Global responsibility and strategic risk management

The emergence of a global business risk, caused by a more intense companies’ strategic and organizational complexity, leads both the researchers and the enterprises to a concept of a global responsibility as a paradigm for effective relationships with all stakeholders. This global concept of responsibility must include the areas of legal, economic, social and environmental commitment and suggests an integrated approach to risk management. The aim of this article is to propose a theoretical framework about the relations among stakeholders’ expectations, responsibility areas and risk management. By means of a qualitative analysis, the authors intend to suggest some reflections about the approach of some meaningful global companies towards their potential risks and the relationships with their stakeholders

Exposure to polychlorinated biphenyls and hexachlorobenzene, semen quality and testicular cancer risk

PURPOSE: We carried out a case-control study to investigate the possible role of occupational and environmental exposure to endocrine disruptors in the onset of testicular cancer (TC). METHODS: We evaluated 125 TC patients and 103 controls. Seminal fluid examination and organochlorine analysis were performed in all subjects. Cases and controls were also interviewed using a structured questionnaire to collect demographic information, residence, andrological medical history and dietary information. RESULTS: We found that a higher level of reproductive tract birth defects was associated with a higher risk of TC. With regard to diet, cases reported a higher consumption of milk and dairy products than controls. Overall, there was a statistically significant increase in TC risk in cases with detectable values of total polychlorinated organic compounds against controls (14.4 vs. 1.0 %; p < 0.001). TC patients with detectable levels of organochlorines had lower mean semen parameters than those with undetectable levels, although this difference was not statistically significant. CONCLUSION: The International Agency for Research on Cancer recently included dioxin-like polychlorinated biphenyls (PCBs) in Group 1 of known human carcinogens. Our study confirmed and identified various risk factors for testicular cancer: cryptorchidism, consumption of milk and dairy products, parents' occupation and serum concentration of hexachlorobenzene and PCBs and, for the first time, we showed the correlation between semen quality and the serum concentration of these pollutants

Intraluminal recanalization of long infrainguinal chronic total occlusions using the Crosser system

Purpose: To assess the safety and efficacy of a device for vibrational angioplasty in the percutaneous intraluminal recanalization of long infrainguinal chronic total occlusions (CTO). Technique: The Crosser CTO Recanalization System is a mechanical recanalization device that uses high-frequency vibrational energy to disrupt and channel through fibrocalcific plaque without harming the vessel wall, thus assisting in the recanalization of an occluded artery. In 12 diabetic patients (7 men; median age 71 years, range 58–80) with critical limb ischemia owing to long (median length 26 cm, range 21–32) infrainguinal CTOs resistant to conventional guidewire techniques, the Crosser CTO Recanalization System was successful in intraluminally crossing the occlusion in 9 (75%) patients in ,5 minutes (mean 4:03 minutes). The safety endpoint (distal lumen guidewire position with no vessel perforation or dissection) was achieved in all successful cases. Conclusion: In our preliminary experience, the Crosser CTO Recanalization Catheter decreased crossing time, was safe, and achieved a high rate of intraluminal recanalization of long infrainguinal CTOs. J Endovasc Ther. 2009;16:23–27 Key words: critical limb ischemia, chronic total occlusion, percutaneous interventions, infrainguinal occlusion, intraluminal recanalization, vibrational energ

Chronic Contained Rupture of an Abdominal Aortic Aneurysm: From Diagnosis to Endovascular Resolution

A male patient, 69 years old, presented with fever, leucocytosis, and persistent low back pain; he also had an abdominal aortic aneurysm (AAA), as previously diagnosed by Doppler UltraSound (US), and was admitted to our hospital. On multislice computed tomography (msCT), a large abdominal mass having no definite border and involving the aorta and both of the psoas muscles was seen. This mass involved the forth-lumbar vertebra with lysis, thus simulating AAA rupture into a paraspinal collection; it was initially considered a paraspinal abscess. After magnetic resonance imaging examination and culture of the fluid aspirated from the mass, no infective organisms were found; therefore, a diagnosisof chronically contained AAA rupture was made, and an aortic endoprosthesis was subsequently implanted. The patient was discharged with decreased lumbar pain. At 12-month follow-up, no evidence of leakage was observed. To our knowledge, this is the first case of endoprosthesis implantation in a patient, who was a poor candidate for surgical intervention due to renal failure, leucocytosis and high fever, having a chronically contained AAA ruptured simulatingspodilodiscitis abscess. Appropriate diagnosis and therapy resolved potentially crippling pathology and avoided surgical graftrelated complications. Keywords Abdominal aortic aneurysm Endoprosthesis implantation Vertebral erosio

Arrival of Paleo-Indians to the Southern Cone of South America: New Clues from Mitogenomes

With analyses of entire mitogenomes, studies of Native American mitochondrial DNA (mtDNA) variation have entered the final phase of phylogenetic refinement: the dissection of the founding haplogroups into clades that arose in America during and after human arrival and spread. Ages and geographic distributions of these clades could provide novel clues on the colonization processes of the different regions of the double continent. As for the Southern Cone of South America, this approach has recently allowed the identification of two local clades (D1g and D1j) whose age estimates agree with the dating of the earliest archaeological sites in South America, indicating that Paleo-Indians might have reached that region from Beringia in less than 2000 years. In this study, we sequenced 46 mitogenomes belonging to two additional clades, termed B2i2 (former B2l) and C1b13, which were recently identified on the basis of mtDNA control-region data and whose geographical distributions appear to be restricted to Chile and Argentina. We confirm that their mutational motifs most likely arose in the Southern Cone region. However, the age estimate for B2i2 and C1b13 (11–13,000 years) appears to be younger than those of other local clades. The difference could reflect the different evolutionary origins of the distinct South American-specific sub-haplogroups, with some being already present, at different times and locations, at the very front of the expansion wave in South America, and others originating later in situ, when the tribalization process had already begun. A delayed origin of a few thousand years in one of the locally derived populations, possibly in the central part of Chile, would have limited the geographical and ethnic diffusion of B2i2 and explain the present-day occurrence that appears to be mainly confined to the Tehuelche and Araucanian-speaking grou

Successful Coronary Stent Retrieval From a Pedal Artery

The purpose of this article is to report complications from a coronary drug-eluting stent lost in the peripheral circulation. We report the case of successful retrieval of a sirolimus coronary stent from a pedal artery in a young patient who underwent coronary angiography for previous anterior myocardial infarction. Recognition of stent embolization requires adequate removal of the device to avoid unwelcome clinical sequelae. Keywords Coronary stent Microsnare technique Peripheral embolization Stent retrieva

Kelp gull ( <i>Larus dominicanus</i> ) as a carrier of pathogens in the patagonian coast

En este trabajo se estudió el transporte de enterobacterias por parte de la gaviota cocinera (<i>Larus dominicanus</i>), en un sector de la costa patagónica. A lo largo de un año (1995-96), un total de 100 individuos de distinto sexo y clase de edad, fueron capturados en el basural pesquero de Puerto Deseado. A cada uno de ellos se le realizó un hisopado cloacal y el sexo fue determinado por disección en el laboratorio. El análisis bacteriológico fue realizado por medio de pruebas bioquímicas convencionales, determinándose la presencia de al menos 10 especies de enterobacterias pertenecientes a los géneros: <i>Escherichia, Proteus, Citrobacter, Salmonella, Hafnia, Shigella, Enterobacter y Yersinia</i>. No se hallaron diferencias en las tasas de prevalencia entre sexos y clases de edades. La presencia de patógenos, para el hombre ó el ganado, en el tracto intestinal de las gaviotas a lo largo del año no mostró grandes diferencias, salvo para Proteus, que tuvo un pico de presencia durante la primavera y el verano y Citrobacter, durante la primavera. Salmonella typhimurium representa la entero bacteria encontrada de mayor riesgo para el hombre y el ganado y fue registrada durante gran parte del año. Aunque en el presente estudio no se investigan las tasas de infección bacteriana en humanos o ganado, la abundancia de gaviotas cocineras, sus hábitos alimenticios y la ubicación relativa de la ciudad (entre las colonias y el basural), convierten a estas aves en un probable candidato como vector de patógenos. Palabras Claves: Gaviotas, Larus dominicanus, enterobacterias, basurales, residuos, PatagoniaIn this paper we analyzed the carriage of pathogens by Kelp gulls (Larus dominicanus) in a portion of the Patagonian coast. During one year (1995-96), 100 individual s of different sex and age class were caught at fisheries tip of Puerto Deseado. Faecal samples were obtained from individual birds by cloacal swab and sex was determined at laboratory by dissection. We registered at least ten species of bacteria of eight genus (Escherichia, Proteus, Citrobacter, Salmonella, Hafnia, Shigella, Enterobacter and Yersinia), using standard biochemical technics. There were no differences in carriage rates between sexes and age classes. Camage rates were similar over almost all year, but Citrobacter was more abundant during Spring and Proteus during Spring and Summer. Salmonella typhimurium represents the more risky species for cattle and humans and it was found during most of the year. Despite this study was not focused to investigate the infection rates in humans or cattle, the abundance of kelp gulls, its pattems of feeding and movements, the relative location of the city (between fisheries tip and breeding areas), makes the species a very likely candidate for a pathogens vector

The "Safari" technique to perform difficult subintimal infragenicular vessels

The purpose of this study was to describe the efficacy of planned combined subintimal arterial flossing with antegrade– retrograde intervention (SAFARI) to obtain the precise recanalization of the patent portion of a distal runoff vessel in critical limb ischemia (CLI) patients presenting long occlusions involving the popliteal trifurcation. Four patients at risk of limb loss due to long occlusions involving the leg vessel tree and not suitable for a surgical bypass were treated by the subintimal antegrade and retrograde (posterior tibial or anterior tibial artery) approach. The patent portion of the runoff vessel was previously assessed by magnetic resonance angiography (MRA) and directly punctured under Doppler ultrasound (US) guidance. A subintimal channel rendezvous was performed to allow snaring of the guidewires. Subsequently, a balloon dilatation was performed without stent deployment. All patients were successfully recanalized and had complete healing of the limb lesions. At the 12-month follow-up all patients showed clinical improvement with no major complications related to the procedure. This combined antegrade and retrograde subintimal approach is currently an excellent endovascular option in patients with long occlusions extending onto the leg vessels trifurcation and at risk of limb loss. Key words: Critical limb ischemia—Subintimal technique— Popliteal branches—Retrograde acces

Standard monomial theory for wonderful varieties

A general setting for a standard monomial theory on a multiset is introduced and applied to the Cox ring of a wonderful variety. This gives a degeneration result of the Cox ring to a multicone over a partial flag variety. Further, we deduce that the Cox ring has rational singularities.Comment: v3: 20 pages, final version to appear on Algebras and Representation Theory. The final publication is available at Springer via http://dx.doi.org/10.1007/s10468-015-9586-z. v2: 20 pages, examples added in Section 3 and in Section

Recanalization of the Native Artery in Patients with Bypass Failure

Our objective was to evaluate the possible role of endovascular recanalization of occluded native artery after a failed bypass graft in the case of either acute or chronic limb-threatening ischemia otherwise leading to amputation. In a single-center retrospective clinical analysis, from January 2004 to March 2007 we collected 31 consecutive high-surgical-risk patients (32 limbs) with critical limb ischemia following late ([30 days after surgery) failure of open surgery bypass graft reconstruction. All patients deemed unfit for surgery underwent tentative endovascular recanalization of the native occluded arterial tract. The mean follow-up period was 24 (range, 6–42) months. Technical success was achieved in 30 (93.7%) of 32 limbs. The cumulative primary assisted patency calculated by Kaplan–Meyer analysis was 92% and 88%, respectively, at 12 and 24 months. The limb salvage rate approached 90% at 30 months. In conclusion, our experience shows the feasibility of occluded native artery endovascular recanalization after a failed bypass graft, with optimal results in terms of midterm arterial patency and limb salvage. Our opinion is that successful recanalization of the arterial tract previously considered unsuitable for endovascular approach is allowed by improved competency and experience of vascular specialists, as well as the advances made in catheter and guidewire technology. This group of patients would previously have been relegated to repeat bypass grafts, with their inherently inferior patency and recognized added technical demands. We recognize previous surgical native artery disconnection and lack of pedal runoff to be the main cause of technical failure. Keywords Native artery Bypass failure Endovascular recanalizatio