Increasing atrial fibrillation: What is the cause?

A 72‐year‐old woman with a history of paroxysmal atrial fibrillation (AF) and sinus node dysfunction is seen in clinic for routine follow‐up.     

Guided walking is more effective than suggested walking in reducing the blood pressure of hypertensive sedentary subjects and in modifying their lifestyle

Sport Sciences for Health - The study has compared the effects of a program of guided walking (GW) and of a program of suggested walking (SW) on the blood pressure and on the lifestyle of sedentary...     

Automatic measurement and visualization of focal femoral cartilage thickness in stress-based regions of interest using three-dimensional knee models

Purpose

Thinning of cartilage is a common manifestation of osteoarthritis. This study addresses the need of measuring the focal femoral cartilage thickness at the weight- bearing regions of the knee by developing a reproducible and automatic method from MR images.

Methods

3D models derived from semiautomatic MR image segmentations were used in this study. Two different methods were examined for identifying the mechanical loading of the knee articulation. The first was based on a generic weight-bearing regions definition, derived from gait characteristics and cadaver studies. The second used a physically based simulation to identify the patient-specific stress distribution of the femoral cartilage, taking into account the forces and movements of the knee. For this purpose, four different scenarios were defined in our 3D finite element (FE) simulations. The radial method was used to calculate the cartilage thickness in stress-based regions of interest, and a study was performed to validate the accuracy and suitability of the radial thickness measurements.

Results

Detailed focal maps using our simulation data and regional measurements of cartilage thickness are given. We present the outcome of the different simulation scenarios and discuss how the internal/external rotations of the knee alter the overall stress distribution and affect the shape and size of the calculated weight-bearing areas. The use of FE simulations allows for a patient-specific calculation of the focal cartilage thickness.

Conclusion

It is important to assess the quantification of focal knee cartilage morphology to monitor the progression of joint diseases or related treatments. When this assessment is based on MR images, accurate and robust tools are required. In this paper, we presented a set of techniques and methodologies in order to accomplish this goal and move toward personalized medicine.

     

Immunization with the conjugate vaccine Vi-CRM(197) against Salmonella Typhi induces Vi-specific mucosal and systemic immune responses in mice

Typhoid fever is a public health problem, especially among young children in developing countries. To address this need, a glycoconjugate vaccine Vi-CRM(197), composed of the polysaccharide antigen Vi covalently conjugated to the non-toxic mutant of diphtheria toxin CRM(197), is under development. Here, we assessed the antibody and cellular responses, both local and systemic, following subcutaneous injection of Vi-CRM(197). The glycoconjugate elicited Vi-specific serum IgG titers significantly higher than unconjugated Vi, with prevalence of IgG1 that persisted for at least 60 days after immunization. Vi-specific IgG, but not IgA, were present in intestinal washes. Lymphocytes proliferation after restimulation with Vi-CRM(197) was observed in spleen and mesenteric lymph nodes. These data confirm the immunogenicity of Vi-CRM(197) and demonstrate that the vaccine-specific antibody and cellular immune responses are present also in the intestinal tract, thus strengthening the suitability of Vi-CRM(197) as a promising candidate vaccine against Salmonella Typhi.     

RETRACTED ARTICLE: Peripheral blood mono-nuclear cells implantation in patients with peripheral arterial disease: a pilot study for clinical and biochemical outcome of neoangiogenesis

Background

Substantial progresses in the management of peripheral arterial disease (PAD) have been made in the past two decades. Progress in the understanding of the endothelial-platelet interaction during health and disease state has resulted in better antiplatelet drugs that can prevent platelet aggregation, activation and thrombosis during angioplasty and stenting. A role in physiological and pathological angiogenesis in adults has been recently shown in bone marrow–derived circulating endothelial progenitors (BM-DCEPs) identified in the peripheral blood. These findings have paved the way for the development of therapeutic neovascularization techniques using endothelial progenitors.

Methods

This pilot study includes five patients, aged 60 to 75, with a history of claudication and recruited from September 2010 to February 2011 at the A.O.U. Federico II of Naples.PBMNCs have been implanted three times in the limb with the worst ABI value in all the patients included in the study.The clinical follow up was performed during the subsequent 12 months from the beginning of the treatment.

Results

In four patients there was a regression of ulcerative lesions.One patient’s condition improved after the first implantation but later did not respond to the further treatments.All patients achieved a pain relief as judged by the numeric pain scale. Pain relief remained satisfactory in three patients for one year. Pain gradually returned to the pre-treatment level in two patients.All patients referred an ameliorating in their quality of life expressed even by an improvement in claudication free walking distance.These improvements are reflected also by intra-arterial digital subtraction angiography (IADSA) that shows an improvement of arterial vascularization.

Conclusions

The data from this study suggest an efficacy of BM-DCEPs implantation in terms of improvement of the vascularization and quality of life in patients affected by Peripheral Arterial Disease. Nevertheless a double-blind placebo-controlled study is needed to confirm our findings.

     

Validation of the Italian version of the SBMA Functional Rating Scale as outcome measure

The Spinal and Bulbar Muscular Atrophy Functional Rating Scale (SBMAFRS) is an established rating instrument used to assess the functional status of patients with Spinal and Bulbar Muscular Atrophy (SBMA). Our aim was to validate an Italian version of the scale. We administered the SBMAFRS to sixty SBMA patients during routine follow-up of clinical evaluations. To estimate the test stability, the scale was re-administered to a subset of 39 randomly selected patients after 8 weeks. The patients underwent clinical evaluation including 6-min walk. Psychometric analysis included reliability assessment and factorial analysis. To evaluate convergent validity, correlations between SBMAFRS items and muscular force assessed by manual testing, ALSFRS total score and subscales scores, and forced vital capacity, were performed. Internal consistency as measured by Cronbach’s alpha (total scale 0.85) was high. Test–retest reliability assessed by Spearman’s rho was also high. Principal component analysis with varimax rotation yielded a four-factor solution accounting for approximately 79 % of the variance. The scale total score and subscales score were strongly correlated with respective items and subscores of the ALSFRS, with respiratory function and with the 6-min walk test. In conclusion, we performed an Italian validation of the only existing disease-specific Functional Rating Scale for SBMA patients. This scale will be a useful tool not only in the clinical practice but also as an outcome measure in upcoming clinical trials.