA, anti-glomerular basement membrane (GBM) antibodies, anti-DNA antibodies and rheumatoid factor were negative. Transthoracic echocardiogram showed normal ventricular function and no valve disease. Standard chest x-ray snapshots found diffuse bilateral alveolar lesions (Figure 1) in chronic phase, which has prompted us to pursue the investigation by chest CT scan, which found multiple bilateral alveolar lesions (Figure 2). Finally, bronchial endoscopy with bronchoalveolar lavage (BAL) was performed and found uniformly haemorrhagic fluid with sterile cultures.
din franceză în engleză: How to proceed after a failed vacuum delivery General field: Medical Detailed field: Juridic (general)
Text sursă - franceză 1. Introduction
La ventouse obstétricale est devenue l’instrument d’extraction le plus utilisé en première intention en France dans les centres hospitaliers universitaires, entre autre du fait d’une courbe d’apprentissage plus rapide que celle du forceps [1].
Le Comité National des Gynécologues obstétriciens Français (CNGOF) a défini l’échec de ventouse par « trois l–chages ou l’absence de progression fœtale après six tractions ».
Son taux d’échec est variable dans la littérature : Revah et al retrouvent un taux de 1 % en étudiant une série de 4103 ventouses mais ne précise pas la hauteur de la présentation dans l’excavation pelvienne lors de la pose de l’instrument [2]. Dans une autre étude, les chiffres atteignent 38 % (122 ventouses étudiées) [3].
Après un échec de ventouse, l’obstétricien peut soit poursuivre la voie basse en changeant d’instrument – aux risques que ce dernier échoue à son tour – ou réaliser une césarienne. En effet, le CNGOF indique que « l’usage séquentiel de deux instruments traduit une extraction difficile et multiplie les risques par rapport à la voie basse spontanée ou à l’extraction réalisée avec un seul instrument » mais également « qu’il n’y a pas d’argument dans la littérature pour recommander un forceps ou une césarienne après un échec de ventouse. Le choix devant être adapté au cas par cas selon l’expérience de l’opérateur » [4].
L’objectif principal de cette étude était de comparer la morbidité maternofoetale chez les patientes ayant accouché par césarienne versus tentative de deuxième instrument après un échec de ventouse.
L’objectif secondaire était de décrire le devenir des fœtus nés par césarienne après échec de deuxième instrument.
2. Méthodes
2.1. Schéma de l’étude
Nous avons mené une étude rétrospective dans une maternité de type III entre le 1er janvier 2006 et le 31 décembre 2014 comparant deux groupes de patientes : césarienne d’emblée versus tentative d’un deuxième instrument après échec d’extraction par ventouse.
Traducere - engleză 1. Introduction
The vacuum extractor has become the most frequently used device for operative vaginal delivery in French university hospital centres, one of the reason being that it entails a shorter learning curve than the use of forceps [1].
The National College of French Gynaecologists and Obstetricians (CNGOF) has defined failed vacuum-assisted vaginal delivery as "three failed attempts or failure to progress after six tractions".
Its failure rate varies in the literature: Revah et al. found a rate of 1% in a series of 4,103 vacuum-assisted vaginal deliveries, but does not specify the height of fetal head presentation in the pelvic cavity when the device is placed [2]. In another study, the rate is up to 38% (122 vacuum-assisted vaginal deliveries studied) [3].
After a failed vacuum-assisted vaginal delivery, the obstetrician can either continue to pursue vaginal delivery, by changing the device - risking to fail again - or perform a c-section. Indeed, CNGOF indicates that sequential use of two devices reflects a difficult extraction and multiplies the risks compared to spontaneous vaginal delivery or extraction performed using a single device but also that the literature does not provide enough evidence to recommend use of forceps or caesarean delivery after failed vacuum-assisted vaginal delivery. The choice must be made on a case by case basis, depending on obstetrician's expertise" [4].
The primary endpoint of this study was to compare maternal and neonatal morbidity in patients having delivered by c-section versus attempted delivery using a second device after failed vacuum-assisted vaginal delivery.
The second endpoint was to describe the outcome of the fetus delivered by c-section after failure of a second device.
2. Methods
2.1. Outline of the study
We conducted a retrospective study in a tertiary maternity centre between 1st January 2006 and 31st December 2014 comparing two groups of patients: scheduled c-section versus attempted delivery using a second device after failed vacuum-assisted vaginal delivery.
din franceză în engleză: Anti-TNF alpha-induced eruptive nevi: Three cases General field: Medical Detailed field: Juridic (general)
Text sursă - franceză Discussion
Les nævus éruptifs sont un phénomène rare caractérisé par l’apparition rapide de nombreux nævus. Les étiologies en sont l’immunosuppression, les thérapies ciblées, les maladies bulleuses auto-immunes, toxiques ou génétiques ou les stimulants de la mélanogenèse. Ils se différencient du développement de nævus acquis, progressif, fait de nævus « classiques » comme il peut être observé chez le patient immunodéprimé [22].
Récemment, des critères diagnostiques ont été proposés pour différencier les nævus éruptifs associés aux médicaments de l’augmentation du nombre de nævus chez le patient immunodéprimé. Ces critères comprennent le développement de un ou plusieurs des éléments suivants pendant une période de 6 mois, en association à la prise de médicaments :
plus de 5 nævus palmoplantaires à tout –ge ;
plus de 10 nævus sur tout le corps en dehors de la puberté et de la grossesse ;
plus de 20 nævus pendant la puberté ou la grossesse [1].
Ces critères, bien que non validés « à grande échelle », sont respectés pour nos trois patients.
Deux grands mécanismes semblent impliqués dans la genèse des nævus éruptifs, comme le soulignent les différentes étiologies : le premier favoriserait la prolifération mélanocytaire soit par action directe comme avec le mélanotane [12,13], soit par phénomènes cicatriciels chroniques comme dans les dermatoses bulleuses [10—12], soit par action sur les voies intracellulaires de la croissance et de différenciation cellulaire comme observé avec les thérapies ciblées [6—9]. Le second serait l’immunodépression, comme en témoignent les nævus éruptifs chez les transplantés, dans les déficits immunitaires, ou les patients sous chimiothérapie [1,3—6]. Ce second mécanisme est probablement celui qui explique ce phénomène avec les anti-TNF-alpha, la rareté du phénomène avec ces biothérapies étant probablement liée au faible niveau d’immunodépression engendré.
Cinq observations de nævus éruptifs associés à la prise d’anti-TNF alpha ont déjà été rapportées (Tableau 1). Dans quatre cas, il s’agissait de patients souffrant de maladie de Crohn et recevant de façon concomitante un autre traitement (azathioprine, 6-mercaptopurine) connu comme potentiellement inducteur de nævus éruptifs [18—21]. Dans une seule observation, il s’agissait d’un patient recevant de l’étanercept en monothérapie pour un psoriasis. Ce même patient avait développé préalablement une première poussée de nævus éruptifs sous alefacept [18]. Dans nos trois nouvelles observations, les patients recevaient en monothérapie un anti-TNF alpha en première ligne. L’imputabilité intrinsèque et extrinsèque de ces traitements est donc forte. Ces observations montrent que les nævus éruptifs peuvent apparaître avec les différents anti-TNF alpha, quels que soient le sexe du patient et ses pathologies sous-jacentes, dermatologiques, digestives ou rhumatologiques.
Traducere - engleză Discussion
Eruptive naevi are a rare phenomenon characterised by rapid appearance of numerous naevi. Among the etiologies are immunosuppression, targeted therapies, autoimmune, toxic or genetic bullous diseases or melanogenesis stimulating agents. Their development differs from the acquired, progressive naevi, classical naevi, as observed in immunocompromised patients [22].
Recently, diagnostic criteria have been proposed for differentiating the eruptive naevi associated with drugs [intake] from the increase in the number of naevi in immunocompromised patients. These criteria include the development of one or several of the following elements over a period of 6 months, in association with drugs intake:
" more than 5 palmoplantar naevi at any age;
" more than 10 naevi on the entire body, except during puberty and pregnancy;
" more than 20 naevi during puberty or pregnancy [1].
Although not validated on large scale, these criteria were respected in [diagnosing] our three patients.
Two major mechanisms seem to be involved in the appearance of eruptive naevi, as stressed by the various etiologies: the first involves promotion of melanocytes proliferation, either by direct action, as in case of melanotan intake [12, 13], by chronic scarring phenomena, as in case of bullous dermatoses [10-12], or by acting on the intracellular pathways of cell growth and differentiation, as observed in case of targeted therapies [6-9].The second [mechanism] is immunosuppression, as evidenced by the eruptive naevi in transplant patients, [patients suffering from] immune deficiency, or patients receiving chemotherapy [1, 3-6].This second mechanism is probably explaining this phenomenon related with anti-TNF alpha [therapy]; the rarity of the phenomenon [associated] with these biotherapies is probably related to the low level of induced immunosuppression.
Five cases of eruptive naevi associated with anti-TNF alpha intake have already been reported (Table 1). Four cases involved patients suffering from Crohn's disease, concomitantly receiving another treatment (azathioprine, 6-mercaptopurine), known as potential inducer of eruptive naevi [18-21].Only one case involved a patient receiving monotherapy with etanercept for psoriasis. This patient previously developed a first outbreak of eruptive naevi under alefacept [18].In the three cases reported by us, the patients were receiving monotherapy with anti-TNF alpha, as first-line therapy. Therefore, the intrinsic and extrinsic causation score is high for these treatments. These cases show that eruptive naevi can appear with different anti-TNF alpha, regardless of the patients sex and underlying dermatological, gastrointestinal or rheumatic diseases.
din italiană în engleză: A case of severe isolated left main coronary artery stenosis in a young woman with previous history of non-Hodgkin lymphoma General field: Medical Detailed field: Terenuri = Imobiliare
Text sursă - italiană CASO CLINICO
Riportiamo il caso di una paziente di 34 anni giunta alla nostra osservazione per la comparsa da circa 4 mesi di dispnea da sforzo (classe NYHA II) ed intensa astenia. I dati anamnestici evidenziavano una storia di linfoma non-Hodgkin a sede mediastinica, insorto all’età di 16 anni e trattato con ripetuti cicli di radioterapia locoregionale e chemioterapia.
Il protocollo utilizzato prevedeva una dose totale radiante di 30 Gy, mentre lo schema farmacologico consisteva nella somministrazione di 6 cicli di chemioterapia con regime ABVD (doxorubicina, bleomicina, vinblastina, dacarbazina).
In anamnesi, inoltre, due gravidanze all’età di 30 e 33 anni, entrambe associate a preeclampsia. I fattori di rischio cardiovascolare tradizionali erano costituiti da ipertensione arteriosa, obesità moderata (indice di massa corporea 26 kg/m2) ed ipotiroidismo. Dopo la comparsa dei sintomi, la paziente si sottoponeva ad accertamenti cardiologici di primo livello. L’ECG a riposo non mostrava alterazioni di carattere ischemico; l’ecocardiogramma transtoracico evidenziava una moderata insufficienza mitralica, in assenza di anomalie della cinetica regionale e della funzione contrattile globale. Il test ergometrico, condotto fino a stadio massimale, era positivo per ischemia inducibile per soli criteri elettrocardiografici. Ad ottimizzazione diagnostica, in considerazione anche della giovane età della paziente, veniva eseguito un eco-stress farmacologico mediante dipiridamolo che mostrava un’ipocinesia inducibile a livello della regione apicale del ventricolo sinistro.
La paziente veniva ricoverata presso il nostro reparto per essere sottoposta a studio coronarografico mediante accesso radiale destro. L’angiografia coronarica mostrava una stenosi focale critica ostiale del tronco comune della coronaria sini stra, restante circolo coronarico indenne da stenosi angiograficamente critiche (Figura 1).
Dopo discussione collegiale del caso in sede di Heart Team, si è preferita una strategia di rivascolarizzazione percutanea, in considerazione sia della lesione isolata ma anche in relazione alle difficoltà tecniche derivanti dalle possibili aderenze toraciche, sequele a lungo termine della pregressa radioesposizione. La procedura di rivascolarizzazione percutanea è stata eseguita mediante predilatazione della lesione e successivo impianto di stent medicato all’everolimus 3.5 x 15 mm (Xience, Abbott Vascular, Abbott Park, IL, USA), completata da successiva post-dilatazione ed ottimizzazione finale mediante “kissing balloon” (Figura 2).
Il controllo post-procedurale eco-guidato mostrava una buona espansione dello stent ed un’ottimale copertura della lesione. Il decorso ospedaliero è stato privo di eventi, non complicanze vascolari significative.
La paziente è stata dimessa in quarta giornata, per permettere un adeguato monitoraggio clinico-strumentale, in ottime condizioni generali e completo benessere clinico. Il controllo ecocardiografico pre-dimissione ha evidenziato una funzione sistolica globale conservata. Il follow-up clinico-strumentale a 6 mesi risultava regolare; al controllo ecografico, riscontro di funzione ventricolare sinistra conservata.
Traducere - engleză CLINICAL CASE
We report the case of a 34-year-old female patient consulted for exertional dyspnoea (NYHA class II) and severe asthenia appeared about 4 months before. Her medical history included mediastinal non-Hodgkin lymphoma appeared at the age of 16 and treated with repeated cycles of locoregional radiotherapy and chemotherapy.
The protocol used involved a total radiation dose of 30 Gy and the chemotherapy consisted in the administration of 6 cycles of ABVD regimen (doxorubicin, bleomycin, vinblastine, dacarbazine).
Clinical history also included two pregnancies at 30 and 33 years of age, both associated with preeclampsia. The traditional cardiovascular risk factors included arterial hypertension, moderate obesity (BMI 26 kg/m2) and hypothyroidism. After onset of symptoms, the patient underwent first line cardiac screening. Resting ECG did not show ischaemic type abnormalities; transthoracic echocardiogram showed a moderate mitral regurgitation, without regional abnormalities regarding wall motion and overall contractile function. The ergometric [stress] test, performed up to maximum mechanical stress level, was positive only for stress-induced ischaemia electrocardiographic criteria. Considering the young age of the patient, a dipyridamole stress echo was performed in order to optimize the diagnosis, which showed induced hypokinesis in the apical region of the left ventricle.
The patient was admitted to our Department to undergo coronary angiography using right radial artery access. The coronary angiography found focal critical ostial stenosis of the left main coronary artery, the rest of the coronary circulation being free from agiographically critical stenosis (Figure 1).
Taking into consideration the isolated lesion and the technical difficulties related to possible thoracic adhesions, long-term sequelae of previous radiation exposure, percutaneous revascularization strategy was chosen after discussing the case with the multidisciplinary team at the Heart Team office. The percutaneous revascularization was performed by pre-dilation of the lesion and subsequent implantation of everolimus-eluting-stent 3.5 x 15 mm (Xience, Abbott Vascular, Abbott Park, IL, USA), completed by post-dilation and final optimization through kissing balloon (Figure 2).
The ultrasound-guided post-surgery checkup showed a good expansion of the stent and optimal coverage of the lesion. The hospital stay was uneventful, without significant vascular complications.
The patient was discharged on the fourth day after ensuring adequate monitoring using special equipment or instruments, in excellent general health condition and overall clinical well-being. The pre-discharge echocardiographic follow-up showed preserved overall systolic function. The six months follow-up using special equipment or instruments was unremarkable; the ultrasound checkup found preserved left ventricular function.
din română în engleză: International child abduction General field: Legislaţie/Brevete Detailed field: Geografie
Text sursă - română In concluzie, pentru toate aceste considerente, parata a solicitat respingere a cererii de chemare in judecată ca neîntemeiată.
In drept, întâmpinarea a fost întemeiată pe dispozițiile Legii nr. 369/2004. Convenția de la Haga din 1980. Raportul Explicativ Perez-Vera, Legea nr. 272/2004.
In dovedire a solicitat administrarea probei cu înscrisuri, a probei testimoniale cu martorul PCVxx, expertiză judiciara având ca obiect evaluare psihologica a părinților și a copiilor.
La ședința din data de 18. 04. 2024, reclamatul a depus răspuns la întâmpinare, prin care arata ca majoritatea susținerilor din întâmpinare nu sunt utile și concludente într-o cauza având ca obiect răpire internațională. Arata ca atât deplasarea, cat și retinerea minorilor in Romania s-au realizat fără acordul reclamantului.
Mentionează ca, interesul superior al copilului, in cadrul procedurii analizate, vizează reintegrarea acestuia in mediul obișnuit de viată, fară a pune in dezbatere dreptul privind încredințarea copilului către un părinte sau altul.
Considera ca parata și-a premeditat plecarea, prin faptul ca și-a asigurat contextul nefavorabil invocat prin prezentarea situației intolerabile, și arata ca in prezenta cauză nu este incidenta nicio situație de excepție prevăzută de art. 13 din Convenție.
Analizând actele și lucrările dosarului, retine următoarele:
in fapt, minorii CATxx și CADxx sunt fii reclamantei și a paratului. Minorii s-au născut și au locuit in Irlanda pana in luna octombrie 20xx când au venit in Romania cu mama, fără acordul tatălui. (f. 60. 61, 95. 96)
Minorii au fost înscriși la scoală in Irlanda pana in luna octombrie 20xx când au venit in Romania.
Traducere - engleză In conclusion, for all these reasons, the Respondent asked that the Application be dismissed as unfounded.
De jure, the Statement of Defence was based on the provisions set out by Law No. 369/2004, 1980 Hague Convention, Perez-Vera Explanatory Report, Law No. 272/2004.
In support of the foregoing, the Party asks to admit into evidence the documents on file, the testimonial evidence presented by the witness PCVxx, the forensic expert's report on the psychological evaluation of the parents and children.
At the hearing of 18.04.2024, the Applicant submitted a Reply to the Defence, in which he stated that most of the allegations presented in the Statement of Defence are not useful and conclusive in a case concerning international abduction. He states that both the removal and the detention of the minors in Romania were carried out without the Applicant's consent.
He states that the best interests of the child, in the context of the proceedings under consideration, are aimed at reintegrating the child into the normal living environment, without calling into question the right to entrust the child to one of the parents.
He considers that the Respondent premeditated her departure by ensuring the adverse context invoked by presenting the intolerable situation, and points out that no situation of exception provided for in Article 13 of the Convention applies in the present Case.
Analysing the documents and the proceedings in this matter, he retains the following:
De facto, the minors CATxx and CADxx are the Applicant’s and the Respondent’s children. The minors were born and lived in Ireland until October 20xx when they travelled to Romania with their mother, without the father’s consent. (page 60, 61, 95, 96)
The children were enrolled in school in Ireland until October 20xx, date of their travel to Romania.
din italiană în engleză: Hague Protocol of 23.11.2007 on substantive law governing maintenance obligations General field: Legislaţie/Brevete Detailed field: Geografie
Text sursă - italiană OGGETTO: domanda proposta ai sensi dell’art.56 par.1 lett. a) e b) Reg. CE 4/2009 da Gxx nei confronti di Dxx.
Egregio Avvocato,
letta la Sua comunicazione dell’11.1.2023, si fa presente che l’art.4 par. 3 del Protocollo de L’Aja del 23.11.2007, il quale individua la legge sostanziale di disciplina delle prestazioni alimentari, è applicabile esclusivamente nei giudizi di cognizione aventi a oggetto la liquidazione di obbligazioni di mantenimento.
Pertanto tale regime non può operare nelle procedure di esecuzione forzata di un titolo già disponibile, le quali sono sottoposte alla legislazione dello Stato in cui viene promossa l’azione esecutiva.
La pretesa esercitata in executivis dalla parte Sua assistita è quindi sottoposta all’art. 21 n. 4 Reg. CE 4/2009, applicabile alla fattispecie in via diretta e non analogica.
Permane così invariata, per le ragioni illustrate nella precedente corrispondenza, la necessità di acquisire la normativa irlandese in materia di prescrizione, la cui trasmissione è stata nuovamente sollecitata aII’Autorità centrale estera con nota separata a Lei inviata per conoscenza.
Le informazioni che perverranno al riguardo Le saranno prontamente rese note.
Distinti saluti.
Traducere - engleză SUBJECT: Application submitted by Gx against Dx pursuant to Art. 56 (1), letter a) and b) of the EC Regulation. CE 4/2009.
Dear Madam,
Having read your communication of 11.1.2023, please note that Art.4(3) of the Hague Protocol of 23.11.2007, which identifies the substantive law governing maintenance obligations, is applicable only to proceedings ascertaining the disputed legal standing for the settlement of maintenance obligations.
Therefore, such regime cannot be applied in the proceedings for the enforcement of a title already granted, which are subject to the law of the State in which the enforcement action is brought.
The claim exercised in executivis by the party assisted by you is therefore subject to Art. 21 No. 4 EC Reg. 4/2009, which is applicable in this case directly and not by analogy.
Thus, for the reasons explained in the previous correspondence, the need to obtain the Irish legislation on prescription, which was again requested from the Foreign Central Authority by a separate correspondence sent to you for information purposes, remains unchanged.
Any information received on this matter will be promptly made available to you.
Yours sincerely,
din italiană în engleză: Electronic controller, version 2.2 of the Xchiller software General field: Altele Detailed field: Economie
Text sursă - italiană Versione software del controllore elettronico
Le funzioni del controllore elettronico indicate di seguito si riferiscono alla versione 2.2 del software xchiller
Consultare la sezione 18.5.8.13 “*” a pag. 106.
Livellostato
(Comando di marcia della pompa del circuito secondario)
(Consenso alla marcia della pompa del circuito secondario)
(Stato della protezione termica della pompa del circuito secondario)
Il display visualizza in tempo reale i dati relativi alle pompe di circolazione del circuito secondario:
Stato della pompa
I possibili stati operativi della pompa possono essere:
(In funzione, in modalità automatica in base alle condizioni del sistema)
(In funzione, in modalità forzata indipendentemente dalle logiche di controllo)
(In funzione, in modalità manuale)
In arresto, in modalità automatica in base alle condizioni del sistema)
(In arresto, in modalità forzata indipendentemente dalle logiche di controllo)
Esclusa dal funzionamento
(Modalità di gestione della pompa come descritto nella sezione 18.6.10 “Impostazione della modalità di funzionamento della pompa di circolazione del circuito secondario ” a pag. 119
espresso in ore e minuti
Modalità di gestione della pompa come descritto nella sezione 18.6.9 “Setting the operating mode of the circulation pump” a pag. 118
In funzione, il conteggio del tempo minimo di funzionamento è in corso per tutti compressori attivi
In funzione, in modalità forzata indipendentemente dalle logiche di controllo
In arresto, perché il conteggio del tempo minimo di arresto è in corso per tutti i compressori disponibili
(In arresto, in modalità forzata indipendentemente dalle logiche di controllo
Impostazione del formato dell’ora e delle unità di misura
Il display visualizza le impostazioni per il formato dell’ora e delle unità di misura:
Premere * per rendere editabile il campo Date Format
Premere * oppure * per scegliere il formato dell’ora DMY (giorno/mese/anno) o MDY (mese/giorno/anno) e confermare con * .
Premere * per selezionare Temp. Unit O e confemare con .
Verificare l’avvenuta esecuzione corretta del comando mediante la comparsa del messaggio di conferma “SUCCESS”
Marcia forzata della pompa di circolazione del circuito secondario (new section)
Premere * per confermare Show Oper.Data.
Il display visualizza in tempo reale i dati del circuito secondario.
Premere * per accedere alla schermata successiva.
Il display visualizza in tempo reale lo stato della pompa di circolazione del circuito secondario
Premere * per rendere editabile il campo Mode
Premere * oppure * per modificare da Mode AUTO a
Mode MAN P1 (Marcia forzata della pompa 1) e confermare con * . La pompa selezionata si aziona. Dopo aver ultimato le operazioni di manutenzione, ripristinare la modalità di funzionamento in Mode AUTO.
Impostazione della modalità di funzionamento della pompa di circolazione del circuito secondario (new section)
Premere * per confermare Second.Circ.Evap.Pump
Premere * per rendere editabile il campo Second.Circ.P.Op.Mod
Premere * oppure * per scegliere
RemoteCtrl (La pompa del circuito secondario è sempre attiva con il refrigeratore in marcia e se l’ingresso digitale “Richiesta pompa circuito secondario” è chiuso)
EvapPumpOn (La pompa circuito secondario è attiva quando la pompa evaporatore è attivata per forzature o cicli di servizio, indipendentemente dallo stato dell’unità)
e confermare con * .
Arresto della pompa di circolazione del circuito secondario
Malfunzionamento o guasto della pompa
Verificare che l’asse del motore giri liberamente, senza rumore o impedimenti
Controllare isolamento, fasi, tensione e corrente assorbita sui morsetti della pompa, eventualmente sostituire la pompa
Questo allarme è riferito alla pompa di circolazione del circuito secondario presente sul refrigeratore o eventualmente installata dall’azienda utilizzatrice sulla parte di impianto di sua competenza.
Il refrigeratore rimane in marcia.
Traducere - engleză Software version of the electronic controller
The functions of the electronic controller outlined below pertain to version 2.2 of the xchiller software
Refer to section 18.5.8.13 “*” on page 106.
Tank level indicator
(Secondary circuit pump run control)
(Secondary circuit pump run consent)
(Secondary circuit pump thermal protection status)
The display shows real-time data for the secondary circuit circulation pumps:
Pump Status
The following are the possible pump's operating states:
(Running, in automatic mode depending on the system's settings)
(Running, in forced mode bypassing control logics)
(Running, in manual mode)
(Stopped, in automatic mode depending on the system's settings)
(Stopped, in forced mode bypassing control logics)
Off
(Pump operating mode as described in section 18.6.10 “Setting the operating mode of the secondary circuit circulation pump” on page 119
expressed in hours and minutes
Pump operating modes as described in section 18.6.9, "Setting the operating mode of the circulation pump," on page 118
Running, the minimum runtime is being calculated for all active compressors
Running, in forced mode bypassing control logics
Stopped, as the minimum downtime is being calculated for all available compressors
(Stopped, in forced mode bypassing control logics
Setting the time format and measurement units
The display shows the settings for the time format and the units of measurement:
Press * to make the Date Format field editable
Press * or * to select the date format: DMY (day/month/year) or MDY (month/day/year), then confirm by pressing * .
Press * to select Evap. Unit O and confirm with .
Verify that the command has been executed correctly by checking for the “SUCCESS” confirmation message
Secondary circuit circulation pump in forced operation mode (new section)
Press * to confirm Show Oper.Data.
The display shows real-time data for the secondary circuit.
Press * to access the next screen.
The display shows real-time data for the secondary circuit circulation pumps
Press * to make the Mode field editable
Press * or * to change from Mode AUTO to
Mode MAN P1 (Pump 1 forced operation mode) and confirm with * . The selected pump is activated. After completing maintenance operations, reset the operation mode to Mode AUTO.
Setting the operating mode of the secondary circuit circulation pump (new section)
Press * to confirm Second.Circ.Evap.Pump
Press * to make editable the field Second.Circ.P.Op.Mod
Press * or * to choose
RemoteCtrl (The secondary circuit pump remains active whenever the chiller is operating and the ‘Secondary circuit pump request’ digital input is off)
EvapPumpOn (The secondary circuit pump is active when the evaporator pump is activated due to forced operation mode or service cycles, regardless of the unit’s operational status)
and confirm with * .
Secondary circuit circulation pump stop
Malfunction or failure of the pump
Check that the motor shaft turns freely, without noise or hindrance
Check insulation, power phases, voltage and current draw at pump terminals, replace pump if necessary
This alarm pertains to the secondary circuit circulation pump located on the chiller or, where applicable, installed by the end-user company on the section of the system under its responsibility.
The chiller continues to run.
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