scholarly journals Mathematical model for preoperative identification of obstructed nasal subsites

2017 ◽  
Vol 37 (05) ◽  
pp. 410-415
Author(s):  
M. Gamerra ◽  
E. Cantone ◽  
G. Sorrentino ◽  
R. De Luca ◽  
M.B. Russo ◽  
...  
Keyword(s):  
Mathematical Model ◽  
Allo Scopo ◽  
Sono Stati

La realizzazione di studi sperimentali per la valutazione dei flussi aerei nasali è particolarmente indaginosa, data la difficoltà di ottenere in vivo un’accurata misurazione degli stessi. Inoltre, sebbene la rinomanometria standard e la rinometria acustica rappresentino i metodi più utilizzati nella pratica clinica, esse forniscono solo una misura globale ed approssimativa dei flussi aerei nasali, senza definirne i particolari temporali o spaziali. Allo stesso modo gli studi sulla fluidodinamica computazionale rappresentano solo una simulazione numerica, ben lontana da quelle che sono le variabili anatomiche e fisiologiche delle cavità nasali. Pertanto, ad oggi, non esistono ancora strumenti diagnostici in grado di misurare oggettivamente la geometria delle cavità nasali, le resistenze ed il grado di ostruzione nei diversi sotto-siti nasali, elemento quest’ultimo fondamentale per una corretta programmazione chirurgica. Allo scopo di superare i limiti della diagnostica standard abbiamo elaborato un modello matematico basato sull’equazione di Bernoulli applicata alle cavità nasali di soggetti sani per lo studio dei gradienti pressori di vari sotto-siti nasali, che sono stati misurati grazie ad un particolare manometro digitale. Il nostro studio, unico in letteratura, ha identificato due curve limite che racchiudono un’area rappresentativa entro cui cadono i livelli “normali” di flusso in corrispondenza del vestibolo nasale. Il modello descritto potrebbe essere utile per studiare tutti i sotto-siti nasali sede di ostruzione ai fini di una corretta programmazione chirurgica e di un valido follow-up postoperatorio.

Capitolo 3: Bibliografia ragionata della Scala HoNOS

2002 ◽  
Vol 11 (S6) ◽  
pp. 15-32
Author(s):  
Roberto Bezzi ◽  
Carla Farinazzo ◽  
Paolo Miragoli
Keyword(s):  
Sono State ◽  
Allo Scopo ◽  
Sono Stati ◽  
Key Worker

Scopo della ricerca descritta in questo articolo era la validazione della HoNOS in un comune contesto clinico. 115 pazienti sono stati valutati da keyworkers (operatori di riferimento, generalmente infermieri ma anche operatori sociali) che utilizzavano la HoNOS e da ricercatori che utilizzavano altri strumenti di confronto (SCAN, SBS, SRPS, scelti in quanto dettagliati, standardizzati e in parte sovrapponibili nel contenuto alla HoNOS) e successivamente compilavano la HoNOS, alla luce di queste informazioni supplementari. Tutte le valutazioni sono state ripetute dopo 6 settimane. Sono stati effettuati confronti tra i punteggi HoNOS ottenuti dai keyworkers e dai ricercatori; questi sono stati inoltre confrontati con i punteggi ottenuti con gli strumenti di riferimento. Ciò ha evidenziato una mediocre performance della HoNOS compilata da keyworkers, in relazione sia alla valutazione da parte dei ricercatori, sia agli strumenti di confronto; la performance era peggiore considerando il cambiamento dei punteggi tra le due successive valutazioni come misura di esito. Riguardo alla performance dei singoli items, più problematici risultavano essere 1'8 (Altri problemi mentali e comportamentali), il 4 (Problemi cognitivi), il 7 (Problemi relativi a umore depresso) e il 12 (Problemi relativi a attività occupazionali) che, se confrontati con gli items equivalenti degli altri strumenti citati, rivelavano una correlazione molto bassa; la correlazione non era comunque in generale elevata, tranne che per il sub-punteggio “Funzionamento sociale”. I risultati di questo studio indicano che la HoNOS non offre una buona valutazione dei sintomi ma fornisce prestazioni migliori come misura di funzionamento sociale. Le difficoltà relative agli items sopra citati sono dovute probabilmente al fatto che ognuno di essi valuta fenomeni e circostanze differenti; questa caratteristica rende lo strumento più conciso ma viene persa la precisione della valutazione. Il valore limitato delle valutazioni HoNOS fatte dai key worker dipenderebbe dal fatto che non sempre le due valutazioni (iniziale e follow-up) venivano fatte dalla stessa persona (a differenza che per i ricercatori), dalla scarsa preparazione dei keyworkers che si evidenziava soprattutto nella valutazione dei sintomi e infine dalla minore disponibilità di informazioni rispetto ai ricercatori. Nel complesso l'uso della HoNOS come misura di routine della condizione clinica nei servizi psichiatrici risulta problematica; la sua performance appare correlata al training e all'esperienza dei keyworkers. Tuttavia gli autori ritengono che questo strumento possa essere utile allo scopo di diffondere una cultura di valutazione nei servizi di comunità; propongono che venga migliorato il training dei keyworkers e che esso comprenda sia aspetti generali relativi alla valutazione dello stato mentale e sociale dei pazienti, sia aspetti specifici riguardanti la compilazione della HoNOS; ritengono inoltre che debbano essere fatti ulteriori miglioramenti alla struttura di questo strumento di valutazione.

Pazienti addicted ad Elevata Complessità Socio-Sanitaria (ECoSS): dall'approccio intuitivo alla definizione di criteri scientifici. Studio retrospettivo osservazionale su una popolazione di 1.003 pazienti

MISSION ◽  
2019 ◽  
pp. 9-25
Author(s):  
Enrico De Vivo ◽  
Marilu Foti ◽  
Manuela Mellano ◽  
Emanuele Bignamini
Keyword(s):  
Allo Scopo ◽  
Sono Stati

Un paziente ad "Elevata Complessità SocioSanitaria" (ECoSS), rappresenta l'esito conclusivo di un investimento terapeutico e, tendenzialmente, non ha più possibilità di riabilitazione; quindi, impegnerà risorse del sistema di cura per tutta la durata della sua vita, costituendo un elemento da considerare in termini di programmazione e investimento delle risorse.  A fronte di queste considerazioni, si pongono diverse questioni. Quando è possibile definire un paziente ECoSS? Qual è la prevalenza dei pazienti che possono essere definiti ECoSS sul totale di quelli in cura? Quali caratteristiche specifiche hanno rispetto ai pazienti "non ECoSS" in cura e rispetto alla popolazione generale? Sono stati esaminati 1003 pazienti allo scopo di rispondere a queste domande.

scholarly journals Data Driven Mathematical Model of FOLFIRI Treatment for Colon Cancer

Cancers ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 2632
Author(s):  
Aparajita Budithi ◽  
Sumeyye Su ◽  
Arkadz Kirshtein ◽  
Leili Shahriyari
Keyword(s):  
Mathematical Model ◽  
Colon Cancer ◽  
Cancer Patients ◽  
Immune Cell ◽  
Treatment Options ◽  
Data Driven ◽  
T Helper ◽  
Primary Tumors ◽  
Cell Fractions

Many colon cancer patients show resistance to their treatments. Therefore, it is important to consider unique characteristic of each tumor to find the best treatment options for each patient. In this study, we develop a data driven mathematical model for interaction between the tumor microenvironment and FOLFIRI drug agents in colon cancer. Patients are divided into five distinct clusters based on their estimated immune cell fractions obtained from their primary tumors’ gene expression data. We then analyze the effects of drugs on cancer cells and immune cells in each group, and we observe different responses to the FOLFIRI drugs between patients in different immune groups. For instance, patients in cluster 3 with the highest T-reg/T-helper ratio respond better to the FOLFIRI treatment, while patients in cluster 2 with the lowest T-reg/T-helper ratio resist the treatment. Moreover, we use ROC curve to validate the model using the tumor status of the patients at their follow up, and the model predicts well for the earlier follow up days.

scholarly journals The Effect of Q-Switched Nd:YAG 1064 nm/532 nm Laser in the Treatment of Onychomycosis In Vivo

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Kostas Kalokasidis ◽  
Meltem Onder ◽  
Myrto-Georgia Trakatelli ◽  
Bertrand Richert ◽  
Klaus Fritz
Keyword(s):  
Clinical Study ◽  
Treatment Time ◽  
Prospective Clinical Study ◽  
Self Evaluation ◽  
Time Period ◽  
Level Of Satisfaction ◽  
Before And After ◽  
532 Nm

In this prospective clinical study, the Q-Switched Nd:YAG 1064 nm/532 nm laser (Light Age, Inc., Somerset, NJ, USA) was used on 131 onychomycosis subjects (94 females, 37 males; ages 18 to 68 years). Mycotic cultures were taken and fungus types were detected. The laser protocol included two sessions with a one-month interval. Treatment duration was approximately 15 minutes per session and patients were observed over a 3-month time period. Laser fluencies of 14 J/cm2were applied at 9 billionths of a second pulse duration and at 5 Hz frequency. Follow-up was performed at 3 months with mycological cultures. Before and after digital photographs were taken. Adverse effects were recorded and all participants completed “self-evaluation questionnaires” rating their level of satisfaction. All subjects were well satisfied with the treatments, there were no noticeable side effects, and no significant differences were found treating men versus women. At the 3-month follow-up 95.42% of the patients were laboratory mycologically cured of fungal infection. This clinical study demonstrates that fungal nail infections can be effectively and safely treated with Q-Switched Nd:YAG 1064 nm/532 nm laser. It can also be combined with systemic oral antifungals providing more limited treatment time.

scholarly journals Safety and efficacy of repeated crosslinking assisted by transepithelial double-cycle iontophoresis in keratoconus progression after primary corneal crosslinking

Eye ◽  
2021 ◽  
Author(s):  
Huping Wu ◽  
Lan Li ◽  
Shunrong Luo ◽  
Xie Fang ◽  
Xumin Shang ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Corneal Thickness ◽  
Good Alternative ◽  
Persistent Epithelial Defect ◽  
Safety And Efficacy ◽  
Corneal Epithelial ◽  
Epithelial Damage ◽  
Corneal Confocal Microscopy

Abstract Objectives To evaluate the safety and efficacy of repeated corneal collagen crosslinking assisted by transepithelial double-cycle iontophoresis (DI-CXL) in the management of keratoconus progression after primary CXL. Methods A retrospective analysis was conducted in the patients who underwent repeated CXL between 2016 and 2018. These patients were treated with DI-CXL if keratoconus progression was confirmed after primary CXL. Scoring of ocular pain and corneal epithelial damage, visual acuity, corneal tomography, in vivo corneal confocal microscopy (IVCM) was performed before and at 3, 6, 12, and 24 months after DI-CXL. Results Overall, 21 eyes of 12 patients (mean age 17.3 ± 1.9 years) were included in this study. Before DI-CXL, an average increase of 4.26 D in Kmax was detected in these patients with a mean follow-up interval of (23.0 ± 13.7) months. After DI-CXL, corneal epithelial damage rapidly recovered within days. Visual acuity remained unchanged with follow-up of 24 months. When compared to baseline, significant decreases were observed in Kmax (at 3 months) and K2 (at 3 and 6 months) after DI-CXL. Corneal thickness of thinnest point significantly decreased at 3 months postoperatively. When compared to baseline, no significant differences were found in any of the refractive or tomographic parameters at 12 and 24 months. IVCM revealed trabecular patterned hyperdense tissues after DI-CXL in the anterior stroma at the depth of 200 μm or more. No corneal infiltration or persistent epithelial defect was recorded after DI-CXL. Conclusion DI-CXL is safe and effective as a good alternative in stabilizing keratoconus progression after primary CXL.

scholarly journals Titanium-interlayer mediated hydroxyapatite coating on polyetheretherketone: a prospective study in patients with single-level cervical degenerative disc disease

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Ce Zhu ◽  
Miaomiao He ◽  
Lili Mao ◽  
Tao Li ◽  
Li Zhang ◽  
...  
Keyword(s):  
Degenerative Disc Disease ◽  
Fusion Rate ◽  
Peek Cage ◽  
Disc Disease ◽  
Degenerative Disc ◽  
Single Level ◽  
Cervical Degenerative Disc Disease ◽  
Post Operation

Abstract Background Currently, there are limited reports regarding investigation of the biological properties of polyetheretherketone (PEEK) coated with titanium (Ti) and hydroxyapatite (HA) in human. The objective of this study is to evaluate the in vivo response of the PEEK cages coated with Ti and HA versus uncoated PEEK cages after anterior cervical discectomy and fusion (ACDF) in patients with single-level cervical degenerative disc disease (CDDD). Methods Twenty-four patients with PEEK cages coated with Ti and HA (PEEK/Ti/HA group) were matched one-to-one with patients with uncoated PEEK cages (PEEK group) based on age, gender, and operative segment. All patients had been followed up for more than 2 years. Radiological assessments included intervertebral height (IH), C2-7 angle (C2-7a), segmental alignment (SA), and fusion rate. Clinical parameters included Visual Analogue Scale (VAS) and Japanese Orthopedic Association (JOA) scores. Results There was no statistical difference in SA, IH, and C2-7a between the two groups before and after surgery and all these parameters were restored postoperatively. The fusion rate of PEEK/Ti/HA group was significantly higher than PEEK group at 3-month post-operation (87.5% vs. 62.5%). At the last follow-up, the fusion rate of the both groups achieved 100%. The VAS and JOA scores were comparable between two groups and improved postoperatively. Conclusions In patients with single-level ACDF, PEEK cage coated with Ti and HA provided a higher fusion rate than uncoated PEEK cage at 3-month post-operation, while both two cages could achieve solid osseous fusion at the last follow up. Compared with the uncoated PEEK cage, PEEK/Ti/HA cage yielded similar favorable segmental and overall cervical lordosis, IH, and clinical outcomes after the surgery.

scholarly journals Effectiveness of Elexacaftor/Tezacaftor/Ivacaftor Therapy in Three Subjects with the Cystic Fibrosis Genotype Phe508del/Unknown and Advanced Lung Disease

Genes ◽  
2021 ◽  
Vol 12 (8) ◽  
pp. 1178
Author(s):  
Vito Terlizzi ◽  
Carmela Colangelo ◽  
Giovanni Marsicovetere ◽  
Michele D’Andria ◽  
Michela Francalanci ◽  
...  
Keyword(s):  
Drug Response ◽  
Ex Vivo ◽  
Forced Expiratory Volume ◽  
Considerable Decrease ◽  
Six Minute Walk Test ◽  
Sweat Chloride ◽  
Access Program ◽  
Minute Walk

We evaluated the effectiveness and safety of elexacaftor/tezacaftor/ivacaftor (ELX/TEZ/IVA) in three subjects carrying the Phe508del/unknown CFTR genotype. An ex vivo analysis on nasal epithelial cells (NEC) indicated a significant improvement of CFTR gating activity after the treatment. Three patients were enrolled in an ELX/TEZ/IVA managed-access program, including subjects with the highest percent predicted Forced Expiratory Volume in the 1st second (ppFEV1) < 40 in the preceding 3 months. Data were collected at baseline and after 8, 12 and 24 weeks of follow-up during treatment. All patients showed a considerable decrease of sweat chloride (i.e., meanly about 60 mmol/L as compared to baseline), relevant improvement of ppFEV1 (i.e., >8) and six-minute walk test, and an increase in body mass index after the first 8 weeks of treatment. No pulmonary exacerbations occurred during the 24 weeks of treatment and all domains of the CF Questionnaire-Revised improved. No safety concerns related to the treatment occurred. This study demonstrates the benefit from the ELX/TEZ/IVA treatment in patients with CF with the Phe508del and one unidentified CFTR variant. The preliminary ex vivo analysis of the drug response on NEC helps to predict the in vivo therapeutic endpoints.

scholarly journals Biocompatibility of Bacterial Magnetosomes as MRI Contrast Agent: A Long-Term In Vivo Follow-Up Study

Nanomaterials ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 1235
Author(s):  
Xiaohui Nan ◽  
Wenjia Lai ◽  
Dan Li ◽  
Jiesheng Tian ◽  
Zhiyuan Hu ◽  
...  
Keyword(s):  
Contrast Agent ◽  
Magnetic Domain ◽  
Bilayer Membrane ◽  
The Body ◽  
Mri Contrast Agent ◽  
Mri Imaging ◽  
Mri Contrast

Derived from magnetotactic bacteria (MTB), magnetosomes consist of magnetite crystals enclosed within a lipid bilayer membrane and are known to possess advantages over artificially synthesized nanoparticles because of the narrow size distribution, uniform morphology, high purity and crystallinity, single magnetic domain, good biocompatibility, and easy surface modification. These unique properties have increasingly attracted researchers to apply bacterial magnetosomes (BMs) in the fields of biology and medicine as MRI imaging contrast agents. Due to the concern of biosafety, a long-term follow-up of the distribution and clearance of BMs after entering the body is necessary. In this study, we tracked changes of BMs in major organs of mice up to 135 days after intravenous injection using a combination of several techniques. We not only confirmed the liver as the well-known targeted organs of BMs, but also found that BMs accumulated in the spleen. Besides, two major elimination paths, as well as the approximate length of time for BMs to be cleared from the mice, were revealed. Together, the results not only confirm that BMs have high biocompatibility, but also provide a long-term in-vivo assessment which may further help to forward the clinical applications of BMs as an MRI contrast agent.

scholarly journals TRIM25 regulates oxaliplatin resistance in colorectal cancer by promoting EZH2 stability

2021 ◽  
Vol 12 (5) ◽  
Author(s):  
Sha Zhou ◽  
Jianhong Peng ◽  
Liuniu Xiao ◽  
Caixia Zhou ◽  
Yujing Fang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Disease Free Survival ◽  
Free Survival ◽  
Epigenetic Regulator ◽  
Crc Management ◽  
Disease Free ◽  
Resistance To Chemotherapy

AbstractResistance to chemotherapy remains the major cause of treatment failure in patients with colorectal cancer (CRC). Here, we identified TRIM25 as an epigenetic regulator of oxaliplatin (OXA) resistance in CRC. The level of TRIM25 in OXA-resistant patients who experienced recurrence during the follow-up period was significantly higher than in those who had no recurrence. Patients with high expression of TRIM25 had a significantly higher recurrence rate and worse disease-free survival than those with low TRIM25 expression. Downregulation of TRIM25 dramatically inhibited, while overexpression of TRIM25 increased, CRC cell survival after OXA treatment. In addition, TRIM25 promoted the stem cell properties of CRC cells both in vitro and in vivo. Importantly, we demonstrated that TRIM25 inhibited the binding of E3 ubiquitin ligase TRAF6 to EZH2, thus stabilizing and upregulating EZH2, and promoting OXA resistance. Our study contributes to a better understanding of OXA resistance and indicates that inhibitors against TRIM25 might be an excellent strategy for CRC management in clinical practice.

scholarly journals Co-Overexpression of TWIST1-CSF1 Is a Common Event in Metastatic Oral Cancer and Drives Biologically Aggressive Phenotype

Cancers ◽  
2021 ◽  
Vol 13 (1) ◽  
pp. 153
Author(s):  
Sabrina Daniela da Silva ◽  
Fabio Albuquerque Marchi ◽  
Jie Su ◽  
Long Yang ◽  
Ludmila Valverde ◽  
...  
Keyword(s):  
Epithelial Mesenchymal Transition ◽  
Inflammatory Cells ◽  
Rank Test ◽  
Mesenchymal Transition ◽  
Genome Wide ◽  
A Genome ◽  
Enhanced Expression ◽  
Advanced Stages

Invasive oral squamous cell carcinoma (OSCC) is often ulcerated and heavily infiltrated by pro-inflammatory cells. We conducted a genome-wide profiling of tissues from OSCC patients (early versus advanced stages) with 10 years follow-up. Co-amplification and co-overexpression of TWIST1, a transcriptional activator of epithelial-mesenchymal-transition (EMT), and colony-stimulating factor-1 (CSF1), a major chemotactic agent for tumor-associated macrophages (TAMs), were observed in metastatic OSCC cases. The overexpression of these markers strongly predicted poor patient survival (log-rank test, p = 0.0035 and p = 0.0219). Protein analysis confirmed the enhanced expression of TWIST1 and CSF1 in metastatic tissues. In preclinical models using OSCC cell lines, macrophages, and an in vivo matrigel plug assay, we demonstrated that TWIST1 gene overexpression induces the activation of CSF1 while TWIST1 gene silencing down-regulates CSF1 preventing OSCC invasion. Furthermore, excessive macrophage activation and polarization was observed in co-culture system involving OSCC cells overexpressing TWIST1. In summary, this study provides insight into the cooperation between TWIST1 transcription factor and CSF1 to promote OSCC invasiveness and opens up the potential therapeutic utility of currently developed antibodies and small molecules targeting cancer-associated macrophages.

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