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Cynthia Aristei Valentina Lancellotta Marco Piergentini Giacomo Costantini Simonetta Saldi Sara Chierchini Antonella Cavalli Luca Di Renzo Oscar Fiorucci Massimo Guasticchi Vittorio Bini Alessandro Ricci 《Brachytherapy》2019,18(1):57-62
Purpose
High-dose-rate, multicatheter interstitial brachytherapy is technically complex and operator-dependent, requiring lengthy training and specialized skills. Furthermore, until the advent of contouring on computerized tomography (CT) images, difficulties existed in locating the target volume precisely. The present article reports the results of a study that aimed at producing and validating a 3D-printed template to aid in target volume localization for multicatheter interstitial brachytherapy in patients with breast cancer.Methods and Materials
Thirteen patients, candidates for accelerated partial breast irradiation or boost, were enrolled in the study. The target volume was defined on CT slices, and a template with empty spaces corresponding to the target volume projection on the patient's skin was produced by a 3D printer. The procedure was compared with the standard method followed in our center (1) visually, by assessing overlap between the target volume projections on the patient's skin, (2) by X-ray findings, and (3) by intraclass correlation coefficient.Results
Visual assessment and X-ray findings showed the 3D-printed target volume always fell within the standard volume in all 13 patients. The intraclass correlation coefficient indicated moderate agreement for both the medial and the lateral skin projections.Conclusions
The 3-D printed templates constitute a quick, easy, and reliable method to localize the target volume for high-dose-rate interstitial multicathether brachytherapy in patients with breast cancer and can safely be used in clinical practice. 相似文献3.
Stefano Ferracuti Benedetta Barchielli Christian Napoli Vittorio Fineschi Gabriele Mandarelli 《International journal of psychiatry in clinical practice》2020,24(3):245-249
AbstractBackground: Suicide is a severe public health problem, in 2008 the Italian ministerial recommendation n° 4 on the management of suicide defined key areas for the identification of suicidal risk in hospital wards. The guidelines are important in defining professional liability issues, in line with Law 24 of 8/3/2017 ‘Gelli-Bianco’. Our study aimed to investigate the appropriateness of the official documents on suicide prevention delivered by Italian hospitals and their compliance with the ministerial recommendation.Methods: The Italian hospitals’ public procedures on suicide prevention issued between 2008 and 2019 (n?=?33) were retrieved thorough web search and further evaluated according to their compliance with the 2008 Italian ministerial recommendations.Results: The guidelines documents were generally in line with the ministerial recommendation. However, we found a lack of implementation in the specific training of health professionals. Most guidelines provided no risk stratification, nor specific procedures for different risk degrees or diagnoses. More than half of the documents did not report standardised tools for the assessment of suicidal risk.Conclusions: The public procedures on suicide prevention in Italian hospitals present general indications, leaving room for interpretation. Public procedures should be implemented with greater attention to the elements of judgement in the assessment of suicidal risk.
- KEY POINTS
Procedures for suicide prevention are of uttermost importance for psychiatrist working in hospital.
Standards in suicide risk evaluations are needed.
Comparison between procedures can improve risk assessment and evaluation
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Alessandro Rambaldi Alessandra Iurlo Alessandro M. Vannucchi Bruno Martino Attilio Guarini Marco Ruggeri Nikolas von Bubnoff Marianna De Muro Mary Frances McMullin Stefania Luciani Vincenzo Martinelli Axel Nogai Vittorio Rosti Alessandra Ricco Paolo Bettica Sara Manzoni Silvia Di Tollo 《Blood cancer journal》2021,11(3)
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Fahrettin Covut Divya Gupta Raisa Pinto Nina Dambrosio Najla El Jurdi Howard Meyerson Masumi Ueda Merle Kolk Richard Creger Leland Metheny Brenda W. Cooper Paolo F. Caimi Ehsan Malek Folashade Otegbeye Hillard M. Lazarus Marcos De Lima Benjamin K. Tomlinson 《Clinical Lymphoma, Myeloma & Leukemia》2019,19(2):73-82
Introduction
Induction chemotherapy with cytarabine and an anthracycline (7+3) remains the standard of care for acute myeloid leukemia (AML).Patients and Methods
We retrospectively analyzed 183 newly diagnosed AML patients to compare the utility of rapid peripheral blast clearance (PBC), day of peripheral blast disappearance, residual blasts, and cellularity at day 14 bone marrow biopsy (D14BM) in predicting clinical response to 7+3 induction, overall survival (OS), and relapse-free survival (RFS).Results
In multivariable logistic regression analysis, day 2 PBC > 85% [P = .0016] was the only predictor of remission status, with sensitivity and specificity of 75%. Peripheral blast disappearance within 5 days after induction and < 10% cellularity in D14BM predicted superior OS and RFS in multivariate analysis. Median follow-up of patients was 28 months since diagnosis. Two-year OS and RFS for patients with ≤ 10% versus > 10% cellularity at D14BM was 60.6% [95% confidence interval (CI), 50.8%-72.2%] versus 32.5% [95% CI, 23.0%-45.8%], and 51.9% [95% CI, 41.9%-64.3%] versus 28.8% [95% CI, 19.1%-43.4%], respectively [P = .0003 for OS and .002 for RFS].Conclusion
Rapid PBC after 7+3 induction showed a significant improvement in specificity compared with D14BM, with similar sensitivity. Neither of these methods were reliably specific tools for the decision of early reinduction, despite their prognostic value. Our findings indicate that morphological cellularity in D14BM is an independent prognostic factor for OS and RFS, regardless of blast percentage, and that ≤ 10% cellularity defines D14BM hypoplasia. 相似文献6.
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Gian N. Frongia Salvatore Naitana Vittorio Farina Sergio D. Gadau Marco D. Stefano Marco Muzzeddu Giovanni Leoni Marco Zedda 《Journal of anatomy》2021,239(1):59-69
Flying is the main means of locomotion for most avian species, and it requires a series of adaptations of the skeleton and of feather distribution on the wing. Flight type is directly associated with the mechanical constraints during flight, which condition both the morphology and microscopic structure of the bones. Three primary flight styles are adopted by avian species: flapping, gliding, and soaring, with different loads among the main wing bones. The purpose of this study was to evaluate the cross-sectional microstructure of the most important skeletal wing bones, humerus, radius, ulna, and carpometacarpus, in griffon vultures (Gyps fulvus) and greater flamingos (Phoenicopterus roseus). These two species show a flapping and soaring flight style, respectively. Densitometry, morphology, and laminarity index were assessed from the main bones of the wing of 10 griffon vultures and 10 flamingos. Regarding bone mineral content, griffon vultures generally displayed a higher mineral density than flamingos. Regarding the morphology of the crucial wing bones involved in flight, while a very slightly longer humerus was observed in the radius and ulna of flamingos, the ulna in griffons was clearly longer than other bones. The laminarity index was significantly higher in griffons. The results of the present study highlight how the mechanics of different types of flight may affect the biomechanical properties of the wing bones most engaged during flight. 相似文献
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Aaron Sathyanesan Panagiotis Kratimenos Vittorio Gallo 《Proceedings of the National Academy of Sciences of the United States of America》2021,118(11)
It is hypothesized that perinatal cerebellar injury leads to long-term functional deficits due to circuit dysmaturation. Using a novel integration of GCaMP6f fiber photometry with automated measurement of cerebellar behavior using the ErasmusLadder, we causally link cerebellar injury to altered Purkinje cell responses during maladaptive behavior. Chemogenetic inhibition of neonatal Purkinje cells is sufficient to phenocopy the effects of perinatal cerebellar injury. Our results uncover a direct link between perinatal cerebellar injury and activity-dependent maturation of cerebellar cortex.Perinatal complications of preterm or term neonates often result in adaptive behavioral deficits. While injury to the developing cerebellum has been correlated to long-term behavioral abnormalities, especially in locomotor function, the specific neural circuits and physiological mechanisms that are disrupted are unknown. Recent work characterized the spatial and temporal components of interlimb coordination in cerebellum-dependent locomotor learning (1). However, the sparsity of techniques available to directly measure neuronal activity during adaptive cerebellar behavior hampers efforts to identify the functional and mechanistic basis of behavioral pathology.We designed a unique method to measure Purkinje cell (PC) activity during an adaptive cerebellum-dependent locomotor learning task. We utilized the ErasmusLadder––an automated behavioral system that can accurately quantify cerebellum-dependent locomotor learning and adaptive behavior. The ErasmusLadder enables the use of an associative conditioned-learning paradigm that is temporally tuned to define cerebellum-specific aspects of motor learning over multiple trials (2, 3). By directly integrating fiber photometry of the genetically encoded Ca2+ indicator—GCaMP6f—with the ErasmusLadder, we successfully and simultaneously recorded population responses of PCs in mice in real time during unrestrained behavior on the ErasmusLadder. We used our method to integrate PC activity measurement with adaptive behavioral quantification to identify a mechanistic basis for locomotor learning dysfunction in a clinically relevant mouse model of neonatal brain injury (4). 相似文献