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31.
Hepatitis B virus (HBV) is DNA-based virus, member of the Hepadnaviridae family, which can cause liver disease and increased risk of hepatocellular carcinoma (HCC) in infected individuals, replicating within the hepatocytes and interacting with several cellular proteins. Chronic hepatitis B can progressively lead to liver cirrhosis, which is an independent risk factor for HCC. Complications as liver decompensation or HCC impact the survival of HBV patients and concurrent HDV infection worsens the disease. The available data provide evidence that HBV infection is associated with the risk of developing HCC with or without an underlying liver cirrhosis, due to various direct and indirect mechanisms promoting hepatocarcinogenesis. The molecular profile of HBV-HCC is extensively and continuously under study, and it is the result of altered molecular pathways, which modify the microenvironment and lead to DNA damage. HBV produces the protein HBx, which has a central role in the oncogenetic process. Furthermore, the molecular profile of HBV-HCC was recently discerned from that of HDV-HCC, despite the obligatory dependence of HDV on HBV. Proper management of the underlying HBV-related liver disease is fundamental, including HCC surveillance, viral suppression, and application of adequate predictive models. When HBV-HCC occurs, liver function and HCC characteristics guide the physician among treatment strategies but always considering the viral etiology in the treatment choice. 相似文献
32.
Coaxial Drainage versus Standard Chest Tube after Pulmonary Lobectomy: A Randomized Controlled Study
Massimiliano Bassi Emilia Mottola Sara Mantovani Davide Amore Andreina Pagini Daniele Diso Jacopo Vannucci Camilla Poggi Tiziano De Giacomo Erino Angelo Rendina Federico Venuta Marco Anile 《Current oncology (Toronto, Ont.)》2022,29(7):4455
Chest tubes are routinely inserted after thoracic surgery procedures in different sizes and numbers. The aim of this study is to assess the efficacy of Smart Drain Coaxial drainage compared with two standard chest tubes in patients undergoing thoracotomy for pulmonary lobectomy. Ninety-eight patients (57 males and 41 females, mean age 68.3 ± 7.4 years) with lung cancer undergoing open pulmonary lobectomy were randomized in two groups: 50 received one upper 28-Fr and one lower 32-Fr standard chest tube (ST group) and 48 received one 28-Fr Smart Drain Coaxial tube (SDC group). Hospitalization, quantity of fluid output, air leaks, radiograph findings, pain control and costs were assessed. SDC group showed shorter hospitalization (7.3 vs. 6.1 days, p = 0.02), lower pain in postoperative day-1 (p = 0.02) and a lower use of analgesic drugs (p = 0.04). Pleural effusion drainage was lower in SDC group in the first postoperative day (median 400.0 ± 200.0 mL vs. 450.0 ± 193.8 mL, p = 0.04) and as a mean of first three PODs (median 325.0 ± 137.5 mL vs. 362.5 ± 96.7 mL, p = 0.01). No difference in terms of fluid retention, residual pleural space, subcutaneous emphysema and complications after chest tubes removal was found. In conclusion, Smart Drain Coaxial chest tube seems a feasible option after thoracotomy for pulmonary lobectomy. The SDC group showed a shorter hospitalization and decreased analgesic drugs use and, thus, a reduction of costs. 相似文献
33.
Paolo De Pasquale Erasmo Rubino Daniele Borzelli Matteo Peditto Enrico Nastro Siniscalchi Francesco Saverio De Ponte Giacomo Oteri Andrea dAvella 《Materials》2022,15(11)
Assessing maximum voluntary bite force is important to characterize the functional state of the masticatory system. Due to several factors affecting the estimation of the maximum bite force, a unique solution combining desirable features such as reliability, accuracy, precision, usability, and comfort is not available. The aim of the present study was to develop a low-cost bite force measurement device allowing for subject-specific customization, comfortable bite force expression, and reliable force estimation over time. The device was realized using an inexpensive load cell, two 3D printed ergonomic forks hosting reusable subject-specific silicone molds, a read-out system based on a low-cost microcontroller, and a wireless link to a personal computer. A simple model was used to estimate bite force taking into account individual morphology and device placement in the mouth. Measurement reliability, accuracy, and precision were assessed on a calibration dataset. A validation procedure on healthy participants was performed to assess the repeatability of the measurements over multiple repetitions and sessions. A 2% precision and 2% accuracy were achieved on measurements of forces in the physiological range of adult bite forces. Multiple recordings on healthy participants demonstrated good repeatability (coefficient of variation 11%) with no significant effect of repetition and session. The novel device provides an affordable and reliable solution for assessing maximum bite force that can be easily used to perform clinical evaluations in single sessions or in longitudinal studies. 相似文献
34.
35.
D'Angelo MG Lorusso ML Civati F Comi GP Magri F Del Bo R Guglieri M Molteni M Turconi AC Bresolin N 《Pediatric neurology》2011,45(5):292-299
The presence of nonprogressive cognitive impairment is recognized as a common feature in a substantial proportion of patients with Duchenne muscular dystrophy. To investigate the possible role of mutations along the dystrophin gene affecting different brain dystrophin isoforms and specific cognitive profiles, 42 school-age children affected with Duchenne muscular dystrophy, subdivided according to sites of mutations along the dystrophin gene, underwent a battery of tests tapping a wide range of intellectual, linguistic, and neuropsychologic functions. Full-scale intelligence quotient was approximately 1 S.D. below the population average in the whole group of dystrophic children. Patients with Duchenne muscular dystrophy and mutations located in the distal portion of the dystrophin gene (involving the 140-kDa brain protein isoform, called Dp140) were generally more severely affected and expressed different patterns of strengths and impairments, compared with patients with Duchenne muscular dystrophy and mutations located in the proximal portion of the dystrophin gene (not involving Dp140). Patients with Duchenne muscular dystrophy and distal mutations demonstrated specific impairments in visuospatial functions and visual memory (which seemed intact in proximally mutated patients) and greater impairment in syntactic processing. 相似文献
36.
Michele Arcangelo Verdano Andrea Pellegrini Giacomo Scita Cosimo Costantino Francesco Ceccarelli 《Musculoskeletal surgery》2013,97(1):51-56
The rotator cuff tear is one of the most frequent musculoskeletal disorders, but the real incidence is not clearly known because it’s usually asymptomatic, even if it’s more common in patients with shoulder pain (36 %). The prevalence of the complete tear among general population is estimated approximately around 20.7 % and it is more usual with the increasing of the age. The aim of this study is to evaluate a group of patients with any size of full-thickness cuff tear treated by arthroscopic technique, comparing the clinical and functional recovery (isokinetic, isotonic and isometric strength) with the un-operated side. Between October 2009 and June 2011, 74 patients, mean age 59 (20–72) years old, underwent arthroscopic treatment for rotator cuff tear. Forty-two patients were finally included in the study, 20 men and 22 women, mean age of 55 (20–68) years old. The mean follow-up was 12 months (6–23 months). The strength of each patient’s shoulder, both operated and un-operated, was evaluated using isokinetic, isotonic and isometric tests (BIODEX Medical System). The functional outcome showed no significant differences between operated and un-operated shoulder, confirmed by Constant–Murley score and DASH score. The isokinetic, isotonic and isometric tests are valid support to clinical evaluation in order to obtain an objective data on shoulder recovery. 相似文献
37.
38.
ApoE is a polymorphic protein involved in the metabolism of plasma lipoproteins; the ε4 allele was shown to be associated
with coronary and aortic atherosclerosis in age-dependent fashion mediated by unknown mechanisms. This study was undertaken
to assess whether the apoE isoforms in humans were associated with normal glucose tolerance and with metabolic and inflammatory
risk factors of CVD. ApoE genotype was assessed in 365 individuals. Of those, 309 were studied in the postabsorptive conditions
and 142 of them also underwent a 3h-OGTT; 56 additional subjects were studied by means of the insulin clamp in combination
with [6,6-2H2] glucose infusion. ApoE genotype frequencies were similar to those previously reported and were not influenced
by age and BMI. Fasting plasma glucose, insulin, FFA, the lipid profile, surrogate markers (HOMA-IR, OGTT-derived index) as
well as the clamp-derived parameters or insulin sensitivity and insulin secretion were not different by apoE genotypes. Serum
adipokines concentrations (leptin, adiponectin, resistin) and markers of inflammation (serum fasting hsCRP and MCP1/CCL2)
were also not different by apoE genotypes. In the subgroup of young ε4 carriers which underwent the clamp procedure, a higher
fasting endogenous glucose production was detected. ApoE genotype was not associated with insulin resistance or altered insulin
secretion, and no abnormalities in the typical circulating endocrine, metabolic, and inflammatory features of the insulin
resistance syndrome were detected. 相似文献
39.
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40.