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BACKGROUND: Caregivers' involvement in the diagnostic and monitoring processes of the level of consciousness of patients with Disorders of Consciousness (DoC) is strongly encouraged by international guidelines, as current literature suggests a better chance to detect behavioural responses when caregivers are involved in clinical assessments. Since caregivers' involvement during clinical assessments can be difficult, the Social And Family Evaluation (SAFE) scale has been recently proposed as a standardised tool that caregivers can autonomously use to collect their opinions about the level of consciousness of patients with DoC, based on the behaviours manifested by the patients in a given time-window. OBJECTIVE: Providing preliminary results concerning SAFE adoption. METHODS: 22 patients with DoC were assessed through the Coma Recovery Scale-revised (CRS-r), while their caregivers filled-in the SAFE. RESULTS: The SAFE showed a very high internal consistency, very high test-retest reliability, and high criterion validity when correlated to the CRS-r total score. Moreover, in line with the literature, the SAFE allowed the detection of some behaviours indicative of a higher level of consciousness than those detected by clinicians through the CRS-r in more than half of the sample. CONCLUSION: Overall, these preliminary data are promising for the adoption of the SAFE to collect the opinions of the caregivers about the level of consciousness of patients with DoC, especially in those settings where it would be otherwise difficult to monitor the patients, such as long-term care structures and at home, as a tool for telemedicine allowing the monitoring of patients in remote settings.
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OBJECTIVE: To describe multiple congenital ocular anomalies in three litters of Jack Russell Terrier puppies. ANIMALS STUDIED: Seven purebred Jack Russell Terrier puppies from three related litters and their four parents. PROCEDURES: Medical records of the puppies and their parents were evaluated. All dogs underwent a complete ophthalmic examination, followed by bilateral ocular ultrasonography in two of the puppies with complete corneal opacity. One eye from an affected puppy was subjected to histopathology. A complete database of pedigrees was built, and individual inbreeding was evaluated. RESULTS: The most commonly diagnosed ocular anomalies in the puppies were: various anomalies of the fundus (12/14 eyes); microphthalmia (10/14 eyes); sclerocornea (8/14 eyes); and persistent pupillary membranes (7/14 eyes). Six out of seven puppies had at least two ocular abnormalities, and only one puppy was normal. Four out of seven puppies had sclerocornea, a particular corneal opacity to date described only in Spanish Podenco dogs. No ocular abnormalities were found in the parents examined (4/4). Analysis of the pedigrees showed that all the puppies and two parents were inbred, and the individual values of the inbreeding puppies were greater than 6.25% in two litters. CONCLUSIONS: Inbreeding with closely related Jack Russell Terriers may result in severe congenital eye abnormalities in puppies.
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Helminth infection was analysed at necropsy and coprology in a total of 54 roe deer from the province of Grosseto (central Italy) between 2018 - 2020. Age and sex data were recorded for each deer for a total of 31 adults (23 females, 8 males) and 23 juveniles (11 females, 12 males). The results on the small intestine (51 samples) highlighted that nematodes belonging to the species Trichostrongylus colubriformis were the most prevalent parasite (41.2 %), followed by the cestode Moniezia expansa (7.8 %). The large intestine results (52 samples) showed Trichuris spp. (53.8 %), Oesophagostomum venulosum (50 %) and Chabertia ovina (26.9 %). In the abomasum, only Ostertagia ostertagi (17.9 %) was found. Of the 34 samples analysed by bronchopulmonary, only the lung of an adult female was positive for Dictyocaulus spp. In two livers out of 33 samples analysed, nematodes of the species Setaria tundra were found on the surface. Copropositivity was observed in 45 of the 52 faecal samples analysed. The results of the present study indicate that the roe deer is host to several species of parasites, which are also common in other cervids and domestic ruminants. Statistical testing highlighted a significant difference between mean intensities in males and females.
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PURPOSE OF REVIEW: Patients with hypertrophic cardiomyopathy (HCM) who have left ventricular outflow tract obstruction (LVOTO) often experience severe symptoms and functional limitation. Relief of LVOTO can be achieved by two invasive interventions, i.e., surgery myectomy and alcohol septal ablation (ASA), leading in experienced hands to a dramatic improvement in clinical status. Despite extensive research, however, the choice of the best option in individual patients remains challenging and poses numerous clinical dilemmas. RECENT FINDINGS: Invasive strategies have been recently incorporated in recommendations for the diagnosis and treatment of HCM on both sides of the Atlantic. These guidelines are based on a bulk of well-designed but retrospective studies as well as on expert opinions. Evidence now exists that adequate evaluation and management of HCM requires a multidisciplinary team capable of choosing the best available options. Management of LVOTO still varies largely based on local expertise and patient preference. Following the trend that has emerged for other cardiac diseases amenable to invasive interventions, the concept of a "HCM heart team" is coming of age.
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Procedimientos Quirúrgicos Cardíacos , Cardiomiopatía Hipertrófica , Ablación por Catéter , Miomectomía Uterina , Cardiomiopatía Hipertrófica/cirugía , Femenino , Humanos , Estudios RetrospectivosRESUMEN
BACKGROUND AND AIM: Adherence to the Mediterranean Diet (MD) has been associated with a longer and better life. The aim of this study was to examine the effects of adherence to the MD, and of nutritional habits on endothelial progenitor (EPCs) and circulating progenitor (CPCs) cells in a cohort of nonagenarians enrolled within the Mugello Study, an epidemiological study aimed at investigating both clinically relevant geriatric items and various health issues, including those related to nutritional status. METHODS AND RESULTS: Four hundred twenty-one nonagenarians (306 F, 115 M, mean age: 93.1 ± 3.2 years) were evaluated. Adherence to MD was assessed through the Mediterranean Diet Score. Elderly subjects who were in the fourth quartile of the Mediterranean diet score showed significantly higher EPCs than subjects grouped into the other three quartiles. After adjustment for confounders, elderly subjects who were in the highest quartile of adherence to the MD score reported to have EPCs' levels significantly higher than those who reported lower values of adherence to the MD. Furthermore, by analyzing different food categories, it was reported that daily consumption of olive oil and a higher consumption of fruit and vegetables showed higher CPCs CD34+ and EPCs CD34+/KDR+ than subjects with not daily or lower consumption. CONCLUSION: Our results support the hypothesis that the adherence to MD, as well as a daily consumption of olive oil and fruit and vegetables, characteristics of MD, may protect against the development of endothelial dysfunction through increasing EPCs and CPCs in older age.
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Dieta Saludable , Dieta Mediterránea , Células Progenitoras Endoteliales/fisiología , Conducta Alimentaria , Envejecimiento Saludable , Estado Nutricional , Factores de Edad , Anciano de 80 o más Años , Antígenos CD34/sangre , Biomarcadores/sangre , Encuestas sobre Dietas , Células Progenitoras Endoteliales/metabolismo , Femenino , Frutas , Evaluación Geriátrica , Humanos , Italia , Masculino , Evaluación Nutricional , Valor Nutritivo , Aceite de Oliva , Factores Protectores , Ingesta Diaria Recomendada , Conducta de Reducción del Riesgo , Receptor 2 de Factores de Crecimiento Endotelial Vascular , VerdurasRESUMEN
Background: A wide range of response rates have been reported in HER2-positive gastric cancer (GC) patients treated with trastuzumab. Other HER2-targeted therapies for GC have yet to show efficacy in clinical trials. These findings raise question about the ability of standard HER2 diagnostics to accurately distinguish between GC patients who would and would not benefit from anti-HER2 therapies. Patients and methods: GC patients (n = 237), including a subset from the Trastuzumab in GC (ToGA) trial were divided into three groups based on HER2 status and history of treatment with standard chemotherapy or chemotherapy plus trastuzumab. We applied mass spectrometry-based proteomic analysis to quantify HER2 protein expression in formalin-fixed tumor samples. Using HER2 expression as a continuous variable, we defined a predictive protein level cutoff to identify which patients would benefit from trastuzumab. We compared quantitated protein level with clinical outcome and HER2 status as determined by conventional HER2 diagnostics. Results: Quantitative proteomics detected a 115-fold range of HER2 protein expression among patients diagnosed as HER2 positive by standard methods. A protein level of 1825 amol/µg was predicted to determine benefit from the addition of trastuzumab to chemotherapy. Trastuzumab treated patients with HER2 protein levels above this cutoff had twice the median overall survival (OS) of their counterparts below the cutoff (35.0 versus 17.5 months, P = 0.011). Conversely, trastuzumab-treated patients with HER2 levels below the cutoff had outcomes similar to HER2-positive patients treated with chemotherapy. (Progression-free survival = 7.0 versus 6.5 months: P = 0.504; OS = 17.5 versus 12.6 months: P = 0.520). HER2 levels were not prognostic for response to chemotherapy. Conclusions: Proteomic analysis of HER2 expression demonstrated a quantitative cutoff that improves selection of GC patients for trastuzumab as compared with current diagnostic methods.
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Antineoplásicos/uso terapéutico , Selección de Paciente , Receptor ErbB-2/análisis , Neoplasias Gástricas/tratamiento farmacológico , Neoplasias Gástricas/genética , Trastuzumab/uso terapéutico , Adulto , Anciano , Supervivencia sin Enfermedad , Femenino , Humanos , Inmunohistoquímica , Hibridación Fluorescente in Situ , Estimación de Kaplan-Meier , Masculino , Espectrometría de Masas/métodos , Persona de Mediana Edad , Terapia Molecular Dirigida/métodos , Modelos de Riesgos Proporcionales , Proteómica/métodos , Receptor ErbB-2/biosíntesis , Neoplasias Gástricas/mortalidadRESUMEN
In this study the anaerobic co-digestion of wine lees together with waste activated sludge in mesophilic and thermophilic conditions was tested at pilot scale. Three organic loading rates (OLRs 2.8, 3.3 and 4.5 kgCOD/m(3)d) and hydraulic retention times (HRTs 21, 19 and 16 days) were applied to the reactors, in order to evaluate the best operational conditions for the maximization of the biogas yields. The addition of lee to sludge determined a higher biogas production: the best yield obtained was 0.40 Nm(3)biogas/kgCODfed. Because of the high presence of soluble chemical oxygen demand (COD) and polyphenols in wine lees, the best results in terms of yields and process stability were obtained when applying the lowest of the three organic loading rates tested together with mesophilic conditions.
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Aguas del Alcantarillado , Eliminación de Residuos Líquidos/métodos , Anaerobiosis , Análisis de la Demanda Biológica de OxígenoRESUMEN
Waste activated sludge production and management plays an important role in wastewater treatment plants (WWTPs), especially from an economic point of view. One possible approach is the anaerobic co-digestion of waste activated sludge with others organic substrates in mesophilic and thermophilic conditions in order to exploit the spare volume of existing reactors, recover energy from biogas production, and obtain a fertilizer as final product. The anaerobic trials were carried out at pilot scale, applying two organic loading rates (2.8 and 4.5 kg chemical oxygen demand (COD)/(m(3)·d)) with a hydraulic retention time of 16 and 21 days. Among agro-wastes, wine lees were chosen because of their continuous availability throughout the year, and their high COD content (up to 200-300 g/l, 70% soluble, on average). The addition of wine lees to activated sludge determined a higher biogas production (best yield was 0.40 Nm(3)/kgCOD(fed)) improving the energetic balance of the sludge line of the WWTP. The characterization of both substrates fed and digester effluents was carried out in terms of heavy metals; comparison with EC proposed limits showed that, due to high content of Cu in wine lees, the loading rate of this agro-waste should be limited to maintain good characteristics of final biosolids.
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Administración de Residuos , Residuos/análisis , Agricultura , Anaerobiosis , Estudios de Factibilidad , Fertilizantes/análisis , VitisRESUMEN
BACKGROUND: In patients with Hypertrophic Cardiomyopathy (HCM) S-ICD is usually the preferred option as pacing is generally not indicated. However, limited data are available on its current practice adoption and long-term follow-up. METHODS: Consecutive HCM patients with S-ICD implanted between 2013 and 2021 in 3 international centers were enrolled in this observational study. Baseline, procedural and follow-up data were regularly collected. Efficacy and safety were compared with a cohort of HCM patients implanted with a tv-ICD. RESULTS: Seventy patients (64% males) were implanted with S-ICD at 41 ± 15 years, whereas 168 patients with tv-ICD at 49 ± 16 years. For S-ICD patients, mean ESC SCD risk score was 4,5 ± 1.9%: 25 (40%) at low-risk, 17 (27%) at intermediate and 20 (33%) at high-risk. Patients were followed-up for 5.1 ± 2.3 years. Two patients (0.6 per 100-person-years, vs 0.4 per 100 person-years with tv-ICD, p = 0.45) received an appropriate shock on VF, 17 (24%) were diagnosed with de-novo AF. Inappropriate shocks occurred in 4 patients (1.2 per 100-person-years, vs 0.9 per 100 person-years with tv-ICD, p = 0.74), all before Smart-Pass algorithm implementation. Four patients experienced device-related adverse events (1.2 per 100-person-years, vs 1 per 100 person-years with tv-ICD, p = 0.35%). CONCLUSIONS: S-ICDs were often implanted in patients with an overall low-intermediate ESC SCD risk, reflecting both the inclusion of additional risk markers and a lower decision threshold. S-ICDs in HCM patients followed for over 5 years showed to be effective in conversion of VF and safe. Greater scrutiny may be required to avoid overtreatment in patients with milder risk profiles.
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Cardiomiopatía Hipertrófica , Desfibriladores Implantables , Humanos , Cardiomiopatía Hipertrófica/terapia , Masculino , Femenino , Persona de Mediana Edad , Adulto , Estudios de Seguimiento , Resultado del Tratamiento , Factores de Tiempo , Anciano , Selección de Paciente , Muerte Súbita Cardíaca/prevención & control , Muerte Súbita Cardíaca/epidemiologíaRESUMEN
BACKGROUND AND AIMS: Whether uric acid (UA) serves as risk factor for cardiovascular diseases or as antioxidant defense has not yet been completely clarified. In this study we investigated the effects of UA on functional recovery in patients receiving cardiac rehabilitation. METHODS AND RESULTS: 306 patients, 209 men and 97 women, age range 25-87 years (mean 68 ± 11), performed the 6-min walk test (6mWT) before and after the rehabilitation, and the increase in walking distance was considered as the outcome measure of the study. Baseline UA serum levels ranged from 1.0 to 10.9 mg/dL (mean 5.2 ± 1.7). As there was a significant (p = 0.005) age*UA levels interaction, patients were divided into two subgroups, less then 65 years (n. 103, 68 men and 35 women, mean age 56 ± 9) and 65 years or more (n. 203, 141 men and 62 women, mean age 74 ± 5). After adjusting for relevant confounders, higher UA levels remained independent positive predictors of the increase in walking distance in older (p < 0.001) but not in younger patients (p = 0.807). CONCLUSIONS: Our findings show an independent association of higher UA levels with better functional recovery after cardiac rehabilitation selectively in elderly patients, suggesting that higher UA levels might reflect the decline in antioxidant defenses that occurs with advancing age. Future studies aimed at understanding the several contradictions concerning UA should, probably, address the issue within this perspective.
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Antioxidantes/metabolismo , Rehabilitación Cardiaca , Enfermedades Cardiovasculares/sangre , Ácido Úrico/sangre , Adulto , Anciano , Anciano de 80 o más Años , Prueba de Esfuerzo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Análisis de Regresión , Factores de RiesgoRESUMEN
Aquagenic urticaria is a rare form of inducible urticaria characterized by wealing at the site of contact of the skin with water, regardless of its temperature, within minutes of exposure. We describe six young women who reported urticarial rashes, triggered mostly by sea bathing, characteristically localized on the inferior facial contours and neck. In four of the six patients, this was the only localization. All six reacted with erythema and wealing to challenge tests with hypertonic saline (3.5% NaCl) applied to the submandibular area and/or neck. Two patients reacted also to tap water or to normal saline, but less intensely. Challenge tests with different hypertonic water solutions, performed in one patient, showed that both salinity and hypertonicity may be pathogenically relevant. Response to antihistamines was poor in three patients. Our experience suggests the existence of a distinct salt-dependent subtype of aquagenic urticaria (SDAU) that affects young women, with a characteristic localization on the inferior facial contours and neck. SDAU is possibly under-recognized and under-reported.
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Agua de Mar/efectos adversos , Cloruro de Sodio/efectos adversos , Urticaria/etiología , Adulto , Femenino , Humanos , Persona de Mediana Edad , Agua/efectos adversos , Adulto Joven , Urticaria Crónica InducibleRESUMEN
Background: Despite having revolutionized the treatment paradigm for advanced melanoma, not all patients benefit from immune checkpoint inhibitor therapy. To date, there are no predictive biomarkers for response or the occurrence of immune-related adverse events (irAEs) to programmed cell death protein 1 (PD-1) inhibitors. Our aim was to investigate the predictive and prognostic role of single nucleotide variants (SNVs) of genes involved in the PD-1 axis. Methods: We analysed, in metastatic melanoma patients treated with nivolumab or pembrolizumab, five PD-1 SNVs, namely PD1.3 G>A (rs11568821), PD1.5 C>T (rs2227981), PD1.6 G>A (rs10204525), PD1.7 T>C(rs7421861), PD1.10 C>G (rs5582977) and three programmed death-ligand 1 (PD-L1) SNVs: +8293 C>A (rs2890658), PD-L1 C>T (rs2297136) and PD-L1 G>C (rs4143815). Association of SNV genotypic frequencies with best overall response to PD-1 inhibitors and development of irAEs were estimated through a modified Poisson regression. A Cox regression modelling approach was applied to evaluate the SNV association with OS. Results: A total of 125 patients with advanced melanoma were included in the analysis. A reduction in irAEs risk was observed in patients carrying the PD-L1 +8293 C/A genotype compared with those carrying the C/C genotype (risk ratio = 0.45; 95% CL 0.22-0.93; P = 0.031). A trend for a reduction in irAEs was also observed with the PD1.5 T allele (risk ratio = 0.70, 95% confidence limits 0.48-1.01 versus C allele). None of the SNVs was associated with response to therapy. Finally, a survival benefit was observed in patients harbouring the PD1.7 C/C genotype (hazard ratio = 0.37; 95% confidence limits 0.14-0.96; P = 0.028) in the homozygous model. Conclusions: Our study showed that PD-1.5 and PD-L1 +8293 SNVs may play a role as a predictive biomarker of development of irAEs to PD-1 inhibitors. PD1.7 SNV may also be associated with a reduction of the risk of death, although further translational research is needed to confirm these results.
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Eight short tandem repeat markers included in the International Society for Animal Genetics panel of 24 loci investigated in canine comparison tests were analysed in a sample of pure-breed dogs, with the purpose of defining an allele nomenclature based on the number of repeats. A regression analysis of the raw data produced by the sequencer, coupled with the direct sequencing of selected alleles, allowed us to propose a system of nomenclature for six of the eight loci (four di-nucleotidic: AHT121, AHTh137, REN169018 and REN64E19, and two tetra-nucleotidic: FH2001 and FH2328). The remaining two loci (INU055 and FH2848) showed a pattern of fragments that did not resolve in a simple allele series. This work may be useful to establish a basis for comparing data across different laboratories for a set of validated canine markers, which can be used in population genetics, forensics and other analyses.
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Perros/clasificación , Perros/genética , Marcadores Genéticos , Repeticiones de Microsatélite , Alelos , Animales , Cruzamiento , Frecuencia de los Genes , Sitios Genéticos , Estándares de Referencia , Análisis de Secuencia de ADNRESUMEN
Wild boar (Sus scrofa L.) is one of the large mammals most spread worldwide, highly adaptable, and its population rapidly increased in many areas in Europe, including Italy, where Tuscany is considered particularly suitable for wild boar. Wild boars are potential hosts for different etiological agents, such as Brucella spp., Leptospira spp. and Pseudorabies virus and they can contribute to maintain and/or to disseminate some bacterial or viral pathogens to humans and domestic animals, above all-in free-range farms. In order to identify hypothetical genomic regions associated with these infection diseases, 96 samples of wild boars hunted in Tuscany during the 2018-2019 and 2019-2020 hunting seasons were considered. Diagnosis was achieved by serological tests and 42 Pseudorabies, 31 Leptospira and 15 Brucella positive animals were identified. All animals were genotyped with Geneseek Genomic Profiler Porcine HD (70 k) and a genome-wide scan was then performed. Significant markers were highlighted for Pseudorabies (two SNPs), Brucella (seven SNPs), and Leptospira (four SNPs) and they were located within, or nearby, 29 annotated genes on chromosome 6, 9, 12, 13, 14 and 18. Eight genes are implicated in viral (SEC14L1, JMJD6, SRSF2, TMPRSS2, MX1, MX2) or bacterial (COL8A1, SPIRE1) infections, seven genes (MFSD11, METTL23, CTTNBP2, BACE2, IMPA2, MPPE1 and GNAL) are involved in mental disorders and one gene (MGAT5B) is related to the Golgi complex. Results presented here provide interesting starting points for future research, validation studies and fine mapping of candidate genes involved in bacterial and viral infections in wild boar.
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Brucella , Leptospira , Seudorrabia , Enfermedades de los Porcinos , Virosis , Animales , Proteínas Portadoras , Humanos , Italia/epidemiología , Histona Demetilasas con Dominio de Jumonji , Leptospira/genética , Fosfoproteínas Fosfatasas , Sus scrofa , Porcinos , Virosis/epidemiologíaRESUMEN
BACKGROUND AND AIM: Previous studies have shown that increased levels of C-reactive protein (CRP) predict cardiovascular events, including stroke, myocardial infarction and death from cardiovascular causes. Previous studies have also shown that increased levels of CRP are strong predictors of the progression of pre-existing carotid artery plaques. However, whether CRP is involved in the development of new plaques, that may or may not be associated with clinical events, in subjects with clean carotid arteries has been scarcely investigated. METHODS AND RESULTS: 486 "InCHIANTI" Study participants (200 men and 286 women, 72% aged 65 years and over) free from carotid artery plaques at baseline, also underwent carotid artery scan three years later. We tested the association of baseline characteristics, cardiovascular risk factors and inflammatory markers with the development of new carotid artery plaques. Older participants were significantly more likely to develop new plaques. Independent of age, the relative risks of developing new plaques associated with heavy smoking and family history of atherosclerosis were 1.7 (95%CI 1.5-1.9) and 1.9 (95%CI 1.2-3.1), respectively. Participants with high (>3 µg/mL) and moderate (≥1 and ≤3 µg/mL) CRP levels had a relative risk of 2.2 (95%CI 1.9-2.6) and 1.9 (95%CI 1.6-2.3) respectively, when compared with subjects with low (<1 µg/mL) CRP levels. Surprisingly, risk factors such as hypertension, diabetes, dyslipidemia and overweight/obesity were not significant predictors of the development of new carotid artery plaques. CONCLUSIONS: High CRP levels independently predict the development of new plaques in older persons with carotid arteries free from atherosclerotic lesions.
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Proteína C-Reactiva/análisis , Arterias Carótidas/patología , Estenosis Carotídea/patología , Factores de Edad , Anciano , Aterosclerosis/genética , Enfermedades Cardiovasculares/sangre , Estenosis Carotídea/epidemiología , Estudios de Cohortes , Femenino , Humanos , Masculino , Estudios Prospectivos , Riesgo , Factores Sexuales , FumarAsunto(s)
Infliximab/efectos adversos , Neurofibromatosis/inducido químicamente , Piel/patología , Anciano , Antirreumáticos/efectos adversos , Antirreumáticos/uso terapéutico , Artritis Reumatoide/tratamiento farmacológico , Biopsia , Femenino , Humanos , Infliximab/uso terapéutico , Neurofibromatosis/diagnósticoAsunto(s)
Hiperplasia Angiolinfoide con Eosinofilia/tratamiento farmacológico , Manejo de la Enfermedad , Dermatosis del Cuero Cabelludo/tratamiento farmacológico , Cuero Cabelludo/patología , Talidomida/uso terapéutico , Hiperplasia Angiolinfoide con Eosinofilia/diagnóstico , Femenino , Humanos , Inmunosupresores , Persona de Mediana Edad , Dermatosis del Cuero Cabelludo/diagnósticoRESUMEN
PURPOSE: The Fugl-Meyer Assessment is the most used and highly recommended clinical assessment of sensorimotor function after stroke. A standardized use of the scale in different countries requires translation and cultural validation to the target language. The objective of the study was to develop an official Italian version of the scale by transcultural translation and validation. METHODS: A standardized multistep translation protocol was adopted to achieve optimal conceptual and semantic equivalence. The developed Italian version was validated in 10 post-stroke hemiparetic patients. Items with low intra- and interrater agreement, quantified as percentage of agreement <70% and/or statistically significant disagreement in relative position or concentration, between different raters were identified and revised. RESULTS: All motor items received a high level of agreement with values well above 70%. Disagreements were observed in 6 items in the sensory, joint range and pain domains and 1 in one reflex item. Items showing disagreements were discussed and revised to establish the final Italian version. CONCLUSIONS: The culturally validated Italian Fugl-Meyer Assessment can reliably be used in research and in clinical practice. A standardized use will improve the quality of sensorimotor assessment in stroke across Italy and allow reliable comparisons of stroke populations internationally.Implications for rehabilitationThe Fugl-Meyer Assessment is the gold standard for evaluation of sensorimotor impairment after stroke.Having access to a transculturally validated official Italian version of Fugl-Meyer Assessment will improve the quality of sensorimotor assessment after stroke among Italian health professionals and researchers. A wider standardized use of the Fugl-Meyer Assessment in Italy will allow reliable international comparison of stroke rehabilitation outcomes.
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Rehabilitación de Accidente Cerebrovascular , Accidente Cerebrovascular , Evaluación de la Discapacidad , Humanos , Lenguaje , Reproducibilidad de los Resultados , Traducciones , Extremidad SuperiorRESUMEN
BACKGROUND AND AIMS: Poststroke shoulder pain is a common complication. We aimed to investigate the prevalence of poststroke shoulder pain, with attention to the neuropathic component, and the relationship between poststroke shoulder pain and upper limb improvement in motor function, strength, disability, and quality of life after upper limb rehabilitation. METHODS: This is a secondary analysis of a multicenter randomized controlled trial to compare upper limb conventional or robotic rehabilitation on 224 patients enrolled in eight rehabilitation centers. We assessed poststroke shoulder pain (using the Numerical Rating Scale and the Douleur Neuropathique 4), and upper limb motor function, strength, disability, and quality of life at baseline (T0), after 30 rehabilitation sessions (T1), and three months after the end of rehabilitation (T2). RESULTS: A moderate/severe poststroke shoulder pain was reported by 28.9% of patients, while 19.6% of them showed a neuropathic component. At T0, the intensity of pain was higher in women and in patients with neglect syndrome, positively correlated with the time since stroke and disability and negatively correlated with motor function, strength, and the physical aspects of the quality of life.Moderate/severe pain and neuropathic component significantly reduced after both treatments and this reduction was maintained at T2. Finally, the intensity of pain at baseline was negatively correlated with the improvement of upper limb motor function. CONCLUSIONS: Poststroke shoulder pain negatively impact on motor performance, strength, disability, and physical aspects of the quality of life as well as on upper limb motor recovery; however, it can be reduced after a robotic or a conventional rehabilitation. Therefore, we suggest considering poststroke shoulder pain when planning the rehabilitation intervention.
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Procedimientos Quirúrgicos Robotizados , Rehabilitación de Accidente Cerebrovascular , Accidente Cerebrovascular , Femenino , Humanos , Calidad de Vida , Recuperación de la Función , Dolor de Hombro/epidemiología , Dolor de Hombro/etiología , Accidente Cerebrovascular/complicaciones , Resultado del Tratamiento , Extremidad SuperiorRESUMEN
Winery wastewaters are variable in nature and are hard to treat by means of the conventional activated sludge process because of the high organic loading associated with their production, especially during vintage. To face this situation, recently, membrane bioreactors have been widely applied to treat winery wastewaters. In this study, a full-scale membrane bioreactor treated some 110 m(3)/d of wastewater and organic loadings up to 1,600 kg COD per day. The average removal efficiency was 95% while the corresponding sludge yield was only 0.1 kg MLVSS per kg COD removed, as usual for these wastewaters. A detailed analysis of energy consumption showed specific energy demands of 2.0-3.6 kWh/m(3) of treated wastewater or 1 kWh per kg of COD removed.