RESUMO
Interoception, perception of one's bodily state, has been associated with mental health and socio-emotional processes. However, several interoception tasks are of questionable validity, meaning associations between interoception and other variables require confirmation with new measures. Here we describe the novel, smartphone-based Phase Adjustment Task (PAT). Tones are presented at the participant's heart rate, but out of phase with heartbeats. Participants adjust the phase relationship between tones and heartbeats until they are synchronous. Data from 124 participants indicates variance in performance across participants which is not affected by physiological or strategic confounds. Associations between interoception and anxiety, depression and stress were not significant. Weak associations between interoception and mental health variables may be a consequence of testing a non-clinical sample. A second study revealed PAT performance to be moderately stable over one week, consistent with state effects on interoception.
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Interocepção , Ansiedade , Transtornos de Ansiedade , Emoções , Frequência Cardíaca , HumanosRESUMO
We investigated how early injuries to developing brain affect the interaction of locomotor patterns with the voluntary action required by obstacle clearance. This task requires higher cognitive load and specific anticipatory sensorimotor integration than more automated steady-state gait. To this end, we compared the adaptive gait patterns during obstacle clearance in 40 children with cerebral palsy (CP) (24 diplegic, 16 hemiplegic, 2-12 yr) and 22 typically developing (TD) children (2-12 yr) by analyzing gait kinematics, joint moments during foot elevation, electromyographic (EMG) activity of 11 pairs of bilateral muscles, and muscle modules evaluated by factorization of the EMG signals. The results confirmed generally slower task performance, plus difficulty in motor planning and control in CP. Thus ~30% of diplegic children failed to perform the task. Children with CP demonstrated higher foot lift, smaller range of motion of distal segments, difficulties in properly activating the hamstring muscles at liftoff, and a modified hip strategy when elevating the trailing limb. Basic muscle modules were generally roughly similar to TD patterns, though they showed a limited adaptation. Thus a distinct activation burst in the adaptable muscle module timed to the voluntary task (liftoff) was less evident in CP. Children with CP also showed prolonged EMG burst durations. Impaired obstacle task performance may reflect impaired or less adaptable supraspinal and spinal control of gait when a locomotor task is superimposed with the voluntary movement. Neurorehabilitation of gait in CP may thus be beneficial by adding voluntary tasks such as obstacle clearance during gait performance.NEW & NOTEWORTHY Previous studies mainly evaluated the neuromuscular pattern generation in cerebral palsy (CP) during unobstructed gait. Here we characterized impairments in the obstacle task performance associated with a limited adaptation of the task-relevant muscle module timed to the foot lift during obstacle crossing. Impaired task performance in children with CP may reflect basic developmental deficits in the adaptable control of gait when the locomotor task is superimposed with the voluntary movement.
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Adaptação Fisiológica/fisiologia , Paralisia Cerebral/fisiopatologia , Desenvolvimento Infantil/fisiologia , Transtornos Neurológicos da Marcha/fisiopatologia , Locomoção/fisiologia , Atividade Motora/fisiologia , Desempenho Psicomotor/fisiologia , Navegação Espacial/fisiologia , Fenômenos Biomecânicos , Paralisia Cerebral/complicações , Criança , Pré-Escolar , Eletromiografia , Feminino , Hemiplegia/etiologia , Hemiplegia/fisiopatologia , Humanos , Masculino , Quadriplegia/etiologia , Quadriplegia/fisiopatologiaRESUMO
We present here the first attempt to understand the fast dynamics of an active basaltic volcano, namely Mt. Etna using soil gas radon measured in some sites located in strategic places around the volcano. Data were measured continuously from July 2015 to February 2017 and the raw signals were treated in order to filter out all possible periodic components that are normally due to non-volcanic factors, applying a method that does not require acquisition of other parameters, which are not always available. The residual signals highlighted seven anomalous changes, with radon values reaching levels from 2 to 5 times higher than the normal background. In six out of seven cases, anomalies were almost contemporaneous in all or almost all of the sites, indicating a common source for the observed radon variations. The pattern of anomalies suggests a transient wave-like propagation in the space/time domain, compatible with pressure-induced displacement of the gas. The observed patterns are most probably caused by the rapid upward motion of gas-rich magma into the volcano conduits, as almost all anomalies precede or accompany major volcanic events. In some cases, an alternative explanation could be the strong and sudden strain releases through earthquakes swarms, with consequent variations in the permeability of rocks at a large scale, given the apparent correlation between those anomalies and intense seismicity.
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Monitoramento de Radiação , Radônio , Poluentes Radioativos do Solo , Itália , SoloRESUMO
Down (DS) and Prader-Willi (PWS) syndromes are chromosomal disorders both characterized by obesity, ligament laxity, and hypotonia, the latter associated with gait instability. Although these shared features may justify a common rehabilitation approach, evidence exists that adults with DS and PWS adopt different postural and walking strategies. The development of an instrumented protocol able to describe these strategies and quantify patients' gait stability in the current clinical routine would be of great benefit for health professionals, allowing them to design personalized rehabilitation programs. This is particularly true for children with DS and PWS, where motor development is dramatically constrained by severe hypotonia and muscle weakness. The aim of this study was, thus, to propose an instrumented protocol, integrated with the clinical routine and based on the use of wearable inertial sensors, to assess gait stability in DS and PWS children. Fifteen children with DS, 11 children with PWS, and 12 typically developing children (CG) were involved in the study. Participants performed a 10-meter walking test while wearing four inertial sensors located at pelvis, sternum, and both distal tibiae levels. Spatiotemporal parameters (walking speed, stride frequency, and stride length) and a set of indices related to gait symmetry and upper-body stability (Root Mean Square, Attenuation Coefficient and Improved Harmonic Ratio) were estimated from pelvis and sternum accelerations. The Gross Motor Functional Measures (GMFM-88) and Intelligence Quotient (IQ Wechsler) were also assessed for each patient. A correlation analysis among the GMFM-88 and IQ scales and the estimated parameters was then performed. Children with DS and PWS exhibit reduced gait symmetry and higher accelerations at pelvis level than CG. While these accelerations are attenuated by about 40% at sternum level in CG and DS, PWS children display significant smaller attenuations, thus reporting reduced gait stability, most likely due to their typical "Trendelenburg gait". Significant correlations were found between the estimated parameters and the GMFM-88 scale when considering the whole PWS and DS group and the PWS group alone. These results promote the adoption of wearable technology in clinical routines to monitor gait patterns in children with DS and PWS: the proposed protocol allows to markedly characterize patient-specific motor limitations even when clinical assessment scores provide similar results in terms of pathology severity. This protocol could be adopted to support health professionals in designing personalized treatments that, in turn, could help improving patients' quality of life in terms of both physical and social perspectives.
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Síndrome de Down/complicações , Transtornos Neurológicos da Marcha/etiologia , Equilíbrio Postural/fisiologia , Síndrome de Prader-Willi/complicações , Aceleração , Criança , Desenvolvimento Infantil , Pré-Escolar , Síndrome de Down/fisiopatologia , Síndrome de Down/reabilitação , Feminino , Marcha/fisiologia , Análise da Marcha/instrumentação , Análise da Marcha/métodos , Transtornos Neurológicos da Marcha/diagnóstico , Transtornos Neurológicos da Marcha/fisiopatologia , Transtornos Neurológicos da Marcha/reabilitação , Humanos , Masculino , Pelve/fisiopatologia , Modalidades de Fisioterapia , Síndrome de Prader-Willi/fisiopatologia , Síndrome de Prader-Willi/reabilitação , Velocidade de Caminhada/fisiologiaRESUMO
AIMS: Inflammation-based scores such as neutrophil-lymphocyte ratio (NLR) and Onodera nutritional index (ONI) have been identified as new prognosticators in several tumors. We conducted a prognostic analysis of these markers and performed a risk stratification of PMP patients submitted to cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). METHODS: 226 patients from two peritoneal surface malignancies centers participated in this study. Cox proportional modeling was used to select predictors of overall survival (OS) among baseline inflammation-based scores, serum tumor markers, clinical and surgical variables. Risk stratification was done using conditional inference tree model. RESULTS: One hundred eighty-two cases had diffuse peritoneal adenomucinosis subtype. Fifty-four cases had received previous systemic chemotherapy. The means of ONI and NLR were 51.4 (SD = 9.8) and 3.2 (SD = 2.3), respectively. Two hundred ten cases were optimally cytoreduced. Cox analysis identified completeness of cytoreduction, histological subtype, previous systemic chemotherapy, NLR, and CA 19-9 as independent prognosticators. Conditional inference tree method identified two poor prognostic subsets: NLR ≤2.7 and CA 19-9>336 (5yr-OS = 15%) and NLR >2.7 and ONI ≤42 (5yr-OS = 30%). CONCLUSIONS: NLR, ONI, and CA 19-9 are new prognosticators that contributed to improve prediction of OS in PMP patients treated by CRS and HIPEC. These markers allowed a risk stratification that could optimize therapeutic management of PMP patients.
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Antineoplásicos/administração & dosagem , Biomarcadores Tumorais/sangue , Procedimentos Cirúrgicos de Citorredução/métodos , Hipertermia Induzida/métodos , Neoplasias Peritoneais/terapia , Pseudomixoma Peritoneal/terapia , Medição de Risco , Terapia Combinada , Feminino , Humanos , Injeções Intraperitoneais , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Neoplasias Peritoneais/sangue , Neoplasias Peritoneais/mortalidade , Prognóstico , Modelos de Riscos Proporcionais , Pseudomixoma Peritoneal/sangue , Pseudomixoma Peritoneal/mortalidade , Estudos Retrospectivos , Taxa de Sobrevida/tendênciasRESUMO
In order to exploit radon profiles for geophysical purposes and also to estimate its entry indoors, it is necessary to study its transport through porous soils. The great number of involved parameters and processes affecting the emanation of radon from the soil grains and its transport in the source medium has led to many theoretical and/or laboratory studies. The authors report the first results of a laboratory study carried out at the Radioactivity Laboratory of the Department of Physics and Astronomy (University of Catania) by means of a facility for measuring radon concentrations in the sample pores at various depths under well-defined and controlled conditions of physical parameters. In particular, radon concentration vertical profiles extracted in low-moisture samples for different advective fluxes and temperatures were compared with expected concentrations, according to a three-phase transport model developed by Andersen (Risø National Laboratory, Denmark), showing, in general, a good agreement between measurements and model calculations.
Assuntos
Fenômenos Geológicos , Radônio/análise , Poluentes Radioativos do Solo/análise , Difusão , Gases , Umidade , Modelos Teóricos , Tamanho da Partícula , Porosidade , Radônio/química , Solo , Poluentes Radioativos do Solo/química , TemperaturaRESUMO
BACKGROUND: Previous studies reported controversial results about the efficacy of video-game based therapy (VGT) in improving neurorehabilitation outcomes in children with cerebral palsy (CP). AIM: Primary aim was to investigate the effectiveness of VGT with respect to conventional therapy (CT) in improving upper limb motor outcomes in a group of children with CP. Secondary aim was to quantify if VGT leads children to perform a higher number of movements. DESIGN: A cross-over randomized controlled trial (RCT) for investigating the primary aim and a cross-sectional study for investigating the secondary aim of this study. SETTINGS: Outpatients. INCLUSION CRITERIA: clinical diagnosis of CP, age between 4 and 14 years, level of GMFC between I and IV. EXCLUSION CRITERIA: QI<35, severe comorbidities, incapacity to stand even with an external support. METHODS: Twenty-two children with CP (6.89±1.91-year old) were enrolled in a cross-over RCT with 16 sessions of VGT (using Xbox with Kinect device) and then 16 of CT or vice versa. Upper limb functioning was assessed using the Quality of Upper Extremities Skills Test (QUEST) and hand abilities using Abilhand-kids score. According to the secondary aim of this study a secondary cross-sectional study has been performed. Eight children with CP (6.50±1.60-year old) were enrolled into a trial in which five wireless triaxial accelerometers were positioned on their forearms, legs and trunk for quantifying the physical activity during VGT vs. CT. RESULTS: QUEST scores significantly improved only after VGT (P=0.003), and not after CT (P=0.056). The reverse occurred for Abilhand-kids scores (P=0.165 vs. P=0.013, respectively). Quantity of performed movements was three times higher in VGT than in CT (+198%, P=0.027). CONCLUSION: VGT resulted effective in improving the motor functions of upper limb extremities in children with CP, conceivably for the increased quantity of limb movements, but failed in improving the manual abilities for performing activities of daily living which benefited more from CT. CLINICAL REHABILITATION IMPACT: VGT performed using the X-Box with Kinect device could enhance the number of upper limb movements in children with CP during rehabilitation and in turn improving upper limb motor skills, but CT remained superior for improving performances in manual activities of daily living.
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Paralisia Cerebral/fisiopatologia , Paralisia Cerebral/reabilitação , Extremidade Superior/fisiopatologia , Jogos de Vídeo , Adolescente , Criança , Pré-Escolar , Estudos Cross-Over , Estudos Transversais , Feminino , Humanos , Masculino , Resultado do TratamentoRESUMO
BACKGROUND: Currently used CA15-3 and CEA have found their clinical application particularly in the follow-up of patients with advanced disease. Novel biomarkers are urgent, especially for improving early diagnosis as well as for discriminating between benign and malignant disease. PATIENTS AND METHODS: In the present study, we used a proteomic approach based on surface-enhanced laser desorption/ionization-time of flight-mass spectrometry screening with the aim of identifying differentially expressed 2-30 kDa proteins in plasma of patients with malignant (65 cases) and benign (88 cases) breast lesions with respect to 121 healthy controls. RESULTS: We found that the most promising SELDI peaks were those corresponding to hepcidin-25 and ferritin light chain. We evaluated the capability of these peaks in predicting malignant and benign breast lesions using the area under the receiver operating characteristic curve (AUC). The results showed a good capacity to predict malignant breast lesions for hepcidin-25 [AUC: 0.82; 95% confidence interval (CI) 0.75-0.90] and ferritin light chain (AUC: 0.86; 95% CI 0.79-0.92). Conversely, a weak and satisfactory capability to predict benign breast lesion was observed for hepcidin-25 (AUC: 0.63; 95% CI 0.41-0.85) and ferritin light chain (AUC: 0.73; 95% CI 0.49-0.97). A significant association between HER2 status and hepcidin-25 was observed and the distribution of transferrin and ferritin were found significantly different in patients with breast cancer when compared with that of controls. CONCLUSIONS: This study provides evidence that hepcidin and ferritin light chain level in plasma may be of clinical usefulness to predict malignant and benign disease with respect to healthy controls.
Assuntos
Biomarcadores Tumorais/sangue , Neoplasias da Mama/sangue , Neoplasias da Mama/diagnóstico , Ferritinas/sangue , Hepcidinas/sangue , Adolescente , Adulto , Idoso , Estudos de Casos e Controles , Detecção Precoce de Câncer , Feminino , Humanos , Pessoa de Meia-Idade , Curva ROC , Adulto JovemRESUMO
The objective of this randomized controlled pilot study was to assess the feasibility and effectiveness of myoelectrically controlled functional electrical stimulation (MeCFES) for rehabilitation of the upper limb in poststroke subjects. Eleven poststroke hemiparetic subjects with residual proximal control of the arm, but impaired volitional opening of the paretic hand, were enrolled and randomized into a treated and a control group. Subjects received 3 to 5 treatment sessions per week until totaling 25 sessions. In the experimental group, myoelectric activity from wrist and finger extensors was used to control stimulation of the same muscles. Patients treated with MeCFES (n = 5) had a significant (p = 0.04) and clinically important improvement in Action Research Arm Test score (median change 9 points), confirmed by an Individually Prioritized Problem Assessment self-evaluation score. This improvement was maintained at follow-up. The control group did not show a significant improvement (p = 0.13). The reduced sample size of participants, together with confounding factors such as spontaneous recovery, calls for larger studies to draw definite conclusions. However, the large and persistent treatment effect seen in our results indicate that MeCFES could play an important role as a clinical tool for stroke rehabilitation.
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Terapia por Estimulação Elétrica , Paresia/etiologia , Paresia/reabilitação , Acidente Vascular Cerebral/complicações , Adulto , Método Duplo-Cego , Terapia por Estimulação Elétrica/métodos , Feminino , Dedos/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/fisiopatologia , Projetos Piloto , Desempenho Psicomotor , Acidente Vascular Cerebral/fisiopatologia , Reabilitação do Acidente Vascular Cerebral , Resultado do Tratamento , Punho/fisiopatologiaRESUMO
Adjuvant chemotherapy significantly decreases recurrences and improves survival in women with early breast cancer (BC). However, the side effects of chemotherapy include weight gain, which is associated with poorer prognosis. We have previously demonstrated that by means of a comprehensive dietary modification which aims at lowering insulin levels it is possible to reduce body weight and decrease the bioavailability of insulin, sex hormones and the growth factors linked to BC risk and prognosis. We are now going to present a randomized controlled study of adjuvant diet in BC patients undergoing chemotherapy. The diet was designed to prevent weight gain during chemotherapy treatment. Women of any age, operated for invasive BC, scheduled for adjuvant chemotherapy and without evidence of distant metastases, were randomized into a dietary intervention group and a control group. The intervention implied changing their usual diet for the whole duration of chemotherapy, following cooking classes and having lunch or dinner at the study centre at least twice per week. 96 BC patients were included in the study. The women in the intervention group showed a significant reduction in their body weight (2.9 kg on average), compared with the controls. They also significantly reduced body fat mass, waist and hip circumferences, biceps, underscapular and suprailiac skinfolds, compared with the women in the control group. Our results support the hypothesis that dietary intervention during adjuvant chemotherapy for BC is feasible and may prevent weight gain.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Neoplasias da Mama/terapia , Carcinoma Ductal de Mama/terapia , Sobrepeso/dietoterapia , Aumento de Peso/efeitos dos fármacos , Adulto , Antraciclinas/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Quimioterapia Adjuvante/efeitos adversos , Ciclofosfamida/administração & dosagem , Dieta Macrobiótica , Dieta Mediterrânea , Feminino , Fluoruracila/administração & dosagem , Humanos , Metotrexato/administração & dosagem , Pessoa de Meia-Idade , Sobrepeso/induzido quimicamente , Sobrepeso/prevenção & controle , Taxoides/administração & dosagem , Resultado do TratamentoRESUMO
Functional taping with elastic bandages and adhesive tapes could limit the action of upper limb spastic muscles and sustain that of weaker muscles in children with hemiplegic cerebral palsy (CP). 16 young children with CP (3±2 years old) were enrolled in this pilot study including 5 months of taping in conjunction with conventional physical therapy, followed by 7 months of physical therapy alone (taping wash-out), and other 5 months of taping plus therapy. Large improvements in the Melbourne assessment score were found in the first period in which taping was used (+15.4%, p<0.001) and also in the second one despite 8 drop-outs (+8.4%, p=0.012), but not during the taping wash-out (- 4.6%; p=0.093). These results suggest that children with CP could benefit from the continuous correction provided by taping in order to limit the development of improper upper limb motor schemas and to favour that of proper ones.
Assuntos
Paralisia Cerebral/reabilitação , Hemiplegia/reabilitação , Modalidades de Fisioterapia/instrumentação , Bandagens , Pré-Escolar , Humanos , Lactente , Espasticidade Muscular/reabilitação , Projetos Piloto , Extremidade SuperiorRESUMO
BACKGROUND: A new automated immunoassay low-mid volume (< or = 250 immunoassays/day) chemiluminescent analyzer, Abbott Architect i1000sR, was evaluated by seven laboratories around the world (4 in Europe, one each in Canada, Japan, and the U.S.A.) to demonstrate equivalent performance for key operating characteristics (e.g., precision, turn around time, limit of detection, functional sensitivity, and linearity). METHODS: The laboratories followed standard protocols to assess precision, limit of detection (LoD), functional sensitivity, assay linearity, method comparison, and sample carryover. Turn around time for three stat assays (beta-hCG, BNP, and CK-MB) and the time required to complete workloads of 50 and 100 tests with a mixture of 75% routine tests and 25% stat tests was also evaluated. RESULTS: Total precision was typically < 5% CV for nine immunoassays. Analytical performance met design goals and demonstrated equivalency to package insert data for assays on market and in use for an existing high volume immunoassay system. Stat turn around times were consistent with the fixed analytical time of 15.6 minutes and met the expectations of the laboratories. Measured test throughput ranged from 47 - 54 tests per hour and demonstrated that the analyzer was fit for the intended purpose of supporting a laboratory that performs < or = 250 immunoassays per day. CONCLUSIONS: A multisite, international analyzer familiarization study is a practical means of confirming that a new instrument meets both a manufacturer's design specifications and users' real world expectations and provides a pragmatic test for the system. The experience of investigators at seven sites around the world indicates that a new fully automated chemiluminescent system is suitable for use.
Assuntos
Imunoensaio/instrumentação , Medições Luminescentes/instrumentação , Gonadotropina Coriônica Humana Subunidade beta/sangue , Creatina Quinase Forma MB/sangue , Estradiol/sangue , Humanos , Imunoensaio/métodos , Medições Luminescentes/métodos , Peptídeo Natriurético Encefálico/sangue , Curva ROC , Reprodutibilidade dos TestesRESUMO
Three different methodologies were used to measure Radon ((222)Rn) in soil, based on both passive and active detection system. The first technique consisted of solid-state nuclear track detectors (SSNTD), CR-39 type, and allowed integrated measurements. The second one consisted of a portable device for short time measurements. The last consisted of a continuous measurement device for extended monitoring, placed in selected sites. Soil (222)Rn activity was measured together with soil Thoron ((220)Rn) and soil carbon dioxide (CO(2)) efflux, and it was compared with the content of radionuclides in the rocks. Two different soil-gas horizontal transects were investigated across the Pernicana fault system (NE flank of Mount Etna), from November 2006 to April 2007. The results obtained with the three methodologies are in a general agreement with each other and reflect the tectonic settings of the investigated study area. The lowest (222)Rn values were recorded just on the fault plane, and relatively higher values were recorded a few tens of meters from the fault axis on both of its sides. This pattern could be explained as a dilution effect resulting from high rates of soil CO(2) efflux. Time variations of (222)Rn activity were mostly linked to atmospheric influences, whereas no significant correlation with the volcanic activity was observed. In order to further investigate regional radon distributions, spot measurements were made to identify sites having high Rn emissions that could subsequently be monitored for temporal radon variations. SSNTD measurements allow for extended-duration monitoring of a relatively large number of sites, although with some loss of temporal resolution due to their long integration time. Continuous monitoring probes are optimal for detailed time monitoring, but because of their expense, they can best be used to complement the information acquired with SSNTD in a network of monitored sites.
Assuntos
Radônio/análise , Solo/análise , Terremotos , Itália , MétodosRESUMO
We report measurements of the thermal conductivity of high-quality crystals of the cubic I-V-VI2 semiconductors AgSbTe2 and AgBiSe2. The thermal conductivity is temperature independent from 80 to 300 K at a value of approximately 0.70 W/mK. Heat conduction is dominated by the lattice term, which we show is limited by umklapp and normal phonon-phonon scattering processes to a value that corresponds to the minimum possible, where the phonon mean free path equals the interatomic distance. Minimum thermal conductivity in cubic I-V-VI2 semiconductors is due to an extreme anharmonicity of the lattice vibrational spectrum that gives rise to a high Grüneisen parameter and strong phonon-phonon interactions. Members of this family of compounds are therefore most promising for thermoelectric applications, particularly as p-type materials.
RESUMO
PURPOSE: Early diagnosis and treatment of venous thrombosis biocontact="no" are essential in preventing pulmonary embolism (PE) and reducing the risk of recurrence. The objective was to assess the usefulness of the D-Dimer testing to rule out symptomatic VT in populations of patients receiving heparin in prophylactic doses. METHODS: One hundred and twenty-three rehabilitation patients with medium or high risk for VT were investigated. Patients were affected by acquired cerebral diseases (n=31), severe brain damage (n=32) or orthopaedic surgical sequelae for major joint replacement or multiple limb fractures (n=60). All patients were receiving prophylactic heparin doses. D-Dimer levels were assessed using Dimertest Latex Agglutination Assay in citrated plasma. Single blinded compression Doppler Ultrasound (DUS) examination was performed in conformity with international standards. RESULTS: In this specific setting, good sensitivity and specificity of the D-Dimer test was confirmed in patients with acquired cerebral diseases during rehabilitation, whereas false positive results were found in most patients who had undergone major joint replacement, until several weeks after surgery. CONCLUSIONS: In rehabilitation patients receiving prophylactic heparin doses, the D-Dimer test seems to confirm high sensitivity and high negative predictive value for VT and PE. Relevant clinical variables seem to reduce the usefulness of the D-Dimer test as a screening tool for VT, at least in orthopaedic patients with joint prosthesis.
Assuntos
Dano Encefálico Crônico/reabilitação , Produtos de Degradação da Fibrina e do Fibrinogênio/análise , Kit de Reagentes para Diagnóstico/normas , Reabilitação do Acidente Vascular Cerebral , Trombose Venosa/diagnóstico , Adulto , Idoso , Anticoagulantes/uso terapêutico , Dano Encefálico Crônico/complicações , Dano Encefálico Crônico/tratamento farmacológico , Feminino , Heparina de Baixo Peso Molecular/uso terapêutico , Humanos , Testes de Fixação do Látex/métodos , Testes de Fixação do Látex/normas , Masculino , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/tratamento farmacológico , Ultrassonografia Doppler , Trombose Venosa/sangue , Trombose Venosa/diagnóstico por imagemRESUMO
Soil radon has been monitored at a fixed location on the northeastern flank of Mt. Etna, a high-risk volcano in Sicily. The aim of this study was to evaluate the effects of the recent volcanic activity on soil radon concentration. Continuous radon measurements have been performed since July 2001. While comparison between the trend in in-soil radon concentration and the acquired meteorological series (temperature, humidity and pressure) appear to confirm a general seasonal correlation, nevertheless particular anomalies suggest a possible dependence of the radon concentration on volcanic dynamics.
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The aim of this outcome study was to evaluate the effectiveness and prognostic factors of inpatient multidisciplinary rehabilitation treatment in patients with multiple sclerosis (MS). We analysed 230 consecutive inpatients with MS admitted to an MS rehabilitation ward who followed an individualized, goal-oriented, multidisciplinary rehabilitation program. Every patient was submitted to a neurological examination and evaluated by means of Kurtzke's Expanded Disability Status Scale (EDSS), with its functional systems (FS), Barthel Index (BI) and the Rivermead Mobility Index (RMI). We observed an effectiveness (percentage of potential improvement achieved during rehabilitation) of nearly 16% on BI and 8% on RMI, corresponding to an improvement in 124 patients (54%) on BI and 113 patients (49%) on RMI. Basal EDSS (beta = -0.32, P <0.001), cognitive status (beta = -0.15, P <0.05) and disease duration (beta = -0.13, P <0.05) were negatively associated with effectiveness of treatment on BI (adjusted R2 = 0.176), whereas effectiveness on RMI was correlated only with the EDSS score (beta = -0.34, P <0.001, adjusted R2 = 0.113). In the logistic regression analysis, the absence of severe sphincteric disturbances was correlated with the probability of improvement on BI that was nearly twice as high (OR =2.25, 95% CI 1.24-4.08) as that of other patients. Moreover, patients without severe cognitive deficits showed a similar probability (OR =2.37, 95% CI 1.05-5.33) of improvement on RMI. The results of this study provide further evidence that intensive multidisciplinary rehabilitation in MS is effective in the majority of MS patients and that early treatment may favour functional recovery.
Assuntos
Esclerose Múltipla Crônica Progressiva/reabilitação , Equipe de Assistência ao Paciente/organização & administração , Centros de Reabilitação/organização & administração , Atividades Cotidianas , Adulto , Avaliação da Deficiência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Avaliação de Programas e Projetos de Saúde , Análise de RegressãoRESUMO
Dendritic cells (DCs) are the most potent antigen-presenting cells of the immune system capable of initiating immune responses to antigens. It is also well documented that cancer patients often experience anergy against tumor antigens. In this study we selected the best protocol for inducing the production of antibodies against the HER2 oncoprotein using DCs to overcome anergy. Murine DCs were pulsed in vitro, using different protocols, with recombinant HER2 fused to a human Fc (in order to improve DC antigen uptake) and were used to vaccinate mice. The obtained results indicate that antigen-pulsed DCs can induce an antibody response and that adding CpG after antigen pulsing greatly increases anti-HER2 antibody production.
Assuntos
Anticorpos Antineoplásicos/imunologia , Antígenos de Neoplasias/imunologia , Vacinas Anticâncer/imunologia , Células Dendríticas , Células Dendríticas/imunologia , Animais , Anticorpos Antineoplásicos/classificação , Formação de Anticorpos , Linfócitos B/imunologia , Neoplasias da Mama/imunologia , Linhagem Celular Tumoral , Células Cultivadas , Citocinas/biossíntese , Células Dendríticas/citologia , Células Dendríticas/efeitos dos fármacos , Células Dendríticas/metabolismo , Feminino , Humanos , Switching de Imunoglobulina/imunologia , Isotipos de Imunoglobulinas/biossíntese , Isotipos de Imunoglobulinas/imunologia , Camundongos , Camundongos Endogâmicos BALB C , Receptor ErbB-2/imunologia , Receptores Fc/imunologia , Receptores Fc/metabolismoRESUMO
Following the bluetongue (BT) epidemic in Italy, the government initiated a vaccination campaign involving all domestic ruminants (cattle, sheep and goats) in the affected and adjacent areas to create a resistant population and to reduce virus circulation. Based on the serotypes circulating in the affected areas, monovalent BT virus (BTV) serotype 2 (BTV-2), or bivalent BTV-2 and BTV-9, modified-live vaccines were used. These are manufactured by Onderstepoort Biological Products in South Africa and, because they are recommended for use in sheep only, very little data exists on their use in cattle under field conditions. To evaluate duration and levels of viraemia and the antibody response following vaccination, 30 cattle in various stages of pregnancy were selected and vaccinated with a bivalent BTV-2/BTV-9 vaccine. Blood samples were taken from the animals three times a week for two months and screened using the competitive enzyme-linked immunosorbent assay (c-ELISA) and the virus neutralisation (VN) test. Intravenous egg inoculation, followed by two blind passages in Vero cells, was used to isolate BTV-2 and BTV-9 from ethylene-diaminetetra-acetic acid (EDTA) blood samples, and virus titres determined in viraemic animals. Titres against BTV were detected in 27 animals between days 4 and 35 post vaccination (pv). Viraemia peaked on day 9 pv with average viral titres of 10(4.5)TCID50/ml. From day 9 pv, the c-ELISA detected antibodies in all animals while low VN titres were observed commencing on day 18 pv. Furthermore, VN antibody to BTV-2 was detected in only 17 of the animals vaccinated and to BTV-9 in 27 animals.
RESUMO
To evaluate the effect of bluetongue (BT) vaccination on milk production in cattle, 30 cows at various stages of gestation were vaccinated using a bivalent bluetongue virus serotype 2 (BTV-2) and BTV-9 modified-live vaccine produced by Onderstepoort Biological Products in South Africa. A second group of 30 pregnant cows was used unvaccinated controls. Blood samples were taken from all animals three times a week for two months. Virus titres were determined and the daily milk production of each cow was quantitatively and qualitatively evaluated. From 27 of the 30 vaccinated cows, BTV was isolated from day 4 to day 28 post vaccination. BTV vaccination had no effect on milk production, somatic cell count, pH, milk fat, protein and lactose content. It is concluded that the bivalent BTV-2/BTV-9 modified-live vaccine does not affect milk production in cows.