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Il percorso formativo come docenti di scuola elementare in didattica della matematica può essere fortemente influenzato da fattori di natura affettiva, che, a loro volta, risultano spesso legati ad esperienze scolastiche negative vissute con la matematica. Il progetto di ricerca-azione qui descritto ha approfondito proprio questo fenomeno, focalizzandosi sui futuri docenti di scuola elementare del Canton Ticino, con un duplice obiettivo: da un lato, progettare e implementare efficaci pratiche formative per lo sviluppo di atteggiamenti positivi verso la matematica e il suo insegnamento; dall’altro, studiare l’evoluzione di tali atteggiamenti nell’arco dei primi due anni della formazione. Sono stati sviluppati specifici interventi didattici e strumenti di osservazione che hanno permesso di rilevare e monitorare gli atteggiamenti degli studenti e di analizzare quali dimensioni – disposizione emozionale, senso di autoefficacia, visione della disciplina (Di Martino & Zan, 2011) – sono state più o meno influenti sul cambiamento di atteggiamento, e su quali componenti quindi la formazione può cercare di intervenire in modo più incisivo ed efficace.

The way we collect, store, and share dental records of our patients is rapidly becoming digital. Many programs have been designed to run on a single computer or local network to handle various tasks, so selecting a system can be complex; it can require high acquisition costs, update fees, and installation difficulties. The purpose of this article is to explain the architecture, characteristics, and advantages related to Web-based Management Software. In particular, this article describes the first Web-based Electronic Medical Record (DocSapiens.com), which is able to view and edit DICOM files directly online.

Two female and three male patients with acquired "tufted angioma" are presented. The age of these patients ranged from 10 to 62 years. Two lesions were sited in the head and neck region, two in the upper extremities, and one on the trunk. Clinically, the angiomatous lesions appeared as elevated plaques, flat lesions with papular and macular areas, or erythematous plaques with small nodules. In four cases a biopsy was done, and in one case the tumour was excised. Histologically, the neoplasms were characterized by irregularly distributed vascular tufts in the dermis, and, in one case, in the upper subcutis. The vascular tufts were composed of plump endothelial cells and spindle-shaped pericytes surrounded by crescent-shaped vascular spaces. The positive staining for CD 31 and for CD 34 and alpha-smooth muscle actin, and the negative staining of endothelial cells for factor VIII underline both the existence of two cellular components in tufted angioma and the immaturity of endothelial cells. Evidence of regular mitotic figures in two cases and increased proliferative activity in three out of four cases tested, emphasize the neoplastic nature of slowly growing tufted angioma. Benign tufted angioma is a distinct entity in the spectrum of capillary haemangiomas and must be distinguished from other vascular neoplasms.

Undue delay between hospital admission and the beginning or urgent operative procedures is considered as a major mortality risk for polytraumatized patients in any trauma center. As part of a quality control study at our institution (Kantonsspital, University of Basel), the time spent for early resuscitation and diagnostic procedures was therefore prospectively recorded in 20 patients (mean age 38 years) with a mean ISS of 26.9 (range: 13 to 43). Time spent in the resuscitation room averaged 31.4 min (range: 10 to 50 min). Conventional radiographic diagnostic procedures took 34.7 more min (range: 20 to 60 min). An additional CT scan was performed in 15 patients requiring 19.5 min per region (head/thorax/abdomen/spine). Four patients underwent angiography necessitating 28 more min (mean). Time elapsed between admission and arrival of the patient in the OR or the ICU respectively accounted for an average of 89 min (range 22 to 200 min). For comparable injury severities this interval was shorter during the day than during the night (77 and 103 min respectively). Diagnoses established during this period were both accurate and comprehensive, as detectable from the low rate of missed diagnosis (three minor fractures). Although our results match favorably with figures reported in the literature we feel that further improvements could be achieved by performing the conventional radiographic procedures simultaneously with the early resuscitation in the resuscitation room. At present time, for reasons of X-ray protection, this is not possible in our institution.

1927 medical helicopter transports were performed in Basle between 1986 and 1989. Of the total flights, 173 transports without patients and 186 incubator transports were excluded from the study. Treatment and transportation were provided for 1085 victims of trauma (70.2%) and 461 medical-surgical patients (29.8%), mostly with life-threatening conditions. 589 trauma patients were treated at the scene of accident and later transported by helicopter to a nearby medical center (54.3%). The 4.3% rate of negative emergency flights is low. Since introduction of the helicopter rescue system at Basle in 1975, scene flights have increased from 29% in 1984 to 46% in 1989. 47.4% of all patients were categorized as seriously ill or severely injured. 36.4% of all patients required intubation and assisted ventilation. Of the trauma patients, 54.3% involved scene-flights requiring in-field intensive therapy. Helicopter transport provides not only a rapid source of transportation, but also vital medical assistance at the scene of emergency. Transport generally occurs only after stabilization of vital functions. These factors contribute to the low mortality before return flights (3%) as well as during transport (0.3%). We conclude that early aggressive in-field intensive therapy can help to decrease both morbidity and mortality in emergency-care patients.

Circulating immune complexes and platelet associated immunoglobulins G (PAIgG) were measured in 14 clinically asymptomatic and 9 diseased HIV infected subjects and compared to their platelet counts in the peripheral blood. In both groups, circulating immune complexes were found to be increased even in the presence of normal platelet counts. Increased PAIgG levels were found in symptomatic HIV infected subjects, along with thrombocytopenia. This study indicates that the mere occurrence of circulating immune complexes is an insufficient finding for induction of thrombocytopenia. Either the molecular composition of the complexes is different in both patient groups, or the thrombocytopenia is induced by additional platelet damaging compounds, e.g. specific antiplatelet antibodies induced by the viral infection.

Blood loss during and after tonsillectomy was assessed in 80 patients, 40 of whom were treated with tranexamic acid. A statistically significant reduction of blood loss (28%) was observed in this group during operation. Later bleedings occurred only in 27.5% (control: 67.5%) and stopped after 2 h (mean of control: 5.6h). Bleedings in the tranexamic acid group were mild and scarcely required other hemostyptic treatment, while in the control group some patients had to be treated with etamsylate or fibrogen for a longer period to stop bleeding. Tranexamic acid appears to be an effective and well-tolerated agent for reduction of blood loss caused by local hyperfibrinolysis.

als Recitativ bearbeitet von C. von Blumenthal, Beilage: Umschlagetikette, abgelöst, Titel von der Umschlagetikette übernommen. Stark beschnitten