Document of uniqueness of the ULCOSAN medical device

ULCOSAN is a device used for treatment with oxygen of trophic injuries of the lower limbs.

This is a chamber that works in normobarism  but with a concentration of oxygen on a therapeutic basis.

It has a patent N. TV2007A000100 which covers the entire country.

The ULCOSAN brand name is registered

With Community Brand No 007086051 in classes 10 and 14

The owner of the patent and the Community brand

Is

Dr Paolo Madeyski

Transcribed herewith is the registration with the Ministry of Health

ULCOSAN has the CE certification quality guarantee System  No MED 25025 by CERMET.

There is another device called VITOSAN which also works with topical oxygen but which does not have the same structural features.

In any case the Vitosan device was covered by a patent which still (until 2012) belongs to Dr Paolo Madeyski.

It is hereby declared therefore that ULCOSAN is and can be the only device with the characteristics described and registered.

In faith  

  Paolo Madeyski

INFORMED CONSENSUS

GIVEN THAT

Oxygen is a comburent and does not cause fire but feeds the combustion of inflammable materials. During use oxygen comes out of the chamber; this could theoretically increase the degree of inflammability of the surrounding materials , (the danger is the same as that which can occur during common therapy with oxygen for respiratory insufficiency). Such emissions, consequent to the operation of supply of oxygen (3-5 LT/minute), do not significantly alter the concentration of oxygen in the external environment.

PRECAUTIONS

• Avoid absolutely the introduction in the oxygen therapy chamber of non fireproof materials or worse, gauzes soaked in ethyl alcohol,  diethyl ether or any other substance known to be inflammable on the label of its container.
• Avoid lighting open flames, smoking or using electrical equipment that could in some way emit sparks or produce short circuits

.

The device is absolutely independent of sources of energy

HAVING NOTED THE ABOVE-STATED INFORMATION AND AWARE OF THE PROMPT OBSERVANCE OF PRECAUTIONS BEFORE USE, THE INTERESTED PARTY AGREES TO UNDERGO A CYCLE OF LOCAL/TOPICAL  OXYGEN THERAPY By ULCOSAN

Place and date …………………….

                                                                                     SIGNATURE

REPORT ON THE SCIENTIFIC EFFECTIVENESS AND ECONOMIC ADVANTAGES OF TOPICAL/LOCAL NORMOBARIC OXYGEN THERAPY FOR THERAPY ON TROPHIC ULCERS OF THE LOWER LIMBS

The pathology: what we are speaking about

Vascular problems connected with arterial deficit and venous insufficiency at the expense of the  lower limbs constitute the main cause of trophic injuries of the lower limbs.

The causes of these injuries are in order of frequency:

• Venous insufficiency
• Arterial deficit
• Diabetes, trauma
• Decubitus
• Iatrogenic and neoplastic

Epidemiology: statistical frequency and numbers

This pathology represents a great problem both medical and socio-medical. It is estimated that in Italy this pathology affects 1.5% of the population and 5% of the population over 65 years old, with an approximate calculation of about two million individuals connected with the problem (P.D.L. N4409/2003). The distribution of this illness is strictly correlated as much to the ageing of the population as to the living conditions and the basic cultural level of the individuals potentially concerned.

An ill person with these  injuries, which by definition are chronic, is often incapable, suffering, depressed since this pathology makes his existence problematic, causes a reduction in the quality of life and weighs heavily on the family environment for the continuous need for assistance, accompanied by a slow and not well defined deterioration

The problem for  society: the costs

Ulcers of the lower limbs are among the pathologies that most greatly affect the health cost since:

• they are difficult to take care of as often their cause cannot be eliminated;
• their improvement depends on individual responses, age and the associated pathologies apart from the causes and contributory causes;

Costs can be :

1. direct (cures and materials used, departments and public services or those within the National Health Service, basic medicine,  integrated domestic assistance and homes for the elderly, costs of diagnoses.
2. Indirect with working days lost both by the patient and family members concerned and possible insurance costs.

And such costs apart from being chronic are increasing and will continue so given the ageing population

Current therapies available

THESE ARE:

• primary therapies aimed at resolving or improving the causes and the contributory causes (vasoactive medicines, diabetics, medicines that act on the viscosity of the blood, vasodilators  etc …) medicines and aids for the medication (creams, gauzes, bandaging, medicating aids etc ..) and medicines for complications (anticoagulants, antibiotics)
• surgical therapies aimed at cleansing injuries or repairing them (plastic surgery)
• oxygen therapy carried out in the hyperbaric chambers which give good results but are difficult to perform for their scarce availability and the general side-effects (organic and psychological) which limit use.

Socio-medical consequences of unsuitable treatment

The potentially negative outcome of insufficient treatment can have grave implications for the patient (infections, gangrene, amputations and in any case sanitary and relational complications) but also for the family (the life of the family, psychological effects and costs for assistance and help) and for the National Health System (greater costs for complications).

Current possible alternative therapy

In the last few years we have experimented with normobaric oxygen therapy applied locally, which as a traditional therapy of proven effectiveness but of empirical use is affirming itself as a therapy without any side effects, modest in cost, easy to use and within reach of everybody, with advantages both for the patient (excellent results) and for the National Health System (minimal costs as it can also be effected at home by non-medical people).

Difference in costs between oxygen therapy with a hyperbaric chamber and oxygen therapy with a normobaric chamber

Costs are calculated both for the patient and family and for the National Health System.

• For the patient and family this means costs tied to the transport of the patient to the Hyperbaric Chamber which on average takes half a day between journey and therapy time; it means transport of a live person and social costs for the work of one person for half a day.
• As regards the National Health System we must consider that the patient can be transported by public means (hospital or council) to the Hyperbaric Chamber and this transport implies the costs of the means of transport, the driver and paramedical personnel who by law must accompany them.

In any case the cost for the NHS is that tied to  the use of the structure accommodating the Hyperbaric Chamber; the Hyperbaric Chambers, except in a  few cases, are the property of private structures operating within the National Health Service.

Normally the structure running the Hyperbaric Chamber is paid €90 a sitting and  a cycle of 60 sittings is normally foreseen; these sittings are carried out for reasons contingent to the structure 5 days out of 7 (from Monday to Friday). The cost of €90 includes the use of the Hyperbaric Chamber, the medical and paramedical staff who must by law be present; to this must be added the cost of transport of  the patient which may be at the expense of the National Health Service or the family.

The cost of the Normobaric Chamber if treatment is carried out at home means resetting or cancelling the cost of transporting the patient.

Thus only the costs of the use of the Normobaric Chamber and the oxygen remain. The costs of medication and medical checks are in theory not varied  but in practice it will be shown that the type and modality of treatment can also reduce the costs of medication and of medical and paramedical staff.

The cost to the patient of the Normobaric Chamber currently used by us is €160 monthly + VAT (with 30 days use out of 30 per month) to which is added €90 of oxygen: to sum up €250 a month or a total of €8 per day.

The pro/therapy cost for the National Health Service is €90 per sitting with the Hyperbaric Chamber and would be just €8 with the Normobaric Chamber, which works out at a saving application/patient of €82 with further advantages such as:

• The saving of health service transport costs;
• Therapeutic continuity without interruption for 30 days per month in the tranquility of one’s own living environment and without trauma;
• The facility of widespread use with the possibility to reach all those eligible patients (200,000 calculated in Italy), who at present cannot be treated with oxygen because of the scarce availability of Hyperbaric Chambers in the country, (the latter used for about 80% to treat chronic ulcers).

It should be noted that at present  the number of patients  receiving therapy in the Hyperbaric Chamber for these pathologies varies between 20,000 and 30,000 per year in our country, this reduced number with respect to the 200,000 eligible cases is determined by limitations for medical side effects and for economic-social problems (availability of the Hyperbaric Chambers, distances, costs of transfers).

However the saving that can be made is even greater. In fact it can be seen (see Progetto di Legge N4409) that the greater costs are absorbed by the expense of the medical and paramedical personnel followed by the various costs of medication. In the case of topical/local* therapy with oxygen, the protocols reduce to the minimum the use of medical and paramedical personnel and the use of various medical aids (like medicated gauzes, antibiotics, creams etc…)  since it has been scientifically shown that:

Oxygen by topical/local* means:

• dries the injury, stimulates granulation of the tissues and incentivates vascularization
• the therapy can also be administered by a family member.

Further savings

COST OF PERSONNEL

• As regards the paramedic personnel (currently the greatest cost) assistance is reduced in collaboration with the doctor during the single surgery or domestic check-up which is recommended once every 15 days.
• The same applies for the medical or specialist personnel who check every 15 days how the pathology is going and judge its course.

COST OF MEDICATION

As regards medication this can be divided into simple medication, that which reduces the exudate and active medication which does not just protect the injury controlling the exudate but which contributes to the process of tissue regeneration.

The costs are variable and one is often induced to use medication with lower costs without considering that improvement or healing of an injury foresees further cost to the National Health Service.

The guidelines of the Royal College of General Practitioners of April 2000 in the U.K. suggest that health operators, even if there is not sufficient proof to recommend one medication rather than another, have to use medication which satisfies clinical demands, the costs and needs of the patient and the location of the injury.

In the same United Kingdom treatment is usually at home to reduce the expense to the National Health institutions.

Thus in the protocol of topical oxygen-therapy all this advice found in the guidelines for the treatment of these injuries is summarized, so that:

• The cost of the hospital and medical and paramedical personnel is reduced.
• Effective treatment in compliance with the patient and family is used with not just objective advantages (progress of the injury) but subjective (clear reduction of symptoms and so the well-being of the patient, at costs which are clearly lower than other treatment.
• Medication is simplified since no passive or active medication is used to reduce exudation and over-infection or to stimulate the tissue of granulation;  in fact  only simple medication is used physiologically with the advantage of cleansing the injury for better use of topical oxygen, leaving the same oxygen the task of reducing infection, exudation and stimulating the tissue of granulation.

In substance considerable savings are achieved on the health costs of medical and paramedical personnel and on the cost of medication.

Both these parameters and savings are difficult to calculate since at present there are no standardized protocols of diagnosis, therapy and assistance.

However it is easy to calculate a saving from 30 to 50% on the cost of medical and paramedical personnel and a greater saving of 50% as regards the cost of medicines.

To these savings should be added the saving calculated for the patient who uses the normobaric chamber with respect to the hyperbaric chamber.                                                     

M.P.SYSTEMS S.R.L.

Madeyski Dr Paolo

SCIENTIFIC ELEMENTS OF LOCAL OXYGEN THERAPY AND MEANS OF APPLICATION TO PATIENTS

Given that

Ulcers of the lower limbs constitute a frequent pathology (1% of the population and 3.5% of the population over 65 years)

It mainly affects the female population with a rapport of about 3 to 1.

It is a chronic invalidating illness where the therapy is not standardized and it presents both medical and social problems.

In fact the treatment has elevated problems, not only medical but particularly social and among these particular relevance must be attached to the cost to the patient, to the collective and the cost to the National Health System. 

Etiology of ulcerative injuries of the lower limbs

In outline they can be:

-phlebostatic: like complications of superficial venous sufficiency (varicose) or profound venous insufficiency (post-phlebitic syndrome)

-arterial (ischemic)

-diabetic

-Traumatic

-in  collagenopathy for causes intrinsic to the illness or for habitual cortisone therapy

Types of therapy available

Medical: which includes pharmacological treatment (general and local) and combined treatment given with medications and medicines.

Surgical: both to eliminate the causes and to deal with complications up to plastic surgery.

Hyperbaric Chamber: based on the principle of oxygen therapy in hyperbarism.

Comparable therapies

Local hyperbaric therapy represents the evolutionary stage of that used in the last thirty years for the treatment of different pathologies linked to circulatory deficit or infective pathologies.

The oxygen administered acts on the devitalized or, however, suffering  tissues  with a contact mechanism and through the action of the component dissolved in the blood in part linked to the hemoglobin, in part dissolved in the blood as a free component (the latter represents the active component of the substance).

In the general hyperbaric chamber an increase of environmental pressure (hyperbarism) is obtained while the concentration or partial pressure of oxygen remains unchanged.

All this determines an increase in the availability of oxygen on the part of  the tissues both as regards the contact component and that dissolved in the plasma.

There are side-effects that limit the use of the hyperbaric chamber. These are medical, personal and  social. They can be summarized as follows:

Medical: cardiovascular, respiratory and cochleovestibulary  illnesses

Personal : Psychological problems besides claustrophobia

Social: difficult availability (little or private), lack of bed-places, high costs of production and use and difficulty of hospital structure or of subjects at home in reaching the chamber with an increase in social and personal costs.

Oxygen therapy in normobarism

The solution to many problems of the hyperbaric chamber can be found in oxygen therapy in normobarism applied locally.

The main concept is that of enabling local application of the therapy performed in the hyperbaric chamber to pathologies of limited extension with the advantage of having absolutely no side-effects.

The concept of local normobaric  therapy applies empirically in the principles and applications in different general Surgery Departments aimed at vascular treatment and in dermatology departments.

The work is not in hyperbarism but in normobarism and therefore not all the body is introduced in the hyperbaric chamber  but just the part of the body requiring oxygen therapy.

Thus all the side effects are removed and both personal and social costs come down.

Differences

 In the chamber for local oxygen therapy the percentage of oxygen internally (in contact with the injury) is about 95%  compared with the 21-23% present in the general hyperbaric chamber. On the other hand the oxygen dissolved in the plasma increases to 2% volume with respect to the 6% which for the effect of hyperbarism is in the hyperbaric chamber. We obtain these values placing the  mask on the patient and giving oxygen with this via the nose and mouth.

In this way (minor oxygen dissolved in the plasma, but increase in oxygen in contact with the ulcer) a therapeutic effect is obtained not unlike that obtained in the traditional hyperbaric chamber, since reduced hyperbarism is compensated by the increase in availability of oxygen, (in many surgical and dermatological departments and surgeries this type of therapy has been applied for years in an empirical and non-standardized manner, the oxygen being supplied through a polyethylene tube connected to the source, the environment is created through a plastic bag closed around the limb being treated). Criticism that may be made to such a  therapy applied up to now was that of it being an empirical, artisan therapy: there was no precision regarding the concentration of oxygen, the concentration of humidity and the time taken was therefore subjective. And the there was a problem of image and aesthetics

The good results of the method led us to look for a more rational, repeatable and aesthetically pleasant application that  guaranteed at the same time concentrations of oxygen, degree of humidity, known pressure values with predictable times of use.

We are also aware that fundamental elements that obstruct the therapies of phlebostatic  ulcers and in general devitalized tissues are the reduction in tension of oxygen and the presence of exudate and necrotic tissue.

To resolve these difficulties optimization of oxygen therapy is being studied with the aid of active medicines introduced by nebulizer which reach the open injuries. Better oxygenation of the cells incentivated by medicines which act directly on the cell-cell mechanisms can be used in all devitalized tissues and also in diabetic injuries.

Advantages

• Elevated compliance
• Documented effectiveness
• Low cost of purchase and use
• Easy availability of therapy
• Absolute absence of side-effects
• Rapid training of personnel

CLINIC PROTOCOL

Recruitment of patients

1)     Patients with phlebostatic ulcers

2)     Patients with diabetic ulcers

Age: patients aged between 50 and 90 are eligible, sub-divided into classes

a)     Between 50 and 60 years

b)     Between 60 and 70 years

c)     Between 70 and 90 years

Sex : males are distinct from females

Accompanying pathologies: must be indicated on the prospectus with the medicines being taken

Correlated orfavoured  pathologies: must be indicated if there is a component

*arterial

*phlebostatic

*arterial and phlebostatic mix

*diabetic

*traumatic

*of collagen with associated cortisone therapy

Evaluation and controls

• Presence of necrotic tissue
• Ease of bleeding
• Quantity and composition of exudate
• Presence and type of pathogens
• PH of the injury
• Deterioration of gradient of O2
• Peripheral neurological damage (in particular for diabetic pathology)
•  Diameter of injury
• Depth of injury
• Incorrect handling of the illness
• Pain or burning or irritation of patient

Every 7 days the following data will be collected

1)     Variations in the quantity of secretion

2)     Variations in the type of secretion

3)     Pain of the patient

4)     Comfort of the patient

5)     Ease of bleeding

6)     Diameter of the injury

7)     Depth of the injury

8)     Tissue of granulation

Duration and method of treatment

• Variable depending on the pathology and the results and the course, (from two to six months), the data will be collected weekly and there will be an evaluation at between three and six months)
• The patient will have treatment daily 6 days out of 7
• The treatment will be for 1 or 2 hours per day (separated by 6 hours)
• The barometric pressure inside the chamber is not considered as it is not influential
• However one should evaluate the degree of humidity and the comfort of the patient depending on the degree of humidity which is varied adding water to the interior.

results acquired until today

Given that this concerns a chronic pathology the phlebostatic and the ischemic ulcer cannot reach definitive healing if the cause is not removed, thus a better quality of life must be aimed at; all cases treated have seen secretion diminish (100%), the subjective symptomatology improve (90%) while objective improvement has seen 85% of cases. In these a cleansing of the injury and a reduction of the diameter and marked evidence of the tissue of granulation have been noticed from the third day of application.

Over the course of the years we have experimented with extensive methods on the use of the device for the application of local normobaric therapy, on average dealing with 3 cases a week in our structure  (Casa di Cura Rizzola in San Donà di Piave) and these cases have been followed personally over time.

To this we add patients followed in other structures like Codivilla Putti in Cortina and private structures and hospitals in other parts of Italy:

The type of ulcers treated were the following:

phlebostatic ulcers

ischemic ulcers in ASO + mixed

 osteomyelitis

traumatic injuries

burns

microfractures

preparations for dermo-epidermal transplants or injuries requiring reconstruction

or patients who have undergone dermo-epidermal transplants

The chamber mod. CID 700/A and following models has been distributed to some hospital facilities and private nursing homes, and considering the ease of use (treatment of subjects can take place both in hospital and inside the home), in this last period we have developed a simplified portable model defined as for the home. This model can be hired  directly by the patient, who with the aid of  a family member can provide their own therapy in the tranquility of the home and with the continuity that only this facility of application can permit.

This experience is producing very positive results, both from the therapeutic point of view and from that of the comfort of the patient, all harmonized with an extremely low social cost, both for the patient and for the health service.

Conclusions

We maintain that use of the local chamber for oxygen therapy for local use, can be a useful instrument, of low cost and without side-effects for a significant number of subjects affected by various pathologies but in particular for those who present devitalized injuries of the lower limbs. The ease of application and the absence of risk during use (the machine is absolutely independent from the electricity supply, and the flow of oxygen from 3 to 5 LT a minute does not alter the percentage of this in the environment) make it suitable for the widest variety of applications both in hospital, in the ambulance and in the home

INDICATIONS OF PROTOCOL IN USING THE TOPICAL OXYGEN THERAPY CHAMBER AND FOR CONTINUING THERAPY ALSO IN THE POST HOSPITALIZATION PHASE

For correct application of this therapy with positive results the following should be considered:

a)     Indications

b)     Method of treatment

c)     Duration of treatment

d)     Evaluation of treatment

Indications

For all trophic injuries situated in the lower limbs which have solutions of continuity of  the skin, the main place is the leg. Injury to the thigh is rare since it has not been taken into consideration. Therapy is applied to injuries with various causes or contributory causes even if with varying results. For the following pathologies:

• Phlebostatic ulcers (frequent and with varying percentages of healing between 60 and 80% depending on contributory causes and associated pathological factors).
• Diabetic ulcers (diabetic foot). These injuries include both trophic injuries of skin and below-skin tissues and those with a relevant exposed bone. These injuries are frequent with percentages of healing which vary from 70% to 90%.
• Ulcers in arteriopaths. Not frequent. Lower results both subjectively and objectively.
• Traumatic injuries. Discreetly frequent with good results but which vary greatly for the associated  general and local conditions.
• Iatrogenic injuries and on a neoplastic basis. Rare with results varying greatly from case to case.

Method of treatment

The experience matured over the last few years has seen a modification in approach and the method of treatment of trophic ulcers in the lower limbs since:

• these injuries are chronic (apart from post-traumatic injuries).
• these injuries were treated in the course of their chronicity with various and varying methods depending on the health service operators.

We maintain that on the basis of the experience obtained and the general principles  we have shown the therapeutic course these directives can follow

1)     Precise indications, as far as possible, for oxygen therapy. These indications must be set by a doctor specializing in therapy, vascular therapy, dermatology, diabetology or by a doctor who has the experience and competence in this pathology and knowledge of the pathologies correlated to the etiology  of such injuries.

2)     The injury to benefit from the oxygen therapy must be cleansed. The cleansing can be done with simple medical cleansing or with surgical cleansing  removing scabs and necrotic tissue in such a way as to bring the oxygen into contact with the tissues with the possibility of granulation.

3)     The possibility of the oxygen therapy and the method of administration must be tested and evaluated by medical or paramedical personnel since the sensitivity to the dosage, the time and  the humidity are individual.

4)     The only substances used by medication are physiological solution for cleansing before and after the application of oxygen. Neither betadine nor  Vaseline medications are used nor whatever does not allow the passage of oxygen.

5)     If the injury is painful, besides increasing the humidity the injury can be bathed with marcaina or other local anesthetic.

The correct procedure in sequence is the following:

• Bandaging of the injury
• Cleansing with a wet gauze with fisiologic water (do not cover the injury with any medication)
• Introduction of the limb in the oxygen chamber
• Closing the same possibly above the knee
• Supplying the oxygen near the injury in accordance with the sensitivity of the patient with a flow between 3 and 4 LT a minute for 10 minutes and then at 2 LT a minute
• The total duration save for particular cases is one hour
• At the end carry out cleansing with a wet physiological gauze and then cover it with gauze with the same solution or with a local anesthetic if the injury is painful.

Duration of the treatment

The duration of the treatment per day is indicated by the doctor who sets the indication and follows the patient and the progress of the injury; in any case we advise the following directives:

• The treatment must be followed daily
• It is preferable to carry out two applications a day, each for one hour.

Improvement is noted generally after 10-15 days and becomes evident on the third week of application; each case, however, presents individual variables given by the subject who presents etiological factors and accompanying variable pathologies.

There are no side-effects even for the treatment, even for 4 hours per day, from the experience of several cases for which the therapy for this duration  was prescribed.

Evaluation of the results

It is useful and should be the case that the injury is photographed at the moment of the first visit and before surgical or medical cleansing.

The injury will then be photographed at regular intervals decided by the medical team.

With the right software the diameters of the injury, the depth, the surface and its circumference can be measured. With the same software one can carry out and register the graphics that  show the behaviour of the injury and the effectiveness or otherwise of the therapy.

On one card it is advisable to note the objective variations but also the subjective impressions that refer to the patient.

Taken into consideration are:

–       The patient’s data

–       The causes

–       The contributory factors

–       Associated pathologies

–       Medicines in use

–       The birth and duration of the injury

–       Symptoms declared by the patient

–       Secretion

–       The characteristics of the injury and the granulation tissue

Possibility of treating the patient at home

The peculiarity of oxygen applied locally, are identifiable, in the absence of side-effects, in the low cost, the simplicity of application, but above all in the need for a certain duration and continuity (this therapy produces better results after about three weeks of regular application). The duration of the therapeutic cycle of oxygen applied locally is difficult to match to the period of hospitalization (in other European countries – P.D.L. 4409/2003 chronic ulcers are treated  at the patient’s home). For this direct experience a course of therapy is indicated coupled with a brief stay in hospital (5-7 days).

Over the course of the years we have obtained the first certification for our domestic model which was then renewed in accordance with the regulations in force. This model used at the patient’s home for therapies of medium – long duration enables social costs to come down and guarantees the continuity of application required. In this way we have already treated patients with various types of ulcer with excellent results and minimum cost.

At present the cost of hire applied to patients is €160 (VAT 4%) monthly; this charge is generally accepted and also includes assistance by telephone and at home for any problem concerning the therapy. These costs are still not reimbursable by the N.H.S. but the invoice is deductible.

A public or private structure in this way can offer a complete service to various patients, increasing the degree of satisfaction and constantly monitoring the development of the pathology with weekly visits but without rigidly committing the structure and the personnel (guidelines already provided by a proposal of law under discussion in the Chamber and applied in many countries in the European Union).

Curriculum  Dott Madeyski Paolo

Born in Trieste on 28.08.1946 Graduated in Medicine and Surgery at Università degli Studi di Padova (Padova University) on 19.07.1972. Qualified in the medical  profession in Padova (Padua) on 02.02.1973

From 1973 to 1976: Annual position teaching Artistic Anatomy at the Liceo Artistico di Treviso

In 1977 he specialized in General Surgery at Università degli Studi di Trieste (Trieste University)

In 1978 he qualified as Surgery Assistant in Rome

In 1978 he participated in the first centre of Televised Endoscopy in Italy

Practical course in Urological Endoscopy in the Department of Urology in Munich (Germany)

!981-1982 he enrolled in Specialization in Urology in Verona

In 1985 he qualified at the Scuola Europea di Senologia  (European School of Senology) in Orta San Giulio (Novara) directed by Prof. Umberto Veronese

In 1986 he followed the Practical Course in Audio-visual Urology at Università degli Studi di Torino (Turin University)

 In 1987 he obtained the post of Head of General Surgery

In 1992 he followed a Specialization Course in Laparoscopic Cholecystectomy at Università degli Studi di Padova

From 1994 he was in charge of the Department of Surgery at Casa di Cura Rizzola in San Donà di Piave (Venice). From 1994 he was  in charge of the Operating Unit of General Surgery at Casa di Cura Rizzola in San Donà di Piave (Venice)

In 1992 in collaboration with the Council of San Donà di Piave (Venice) and the doctors of the department of General Medicine of the town he organized the ”Campaign of Sensitivity for the Early Diagnosis of Breast Tumours”

In 1993 he was first selected and then collaborated in the “No Smoking Education Course” in the schools of the Lower Piave

From 1993 he has been Webmaster on the internet site “Le Pagine della Salute” (Health Pages) which received an award from the “PC World” magazine in 1994 with third prize as social medical site and received the attention of various Italian and foreign magazines, Italian and foreign university sites

At the end of the 1980s and the start of the 1990s he coordinated the medical-social  part of the television transmission “San Donà and surroundings”. From 2000 he directed the medical transmission “Three minutes for your health” on the air on Veneto local TV stations 4 days a week. From 1991 he was responsible for the weekly radio transmission (broadcast locally) “One to one with the doctor”, a popular programme? , based principally on themes of prevention.

Since 1999 he has been coordinator for the Council of San Donà di Piave (Venice) of the “Healthy Towns Network”. Since 1999 he has been vice-president of the third commission (Health) of San Donà di Piave. From 2003 he leaves every political commitment to dedicate himself solely to medical and social matters.

In 2002 he created and patented Europe-wide the Local Normobaric Chamber” and continues production in Italy and abroad with the name ULCOSAN with the aim of improving the well-being of the individual.

In the last two years he has started to elaborate a project to make available to the population products which help to maintain physical-mental well-being. Among these, the green tea called Tè Verde del Benessere (Green Tea for your well-being) which has proved to be the only completely natural, rich anti-oxidant with all the benefits of green tea.

On 02.06.2010 he received the award of Cavalliere Ordine al Merito della Repubblica (Order of Knights of the Republic) for his social work for the population.

He currently has 4 internet  sites.

www.lasalute.org

www.ilponte.ws

www.mpsystem.info

www.salusjuice.it

In 2011-2012 he was President of the Rotary Club of San Donà di Piave

In May 2012 he was invited to the University of Santa Cruz in Tenerife to teach normobaric oxygen therapy with his Ulcosan device.