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This paper focuses on seismic fragility and damage scenario assessment of minor Italian historical centres through the development of urban fragility curves. With reference to the case study of Balvano, a small centre located in Basilicata Region of Italy, two hybrid models have been adopted. The first is a mechanic-based hybrid model developed by the authors to derive urban fragility curves specifically; the second is the macroseismic method, originally conceived to derive typological fragility curves for single building classes, expanded to derive urban fragility curve herein. Balvano was strongly struck by 1980 Irpinia-Basilicata earthquake (Ms = 6.90) and hence subjected to an intense reconstruction process during 1980s, where almost the 80% of the buildings were reconstructed with reinforced concrete structures in the place of unreinforced masonry ones. Seismic vulnerability and damage scenarios before and after 1980 have been assessed and compared with the purpose of validating the effectiveness of the urban scale fragility curves obtained through hybrid methodologies and quantifying the effect of the 'new' seismic hazard maps and first seismic codes and recommendations released by the Italian Government in the aftermath of 1980 for the construction of new buildings or for retrofitting the existing ones. A good matching between predicted and occurred damage scenario from the research outcomes emerged, confirming the effectiveness of the urban scale hybrid fragility curves to assess seismic vulnerability at urban scale. Moreover, the comparison of the damage scenarios pre and post-reconstruction highlighted the crucial role played by the code prescriptions adopted in that years for reducing the seismic vulnerability of the municipality and the importance of the 'new' seismic hazard maps introduced in 1980s. Finally, the differences between mechanical-based hybrid and macroseismic model have been discussed in the paper. [ABSTRACT FROM AUTHOR]

A 61-year-old female underwent a right radical nephrectomy and a left nephron sparing surgery in 2014 due to renal cell carcinoma. A renal cell carcinoma local recurrence, 28 mm in size, centrally located in the left kidney was treated using cryoablation in 2016. In November 2018, computed tomography (CT) scan showed three nodules (maximum size 15 × 11 mm) in the left kidney, and CT-guided needle biopsy was performed. For multifocal recurrence and the anatomical site of these three nodules, a simultaneous reversible electrochemotherapy treatment was performed in April 2019. At 6-month CT control, no evidence of residual disease was found. Electrochemotherapy could be used to treat locoregional renal cell carcinoma recurrence when other ablative techniques are not suitable. LEVEL OF EVIDENCE: Level 4, Case Report. [ABSTRACT FROM AUTHOR]

Objective: To investigate the association between application of fundal pressure during the second stage of labor (Kristeller maneuver) and the risk of levator ani muscle (LAM) injury.Methods: This was a prospective case-control study of women recruited immediately after their first vaginal delivery in our university hospital between March 2014 and September 2016. Women who underwent the Kristeller maneuver were recruited as cases. For each case, a control (no Kristeller) was recruited matched for body mass index, use of epidural analgesia, duration of second stage of labor and birth weight. All women were invited to undergo four-dimensional (4D) transperineal ultrasound (TPU) 3-6 months postpartum. The main outcome measure was the presence of LAM avulsion on 4D-TPU. TPU results were compared between cases and controls. Multivariate logistic regression analysis was performed to identify independent risk factors for LAM avulsion.Results: During the study period, 134 women in the Kristeller maneuver group and 128 women in the control group underwent TPU assessment. Women who underwent the Kristeller maneuver had a higher prevalence of LAM avulsion than did controls (38/134 (28.4%) vs 18/128 (14.1%); P = 0.005). In addition, women in the Kristeller-maneuver group had a larger hiatal area on maximum Valsalva maneuver and a greater increase in hiatal area from rest to maximum Valsalva. On multivariate logistic regression analysis, use of the Kristeller maneuver was the only independent factor associated with LAM avulsion (odds ratio, 2.5 (95% CI, 1.29-4.51)).Conclusion: The Kristeller maneuver is associated with an increased risk of LAM avulsion when applied in women during their first vaginal delivery. This should be taken into account when deciding to use fundal pressure to accelerate the second stage of labor and when counseling women following childbirth. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR]

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