Sample records for agenzia spaziale italiana

  1. Health Authorities Data Collection of THC:CBD Oromucosal Spray (L'Agenzia Italiana del Farmaco Web Registry): Figures after 1.5 Years.

    PubMed

    Patti, Francesco

    2016-01-01

    In Italy, all prescriptions for THC:CBD oromucosal spray for treatment of multiple sclerosis (MS) spasticity are linked to the official Agenzia Italiana del Farmaco (AIFA) web-based registry, which tracks the effectiveness and tolerability of medications in a prospective and observational manner. AIFA e-registry data for THC:CBD oromucosal spray collected between January 2014 and February 2015 for 1,534 patients from 30 large Italian specialized MS centres were compiled. Patients had a long disease history (17.6 ± 8.6 years) and significant impairment (mean Expanded Disability Status Scale score 6.4 ± 1.2). MS spasticity was evaluated using the 0-10 numerical rating scale (NRS). After the first month titration and trial period, 61.9% of patients achieved sufficient improvement in spasticity (≥20% NRS) to qualify for continued treatment. After 6 months, clinically meaningful ≥30% NRS improvement was recorded in 40.2% of patients continuing with treatment. Spasticity-associated symptoms such as cramps and nocturnal spasms improved in most responding patients. Mean reported doses of THC:CBD oromucosal spray (6.2-6.7 sprays/day) were lower than those reported in clinical trials. Adverse events (mainly mild to moderate) were reported by 15% of patients; no new safety concerns beyond the approved label were identified. The results of the AIFA e-registry analysis align with those of other THC:CBD observational projects and reaffirm the characteristics of this therapeutic option in the management of treatment-resistant MS spasticity, a frequently overlooked symptom. © 2016 S. Karger AG, Basel.

  2. Work continues on Destiny, the U.S. Lab module, in the Space Station Processing Facility

    NASA Technical Reports Server (NTRS)

    1999-01-01

    In the Space Station Processing Facility (SSPF), work continues on the U.S. Lab module, Destiny, which is scheduled to be launched on Space Shuttle Endeavour in early 2000. It will become the centerpiece of scientific research on the International Space Station. Destiny shares space in the SSPF with the Shuttle Radar Topography Mission (SRTM) and Leonardo, the Multipurpose Logistics Module (MPLM) built by the Agenzia Spaziale Italiana (ASI). The SRTM is targeted for launch on mission STS-99 in September 1999. Leonardo is scheduled to launch on mission STS- 102 in June 2000.

  3. Work continues on Leonardo, the Multi-Purpose Logistics Module, in the Space Station Processing Faci

    NASA Technical Reports Server (NTRS)

    1999-01-01

    Workers in the Space Station Processing Facility work on Leonardo, the Multipurpose Logistics Module (MPLM) built by the Agenzia Spaziale Italiana (ASI). The MPLM, a reusable logistics carrier, will be the primary delivery system used to resupply and return International Space Station cargo requiring a pressurized environment. Leonardo is the first of three MPLM carriers for the International Space Station. It is scheduled to be launched on Space Shuttle Mission STS-102, targeted for June 2000. Leonardo shares space in the SSPF with the Shuttle Radar Topography Mission (SRTM), targeted for launch in September 1999, and Destiny, the U.S. Lab module, targeted for mission STS-98 in late April 2000.

  4. KSC-98pc1775

    NASA Image and Video Library

    1998-12-03

    KENNEDY SPACE CENTER, FLA. -- Participants pose for a photo at the Space Station Processing Facility ceremony transferring the "Leonardo" Multipurpose Logistics Module (MPLM) from the Italian Space Agency, Agenzia Spaziale Italiana (ASI), to NASA. From left, they are astronaut Jim Voss, ASI President Sergio De Julio, European Space Agency astronaut Umberto Guidoni of Italy, NASA Administrator Daniel S. Goldin and European Space Agency astronaut Christer Fuglesang of Sweden. The MPLM, a reusable logistics carrier, will be the primary delivery system used to resupply and return International Space Station cargo requiring a pressurized environment. Leonardo is the first of three MPLM carriers for the International Space Station. It is scheduled to be launched on Space Shuttle Mission STS-100, targeted for April 2000

  5. KSC-98pc1774

    NASA Image and Video Library

    1998-12-03

    KENNEDY SPACE CENTER, FLA. -- Participants pose for a photo at the Space Station Processing Facility ceremony transferring the "Leonardo" Multipurpose Logistics Module (MPLM) from the Italian Space Agency, Agenzia Spaziale Italiana (ASI), to NASA. From left, they are astronaut Jim Voss, ASI President Sergio De Julio, European Space Agency astronaut Umberto Guidoni of Italy, NASA Administrator Daniel S. Goldin and European Space Agency astronaut Christer Fuglesang of Sweden. The MPLM, a reusable logistics carrier, will be the primary delivery system used to resupply and return International Space Station cargo requiring a pressurized environment. Leonardo is the first of three MPLM carriers for the International Space Station. It is scheduled to be launched on Space Shuttle Mission STS-100, targeted for April 2000

  6. The ceremonial transfer of Leonardo, the first MPLM, from ASI to NASA

    NASA Technical Reports Server (NTRS)

    1998-01-01

    Participants pose for a photo at the Space Station Processing Facility ceremony transferring the 'Leonardo' Multipurpose Logistics Module (MPLM) from the Italian Space Agency, Agenzia Spaziale Italiana (ASI), to NASA. From left, they are astronaut Jim Voss, European Space Agency astronauts Umberto Guidoni of Italy and Christer Fuglesang of Sweden, NASA International Space Station Program Manager Randy Brinkley, NASA Administrator Daniel S. Goldin, ASI President Sergio De Julio and Stephen Francois, director, International Space Station Launch Site Support at KSC. The MPLM, a reusable logistics carrier, will be the primary delivery system used to resupply and return International Space Station cargo requiring a pressurized environment. Leonardo is the first of three MPLM carriers for the International Space Station. It is scheduled to be launched on Space Shuttle Mission STS-100, targeted for April 2000.

  7. KSC-98pc1776

    NASA Image and Video Library

    1998-12-03

    KENNEDY SPACE CENTER, FLA. -- Participants pose for a photo at the Space Station Processing Facility ceremony transferring the "Leonardo" Multipurpose Logistics Module (MPLM) from the Italian Space Agency, Agenzia Spaziale Italiana (ASI), to NASA. From left, they are astronaut Jim Voss, European Space Agency astronauts Umberto Guidoni of Italy and Christer Fuglesang of Sweden, NASA International Space Station Program Manager Randy Brinkley, NASA Administrator Daniel S. Goldin, ASI President Sergio De Julio and Stephen Francois, director, International Space Station Launch Site Support at KSC. The MPLM, a reusable logistics carrier, will be the primary delivery system used to resupply and return International Space Station cargo requiring a pressurized environment. Leonardo is the first of three MPLM carriers for the International Space Station. It is scheduled to be launched on Space Shuttle Mission STS-100, targeted for April 2000

  8. The Imaging X-Ray Polarimetry Explorer (IXPE): Overview

    NASA Technical Reports Server (NTRS)

    O'Dell, Steve; Weisskopf, M.; Soffitta, P.; Baldini, L.; Bellazzini, R.; Costa, E.; Elsner, R.; Kaspi, V.; Kolodziejczak, J.; Latronico, L.; hide

    2017-01-01

    Mission background: Imaging x-ray polarimetry in 2–8 kiloelectronvolt band; NASA Astrophysics Small Explorer (SMEX) selected in 2017 January. Orbit: Pegasus-XL (airborne) launch in 2021, from Kwajalein; Equatorial circular orbit at greater than or approximately equal to 540 kilometers (620 kilometers, goal) altitude. Flight system: Spacecraft, payload structure, and integration by Ball Aerospace - Deployable payload boom from Orbital-ATK, under contract to Ball; X-ray Mirror Module Assemblies by NASA/MSFC; X-ray (polarization-sensitive) Instruments by IAPS/INAF (Istituto di Astrofisica e Planetologia Spaziali / Istituto Nazionale di Astrofisica) and INFN (Istituto Nazionale di Fisica Nucleare). Ground system: ASI (Agenzia Spaziale Italiana) Malindi ground station, with Singapore backup; Mission Operations Center at LASP (Laboratory for Atmospheric and Space Physics, University of Colorado); Science Operations Center at NASA/MSFC; Data archive at HEASARC (High Energy Astrophysics Science Archive Research Center), (NASA/GSFC), mirror at ASI Data Center. Science: Active galactic nuclei; Microquasars; Radio pulsars and pulsar wind nebulae; Supernova remnants; Magnetars; Accreting x-ray pulsars.

  9. The COSMO-SkyMed ground and ILS and OPS segments upgrades for full civilian capacity exploitation

    NASA Astrophysics Data System (ADS)

    Fasano, L.; De Luca, G. F.; Cardone, M.; Loizzo, R.; Sacco, P.; Daraio, M. G.

    2015-10-01

    COSMO-SkyMed (CSK), is an Earth Observation joint program between Agenzia Spaziale Italiana (Italian Space Agency, ASI) and Italian Ministry of Defense (It-MoD). It consists of a constellation of four X Band Synthetic Aperture Radar (SAR) whose first satellite of has been launched on June 2007. Today the full constellation is fully qualified and is in an operative phase. The COSMO-SkyMed System includes 3 Segments: the Space Segment, the Ground Segment and the Integrated Logistic Support and Operations Segment (ILS and OPS) As part of a more complex re-engineering process aimed to improve the expected constellation lifetime, to fully exploit several system capabilities, to manage the obsolescence, to reduce the maintenance costs and to exploit the entire constellation capability for Civilian users a series of activities have been performed. In the next months these activities are planned to be completed and start to be operational so that it will be possible the programming, planning, acquisition, raw processing and archiving of all the images that the constellation can acquire.

  10. Matera Laser Ranging Observatory (MLRO): An overview

    NASA Technical Reports Server (NTRS)

    Varghese, Thomas K.; Decker, Winfield M.; Crooks, Henry A.; Bianco, Giuseppe

    1993-01-01

    The Agenzia Spaziale Italiana (ASI) is currently under negotiation with the Bendix Field Engineering Corporation (BFEC) of the Allied Signal Aerospace Company (ASAC) to build a state-of-the-art laser ranging observatory for the Centro di Geodesia Spaziale, in Matera, Italy. The contract calls for the delivery of a system based on a 1.5 meter afocal Cassegrain astronomical quality telescope with multiple ports to support a variety of experiments for the future, with primary emphasis on laser ranging. Three focal planes, viz. Cassegrain, Coude, and Nasmyth will be available for these experiments. The open telescope system will be protected from dust and turbulence using a specialized dome which will be part of the building facilities to be provided by ASI. The fixed observatory facility will be partitioned into four areas for locating the following: laser, transmit/receive optics, telescope/dome enclosure, and the operations console. The optical tables and mount rest on a common concrete pad for added mechanical stability. Provisions will be in place for minimizing the effects of EMI, for obtaining maximum cleanliness for high power laser and transmit optics, and for providing an ergonomic environment fitting to a state-of-the-art multipurpose laboratory. The system is currently designed to be highly modular and adaptable for scaling or changes in technology. It is conceived to be a highly automated system with superior performance specifications to any currently operational system. Provisions are also made to adapt and accommodate changes that are of significance during the course of design and integration.

  11. BaR-SPOrt: the instrument to be accommodated at Dome C

    NASA Astrophysics Data System (ADS)

    Zannoni, M.; Carretti, E.; Cortiglioni, S.; Macculi, C.; Ramponi, M.; Sbarra, C.; Ventura, G.; Monari, J.; Poloni, M.; Poppi, S.; Natale, V.; Nesti, R.; Baralis, M.; Peverini, O.; Tascone, R.; Virone, G.; Boscaleri, A.; Boella, G.; Sironi, G.; Gervasi, M.; de Bernardis, P.; Masi, S.; de Petris, M.

    The BaR-SPOrt (Balloon-Borne Radiometers for Sky Polarization Observations) experiment, a program of the Agenzia Spaziale Italiana (ASI) co-funded by PNRA (Progetto Nazionale di Ricerca in Antartide) was originally designed as a payload for long duration balloons flights. The changing scenario, both scientific and strategic, has led us to propose it for the starting winter campaign of at the Concordia Base. Here the instrument and the features making it suitable to operate at Dome-C are described. After the initial setup, BaR-SPOrt should not require any kind of routine intervention by a dedicated base staff. The experiment will just need electrical power (less than 2 kW) and a suitable accommodation on the field. It can be fully monitored and controlled, including the data acquisition, through its own telemetry/telecommand link using IRIDIUM modems. Both the receiver and the critical electronics are housed inside a temperature-controlled vacuum chamber, providing the properly stabilized environment. The cold part of the radiometer employs a closed loop mechanical cryo-cooler that provides temperatures <70 ±0.1 K with low power consumption (<200 W).

  12. Space Science

    NASA Image and Video Library

    1997-10-15

    The 7-year journey to Saturn began with the liftoff of a Titan IVB/Centaur carrying the Cassini orbiter and its attached Huygens probe. After a 2.2-billion mile journey that included two swingbys of Venus and one of Earth to gain additional velocity, the two-story tall spacecraft will arrive at Saturn in July 2004. The orbiter will circle the planet for 4 years, its compliment of 12 scientific instruments gathering data about Saturn's atmosphere, rings and magnetosphere, and conducting close-up observations of the Saturnian moons. Huygens, with a separate suite of 6 science instruments, will separate from Cassini to fly on a ballistic trajectory toward Titan, the only celestial body besides Earth to have an atmosphere rich in nitrogen. Scientists are eager to study further this chemical similarity in hopes of learning more about the origins of our own planet Earth. Huygens will provide the first direct sampling of Titan's atmospheric chemistry and the first detailed photographs of its surface. The Cassini mission is an international effort involving NASA, the European Space Agency (ESA), and the Italian Space Agency, Agenzia Spaziale Italiana (ASI).

  13. Italian aerospace company Alenia prepare TSS-1R in O&C

    NASA Technical Reports Server (NTRS)

    1995-01-01

    Employees of the Italian aerospace company Alenia Spazio S.p.A. prepare the Tethered Satellite System-1R (TSS-1R) that is one of two primary payloads scheduled to fly aboard the Orbiter Columbia during the STS-75 mission in early 1996 for a series of tests in the Operations and Checkout (O&C) Building. The TSS program is a joint venture between NASA and the Agenzia Spaziale Italiana, or Italian Space Agency. The 'R' designation indicates a reflight. The TSS-1 flew aboard Atlantis during the STS-46 mission in July 1992 and achieved only a partial success when its tether reel mechanism became jammed after only approximately 840 feet of the 12-mile-long tether had been unwound as the satellite rose from its cradle in the orbiter's payload bay. Once deployed to the 12- mile height on the STS-75 mission, the satellite will be used to validate theories that such a system could possibly be used in the future to generate electrical power to power orbital systems, raise and lower spacecraft, study atmospheric conditions at several different heights and for many other applications.

  14. Space Science

    NASA Image and Video Library

    1997-10-15

    The 7-year journey to Saturn began with the liftoff of a Titan IVB/ Centaur carrying the Cassini orbiter and its attached Huygens probe. After a 2.2-billion mile journey that included two swingbys of Venus and one of the Earth to gain additional velocity, the two-story tall spacecraft will arrive at Saturn in July 2004. The orbiter will circle the planet for 4 years, its compliment of 12 scientific instruments gathering data about Saturn's atmosphere, rings and magnetosphere and conducting close-up observations of Saturnian moons. Huygens, with a separate suite of 6 science instruments, will separate from Cassini to fly on a ballistic trajectory toward Titan, the only celestial body besides Earth to have an atmosphere rich in nitrogen. Scientists are eager to study further this chemical similarity in hopes of learning more about the origins of our own planet Earth. Huygens will provide the first direct sampling of Titan's atmospheric chemistry and the first detailed photographs of its surface. The Cassini mission is an International effort involving NASA, the European Space Agency (ESA), and the Italian Space Agency, Agenzia Spaziale Italiana (ASI).

  15. TSS-1R satellite integration in O&C Building

    NASA Technical Reports Server (NTRS)

    1995-01-01

    John Powell (left) and Jim Nail (second from right) of McDonnell Douglas Space and Defense Systems prepare the satellite element of the Tethered Satellite System-1R (TSS-1R) for integration with its support unit in the Operations and Checkout (O&C) Building. The TSS-1R is one of two primary payloads scheduled to fly aboard the Orbiter Columbia during the STS-75 mission in early 1996. The TSS program is a joint venture between NASA and the Agenzia Spaziale Italiana, or Italian Space Agency. The 'R' designation indicates a reflight. The TSS-1 flew aboard Atlantis during the STS-46 mission in July 1992 and achieved only a partial success when its tether reel mechanism became jammed after only approximately 840 feet of the 12-mile-long tether had been unwound as the satellite rose from its cradle in the orbiter's payload bay. Once deployed to the 12-mile height on the STS-75 mission, the satellite will be used to validate theories that such a system could possibly be used in the future to generate electrical power to power orbital systems, raise and lower spacecraft, study atmospheric conditions at several different heights and for many other applications.

  16. 3-D Imaging of Mars’ Polar Ice Caps Using Orbital Radar Data

    PubMed Central

    Foss, Frederick J.; Putzig, Nathaniel E.; Campbell, Bruce A.; Phillips, Roger J.

    2018-01-01

    Since its arrival in early 2006, various instruments aboard NASA’s Mars Reconnaissance Orbiter (MRO) have been collecting a variety of scientific and engineering data from orbit around Mars. Among these is the SHAllow RADar (SHARAD) instrument, supplied by Agenzia Spaziale Italiana (ASI) and designed for subsurface sounding in the 15–25 MHz frequency band. As of this writing, MRO has completed over 46,000 nearly polar orbits of Mars, 30% of which have included active SHARAD data collection. By 2009, a sufficient density of SHARAD coverage had been obtained over the polar regions to support 3-D processing and analysis of the data. Using tools and techniques commonly employed in terrestrial seismic data processing, we have processed subsets of the resulting collection of SHARAD observations covering the north and south polar regions as SHARAD 3-D volumes, imaging the interiors of the north and south polar ice caps known, respectively, as Planum Boreum and Planum Australe. After overcoming a series of challenges revealed during the 3-D processing and analysis, a completed Planum Boreum 3-D volume is currently being used for scientific research. Lessons learned in the northern work fed forward into our 3-D processing and analysis of the Planum Australe 3-D volume, currently under way. We discuss our experiences with these projects and present results and scientific insights stemming from these efforts. PMID:29400351

  17. Enzyme catalysis in microgravity: steady-state kinetic analysis of the isocitrate lyase reaction.

    PubMed

    Ranaldi, Francesco; Vanni, Paolo; Giachetti, Eugenio

    2003-01-21

    Two decades of research in microgravity have shown that certain biochemical processes can be altered by weightlessness. Approximately 10 years ago, our team, supported by the European Space Agency (ESA) and the Agenzia Spaziale Italiana, started the Effect of Microgravity on Enzyme Catalysis project to test the possibility that the microgravity effect observed at cellular level could be mediated by enzyme reactions. An experiment to study the cleavage reaction catalyzed by isocitrate lyase was flown on the sounding rocket MASER 7, and we found that the kinetic parameters were not altered by microgravity. During the 28th ESA parabolic flight campaign, we had the opportunity to replicate the MASER 7 experiment and to perform a complete steady-state analysis of the isocitrate lyase reaction. This study showed that both in microgravity and in standard g controls the enzyme reaction obeyed the same kinetic mechanism and none of the kinetic parameters, nor the equilibrium constant of the overall reaction were altered. Our results contrast with those of a similar experiment, which was performed during the same parabolic flight campaign, and showed that microgravity increased the affinity of lipoxygenase-1 for linoleic acid. The hypotheses suggested to explain this change effect of the latter were here tested by computer simulation, and appeared to be inconsistent with the experimental outcome.

  18. Progress in the hyperspectral payload for PRISMA programme

    NASA Astrophysics Data System (ADS)

    Meini, Marco; Battazza, Fabrizio; Formaro, Roberto; Bini, Alessandro

    2013-10-01

    The PRISMA (PRecursore IperSpettrale della Missione Applicativa) Programme is an ASI (Agenzia Spaziale Italiana) hyperspectral mission for Earth observation based on a mono-payload single satellite: an Italian Consortium is in charge to realize the mission; Selex ES has the full responsibility of the hyperspectral payload composed by a high spectral resolution spectrometer optically integrated with a medium resolution panchromatic camera. The optical design permits to cover the wavelength range from 400 to 2500 nm and it is based on high transmittance optical assemblies, including a reflective common telescope in Three-Mirror Anastigmat (TMA) configuration, a single slit aperture, a panchromatic camera (700-900 nm) and a spectrometer having two channels (VNIR and SWIR), each one using an suitable prism configuration and spectrally separated by a beam splitter, conceived to minimize the number of optical elements. High performance MCT-based detectors represent the core of the instrument. To provide the required data quality for the entire mission lifetime (5 years), an accurate and stable calibration unit (radiometric and spectral) is integrated, for the in-flight instrument calibration. The thermal design has been based on a passive cooling system: a double stage radiator, suitable oriented and protected from unwanted heat fluxes, high performance heat pipes and an operational heaters network represent the solution adopted to achieve the required thermal stability.

  19. On the Estimate of Frequency Break and Spectral Index at Ion Scales for Interplanetary Magnetic Field Fluctuations

    NASA Astrophysics Data System (ADS)

    Telloni, D.; Bruno, R.; Trenchi, L.

    2014-12-01

    We exploited radial alignments between MESSENGER and WIND spacecraft to study: 1) the radial dependence of the spectral break located at the border between fluid and kinetic regimes; 2) the dependence, if any, of the spectral slope, around the frequency break, on the type of wind, either fast or slow.We found that this spectral break moves to lower and lower frequencies as heliocentric distance increases, following a power-law dependence. Moreover, we found evidence that a cyclotron-resonant dissipation mechanism must participate into the spectral energy cascade together with other possible kinetic noncyclotron-resonant mechanisms.On the other hand, the spectral slope shows a large variability between -3.75 and -1.75 with an average value around -2.8 and a robust tendency for this parameter to be steeper within the trailing edge of high speed streams and to be flatter within the subsequent slower wind, following a gradual transition between these two states. The value of the spectral index seems to depend firmly on the power associated to the fluctuations within the inertial range, higher the power steeper the slope. Research partially supported by the Agenzia Spaziale Italiana, contract ASI/INAF I/013/12/0 and by the European Community's Seventh Framework Programme (FP7/2007-2013) under grant agreement n° 313038/STORM

  20. Huygens Highlights and lessons learned

    NASA Astrophysics Data System (ADS)

    Lebreton, Jean-Pierre

    2015-04-01

    Ten years ago, on 14 January 2005, the Huygens Probe parachuted down to the surface of Titan, Saturn's largest moon. Huygens is part of the international Cassini/Huygens mission, a joint endeavor of NASA, the European Space Agency, and Agenzia Spaziale Italiana. Cassini/Huygens, comprising the NASA-provided Saturn Orbiter and the ESA-provided Huygens probe, was launched in October 1997. It arrived at Saturn in early July 2004. Huygens was released on the 3rd orbit around Saturn. It made measurements during the hypersonic entry, the descent, and for more than one hour on the surface. Unique in situ characterization of the atmosphere along the entry and descent trajectory and of the surface at the landing site was provided, revealing that many Earth-like processes were at work on Titan, a very fascinating methane world. Huygens observations also allowed inferring the ice crust thickness, hence an estimation of the depth of the icy crust/liquid water ocean interface. Huygens measurements are also used as ground-truth of the measurements made by the orbiter during Titan flybys. In this presentation, after a brief review of the major mission milestones, Huygens achievements are discussed in the context of the progress made in our understanding of Titan during the Cassini/Huygens mission. Lessons learned for the future in situ exploration of Titan are addressed. * Most of this work was performed while at ESA/ESTEC, Noordwijk, The Netherlands

  1. Proposed noncryogenic, nondrag-free test of the equivalence principle in space

    NASA Astrophysics Data System (ADS)

    Nobili, A. M.; Bramanti, D.; Catastini, G.; Polacco, E.; Genta, G.; Brusa, E.; Mitrofanov, V. P.; Bernard, A.; Touboul, P.; Cook, A. J.; Hough, J.; Roxburgh, I. W.; Polnarev, A.; Flury, W.; Barlier, F.; Marchal, C.

    1998-04-01

    Ever since Galileo scientists have known that all bodies fall with the same acceleration regardless of their mass and composition. Known as the Universality of Free Fall, this is the most direct experimental evidence of the Weak Equivalence Principle, a founding pillar of General Relativity according to which the gravitational (passive) mass mg and the inertial mass mi are always in the same positive ratio in all test bodies. A space experiment offers two main advantages: a signal about a factor of a thousand bigger than on Earth and the absence of weight. A new space mission named GALILEO GALILEI (GG) has been proposed (Nobili et al., 1995 [J. Astronautical Sciences, 43, 219]; GALILEO GALILEI (GG), PRE PHASE A REPORT, ASI (Agenzia Spaziale Italiana), September 1996) aimed at testing the weak Equivalence Principle (EP) to 1 part in 10 17 in a rapidly spinning (5 Hz) drag-free spacecraft at room temperature, the most recent ground experiments having reached the level of 10 -12 (Adelberger et al., 1990 [PhRvD, 42, 3267]; Su et al., 1994 [PhRvD, 50, 3614]). Here we present a nondrag-free version of GG which could reach a sensitivity of 1 part in 10 16. The main feature of GG is that, similarly to the most recent ground experiments, the expected (low frequency) signal is modulated at higher frequency by spinning the system, in this case by rotating the test bodies (in the shape of hollow cylinders) around their symmetry axes, the signal being in the perpendicular plane. They are mechanically suspended inside the spacecraft and have very low frequencies of natural oscillation (due to the weakness of the springs that can be used because of weightlessness) so as to allow self-centering of the axes; vibrational noise around the spin/signal frequency is attenuated by means of mechanical suspensions. The signal of an EP violation would appear at the spin frequency as a relative ( differential) displacement of the test masses perpendicularly to the spin axis, and be detected

  2. Surprises in the Saturn System: 10 Years of Cassini Discoveries and More Excitement to Come

    NASA Astrophysics Data System (ADS)

    Spilker, L. J.; Altobelli, N.; Edgington, S. G.

    2014-12-01

    Cassini's findings have revolutionized our understanding of Saturn, its complex rings, the amazing assortment of moons and the planet's dynamic magnetic environment. The robotic spacecraft arrived in 2004 after a 7-year flight from Earth, dropped a parachuted probe named Huygens to study the atmosphere and surface of Saturn's big moon Titan, and commenced making astonishing discoveries that continue today. Icy jets shoot from the tiny moon Enceladus; Titan's hydrocarbon lakes and seas are dominated by liquid ethane and methane, and complex pre-biotic chemicals form in the atmosphere and rain to the surface; 3-dimensional structures rise above Saturn's rings, and a giant Saturn storm circled the entire planet. Cassini's findings at Saturn have also fundamentally altered many of our concepts of how planets form around stars. The Solstice Mission continues to provide fundamental new science as Cassini observes seasonal and temporal changes, and addresses new questions that have arisen during the mission thus far. The mission's grand finale occurs in 2017, with 22 inclined orbits between the innermost D ring and the upper portions of Saturn's atmosphere, enabling unique gravity and magnetic field measurements of the planet, unprecedented determination of the ring mass, some of the highest resolution measurements of the rings and Saturn, and in situ observations in a completely new region around the planet. Highlights from 10 years of Cassini's ambitious inquiry at Saturn will be presented along with the remarkable science that will be collected in the next three years. Cassini-Huygens is a cooperative undertaking by NASA, the European Space Agency (ESA), and the Italian space agency (Agenzia Spaziale Italiana, ASI). This work was carried out in part at the Jet Propulsion Laboratory, California Institute of Technology, under contract with NASA. Copyright 2014 California Institute of Technology. Government sponsorship is acknowledged.

  3. KSC-97PC1544

    NASA Image and Video Library

    1997-10-15

    A seven-year journey to the ringed planet Saturn begins with the liftoff of a Titan IVB/Centaur carrying the Cassini orbiter and its attached Huygens probe. Launch occurred at 4:43 a.m. EDT, Oct. 15, from Launch Complex 40 on Cape Canaveral Air Station. After a 2.2-billion mile journey that will include two swingbys of Venus and one of Earth to gain additional velocity, the two-story tall spacecraft will arrive at Saturn in July 2004. The orbiter will circle the planet for four years, its complement of 12 scientific instruments gathering data about Saturn's atmosphere, rings and magnetosphere and conducting closeup observations of the Saturnian moons. Huygens, with a separate suite of six science instruments, will separate from Cassini to fly on a ballistic trajectory toward Titan, the only celestial body besides Earth to have an atmosphere rich in nitrogen. Scientists are eager to study further this chemical similarity in hopes of learning more about the origins of our own planet Earth. Huygens will provide the first direct sampling of Titan's atmospheric chemistry and the first detailed photographs of its surface. The Cassini mission is an international effort involving NASA, the European Space Agency (ESA) and the Italian Space Agency, Agenzia Spaziale Italiana (ASI). The Jet Propulsion Laboratory manages the U.S. contribution to the mission for NASA's Office of Space Science. The major U.S. contractor is Lockheed Martin, which provided the launch vehicle and upper stage, spacecraft propulsion module and radioisotope thermoelectric generators that will provide power for the spacecraft. The Titan IV/Centaur is a U.S. Air Force launch vehicle, and launch operations were managed by the 45th Space Wing

  4. KSC-97PC1546

    NASA Image and Video Library

    1997-10-15

    KENNEDY SPACE CENTER, FLA. -- A seven-year journey to the ringed planet Saturn begins with the liftoff of a Titan IVB/Centaur carrying the Cassini orbiter and its attached Huygens probe. Launch occurred at 4:43 a.m. EDT, Oct. 15, from Launch Complex 40 on Cape Canaveral Air Station. After a 2.2-billion mile journey that will include two swingbys of Venus and one of Earth to gain additional velocity, the two-story tall spacecraft will arrive at Saturn in July 2004. The orbiter will circle the planet for four years, its complement of 12 scientific instruments gathering data about Saturn's atmosphere, rings and magnetosphere and conducting closeup observations of the Saturnian moons. Huygens, with a separate suite of six science instruments, will separate from Cassini to fly on a ballistic trajectory toward Titan, the only celestial body besides Earth to have an atmosphere rich in nitrogen. Scientists are eager to study further this chemical similarity in hopes of learning more about the origins of our own planet Earth. Huygens will provide the first direct sampling of Titan's atmospheric chemistry and the first detailed photographs of its surface. The Cassini mission is an international effort involving NASA, the European Space Agency (ESA) and the Italian Space Agency, Agenzia Spaziale Italiana (ASI). The Jet Propulsion Laboratory manages the U.S. contribution to the mission for NASA's Office of Space Science. The major U.S. contractor is Lockheed Martin, which provided the launch vehicle and upper stage, spacecraft propulsion module and radioisotope thermoelectric generators that will provide power for the spacecraft. The Titan IV/Centaur is a U.S. Air Force launch vehicle, and launch operations were managed by the 45th Space Wing

  5. KSC-cassini

    NASA Image and Video Library

    1997-10-15

    A seven-year journey to the ringed planet Saturn begins with the liftoff of a Titan IVB/Centaur carrying the Cassini orbiter and its attached Huygens probe. Launch occurred at 4:43 a.m. EDT, Oct. 15, from Launch Complex 40 on Cape Canaveral Air Station. After a 2.2-billion mile journey that will include two swingbys of Venus and one of Earth to gain additional velocity, the two-story tall spacecraft will arrive at Saturn in July 2004. The orbiter will circle the planet for four years, its complement of 12 scientific instruments gathering data about Saturn's atmosphere, rings and magnetosphere and conducting closeup observations of the Saturnian moons. Huygens, with a separate suite of six science instruments, will separate from Cassini to fly on a ballistic trajectory toward Titan, the only celestial body besides Earth to have an atmosphere rich in nitrogen. Scientists are eager to study further this chemical similarity in hopes of learning more about the origins of our own planet Earth. Huygens will provide the first direct sampling of Titan's atmospheric chemistry and the first detailed photographs of its surface. The Cassini mission is an international effort involving NASA, the European Space Agency (ESA) and the Italian Space Agency, Agenzia Spaziale Italiana (ASI). The Jet Propulsion Laboratory manages the U.S. contribution to the mission for NASA's Office of Space Science. The major U.S. contractor is Lockheed Martin, which provided the launch vehicle and upper stage, spacecraft propulsion module and radioisotope thermoelectric generators that will provide power for the spacecraft. The Titan IV/Centaur is a U.S. Air Force launch vehicle, and launch operations were managed by the 45th Space Wing

  6. KSC-97PC1547

    NASA Image and Video Library

    1997-10-15

    A seven-year journey to the ringed planet Saturn begins with the liftoff of a Titan IVB/Centaur carrying the Cassini orbiter and its attached Huygens probe. Launch occurred at 4:43 a.m. EDT, Oct. 15, from Launch Complex 40 on Cape Canaveral Air Station. After a 2.2-billion mile journey that will include two swingbys of Venus and one of Earth to gain additional velocity, the two-story tall spacecraft will arrive at Saturn in July 2004. The orbiter will circle the planet for four years, its complement of 12 scientific instruments gathering data about Saturn's atmosphere, rings and magnetosphere and conducting closeup observations of the Saturnian moons. Huygens, with a separate suite of six science instruments, will separate from Cassini to fly on a ballistic trajectory toward Titan, the only celestial body besides Earth to have an atmosphere rich in nitrogen. Scientists are eager to study further this chemical similarity in hopes of learning more about the origins of our own planet Earth. Huygens will provide the first direct sampling of Titan's atmospheric chemistry and the first detailed photographs of its surface. The Cassini mission is an international effort involving NASA, the European Space Agency (ESA) and the Italian Space Agency, Agenzia Spaziale Italiana (ASI). The Jet Propulsion Laboratory manages the U.S. contribution to the mission for NASA's Office of Space Science. The major U.S. contractor is Lockheed Martin, which provided the launch vehicle and upper stage, spacecraft propulsion module and radioisotope thermoelectric generators that will provide power for the spacecraft. The Titan IV/Centaur is a U.S. Air Force launch vehicle, and launch operations were managed by the 45th Space Wing

  7. KSC-97PC1545

    NASA Image and Video Library

    1997-10-15

    A seven-year journey to the ringed planet Saturn begins with the liftoff of a Titan IVB/Centaur carrying the Cassini orbiter and its attached Huygens probe. Launch occurred at 4:43 a.m. EDT, Oct. 15, from Launch Complex 40 on Cape Canaveral Air Station. After a 2.2-billion mile journey that will include two swingbys of Venus and one of Earth to gain additional velocity, the two-story tall spacecraft will arrive at Saturn in July 2004. The orbiter will circle the planet for four years, its complement of 12 scientific instruments gathering data about Saturn's atmosphere, rings and magnetosphere and conducting closeup observations of the Saturnian moons. Huygens, with a separate suite of six science instruments, will separate from Cassini to fly on a ballistic trajectory toward Titan, the only celestial body besides Earth to have an atmosphere rich in nitrogen. Scientists are eager to study further this chemical similarity in hopes of learning more about the origins of our own planet Earth. Huygens will provide the first direct sampling of Titan's atmospheric chemistry and the first detailed photographs of its surface. The Cassini mission is an international effort involving NASA, the European Space Agency (ESA) and the Italian Space Agency, Agenzia Spaziale Italiana (ASI). The Jet Propulsion Laboratory manages the U.S. contribution to the mission for NASA's Office of Space Science. The major U.S. contractor is Lockheed Martin, which provided the launch vehicle and upper stage, spacecraft propulsion module and radioisotope thermoelectric generators that will provide power for the spacecraft. The Titan IV/Centaur is a U.S. Air Force launch vehicle, and launch operations were managed by the 45th Space Wing

  8. Coma dust environment observed by GIADA during the Perihelion of 67P/Churyumov-Gerasimenko.

    NASA Astrophysics Data System (ADS)

    Rotundi, A.; Della Corte, V.; Fulle, M.; Ferrari, M.; Ivanovski, S. L.; Sordini, R.; Mazzotta Epifani, E.; Palumbo, P.; Colangeli, L.; Lopez-Moreno, J. J.; Rodriguez, J.; Zakharov, V.; Bussoletti, E.; Crifo, J. F.; Esposito, F.; Green, S.; Gruen, E.; Lamy, P. L.; McDonnell, T.; Mennella, V.; Molina, A.; Moreno, F.; Ortiz, J. L.; Palomba, E.; Perrin, J. M.; Rodrigo, R.; Weissman, P. R.; Zarnecki, J.; Cosi, M.; Giovane, F.; Gustafson, B.; Herranz, M.; Jeronimo, J. M.; Leese, M.; Lopez-Jimenez, A.; Morales, R.

    2015-12-01

    GIADA (Grain Impact Analyzer and Dust Accumulator) is an in-situ instrument mounted onboard Rosetta monitoring the dust environment of comet 67P/Churyumov-Gerasimenko. GIADA is composed of 3 sub-systems: 1) the Grain Detection System, based on particle detection through light scattering; 2) the Impact Sensor, giving momentum measurement; 3) the Micro-Balances System, constituted of 5 quartz crystal microbalances, giving cumulative deposited dust. The combination of the measurements performed by these 3 subsystems provides: the number, the mass, the momentum and the speed distribution of dust particles emitted from the comet nucleus. We will present the coma dust environment as observed by GIADA during the perihelion phase of the Rosetta space mission. Despite the large distance from the nucleus, more than 200 km, GIADA was able to detect temporal and spatial variation of dust density distribution. Specific high dust spatial density sectors of the coma have been identified and their evolution during the perihelion phase was studied. Acknowledgements. GIADA was built by a consortium led by the Univ. Napoli "Parthenope" & INAF- Oss. Astr. Capodimonte, IT, in collaboration with the Inst. de Astrofisica de Andalucia, ES, Selex-ES s.p.a. and SENER. GIADA is presently managed & operated by Ist. di Astrofisica e Planetologia Spaziali-INAF, IT. GIADA was funded and managed by the Agenzia Spaziale Italiana, IT, with a support of the Spanish Ministry of Education and Science MEC, ES. GIADA was developped from a PI proposal supported by the University of Kent; sci. & tech. contribution given by CISAS, IT, Lab. d'Astr. Spat., FR, and Institutions from UK, IT, FR, DE and USA. We thank the RSGS/ESAC, RMOC/ESOC & Rosetta Project/ESTEC for their outstanding work. Science support provided by NASA through the US Rosetta Project managed by JPL/California Institute of Technology. GIADA calibrated data will be available through the ESA's PSA web site.

  9. KSC-97PC1543

    NASA Image and Video Library

    1997-10-15

    A seven-year journey to the ringed planet Saturn begins with the liftoff of a Titan IVB/Centaur carrying the Cassini orbiter and its attached Huygens probe. This spectacular streak shot was taken from Hangar AF on Cape Canaveral Air Station, with a solid rocket booster retrieval ship in the foreground. Launch occurred at 4:43 a.m. EDT, Oct. 15, from Launch Complex 40 on Cape Canaveral Air Station. After a 2.2-billion mile journey that will include two swingbys of Venus and one of Earth to gain additional velocity, the two-story tall spacecraft will arrive at Saturn in July 2004. The orbiter will circle the planet for four years, its complement of 12 scientific instruments gathering data about Saturn's atmosphere, rings and magnetosphere and conducting closeup observations of the Saturnian moons. Huygens, with a separate suite of six science instruments, will separate from Cassini to fly on a ballistic trajectory toward Titan, the only celestial body besides Earth to have an atmosphere rich in nitrogen. Scientists are eager to study further this chemical similarity in hopes of learning more about the origins of our own planet Earth. Huygens will provide the first direct sampling of Titan's atmospheric chemistry and the first detailed photographs of its surface. The Cassini mission is an international effort involving NASA, the European Space Agency (ESA) and the Italian Space Agency, Agenzia Spaziale Italiana (ASI). The Jet Propulsion Laboratory manages the U.S. contribution to the mission for NASA's Office of Space Science. The major U.S. contractor is Lockheed Martin, which provided the launch vehicle and upper stage, spacecraft propulsion module and radioisotope thermoelectric generators that will provide power for the spacecraft. The Titan IV/Centaur is a U.S. Air Force launch vehicle, and launch operations were managed by the 45th Space Wing

  10. Space Radar Image of Kilauea Volcano, Hawaii

    NASA Technical Reports Server (NTRS)

    1994-01-01

    This three-dimensional image of the volcano Kilauea was generated based on interferometric fringes derived from two X-band Synthetic Aperture Radar data takes on April 13, 1994 and October 4, 1994. The altitude lines are based on quantitative interpolation of the topographic fringes. The level difference between neighboring altitude lines is 20 meters (66 feet). The ground area covers 12 kilometers by 4 kilometers (7.5 miles by 2.5 miles). The altitude difference in the image is about 500 meters (1,640 feet). The volcano is located around 19.58 degrees north latitude and 155.55 degrees west longitude. Spaceborne Imaging Radar-C and X-band Synthetic Aperture Radar (SIR-C/X-SAR) is part of NASA's Mission to Planet Earth. The radars illuminate Earth with microwaves, allowing detailed observations at any time, regardless of weather or sunlight conditions. SIR-C/X-SAR uses three microwave wavelengths: L-band (24 cm), C-band (6 cm) and X-band (3 cm). The multi-frequency data will be used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI), with the Deutsche Forschungsanstalt fuer Luft und Raumfahrt e.V.(DLR), the major partner in science, operations and data processing of X-SAR. The Instituto Ricerca Elettromagnetismo Componenti Elettronici (IRECE) at the University of Naples was a partner in the interferometry analysis.

  11. Ten years of Cassini Discoveries in the Saturn System and More Excitement to Come

    NASA Astrophysics Data System (ADS)

    Spilker, Linda J.; Edgington, Scott; Altobelli, Nicolas

    2014-11-01

    Cassini’s findings have revolutionized our understanding of Saturn, its complex rings, the amazing assortment of moons and the planet’s dynamic magnetic environment. The robotic spacecraft arrived in 2004 after a 7-year flight from Earth, dropped a parachuted probe named Huygens to study the atmosphere and surface of Saturn’s big moon Titan, and commenced making astonishing discoveries that continue today. Icy jets shoot from the tiny moon Enceladus; Titan’s hydrocarbon lakes and seas are dominated by liquid ethane and methane, and complex pre-biotic chemicals form in the atmosphere and rain to the surface; 3-dimensional structures rise above Saturn’s rings, and a giant Saturn storm circled the entire planet. Cassini’s findings at Saturn have also fundamentally altered many of our concepts of how planets form around stars. The Solstice Mission continues to provide fundamental new science as Cassini observes seasonal and temporal changes, and addresses new questions that have arisen during the mission thus far. Cassini is now 4 years into its 7-year Solstice Mission. The mission’s grand finale occurs in 2017, with 22 inclined orbits between the innermost D ring and the upper portions of Saturn’s atmosphere, enabling unique gravity and magnetic field measurements of the planet, unprecedented determination of the ring mass, some of the highest resolution measurements of the rings and Saturn, and in situ observations in a completely new region around the planet. Highlights from 10 years of Cassini’s ambitious inquiry at Saturn will be presented along with the remarkable science that will be collected in the next three years.Cassini-Huygens is a cooperative undertaking by NASA, the European Space Agency (ESA), and the Italian space agency (Agenzia Spaziale Italiana, ASI).This work was carried out in part at the Jet Propulsion Laboratory, California Institute of Technology, under contract with NASA. Copyright 2014 California Institute of Technology

  12. Three dimensional perspective view of Mammoth Mountain, California

    NASA Image and Video Library

    1994-04-17

    STS059-S-084 (17 April 1994) --- This is a three-dimensional perspective of Mammoth Mountain, California. This view was constructed by overlaying a SIR-C radar image on a U.S. Geological Survey digital elevation map. Vertical exaggeration is 2x. The image is centered at 37.6 degrees north, 119.0 degrees west. It was acquired from the Spaceborne Imaging Radar-C and X-Band Synthetic Aperture Radar (SIR-C/X-SAR) onboard the Space Shuttle Endeavour on its 67th orbit, April 13, 1994. In this color representation, red is C-Band HV-polarization, green is C-Band VV-polarization and blue is the ratio of C-Band VV to C-Band HV. Blue areas are smooth and yellow areas are rock outcrops with varying amounts of snow and vegetation. Crowley Lake is in the foreground and Highway 395 crosses in the middle of the image. Mammoth Mountain is shown in the upper right. SIR-C/X-SAR is part of NASA's Mission to Planet Earth (MTPE). SIR-C/X-SAR radars illuminate Earth with microwaves allowing detailed observations at any time, regardless of weather or sunlight conditions. SIR-C/X-SAR uses three microwave wavelengths: L-Band (24 cm), C-Band (6 cm), and X-Band (3 cm). The multi-frequency data will be used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory (JPL). X-SAR was developed by the Dornire and Alenia Spazio Companies for the German Space Agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian Space Agency, Agenzia Spaziale Italiana (ASI). JPL Photo ID: P-43933

  13. Methodology and results of a space station education pilot programme in the primary school

    NASA Astrophysics Data System (ADS)

    Mirra, G.; Mirra, C.

    Potential users of the Space Station Freedom are now still in the Primary School. Subject studies 1 have shown that a robust familiarization programme has to be developed in order to increase public awareness on the microgravity environment and its capabilities to perform unique science. At the same time, several surveys 2 have demonstrated that elementary school students are showing the greatest interest and enthusiasm in space related activities among all school students. With these boundary conditions, a pilot programme, aimed at verifying the capabilities of young primary school pupils (aged between 10 and 12) in understanding why one performs research in space, has been conceived. In order to overcome the lack of space training of school teachers, an expert in space operations joined a group of elementary teachers to activate this program: merging the necessary didactic and technical capabilities. Consequently, the aim of the program becomes two folded: •generate critical thinking and problem solving capacities as well as inventiveness in children making them aware on the use of space to improve life on Earth. •identify the key issues for the definition of a robust space utilization educational programme. The programme has been managed by MARS Center. the Italian User Support Center for the Space Station utilization, and the institute "Speranzas" in the nearby of Naples, Italy. MARS Center, in particular, is responsible towards the national agency ASI, Agenzia Spaziale Italiana, of the execution of the promotional activity towards all the possible target groups: young students are among these groups. This programme started in late 1992 and is currently ongoing. The objective of this paper is to provide a description of the methodology and the reasons of such a programme with a snapshot on the preliminary results and future trends. Means used as supporting tools, such as films, posters and role plays are herein depicted as well as statistics on the pupils

  14. Space Radar Image of Kilauea, Hawaii - interferometry 1

    NASA Technical Reports Server (NTRS)

    1994-01-01

    This X-band image of the volcano Kilauea was taken on October 4, 1994, by the Spaceborne Imaging Radar-C/X-band Synthetic Aperture Radar. The area shown is about 9 kilometers by 13 kilometers (5.5 miles by 8 miles) and is centered at about 19.58 degrees north latitude and 155.55 degrees west longitude. This image and a similar image taken during the first flight of the radar instrument on April 13, 1994 were combined to produce the topographic information by means of an interferometric process. This is a process by which radar data acquired on different passes of the space shuttle is overlaid to obtain elevation information. Three additional images are provided showing an overlay of radar data with interferometric fringes; a three-dimensional image based on altitude lines; and, finally, a topographic view of the region. Spaceborne Imaging Radar-C and X-band Synthetic Aperture Radar (SIR-C/X-SAR) is part of NASA's Mission to Planet Earth. The radars illuminate Earth with microwaves, allowing detailed observations at any time, regardless of weather or sunlight conditions. SIR-C/X-SAR uses three microwave wavelengths: L-band (24 cm), C-band (6 cm) and X-band (3 cm). The multi-frequency data will be used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI), with the Deutsche Forschungsanstalt fuer Luft und Raumfahrt e.V.(DLR), the major partner in science, operations and data processing of X-SAR. The Instituto Ricerca Elettromagnetismo

  15. Space Radar Image of Kilauea, Hawaii

    NASA Technical Reports Server (NTRS)

    1994-01-01

    Data acquired on April 13, 1994 and on October 4, 1994 from the X-band Synthetic Aperture Radar on board the space shuttle Endeavour were used to generate interferometric fringes, which were overlaid on the X-SAR image of Kilauea. The volcano is centered in this image at 19.58 degrees north latitude and 155.55 degrees west longitude. The image covers about 9 kilometers by 13 kilometers (5.6 miles by 8 miles). The X-band fringes correspond clearly to the expected topographic image. The yellow line indicates the area below which was used for the three-dimensional image using altitude lines. The yellow rectangular frame fences the area for the final topographic image. Spaceborne Imaging Radar-C and X-band Synthetic Aperture Radar (SIR-C/X-SAR) is part of NASA's Mission to Planet Earth. The radars illuminate Earth with microwaves, allowing detailed observations at any time, regardless of weather or sunlight conditions. SIR-C/X-SAR uses three microwave wavelengths: L-band (24 cm), C-band (6 cm) and X-band (3 cm). The multi-frequency data will be used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI), with the Deutsche Forschungsanstalt fuer Luft und Raumfahrt e.V.(DLR), the major partner in science, operations and data processing of X-SAR. The Instituto Ricerca Elettromagnetismo Componenti Elettronici (IRECE) at the University of Naples was a partner in interferometry analysis.

  16. Monitoring Comet 67P/C-G Micrometer Dust Flux: GIADA onboard Rosetta.

    NASA Astrophysics Data System (ADS)

    Della Corte, Vincenzo; Rotundi, Alessandra; Ivanovski, Stavro; Accolla, Mario; Ferrari, Marco; Sordini, Roberto; Lucarelli, Francesca; Zakharov, Vladimir; Fulle, Marco; Mazzotta Epifani, Elena; López-Moreno, José J.; Rodríguez, Julio; Colangeli, Luigi; Palumbo, Pasquale; Bussoletti, Ezio; Crifo, Jean-Francois; Esposito, Francesca; Green, Simon F.; Grün, Eberhard; Lamy, Philippe L.

    2015-04-01

    (21)ESA-ESAC, Camino Bajo del Castillo, s/n., Urb. Villafranca del Castillo, 28692 Villanueva de la Cañada, Madrid, Spagna The MicroBalance System (MBS) is one of the three measurement subsystems of GIADA, the Grain Impact Analyzer and Dust Accumulator on board the Rosetta/ESA spacecraft (S/C). It consists of five Quartz Crystal Microbalances (QCMs) in roughly orthogonal directions providing the cumulative dust flux of grains smaller than 10 microns. The MBS is continuously monitoring comet 67P/CG since the beginning of May 2014. During the first 4 months of measurements, before the insertion of the S/C in the bound orbit phase, there were no evidences of dust accumulation on the QCMs. Starting from the beginning of October, three out of five QCMs measured an increase of the deposited dust. The measured fluxes show, as expected, a strong anisotropy. In particular, the dust flux appears to be much higher from the Sun direction with respect to the comet direction. Acknowledgment: GIADA was built by a consortum led by the Univ. Napoli "Parthenope" & INAF- Oss. Astr. Capodimonte, in collaboration with the Inst. de Astrofisica de Andalucia, Selex-ES, FI and SENER. GIADA is presently managed & operated by Ist. di Astrofisica e Planetologia Spaziali-INAF, IT. GIADA was funded and managed by the Agenzia Spaziale Italiana, IT, with the support of the Spanish Ministry of Education and Science MEC, ES. GIADA was developed from a PI proposal from the University of Kent; sci. & tech. contribution were provided by CISAS, IT, Lab. d'Astr. Spat., FR, and Institutions from UK, IT, FR, DE and USA. We thank the RSGS/ESAC, RMOC/ESOC & Rosetta Project/ESTEC for their out-standing work. Science support provided was by NASA through the US Rosetta Project managed by the Jet Propulsion Laboratory/ California Institute of Technology. GIADA calibrated data will be available through ESA's PSA web site (www.rssd.esa.int/index.php? project=PSA&page=in dex). We would like to thank Angioletta

  17. False-color L-band image of Manaus region of Brazil

    NASA Image and Video Library

    1994-04-13

    for the German Space Agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian Space Agency, Agenzia Spaziale Italiana (ASI). JPL Photo ID: P-43895

  18. Space Radar Image of Raco Biomass Map

    NASA Technical Reports Server (NTRS)

    1999-01-01

    space agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI), with the Deutsche Forschungsanstalt fuer Luft und Raumfahrt e.v. (DLR), the major partner in science, operations and data processing of X-SAR.

  19. Giada improved calibration of measurement subsystems

    NASA Astrophysics Data System (ADS)

    Della Corte, V.; Rotundi, A.; Sordini, R.; Accolla, M.; Ferrari, M.; Ivanovski, S.; Lucarelli, F.; Mazzotta Epifani, E.; Palumbo, P.

    2014-12-01

    GIADA (Grain Impact Analyzer and Dust Accumulator) is an in-situ instrument devoted to measure the dynamical properties of the dust grains emitted by the comet. An Extended Calibration activity using the GIADA Flight Spare Model has been carried out taking into account the knowledge gained through the analyses of IDPs and cometary samples returned from comet 81P/Wild 2. GIADA consists of three measurement subsystems: Grain Detection System, an optical device measuring the optical cross-section for individual dust; Impact Sensor an aluminum plate connected to 5 piezo-sensors measuring the momentum of impacting single dust grains; Micro Balance System measuring the cumulative deposition in time of dust grains smaller than 10 μm. The results of the analyses on data acquired with the GIADA PFM and the comparison with calibration data acquired during the pre-launch campaign allowed us to improve GIADA performances and capabilities. We will report the results of the following main activities: a) definition of a correlation between the 2 GIADA Models (PFM housed in laboratory and In-Flight Model on-board ROSETTA); b) characterization of the sub-systems performances (signal elaboration, sensitivities, space environment effects); c) new calibration measurements and related curves by means of the PFM model using realistic cometary dust analogues. Acknowledgements: GIADA was built by a consortium led by the Univ. Napoli "Parthenope" & INAF-Oss. Astr. Capodimonte, IT, in collaboration with the Inst. de Astrofisica de Andalucia, ES, Selex-ES s.p.a. and SENER. GIADA is presently managed & operated by Ist. di Astrofisica e Planetologia Spaziali-INAF, IT. GIADA was funded and managed by the Agenzia Spaziale Italiana, IT, with a support of the Spanish Ministry of Education and Science MEC, ES. GIADA was developed from a University of Kent, UK, PI proposal; sci. & tech. contribution given by CISAS, IT, Lab. d'Astr. Spat., FR, and Institutions from UK, IT, FR, DE and USA. We thank

  20. GIADA On-Board Rosetta: Early Dust Grain Detections and Dust Coma Characterization of Comet 67P/C-G

    NASA Astrophysics Data System (ADS)

    Rotundi, A.; Della Corte, V.; Accolla, M.; Ferrari, M.; Ivanovski, S.; Lucarelli, F.; Mazzotta Epifani, E.; Sordini, R.; Palumbo, P.; Colangeli, L.; Lopez-Moreno, J. J.; Rodriguez, J.; Fulle, M.; Bussoletti, E.; Crifo, J. F.; Esposito, F.; Green, S.; Grün, E.; Lamy, P. L.; McDonnell, T.; Mennella, V.; Molina, A.; Moreno, F.; Ortiz, J. L.; Palomba, E.; Perrin, J. M.; Rodrigo, R.; Weissman, P. R.; Zakharov, V.; Zarnecki, J.

    2014-12-01

    GIADA (Grain Impact Analyzer and Dust Accumulator) flying on-board Rosetta is devoted to study the cometary dust environment of 67P/Churiumov-Gerasimenko. GIADA is composed of 3 sub-systems: the GDS (Grain Detection System), based on grain detection through light scattering; an IS (Impact Sensor), giving momentum measurement detecting the impact on a sensed plate connected with 5 piezoelectric sensors; the MBS (MicroBalances System), constituted of 5 Quartz Crystal Microbalances (QCMs), giving cumulative deposited dust mass by measuring the variations of the sensors' frequency. The combination of the measurements performed by these 3 subsystems provides: the number, the mass, the momentum and the velocity distribution of dust grains emitted from the cometary nucleus.No prior in situ dust dynamical measurements at these close distances from the nucleus and starting from such large heliocentric distances are available up to date. We present here the first results obtained from the beginning of the Rosetta scientific phase. We will report dust grains early detection at about 800 km from the nucleus in August 2014 and the following measurements that allowed us characterizing the 67P/C-G dust environment at distances less than 100 km from the nucleus and single grains dynamical properties. Acknowledgements. GIADA was built by a consortium led by the Univ. Napoli "Parthenope" & INAF-Oss. Astr. Capodimonte, IT, in collaboration with the Inst. de Astrofisica de Andalucia, ES, Selex-ES s.p.a. and SENER. GIADA is presently managed & operated by Ist. di Astrofisica e Planetologia Spaziali-INAF, IT. GIADA was funded and managed by the Agenzia Spaziale Italiana, IT, with a support of the Spanish Ministry of Education and Science MEC, ES. GIADA was developped from a PI proposal supported by the University of Kent; sci. & tech. contribution given by CISAS, IT, Lab. d'Astr. Spat., FR, and Institutions from UK, IT, FR, DE and USA. We thank the RSGS/ESAC, RMOC/ESOC & Rosetta Project

  1. Nexavar®-related adverse reactions: Calabrian (Italy) experience for sorafenib exposition in 2012

    PubMed Central

    Cilurzo, Felisa; Staltari, Orietta; Patanè, Marinella; Ammendola, Michele; Garaffo, Caterina; Di Paola, Eugenio Donato

    2013-01-01

    Hepatocellular carcinoma (HCC) remains a major global health problem and Calabria in the south of Italy is not an exception. Sorafenib is the first and only Food and Drug Administration approved drug for the treatment of advanced HCC and it is currently under intensive monitoring by the Health Authorities in Italy Agenzia Italiana del Farmaco. This general report has been developed with the aim of briefly reviewing the data found in the reports of adverse reactions (ADRs) collected in Calabria in 2012 for sorafenib treated patients. Extrapolated data have highlighted some differences between the adverse drug reactions reported in patients younger or older than 70 years and other important differences with the current approved leaflet. Several limitations might be present in data analysis form spontaneous reporting, however, the relevance of reporting ADRs (dermatitis, asthenia, vomiting, etc.) for the early identification of drug related signals has to be underlined. PMID:24347990

  2. Space Radar Image of Niya ruins, Taklamakan desert

    NASA Technical Reports Server (NTRS)

    1999-01-01

    human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtange-legenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI), with the Deutsche Forschungsanstaltfuer Luft und Raumfahrt e.v.(DLR), the major partner in science, operations and data processing of X-SAR.

  3. Space Radar Image of Colima Volcano, Jalisco, Mexico

    NASA Technical Reports Server (NTRS)

    1994-01-01

    and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI), with the Deutsche Forschungsanstalt fuer Luft und Raumfahrt e.V.(DLR), the major partner in science, operations and data processing of X-SAR.

  4. Color Image of Death Valley, California from SIR-C

    NASA Technical Reports Server (NTRS)

    1999-01-01

    studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI).

  5. Three dimensional perspective view of portion of western Galapagos Islands

    NASA Image and Video Library

    1994-04-18

    which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory (JPL). X-SAR was developed by the Dornire and Alenia Spazio Companies for the German Space Agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian Space Agency, Agenzia Spaziale Italiana (ASI). JPL Photo ID: P-43938

  6. GIADA onboard Rosetta characterising comet 67/PChuryumov-Gerasimenko dust environment inbound to and outbound from perihelion.

    NASA Astrophysics Data System (ADS)

    Della Corte, Vincenzo; Rotundi, Alessandra; Fulle, Marco

    2016-07-01

    GIADA (Grain Impact Analyzer and Dust Accumulator) is an in-situ instrument onboard Rosetta monitoring the dust environment of comet 67P/Churyumov-Gerasimenko. GIADA is composed of 3 sub-systems: 1) the Grain Detection System, based on particle detection through light scattering; 2) the Impact Sensor, measuring particle momentum; 3) the Micro-Balances System, constituted of 5 quartz crystal microbalances, providing cumulated dust from different directions. From the combination of the measurements performed by the three subsystems we retrieve: the number, the mass, the momentum, the speed of individual dust particles and the cumulative dust flux emitted from the comet nucleus. We will present the coma dust environment as observed by GIADA during the pre-landing and escort phases of the Rosetta space mission. GIADA was able to detect temporal and spatial variation of dust density distribution and to disentangle different types of impacting dust particles. Specific high dust spatial density sectors of the coma have been identified and their evolution with respect to the heliocentric distance was studied. From August 2014 to December 2015, i.e. inbound, at and outbound perihelion, Rosetta performed different trajectories around the nucleus and flybys with different close approach distances, different coordinates of the sub-spacecraft point and different observing geometry (phase angle), allowed GIADA to characterize the dust environment within the 67P/C-G coma and its temporal variation. Acknowledgements. GIADA was built by a consortium led by the Univ. Napoli "Parthenope" & INAF- Oss. Astr. Capodimonte, IT, in collaboration with the Inst. de Astrofisica de Andalucia, ES, Selex-ES s.p.a. and SENER. GIADA is presently managed & operated by Ist. di Astrofisica e Planetologia Spaziali-INAF, IT. GIADA was funded and managed by the Agenzia Spaziale Italiana, IT, with a support of the Spanish Ministry of Education and Science MEC, ES. GIADA was developed from a PI proposal

  7. False-color composite image of Raco, Michigan

    NASA Image and Video Library

    1994-04-10

    insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory (JPL). X-SAR was developed by the Dornire and Alenia Spazio Companies for the German Space Agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian Space Agency, Agenzia Spaziale Italiana (ASI). JPL Photo ID: P-43882

  8. Radar Image of Galapagos Island

    NASA Technical Reports Server (NTRS)

    1994-01-01

    which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI).

  9. North Central Thailand

    NASA Technical Reports Server (NTRS)

    1998-01-01

    NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI), with the Deutsche Forschungsanstalt fuer Luft und Raumfahrt e.v.(DLR), the major partner in science, operations, and data processing of X-SAR.

  10. [Counterfeit Medicines in Internet and the Fakeshare European Project: Experiences and Activities in Spain].

    PubMed

    Catalán-Matamoros, Daniel; González-Ochando, Nuria; Pecharroman-Arribas, Henar; Fernández-Muelas, Ana; Bentolila-Benchimol, Stella Sandra; IbarraLorente, Manuel

    2016-08-16

    The illicit trafficking of medicines over the Internet is a growing problem that affects public health. Since 2013, the Spanish Agency of Medicines and Medical Devices (AEMPS) participates in the European project Fakeshare, co-funded by the European Commission and coordinated by the Italian Medicines Agency (Agenzia Italiana del Farmaco, AIFA). This project aims to coordinate initiatives against the illegal supply of medicines, including from purchases through websites engaged in illegal activity, to thefts and other diversions of medicines to the illicit trafficking.This paper presents the activities in that area as well as strategies and elaborated materials at the national level. The keys to fight or face the illegal sale of medicines over the internet are coordinated cooperation with all the stakeholders, development of communication campaigns to raise awareness and sensitize consumers, health professionals and industry organizations about the risks of buying medicines on illegal websites, creating databases to share information on thefts and other deviations to the illegal market and disseminate national practices to combat illicit medicines trafficking at European and international levels.

  11. [Safety and tolerability of psychotropic medications in childhood: preliminary data of a pharmacovigilance study].

    PubMed

    Magazù, A; Masi, G; Germanò, E; Gagliostro, M S; Siracusano, R; Arcoraci, V; Spina, E; Gagliano, A

    2014-06-01

    The aim of this study was to evaluate adverse drug reactions (ADRs) of psychotropic medications in childhood. One hundred and two children and adolescents (M 82.4%, F 17.6%) followed-up at the Division of Child Neurology and Psychiatry at the University of Messina, and at the Scientific Institute Child Neurology and Psychiatry, IRCCS Stella Maris, Calambrone, Pisa, were recruited between January 2009 and December 2011. All participants met DSM-IV diagnostic criteria for psychiatric disorders. The data were collected using a recording sheet for ADRs. An electronic database was also used. The recording sheet was designed to note all relevant information about drug treatment and ADRs according to AIFA (Agenzia Italiana del Farmaco) suggestions. The most prescribed drugs were: risperidone (19.6%), aripiprazole (18.4%) and valproic acid (14.8%). The ADRs more frequently recorded had been: weight gain (12.6%), sleepiness (8.4%), and irritability (6.7%). None of recorded ADRs were classified as "serious". This study can provide a basic model to collect information on safety and tolerability of psychotropic drugs in childhood.

  12. Space Radar Image of Manaus, Brazil

    NASA Technical Reports Server (NTRS)

    1999-01-01

    changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI), with the Deutsche Forschungsanstalt fuer Luft und Raumfahrt e.v. (DLR), the major partner in science, operations and data processing of X-SAR.

  13. Mission X: Train Like an Astronaut Challenge

    NASA Technical Reports Server (NTRS)

    Lloyd, Charles W.

    2016-01-01

    The Mission X: Train Like an Astronaut Challenge was developed in 2011 to encourage proper exercise and nutrition at an early age by teaching young people to live and eat like space explorers. The strong correlation between an unhealthy childhood diet and adolescent fitness, and the onset of chronic diseases as an adult is the catalyst for Mission X. Mission X is dedicated to assisting people on a global scale to live healthier lifestyles and learn about human space exploration. The Mission X: Train Like an Astronaut 2015 (MX15) International Challenge hosted almost 40,000 children on 800 teams, 28 countries affiliated with 12 space agencies. The MX15 website included 17 languages. MX15, the fifth annual international fitness challenges sponsored by the NASA Human Research Program worked with the European Space Agency and other space agencies from around the world. In comparison to MX14, MX15 expanded to include four additional new countries, increased the number of students by approximately 68% and the number of teams by 29%. Chile' and South Korea participated in the new fall Astro Charlie Walk Around the Earth Challenge. Pre-challenge training materials were made more readily available from the website. South Korea completed a prospective assessment of the usability of the MX content for improving health and fitness in 212 preschool children and their families. Mission X is fortunate to have the support of the NASA, ESA and JAXA astronaut corps. In MX15, they participated in the opening and closing events as well as while on-board the International Space Station. Italian Astronaut Samantha Cristoretti participated as the MX15 Astronaut Ambassador for health and fitness providing the opening video and other videos from ISS. United Kingdom Astronaut Tim Peake and US Astronaut Kate Rubins have agreed to be the MX Ambassadors for 2016 and 2017 respectively. The MX15 International Working Group Face-to-Face meeting and Closing Event were held at the Agenzia Spaziale

  14. Space Radar Image of Central African Gorilla Habitat

    NASA Technical Reports Server (NTRS)

    1999-01-01

    Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI), with the Deutsche Forschungsanstalt fuer Luft und Raumfahrt e.v. (DLR), the major partner in science, operations and data processing of X-SAR.

  15. Space Radar Image Isla Isabela in 3-D

    NASA Technical Reports Server (NTRS)

    1999-01-01

    , complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI).

  16. Cassini-Huygens Science Highlights: Surprises in the Saturn System

    NASA Astrophysics Data System (ADS)

    Spilker, Linda; Altobelli, Nicolas; Edgington, Scott

    2014-05-01

    mission occurs in 2017, when a series of 22 inclined orbits sends Cassini between the innermost D ring and the upper portions of Saturn's atmosphere, enabling unique gravity and magnetic field measurements of the planet, unprecedented determination of the ring mass, some of the highest resolution measurements of the rings and Saturn, and in situ observations in a completely new region around the planet. Cassini-Huygens is a cooperative undertaking by NASA, the European Space Agency (ESA), and the Italian space agency (Agenzia Spaziale Italiana, ASI). This work was carried out in part at the Jet Propulsion Laboratory, California Institute of Technology, under contract with NASA. Copyright 2014 California Institute of Technology. Government sponsorship is acknowledged.

  17. Space Radar Image of San Francisco, California

    NASA Technical Reports Server (NTRS)

    1994-01-01

    which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI), with the Deutsche Forschungsanstalt fuer Luft und Raumfahrt e.V. (DLR), the major partner in science, operations and data processing of X-SAR.

  18. Space Radar Image of Mammoth, California

    NASA Technical Reports Server (NTRS)

    1999-01-01

    environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI) with the Deutsche Forschungsanstalt fur Luft und Raumfahrt e.v. (DLR), the major partner in science, operation and data processing of X-SAR.

  19. Space Radar Image of Colombian Volcano

    NASA Technical Reports Server (NTRS)

    1999-01-01

    weather or sunlight conditions. SIR-C/X-SAR uses three microwave wavelengths: L-band (24 cm), C-band (6 cm) and X-band (3 cm). The multi-frequency data will be used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companiesfor the German space agency, Deutsche Agentur fuer Raumfahrtange-legenheiten (DARA), and the Italian space agency,Agenzia SpazialeItaliana (ASI), with the Deutsche Forschungsanstalt fuer Luft undRaumfahrt e.v.(DLR), the major partner in science,operations, and data processing of X-SAR.

  20. Three frequency false color image of Flevoland, the Netherlands

    NASA Image and Video Library

    1994-04-18

    international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory (JPL). X-SAR was developed by the Dornire and Alenia Spazio Companies for the German Space Agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian Space Agency, Agenzia Spaziale Italiana (ASI). JPL Photo ID: P-43941

  1. STS-68 radar image: Glasgow, Missouri

    NASA Image and Video Library

    1994-10-07

    -frequency data will be used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory (JPL). X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI), with the Deutsche Forschungsanstalt fuer Luft und Raumfahrt e.v. (DLR), the major partner in science, operations and data processing of X-SAR. (P-44734)

  2. Space Radar Image of Moscow, Russia

    NASA Technical Reports Server (NTRS)

    1994-01-01

    community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI), with the Deutsche Forschungsanstalt fuer Luft und Raumfahrt e.V.(DLR), the major partner in science, operations and data processing of X-SAR.

  3. Color composite C-band and L-band image of Kilauea volcanoe on Hawaii

    NASA Image and Video Library

    1994-04-15

    -C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory (JPL). X-SAR was developed by the Dornire and Alenia Spazio Companies for the German Space Agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian Space Agency, Agenzia Spaziale Italiana (ASI). JPL Photo ID: P-43918

  4. Unzen Volcano, Japan

    NASA Technical Reports Server (NTRS)

    1995-01-01

    multi-frequency data will be used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI).

  5. Space Radar Image of Kilauea, Hawaii

    NASA Technical Reports Server (NTRS)

    1999-01-01

    community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI).

  6. Space Radar Image of the Yucatan Impact Crater Site

    NASA Technical Reports Server (NTRS)

    1999-01-01

    to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtange-legenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI), with the Deutsche Forschungsanstalt fuer Luft und Raumfahrt e.v.(DLR), the major partner in science, operations, and data processing of X-SAR. Research on the biological effects of the Chicxulub impact is supported by the NASA Exobiology Program.

  7. Space Radar Image of Bebedauro, Brazil, seasonal

    NASA Technical Reports Server (NTRS)

    1994-01-01

    -C/X-SAR) is part of NASA's Mission to Planet Earth. The radars illuminate Earth with microwaves, allowing detailed observations at any time, regardless of weather or sunlight conditions. SIR-C/X-SAR uses three microwave wavelengths: L-band (24 cm), C-band (6 cm) and X-band (3 cm). The multi-frequency data will be used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI), with the Deutsche Forschungsanstalt fuer Luft und Raumfahrt e.V. (DLR), the major partner in science, operations and data processing of X-SAR.

  8. On the COSMO-SkyMed Exploitation for Interferometric DEM Generation

    NASA Astrophysics Data System (ADS)

    Teresa, C. M.; Raffaele, N.; Oscar, N. D.; Fabio, B.

    2011-12-01

    Work supported by ASI (Agenzia Spaziale Italiana) in the framework of the project "AO-COSMO Project ID-1462 - Feasibility of possible use of COSMO/SkyMed in bistatic SAR Earth observation - ASI Contract I/063/09/0". References [1] B. Rabus, M. Eineder, A. Roth, and R. Bamler, "The Shuttle Radar Topography Mission-A new class of digital elevation models acquired by spaceborne radar," ISPRS J. Photogramm. Remote Sens., vol. 57, no. 4, pp. 241-262, Feb. 2003. [2] F. BOVENGA, D. O. NITTI, R. NUTRICATO, M. T. CHIARADIA, "C- and X-band multi-pass InSAR analysis over Alpine and Apennine regions". In Proceedings of the European Space Agency Living Planet Symposium, June 28 - July 2, 2010, Bergen, Norway. [3] D. REALE, D. O. NITTI, D. PEDUTO, R. NUTRICATO, F. BOVENGA, G. FORNARO, "Postseismic Deformation Monitoring With The COSMO/SKYMED Constellation". IEEE Geoscience Remote Sensing Letters, 2011. DOI: 10.1109/LGRS.2010.2100364 [4] Nitti, D.O., Nutricato, R., Bovenga, F., Conte, D., Guerriero, L. & Milillo, G., "Quantitative Analysis of Stripmap And Spotlight SAR Interferometry with CosmoSkyMed constellation.", Proceedings if IEEE IGARSS 2009, July 13-17, 2009. Cape Town, South Africa.

  9. Three frequency false-color image of Oberpfaffenhofen supersite in Germany

    NASA Image and Video Library

    1994-04-18

    -C/X-SAR radars illuminate Earth with microwaves allowing detailed observations at any time, regardless of weather or sunlight conditions. SIR-C/X-SAR uses three microwave wavelengths: L-Band (24 cm), C-Band (6 cm), and X-Band (3 cm). The multi-frequency data will be used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory (JPL). X-SAR was developed by the Dornire and Alenia Spazio Companies for the German Space Agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian Space Agency, Agenzia Spaziale Italiana (ASI). JPL Photo ID: P-43930

  10. Space Radar Image of Chernobyl

    NASA Technical Reports Server (NTRS)

    1994-01-01

    conditions. SIR-C/X-SAR uses three microwave wavelengths: L-band (24 cm), C-band (6 cm) and X-band (3 cm). The multi-frequency data will be used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI), with the Deutsche Forschungsanstalt fuer Luft und Raumfahrt e.v.(DLR), the major partner in science, operations and data processing of X-SAR.

  11. False-color composite of Oetztal, Austria

    NASA Image and Video Library

    1994-04-13

    detailed observations at any time, regardless of weather or sunlight conditions. SIR-C/X-SAR uses three microwave wavelengths: L-Band (24 cm), C-Band (6 cm), and X-Band (3 cm). The multi-frequency data will be used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory (JPL). X-SAR was developed by the Dornire and Alenia Spazio Companies for the German Space Agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian Space Agency, Agenzia Spaziale Italiana (ASI). JPL Photo ID: P-43890

  12. Space Radar Image of Kliuchevskoi Volcano, Russia

    NASA Technical Reports Server (NTRS)

    1994-01-01

    illuminate Earth with microwaves, allowing detailed observations at any time, regardless of weather or sunlight conditions. SIR-C/X-SAR uses three microwave wavelengths: L-band (24 cm), C-band (6 cm) and X-band (3 cm). The multi-frequency data will be used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI), with the Deutsche Forschungsanstalt fuer Luft und Raumfahrte.v. (DLR), the major partner in science, operations and data processing of X-SAR.

  13. Space Radar Image of Mississippi Delta

    NASA Technical Reports Server (NTRS)

    1999-01-01

    illuminate Earth with microwaves allowing detailed observations at any time, regardless of weather or sunlight conditions. SIR-C/X-SAR uses three microwave wavelengths: L-band (24 cm), C-band (6 cm) and X-band (3 cm). The multi-frequency data will be used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI), with the Deutsche Forschungsanstalt fuer Luft und Raumfahrt e.v.(DLR), the major partner in science, operations, and data processing of X-SAR.

  14. Space Radar Image of Taal Volcano, Philippines

    NASA Technical Reports Server (NTRS)

    1994-01-01

    with microwaves, allowing detailed observations at any time, regardless of weather or sunlight conditions. SIR-C/X-SAR uses three microwave wavelengths: L-band (24 cm), C-band (6 cm) and X-band (3 cm). The multi-frequency data will be used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI), with the Deutsche Forschungsanstalt fuer Luft und Raumfahrt e.v.(DLR), the major partner in science, operations and data processing of X-SAR.

  15. Space Radar Image of Oetzal, Austria

    NASA Technical Reports Server (NTRS)

    1999-01-01

    microwaves allowing detailed observations at any time, regardless of weather or sunlight conditions. SIR-C/X-SAR uses three microwave wavelengths: L-band (24 cm), C-band (6 cm) and X-band (3 cm). The multi-frequency data will be used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI).

  16. Space Radar Image of Oberpfaffenhofen, Germany

    NASA Technical Reports Server (NTRS)

    1999-01-01

    -C/X-SAR uses three microwave wavelengths: L-band (24 cm), C-band (6 cm) and X-band (3 cm). The multi-frequency data will be used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI), with the Deutsche Forschungsanstalt fuer Luft und Raumfahrt e.v. (DLR), the major partner in science, operations and data processing of X-SAR.

  17. Space Radar Image of Flevoland, Netherlands

    NASA Technical Reports Server (NTRS)

    1999-01-01

    used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI), with the Deutsche Forschungsanstalt fuer Luft und Raumfahrte.v. (DLR), the major partner in science, operations and data processing of X-SAR.

  18. Pharmacovigilance and drug safety in Calabria (Italy): 2012 adverse events analysis

    PubMed Central

    Giofrè, Chiara; Scicchitano, Francesca; Palleria, Caterina; Mazzitello, Carmela; Ciriaco, Miriam; Gallelli, Luca; Paletta, Laura; Marrazzo, Giuseppina; Leporini, Christian; Ventrice, Pasquale; Carbone, Claudia; Saullo, Francesca; Rende, Pierandrea; Menniti, Michele; Mumoli, Laura; Chimirri, Serafina; Patanè, Marinella; Esposito, Stefania; Cilurzo, Felisa; Staltari, Orietta; Russo, Emilio; De Sarro, Giovambattista

    2013-01-01

    Introduction: Pharmacovigilance (PV) is designed to monitor drugs continuously after their commercialization, assessing and improving their safety profile. The main objective is to increase the spontaneous reporting of adverse drug reactions (ADRs), in order to have a wide variety of information. The Italian Drug Agency (Agenzia Italiana del Farmaco [AIFA]) is financing several projects to increase reporting. In Calabria, a PV information center has been created in 2010. Materials and Methods: We obtained data using the database of the National Health Information System AIFA relatively to Italy and Calabria in the year 2012. Descriptive statistics were performed to analyze the ADRs. Results: A total number of 461 ADRs have been reported in the year 2012 with an increase of 234% compared with 2011 (138 reports). Hospital doctors are the main source of this reporting (51.62%). Sorafenib (Nexavar®), the combination of amoxicillin/clavulanic acid and ketoprofen represent the drugs most frequently reported causing adverse reactions. Adverse events in female patients (61.83%) were more frequently reported, whereas the age groups “41-65” (39.07%) and “over 65” (27.9%) were the most affected. Conclusions: Calabria has had a positive increase in the number of ADRs reported, although it has not yet reached the gold standard set by World Health Organization (about 600 reports), the data have shown that PV culture is making inroads in this region and that PV projects stimulating and increasing PV knowledge are needed. PMID:24347984

  19. Pharmacovigilance and drug safety 2011 in Calabria (Italy): Adverse events analysis.

    PubMed

    Scicchitano, Francesca; Giofrè, Chiara; Palleria, Caterina; Mazzitello, Carmela; Ciriaco, Miriam; Gallelli, Luca; Paletta, Laura; Marrazzo, Giuseppina; De Fazio, Salvatore; Menniti, Michele; Curia, Rubens; Arena, Concetta; Chimirri, Serafina; Patanè, Marinella; Esposito, Stefania; Cilurzo, Felisa; Staltari, Orietta; Russo, Emilio; De Sarro, Giovambattista

    2012-09-01

    Pharmacovigilance assesses the safety profile of drugs. Its main aim is the increase of spontaneous reporting of adverse drug reactions (ADRs). The Italian Drug Agency (AIFA; Agenzia Italiana del Farmaco) is financing several projects to the aim of increasing reporting, and in Calabria a Pharmacovigilance Information Centre has been created. We analyzed the AIFA database relatively to Calabria in the year 2011 and we have analyzed ADRs using descriptive statistics. We have also collected a questionnaire-based interview in order to describe the background knowledge in the field. Regarding the number of AIFA reported ADRs from Calabria, a 38% increase (138 vs. 100) in comparison to 2010 was evidenced. Hospital Doctors represent the main source of signaling (71.7 %). Ketoprofene and the combination amoxicillin/clavulanic acid represent the most frequently reported drugs causing ADRs. Our questionnaires indicated that despite the health professionals have met at least once an ADR only a small percentage of them was reported to the authorities (37%). There is a very good knowledge of the ADR concept and reporting system (90% of interviewed distinguish an ADR and knows how to report it), and there is a strong interest in participating to training courses in the field (95% are interested). Despite Calabria has had a positive increase in the number of reported ADRs, the total number is very low and the pharmacovigilance culture is far from being achieved in this region.

  20. Pharmacovigilance and drug safety in Calabria (Italy): 2012 adverse events analysis.

    PubMed

    Giofrè, Chiara; Scicchitano, Francesca; Palleria, Caterina; Mazzitello, Carmela; Ciriaco, Miriam; Gallelli, Luca; Paletta, Laura; Marrazzo, Giuseppina; Leporini, Christian; Ventrice, Pasquale; Carbone, Claudia; Saullo, Francesca; Rende, Pierandrea; Menniti, Michele; Mumoli, Laura; Chimirri, Serafina; Patanè, Marinella; Esposito, Stefania; Cilurzo, Felisa; Staltari, Orietta; Russo, Emilio; De Sarro, Giovambattista

    2013-12-01

    Pharmacovigilance (PV) is designed to monitor drugs continuously after their commercialization, assessing and improving their safety profile. The main objective is to increase the spontaneous reporting of adverse drug reactions (ADRs), in order to have a wide variety of information. The Italian Drug Agency (Agenzia Italiana del Farmaco [AIFA]) is financing several projects to increase reporting. In Calabria, a PV information center has been created in 2010. We obtained data using the database of the National Health Information System AIFA relatively to Italy and Calabria in the year 2012. Descriptive statistics were performed to analyze the ADRs. A total number of 461 ADRs have been reported in the year 2012 with an increase of 234% compared with 2011 (138 reports). Hospital doctors are the main source of this reporting (51.62%). Sorafenib (Nexavar(®)), the combination of amoxicillin/clavulanic acid and ketoprofen represent the drugs most frequently reported causing adverse reactions. Adverse events in female patients (61.83%) were more frequently reported, whereas the age groups "41-65" (39.07%) and "over 65" (27.9%) were the most affected. Calabria has had a positive increase in the number of ADRs reported, although it has not yet reached the gold standard set by World Health Organization (about 600 reports), the data have shown that PV culture is making inroads in this region and that PV projects stimulating and increasing PV knowledge are needed.

  1. Pharmacovigilance and drug safety 2011 in Calabria (Italy): Adverse events analysis

    PubMed Central

    Scicchitano, Francesca; Giofrè, Chiara; Palleria, Caterina; Mazzitello, Carmela; Ciriaco, Miriam; Gallelli, Luca; Paletta, Laura; Marrazzo, Giuseppina; De Fazio, Salvatore; Menniti, Michele; Curia, Rubens; Arena, Concetta; Chimirri, Serafina; Patanè, Marinella; Esposito, Stefania; Cilurzo, Felisa; Staltari, Orietta; Russo, Emilio; De Sarro, Giovambattista

    2012-01-01

    Background: Pharmacovigilance assesses the safety profile of drugs. Its main aim is the increase of spontaneous reporting of adverse drug reactions (ADRs). The Italian Drug Agency (AIFA; Agenzia Italiana del Farmaco) is financing several projects to the aim of increasing reporting, and in Calabria a Pharmacovigilance Information Centre has been created. Materials and Methods: We analyzed the AIFA database relatively to Calabria in the year 2011 and we have analyzed ADRs using descriptive statistics. We have also collected a questionnaire-based interview in order to describe the background knowledge in the field. Results: Regarding the number of AIFA reported ADRs from Calabria, a 38% increase (138 vs. 100) in comparison to 2010 was evidenced. Hospital Doctors represent the main source of signaling (71.7 %). Ketoprofene and the combination amoxicillin/clavulanic acid represent the most frequently reported drugs causing ADRs. Our questionnaires indicated that despite the health professionals have met at least once an ADR only a small percentage of them was reported to the authorities (37%). There is a very good knowledge of the ADR concept and reporting system (90% of interviewed distinguish an ADR and knows how to report it), and there is a strong interest in participating to training courses in the field (95% are interested). Conclusions: Despite Calabria has had a positive increase in the number of reported ADRs, the total number is very low and the pharmacovigilance culture is far from being achieved in this region. PMID:23826016

  2. Space Radar Image of the Silk route in Niya, Taklamak, China

    NASA Technical Reports Server (NTRS)

    1999-01-01

    -C and X-band Synthetic Aperture Radar (SIR-C/X-SAR) is part of NASA's Mission to Planet Earth. The radars illuminate Earth with microwaves, allowing detailed observations at any time, regardless of weather or sunlight conditions. SIR-C/X-SAR uses three microwave wavelengths: the L-band (24 cm), C-band (6 cm) and X-band (3 cm). The multi-frequency data will be used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI), with the Deutsche Forschungsanstalt fuer Luft und Raumfahrt e.v.(DLR), the major partner in science, operations and data processing of X-SAR.

  3. EDITORIAL: Proceedings of the 8th International LISA Symposium, Stanford University, California, USA, 28 June-2 July 2010 Proceedings of the 8th International LISA Symposium, Stanford University, California, USA, 28 June-2 July 2010

    NASA Astrophysics Data System (ADS)

    Buchman, Sasha; Sun, Ke-Xun

    2011-05-01

    (CQG) and Journal of Physics: Conference Series (JPCS). The plenary lectures are published in CQG, while most parallel talks and posters are being published in JPCS. At the recommendation of the science organization committee (SOC) other selected work from the conference will also appear in CQG. All papers in CQG have been screened through the journal's regular peer review process. We gratefully acknowledge the support of the CQG and JPCS Publishers and staff for the publication of the proceedings. The symposium and proceedings are generously sponsored by L'Agenzia Spaziale Italiana, the California Institute of Technology, EADS Astrium Germany, the KACST Foundation Saudi Arabia, the LIGO collaboration, the Max-Planck Institute in Potsdam, Germany, NASA, and the National Science Foundation. Stanford University made very significant contributions through the Dean of Research Office, the Department of Applied Physics, the Department of Physics, the Hansen Experimental Physics Laboratory (HEPL), and the SLAC National Accelerator Laboratory. We thank the Stanford local organization committee (LOC), administration and professional staff, KACST engineers, and graduate students for their support of the symposium operations. LISA is one of the most tantalizing yet challenging scientific space missions ever. The 8th International LISA Symposium and publication of the proceedings contribute to its progress. Sasha Buchman and Ke-Xun Sun Stanford University Guest Editors

  4. Space Radar Image of Mammoth, California

    NASA Technical Reports Server (NTRS)

    1999-01-01

    . The radars illuminate Earth with microwaves allowing detailed observations at any time, regardless of weather or sunlight conditions. SIR-C/X-SAR uses three microwave wavelengths: L-band (24 cm), C-band (6 cm) and X-band (3 cm). The multi-frequency data will be used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI), with the Deutsche Forschungsanstalt fuer Luft und Raumfahrt e.v. (DLR), the major partner in science, operations and data processing of X-SAR.

  5. Space Radar Image of Kilauea Volcano, Hawaii

    NASA Technical Reports Server (NTRS)

    1994-01-01

    radar missions to help in better understanding the processes responsible for volcanic eruptions and earthquakes. Spaceborne Imaging Radar-C and X-band Synthetic Aperture Radar (SIR-C/X-SAR) is part of NASA's Mission to Planet Earth. The radars illuminate Earth with microwaves, allowing detailed observations at any time, regardless of weather or sunlight conditions. SIR-C/X-SAR uses three microwave wavelengths: L-band (24 cm), C-band (6 cm) and X-band (3 cm). The multi-frequency data will be used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI), with the Deutsche Forschungsanstalt fuer Luft und Raumfahrt e.V.(DLR), the major partner in science, operations and data processing of X-SAR.

  6. Space Radar Image of Houston, Texas

    NASA Technical Reports Server (NTRS)

    1994-01-01

    -C/X-band Synthetic Aperture Radar(SIR-C/X-SAR) is part of NASA's Mission to Planet Earth. The radars illuminate Earth with microwaves, allowing detailed observations at any time, regardless of weather or sunlight conditions. SIR-C/X-SAR uses three microwave wavelengths: L-band (24 cm), C-band (6 cm) and X-band (3 cm). The multi-frequency data will be used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI) with the Deutsche Forschungsanstalt fuer luft und Raumfahrt e.V.(DLR), the major partner in science, operations and data processing of X-SAR.

  7. Space Radar Image of West Texas - SAR scan

    NASA Technical Reports Server (NTRS)

    1999-01-01

    forthcoming Canadian RADARSAT satellite. Spaceborne Imaging Radar-C and X-band Synthetic Aperture Radar (SIR-C/X-SAR) is part of NASA's Mission to Planet Earth. The radars illuminate Earth with microwaves, allowing detailed observations at any time, regardless of weather or sunlight conditions. SIR-C/X-SAR uses three microwave wavelengths: L-band (24 cm), C-band (6 cm) and X-band (3 cm). The multi-frequency data will be used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI), with the Deutsche Forschungsanstalt fuer Luft und Raumfahrt e.v.(DLR), the major partner in science, operations, and data processing of X-SAR.

  8. Space Radar Image of North Sea, Germany

    NASA Technical Reports Server (NTRS)

    1994-01-01

    swiftly than is currently possible. Spaceborne Imaging Radar-C and X-band Synthetic Aperture Radar (SIR-C/X-SAR) is part of NASA's Mission to Planet Earth. The radars illuminate Earth with microwaves, allowing detailed observations at any time, regardless of weather or sunlight conditions. SIR-C/X-SAR uses three microwave wavelengths: L-band (24 cm), C-band (6 cm) and X-band (3 cm). The multi-frequency data will be used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI), with the Deutsche Forschungsanstalt fuer Luft und Raumfahrt e.V.(DLR), the major partner in science, operations and data processing of X-SAR.

  9. Space Radar Image of Altona, Manitoba, Canada

    NASA Technical Reports Server (NTRS)

    1994-01-01

    the magenta indicate differences in the degree of soil moisture change and differences in surface roughness. This seasonal composite demonstrates the sensitivity of radar to changes in agricultural surface conditions such as soil moisture, tillage, cropping and harvesting. Spaceborne Imaging Radar-C and X-band Synthetic Aperture Radar (SIR-C/X-SAR) is part of NASA's Mission to Planet Earth. The radars illuminate Earth with microwaves, allowing detailed observations at any time, regardless of weather or sunlight conditions. SIR-C/X-SAR uses three microwave wavelengths: L-band (24 cm), C-band (6 cm) and X-band (3 cm). The multi-frequency data will be used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI), with the Deutsche Forschungsanstalt fuer Luft und Raumfahrt e.V.(DLR), the major partner in science, operations and data processing of X-SAR.

  10. Space Radar Image of Karisoke & Virunga Volcanoes

    NASA Technical Reports Server (NTRS)

    1994-01-01

    vegetation maps of the area to aid in their studies of the last 650 mountain gorillas in the world. The faint lines above the bamboo forest are the result of agricultural terracing by the people who live in the region. Spaceborne Imaging Radar-C and X-Synthetic Aperture Radar (SIR-C/X-SAR) is part of NASA's Mission to Planet Earth. The radars illuminate Earth with microwaves, allowing detailed observations at any time, regardless of weather or sunlight conditions. SIR-C/X-SAR uses three microwave wavelengths: L-band (24 cm), C-band (6 cm) and X-band (3 cm). The multi-frequency data will be used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI), with the Deutsche Forschungsanstalt fuer Luft und Raumfahrt e.V. (DLR), the major partner in science, operations and data processing of X-SAR.

  11. Space Radar Image of Oetzal, Austria

    NASA Technical Reports Server (NTRS)

    1994-01-01

    site is covered by glaciers. Corner reflectors are set up for calibration. Five corner reflectors can be seen on the Gepatschferner and two can be seen on the Vernagtferner. Spaceborne Imaging Radar-C and X-band Synthetic Aperture Radar (SIR-C/X-SAR) is part of NASA's Mission to Planet Earth. The radars illuminate Earth with microwaves, allowing detailed observations at any time, regardless of weather or sunlight conditions. SIR-C/X-SAR uses three microwave wavelengths: L-band (24 cm), C-band (6 cm) and X-band (3 cm). The multi-frequency data will be used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI), with the Deutsche Forschungsanstalt fuer Luft und Raumfahrt e.V.(DLR), the major partner in science, operations and data processing of X-SAR.

  12. Space Radar Image of Death Valley, California

    NASA Technical Reports Server (NTRS)

    1999-01-01

    also one of the primary calibration sites for SIR-C/X-SAR. The bright dots near the center of the image are corner reflectors that have been set-up to calibrate the radar as the shuttle passes overhead. Thirty triangular-shaped reflectors (they look like aluminum pyramids) have been deployed by the calibration team from JPL over a 40- by 40-kilometer (25- by 25-mile) area in and around Death Valley. The calibration team will also deploy transponders (electronic reflectors) and receivers to measure the radar signals from SIR-C/X-SAR on the ground. SIR-C/X-SAR is part of NASA's Mission to Planet Earth. The radars illuminate Earth with microwaves allowing detailed observations at any time, regardless of weather or sunlight conditions. SIR-C/X-SAR uses three microwave wavelengths: L-band (24 cm), C-band (6 cm) and X-band (3 cm). The multi-frequency data will be used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI).

  13. Space Radar Image of Raco, Michigan, ecological test site

    NASA Technical Reports Server (NTRS)

    1994-01-01

    global changes resulting from climatic warming. Baseline studies of vegetation are essential in monitoring these expected changes. Spaceborne Imaging Radar-C and X-band Synthetic Aperture Radar (SIR-C/X-SAR) is part of NASA's Mission to Planet Earth. The radars illuminate Earth with microwaves, allowing detailed observations at any time, regardless of weather or sunlight conditions. SIR-C/X-SAR uses three microwave wavelengths: L-band (24 cm), C-band (6 cm) and X-band (3 cm). The multi-frequency data will be used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI), with the Deutsche Forschungsanstalt fuer Luft und Raumfahrt e.V.(DLR), the major partner in science, operations and data processing of X-SAR.

  14. Space Radar Image of Kliuchevskoi, Russia

    NASA Technical Reports Server (NTRS)

    1994-01-01

    mature in Kamchatka's 120-day growing season. The forest industry is managing these forests and practicing selective cutting to allow younger trees time to grow and reseed. X-SAR images will aid in mapping these deforested areas and in encouraging further recultivation efforts. Spaceborne Imaging Radar-C and X-band Synthetic Aperture Radar (SIR-C/X-SAR) is part of NASA's Mission to Planet Earth. The radars illuminate Earth with microwaves, allowing detailed observations at any time, regardless of weather or sunlight conditions. SIR-C/X-SAR uses three microwave wavelengths: L-band (24 cm), C-band (6 cm) and X-band (3 cm). The multi-frequency data will be used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtange-legenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI), with the Deutsche Forschungsanstalt fuer Luft und Raumfahrt e.V.(DLR), the major partner in science, operations and data processing of X-SAR.

  15. Space Radar Image of Kiluchevskoi, Volcano, Russia

    NASA Technical Reports Server (NTRS)

    1994-01-01

    flanks of the volcano. Paths of these flows can be seen as thin lines in various shades of blue and green on the north flank in the center of the image. Spaceborne Imaging Radar-C and X-band Synthetic Aperture Radar (SIR-C/X-SAR) is part of NASA's Mission to Planet Earth. The radars illuminate Earth with microwaves, allowing detailed observations at any time, regardless of weather or sunlight conditions. SIR-C/X-SAR uses three microwave wavelengths: L-band (24 cm), C-band (6 cm) and X-band (3 cm). The multi-frequency data will be used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI), with the Deutsche Forschungsanstalt fuer Luft und Raumfahrt e.v.(DLR), the major partner in science, operations and data processing of X-SAR.

  16. Space Radar Image of Rabaul Volcano, New Guinea

    NASA Technical Reports Server (NTRS)

    1994-01-01

    the image. Ashfall and subsequent rains caused the collapse of most buildings in the town of Rabaul. Mudflows and flooding continue to pose serious threats to the town and surrounding villages. Volcanologists and local authorities expect to use data such as this radar image to assist them in identifying the mechanisms of the eruption and future hazardous conditions that may be associated with the vigorously active volcano. Spaceborne Imaging Radar-C/X-band Synthetic Aperture Radar (SIR-C/X-SAR) is part of NASA's Mission to Planet Earth. The radars illuminate Earth with microwaves, allowing detailed observations at any time, regardless of weather or sunlight conditions. SIR-C/X-SAR uses three microwave wavelengths: L-band (24 cm), C-band (6 cm) and X-band (3 cm). The multi-frequency data will be used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI), with the Deutsche Forschungsanstalt fuer Luft und Raumfahrt e.v.(DLR), the major partner in science, operations and data processing of X-SAR.

  17. Space Radar Image of Manaus region of Brazil

    NASA Technical Reports Server (NTRS)

    1994-01-01

    the first and second flights of the SIR-C/X-SAR system have validated the interpretation of the radar images. Spaceborne Imaging Radar-C and X-band Synthetic Aperture Radar (SIR-C/X-SAR) is part of NASA's Mission to Planet Earth. The radars illuminate Earth with microwaves, allowing detailed observations at any time, regardless of weather or sunlight conditions. SIR-C/X-SAR uses three microwave wavelengths: L-band (24 cm), C-band (6 cm) and X-band (3 cm). The multi-frequency data will be used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI), with the Deutsche Forschungsanstalt fuer Luft und Raumfahrt e.V.(DLR), the major partner in science, operations and data processing of X-SAR.

  18. Space Radar Image of Manaus, Brazil

    NASA Technical Reports Server (NTRS)

    1994-01-01

    Estaciais, during the first and second flights of the SIR-C/X-SAR system have validated the interpretation of the radar images. Spaceborne Imaging Radar-C and X-band Synthetic Aperture Radar (SIR-C/X-SAR) is part of NASA's Mission to Planet Earth. The radars illuminate Earth with microwaves, allowing detailed observations at any time, regardless of weather or sunlight conditions. SIR-C/X-SAR uses three microwave wavelengths: L-band (24 cm), C-band (6 cm) and X-band (3 cm). The multi-frequency data will be used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI), with the Deutsche Forschungsanstalt fuer Luft und Raumfahrt e.V.(DLR), the major partner in science, operations and data processing of X-SAR.

  19. Angkor, Cambodia

    NASA Technical Reports Server (NTRS)

    1995-01-01

    the ancient city. The SIR-C/X-SAR data are being used by archaeologists at the World Monuments Fund and the Royal Angkor Foundation to understand how the city grew, flourished and later fell into disuse over an 800-year period. The data are also being used to help reconstruct the vast system of hydrological works, canals and reservoirs, which have gone out of use over time. Research teams from more than 11 countries will be using this data to study the Angkor complex.

    Spaceborne Imaging Radar-C and X-Synthetic Aperture Radar (SIR-C/X-SAR) is part of NASA's Mission to Planet Earth. The radars illuminate Earth with microwaves allowing detailed observations at any time, regardless of weather or sunlight conditions. SIR-C/X-SAR uses three microwave wavelengths: L-band (24 cm), C-band (6 cm) and X-band (3 cm). The multi-frequency data will be used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI).

  20. Space Radar Image of the Lost City of Ubar

    NASA Technical Reports Server (NTRS)

    1999-01-01

    Imaging Radar-C and X-Band Synthetic Aperture Radar (SIR-C/X-SAR) is part of NASA's Mission to Planet Earth. The radars illuminate Earth with microwaves allowing detailed observations at any time, regardless of weather or sunlight conditions. SIR-C/X-SAR uses three microwave wavelengths: L-band (24 cm), C-band (6 cm) and X-band (3 cm). The multi-frequency data will be used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtange-legenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI), with the Deutsche Forschungsanstalt fuer Luft und Raumfahrt e.v.(DLR), the major partner in science, operations, and data processing of X-SAR.

  1. GIADA on-board Rosetta: comet 67P/C-G dust coma characterization

    NASA Astrophysics Data System (ADS)

    Rotundi, Alessandra; Della Corte, Vincenzo; Fulle, Marco; Sordini, Roberto; Ivanovski, Stavro; Accolla, Mario; Ferrari, Marco; Lucarelli, Francesca; Zakharov, Vladimir; Mazzotta Epifani, Elena; López-Moreno, José J.; Rodríguez, Julio; Colangeli, Luigi; Palumbo, Pasquale; Bussoletti, Ezio; Crifo, Jean-Francois; Esposito, Francesca; Green, Simon F.; Grün, Eberhard; Lamy, Philippe L.

    2015-04-01

    complete set of dust grain parameters, i.e., mass, speed, and geometrical cross-section. These detections allowed us to constraint the grain density. The GIADA detections type was studied as a function of the observational geometrical configuration. Acknowledgments: GIADA was built by a consortium led by the Univ. Napoli "Parthenope" & INAF- Oss. Astr. Capodimonte, in collaboration with the Inst. de Astrofisica de Andalucia, Selex-ES, FI and SENER. GIADA is presently managed & operated by Ist. di Astrofisica e Planetologia Spaziali-INAF, IT. GIADA was funded and managed by the Agenzia Spaziale Italiana, IT, with the support of the Spanish Ministry of Education and Science MEC, ES. GIADA was developed from a PI proposal from the University of Kent; sci. & tech. contribution were provided by CISAS, IT, Lab. d'Astr. Spat., FR, and Institutions from UK, IT, FR, DE and USA. We thank the RSGS/ESAC, RMOC/ESOC & Rosetta Project/ESTEC for their outstanding work. Science support provided was by NASA through the US Rosetta Project managed by the Jet Propulsion Laboratory/California Institute of Technology. GIADA calibrated data will be available through ESA's PSA web site (www.rssd.esa.int/index.php?project=PSA&page=in dex). We would like to thank Angioletta Coradini for her contribution as a GIADA Co-I.

  2. Rituximab, bendamustine, and low-dose cytarabine as induction therapy in elderly patients with mantle cell lymphoma: a multicentre, phase 2 trial from Fondazione Italiana Linfomi.

    PubMed

    Visco, Carlo; Chiappella, Annalisa; Nassi, Luca; Patti, Caterina; Ferrero, Simone; Barbero, Daniela; Evangelista, Andrea; Spina, Michele; Molinari, Annalia; Rigacci, Luigi; Tani, Monica; Rocco, Alice Di; Pinotti, Graziella; Fabbri, Alberto; Zambello, Renato; Finotto, Silvia; Gotti, Manuel; Carella, Angelo M; Salvi, Flavia; Pileri, Stefano A; Ladetto, Marco; Ciccone, Giovannino; Gaidano, Gianluca; Ruggeri, Marco; Martelli, Maurizio; Vitolo, Umberto

    2017-01-01

    The combination of rituximab, bendamustine, and cytarabine (R-BAC) was highly active in a pilot trial of mantle cell lymphoma, but its use was restricted by high haematological toxicity. We aimed to assess the efficacy and safety of an R-BAC regimen with low-dose cytarabine (RBAC500). In this multicentre, phase 2 trial, we recruited previously untreated patients with an established histological diagnosis of mantle cell lymphoma from 29 Fondazione Italiana Linfomi centres in Italy. Patients had to be older than 65 years and fit according to the comprehensive geriatric assessment, or aged 60-65 years if they were ineligible for high-dose chemotherapy plus autologous stem-cell transplantation and were fit or unfit. All patients received RBAC500 (rituximab 375 mg/m 2 on day 1, bendamustine 70 mg/m 2 on days 2 and 3, and cytarabine 500 mg/m 2 on days 2-4; all administered intravenously) every 4 weeks for up to six cycles. Primary endpoints were the proportion of patients achieving complete response at the end of treatment and toxicity, defined as the occurrence of any of the stop treatment criteria or of any episode of relevant toxicity. All patients who started at least one cycle of RBAC500 were included in the primary and safety analyses. Using efficacy and toxicity as a composite primary endpoint, we considered the final conclusion positive if more than 28 of 57 patients achieve complete response and fewer than 18 of 57 patients report toxicities. This study is registered with EudraCT, number 2011-005739-23, and ClinicalTrials.gov, number NCT01662050, and is completed. Between May 2, 2012, and Feb 25, 2014, we enrolled 57 patients (median age 71 years, IQR 67-75). 54 (95%) patients received at least four RBAC500 cycles (three discontinued because of toxicity), and 38 (67%) completed six cycles. Two (4%) had disease progression (one after the fourth cycle and one after the sixth cycle). All 52 (91%, lower limit of one-sided 95% CI 85%) remaining patients achieved

  3. Acute pain management: acetaminophen and ibuprofen are often under-dosed.

    PubMed

    Milani, Gregorio P; Benini, Franca; Dell'Era, Laura; Silvagni, Davide; Podestà, Alberto F; Mancusi, Rossella Letizia; Fossali, Emilio F

    2017-07-01

    Most children with pain are managed by either acetaminophen or ibuprofen. However, no study has so far investigated if children are prescribed adequate doses of acetaminophen or ibuprofen in emergency department. Aim of this retrospective study was to investigate the prevalence of under-dosage of these drugs in children presenting with pain in emergency department. Children initially prescribed with acetaminophen or ibuprofen for pain management were included. The χ 2 automatic interaction detection method was used considering the percentage variation from the minimum of the appropriate dose as dependent variable while prescribed drug, age, gender, body weight, type of hospital (pediatric or general), and availability of internal guidelines on pediatric pain management in the emergency department as independent variables. Data on 1471 children managed for pain were available. Under-dosage was prescribed in 893 subjects (61%), of whom 577 were prescribed acetaminophen and 316 ibuprofen. The use of acetaminophen suppositories, body weight <12 kg or >40 kg, and the use of oral ibuprofen identified clusters of children associated with under-dosage prescription. Prescription of acetaminophen and ibuprofen was frequently under-dosed. The use of suppositories, lower and higher body weight, and the use of ibuprofen were associated with under-dosage. Under-dosing may reflect prescription of anti-pyretic doses. Agenzia Italiana del Farmaco-Observational Study Register (RSO). Registration code: PIERRE/1 What is Known: • Pain is frequent in children presented to emergency department. • International recommendations on pain management are often not implemented. What is New: • Acetaminophen and ibuprofen were frequently underdosed in children prescribed for pain in the Italian emergency departments. • Under-dosage may be related to the habit of using acetaminophen and ibuprofen in the recommended range for fever treatment.

  4. Deployer Performance Results for the TSS-1 Mission

    NASA Technical Reports Server (NTRS)

    Marshall, Leland S.; Geiger, Ronald V.

    1995-01-01

    Performance of the Tethered Satellite System (TSS) Deployer during the STS-46 mission (July and August 1992) is analyzed in terms of hardware operation at the component and system level. Although only a limited deployment of the satellite was achieved (256 meters vs 20 kilometers planned), the mission served to verify the basic capability of the Deployer to release, control and retrieve a tethered satellite. - Deployer operational flexibility that was demonstrated during the flight is also addressed. Martin Marietta was the prime contractor for the development of the Deployer, under management of the NASA George C. Marshall Space Flight Center (MSFC). The satellite was provided by Alenia, Torino, Italy under contract to the Agencia Spaziale Italiana (ASI). Proper operation of the avionics components and the majority of mechanisms was observed during the flight. System operations driven by control laws for the deployment and retrieval of the satellite were also successful for the limited deployment distance. Anomalies included separation problems for one of the two umbilical connectors between the Deployer and satellite, tether jamming (at initial Satellite fly-away and at a deployment distance of 224 meters), and a mechanical interference which prevented tether deployment beyond 256 meters. The Deployer was used in several off-nominal conditions to respond to these anomalies, which ultimately enabled a successful satellite retrieval and preservation of hardware integrity for a future re-flight. The paper begins with an introduction defining the significance of the TSS-1 mission. The body of the paper is divided into four major sections: (1) Description of Deployer System and Components, (2) Deployer Components/Systems Demonstrating Successful Operation, (3) Hardware Anomalies and Operational Responses, and (4) Design Modifications for the TSS-1R Re-flight Mission. Conclusions from the TSS-1 mission, including lessons learned are presented at the end of the

  5. Emergency and Continuous Exposure Limits for Selected Airborne Contaminants. Volume 1

    DTIC Science & Technology

    1984-04-01

    fuels, corn remover, drawing inks, fuel-system deicer, glue, nail-polish remover, paint-brush cleaners, paint and varnish removers, and china ,• ~ ~film...and fire hazards of butanone and acetone. Ind. Bull. (N.Y. State Dept. Labor) 23:173-176. Societa Italiana di Medicina del Lavoro. 1975. Associazione...Italiana di Medicina del Lavoro 1975. Associazione Italiana - -degli Igienisti Industriali. Valori Limite Ponderati degli Inquinanti Chimici e

  6. The AISPEP (Associazione Italiana Sindromi Pelvico Prostatiche) chronic prostatitis questionnaire (AISPEP-Q). focus on the disease: anamnestic data, life activities, symptoms, sexual habits, quality of life and knowledge about prostatitis from 93 questions answered on the Internet.

    PubMed

    Mazzoli, Sandra; Magri, Vittorio; Guercini, Federico; Simone, Alberto; Paolicchi, Fabio; Cai, Tommaso

    2007-06-01

    Chronic prostatitis (CP) has been described as one of the most common illnesses men aged < or = 50, showing a significant impact on patients' quality of life comparable with other chronic diseases, such as unstable angina or Crohn's disease. CP also is a social and economic problem due to its high incidence in the young male population and to the absence of evidence for the effectiveness of treatment. Today, however, although validated outcome questionnaires are available to follow prostatitis patients, diagnostic and treatment options are based on experience, expert opinion and poor clinical trial data. More extensive and better-designed epidemiological studies are needed to evaluate and describe prostatitis patient clinical characteristics, in order to carry out correct and useful treatment. The aim of this report is to present the new Associazione Italiana Sindromi Pelvico Prostatiche questionnaire (AISPEP-Q) in order to provide a tool for increasing knowledge in prostatitis patient characteristics and design future epidemiological studies.

  7. Prognostic roles of absolute monocyte and absolute lymphocyte counts in patients with advanced-stage follicular lymphoma in the rituximab era: an analysis from the FOLL05 trial of the Fondazione Italiana Linfomi.

    PubMed

    Marcheselli, Luigi; Bari, Alessia; Anastasia, Antonella; Botto, Barbara; Puccini, Benedetta; Dondi, Alessandra; Carella, Angelo M; Alvarez, Isabel; Chiarenza, Annalisa; Arcari, Annalisa; Salvi, Flavia; Federico, Massimo

    2015-05-01

    Recently, in an attempt to improve the discrimination power of the international prognostic index (IPI), patients with diffuse large B-cell lymphoma were evaluated to determine the prognostic roles of peripheral blood absolute monocyte count (AMC) and absolute lymphocyte count (ALC). Here, we analysed data of 428 patients with follicular lymphoma (FL) enrolled in a prospective, randomized trial (FOLL05 study) conducted by Fondazione Italiana Linfomi, to assess the impact of AMC and ALC on progression-free survival (PFS). All patients had been treated with one of three treatment combinations: (i) rituximab (R) plus cyclophosphamide, vincristine and prednisone; (ii) R plus cyclophosphamide, doxorubicin, vincristine and prednisone or (iii) R plus mitoxantrone and fludarabine. We showed that only AMC was a powerful predictor of PFS, and possibly overall survival, in patients with FL treated with combination chemotherapy regimens that contained R. The AMC can be used alone as a novel, simple factor that can predict survival outcome in patients with FL, independent of the immunochemotherapy regimen. It may therefore be widely used by clinicians, due to its simplicity and broad applicability. Additionally, it can be combined with other factors that determine the IPI or FLIPI, to increase the discriminating ability of these indices. © 2015 John Wiley & Sons Ltd.

  8. Three frequency false-color image of Prince Albert, Canada

    NASA Image and Video Library

    1994-04-18

    . As the frequency increases, the penetration depth in the canopy decreases. Over forest canopies, the X-Band radar contains information about the top of the canopy. Whereas, C-Band and L-Band radar returns show contributions from the crown and trunk areas respectively. The bright areas in the image are dense mixed aspen and old jackpine forests where the return from all three bands is high. The reddish area corresponds to more sparse old jack pine (12 to 17 meters in height and 60 to 75 years old) where the L-Band signal penetrates deeper in the canopy and dominates C-Band and X-Band returns. Comparison of the image with the forest cover map of the area indicates that the three band radar can be used to classify various stands. SIR-C/X-SAR is part of NASA's Mission to Planet Earth (MTPE). SIR-C/X-SAR radars illuminate Earth with microwaves allowing detailed observations at any time, regardless of weather or sunlight conditions. SIR-C/X-SAR uses three microwave wavelengths: L-Band (24 cm), C-Band (6 cm), and X-Band (3 cm). The multi-frequency data will be used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory (JPL). X-SAR was developed by the Dornire and Alenia Spazio Companies for the German Space Agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian Space Agency, Agenzia Spaziale Italiana (ASI). JPL Photo ID: P-43929

  9. False-color composite image of Prince Albert, Canada

    NASA Image and Video Library

    1994-04-11

    -75 years old. The orange-greenish areas are young jack pine trees, 3-5 meters (10-16 feet) in height and 11-16 years old. The green areas are due to the relative high intensity of the HV channel which is strongly correlated with the amount of biomass. L-Band HV channel shows the biomass variations over the entire region. Most of the green areas, when compared to the forest cover maps are identified as black spruce trees. The dark blue and dark purple colors show recently harvested or re-growth areas respectively. SIR-C/X-SAR is part of NASA's Mission to Planet Earth (MTPE). SIR-C/X-SAR radars illuminate Earth with microwaves allowing detailed observations at any time, regardless of weather or sunlight conditions. SIR-C/X-SAR uses three microwave wavelengths: L-Band (24 cm), C-Band (6 cm), and X-Band (3 cm). The multi-frequency data will be used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory (JPL). X-SAR was developed by the Dornire and Alenia Spazio Companies for the German Space Agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian Space Agency, Agenzia Spaziale Italiana (ASI). JPL Photo ID: P-43886

  10. Space Radar Image of Prince Albert, Canada

    NASA Technical Reports Server (NTRS)

    1999-01-01

    -greenish areas are young jack pine trees, 3 to 5 meters (10 to 16 feet) in height and 11 to 16 years old. The green areas are due to the relative high intensity of the HV channel which is strongly correlated with the amount of biomass. L-band HV channel shows the biomass variations over the entire region. Most of the green areas, when compared to the forest cover maps are identified as black spruce trees. The dark blue and dark purple colors show recently harvested or regrowth areas respectively. SIR-C/X-SAR is part of NASA's Mission to Planet Earth. The radars illuminate Earth with microwaves allowing detailed observations at any time, regardless of weather or sunlight conditions. SIR-C/X-SAR uses three microwave wavelengths: L-band (24 cm), C-band (6 cm) and X-band (3 cm). The multi-frequency data will be used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI).

  11. Death Valley, California

    NASA Image and Video Library

    1994-04-11

    . Death Valley is also one of the primary calibration sites for SIR-C/X-SAR. The bright dots near the center of the image are corner reflectors that have been set-up to calibrate the radar as the Shuttle passes overhead. Thirty triangular-shaped reflectors (they look like aluminum pyramids) have been deployed by the calibration team from JPL over a 40 kilometer by 40 kilometer area in and around Death Valley. The calibration team will also deploy transponders (electronic reflectors) and recievers to measure the radar signals from SIR-C/X-SAR on the ground. Spaceborne Imaging Radar-C and X-Synthetic Aperture Radar (SIR-C/X-SAR) is part of NASA's Mission to Planet Earth (MTPE). The radars illuminate Earth with microwaves allowing detailed observations at any time, regardless of weather or sunlight conditions. SIR-C/X-SAR uses three microwave wavelengths: L-Band (24 cm), C-Band (6 cm), and X-Band (3 cm). The multi-frequency data will be used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was develpoed by NASA's Jet Propulsion Laboratory (JPL). X-SAR was developed by the Dornire and Alenia Spazio Companies for the German Space Agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian Space Agency, Agenzia Spaziale Italiana (ASI). JPL Photo ID: P-43883

  12. The Huygens Descent Trajectory Working Group and the Reconstruction of the Huygens Probe Entry and Descent Trajectory at Titan

    NASA Astrophysics Data System (ADS)

    Atkinson, David H.; Kazeminejad, Bobby; Lebreton, Jean-Pierre

    2015-04-01

    Cassini/Huygens, a flagship mission to explore the rings, atmosphere, magnetic field, and moons that make up the Saturn system, is a joint endeavor of NASA, the European Space Agency, and Agenzia Spaziale Italiana. Comprising two spacecraft - a Saturn orbiter built by NASA and a Titan entry/descent probe built by the European Space Agency - Cassini/Huygens was launched in October 1997 and arrived at Saturn in 2004. The Huygens probe parachuted to the surface of Titan in January 2005. During the descent, six science instruments provided measurements of Titan's atmosphere, clouds, and winds, and photographed Titan's surface. It was recognized early in the Huygens program that to correctly interpret and correlate results from the probe science experiments and to provide a reference set of data for ground truth calibration of the Cassini orbiter remote sensing observations, an accurate reconstruction of the probe entry and descent trajectory and surface landing location would be necessary. The Huygens Descent Trajectory Working Group (DTWG) was chartered in 1996 as a subgroup of the Huygens Science Working Team. With membership comprising representatives from all the probe engineering and instrument teams as well as representatives of industry and the Cassini and Huygens Project Scientists, the DTWG presented an organizational framework within which instrument data was shared, the entry and descent trajectory reconstruction implemented, and the trajectory reconstruction efficiently disseminated. The primary goal of the Descent Trajectory Working Group was to develop retrieval methodologies for the probe descent trajectory reconstruction from the entry interface altitude of 1270 km to the surface using navigation data, and engineering and science data acquired by the instruments on the Huygens Probe, and to provide a reconstruction of the Huygens probe trajectory from entry to the surface of Titan that is maximally consistent with all available engineering and science

  13. The International Symposium on Applied Military Psychology (18th) Held at London, England on 21-25 June 1982,

    DTIC Science & Technology

    1982-11-30

    just this past year the separate and indeed they often went directly to women’s services were legally abolished, their bunks to recuperate after a work...5* Rep. Sanitfi A.M. Centro Studie Ricerche Medicina Aeronauticae Spaziale Viale P. Gobetti, 2-2A 00185 Roma Dr. Massimiliano Stracca Ispettorato

  14. Computer Simulation Modeling: A Method for Predicting the Utilities of Alternative Computer-Aided Treat Evaluation Algorithms

    DTIC Science & Technology

    1990-09-01

    1988). Current versions of the ADATS have CATE systems insLzlled, but the software is still under development by the radar manufacturer, Contraves ...Italiana, a subcontractor to Martin Marietta (USA). Contraves Italiana will deliver the final version of the software to Martin Marietta in 1991. Until then

  15. Language Policy and Planning: The Case of Italian Sign Language

    ERIC Educational Resources Information Center

    Geraci, Carlo

    2012-01-01

    Italian Sign Language (LIS) is the name of the language used by the Italian Deaf community. The acronym LIS derives from Lingua italiana dei segni ("Italian language of signs"), although nowadays Italians refers to LIS as Lingua dei segni italiana, reflecting the more appropriate phrasing "Italian sign language." Historically,…

  16. A randomised controlled cross-over double-blind pilot study protocol on THC:CBD oromucosal spray efficacy as an add-on therapy for post-stroke spasticity.

    PubMed

    Marinelli, Lucio; Balestrino, Maurizio; Mori, Laura; Puce, Luca; Rosa, Gian Marco; Giorello, Laura; Currà, Antonio; Fattapposta, Francesco; Serrati, Carlo; Gandolfo, Carlo; Abbruzzese, Giovanni; Trompetto, Carlo

    2017-09-07

    Stroke is the most disabling neurological disorder and often causes spasticity. Transmucosal cannabinoids (tetrahydrocannabinol and cannabidiol (THC:CBD), Sativex) is currently available to treat spasticity-associated symptoms in patients with multiple sclerosis. Cannabinoids are being considered useful also in the treatment of pain, nausea and epilepsy, but may bear and increased risk for cardiovascular events. Spasticity is often assessed with subjective and clinical rating scales, which are unable to measure the increased excitability of the monosynaptic reflex, considered the hallmark of spasticity. The neurophysiological assessment of the stretch reflex provides a precise and objective method to measure spasticity. We propose a novel study to understand if Sativex could be useful in reducing spasticity in stroke survivors and investigating tolerability and safety by accurate cardiovascular monitoring. We will recruit 50 patients with spasticity following stroke to take THC:CBD in a double-blind placebo-controlled cross-over study. Spasticity will be assessed with a numeric rating scale for spasticity, the modified Ashworth scale and with the electromyographical recording of the stretch reflex. The cardiovascular risk will be assessed prior to inclusion. Blood pressure, heart rate, number of daily spasms, bladder function, sleep disruption and adverse events will be monitored throughout the study. A mixed-model analysis of variance will be used to compare the stretch reflex amplitude between the time points; semiquantitative measures will be compared using the Mann-Whitney test (THC:CBD vs placebo) and Wilcoxon test (baseline vs treatment). The study was registered on the EudraCT database with number 2016-001034-10 and approved by both the Italian Medicines Agency (Agenzia Italiana del Farmaco) and local Ethics Committee 'Comitato Etico Regionale della Liguria'. Data will be made anonymous and uploaded to a open access repository. Results will be disseminated

  17. New Satellite Damage Maps Assist Italy Earthquake Disaster Response

    NASA Image and Video Library

    2016-09-01

    Italy earthquake. The quake has caused significant damage in the historic town of Amatrice. To assist in the disaster response efforts, scientists at NASA's Jet Propulsion Laboratory, Pasadena, California, and the California Institute of Technology in Pasadena, in collaboration with the Italian Space Agency (ASI), generated this image of the earthquake's hardest-hit region. The 40-by-75 mile (65-by-120 kilometer) Damage Proxy Map (DPM) was derived from two consecutive frames of the Japan Aerospace Exploration Agency's (JAXA's) L-band interferometric synthetic aperture radar (InSAR) data from the ALOS-2 satellite (cyan rectangles), and the 25-by-31 mile (40-by-50 kilometer) DPM was derived from InSAR data from the Agenzia Spaciale Italiana's (ASI's) X-band COSMO-SkyMed satellite (red rectangle). Both DPMs cover the historic town of Amatrice, revealing severe damage in the western side of the town (right panels). The time span of the data for the change is Jan. 27, 2016 to Aug. 24, 2016 for ALOS-2 and Aug. 20, 2016 to Aug. 28, 2016 for COSMO-SkyMed. Each pixel in the damage proxy map is about 100 feet (30 meters) across. The SAR data were processed by the Advanced Rapid Imaging and Analysis (ARIA) team at JPL and Caltech. The technique uses a prototype algorithm to rapidly detect surface changes caused by natural or human-produced damage. The assessment technique is most sensitive to destruction of the built environment. When the radar images areas with little to no destruction, its image pixels are transparent. Increased opacity of the radar image pixels reflects damage, with areas in red reflecting the heaviest damage to cities and towns. The color variations from yellow to red indicate increasingly more significant ground surface change. Preliminary validation was done by comparing the DPMs to a damage assessment map produced by the Copernicus Emergency Management Service, which is based on visual inspection of before and after high-resolution aerial imagery

  18. Anisotropies in the Diffuse Gamma-Ray Background Measured by the Fermi LAT

    DTIC Science & Technology

    2012-05-02

    D-15738 Zeuthen, Germany 2W.W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology , Department of Physics...and SLAC National Accelerator Laboratory, Stanford University, Stanford, California 94305, USA 3Department of Physics, Center for Cosmology and Astro...Greenbelt, Maryland 20771, USA 57Consorzio Interuniversitario per la Fisica Spaziale (CIFS), I-10133 Torino, Italy E. Komatsu{ Texas Cosmology Center

  19. Prevalence and Determinants of the Use of Lipid-Lowering Agents in a Population of Older Hospitalized Patients: the Findings from the REPOSI (REgistro POliterapie Società Italiana di Medicina Interna) Study.

    PubMed

    Bertolotti, Marco; Franchi, Carlotta; Rocchi, Marco B L; Miceli, Andrea; Libbra, M Vittoria; Nobili, Alessandro; Lancellotti, Giulia; Carulli, Lucia; Mussi, Chiara

    2017-04-01

    Older patients are prone to multimorbidity and polypharmacy, with an inherent risk of adverse events and drug interactions. To the best of our knowledge, available information on the appropriateness of lipid-lowering treatment is extremely limited. The aim of the present study was to quantify and characterize lipid-lowering drug use in a population of complex in-hospital older patients. We analyzed data from 87 units of internal medicine or geriatric medicine in the REPOSI (Registro Politerapie della Società Italiana di Medicina Interna) study, with reference to the 2010 and 2012 patient cohorts. Lipid-lowering drug use was closely correlated with the clinical profiles, including multimorbidity markers and polypharmacy. 2171 patients aged >65 years were enrolled (1057 males, 1114 females, mean age 78.6 years). The patients treated with lipid-lowering drugs amounted to 508 subjects (23.4%), with no gender difference. Atorvastatin (39.3%) and simvastatin (34.0%) were the most widely used statin drugs. Likelihood of treatment was associated with polypharmacy (≥5 drugs) and with higher Cumulative Illness Rating Scale (CIRS) score. At logistic regression analysis, the presence of coronary heart disease, peripheral vascular disease, and hypertension were significantly correlated with lipid-lowering drug use, whereas age showed an inverse correlation. Diabetes was not associated with drug treatment. In this in-hospital cohort, the use of lipid-lowering agents was mainly driven by patients' clinical history, most notably the presence of clinically overt manifestations of atherosclerosis. Increasing age seems to be associated with lower prescription rates. This might be indicative of cautious behavior towards a potentially toxic treatment regimen.

  20. Spaceborne Gravity Gradiometers. Part 3: Instrument status and prospects

    NASA Technical Reports Server (NTRS)

    1984-01-01

    Various technologies incorporated in the development of gravity gradiometers are demonstrated through descriptions of specific instruments. Concepts covered include: rotating, spherical, cryogenic, and superconducting gravity gradiometers with and without accelerometers. The application of superconducting cavity oscillators to mass-spring gradiometers, and cooperation of Italy's Piano Spaziale Nazionale with the Smithsonian Astrophysics Observatory in the design and development of a high sensitivity gradiometer are described. Schematics are provided for each instrument.

  1. Aviation Medicine Translations: Annotated Bibliography of Recently Translated Material. X,

    DTIC Science & Technology

    1981-01-01

    Professionnelles (France), 24:1-45, 1963. Legal provisions relative to working hours and the principal work schedules used in France are reviewed. Their...month, an extra morning shift was included to comply with the legal working hours of 46 hours a week. The group was investigated for 3 years before and...e degli operatori-radar. (Psychopathology of air traffic controllers and radar operators.) Rivista di Medicina Aeronautica e Spaziale (Italian), 39

  2. Space Radar Image of Mt. Rainer, Washington

    NASA Technical Reports Server (NTRS)

    1994-01-01

    White River, and the river leaving the mountain at the bottom right of the image (south) is the Nisqually River, which flows out of the Nisqually glacier on the mountain. The river leaving to the left of the mountain is the Carbon River, leading west and north toward heavily populated regions near Tacoma. The dark patch at the top right of the image is Bumping Lake. Other dark areas seen to the right of ridges throughout the image are radar shadow zones. Radar images can be used to study the volcanic structure and the surrounding regions with linear rock boundaries and faults. In addition, the recovery of forested lands from natural disasters and the success of reforestation programs can also be monitored. Ultimately this data may be used to study the advance and retreat of glaciers and other forces of global change. Spaceborne Imaging Radar-C and X-band Synthetic Aperture Radar (SIR-C/X-SAR) is part of NASA's Mission to Planet Earth. The radars illuminate Earth with microwaves, allowing detailed observations at any time, regardless of weather or sunlight conditions. SIR-C/X-SAR uses three microwave wavelengths: the L-band (24 cm), the C-band (6 cm) and the X-band (3 cm). The multi-frequency data will be used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI), with the Deutsche Forschungsanstalt fuer Luft und Raumfahrt e.v.(DLR), the major partner in science, operations and data processing of X-SAR.

  3. Space Radar Image of Death Valley in 3-D

    NASA Technical Reports Server (NTRS)

    1999-01-01

    -SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fur Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI).

  4. Space Radar Image of Yellowstone Park, Wyoming

    NASA Technical Reports Server (NTRS)

    1994-01-01

    Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI), with the Deutsche Forschungsanstalt fuer Luft und Raumfahrt e.V.(DLR), the major partner in science, operations and data processing of X-SAR.

  5. Space Radar Image of Safsaf, North Africa

    NASA Technical Reports Server (NTRS)

    1999-01-01

    , Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI).

  6. Dust Measurements in the Coma of Comet 67P/Churyumov-Gerasimenko Inbound to the Sun Between 3.7 and 3.4 AU

    NASA Astrophysics Data System (ADS)

    Rotundi, Alessandra; Della Corte, Vincenzo; Fulle, Marco; Ferrari, Marco; Sordini, Roberto; Ivanovski, Stavro; Accolla, Mario; Lucarelli, Francesca; Zakharov, Vladimir; Mazzotta Epifani, Elena; López-Moreno, José J.; Rodríguez, Julio; Colangeli, Luigi; Palumbo, Pasquale; Bussoletti, Ezio; Crifo, Jean-Francois; Esposito, Francesca; Green, Simon F.; Grün, Eberhard; Lamy, Philippe L.

    2015-04-01

    data on grain speed and its optical cross section. The IS grain momentum measurement, when combined with the GDS detection time, provides a direct measurement of grain speed and mass. These combined measurements characterize single grain dust dynamics in the coma of 67P/CG. The first grain was detected on 1 August 2014 at 814 km from the comet nucleus. Between then and 13 Septem-ber 2014 GIADA detected 35 grains ranging in mass from ~ 5 x 10-10 to 8 x 10-8 kg. Including complementary data from the OSIRIS narrow angle camera, the dust mass loss was calculated over an additional three orders of magni-tude in mass, extending the ejected dust grain sizes up to 2 cm. Combined with data from the MIRO and the ROSINA instruments onboard Rosetta we find a dust/gas mass ratio of 4 +/- 2 averaged over the sunlit nucleus sur-face. The dust to gas ratio may change as the comet approaches closer to the Sun. Acknowledgments: GIADA was built by a consortium led by the Univ. Napoli "Parthenope" & INAF- Oss. Astr. Capodimonte, in collabo-ration with the Inst. de Astrofisica de Andalucia, Selex-ES, FI and SENER. GIADA is presently managed & operated by Ist. di Astrofisica e Planetologia Spaziali-INAF, IT. GIADA was funded and managed by the Agenzia Spaziale Italiana, IT, with the support of the Spanish Ministry of Education and Science MEC, ES. GIADA was developed from a PI proposal from the University of Kent; sci. & tech. contribution were pro-vided by CISAS, IT, Lab. d'Astr. Spat., FR, and Institutions from UK, IT, FR, DE and USA. We thank the RSGS/ESAC, RMOC/ESOC & Rosetta Project/ESTEC for their outstanding work. Science support provided was by NASA through the US Rosetta Project managed by the Jet Propulsion Laboratory/California Institute of Technology. GIADA calibrated data will be available through ESA's PSA web site(www.rssd.esa.int/index.php?project=PSA&page=in dex). We would like to thank Angioletta Coradini for her contribution as a GIADA Co-I. We thank the MIRO, OSIRIS and

  7. Management of patients with cardiac implantable electronic devices (CIED) undergoing radiotherapy: A consensus document from Associazione Italiana Aritmologia e Cardiostimolazione (AIAC), Associazione Italiana Radioterapia Oncologica (AIRO), Associazione Italiana Fisica Medica (AIFM).

    PubMed

    Zecchin, Massimo; Severgnini, Mara; Fiorentino, Alba; Malavasi, Vincenzo Livio; Menegotti, Loris; Alongi, Filippo; Catanzariti, Domenico; Jereczek-Fossa, Barbara Alicja; Stasi, Michele; Russi, Elvio; Boriani, Giuseppe

    2018-03-15

    The management of patients with a cardiac implanted electronic device (CIED) receiving radiotherapy (RT) is challenging and requires a structured multidisciplinary approach. A consensus document is presented as a result of a multidisciplinary working group involving cardiac electrophysiologists, radiation oncologists and physicists in order to stratify the risk of patients with CIED requiring RT and approaching RT sessions appropriately. When high radiation doses and beam energy higher than 6MV are used, CIED malfunctions can occur during treatment. In our document, we reviewed the different types of RT and CIED behavior in the presence of ionizing radiations and electromagnetic interferences, from the cardiologist's, radiation oncologist's and medical physicist's point of view. We also reviewed in vitro and in vivo literature data and other national published guidelines on this issue so far. On the basis of literature data and consensus of experts, a detailed approach based on risk stratification and appropriate management of RT patients with CIEDs is suggested, with important implications for clinical practice. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  8. Telangiectatic osteosarcoma of the rib: a rare entity and a potential diagnostic pitfall.

    PubMed

    Saguem, I; Ayadi, L; Kallel, R; Charfi, S; Bahri, I; Gouiaa, N; Sellami-Boudawara, T

    2016-12-01

    Osteosarcoma (OS) is a common primary malignant tumor of bones that produces osteoid matrix. Telangiectatic osteosarcoma (TOS) is a rare variant of OS. It affects the long bones especially the lower end of femur and the upper ends of tibia and humerus, a distribution similar to the conventional osteosarcoma. The rib involvement is very infrequent. We present a case of TOS of the rib that posed a diagnostic difficulty owing to its unusual location and to its resemblance to giant cell tumor and aneurysmal bone cyst. Correspondence. © Copyright Società Italiana di Anatomia Patologica e Citopatologia Diagnostica, Divisione Italiana della International Academy of Pathology.

  9. Space Radar Image of Kilauea, Hawaii in 3-D

    NASA Technical Reports Server (NTRS)

    1999-01-01

    companies for the German space agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI), with the Deutsche Forschungsanstalt fuer Luft und Raumfahrte.v. (DLR), the major partner in science, operations and data processing of X-SAR.

  10. [Linee guida italiane per il trattamento dell'alcolismo].

    PubMed

    Ceccanti, Mauro; Iannitelli, Angela; Fiore, Marco

    2018-01-01

    RIASSUNTO. L'Europa è la regione con il più forte consumo di alcol al mondo, con la più elevata percentuale di malattie totali e morti premature alcol-correlate. In Italia, questo fenomeno coinvolge circa il 13% della popolazione oltre i 18 anni e oltre il 25% dei pazienti ospedalizzati. Sfortunatamente, solo il 5% di questi pazienti vengono riconosciuti come persone affette da disturbo da uso di alcol (DUA). Una scarsa conoscenza della malattia, la mancanza di accesso alle cure e le poche risorse messe a disposizione nella gestione del problema sono tra le principali cause di ritardo nella diagnosi, alla fine con conseguenze cliniche molto più importanti e costose da gestire. Alla luce di ciò, abbiamo deciso di dedicare questo numero speciale della Rivista di psichiatria a una serie di articoli riguardanti le linee guida italiane per il trattamento della dipendenza da alcol. Realizzate in collaborazione con numerosi esperti e importanti società scientifiche italiane come il Centro di Riferimento Alcologico della Regione Lazio (CRARL), la Società Italiana Tossicodipendenze (SITD), la Società italiana per il Trattamento dell'Alcolismo e le sue Complicanze (SITAC), la Società Italiana Psichiatria delle Dipendenze (SIPDip), la Società Italiana Patologie da Dipendenza (SIPaD) e l'Istituto di Biologia Cellulare e Neurobiologia (IBCN-CNR), queste linee guida forniscono agli operatori una serie di raccomandazioni basate su prove di efficacia volte ad aumentare la conoscenza e un uso appropriato dei farmaci per le persone affette da DUA. Con la possibilità di un continuo aggiornamento, l'obiettivo principale di queste linee guida sarà quello di garantire l'omogeneità dei trattamenti e un incremento qualitativo nell'assistenza dei pazienti affetti da DUA, così da ridurre le conseguenze psicosociali e sulla salute pubblica di questa importante malattia psichiatrica.

  11. Practice guidelines on the use of esophageal manometry - A GISMAD-SIGE-AIGO medical position statement.

    PubMed

    Savarino, Edoardo; de Bortoli, Nicola; Bellini, Massimo; Galeazzi, Francesca; Ribolsi, Mentore; Salvador, Renato; Savarino, Vincenzo; Penagini, Roberto

    2016-10-01

    Patients with esophageal symptoms potentially associated to esophageal motor disorders such as dysphagia, chest pain, heartburn and regurgitation, represent one of the most frequent reasons for referral to gastroenterological evaluation. The utility of esophageal manometry in clinical practice is: (1) to accurately define esophageal motor function, (2) to identify abnormal motor function, and (3) to establish a treatment plan based on motor abnormalities. With this in mind, in the last decade, investigations and technical advances, with the introduction of high-resolution esophageal manometry, have enhanced our understanding and management of esophageal motility disorders. The following recommendations were developed to assist physicians in the appropriate use of esophageal manometry in modern patient care. They were discussed and approved after a comprehensive review of the medical literature pertaining to manometric techniques and their recent application. This position statement created under the auspices of the Gruppo Italiano di Studio per la Motilità dell'Apparato Digerente (GISMAD), Società Italiana di Gastroenterologia ed Endoscopia Digestiva (SIGE) and Associazione Italiana Gastroenterologi ed Endoscopisti Digestivi Ospedalieri (AIGO) is intended to help clinicians in applying manometric studies in the most fruitful manner within the context of their patients with esophageal symptoms. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  12. Neuroglial heterotopia of the scalp.

    PubMed

    Attafi, S; Lahmar-Boufaroua, A; Rekik, W; Fraoua, F; Fadhel, C B; Bouraoui, S; Mzabi-Rgaya, S

    2016-03-01

    Heterotopic glial nodules of the scalp are non hereditary congenital malformations composed of mature brain tissue isolated from the cranial cavity. The majority of these lesions are found in the nasal region and occur rarely on the scalp. They are frequently diagnosed in newborn infants. However, they may rarely be found in adults. The pathogenesis of these lesions remains unknown. We describe the case of a temporal scalp nodule in a 50 year-old man. At the time of the excision, the mass was not associated with intracranial connection. Histological examination revealed neural tissue staining with S100-protein and the glial fibrillary acidic protein (GFAP). © Copyright Società Italiana di Anatomia Patologica e Citopatologia Diagnostica, Divisione Italiana della International Academy of Pathology.

  13. Acknowledgements

    NASA Astrophysics Data System (ADS)

    2016-07-01

    The Meeting was sponsored by the Istituto Nazionale di Fisica Nucleare (INFN), the Società Italiana di Fisica (SIF), the European Physics Society (EPS), the University of Pisa and the University of Siena.

  14. JPRS Report, West Europe, Reference Aid, Glossary of Acronyms and Abbreviations of Italy

    DTIC Science & Technology

    1989-01-27

    Italiana Naturisti bookseller bookshop Italian League for Divorce International League of Human Rights Italian Naturists League (i.e., nudists ...perpendiculari L.P.S. Lavori, Ponti e Strade l.r. lanciarazzi Italian Navy League National Naturists League (i.e., nudists ) Italian Origins Book

  15. Space and U.S. Security. A Net Assessment

    DTIC Science & Technology

    2009-01-01

    spacecraft mission. This included not only a spacewalk by a Chinese astronaut, but also a companion satellite. China demonstrated the ability to release...telecommunications, the Italian Armed Forces use the SICRAL ( Sistema Italiana de Communicazione Riservente Allarmi) system. Thus far, one satellite

  16. Space Radar Image of Prince Albert, Canada, seasonal

    NASA Technical Reports Server (NTRS)

    1994-01-01

    -C/X-SAR) is part of NASA's Mission to Planet Earth. The radars illuminate Earth with microwaves, allowing detailed observations at any time, regardless of weather or sunlight conditions. SIR-C/X-SAR uses three microwave wavelengths: L-band (24 cm), C-band (6 cm) and X-band (3 cm). The multi-frequency data will be used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI), with the Deutsche Forschungsanstalt fuer Luft und Raumfahrt e.V.(DLR), the major partner in science, operations and data processing of X-SAR.

  17. Space Radar Image of Mount Pinatubo Volcano, Philippines

    NASA Technical Reports Server (NTRS)

    1994-01-01

    radars illuminate Earth with microwaves, allowing detailed observations at any time, regardless of weather or sunlight conditions. SIR-C/X-SAR uses three microwave wavelengths: L-band (24 cm), C-band (6 cm) and X-band (3 cm). The multi-frequency data will be used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI), with the Deutsche Forschungsanstalt fuer Luft und Raumfahrt e.V.(DLR), the major partner in science, operations and data processing of X-SAR.

  18. Space Radar Image of Bahia

    NASA Technical Reports Server (NTRS)

    1994-01-01

    . The radars illuminate Earth with microwaves, allowing detailed observations at any time, regardless of weather or sunlight conditions. SIR-C/X-SAR uses three microwave wavelengths: L-band (24 cm), C-band (6 cm) and X-band (3 cm). The multi-frequency data will be used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI) with the Deutsche Forschungsanstalt fuer luft und Raumfahrt e.V.(DLR), the major partner in science, operations and data processing of X-SAR.

  19. Interdisciplinary Co-operation (Part II of "Language Learning: Individual Needs, Interdisciplinary Co-operation, Bi- and Multilingualism").

    ERIC Educational Resources Information Center

    1978

    The following papers on interdisciplinary cooperation in second language instruction are included: (1) "Language Teaching: Possibilities for Interdisciplinary Co-operation," by James E. Alatis; (2) "L'insegnamento della letteratura italiana (The Teaching of Italian Literature)," by Ezio Raimondi; (3) "Objective Evaluation and Transparency," by…

  20. The Community as a Source of Pragmatic Input for Learners of Italian: The Multimedia Repository LIRA

    ERIC Educational Resources Information Center

    Zanoni, Greta

    2016-01-01

    This paper focuses on community participation within the LIRA project--Lingua/Cultura Italiana in Rete per l'Apprendimento (Italian language and culture for online learning). LIRA is a multimedia repository of e-learning materials aiming at recovering, preserving and developing the linguistic, pragmatic and cultural competences of second and third…

  1. The Emergence of For-Profit E-learning Providers in Asia

    ERIC Educational Resources Information Center

    Perkins, Ross

    2009-01-01

    This article presents an interview with Dr. Luca Botturi, winner of the 2008 Educational Communication and Technology (ECT) Foundation Robert deKeiffer International Fellowship Award. Dr. Botturi, an Italian originally from the suburbs of Milano, works at the Universita della Svizzera italiana (USI, also called the University of Lugano) in its New…

  2. Microbeam radiosurgery: An industrial perspective.

    PubMed

    Wright, Michael D

    2015-09-01

    In spite of its long demonstrated potential, microbeam radiosurgery (MBRS) has yet to be developed into a clinical tool. This article examines the problems associated with MBRS, and potential solutions. It is shown that a path to a clinically useful device is emerging. Copyright © 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  3. Management of patients with end-stage renal disease undergoing chemotherapy: recommendations of the Associazione Italiana di Oncologia Medica (AIOM) and the Società Italiana di Nefrologia (SIN)

    PubMed Central

    Pedrazzoli, Paolo; Silvestris, Nicola; Santoro, Antonio; Secondino, Simona; Brunetti, Oronzo; Longo, Vito; Mancini, Elena; Mariucci, Sara; Rampino, Teresa; Delfanti, Sara; Brugnatelli, Silvia; Cinieri, Saverio

    2017-01-01

    Background The overall risk of some cancers is increased in patients receiving regular dialysis treatment due to chronic oxidative stress, a weakened immune system and enhanced genomic damage. These patients could benefit from the same antineoplastic treatment delivered to patients with normal renal function, but a better risk/benefit ratio could be achieved by establishing specific guidelines. Key considerations are which chemotherapeutic agent to use, adjustment of dosages and timing of dialysis in relation to the administration of chemotherapy. Methods We have reviewed available data present in the literature, including recommendations and expert opinions on cancer risk and use of chemotherapeutic agents in patients with end-stage renal disease. Experts selected by the boards of the societies provided additional information which helped greatly in clarifying some issues on which clear-cut information was missing or available data were conflicting. Results Data on the optimal use of chemotherapeutic agents or on credible schemes of polychemotherapy in haemodialysed patients are sparse and mainly derive from case reports or small case series. However, recommendations on dosing and timing of dialysis can be proposed for the most prescribed chemotherapeutic agents. Discussion The use of chemotherapeutic agents as single agents, or in combination, can be safely given in patients with end-stage renal disease. Appropriate dosage adjustments should be considered based on drug dialysability and pharmacokinetics. Coordinated care between oncologists, nephrologists and pharmacists is of pivotal importance to optimise drug delivery and timing of dialysis. PMID:29209521

  4. Management of patients with end-stage renal disease undergoing chemotherapy: recommendations of the Associazione Italiana di Oncologia Medica (AIOM) and the Società Italiana di Nefrologia (SIN).

    PubMed

    Pedrazzoli, Paolo; Silvestris, Nicola; Santoro, Antonio; Secondino, Simona; Brunetti, Oronzo; Longo, Vito; Mancini, Elena; Mariucci, Sara; Rampino, Teresa; Delfanti, Sara; Brugnatelli, Silvia; Cinieri, Saverio

    2017-01-01

    The overall risk of some cancers is increased in patients receiving regular dialysis treatment due to chronic oxidative stress, a weakened immune system and enhanced genomic damage. These patients could benefit from the same antineoplastic treatment delivered to patients with normal renal function, but a better risk/benefit ratio could be achieved by establishing specific guidelines. Key considerations are which chemotherapeutic agent to use, adjustment of dosages and timing of dialysis in relation to the administration of chemotherapy. We have reviewed available data present in the literature, including recommendations and expert opinions on cancer risk and use of chemotherapeutic agents in patients with end-stage renal disease. Experts selected by the boards of the societies provided additional information which helped greatly in clarifying some issues on which clear-cut information was missing or available data were conflicting. Data on the optimal use of chemotherapeutic agents or on credible schemes of polychemotherapy in haemodialysed patients are sparse and mainly derive from case reports or small case series. However, recommendations on dosing and timing of dialysis can be proposed for the most prescribed chemotherapeutic agents. The use of chemotherapeutic agents as single agents, or in combination, can be safely given in patients with end-stage renal disease. Appropriate dosage adjustments should be considered based on drug dialysability and pharmacokinetics. Coordinated care between oncologists, nephrologists and pharmacists is of pivotal importance to optimise drug delivery and timing of dialysis.

  5. An Atlas of Original and Mercator-Transformed Satellite-Data Images of the Alboran Sea, August-October 1983,

    DTIC Science & Technology

    1985-08-01

    the movements of the thermal front south of Capo de Geta (northeastern limit of the Alboran Sea) both westwards and eastwards. This demonstrates how...tactical applications guide, operational environmental satellite; polar-orbiting satellites and geostationary satellites; spacecraft, sensors , imagery...DETERMINATE L’UMIDITA’ RELATIVA E LA TEMPERATURA DI RUGIADA 0 DI BRINA MEDIANTE LO PSICROMETRO. AERONAUTICA MILITARE Italiana. Ispettorato delle

  6. The LIS Corpus Project: A Discussion of Sociolinguistic Variation in the Lexicon

    ERIC Educational Resources Information Center

    Geraci, Carlo; Battaglia, Katia; Cardinaletti, Anna; Cecchetto, Carlo; Donati, Caterina; Giudice, Serena; Mereghetti, Emiliano

    2011-01-01

    Following a well-established tradition going back to the 1980s (cf. Volterra 1987/2004), the authors use the name Lingua dei Segni Italiana (Italian Sign Language [LIS]) for the language used by Italian deaf people (and by Swiss deaf people living in the Ticino canton). LIS is becoming more and more visible, and its status as a minority language…

  7. [Digoxin poisoning: new prospects for therapy].

    PubMed

    Marino, Alfonsina; Giordano, Lorenzo; Ardu, Francesco

    2017-04-01

    The filter has been approved by the Food and Drug Administration for the removal of beta-2 microglobulin in patient undergoing hemodialysis. We used the filter (the patient agrees) off label, in the course of digitalis intoxication and we have shown that the filter is capable of removing the drug effectively. Copyright by Società Italiana di Nefrologia SIN, Rome, Italy.

  8. Space Radar Image of San Rafael Glacier, Chile

    NASA Technical Reports Server (NTRS)

    1994-01-01

    means. Spaceborne Imaging Radar-C and X-Synthetic Aperture Radar (SIR-C/X-SAR) are part of NASA's Mission to Planet Earth. The radars illuminate Earth with microwaves, allowing detailed observations at any time, regardless of weather or sunlight conditions. SIR-C/X-SAR uses three microwave wavelengths: L-band (24 cm), C-band (6 cm), and X-band (3 cm). The multi-frequency data will be used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes that are caused by nature and those changes that are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory. X-SAR was developed by the Dornier and Alenia Spazio companies for the German space agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian space agency, Agenzia Spaziale Italiana (ASI), with the Deutsche Forschungsanstalt fuer Luft und Raumfahrt e.v.(DLR), the major partner in science, operations and data processing of X-SAR.

  9. Cassini-Huygens makes first close approach to Titan

    NASA Astrophysics Data System (ADS)

    2004-10-01

    distance of 295 000 kilometres. The Cassini-Huygens spacecraft will pass within 246 000 kilometres of this moon at a speed of 13.8 kilometres per second. At this distance the narrow-angle camera should be able to resolve features down to about 1.4 kilometres in size. Note to Editors The Cassini-Huygens mission to Saturn is the most ambitious effort in planetary space exploration ever mounted. A cooperative endeavour of the European Space Agency (ESA), NASA and the Italian space agency, Agenzia Spaziale Italiana (ASI), Cassini-Huygens is sending a sophisticated robotic spacecraft to orbit the ringed planet and study the Saturnian system in detail over a four-year period. On board Cassini is a scientific probe called Huygens, provided by ESA, which will be released from the main spacecraft to parachute through the atmosphere to the surface of Saturn’s largest and most interesting moon, Titan. For more information about the Cassini-Huygens mission please see: http://saturn.esa.int

  10. 1991-1992 Europe & Asia in Space.

    DTIC Science & Technology

    1991-01-01

    being designed is the SICRAL ( Sistema Italiana de Communicazione Riservente Allarmi) military communications systems with satellites posi- tioned...3,053 km orbit. Using a concept very similar to Aktivnyy, the Czech Magion-3 is a companion to the mother satellite. The mother craft injects...Magion spacecraft have been successfully deployed since the first in 1978 with Interkosmos 18. The second and third in the series were companions

  11. Assessing the Adaptability to Irregular Rest-Work Rhythms in Military Personnel

    DTIC Science & Technology

    2000-03-01

    Aeronautica Militare Italiana, CSV Reparto Medicina Aerospaziale Pratica di Mare, 00040 Pomezia (Roma) Italy 2 Dipartimento di Psicologia - Universitd...characteristics to adapt to increased work errors and impaired social work at unusual hours. and family relationship. In addition, there is an increased mortality...DUTY: a brief questionnaire on critical evaluation. Journal of Personality the sleep-wake cycle and vigilance filled in and Social Psychology. 58: 844

  12. Individual Differences in Vigilance and Performance During Continuous/Sustained Operations

    DTIC Science & Technology

    2002-11-01

    Casagrande Dipartimento di Psicologia UniversitA degli Studi di Roma "La Sapienza" Via dei Marsi, 78 -00185 Roma, Italy Aeronautica Militare Italiana...8217based. approach, Journal of Personality and Social Psychologv. 56, 267-283. Casagrande M, Violani C, Curcio G., Bertini M. (1997) Individual differences...Multidimensional assessment of coping: A critical evaluation. Journal of Personality and Social Psychology. 58: 844-854. Evans FJ, Cook MR, Cohen HD, Ome EC

  13. Symposium on Signal and Image Processing English-Language Abstracts (12th) Held in Juan-Les-Pins, France on 12-16 June 1989

    DTIC Science & Technology

    1989-12-01

    Neril1" (’)INFOCOM Dpt., via Eudossiana 18, 1-00184 Roma, Italy (2) CONTRAVES Italiana SpA. via Affile 102, 1-00139 Roma, Italy SUMMARY The paper...central processor. This makes the perception of the system less accurate and induces a loss in performance. Previous studies have considered the case...current practice. An inner code, often decoded using a weighted input, is concatenated with an outer code decoded without such a weighting . If

  14. Asteroidi

    NASA Astrophysics Data System (ADS)

    Foglia, Sergio; Morbidelli, Alessandro; Masi, Gianluca; Carusi, Andrea

    2006-10-01

    Contents: Parte I: Asteroidi. 1. Introduzione. 2. Dinamica degli asteroidi. 3. Distribuzione degli asteroidi. 4. Proprietà fisiche degli asteroidi. 5. Interrelazioni nel Sistema Solare. Parte II: Le Osservazioni. 6. La pianificazione. 7. Astrometria. 8. Fotometria. Appendici: A. Tempo delle Effemeridi e Tempo Universale. B. Calcolo Effemeridi. C. Guida all'utilizzo del Minor Planet Software rel. 8. D. Determinazione della Coordinate Geografiche di una postazione di osservazione dalle Coordinate Metriche U.T.M. nella principale cartografia italiana.

  15. The diagnostic value of cytohistological urine analysis and cytokeratin 20 in malignant and atypical urothelial cells.

    PubMed

    Negri, S; Biavati, P; Bondi, A

    2016-09-01

    To determine the ability of cytohistology and cytokeratin 20 (CK 20) expression in malignant and atypical cells (AUC) from urine to serve as a diagnostic tool for assessing urothelial carcinoma (UC). Diagnoses from 55 urine cytological samples from 55 patients were analyzed and correlated with subsequent biopsy findings. A total of 50 archived urine slides from patients that received a cytological diagnosis and histological follow-up were selected for immunostaining with monoclonal CK 20 antibodies and elaborated by Z-test for proportions. The majority of all positive or atypical smears (24; 89%) were confirmed through histological analysis. The majority of urinary cytological diagnoses reported as negative (15; 54%) were also confirmed through biopsies. The overall sensitivity, specificity, PPV, and NPV were 65%, 83%, 89%, and 54%, respectively. All 13 smears cytologically determined to contain malignant cells, with subsequent biopsies confirming UC, exhibited strong positive staining with the CK 20 antibody. All cases evaluated as benign both cytologically and histologically had negative CK 20 staining. Of the 15 AUC cases with lesions confirmed through biopsies, 11 (73%) had atypical cells that stained positive for CK 20. Our results demonstrate the diagnostic value of urinary cytology and confirm CK 20 as an adjunct marker for the diagnosis of UC and for the triage of AUC. © Copyright Società Italiana di Anatomia Patologica e Citopatologia Diagnostica, Divisione Italiana della International Academy of Pathology.

  16. Italian biophysics and SIBPA speed-up the pace towards the long and winding road of the interdisciplinary science.

    PubMed

    Giacomazza, Daniela; Musio, Carlo

    2016-01-01

    This Special Issue of Biophysical Chemistry presents a selection of the contributions presented at the XXII National Congress of the Italian Society of Pure and Applied Biophysics (i.e., SIBPA, Società Italiana di Biofisica Pura ed Applicata) held on September 2014 in Palermo, Italy. Topics cover all biophysical disciplines, from molecular to cellular, to integrative biophysics giving a comprehensive view of the inter- and multi-disciplinary approach of modern biophysics. SIBPA, which turned 40 in 2013, continues to grow and attract interest.

  17. Management of diabetes at summer camps.

    PubMed

    Ciambra, Roberta; Locatelli, Chiara; Suprani, Tosca; Pocecco, Mauro

    2005-01-01

    We report our experience in the organization of diabetic children summer-camps since 1973. Guidelines for organization have been recently reported by the SIEDP (Società Italiana di Endocrinologia e Diabetologia Pediatrica). Our attention is focused on diabetes management at camp, organization and planning, medical staff composition and staff training, treatment of diabetes-related emergencies, written camp management plan, diabetes education and psychological issues at camp, prevention of possible risks, assessment of effectiveness of education in summer camps and research at camp.

  18. The Dispersion Tensor and Its Unique Minimizer in Hashin-Shtrikman Micro-structures

    NASA Astrophysics Data System (ADS)

    Bălilescu, Loredana; Conca, Carlos; Ghosh, Tuhin; San Martín, Jorge; Vanninathan, Muthusamy

    2018-05-01

    In this paper, we introduce a macroscopic quantity, namely the dispersion tensor or the Burnett coefficients in the class of generalized Hashin-Shtrikman micro-structures (Tartar in The general theory of homogenization, volume 7 of Lecture notes of the Unione Matematica Italiana, Springer, Berlin, p 281, 2009). In the case of two-phase materials associated with the periodic Hashin-Shtrikman structures, we settle the issue that the dispersion tensor has a unique minimizer, which is the so called Apollonian-Hashin-Shtrikman micro-structure.

  19. The Italian Cloud-based brokering Infrastructure to sustain Interoperability for Operative Hydrology

    NASA Astrophysics Data System (ADS)

    Boldrini, E.; Pecora, S.; Bussettini, M.; Bordini, F.; Nativi, S.

    2015-12-01

    This work presents the informatics platform carried out to implement the National Hydrological Operative Information System of Italy. In particular, the presentation will focus on the governing aspects of the cloud infrastructure and brokering software that make possible to sustain the hydrology data flow between heterogeneous user clients and data providers.The Institute for Environmental Protection and Research, ISPRA (Istituto Superiore per la Protezione e la Ricerca Ambientale) in collaboration with the Regional Agency for Environmental Protection in the Emilia-Romagna region, ARPA-ER (Agenzia Regionale per la Prevenzione e l´Ambiente dell´Emilia-Romagna) and CNR-IIA (National Research Council of Italy) designed and developed an innovative platform for the discovery and access of hydrological data coming from 19 Italian administrative regions and 2 Italian autonomous provinces, in near real time. ISPRA has deployed and governs such a system. The presentation will introduce and discuss the technological barriers for interoperability as well as social and policy ones. The adopted solutions will be described outlining the sustainability challenges and benefits.

  20. Systems and Technologies for Space Exploration: the regional project STEPS

    NASA Astrophysics Data System (ADS)

    Boggiatto, D.; Moncalvo, D.

    The Aerospace technology network of Piemonte represents ˜25% of the italian capacity and handles a comprehensive spectrum of products (aircraft, propulsion, satellites, space station modules, avionics. components, services...). The cooperation between the Comitato Distretto Aerospaziale Piemonte and the European Regional Development Fund 2007-2013 has enabled Regione Piemonte to launch three regional Projects capable to enhance the synergy and competitiveness of the network, among which: STEPS - Sistemi e Tecnologie per l'EsPlorazione Spaziale, a joint development of technologies for robotic and human Space Exploration by 3 large Industries, 27 SMEs, 3 Universities and one public Research Centre. STEPS develops virtual and hardware demonstrators for a range of technologies to do with a Lander's descent and soft landing, and a Rover's surface mobility, of both robotic and manned equipment on Moon and Mars. It also foresees the development of Teleoperations labs and Virtual Reality environments and physical simulations of Moon and Mars surface conditions and ground. Mid-way along STEPS planned development, initial results in several technology domains are available and are presented in this paper.

  1. Selected Bibliography on Fiber-Reinforced Cement and Concrete. Supplement Number 4.

    DTIC Science & Technology

    1982-08-01

    Building Industry," L’Industria Italiana del Cemento , Vol 50, No. 12, Dec 1980, pp 1135-1144. 19. Bartos, P., "Pullout Failure of Fibres Embedded in Cement...Vol 43, No. 11, Nov 1977, pp 561-564. 21. Bassan, M., "Model of Behavior of Fiber-Reinforced Concretes Under Impact Stresses," il Cemento , Vol 74, No...Pastes," il Cemento , Vol 75, No. 3, Jul-Sep 1978, pp 277-284. 210. Mills, R. H., "Age-Embrittlement of Glass-Reinforced Concrete Containing Blastfurance

  2. A reflection on the work of Gianni Bonadonna from the viewpoint of the global challenge of adolescents and young adults with cancer.

    PubMed

    Barr, Ronald D; Bleyer, W Archie

    2017-11-23

    Adolescents and young adults (AYAs - ages 15 to 39) constitute approximately 40% of the world's population and contribute an estimated one million new cases of cancer annually, the great majority in low- and middle-income countries (LMICs). In high-income countries (HICs) cancer is the commonest cause of disease-related death in AYAs, though overall 5-year survival rates now exceed 80%. A very different circumstance likely holds in LMICs, but accurate assessments are not readily available.Breast cancer accounts for 40% of tumours in female AYAs and this age group includes the peak incidence of Hodgkin lymphoma. The late Professor Gianni Bonadonna contributed importantly to improved survival in patients with these two diseases. Accordingly, he would be justifiably proud of the advances in AYA oncology that are being made in Italy, especially the impact of his colleagues at the Istituto Nazionale dei Tumori (INT). The initiatives of the Associazione Italiana Ematologia Pediatrica and the Società Italiana Adolescenti con Malattie Onco-ematologiche are particularly noteworthy, with the accomplishment of productive collaboration between paediatric and adult cancer care providers serving as a model for other countries to emulate.Exporting these advances can be successful through the vehicle of "twinning": establishing sustainable cooperation between institutions in HICs and partners in LMICs. Colleagues in Monza and at INT have been leaders in such programmes for decades. Cancer in AYAs remains a global challenge to which Gianni Bonadonna surely would have risen with enthusiasm and leadership while securing measurable achievements.

  3. Quantitative assessment of changes in landslide risk using a regional scale run-out model

    NASA Astrophysics Data System (ADS)

    Hussin, Haydar; Chen, Lixia; Ciurean, Roxana; van Westen, Cees; Reichenbach, Paola; Sterlacchini, Simone

    2015-04-01

    The risk of landslide hazard continuously changes in time and space and is rarely a static or constant phenomena in an affected area. However one of the main challenges of quantitatively assessing changes in landslide risk is the availability of multi-temporal data for the different components of risk. Furthermore, a truly "quantitative" landslide risk analysis requires the modeling of the landslide intensity (e.g. flow depth, velocities or impact pressures) affecting the elements at risk. Such a quantitative approach is often lacking in medium to regional scale studies in the scientific literature or is left out altogether. In this research we modelled the temporal and spatial changes of debris flow risk in a narrow alpine valley in the North Eastern Italian Alps. The debris flow inventory from 1996 to 2011 and multi-temporal digital elevation models (DEMs) were used to assess the susceptibility of debris flow triggering areas and to simulate debris flow run-out using the Flow-R regional scale model. In order to determine debris flow intensities, we used a linear relationship that was found between back calibrated physically based Flo-2D simulations (local scale models of five debris flows from 2003) and the probability values of the Flow-R software. This gave us the possibility to assign flow depth to a total of 10 separate classes on a regional scale. Debris flow vulnerability curves from the literature and one curve specifically for our case study area were used to determine the damage for different material and building types associated with the elements at risk. The building values were obtained from the Italian Revenue Agency (Agenzia delle Entrate) and were classified per cadastral zone according to the Real Estate Observatory data (Osservatorio del Mercato Immobiliare, Agenzia Entrate - OMI). The minimum and maximum market value for each building was obtained by multiplying the corresponding land-use value (€/msq) with building area and number of floors

  4. Colorectal tumors: the histology report.

    PubMed

    Lanza, Giovanni; Messerini, Luca; Gafà, Roberta; Risio, Mauro

    2011-03-01

    Epithelial colorectal tumors are common pathologic entities. Their histology report should be comprehensive of a series of pathologic parameters essential for the correct clinical management of the patients. Diagnostic histologic criteria of adenomatous, serrated, inflammatory, and hamartomatous polyps and of polyposis syndromes are discussed. In addition, the pathologic features of early and advanced colorectal cancer are described and a checklist is given. Finally, molecular prognostic and predictive factors currently employed in the treatment of colorectal cancer are discussed. Copyright © 2011 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd.. All rights reserved.

  5. Historical Archives in Italian Astronomical Observatories: The ``Specola 2000'' Project

    NASA Astrophysics Data System (ADS)

    Chinnici, I.; Mandrino, A.; Bònoli, F.

    2006-12-01

    Italy's well-consolidated tradition in astronomy is fully witnessed by its rich archival heritage. Astronomical records are stored in many observatories and universities, as well as in libraries and in private institutions. In 2000 a project was promoted to arrange and produce inventories of all material kept in Italian observatory archives. The project was planned by the Società Astronomica Italiana, and financial support was provided by the Italian Ministero per i Beni e le Attività Culturali. In this paper, the results obtained thus far are presented and commented on.

  6. [Atherosclerosis, chronic inflammation and oxidative stress in CKD].

    PubMed

    Leoni, Marco; Gorini, Antonio

    2017-03-01

    Chronic low-grade inflammation is emerging as the pathophysiological mechanism underlying of the several chronic degenerative diseases. Atherosclerosis, inflammation and oxidative stress are some of the issues that arise from the general context of chronic inflammation. In this manuscript we analyzed the role of the immune system, metabolism and inflammation's molecular mediators in order to show an overview about only apparently different problems. Finally, we proposed some possible solutions to improve the survival and quality of life of patient with chronic kidney disease. Copyright by Società Italiana di Nefrologia SIN, Rome, Italy.

  7. The European Federation of Organisations for Medical Physics Policy Statement No 14: the role of the Medical Physicist in the management of safety within the magnetic resonance imaging environment: EFOMP recommendations.

    PubMed

    Hand, J; Bosmans, H; Caruana, C; Keevil, S; Norris, D G; Padovani, R; Speck, O

    2013-03-01

    This European Federation of Organisations for Medical Physics (EFOMP) Policy Statement outlines the way in which a Safety Management System can be developed for MRI units. The Policy Statement can help eliminate or at least minimize accidents or incidents in the magnetic resonance environment and is recommended as a step towards harmonisation of safety of workers, patients, and the general public regarding the use of magnetic resonance imaging systems in diagnostic and interventional procedures. Copyright © 2012 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  8. Carcinoma of the exocrine pancreas: the histology report.

    PubMed

    Capella, Carlo; Albarello, Luca; Capelli, Paola; Sessa, Fausta; Zamboni, Giuseppe

    2011-03-01

    The Italian Group of Gastrointestinal Pathologists has named a committee to develop recommendations concerning the surgical pathology report for pancreatic cancer. The committee, formed by individuals with special expertise, wrote the recommendations, which were reviewed and approved by council of the Group. The recommendations are divided into several areas including an informative gross description, gross specimen handling, histopathologic diagnosis, immunohistochemistry, molecular findings, and a checklist. The purpose of these recommendations is to provide a fully informative report for the clinician. Copyright © 2011 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd.. All rights reserved.

  9. Calculating and controlling the error of discrete representations of Pareto surfaces in convex multi-criteria optimization.

    PubMed

    Craft, David

    2010-10-01

    A discrete set of points and their convex combinations can serve as a sparse representation of the Pareto surface in multiple objective convex optimization. We develop a method to evaluate the quality of such a representation, and show by example that in multiple objective radiotherapy planning, the number of Pareto optimal solutions needed to represent Pareto surfaces of up to five dimensions grows at most linearly with the number of objectives. The method described is also applicable to the representation of convex sets. Copyright © 2009 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  10. [Protein carbamylation: what it is and why it concerns nephrologists].

    PubMed

    De Simone, Emanuele; Di Micco, Lucia; La Manna, Gaetano; Di Iorio, Biagio

    2018-05-01

    Spontaneous urea dissociation in water solution is a prominent source of protein carbamylation in our body. Protein carbamylation is a well-known phenomenon since early seventies. Some years ago, much interest in the diagnostic power of carbamylated protein arouse. Recently the target of the researches focused on its potential cardiovascular pathogenicity. Some authors claimed that this could be a reason for higher cardiovascular mortality in uremic patients. Nutritional therapy, amino acids supplementation and intensive dialysis regimen are some of the therapeutic tools tested to lower the carbamylation burst in this population. Copyright by Società Italiana di Nefrologia SIN, Rome, Italy.

  11. Marie Curie's contribution to Medical Physics.

    PubMed

    Jean-Claude, Rosenwald; Nüsslin, Fridtjof

    2013-09-01

    On occasion of its 50th anniversary, the International Organization for Medical Physics (IOMP) from now on is going to celebrate annually an International Day of Medical Physics for which the 7th November, the birthday of Marie Sklodowska Curie, a most exceptional character in science at all and a pioneer of medical physics, has been chosen. This article briefly outlines her outstanding personality, sketches her fundamental discovery of radioactivity and emphasizes the impact of her various achievements on the development of medical physics at large. © 2013 Published by Elsevier Ltd on behalf of Associazione Italiana di Fisica Medica.

  12. [About some medical bibliographical sources of Jacobinic and Napoleonic age].

    PubMed

    Porro, Alessandro; Franchini, Antonia Francesca; Falconi, Bruno

    2011-01-01

    The authors analyze some bibliographical sources of jacobinic and Napoleonic age: books and pamphlets published by Stamperia Italiana e Francese in Milan (Lombardy); the Bullettino del Consiglio Subalpino di SanitY, ossia Giornale Fisico-Medico del Piemonte in Turin (Piedmont); some Charles Botta (1766-1837) books (Storia naturale e medica dell 'isola di Corfù; Mémoire du [...] sur la doctrine de Brown; Vicissitudes de l'instruction publique en Piémont depuis l'an VII jusq'au mois de ventose an XI [...]). They are useful to analyse the spreading of John Brown (1735-1788) theories in Italy, during the jacobinic and napoleonic time.

  13. Hard X-ray index of refraction tomography of a whole rabbit knee joint: A feasibility study.

    PubMed

    Gasilov, S; Mittone, A; Horng, A; Geith, T; Bravin, A; Baumbach, T; Coan, P

    2016-12-01

    We report results of the computed tomography reconstruction of the index of refraction in a whole rabbit knee joint examined at the photon energy of 51keV. Refraction based images make it possible to delineate the bone, cartilage, and soft tissues without adjusting the contrast window width and level. Density variations, which are related to tissue composition and are not visible in absorption X-ray images, are detected in the obtained refraction based images. We discuss why refraction-based images provide better detectability of low contrast features than absorption images. Copyright © 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  14. [Cardio-Pulmonary-Renal interactions].

    PubMed

    Samoni, Sara; Husain-Syed, Faeq; De Rosa, Silvia; Ronco, Claudio

    2017-03-01

    Over the past decade, understanding about feedback mechanisms involving the heart, lung and kidney is significantly improved. Each organ injury may trigger hemodynamic, neuro-hormonal and cellular pathway that may damage diverse organs. Recurrent acute on chronic injury may lead to the advanced stage of disease. On the other hand, chronic pathological conditions may decrease functional reserve leading to a high susceptibility to acute injury. Assessment of functional reserve and dosage of novel biomarkers may allow an early diagnosis and treatment. This review summarizes the current state-of-the-art understanding of cardio-pulmonary-renal interactions. Copyright by Società Italiana di Nefrologia SIN, Rome, Italy.

  15. Average snowcover density values in Eastern Alps mountain

    NASA Astrophysics Data System (ADS)

    Valt, M.; Moro, D.

    2009-04-01

    The Italian Avalanche Warning Services monitor the snow cover characteristics through networks evenly distributed all over the alpine chain. Measurements of snow stratigraphy and density are very frequently performed with sampling rates of 1 -2 times per week. Snow cover density values are used to compute the dimensions of the building roofs as well as to design avalanche barriers. Based on the measured snow densities the Electricity Board can predict the amount of water resources deriving from snow melt in high relieves drainage basins. In this work it was possible to compute characteristic density values of the snow cover in the Eastern Alps using the information contained in the database from the ARPA (Agenzia Regionale Protezione Ambiente)-Centro Valanghe di Arabba, and Ufficio Valanghe- Udine. Among the other things, this database includes 15 years of stratigraphic measurements. More than 6,000 snow stratigraphic logs were analysed, in order to derive typical values as for geographical area, altitude, exposure, snow cover thickness and season. Computed values were compared to those established by the current Italian laws. Eventually, experts identified and evaluated the correlations between the seasonal variations of the average snow density and the variations related to the snowfall rate in the period 1994-2008 in the Eastern Alps mountain range

  16. Cosmic Ink: Fragments from the Past on Journal Pages

    NASA Astrophysics Data System (ADS)

    Mandrino, A.; Gargano, M.; Gasperini, A.

    2015-04-01

    This contribution describes an editorial project started in 2012 to enhance the cultural heritage of the Italian observatories. It includes a regular column Cieli di inchiostro (Cosmic ink) devoted to promoting the astronomical historical archives and published in the Giornale di astronomia, a journal of the Società Astronomica Italiana. In every issue of the journal, a significant historical artifact is presented and described. This can be a letter, a diary page, a photograph, a map, a drawing, or another type of item pulled out of the archival folders to bring its history to light. The column is intended to invite historians, amateurs, and students to search and use the documents kept in the archives of the observatories.

  17. The role of dosimetry audit in lung SBRT multi-centre clinical trials.

    PubMed

    Clark, Catharine H; Hurkmans, Coen W; Kry, Stephen F

    2017-12-01

    Stereotactic Body Radiotherapy (SBRT) in the lung is a challenging technique which requires high quality clinical trials to answer the un-resolved clinical questions. Quality assurance of these clinical trials not only ensures the safety of the treatment of the participating patients but also minimises the variation in treatment, thus allowing the lowest number of patient treatments to answer the trial question. This review addresses the role of dosimetry audits in the quality assurance process and considers what can be done to ensure the highest accuracy of dose calculation and delivery and it's assessment in multi-centre trials. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  18. Adolescents with Cancer in Italy: Improving Access to National Cooperative Pediatric Oncology Group (AIEOP) Centers.

    PubMed

    Ferrari, Andrea; Rondelli, Roberto; Pession, Andrea; Mascarin, Maurizio; Buzzoni, Carlotta; Mosso, Maria Luisa; Maule, Milena; Barisone, Elena; Bertolotti, Marina; Clerici, Carlo Alfredo; Jankovic, Momcilo; Fagioli, Franca; Biondi, Andrea

    2016-06-01

    This analysis compared the numbers of patients treated at Italian pediatric oncology group (Associazione Italiana Ematologia Oncologia Pediatrica [AIEOP]) centers with the numbers of cases predicted according to the population-based registry. It considered 32,431 patients registered in the AIEOP database (1989-2012). The ratio of observed (O) to expected (E) cases was 0.79 for children (0-14 years old) and 0.15 for adolescents (15-19 years old). The proportion of adolescents increased significantly over the years, however, from 0.05 in the earliest period to 0.10, 0.18, and then 0.28 in the latest period of observation, suggesting a greater efficacy of local/national programs dedicated to adolescents. © 2016 Wiley Periodicals, Inc.

  19. Coeliac disease: the histology report.

    PubMed

    Villanacci, Vincenzo; Ceppa, Paola; Tavani, Enrico; Vindigni, Carla; Volta, Umberto

    2011-03-01

    To this day intestinal biopsy is justly considered the "gold standard" for the diagnosis of coeliac disease (CD). The aim of the authors in setting up these guidelines was to assist pathologists in formulating a more precise morphological evaluation of a duodenal biopsy in the light of clinical and laboratory data, to prepare histological samples with correctly oriented biopsies and in the differential diagnosis with other pathological entities and complications of the disease. A further intention was to promote the conviction for the need of a close collaborative relationship between different specialists namely the concept of a "multidisciplinary team". Copyright © 2011 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd.. All rights reserved.

  20. Early management of acute pancreatitis: A review of the best evidence.

    PubMed

    Stigliano, Serena; Sternby, Hanna; de Madaria, Enrique; Capurso, Gabriele; Petrov, Maxim S

    2017-06-01

    In the 20th century early management of acute pancreatitis often included surgical intervention, despite overwhelming mortality. The emergence of high-quality evidence (randomized controlled trials and meta-analyses) over the past two decades has notably shifted the treatment paradigm towards predominantly non-surgical management early in the course of acute pancreatitis. The present evidence-based review focuses on contemporary aspects of early management (which include analgesia, fluid resuscitation, antibiotics, nutrition, and endoscopic retrograde cholangiopancreatography) with a view to providing clear and succinct guidelines on early management of patients with acute pancreatitis in 2017 and beyond. Copyright © 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  1. Three models intercomparison for Quantitative Precipitation Forecast over Calabria

    NASA Astrophysics Data System (ADS)

    Federico, S.; Avolio, E.; Bellecci, C.; Colacino, M.; Lavagnini, A.; Accadia, C.; Mariani, S.; Casaioli, M.

    2004-11-01

    In the framework of the National Project “Sviluppo di distretti industriali per le Osservazioni della Terra” (Development of Industrial Districts for Earth Observations) funded by MIUR (Ministero dell'Università e della Ricerca Scientifica --Italian Ministry of the University and Scientific Research) two operational mesoscale models were set-up for Calabria, the southernmost tip of the Italian peninsula. Models are RAMS (Regional Atmospheric Modeling System) and MM5 (Mesoscale Modeling 5) that are run every day at Crati scrl to produce weather forecast over Calabria (http://www.crati.it). This paper reports model intercomparison for Quantitative Precipitation Forecast evaluated for a 20 month period from 1th October 2000 to 31th May 2002. In addition to RAMS and MM5 outputs, QBOLAM rainfall fields are available for the period selected and included in the comparison. This model runs operationally at “Agenzia per la Protezione dell'Ambiente e per i Servizi Tecnici”. Forecasts are verified comparing models outputs with raingauge data recorded by the regional meteorological network, which has 75 raingauges. Large-scale forcing is the same for all models considered and differences are due to physical/numerical parameterizations and horizontal resolutions. QPFs show differences between models. Largest differences are for BIA compared to the other considered scores. Performances decrease with increasing forecast time for RAMS and MM5, whilst QBOLAM scores better for second day forecast.

  2. Urea and impairment of the Gut-Kidney axis in Chronic Kidney Disease.

    PubMed

    Di Iorio, Biagio Raffaele; Marzocco, Stefania; Nardone, Luca; Sirico, Marilisa; De Simone, Emanuele; Di Natale, Gabriella; Di Micco, Lucia

    2017-12-05

    Gut microbiota can be considered a real organ coordinating health and wellness of our body. It is made of more than 100 trillions of microorganisms, thus about 3 times higher than the number of human body cells and more than 150 times than human genes containing 1000 different microbe species. It has been described a symbiotic relationship between gut and kidney, confirmed by several observations. This is a bi-directional relation with a mutual influence, even when kidney disease occurs, and consequent alterations of intestinal microbiota and production of uremic toxins, that in turn worsens kidney disease and its progression. Our review analyzes the components of gut-kidney axis and relative clinical consequences. Copyright by Società Italiana di Nefrologia SIN, Rome, Italy.

  3. Boron neutron capture therapy (BNCT) in Finland: technological and physical prospects after 20 years of experiences.

    PubMed

    Savolainen, Sauli; Kortesniemi, Mika; Timonen, Marjut; Reijonen, Vappu; Kuusela, Linda; Uusi-Simola, Jouni; Salli, Eero; Koivunoro, Hanna; Seppälä, Tiina; Lönnroth, Nadja; Välimäki, Petteri; Hyvönen, Heini; Kotiluoto, Petri; Serén, Tom; Kuronen, Antti; Heikkinen, Sami; Kosunen, Antti; Auterinen, Iiro

    2013-05-01

    Boron Neutron Capture Therapy (BNCT) is a binary radiotherapy method developed to treat patients with certain malignant tumours. To date, over 300 treatments have been carried out at the Finnish BNCT facility in various on-going and past clinical trials. In this technical review, we discuss our research work in the field of medical physics to form the groundwork for the Finnish BNCT patient treatments, as well as the possibilities to further develop and optimize the method in the future. Accordingly, the following aspects are described: neutron sources, beam dosimetry, treatment planning, boron imaging and determination, and finally the possibilities to detect the efficacy and effects of BNCT on patients. Copyright © 2012 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  4. Incidence of colonization and bloodstream infection with carbapenem-resistant Enterobacteriaceae in children receiving antineoplastic chemotherapy in Italy.

    PubMed

    Caselli, Desiree; Cesaro, Simone; Fagioli, Franca; Carraro, Francesca; Ziino, Ottavio; Zanazzo, Giulio; Meazza, Cristina; Colombini, Antonella; Castagnola, Elio

    2016-02-01

    Few data are available on the incidence of carbapenemase-producing Enterobacteriaceae (CPE) infection or colonization in children receiving anticancer chemotherapy. We performed a nationwide survey among centers participating in the pediatric hematology-oncology cooperative study group (Associazione Italiana Ematologia Oncologia Pediatrica, AIEOP). During a 2-year observation period, we observed a threefold increase in the colonization rate, and a fourfold increase of bloodstream infection episodes, caused by CPE, with a 90-day mortality of 14%. This first nationwide Italian pediatric survey shows that the circulation of CPE strains in the pediatric hematology-oncology environment is increasing. Given the mortality rate, which is higher than for other bacterial strains, specific monitoring should be applied and the results should have implications for health-care practice in pediatric hematology-oncology.

  5. 1st European Congress of Medical Physics September 1-4, 2016; Medical Physics innovation and vision within Europe and beyond.

    PubMed

    Tsapaki, Virginia; Kagadis, George C; Brambilla, Marco; Ciocca, Mario; Clark, Catharine H; Delis, Harry; Mettivier, Giovanni

    2017-09-01

    Medical Physics is the scientific healthcare profession concerned with the application of the concepts and methods of physics in medicine. The European Federation of Organisations for Medical Physics (EFOMP) acts as the umbrella organization for European Medical Physics societies. Due to the rapid advancements in related scientific fields, medical physicists must have continuous education through workshops, training courses, conferences, and congresses during their professional life. The latest developments related to this increasingly significant medical speciality were presented during the 1st European Congress of Medical Physics 2016, held in Athens, September 1-4, 2016, organized by EFOMP, hosted by the Hellenic Association of Medical Physicists (HAMP), and summarized in the current volume. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  6. Whole-brain radiotherapy or autologous stem-cell transplantation as consolidation strategies after high-dose methotrexate-based chemoimmunotherapy in patients with primary CNS lymphoma: results of the second randomisation of the International Extranodal Lymphoma Study Group-32 phase 2 trial.

    PubMed

    Ferreri, Andrés J M; Cwynarski, Kate; Pulczynski, Elisa; Fox, Christopher P; Schorb, Elisabeth; La Rosée, Paul; Binder, Mascha; Fabbri, Alberto; Torri, Valter; Minacapelli, Eleonora; Falautano, Monica; Ilariucci, Fiorella; Ambrosetti, Achille; Roth, Alexander; Hemmaway, Claire; Johnson, Peter; Linton, Kim M; Pukrop, Tobias; Sønderskov Gørløv, Jette; Balzarotti, Monica; Hess, Georg; Keller, Ulrich; Stilgenbauer, Stephan; Panse, Jens; Tucci, Alessandra; Orsucci, Lorella; Pisani, Francesco; Levis, Alessandro; Krause, Stefan W; Schmoll, Hans J; Hertenstein, Bernd; Rummel, Mathias; Smith, Jeffery; Pfreundschuh, Michael; Cabras, Giuseppina; Angrilli, Francesco; Ponzoni, Maurilio; Deckert, Martina; Politi, Letterio S; Finke, Jürgen; Reni, Michele; Cavalli, Franco; Zucca, Emanuele; Illerhaus, Gerald

    2017-11-01

    -generated randomisation list was used within each stratum. No masking after assignment to intervention was adopted. The primary endpoint was 2-year progression-free survival, with induction group and response to induction chemotherapy as stratification parameters. Analyses were done on a modified intention-to-treat basis. This study is registered with ClinicalTrials.gov, number NCT01011920. Between Feb 19, 2010, and Aug 27, 2014, 227 patients were recruited from 53 centres in five countries. 219 of 227 enrolled patients were assessable. Of the 122 patients eligible for the second randomisation, 118 patients were randomly assigned to WBRT or ASCT (59 patients per group) and constitute the study population. WBRT and ASCT were both effective, and achieved the predetermined efficacy threshold of at least 40 progression-free survivors at 2 years among the first 52 patients in both groups D and E. There were no significant differences in 2-year progression-free survival between WBRT and ASCT: 80% (95% CI 70-90) in group D and 69% (59-79) in group E (hazard ratio 1·50, 95% CI 0·83-2·71; p=0·17). Both consolidation therapies were well tolerated. Grade 4 non-haematological toxicity was uncommon; as expected, haematological toxicity was more common in patients treated with ASCT than in those who received WBRT. Two toxic deaths (infections) were recorded, both in patients who received ASCT. WBRT and ASCT are both feasible and effective as consolidation therapies after high-dose methotrexate-based chemoimmunotherapy in patients aged 70 years or younger with primary CNS lymphoma. The risks and implications of cognitive impairment after WBRT should be considered at the time of therapeutic decision. Agenzia Italiana del Farmaco, Cancer Research UK, Oncosuisse, and Swiss National Science Foundation. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Kikuchi-Fujimoto disease: a clinicopathologic update.

    PubMed

    Pepe, F; Disma, S; Teodoro, C; Pepe, P; Magro, G

    2016-09-01

    suspected malignant lymphomas or other diseases. © Copyright Società Italiana di Anatomia Patologica e Citopatologia Diagnostica, Divisione Italiana della International Academy of Pathology.

  8. Building blocks of the GIPU, Italian Group of Ultrastructural Pathology.

    PubMed

    Papa, V; Costa, R; Cenacchi, G

    2016-06-01

    researchers interested in pathology and electron microscopy. © Copyright Società Italiana di Anatomia Patologica e Citopatologia Diagnostica, Divisione Italiana della International Academy of Pathology.

  9. Infant Ependymoma in a 10-Year AIEOP (Associazione Italiana Ematologia Oncologia Pediatrica) Experience With Omitted or Deferred Radiotherapy

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Massimino, Maura, E-mail: maura.massimino@istitutotumori.mi.it; Gandola, Lorenza; Barra, Salvina

    Purpose: The protocols of the 1990s omitted or delayed irradiation, using upfront chemotherapy to spare the youngest children with ependymoma the sequelae of radiotherapy (RT). We treated 41 children under the age of 3 years with intracranial ependymoma between 1994 and 2003. Patients and Methods: After surgery, chemotherapy was given as follows: regimen I with four blocks of vincristine, high-dose methotrexate 5 g/m{sup 2}, and cyclophosphamide 1.5 g/m{sup 2} alternating with cisplatin 90 mg/m{sup 2} plus VP16 450 mg/m{sup 2} for 14 months; subsequently, regimen II was used: VEC (VCR, VP16 300 mg/m{sup 2}, and cyclophosphamide 3 g/m{sup 2}) formore » 6 months. Radiotherapy was planned for residual tumor after the completion of chemotherapy or for progression. Results: We treated 23 boys and 18 girls who were a median 22 months old; 14 were given regimen I, 27 were given regimen II; 22 underwent complete resection, 19 had residual tumor. Ependymoma was Grade 2 in 25 patients and Grade 3 in 16; tumors were infratentorial in 37 patients and supratentorial in 4. One child had intracranial metastases; 29 had progressed locally after a median 9 months. Event-free survival was 26% at 3 and 5 years and 23% at 8 years. One child died of sepsis, and another developed a glioblastoma 72 months after RT. Progression-free survival was 27% at 3, 5, and 8 years, and overall survival was 48%, 37%, and 28% at 3, 5, and 8 years, respectively. Of the 13 survivors, 6 never received RT; their intellectual outcome did not differ significantly in those children than in those without RT. Conclusions: Our results confirm poor rates of event-free survival and overall survival for up-front chemotherapy in infant ependymoma. No better neurocognitive outcome was demonstrated in the few survivors who never received RT.« less

  10. Gastric lymphoma: the histology report.

    PubMed

    Doglioni, Claudio; Ponzoni, Maurilio; Ferreri, Andrés J M; Savio, Antonella

    2011-03-01

    The diagnosis of gastric MALT lymphoma is frequently difficult for the general histopathologist. During recent years there have been relevant changes in the therapeutic approach to gastric MALT lymphoma and our knowledge about its pathogenesis has greatly improved. The management of this disease actually requires a close cooperation between the histopathologist and the clinicians. The histology report of biopsies of a newly diagnosed or of an already treated case implies information of clinical and therapeutical relevance. This paper aims at giving the histopathologist a general knowledge about the state of art of this disease and its management. The diagnostic process leading to a complete and competent report is then described step by step. Copyright © 2011 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd.. All rights reserved.

  11. Chronic idiopathic inflammatory bowel diseases: the histology report.

    PubMed

    Cornaggia, Matteo; Leutner, Monica; Mescoli, Claudia; Sturniolo, Giacomo Carlo; Gullotta, Renzo

    2011-03-01

    The incidence of chronic idiopathic inflammatory bowel diseases (IBD) is growing in western countries, making their histological diagnosis an everyday task for all pathologists. Reviews from the literature strongly suggest that such diagnosis cannot be performed on the histological ground alone but requires a clinical-pathological approach. Moreover, bewildering variations can be observed in the terminology employed to report either individual lesions or diagnostic categories. The aim of the present paper is to suggest a practical diagnostic algorithm summarizing the main data from the literature. Particular emphasis has been placed on minimum clinical information required and the accurate definition of individual lesions. Diagnostic categories to employ and to avoid in daily practice have furthermore been stressed. Copyright © 2011 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd.. All rights reserved.

  12. Method for data analysis in different institutions: example of image guidance of prostate cancer patients.

    PubMed

    Piotrowski, T; Rodrigues, G; Bajon, T; Yartsev, S

    2014-03-01

    Multi-institutional collaborations allow for more information to be analyzed but the data from different sources may vary in the subgroup sizes and/or conditions of measuring. Rigorous statistical analysis is required for pooling the data in a larger set. Careful comparison of all the components of the data acquisition is indispensable: identical conditions allow for enlargement of the database with improved statistical analysis, clearly defined differences provide opportunity for establishing a better practice. The optimal sequence of required normality, asymptotic normality, and independence tests is proposed. An example of analysis of six subgroups of position corrections in three directions obtained during image guidance procedures for 216 prostate cancer patients from two institutions is presented. Copyright © 2013 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  13. [Cardio-renal axis: pathophysiological evidences and clinical implications].

    PubMed

    Di Lullo, Luca; Ronco, Claudio

    2017-03-01

    According to the recent definition proposed by the Consensus conference on Acute Dialysis Quality Initiative Group, the term cardio-renal syndrome CRS has been used to define different clinical conditions in which heart and kidney dysfunction overlap. Type 1 CRS acute cardio - renal syndrome is characterized by acute worsening of cardiac function leading to AKI in the setting of active cardiac disease such as ADHF, while type - 2 CRS occurs in a setting of chronic heart disease. Type 3 CRS is closely link to acute kidney injury, while type 4 represent cardiovascular involvement in chronic kidney disese patients. Type 5 CRS represent cardiac and renal involvement in several diseases such as sepsis, hepato - renal syndrome and immune - mediated diseases. Copyright by Società Italiana di Nefrologia SIN, Rome, Italy.

  14. Toward precision medicine in primary biliary cholangitis.

    PubMed

    Carbone, Marco; Ronca, Vincenzo; Bruno, Savino; Invernizzi, Pietro; Mells, George F

    2016-08-01

    Primary biliary cholangitis is a chronic, cholestatic liver disease characterized by a heterogeneous presentation, symptomatology, disease progression and response to therapy. In contrast, clinical management and treatment of PBC is homogeneous with a 'one size fits all' approach. The evolving research landscape, with the emergence of the -omics field and the availability of large patient cohorts are creating a unique opportunity of translational epidemiology. Furthermore, several novel disease and symptom-modifying agents for PBC are currently in development. The time is therefore ripe for precision medicine in PBC. In this manuscript we describe the concept of precision medicine; review current approaches to risk-stratification in PBC, and speculate how precision medicine in PBC might develop in the near future. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  15. Comparison of Vegetation Indices from Rpas and SENTINEL-2 Imagery for Detecting Permanent Pastures

    NASA Astrophysics Data System (ADS)

    Piragnolo, M.; Lusiani, G.; Pirotti, F.

    2018-04-01

    Permanent pastures (PP) are defined as grasslands, which are not subjected to any tillage, but only to natural growth. They are important for local economies in the production of fodder and pastures (Ali et al. 2016). Under these definitions, a pasture is permanent when it is not under any crop-rotation, and its production is related to only irrigation, fertilization and mowing. Subsidy payments to landowners require monitoring activities to determine which sites can be considered PP. These activities are mainly done with visual field surveys by experienced personnel or lately also using remote sensing techniques. The regional agency for SPS subsidies, the Agenzia Veneta per i Pagamenti in Agricoltura (AVEPA) takes care of monitoring and control on behalf of the Veneto Region using remote sensing techniques. The investigation integrate temporal series of Sentinel-2 imagery with RPAS. Indeed, the testing area is specific region were the agricultural land is intensively cultivated for production of hay harvesting four times every year between May and October. The study goal of this study is to monitor vegetation presence and amount using the Normalized Difference Vegetation Index (NDVI), the Soil-adjusted Vegetation Index (SAVI), the Normalized Difference Water Index (NDWI), and the Normalized Difference Built Index (NDBI). The overall objective is to define for each index a set of thresholds to define if a pasture can be classified as PP or not and recognize the mowing.

  16. X-SAR: The X-band synthetic aperture radar on board the Space Shuttle

    NASA Technical Reports Server (NTRS)

    Werner, Marian U.

    1993-01-01

    The X-band synthetic aperture radar (X-SAR) is the German/Italian contribution to the NASA/JPL Shuttle Radar Lab missions as part of the preparation for the Earth Observation System (EOS) program. The Shuttle Radar Lab is a combination of several radars: an L-band (1.2 GHz) and a C-band (5.3 GHz) multipolarization SAR known as SIR-C (Shuttle Imaging Radar); and an X-band (9.6 GHz) vertically polarized SAR which will be operated synchronously over the same target areas to deliver calibrated multifrequency and multipolarization SAR data at multiple incidence angles from space. A joint German/Italian project office at DARA (German Space Agency) is responsible for the management of the X-SAR project. The space hardware has been developed and manufactured under industrial contract by Dornier and Alenia Spazio. Besides supporting all the technical and scientific tasks, DLR, in cooperation with ASI (Agencia Spaziale Italiano) is responsible for mission operation, calibration, and high precision SAR processing. In addition, DLR developed an airborne X-band SAR to support the experimenters with campaigns to prepare for the missions. The main advantage of adding a shorter wavelength (3 cm) radar to the SIR-C radars is the X-band radar's weaker penetration into vegetation and soil and its high sensitivity to surface roughness and associated phenomena. The performance of each of the three radars is comparable with respect to radiometric and geometric resolution.

  17. From analytic inversion to contemporary IMRT optimization: radiation therapy planning revisited from a mathematical perspective.

    PubMed

    Censor, Yair; Unkelbach, Jan

    2012-04-01

    In this paper we look at the development of radiation therapy treatment planning from a mathematical point of view. Historically, planning for Intensity-Modulated Radiation Therapy (IMRT) has been considered as an inverse problem. We discuss first the two fundamental approaches that have been investigated to solve this inverse problem: Continuous analytic inversion techniques on one hand, and fully-discretized algebraic methods on the other hand. In the second part of the paper, we review another fundamental question which has been subject to debate from the beginning of IMRT until the present day: The rotation therapy approach versus fixed angle IMRT. This builds a bridge from historic work on IMRT planning to contemporary research in the context of Intensity-Modulated Arc Therapy (IMAT). Copyright © 2011 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  18. Recommendations for the use of molecular diagnostics in the diagnosis of allergic dis-eases.

    PubMed

    Villalta, D; Tonutti, E; Bizzaro, N; Brusca, I; Sargentini, V; Asero, R; Bilo, M B; Manzotti, G; Murzilli, F; Cecchi, L; Musarra, A

    2018-03-01

    The Study Group on Allergology of the Italian Society of Clinical Pathology and Laboratory Medicine (SIPMeL) and the Associazione Italiana degli Allergologi e Immunologi Territoriali e Ospedalieri (AAIITO) developed the present recommendations on the diagnosis of allergic diseases based on the use of molecular allergenic components, whose purpose is to provide the pathologists and the clinicians with information and algorithms enabling a proper use of this second-level diagnostics. Molecular diagnostics allows definition of the exact sensitization profile of the allergic patient. The methodology followed to develop these recommendations included an initial phase of discussion between all the components to integrate the knowledge derived from scientific evidence, a revision of the recommendations made by Italian and foreign experts, and the subsequent production of this document to be disseminated to all those who deal with allergy diagnostics.

  19. Management and endoscopic techniques for digestive foreign body and food bolus impaction.

    PubMed

    Chauvin, Armelle; Viala, Jerome; Marteau, Philippe; Hermann, Philippe; Dray, Xavier

    2013-07-01

    Ingested foreign bodies, food bolus impaction, migration or retention of medical devices are frequent, in children as well as in adults. Most of these foreign bodies will naturally pass through the gastro-intestinal tract. Complications are rare but sometimes severe (oesophageal perforations are the most frequent and most feared). We aimed to review the literature on therapeutic management of digestive foreign bodies and food bolus impaction, with special focus on endoscopic indications, material, timing and techniques for removal. The role of the gastroenterologist is to recognise specific situations and to plan endoscopic removal in a timely manner with the most adequate conditions and extraction tools. Risk factors and underlying pathology, for example eosinophilic esophagitis, must be investigated and if necessary treated. Copyright © 2012 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  20. Technological advances for improving adenoma detection rates: The changing face of colonoscopy.

    PubMed

    Ishaq, Sauid; Siau, Keith; Harrison, Elizabeth; Tontini, Gian Eugenio; Hoffman, Arthur; Gross, Seth; Kiesslich, Ralf; Neumann, Helmut

    2017-07-01

    Worldwide, colorectal cancer is the third commonest cancer. Over 90% follow an adenoma-to-cancer sequence over many years. Colonoscopy is the gold standard method for cancer screening and early adenoma detection. However, considerable variation exists between endoscopists' detection rates. This review considers the effects of different endoscopic techniques on adenoma detection. Two areas of technological interest were considered: (1) optical technologies and (2) mechanical technologies. Optical solutions, including FICE, NBI, i-SCAN and high definition colonoscopy showed mixed results. In contrast, mechanical advances, such as cap-assisted colonoscopy, FUSE, EndoCuff and G-EYE™, showed promise, with reported detections rates of up to 69%. However, before definitive recommendations can be made for their incorporation into daily practice, further studies and comparison trials are required. Copyright © 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  1. Early definition of type, degree and audiogram shape in childhood hearing impairment.

    PubMed

    Conti, G; Gallus, R; Fetoni, A R; Martina, B M; Muzzi, E; Orzan, E; Bastanza, G

    2016-02-01

    In the context of permanent childhood hearing loss, early audiological diagnosis is a prerequisite for activation of an adequate rehabilitation program to prevent or limit the known effects that auditory deprivation determines on language development and cognitive skills in neonates. Audiological diagnosis consists schematically of three phases: identification of subjects at risk, definition of hearing loss and/or children features, verification of appropriateness of diagnosis itself and a rehabilitation programme. Strategies and methods of audiological diagnosis are well defined and include an integration of data coming from objective methods with clinical and behavioural data. Although the substantial effectiveness of procedures and a general consensus on their use and interpretation have been defined, there are several critical issues concerning the achievement of this objective, which will be discussed in this paper. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale.

  2. Post-upgrade testing on a radiotherapy oncology information system with an embedded record and verify system following the IAEA Human Health Report No. 7 recommendations.

    PubMed

    Nyathi, Thulani; Colyer, Christopher; Bhardwaj, Anup Kumar; Rijken, James; Morton, Jason

    2016-06-01

    Record and verify (R&V) systems have proven that their application in radiotherapy clinics leads to a significant reduction in mis-treatments of patients. The purpose of this technical note is to share our experience of acceptance testing, commissioning and setting up a quality assurance programme for the MOSAIQ® oncology information system and R&V system after upgrading from software version 2.41 to 2.6 in a multi-vendor, multi-site environment. Testing was guided primarily by the IAEA Human Report No. 7 recommendations, but complemented by other departmental workflow specific tests. To the best of our knowledge, this is the first time successful implementation of the IAEA Human Health Report Series No. 7 recommendations have been reported in the literature. Copyright © 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  3. Class III camouflage using skeletal anchorage and Pendex appliance.

    PubMed

    Miguel, José Augusto M; Zanardi, Gustavo

    2011-01-01

    This case report describes the orthodontic treatment for a young female, aged 18 years 4 months, with a Class III malocclusion on the right side, with a combination of a posterior and anterior crossbite. Two rigid orthodontic mini-implants were placed in the retromolar region in order to move the entire lower arch distally with nickel-titanium coil springs. In addition, a Pendex appliance was used to create space and to improve the arch form and the transverse relationship. The active treatment period was 17 months. Normal overjet and overbite were obtained, and facial balance was improved. Although the cephalometric superimposition has demonstrated the effects of dental compensation, the final dental and facial results were satisfactory and stable after the second year in retention. Copyright © 2011 Società Italiana di Ortodonzia SIDO. Published by Elsevier Srl. All rights reserved.

  4. Common issues in the management of patients in the waiting list and after liver transplantation.

    PubMed

    Burra, Patrizia; Belli, Luca Saverio; Ginanni Corradini, Stefano; Volpes, Riccardo; Marzioni, Marco; Giannini, Edoardo; Toniutto, Pierluigi

    2017-03-01

    The present document contains the recommendations of an expert panel of transplant hepatologists, appointed by the Italian Association for the Study of the Liver (AISF), on how to manage the most common aspects of liver transplantation: the topics covered include: new treatments for HCV in patients on the waiting list for liver transplantation; antiviral treatments in patients with HCV recurrence after liver transplantation; prophylaxis for HBV recurrence after liver transplantation; indications for liver transplantation in alcoholic liver disease; and Immunosuppressive therapy. The statements on each topic were approved by participants at the AISF Transplant Hepatologist Expert Meeting (organized by the Permanent Committee on Liver Transplantation in Mondello on 4-5 October 2015), and are graded according to the Oxford classification of levels of evidence. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  5. Gastroenteropancreatic (neuro)endocrine neoplasms: the histology report.

    PubMed

    Rindi, Guido; Bordi, C; La Rosa, S; Solcia, E; Delle Fave, Gianfranco

    2011-03-01

    Based on the year 2000 World Health Organization (WHO) classification and the European Neuroendocrine Tumor Society (ENETS) grading and staging proposals, we here define the minimal guidelines for pathology reporting of (neuro)endocrine neoplasms. The macroscopical description is recommended according to standard procedures and the microscopical description according to recognized architectural and cytological features for endocrine lesions. Minimal diagnostic immunohistochemistry entails the use of chromogranin A, synaptophysin and Ki67. Other potentially useful tests are those for CD56 N-CAM, PGP 9.5 and hormones for diagnosis, the somatostatin receptor subtype 2 for potential radiodiagnostics and therapy, and transcription factors like TTF1 and CDX2, for site of origin. Grading definition is always mandatory as well as TNM staging for surgical specimens. Copyright © 2011 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd.. All rights reserved.

  6. Correlation between musical aptitude and learning foreign languages: an epidemiological study in secondary school Italian students.

    PubMed

    Picciotti, P M; Bussu, F; Calò, L; Gallus, R; Scarano, E; DI Cintio, G; Cassarà, F; D'Alatri, L

    2018-02-01

    The aim of this study was to assess if a correlation exists between language learning skills and musical aptitude through the analysis of scholarly outcomes concerning the study of foreign languages and music. We enrolled 502 students from a secondary Italian school (10-14 years old), attending both traditional courses (2 hours/week of music classes scheduled) and special courses (six hours). For statistical analysis, we considered grades in English, French and Music. Our results showed a significant correlation between grades in the two foreign languages and in music, both in the traditional courses and in special courses, and better results in French than for special courses. These results are discussed and interpreted through the literature about neuroanatomical and physiological mechanisms of foreign language learning and music perception. Copyright © 2018 Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale, Rome, Italy.

  7. "Bernardino Ramazzini, three hundred years after his death", Padua (Italy), October 18th, 2014.

    PubMed

    Riva, Michele Augusto; Zampieri, Fabio

    2015-01-29

    The year 2014 has marked the tercentenary from the death of Bernardino Ramazzini (1633-1714), universally credited as the founder of Occupational Health (5, 9, 10, 11). Indeed, the renowned physician died on November 5th 1714 in Padua, where he had been appointed as Professor of Practical Medicine at the local prestigious University from the year 1700. To commemorate this anniversary, the professors of Occupational Health of the University of Padua, the Italian Society of Occupational Health and Industrial Hygiene (Società Italiana di Medicina del Lavoro eIgiene Industriale, SIMLII), the International Commission on Occupational Health (ICOH) and the University of Padua organized a conference in the wonderful location of Palazzo Bo (Main Hall) under the patronage of the Padua Municipality, the Workers' Compensation Authority (INAIL), the Venetian Region and the Societas Internationalis Historiae Medicinae.[...].

  8. Monte Carlo modeling of the Siemens Optifocus multileaf collimator.

    PubMed

    Laliena, Victor; García-Romero, Alejandro

    2015-05-01

    We have developed a new component module for the BEAMnrc software package, called SMLC, which models the tongue-and-groove structure of the Siemens Optifocus multileaf collimator. The ultimate goal is to perform accurate Monte Carlo simulations of the IMRT treatments carried out with Optifocus. SMLC has been validated by direct geometry checks and by comparing quantitatively the results of simulations performed with it and with the component module VARMLC. Measurements and Monte Carlo simulations of absorbed dose distributions of radiation fields sensitive to the tongue-and-groove effect have been performed to tune the free parameters of SMLC. The measurements cannot be accurately reproduced with VARMLC. Finally, simulations of a typical IMRT field showed that SMLC improves the agreement with experimental measurements with respect to VARMLC in clinically relevant cases. 87.55. K. Copyright © 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  9. The AstroBID: Searching through the Italian Astronomical Heritage

    NASA Astrophysics Data System (ADS)

    Cirella, E. O.; Gargano, M.; Gasperini, A.; Mandrino, A.; Randazzo, D.; Zanini, V.

    2015-04-01

    The scientific heritage held in the National Institute for Astrophysics (INAF), made up of rare and modern books, instruments, and archival documents spanning from the 15th to the early 20th century, marks the milestones in the history of astronomy in Italy. To promote this history of this historical collection, the Libraries and Historical Archives Service and the Museums Service of INAF have developed a project aimed at creating a single web portal: Polvere di stelle. I beni culturali dell'astronomia italiana (Stardust. The cultural heritage of the Italian astronomy). This portal searches for data coming from the libraries, the instruments collections and the historical archives, regarding the heritage of the Italian Observatories. The BID (Books, Instruments, Documents) of the project is the creation of a multimedia web facility, which allows the public to make simultaneous searches on the three different types of materials.

  10. Effects of simultaneous palatal expansion and mandibular advancement in a child suffering from OSA.

    PubMed

    Galeotti, A; Festa, P; Pavone, M; De Vincentiis, G C

    2016-08-01

    This clinical report describes a child suffering from obstructive sleep apnoea (OSA) and class II skeletal malocclusion with maxillary contraction and anterior open bite. He presented moderate obstructive sleep apnoea with large impact on quality of life of patient and parents. He was treated using an innovative orthodontic device (Sleep Apnea Twin Expander) to simultaneously carry out palatal expansion and mandibular advancement. After orthodontic therapy, the OSA-18 questionnaire demonstrated an improvement of the main respiratory symptoms, while cardiorespiratory sleep study revealed a reduction in obstructive sleep apnoea events. Post-treatment, clinical assessment and cephalometric analysis showed a reduction of sagittal maxillary discrepancy and an extension of upper airway space. In conclusion, this case report suggests that orthodontic treatment might be a valuable alternative treatment in children with obstructive sleep apnoea related to craniofacial anomalies. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale, Rome, Italy.

  11. Viewing boxes: a survey in diagnostic radiology departments of Moroccan hospitals.

    PubMed

    Bentayeb, F; Nfaoiu, K; Basraoui, O; Azevedo, A C P

    2010-10-01

    This work consists on a survey of the performance of viewing boxes installed in diagnostic radiology departments and included several aspects: checking the illuminance of the diagnostic rooms where the viewing boxes are located as well as the viewing boxes luminance levels and homogeneity. Seven hospitals took part in the survey, being three in the city of Casablanca and four in Rabat. A total of 136 viewing boxes and 18 diagnostic rooms have been checked. It was found that one diagnostic room works under normal conditions and that 80% of the viewing boxes present luminance levels below the international recommendations and the homogeneity is inadequate in 85%. Some simple and cheap initiatives can be performed in these departments to increase luminance and improve homogeneity levels such as cleaning and bulbs replacement. Copyright © 2009 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  12. Molar uprighting with mini screws: comparison among different systems and relative biomechanical analysis.

    PubMed

    Musilli, Marino; Marsico, Marco; Romanucci, Annalisa; Grampone, Francesco

    2010-01-01

    Starting from a segmented approach, the Authors propose 3 different methods of using mini screws during the process of molar uprighting. The first UPG is performed by placing a mini screw in the retromolar area and by applying an elastic chain loaded between the screw and the molar.The second UPG is made by placing a screw in the retro molar area and by using a small cantilever which is active during intrusion and uprighting.The third UPG is made by using a miniscrew placed a few millimeters mesial to the molar to control the vertical force produced by the uprighting with a long cantilever to the frontal teeth.To assist in the understanding of the different clinical indications, the biomechanical differences between these three systems are analyzed. Copyright © 2010 Società Italiana di Ortodonzia SIDO. Published by Elsevier Srl. All rights reserved.

  13. Clinical nutrition guidelines of the French Speaking Society of Clinical Nutrition and Metabolism (SFNEP): Summary of recommendations for adults undergoing non-surgical anticancer treatment.

    PubMed

    2014-08-01

    Up to 50% of patients with cancer suffer from weight loss and undernutrition (as called cachexia) even though it is rarely screened or properly handled. Patients' prognosis and quality of life could be greatly improved by simple and inexpensive means encompassing nutritional status assessment and effective nutritional care. These guidelines aim to give health professionals and patients practical and up-to-date advice to manage nutrition in the principal situations encountered during the cancer course according to the type of tumour and treatment (i.e. radio and/or chemotherapy). Specific suggestions are made for palliative and elderly patients because of specific risks of undernutrition and related comorbidities in this subset. Levels of evidence and grades of recommendations are detailed as stated by current literature and consensus opinion of clinical experts in each field. Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  14. Improving regional universal newborn hearing screening programmes in Italy.

    PubMed

    Molini, E; Cristi, M C; Lapenna, R; Calzolaro, L; Muzzi, E; Ciciriello, E; Della Volpe, A; Orzan, E; Ricci, G

    2016-02-01

    The Universal Newborn Hearing Screening (UNHS) programme aims at achieving early detection of hearing impairment. Subsequent diagnosis and intervention should follow promptly. Within the framework of the Ministry of Health project CCM 2013 "Preventing Communication Disorders: a Regional Program for early Identification, Intervention and Care of Hearing Impaired Children", the limitations and strengths of current UNHS programs in Italy have been analysed by a group of professionals working in tertiary centres involved in regional UNHS programmes, using SWOT analysis and a subsequent TOWS matrix. Coverage and lost-to-follow up rates are issues related to UNHS programmes. Recommendations to improve the effectiveness of the UNHS programme have been identified. The need for homogeneous policies, high-quality information and dissemination of knowledge for operators and families of hearing-impaired children emerged from the discussion. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale.

  15. Advanced technologies in the ASI MLRO towards a new generation laser ranging system

    NASA Technical Reports Server (NTRS)

    Varghese, Thomas; Bianco, Giuseppe

    1994-01-01

    Matera Laser Ranging Observatory (MLRO) is a high performance, highly automated optical and astronomical observatory currently under design and development by AlliedSignal for the Italian Space Agency (ASI). It is projected to become operational at the Centro Geodesia Spaziale in Matera, Italy, in 1997. MLRO, based on a 1.5-meter astronomical quality telescope, will perform ranging to spacecraft in earthbound orbits, lunar reflectors, and specially equipped deep space missions. The primary emphasis during design is to incorporate state-of-the-art technologies to produce an intelligent, automated, high accuracy ranging system that will mimic the characteristic features of a fifth generation laser ranging system. The telescope has multiple ports and foci to support future experiments in the areas of laser communications, lidar, astrometry, etc. The key features providing state-of-the-art ranging performance include: a diode-pumped picosecond (50 ps) laser, high speed (3-5 GHz) optoelectronic detection and signal processing, and a high accuracy (6 ps) high resolution (less than 2 ps) time measurement capability. The above combination of technologies is expected to yield millimeter laser ranging precision and accuracy on targets up to 300,000 km, surpassing the best operational instrument performance to date by a factor of five or more. Distributed processing and control using a state-of-the-art computing environment provides the framework for efficient operation, system optimization, and diagnostics. A computationally intelligent environment permits optimal planning, scheduling, tracking, and data processing. It also supports remote access, monitor, and control for joint experiments with other observatories.

  16. Controversies on Hodgkin's disease and anaplastic large cell lymphoma. Hematopathology Study Group of the Società Italiana di Anatomia Patologica.

    PubMed

    Pileri, S

    1994-01-01

    Just one year ago the Italian Society of Pathology (S.I.A.P.) created a Study Group which included members of the most active Italian hematopathology teams. Prof. Pasquale Calapso was asked to chair the Group and Prof. Stefano Pileri to take care of secretarial duties. The aim of the Group is to spread hematopathologic knowledge among young pathologists and to promote activities that can contribute to updating Italian pathologists on topics of both speculative and diagnostic interest. The first Workshop of the S.I.A.P. Hematopathology Group was held at the Palazzo dei Congressi in Bologna, November 20, 1993. About 150 pathologists from all over Italy took part in the meeting, which consisted of two sections devoted to: a) discussion of the boundaries between Hodgkin's disease and non-Hodgkin's lymphomas, and b) a case seminar illustrating the impact of immunohistochemistry in the diagnosis of bone-marrow biopsy. The first section included 5 presentations and a Round Table chaired by Prof. Luciano Fiore-Donati. Below, the contributors to this section summarize the content of their presentations, which were aimed at answering specific questions the Organizers had put to them.

  17. Dosimetric characterization of the (60)Co BEBIG Co0.A86 high dose rate brachytherapy source using PENELOPE.

    PubMed

    Guerrero, Rafael; Almansa, Julio F; Torres, Javier; Lallena, Antonio M

    2014-12-01

    (60)Co sources are being used as an alternative to (192)Ir sources in high dose rate brachytherapy treatments. In a recent document from AAPM and ESTRO, a consensus dataset for the (60)Co BEBIG (model Co0.A86) high dose rate source was prepared by using results taken from different publications due to discrepancies observed among them. The aim of the present work is to provide a new calculation of the dosimetric characteristics of that (60)Co source according to the recommendations of the AAPM and ESTRO report. Radial dose function, anisotropy function, air-kerma strength, dose rate constant and absorbed dose rate in water have been calculated and compared to the results of previous works. Simulations using the two different geometries considered by other authors have been carried out and the effect of the cable density and length has been studied. Copyright © 2014 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  18. Faecal microbiota transplantation in recurrent Clostridium difficile infection: Recommendations from the French Group of Faecal microbiota Transplantation.

    PubMed

    Sokol, Harry; Galperine, Tatiana; Kapel, Nathalie; Bourlioux, Pierre; Seksik, Philippe; Barbut, Frederic; Scanzi, Julien; Chast, François; Batista, Rui; Joly, Francisca; Joly, Anne-Christine; Collignon, Anne; Guery, Benoit; Beaugerie, Laurent

    2016-03-01

    Faecal microbiota transplantation is effective for treating recurrent forms of Clostridium difficile infection and its use in this indication is recommended in the most recent European and North American guidelines. In this context, faecal microbiota transplantation is beginning to be performed in France in clinical practice, while the rules governing this procedure have been defined in France only for clinical trials. To unify, secure, and evaluate practice in this field in France, the French Group of Faecal microbiota Transplantation (FGFT) was created in October 2014 with the support of the French National Society of Gastroenterology, the French Infectious Disease Society, and the National Academy of Pharmacy. We present here the deliberations of this group regarding the use of faecal microbiota transplantation for recurrent Clostridium difficile infection. The issues addressed are the indications, therapeutic sequence, delivery procedures, donor selection, methods and conditions of specimen preparation, and traceability. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  19. Eye lens exposure to medical staff during endoscopic retrograde cholangiopancreatography.

    PubMed

    Zagorska, A; Romanova, K; Hristova-Popova, J; Vassileva, J; Katzarov, K

    2015-11-01

    The paper presents a study of the radiation doses to eye lens of medical staff during endoscopic retrograde cholangiopancreatography (ERCP) procedures performed in a busy gastroenterology department. For each procedure the dose equivalent to the eye, exposure time, dose rate, Kerma Area Product and fluoroscopy time were recorded. Measurements were performed for a period of two months in four main positions of the operating staff, and then extrapolated to estimate annual doses. The fluoroscopy time per ERCP procedure varied between 1.0 min and 28.8 min, with a mean value of 4.6 min. The calculated mean eye dose per procedure varied between 34.9 μSv and 93.3 μSv. The results demonstrated that if eye protection is not used, annual doses to the eye lens of the gastroenterologist performing the procedure and the anesthesiologist can exceed the dose limit of 20 mSv per year. Copyright © 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  20. Venous thromboembolism and cancer: guidelines of the Italian Association of Medical Oncology (AIOM).

    PubMed

    Mandalà, M; Falanga, A; Piccioli, A; Prandoni, P; Pogliani, E M; Labianca, R; Barni, S

    2006-09-01

    Thromboembolic complications represent one of the most important cause of morbidity and mortality in cancer patients. Although several data have been published demonstrating the strong association between cancer and venous thromboembolism (VTE), there is poor perception, among oncologists, of the level of risk of thrombosis and of relevance of managing VTE in these patients. The Associazione Italiana di Oncologia Medica (AIOM) has provided some recommendations to direct clinical practice according to evidence-based data concerning cancer and VTE. In fact, we conducted an extensive literature review (1996-2005) to produce evidence-based recommendations to improve perceptions of the magnitude of this risk among Italian medical and surgical oncologists and alert on the new approaches to prophylaxis and treatment of VTE in cancer patients. Levels of evidence are given according to a five-point rating system, and similarly for each key recommendation a five-point rating system suggests if the evidence is strong and indicate that the benefits do, or do not, outweigh risks and burden.

  1. High-doses of proton pump inhibitors in refractory gastro-intestinal cancer: A case series and the state of art.

    PubMed

    Falcone, Rosa; Roberto, Michela; D'Antonio, Chiara; Romiti, Adriana; Milano, Annalisa; Onesti, Concetta Elisa; Marchetti, Paolo; Fais, Stefano

    2016-12-01

    In recent years, proton pump inhibitors (PPIs) have been investigated at high-dose to modulate tumour microenvironment acidification thus restoring chemotherapeutic sensitivity. Moreover, several clinical data supports the role of cytotoxic drugs at low-dose continuously delivered as anticancer therapy. Clinical records of three patients affected with gastrointestinal cancer refractory to standard treatments, who had received a combination of high-dose rabeprazole and metronomic chemotherapy were reviewed. The first case, a 78-year-old man was treated for lung metastasis from colon adenocarcinoma. The second case, a 73-year-old man was treated for metastatic rectal cancer to the liver. The third one, a 68-year-old man, underwent the combination regimen for colon cancer with lung, liver and peritoneal metastases. Despite the failure of previous standard chemotherapy for metastatic disease, good clinical outcome was shown in these patients treated with an unconventional association of high-dose PPIs and metronomic chemotherapy. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  2. Diagnosis and management of newly diagnosed childhood autoimmune haemolytic anaemia. Recommendations from the Red Cell Study Group of the Paediatric Haemato-Oncology Italian Association

    PubMed Central

    Ladogana, Saverio; Maruzzi, Matteo; Samperi, Piera; Perrotta, Silverio; Del Vecchio, Giovanni C.; Notarangelo, Lucia D.; Farruggia, Piero; Verzegnassi, Federico; Masera, Nicoletta; Saracco, Paola; Fasoli, Silvia; Miano, Maurizio; Girelli, Gabriella; Barcellini, Wilma; Zanella, Alberto; Russo, Giovanna

    2017-01-01

    Autoimmune haemolytic anaemia is an uncommon disorder to which paediatric haematology centres take a variety of diagnostic and therapeutic approaches. The Red Cell Working Group of the Italian Association of Paediatric Onco-haematology (Associazione Italiana di Ematologia ed Oncologia Pediatrica, AIEOP) developed this document in order to collate expert opinions on the management of newly diagnosed childhood autoimmune haemolytic anaemia. The diagnostic process includes the direct and indirect antiglobulin tests; recommendations are given regarding further diagnostic tests, specifically in the cases that the direct and indirect antiglobulin tests are negative. Clear-cut definitions of clinical response are stated. Specific recommendations for treatment include: dosage of steroid therapy and tapering modality for warm autoimmune haemolytic anaemia; the choice of rituximab as first-line therapy for the rare primary transfusion-dependent cold autoimmune haemolytic anaemia; the indications for supportive therapy; the need for switching to second-line therapy. Each statement is provided with a score expressing the level of appropriateness and the agreement among participants. PMID:28151390

  3. [Italian health centers and Web Marketing strategy: necessary improvements, even in nephrology].

    PubMed

    Rinaldi Miliani, Maria; Barracca, Antonio; Quintaliani, Giuseppe

    2017-09-28

    The complete digitalization of the health system is an objective that Italy, from 2014, is pursuing with great difficulty, spurred by the many European initiatives dedicated to it. Despite the social and cultural background seems to be clearly ready for an application of the renewal strategies, e-Health and m-Health are struggling to get off the ground throughout the territory. The main difficulties are find at local level and don't spare any medical discipline, nephrology included. The characteristics of the official websites belonging to the local health centers demonstrate it. Today, these institutions are still sparsely present on Social Media or in the Italian Smart Mobile Technology landscape. The article illustrates the main features of the phenomenon and calls for reflection on the necessity to accelerate the digital innovation of the communication with patients. This is a possible strategy for reducing chronicity through prevention, and, potentially, for decreasing health costs. Copyright by Società Italiana di Nefrologia SIN, Rome, Italy.

  4. Hemospray for treatment of acute bleeding due to upper gastrointestinal tumours.

    PubMed

    Arena, Monica; Masci, Enzo; Eusebi, Leonardo Henry; Iabichino, Giuseppe; Mangiavillano, Benedetto; Viaggi, Paolo; Morandi, Elisabetta; Fanti, Lorella; Granata, Antonino; Traina, Mario; Testoni, Pier Alberto; Opocher, Enrico; Luigiano, Carmelo

    2017-05-01

    Hemospray is a new endoscopic haemostatic powder that can be used in the management of upper gastrointestinal bleedings. To assess the efficacy and safety of Hemospray as monotherapy for the treatment of acute upper gastrointestinal bleeding due to cancer. The endoscopy databases of 3 Italian Endoscopic Units were reviewed retrospectively and 15 patients (8 males; mean age 74 years) were included in this study. Immediate haemostasis was achieved in 93% of cases. Among the successful cases, 3 re-bled, one case treated with Hemospray and injection had a good outcome, while 2 cases died both re-treated with Hemospray, injection and thermal therapy. No complications related to Hemospray occurred. Finally, 80% of patients had a good clinical outcome at 30days and 50% at six months. Hemospray may be considered an effective and safe method for the endoscopic management of acute neoplastic upper gastrointestinal bleedings. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  5. Nuclear and radiological emergencies: Building capacity in medical physics to support response.

    PubMed

    Berris, Theocharis; Nüsslin, Fridtjof; Meghzifene, Ahmed; Ansari, Armin; Herrera-Reyes, Eduardo; Dainiak, Nicholas; Akashi, Makoto; Gilley, Debbie; Ohtsuru, Akira

    2017-10-01

    Medical physicists represent a valuable asset at the disposal of a structured and planned response to nuclear or radiological emergencies (NREs), especially in the hospital environment. The recognition of this fact led the International Atomic Energy Agency (IAEA) and the International Organization for Medical Physics (IOMP) to start a fruitful collaboration aiming to improve education and training of medical physicists so that they may support response efforts in case of NREs. Existing shortcomings in specific technical areas were identified through international consultations supported by the IAEA and led to the development of a project aiming at preparing a specific and standardized training package for medical physicists in support to NREs. The Project was funded through extra-budgetary contribution from Japan within the IAEA Nuclear Safety Action Plan. This paper presents the work accomplished through that project and describes the current steps and future direction for enabling medical physicists to better support response to NREs. Copyright © 2017 Associazione Italiana di Fisica Medica. All rights reserved.

  6. Advantages of statistical analysis of giant vesicle flickering for bending elasticity measurements.

    PubMed

    Méléard, P; Pott, T; Bouvrais, H; Ipsen, J H

    2011-10-01

    We show how to greatly improve precision when determining bending elasticity of giant unilamellar vesicles. Taking advantage of the well-known quasi-spherical model of liposome flickering, we analyze the full probability distributions of the configurational fluctuations instead of limiting the analysis to the second moment measurements only as usually done in previously published works. This leads to objective criteria to reject vesicles that do not behave according to the model. As a result, the confidence in the bending elasticity determination of individual vesicles that fit the model is improved and, consequently, the reproducibility of this measurement for a given membrane system. This approach uncovers new possibilities for bending elasticity studies like detection of minute influences by solutes in the buffer or into the membrane. In the same way, we are now able to detect the inhomogeneous behavior of giant vesicle systems such as the hazardous production of peroxide in bilayers containing fluorescent dyes. © EDP Sciences / Società Italiana di Fisica / Springer-Verlag 2011

  7. Frontiers in planning optimization for lung SBRT.

    PubMed

    Giglioli, Francesca Romana; Clemente, Stefania; Esposito, Marco; Fiandra, Christian; Marino, Carmelo; Russo, Serenella; Strigari, Lidia; Villaggi, Elena; Stasi, Michele; Mancosu, Pietro

    2017-12-01

    Emerging data are showing the safety and the efficacy of Stereotactic Body Radiation therapy (SBRT) in lung cancer management. In this context, the very high doses delivered to the Planning Target Volume, make the planning phase essential for achieving high dose levels conformed to the shape of the target in order to have a good prognosis for tumor control and to avoid an overdose in relevant healthy adjacent tissue. In this non-systematic review we analyzed the technological and the physics aspects of SBRT planning for lung cancer. In particular, the aims of the study were: (i) to evaluate prescription strategies (homogeneous or inhomogeneous), (ii) to outline possible geometrical solutions by comparing the dosimetric results (iii) to describe the technological possibilities for a safe and effective treatment, (iv) to present the issues concerning radiobiological planning and the automation of the planning process. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  8. [The role of endoscopy in gastroenteropancreatic neuroendocrine tumors].

    PubMed

    Magno, L; Sivero, L; Napolitano, V; Ruggiero, S; Fontanarosa, G; Massa, S

    2010-01-01

    Versione italiana Riassunto: Il ruolo dell'endoscopia nei tumori neuroendocrini gastroenteropancreatici. L. Magno, L. Sivero, V. Napolitano, S. Ruggiero, G. Fontanarosa, S. Massa I tumori neuroendocrini (NET) gastro-entero-pancreatici (GEP) sono neoplasie rare che originano dalle cellule neuroendocrine del tubo digerente e del pancreas. L'endoscopia digestiva e l'ecoendoscopia rivestono un ruolo importante nella diagnosi, stadiazione e sorveglianza dei pazienti con NET. Inoltre, in casi selezionati, le tecniche endoscopiche operative consentono il trattamento di queste neoplasie in fase precoce. English version Summary: The role of endoscopy in gastroenteropancreatic neuroendocrine tumors. L. Magno, L. Sivero, V. Napolitano, S. Ruggiero, G. Fontanarosa, S. Massa Gastroenteropancreatic (GEP) neuroendocrine tumors (NET) are rare neoplasia arisen from neuroendocrine cells present in the gut mucosa and pancreas. Digestive endoscopy and endoscopic ultrasonography play a relevant role in NET diagnosis, stadiation and surveillance. Moreover, in selected patients, surgical endoscopy allows the tratment of these cancers at an early stage.

  9. A palm-sized high-sensitivity near-infrared fluorescence imager for laparotomy surgery.

    PubMed

    Dorval, Paul; Mangeret, Norman; Guillermet, Stephanie; Atallah, Ihab; Righini, Christian; Barabino, Gabriele; Coll, Jean-Luc; Rizo, Philippe; Poulet, Patrick

    2016-01-01

    In laparotomy surgery guided by near-infrared fluorescence imaging, the access to the field of operation is limited by the illumination and/or the imaging field. The side of cavities or organs such as the liver or the heart cannot be examined with the systems available on the market, which are too large and too heavy. In this article, we describe and evaluate a palm sized probe, whose properties, weight, size and sensitivity are adapted for guiding laparotomy surgery. Different experiments have been performed to determine its main characteristics, both on the illumination and imaging sides. The device has been tested for fluorescent molecular probe imaging in preclinical procedures, to prove its ability to be used in cancer nodule detection during surgery. This system is now CE certified for clinical procedures and Indocyanine Green imaging has been performed during clinical investigations: lymphedema and surgical resection of liver metastases of colorectal cancers. Copyright © 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  10. A review of GPU-based medical image reconstruction.

    PubMed

    Després, Philippe; Jia, Xun

    2017-10-01

    Tomographic image reconstruction is a computationally demanding task, even more so when advanced models are used to describe a more complete and accurate picture of the image formation process. Such advanced modeling and reconstruction algorithms can lead to better images, often with less dose, but at the price of long calculation times that are hardly compatible with clinical workflows. Fortunately, reconstruction tasks can often be executed advantageously on Graphics Processing Units (GPUs), which are exploited as massively parallel computational engines. This review paper focuses on recent developments made in GPU-based medical image reconstruction, from a CT, PET, SPECT, MRI and US perspective. Strategies and approaches to get the most out of GPUs in image reconstruction are presented as well as innovative applications arising from an increased computing capacity. The future of GPU-based image reconstruction is also envisioned, based on current trends in high-performance computing. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  11. The use of noise equivalent count rate and the NEMA phantom for PET image quality evaluation.

    PubMed

    Yang, Xin; Peng, Hao

    2015-03-01

    PET image quality is directly associated with two important parameters among others: count-rate performance and image signal-to-noise ratio (SNR). The framework of noise equivalent count rate (NECR) was developed back in the 1990s and has been widely used since then to evaluate count-rate performance for PET systems. The concept of NECR is not entirely straightforward, however, and among the issues requiring clarification are its original definition, its relationship to image quality, and its consistency among different derivation methods. In particular, we try to answer whether a higher NECR measurement using a standard NEMA phantom actually corresponds to better imaging performance. The paper includes the following topics: 1) revisiting the original analytical model for NECR derivation; 2) validating three methods for NECR calculation based on the NEMA phantom/standard; and 3) studying the spatial dependence of NECR and quantitative relationship between NECR and image SNR. Copyright © 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  12. Characterization of commercial MOSFET detectors and their feasibility for in-vivo HDR brachytherapy.

    PubMed

    Phurailatpam, Reena; Upreti, Rituraj; Nojin Paul, Siji; Jamema, Swamidas V; Deshpande, Deepak D

    2016-01-01

    The present study was to investigate the use of MOSFET as an vivo dosimeter for the application of Ir-192 HDR brachytherapy treatments. MOSFET was characterized for dose linearity in the range of 50-1000 cGy, depth dose dependence from 2 to 7 cm, angular dependence. Signal fading was checked for two weeks. Dose linearity was found to be within 2% in the dose range (50-1000 cGy). The response varied within 8.07% for detector-source distance of 2-7 cm. The response of MOSFET with the epoxy side facing the source (0 degree) is the highest and the lowest response was observed at 90 and 270 degrees. Signal was stable during the study period. The detector showed high dose linearity and insignificant fading. But due to angular and depth dependence, care should be taken and corrections must be applied for clinical dosimetry. Copyright © 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  13. Italian quality assurance in mental health.

    PubMed

    Rossi, Giovanni; Agnetti, Germana; Bosio, Roberto; De Luca, Pasquale; Erlicher, Arcadio; Morganti, Carla; Neri, Giovanni; Re, Edoardo; Semisa, Domenico; Fioritti, Angelo

    2014-06-01

    Since the radical changes in Italian mental health law in the 1970s, quality assurance models have gained consensus as the most suitable service assessment tool. In the 1990s, the whole Italian National Health System changed into a corporate model, and an accreditation system was implemented.The Italian Association for Quality and Accreditation in Mental Health (Associazione Italiana per la Qualità e l'Accreditamento in Salute Mentale [QUASM]) was founded in 1984, and since then, it offers consultation and support for Mental Health Departments and Regional Governments to help them to develop psychiatric programs, self-evaluation, educational programs, and professional peer-model accreditation. The QUASM accreditation manual has now gone through several revisions, the last in 2008. Until 2008, QUASM was successful in promoting quality and facilitating both institutional and professional accreditation. However, radical changes triggered by financial crisis have jeopardized quality assurance implementation. Nowadays, the challenge for QUASM is to maintain quality and accreditation geared to excellence against prevailing leveling trends.

  14. [Home Daily Hemodialysis with NxStage System One: monocentric italian casistic results].

    PubMed

    Brunati, Chiara; Cassaro, Franca; Cretti, Laura; Izzo, Michela; Pegoraro, Marisa; Negri, Daniela; Gervasi, Francesca; Colussi, Giacomo

    2017-09-28

    NxStage System One is a new dialytic technology based on easy setup, simplicity of use and reduced dimensions, which is increasingly in use worldwide for home hemodialysis treatments. The system utilizes a low amount of dialysate, usually 15-30 liters according to anthropometric patients' values. The dialysate is supplied at very low flux, generally about 1/3 of blood flow, in order to obtain an elevated saturation of dialysate for solutes. In these conditions the clearance of urea will be almost equal to dialysate flow rate. In order to achieve an obptimal weekly clearance evaluated by Std Kt/V the dialysis sessions are repeated six times a week. In this way a good control of blood voleme can be reached. In this paper we report our experience of treatment with NxStage System One in 12 patients from May 2011 to Dicember 2016. Copyright by Società Italiana di Nefrologia SIN, Rome, Italy.

  15. K-edge subtraction synchrotron X-ray imaging in bio-medical research.

    PubMed

    Thomlinson, W; Elleaume, H; Porra, L; Suortti, P

    2018-05-01

    High contrast in X-ray medical imaging, while maintaining acceptable radiation dose levels to the patient, has long been a goal. One of the most promising methods is that of K-edge subtraction imaging. This technique, first advanced as long ago as 1953 by B. Jacobson, uses the large difference in the absorption coefficient of elements at energies above and below the K-edge. Two images, one taken above the edge and one below the edge, are subtracted leaving, ideally, only the image of the distribution of the target element. This paper reviews the development of the KES techniques and technology as applied to bio-medical imaging from the early low-power tube sources of X-rays to the latest high-power synchrotron sources. Applications to coronary angiography, functional lung imaging and bone growth are highlighted. A vision of possible imaging with new compact sources is presented. Copyright © 2018 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  16. Olminska and colleagues' study, "Conversion of the helical tomotherapy plans to the step-and-shoot IMRT plans for patients with hip prosthesis during radiotherapy for prostate cancer" was interesting to read.

    PubMed

    Cihan, Yasemin Benderli

    2016-11-01

    Olmińska and colleagues' study, Olmińska et al. (2016) was interesting to read [1]. While prasining the authors for their great work, I want to emphasize e few points. In the recent years, with the development of new device technology, Intensity Modulated Radiotherapy (IMRT) and complex treatment modalities such as stereotactic radiosurgery and helical tomotherapy were started to be implemented. Thus, due to increased local control of tumor growth and reduction of dose received by surrounding critical organs, serious complications were avoided. In this new treatment modality, while calculating appropriate dose, all the parameters such as patient anatomy and characteristics of radiation should be taken into account. Besides, during conformal radiotherapy, if hip prosthesis is located around or in the clinical target volume (CTV), type, thickness and density of biomaterial should be considered to avoid dose differences. Copyright © 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  17. The human gut microbiota and virome: Potential therapeutic implications.

    PubMed

    Scarpellini, Emidio; Ianiro, Gianluca; Attili, Fabia; Bassanelli, Chiara; De Santis, Adriano; Gasbarrini, Antonio

    2015-12-01

    Human gut microbiota is a complex ecosystem with several functions integrated in the host organism (metabolic, immune, nutrients absorption, etc.). Human microbiota is composed by bacteria, yeasts, fungi and, last but not least, viruses, whose composition has not been completely described. According to previous evidence on pathogenic viruses, the human gut harbours plant-derived viruses, giant viruses and, only recently, abundant bacteriophages. New metagenomic methods have allowed to reconstitute entire viral genomes from the genetic material spread in the human gut, opening new perspectives on the understanding of the gut virome composition, the importance of gut microbiome, and potential clinical applications. This review reports the latest evidence on human gut "virome" composition and its function, possible future therapeutic applications in human health in the context of the gut microbiota, and attempts to clarify the role of the gut "virome" in the larger microbial ecosystem. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  18. Attitudes of Italian general practitioners in the treatment of cancer pain. The Committee of the Associazione Italiana di Oncologia Medica (AIOM).

    PubMed

    Minotti, V; Betti, M

    1997-01-01

    The attitude of Italian general practitioners in prescribing practices for patients with cancer pain was assessed by means of a questionnaire. The results indicated that among most of the doctors who completed the questionnaire the basic principles of pain treatment in cancer patients are largely understood. Oral morphine emerged as the most commonly used opioid (60%) and controlled-release morphine as the preferred preparation. Non-steroidal anti-inflammatory drugs were the most commonly used minor analgesics. Fear of side effects and restrictive prescribing regulations emerged as the most important barrier against adequate pain management. The survey emphasised the need for continued efforts in implementing specific educational programming for improvement in cancer pain management.

  19. Curriculum Guide for Italian Language Arts. Literature Levels AB = Guida alla Lettura della Lingua Italiana Letteratura Ciclo A & B. Working Draft.

    ERIC Educational Resources Information Center

    Chicago Board of Education, IL. Dept. of Curriculum.

    A curriculum and teaching guide for introductory literature appreciation in the Chicago public schools is an orientation for the bilingual teacher of Italian students. Concepts such as rhyme and personification are developed for the teacher. For each of the two levels included, the section begins with a list of specific performance objectives,…

  20. Melanocytic nevi and non-neoplastic hyperpigmentations.

    PubMed

    Clemente, C

    2017-06-01

    diagnosis of melanocytic lesions starts from the clinic examination and the mutual comparison between dermatologist and pathologist is a great richness of knowledge for both. Finally thank to my collaborators Barbara Rubino, Barbara Bruni and Antonella Festa for the large number of material collected in these years at the Pathology Service of the IRCCS Policlinico San Donato and a particular thank to Marco Turina who collaborated in the drafting of this text. © Copyright Società Italiana di Anatomia Patologica e Citopatologia Diagnostica, Divisione Italiana della International Academy of Pathology.

  1. A proposal for limited criminal liability in high-accuracy endoscopic sinus surgery.

    PubMed

    Voultsos, P; Casini, M; Ricci, G; Tambone, V; Midolo, E; Spagnolo, A G

    2017-02-01

    The aim of the present study is to propose legal reform limiting surgeons' criminal liability in high-accuracy and high-risk surgery such as endoscopic sinus surgery (ESS). The study includes a review of the medical literature, focusing on identifying and examining reasons why ESS carries a very high risk of serious complications related to inaccurate surgical manoeuvers and reviewing British and Italian legal theory and case-law on medical negligence, especially with regard to Italian Law 189/2012 (so called "Balduzzi" Law). It was found that serious complications due to inaccurate surgical manoeuvers may occur in ESS regardless of the skill, experience and prudence/diligence of the surgeon. Subjectivity should be essential to medical negligence, especially regarding high-accuracy surgery. Italian Law 189/2012 represents a good basis for the limitation of criminal liability resulting from inaccurate manoeuvres in high-accuracy surgery such as ESS. It is concluded that ESS surgeons should be relieved of criminal liability in cases of simple/ordinary negligence where guidelines have been observed. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale, Rome, Italy.

  2. Rumination syndrome: when the lower oesophageal sphincter rises.

    PubMed

    Gourcerol, Guillaume; Dechelotte, Pierre; Ducrotte, Philippe; Leroi, Anne Marie

    2011-07-01

    Rumination syndrome is an uncommon condition characterised by the self-induced regurgitation from the stomach to the mouth of recently ingested meal that is chewed and reswallowed. Rumination is caused by a voluntary rise in intra-abdominal and intra-gastric pressure leading to the reflux of the gastric content into the oesophagus. However, the precise mechanisms preventing reflux at the gastro-oesophageal junction during the rise in intra-gastric pressure remains unknown. In 5 patients, rumination episodes were monitored using combined multiple intra-luminal impedance monitoring, high resolution manometry, and video-fluoroscopic recording. We showed that the gastro-oesophageal junction moved from the abdominal cavity into the thorax creating a "pseudo-hernia". This occurred at a range of 1.4 ± 0.3 s before the rise in intra-oesophageal pressure and the gastro-oesophageal reflux. This displacement of the gastro-oesophageal junction into thorax, rather than a lower oesophageal sphincter opening, explains the mechanism of voluntary regurgitations occurring during rumination syndrome. Copyright © 2011 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  3. Infrared camera assessment of skin surface temperature--effect of emissivity.

    PubMed

    Bernard, V; Staffa, E; Mornstein, V; Bourek, A

    2013-11-01

    Infrared thermoimaging is one of the options for object temperature analysis. Infrared thermoimaging is unique due to the non-contact principle of measurement. So it is often used in medicine and for scientific experimental measurements. The presented work aims to determine whether the measurement results could be influenced by topical treatment of the hand surface by various substances. The authors attempted to determine whether the emissivity can be neglected or not in situations of topical application of substances such as ultrasound gel, ointment, disinfection, etc. The results of experiments showed that the value of surface temperature is more or less distorted by the topically applied substance. Our findings demonstrate the effect of emissivity of applied substances on resulting temperature and showed the necessity to integrate the emissivity into calculation of the final surface temperature. Infrared thermoimaging can be an appropriate method for determining the temperature of organisms, if this is understood as the surface temperature, and the surrounding environment and its temperature is taken into account. Copyright © 2012 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  4. Epstein-Barr virus-positive mucocutaneous ulcer in Crohn's disease. A condition to consider in immunosuppressed IBD patients.

    PubMed

    Juan, Alba; Lobatón, Triana; Tapia, Gustavo; Mañosa, Míriam; Cabré, Eduard; Domènech, Eugeni

    2017-08-01

    Epstein-Barr virus-positive mucocutaneous ulcer (EBVMCU) is a little known entity that can affect the oropharyngeal mucosa, the gastrointestinal tract and the skin. The main risk factor for the development of this lesion is immunosuppression. Because its features are similar to other Epstein-Barr virus-associated lymphoproliferative disorders, a differential diagnosis can sometimes prove challenging. Here, we report the case of a man diagnosed with Crohn's disease and treated with azathioprine and infliximab who developed ulceration at the rectum that was refractory to conventional medical treatment. Although the histological characteristics were suggestive of an EBVMCU, lymphoproliferative disease could not be ruled out. The patient did not improve after discontinuation of the treatment, a proctectomy was performed and the diagnosis of this disease was confirmed. Although very few cases of EBVMCU affecting the colon have been reported, its diagnosis should be always considered in refractory cases of inflammatory bowel disease with patients undergoing immunosuppressive treatment. Copyright © 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  5. The METIS project for generalist ultrasonography.

    PubMed

    Bono, F; Campanini, A

    2007-12-01

    Reorganization of the community healthcare system and the growing presence of group practices in the field of general medicine have increased the demands placed on primary-care medicine, in terms of the skills required and the level of responsibility. Satisfying the need for rapid, effective primary-care solutions to the health problems of citizens is easier thanks to technological and medical advances that provide high level equipment at costs within the reach of general practitioners (GPs). In the near future, trained GPs equipped with appropriate diagnostic scanners will be able to handle up to 40% of the requests of ultrasound examinations of each primary-care group (each PCG includes approximately 15,000-20,000 citizens). The Italian Federation of General Practitioners (Federazione Italiana dei Medici di Medicina Generale - FIMMG) and its Scientific Society, METIS, have organized national courses for those GPs who wish to become generalist ultrasonographers, in a joint effort with the two most important Italian scientific societies of imaging, the Italian Society of Ultrasonology in Medicine and Biology and the Italian Society of Medical Radiology.

  6. Safety of treatments for inflammatory bowel disease: Clinical practice guidelines of the Italian Group for the Study of Inflammatory Bowel Disease (IG-IBD).

    PubMed

    Biancone, Livia; Annese, Vito; Ardizzone, Sandro; Armuzzi, Alessandro; Calabrese, Emma; Caprioli, Flavio; Castiglione, Fabiana; Comberlato, Michele; Cottone, Mario; Danese, Silvio; Daperno, Marco; D'Incà, Renata; Frieri, Giuseppe; Fries, Walter; Gionchetti, Paolo; Kohn, Anna; Latella, Giovanni; Milla, Monica; Orlando, Ambrogio; Papi, Claudio; Petruzziello, Carmelina; Riegler, Gabriele; Rizzello, Fernando; Saibeni, Simone; Scribano, Maria Lia; Vecchi, Maurizio; Vernia, Piero; Meucci, Gianmichele

    2017-04-01

    Inflammatory bowel diseases are chronic conditions of unknown etiology, showing a growing incidence and prevalence in several countries, including Italy. Although the etiology of Crohn's disease and ulcerative colitis is unknown, due to the current knowledge regarding their pathogenesis, effective treatment strategies have been developed. Several guidelines are available regarding the efficacy and safety of available drug treatments for inflammatory bowel diseases. Nevertheless, national guidelines provide additional information adapted to local feasibility, costs and legal issues related to the use of the same drugs. These observations prompted the Italian Group for the Study of Inflammatory Bowel Disease (IG-IBD) to establish Italian guidelines on the safety of currently available treatments for Crohn's disease and ulcerative colitis. These guidelines discuss the use of aminosalicylates, systemic and low bioavailability corticosteroids, antibiotics (metronidazole, ciprofloxacin, rifaximin), thiopurines, methotrexate, cyclosporine A, TNFα antagonists, vedolizumab, and combination therapies. These guidelines are based on current knowledge derived from evidence-based medicine coupled with clinical experience of a national working group. Copyright © 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  7. Microscopic esophagitis and Barrett's esophagus: the histology report.

    PubMed

    Fiocca, Roberto; Mastracci, Luca; Milione, Massimo; Parente, Paola; Savarino, Vincenzo

    2011-03-01

    Gastro-esophageal reflux disease (GERD) is the most common digestive disease in industrialized countries (Europe and North America) and is associated with microscopic changes in the squamous epithelium. However, biopsy is not presently included in the routine diagnostic flow chart of GERD. In contrast, esophageal biopsy is mandatory when diagnosing Barrett's esophagus. High quality histology reports are necessary to provide information on diagnosis and can also be important for research and epidemiological studies. It has been evident for decades that pathology reports vary between institutions and even within a single institution. Standardization of reporting is the best way to ensure that information necessary for patient management is included in pathology reports. This paper details the histological criteria for diagnosing GERD-associated microscopic esophagitis, other forms of esophagitis with specific features and columnar metaplasia in the lower esophagus (Barrett's esophagus). It provides a detailed description of appropriate sampling criteria, individual lesions and how they contribute to the histology report. Copyright © 2011 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd.. All rights reserved.

  8. Gastrointestinal stromal tumors: the histology report.

    PubMed

    Dei Tos, Angelo P; Laurino, Licia; Bearzi, Italo; Messerini, Luca; Farinati, Fabio

    2011-03-01

    Gastrointestinal stromal tumors (GISTs) represent a mesenchymal neoplasm occurring primarily in the gastrointestinal tract, and showing differentiation toward the interstitial cell of Cajal. Its incidence is approximately 15 case/100,000/year. Stomach and small bowel are the most frequently affected anatomic sites. GIST represents a morphological, immunophenotypical and molecular distinct entity, the recognition of which has profound therapeutic implications. In fact, they have shown an exquisite sensitivity to treatment with the tyrosine kinase inhibitor imatinib. Diagnosis relies upon morphology along with immunodetection of KIT and/or DOG1. When dealing with KIT negative cases, molecular analysis of KIT/PDGFRA genes may help in confirming diagnosis. Molecular evaluation of both genes are in any case recommended as mutational status provides key predictive information. Pathologists also play a key role in providing an estimation of the risk of biological aggressiveness, which is currently based on anatomic location of the tumor, size, and mitotic activity. Copyright © 2011 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd.. All rights reserved.

  9. Modelling the radiotherapy effect in the reaction-diffusion equation.

    PubMed

    Borasi, Giovanni; Nahum, Alan

    2016-09-01

    In recent years, the reaction-diffusion (Fisher-Kolmogorov) equation has received much attention from the oncology research community due to its ability to describe the infiltrating nature of glioblastoma multiforme and its extraordinary resistance to any type of therapy. However, in a number of previous papers in the literature on applications of this equation, the term (R) expressing the 'External Radiotherapy effect' was incorrectly derived. In this note we derive an analytical expression for this term in the correct form to be included in the reaction-diffusion equation. The R term has been derived starting from the Linear-Quadratic theory of cell killing by ionizing radiation. The correct definition of R was adopted and the basic principles of differential calculus applied. The compatibility of the R term derived here with the reaction-diffusion equation was demonstrated. Referring to a typical glioblastoma tumour, we have compared the results obtained using our expression for the R term with the 'incorrect' expression proposed by other authors. Copyright © 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  10. [Brachial artery pseudoaneurysm: a rare but serious complication in hemodialysis patients with arteriovenous fistula].

    PubMed

    Mancini, Andrea; Castriotta, Giuseppe; Angelini, Pernina; Bozzi, Michele; Giancaspro, Vincenzo; La Raia, Elvira; Nisi, Maria Teresa; Proscia, Anna Rita; Tarantino, Giuseppe; Vitale, Ottavia; Cuzzola, Cristoforo

    2017-06-01

    A pseudoaneurysm or false aneurysm of the brachial artery is an uncommon occurrence in patients receiving hemodialysis with arteriovenous fistula (AVF). We describe the case of a 76-year-old woman presenting with a large, tender, pulsatile mass in the right antecubital region 10 cm from the AVF. B-mode ultrasound examination revealed a saccular hematoma. Color doppler showed a recirculation movement of blood, creating a two colors image called "Korean flag". The patient was transferred to the surgical unit where she first underwent ultrasound-guided compression and then surgical repair of the pseudoaneurysm. Two weeks after surgery the AVF was used again as an access for hemodialysis. Differentiating between a false and a true aneurysm based on ultrasound is not always straightforward. Doppler ultrasound findings can be decisive for the early diagnosis of a pseudoaneurysm to ensure proper treatment planning given the dangerous complications of ruptures. Treatment options include: compression, percutaneous thrombin injection, endovascular exclusion with covered stents, aneurysmectomy and surgical repair. Copyright by Società Italiana di Nefrologia SIN, Rome, Italy.

  11. Intramuscular fatty acid composition of lambs fed diets containing alternative protein sources.

    PubMed

    Scerra, M; Caparra, P; Foti, F; Cilione, C; Zappia, G; Motta, C; Scerra, V

    2011-03-01

    Thirty male Merinizzata italiana lambs were divided into three groups after weaning according to live weight. The diet of the three groups differed in the main protein source used in the concentrate, soybean meal for treatment SBM, faba bean for treatment FB and peas for treatment PEA. Lambs were fed ad libitum and slaughtered at about 160 days of age. Meat from the PEA group had higher proportions of the essential fatty acids C18:2 ω-6 and C18:3 ω-3 than from FB and SBM lambs and consequently its derivatives, C20:4 ω-6 and C20:5 ω-3 respectively, were higher in meat from PEA animals, compared to SBM and FB ones. The total n-3 fatty acids were highest in meat from PEA lambs and consequently PEA lambs showed a more favourable n-6/n-3 ratio. In conclusion the use of legume seeds such as peas in lamb diets positively affected intramuscular fatty acid composition. Copyright © 2010 The American Meat Science Association. Published by Elsevier Ltd. All rights reserved.

  12. Difficult removal of fully covered self expandable metal stents (SEMS) for benign biliary strictures: the "SEMS in SEMS" technique.

    PubMed

    Tringali, Andrea; Blero, Daniel; Boškoski, Ivo; Familiari, Pietro; Perri, Vincenzo; Devière, Jacques; Costamagna, Guido

    2014-06-01

    Removal of biliary Fully Covered Self Expandable Metal Stents can fail due to stent migration and/or hyperplastic ingrowth/overgrowth. A case series of 5 patients with benign biliary strictures (2 post-cholecystectomy, 2 following liver transplantation and 1 related to chronic pancreatitis) is reported. The biliary stricture was treated by temporary insertion of Fully Covered Self Expandable Metal Stents. Stent removal failed due to proximal stent migration and/or overgrowth. Metal stent removal was attempted a few weeks after the insertion of another Fully Covered Metal Stent into the first one. The inner Fully Covered Self Expandable Metal Stent compressed the hyperplastic tissue, leading to the extraction of both the stents in all cases. Two complications were reported as a result of the attempt to stents removal (mild pancreatitis and self-limited haemobilia). In the present series, the "SEMS in SEMS" technique revealed to be effective when difficulties are encountered during Fully Covered Self Expandable Metal Stents removal. Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  13. Vedolizumab is an effective alternative in inflammatory bowel disease patients with anti-TNF-alpha therapy-induced dermatological side effects.

    PubMed

    Pijls, Philippe A R R; Gilissen, Lennard P L

    2016-11-01

    The treatment of patients with inflammatory bowel diseases has been revolutionized by the introduction of biological therapy with TNF-alpha blockers. However, TNF-alpha blockers are also associated with a wide variety of dermatological side effects, such as local skin infections, psoriasis and eczema. A new biological therapy, targeting the gut-specific adhesion molecule alpha4beta7 integrin, is the humanized monoclonal IgG1 antibody vedolizumab. Vedolizumab prevents leukocyte migration to the gastrointestinal tract, thereby reducing inflammation. This gut-specific therapy has the potential to reduce systemic side effects, including dermatological ones. We describe 3 inflammatory bowel disease patients who experience anti-TNF-alpha therapy-induced dermatological side effects, consisting of hidradenitis suppurativa, a folliculitis, scalp psoriasis and a dissecting folliculitis. In all patients, anti-TNF-alpha therapy-induced dermatological side effects diminished after switching to vedolizumab. Vedolizumab may be a viable alternative biological therapy in inflammatory bowel disease patients who experience anti-TNF-alpha therapy-induced dermatological side effects. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  14. Lithium battery lodged in the oesophagus: A report of three paediatric cases.

    PubMed

    Barabino, Arrigo Vittorio; Gandullia, Paolo; Vignola, Silvia; Arrigo, Serena; Zannini, Lucio; Di Pietro, Pasquale

    2015-11-01

    Over the last years the ingestion of disk batteries has become frequent in children with serious consequences. The severity of injuries is related to the growing use of new lithium batteries that may cause catastrophic damages when lodged in the oesophagus. The notes of three consecutive children with lithium batteries lodged in the oesophagus, admitted to our Institute from 2010 to 2014, were reviewed. Clinical presentation, management, and outcome were considered. The first child, a 22-month-old girl, died of a sudden exsanguination due to an aorto-oesophageal fistula. The second case, a 5-year-old boy, had an exploratory thoracotomy to exclude aortic lesion before battery removal, and a spontaneous oesophageal perforation. The third child, a 18-month-old boy, fully recovered after suffering ulcerative oesophageal burns. Lithium battery lodged in the oesophagus is a paediatric emergency requiring a multidisciplinary approach that can be implemented in a tertiary children's hospital. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  15. Performance evaluation of a retrofit digital detector-based mammography system.

    PubMed

    Marshall, Nicholas W; van Ongeval, Chantal; Bosmans, Hilde

    2016-02-01

    A retrofit flat panel detector was integrated with a GE DMR+ analog mammography system and characterized using detective quantum efficiency (DQE). Technical system performance was evaluated using the European Guidelines protocol, followed by a limited evaluation of clinical image quality for 20 cases using image quality criteria in the European Guidelines. Optimal anode/filter selections were established using signal difference-to-noise ratio measurements. Only small differences in peak DQE were seen between the three anode/filter settings, with an average value of 0.53. For poly(methyl methacrylate) (PMMA) thicknesses above 60 mm, the Rh/Rh setting was the optimal anode/filter setting. The system required a mean glandular dose of 0.54 mGy at 30 kV Rh/Rh to reach the Acceptable gold thickness limit for 0.1 mm details. Imaging performance of the retrofit unit with the GE DMR+ is notably better than of powder based computed radiography systems and is comparable to current flat panel FFDM systems. Copyright © 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  16. Chemotherapy versus self-expanding metal stent as primary treatment of severe dysphagia from unresectable oesophageal or gastro-oesophageal junction cancer.

    PubMed

    Touchefeu, Yann; Archambeaud, Isabelle; Landi, Bruno; Lièvre, Astrid; Lepère, Céline; Rougier, Philippe; Mitry, Emmanuel

    2014-03-01

    To compare chemotherapy first (group 1) versus self-expanding metal stent first (group 2) for the management of malignant dysphagia in unresectable oesophageal or gastro-oesophageal junction cancer. Patients from two university hospitals with severe malignant dysphagia (dysphagia score ≥ 2) uneligible for surgery or radiochemotherapy were evaluated retrospectively. Forty-two patients were included in group 1, and 29 in group 2. After 4 weeks, dysphagia scores improved by at least 1 point in 67% of patients in group 1 versus 93% in group 2 (p=0.01); 48% of patients in group 1 were able to eat solid food versus 68% in group 2 (p=0.054). In group 1, a self-expanding metal stent was secondarily placed in 18 patients (42.9%), whereas in group 2 dysphagia required a second self-expanding metal stent placement in 33.3% of patients. Chemotherapy as the first treatment may be a valid option, avoiding self-expanding metal stent insertion in half of the patients. Copyright © 2013 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  17. Follow-up of permanent hearing impairment in childhood.

    PubMed

    Della Volpe, A; De Lucia, A; Pastore, V; Bracci Laudiero, L; Buonissimo, I; Ricci, G

    2016-02-01

    Programmes for early childhood childhood hearing impairment identification allows to quickly start the appropriate hearing aid fitting and rehabilitation process; nevertheless, a large number of patients do not join the treatment program. The goal of this article is to present the results of a strategic review of the strengths, weaknesses, opportunities and threats connected with the audiologic/prosthetic/language follow-up process of children with bilateral permanent hearing impairment. Involving small children, the follow-up includes the involvement of specialised professionals of a multidisciplinary team and a complex and prolonged multi-faced management. Within the framework of the Italian Ministry of Health project CCM 2013 "Preventing Communication Disorders: a Regional Program for Early Identification, Intervention and Care of Hearing Impaired Children", the purpose of this analysis was to propose recommendations that can harmonise criteria for outcome evaluation and provide guidance on the most appropriate assessment methods to be used in the follow-up course of children with permanent hearing impairment. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale.

  18. Achieving effective hearing aid fitting within one month after identification of childhood permanent hearing impairment.

    PubMed

    Bastanza, G; Gallus, R; De Carlini, M; Picciotti, P M; Muzzi, E; Ciciriello, E; Orzan, E; Conti, G

    2016-02-01

    Diagnosis of child permanent hearing impairment (PHI) can be made with extreme timeliness compared to the past thanks to improvements in PHI identification through newborn hearing screening programmes. It now becomes essential to provide an effective amplification as quickly as possible in order to restore auditory function and favour speech and language development. The early fitting of hearing aids and possible later cochlear implantation indeed prompts the development of central auditory pathways, connections with secondary sensory brain areas, as well as with motor and articulatory cortex. The aim of this paper is to report the results of a strategic analysis that involves identification of strengths, weaknesses, opportunities and threats regarding the process of achieving early amplification in all cases of significant childhood PHI. The analysis is focused on the Italian situation and is part of the Italian Ministry of Health project CCM 2013 "Preventing Communication Disorders: a Regional Program for Early Identification, Intervention and Care of Hearing Impaired Children". © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale.

  19. A review of technical aspects of T1-weighted dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in human brain tumors.

    PubMed

    Bergamino, M; Bonzano, L; Levrero, F; Mancardi, G L; Roccatagliata, L

    2014-09-01

    In the last few years, several imaging methods, such as magnetic resonance imaging (MRI) and computed tomography, have been used to investigate the degree of blood-brain barrier (BBB) permeability in patients with neurological diseases including multiple sclerosis, ischemic stroke, and brain tumors. One promising MRI method for assessing the BBB permeability of patients with neurological diseases in vivo is T1-weighted dynamic contrast-enhanced (DCE)-MRI. Here we review the technical issues involved in DCE-MRI in the study of human brain tumors. In the first part of this paper, theoretical models for the DCE-MRI analysis will be described, including the Toft-Kety models, the adiabatic approximation to the tissue homogeneity model and the two-compartment exchange model. These models can be used to estimate important kinetic parameters related to BBB permeability. In the second part of this paper, details of the data acquisition, issues related to the arterial input function, and procedures for DCE-MRI image analysis are illustrated. Copyright © 2014 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  20. Track structure modeling in liquid water: A review of the Geant4-DNA very low energy extension of the Geant4 Monte Carlo simulation toolkit.

    PubMed

    Bernal, M A; Bordage, M C; Brown, J M C; Davídková, M; Delage, E; El Bitar, Z; Enger, S A; Francis, Z; Guatelli, S; Ivanchenko, V N; Karamitros, M; Kyriakou, I; Maigne, L; Meylan, S; Murakami, K; Okada, S; Payno, H; Perrot, Y; Petrovic, I; Pham, Q T; Ristic-Fira, A; Sasaki, T; Štěpán, V; Tran, H N; Villagrasa, C; Incerti, S

    2015-12-01

    Understanding the fundamental mechanisms involved in the induction of biological damage by ionizing radiation remains a major challenge of today's radiobiology research. The Monte Carlo simulation of physical, physicochemical and chemical processes involved may provide a powerful tool for the simulation of early damage induction. The Geant4-DNA extension of the general purpose Monte Carlo Geant4 simulation toolkit aims to provide the scientific community with an open source access platform for the mechanistic simulation of such early damage. This paper presents the most recent review of the Geant4-DNA extension, as available to Geant4 users since June 2015 (release 10.2 Beta). In particular, the review includes the description of new physical models for the description of electron elastic and inelastic interactions in liquid water, as well as new examples dedicated to the simulation of physicochemical and chemical stages of water radiolysis. Several implementations of geometrical models of biological targets are presented as well, and the list of Geant4-DNA examples is described. Copyright © 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  1. Topical Mitomycin C application in the treatment of refractory benign esophageal strictures in adults and comprehensive literature review.

    PubMed

    Bartel, Michael J; Seeger, Kristina; Jeffers, Kayin; Clayton, Donnesha; Wallace, Michael B; Raimondo, Massimo; Woodward, Timothy A

    2016-09-01

    Recurrent complex esophageal strictures remain difficult to manage. To determine the efficacy of topical Mitomycin C application for recurrent benign esophageal strictures. All patients who underwent balloon dilation followed by topical Mitomycin C application for recurrent benign esophageal strictures were included. Primary outcome was number of dilations and change of dysphagia score. Nine patients with anastomotic (3), radiation-induced (3), caustic (2), and combined anastomotic and radiation-induced (1) strictures were included. Strictures had a mean length of 13.75mm, diameter of 8.0mm, and were dilated 10.7 times over a median of 8 months (1.5 dilations per month). Following Mitomycin C application, the need for further dilation decreased to 0.39 dilations per month over a median of 10 months; however, dysphagia scores improved not significantly from 3.2 to 2.6 (mean). In this pilot study, topical Mitomycin C in conjunction with dilation decreased the frequency of esophageal dilations for recurrent benign esophageal strictures. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  2. Tables for simplifying calculations of activities produced by thermal neutrons

    USGS Publications Warehouse

    Senftle, F.E.; Champion, W.R.

    1954-01-01

    The method of calculation described is useful for the types of work of which examples are given. It is also useful in making rapid comparison of the activities that might be expected from several different elements. For instance, suppose it is desired to know which of the three elements, cobalt, nickel, or vanadium is, under similar conditions, activated to the greatest extent by thermal neutrons. If reference is made to a cross-section table only, the values may be misleading unless properly interpreted by a suitable comparison of half-lives and abundances. In this table all the variables have been combined and the desired information can be obtained directly from the values of A 3??, the activity produced per gram per second of irradiation, under the stated conditions. Hence, it is easily seen that, under similar circumstances of irradiation, vanadium is most easily activated even though the cross section of one of the cobalt isotopes is nearly five times that of vanadium and the cross section of one of the nickel isotopes is three times that of vanadium. ?? 1954 Societa?? Italiana di Fisica.

  3. [PRES (Posterior Reversible Encephalopathy Syndrome): potential complication of hypertensive crisis. Case report and literature review].

    PubMed

    Vergura, Michele; Prencipe, Michele; Del Giudice, Antonio Maria; Grifa, Rachele; Miscio, Filomena; Pennelli, Anna Maria; Popolizio, Teresa; Simeone, Anna; Ferrara, Mariangela; Leone, Maurizio; Aucella, Filippo

    2017-04-01

    Posterior reversible encephalopathy syndrome (PRES) is a clinical-radiological syndrome, usually reversible, characterized by vasogenic oedema in cerebral posterior regions in patients with autoimmune diseases, nephropathies, hypertensive crisis, eclampsia and exposure to cytotoxic drugs. The main symptoms are: headache, nausea, vomiting, seizures, visual disturbance and altered consciousness. Complications as cerebral hemorrhage and recurrences are rare. We describe a case of a 65 years old woman, affected by chronic kidney disease, recently exacerbated, diabetes and hypertension in treatment, who showed an heterogeneous clinical presentation with vomiting, headache, blurred vision and impaired consciousness during an episode of acute hypertension. After an adjustement of the antihypertensive treatment we observed a regression of symptoms in one week. FLAIR sequences on MRI showed cerebral bilateral vasogenic oedema in posterior regions, typical for PRES. This case was suggestive for PRES and a prompt adjustement of the antihypertensive treatment was critical for clinical recovery. Brain MRI was crucial for diagnosis. It is important for clinicians to recognize PRES as a possible complication of renal disease and hypertensive crisis. Copyright by Società Italiana di Nefrologia SIN, Rome, Italy.

  4. Mortality for chronic-degenerative diseases in Tuscany: Ecological study comparing neighboring areas with substantial differences in environmental pollution.

    PubMed

    Marabotti, Claudio; Piaggi, Paolo; Scarsi, Paolo; Venturini, Elio; Cecchi, Romina; Pingitore, Alessandro

    2017-06-19

    Environmental pollution is associated with morbidity and mortality for chronic-degenerative diseases. Recent data points out a relationship between proximity to industrial plants and mortality due to neoplasms. The aim of this study has been to compare mortality due to chronic-degenerative diseases in the area of Tuscany (Bassa Val di Cecina), Italy, characterized by the presence of 2 neighboring municipalities similar in terms of size but with substantial differences in industrial activities: Rosignano (the site of chemical, energy production and waste processing industries) and Cecina (with no polluting activity). Standardized mortality rates for the 2001-2010 decade were calculated; the data of the whole Tuscany was assumed as reference. Environmental levels of pollutants were obtained by databases of the Environmental Protection Agency of Tuscany Region (Agenzia Regionale per la Protezione Ambientale della Toscana - ARPAT). Maximum tolerated pollutant levels set by national laws were assumed as reference. In the whole Bassa Val di Cecina, significantly elevated standardized mortality rates due to mesothelioma, ischemic heart diseases, cerebrovascular diseases and Alzheimer and other degenerative diseases of nervous system were observed. In the municipality of Rosignano, a significant excess of mortality for all these groups of diseases was confirmed. On the contrary, the municipality of Cecina showed only significantly higher mortality rates for ischemic heart diseases. Elevated levels of heavy metals in sea water and of particulate matter which contains particles of diameter ≤ 10 mm (PM10) and ozone in air were detected in Rosignano. This study shows an excess of mortality for chronic-degenerative diseases in the area with elevated concentration of polluting factories. Proximity to industrial plants seems to represent a risk factor for those diseases. Int J Occup Med Environ Health 2017;30(4):641-653. This work is available in Open Access model

  5. Planck focal plane instruments: advanced modelization and combined analysis

    NASA Astrophysics Data System (ADS)

    Zonca, Andrea; Mennella, Aniello

    2012-08-01

    This thesis is the result of my work as research fellow at IASF-MI, Milan section of the Istituto di Astrofisica Spaziale e Fisica Cosmica, part of INAF, Istituto Nazionale di Astrofisica. This work started in January 2006 in the context of the PhD school program in Astrophysics held at the Physics Department of Universita' degli Studi di Milano under the supervision of Aniello Mennella. The main topic of my work is the software modelling of the Low Frequency Instrument (LFI) radiometers. The LFI is one of the two instruments on-board the European Space Agency Planck Mission for high precision measurements of the anisotropies of the Cosmic Microwave Background (CMB). I was also selected to participate at the International Doctorate in Antiparticles Physics, IDAPP. IDAPP is funded by the Italian Ministry of University and Research (MIUR) and coordinated by Giovanni Fiorentini (Universita' di Ferrara) with the objective of supporting the growing collaboration between the Astrophysics and Particles Physics communities. It is an international program in collaboration with the Paris PhD school, involving Paris VI, VII and XI Universities, leading to a double French-Italian doctoral degree title. My work was performed with the co-tutoring of Jean-Michel Lamarre, Instrument Scientist of the High Frequency Instrument (HFI), the bolometric instrument on-board Planck. Thanks to this collaboration I had the opportunity to work with the HFI team for four months at the Paris Observatory, so that the focus of my activity was broadened and included the study of cross-correlation between HFI and LFI data. Planck is the first CMB mission to have on-board the same satellite very different detection technologies, which is a key element for controlling systematic effects and improve measurements quality.

  6. Historical hydrology and database on flood events (Apulia, southern Italy)

    NASA Astrophysics Data System (ADS)

    Lonigro, Teresa; Basso, Alessia; Gentile, Francesco; Polemio, Maurizio

    2014-05-01

    . More details on previous results of this research activity were recently published (Polemio, 2010; Basso et al., 2012; Lonigro et al., 2013) References Basso A., Lonigro T. and Polemio M. (2012) "The improvement of historical database on damaging hydrogeological events in the case of Apulia (Southern Italy)". Rendiconti online della Società Geologica Italiana, 21: 379-380; Lonigro T., Basso A. and Polemio M. (2013) "Historical database on damaging hydrogeological events in Apulia region (Southern Italy)". Rendiconti online della Società Geologica Italiana, 24: 196-198; Polemio M. (2010) "Historical floods and a recent extreme rainfall event in the Murgia karstic environment (Southern Italy)". Zeitschrift für Geomorphologie, 54(2): 195-219.

  7. Determinants of career structure and advancement among Italian cardiologists. An example of segregation and discrimination against women? SCIC Group. Studio Condizione Italiana Cardiologi.

    PubMed

    Modena, M G; Lalla, M; Molinari, R

    1999-09-01

    The aim of this study was to analyse the processes through which job, career and research-related choices are determined in Italian cardiology, focusing on characteristics such as productivity, gender and family. In June 1996, a questionnaire surveying individual and career-related data was mailed to all members (8000) of the Italian societies of cardiology. Returned questionnaires numbered 1715 (21.4% of the total mailed), 83% were completed by men and 17% by women. For both hospital and academic careers, advancement in rank was influenced by variables denoting productivity, family and individual characteristics. However, men and women showed slightly different patterns. Promotion to the upper ranks of the hierarchy was highly dependent upon time (once the effects of the covariates were eliminated). This situation is typical of the internal labour market, that is, in institutions in which staff members are ranked on a hierarchical scale according to formal criteria that are 'rigid' and institutionalized, partially sheltered from competition. Therefore, once a member has gained access to the bottom of the hierarchy, the professional career is 'pre-determined' and seniority has an appreciable influence on promotion decisions; in this context, women appear to be at a disadvantage. Copyright 1999 The European Society of Cardiology.

  8. Pearson Syndrome: A Retrospective Cohort Study from the Marrow Failure Study Group of A.I.E.O.P. (Associazione Italiana Emato-Oncologia Pediatrica).

    PubMed

    Farruggia, Piero; Di Cataldo, Andrea; Pinto, Rita M; Palmisani, Elena; Macaluso, Alessandra; Valvo, Laura Lo; Cantarini, Maria E; Tornesello, Assunta; Corti, Paola; Fioredda, Francesca; Varotto, Stefania; Martire, Baldo; Moroni, Isabella; Puccio, Giuseppe; Russo, Giovanna; Dufour, Carlo; Pillon, Marta

    2016-01-01

    Pearson syndrome (PS) is a very rare and often fatal multisystemic mitochondrial disorder involving the liver, kidney, pancreas, and hematopoietic and central nervous system. It is characterized principally by a transfusion-dependent anemia that usually improves over time, a tendency to develop severe infections, and a high mortality rate. We describe a group of 11 PS patients diagnosed in Italy in the period 1993-2014. The analysis of this reasonably sized cohort of patients contributes to the clinical profile of the disease and highlights a rough incidence of 1 case/million newborns. Furthermore, it seems that some biochemical parameters like increased serum alanine and urinary fumaric acid can help to address an early diagnosis.

  9. Prima Platform: A Scheme for Managing Equipment-Dependent Onboard Functions and Impacts on the Avionics Software Production Process

    NASA Astrophysics Data System (ADS)

    Candia, Sante; Lisio, Giovanni; Campolo, Giovanni; Pascucci, Dario

    2010-08-01

    The Avionics Software (ASW), in charge of controlling the Low Earth Orbit (LEO) Spacecraft PRIMA Platform (Piattaforma Ri-configurabile Italiana Multi-Applicativa), is evolving towards a highly modular and re-usable architecture based on an architectural framework allowing the effective integration of the software building blocks (SWBBs) providing the on-board control functions. During the recent years, the PRIMA ASW design and production processes have been improved to reach the following objectives: (a) at PUS Services level, separation of the mission-independent software mechanisms from the mission-dependent configuration information; (b) at Application level, identification of mission-independent recurrent functions for promoting abstraction and obtaining a more efficient and safe ASW production, with positive implications also on the software validation activities. This paper is dedicated to the characterisation activity which has been performed at Application level for a software component abstracting a set of functions for the generic On-Board Assembly (OBA), a set of hardware units used to deliver an on-board service. Moreover, the ASW production process is specified to show how it results after the introduction of the new design features.

  10. Endoscopic peroral jejunal fecal microbiota transplantation.

    PubMed

    Link, Alexander; Lachmund, Tim; Schulz, Christian; Weigt, Jochen; Malfertheiner, Peter

    2016-11-01

    Fecal microbiota transplantation (FMT) is a valuable treatment modality for recurrent Clostridium difficile (C. difficile) colitis. Multiple questions including the best delivery route and volume remain unanswered. Here, we report a case series of high-volume FMT using endoscopic jejunal application route. In prospective observational study, FMT was performed using fresh specimen from healthy unrelated donors to the patients with recurrent or refractory C. difficile colitis. Selection of the route was based on the patient's preferences. Specimens of at least 50g were dissolved in 500ml of electrolyte solution and administered using endoscope directly in jejunum. All procedures led to cure of C. difficile colitis. With exception of one case the procedure was well tolerated. In two cases, we observed FMT-reflux into the stomach despite deep jejunal application and in single case the FMT-reflux led to tracheal aspiration and severe pneumonia. High-volume FMT via endoscopic jejunal route is an effective treatment option that is well tolerated and easy to perform. Nevertheless, aspiration is potential life-threatening event that needs to be kept in mind during the FMT-procedure. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  11. An accurate model for the computation of the dose of protons in water.

    PubMed

    Embriaco, A; Bellinzona, V E; Fontana, A; Rotondi, A

    2017-06-01

    The accurate and fast calculation of the dose in proton radiation therapy is an essential ingredient for successful treatments. We propose a novel approach with a minimal number of parameters. The approach is based on the exact calculation of the electromagnetic part of the interaction, namely the Molière theory of the multiple Coulomb scattering for the transversal 1D projection and the Bethe-Bloch formula for the longitudinal stopping power profile, including a gaussian energy straggling. To this e.m. contribution the nuclear proton-nucleus interaction is added with a simple two-parameter model. Then, the non gaussian lateral profile is used to calculate the radial dose distribution with a method that assumes the cylindrical symmetry of the distribution. The results, obtained with a fast C++ based computational code called MONET (MOdel of ioN dosE for Therapy), are in very good agreement with the FLUKA MC code, within a few percent in the worst case. This study provides a new tool for fast dose calculation or verification, possibly for clinical use. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  12. Synchrotron based planar imaging and digital tomosynthesis of breast and biopsy phantoms using a CMOS active pixel sensor.

    PubMed

    Szafraniec, Magdalena B; Konstantinidis, Anastasios C; Tromba, Giuliana; Dreossi, Diego; Vecchio, Sara; Rigon, Luigi; Sodini, Nicola; Naday, Steve; Gunn, Spencer; McArthur, Alan; Olivo, Alessandro

    2015-03-01

    The SYRMEP (SYnchrotron Radiation for MEdical Physics) beamline at Elettra is performing the first mammography study on human patients using free-space propagation phase contrast imaging. The stricter spatial resolution requirements of this method currently force the use of conventional films or specialized computed radiography (CR) systems. This also prevents the implementation of three-dimensional (3D) approaches. This paper explores the use of an X-ray detector based on complementary metal-oxide-semiconductor (CMOS) active pixel sensor (APS) technology as a possible alternative, for acquisitions both in planar and tomosynthesis geometry. Results indicate higher quality of the images acquired with the synchrotron set-up in both geometries. This improvement can be partly ascribed to the use of parallel, collimated and monochromatic synchrotron radiation (resulting in scatter rejection, no penumbra-induced blurring and optimized X-ray energy), and partly to phase contrast effects. Even though the pixel size of the used detector is still too large - and thus suboptimal - for free-space propagation phase contrast imaging, a degree of phase-induced edge enhancement can clearly be observed in the images. Copyright © 2014 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  13. An increase in serum tumour necrosis factor-α during anti-tumour necrosis factor-α therapy for Crohn's disease - A paradox or a predictive index?

    PubMed

    Eder, Piotr; Korybalska, Katarzyna; Łykowska-Szuber, Liliana; Stawczyk-Eder, Kamila; Krela-Kaźmierczak, Iwona; Łuczak, Joanna; Czepulis, Natasza; Linke, Krzysztof; Witowski, Janusz

    2016-10-01

    Soluble tumour necrosis factor-α (sTNF-α) has been reported to increase in the course of anti-TNF-α therapy for rheumatoid and skin diseases. To assess changes in sTNF-α and clinical efficacy of anti-TNF-α agents in Crohn's disease (CD). Sixty-four patients on infliximab or adalimumab were analyzed. Clinical outcomes were assessed by using CD Activity Index after the induction therapy and at week 52. sTNF-α was measured before and after the induction therapy with high-sensitivity immunoassay. In the majority of patients, sTNF-α increased significantly. Those with the greatest increase were more likely to experience long-term response, were more often treated with infliximab, had less frequently isolated small bowel CD, and tended to have sTNF-α levels at baseline that correlated with C-reactive protein. Neutralization of sTNF-α does not seem to be critical for the efficacy of anti-TNF-α therapy in CD. Paradoxically - an increase in sTNF-α may reflect an ongoing process that is beneficial for the clinical outcome. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  14. Design of a new tracking device for on-line beam range monitor in carbon therapy.

    PubMed

    Traini, Giacomo; Battistoni, Giuseppe; Bollella, Angela; Collamati, Francesco; De Lucia, Erika; Faccini, Riccardo; Ferroni, Fernando; Frallicciardi, Paola Maria; Mancini-Terracciano, Carlo; Marafini, Michela; Mattei, Ilaria; Miraglia, Federico; Muraro, Silvia; Paramatti, Riccardo; Piersanti, Luca; Pinci, Davide; Rucinski, Antoni; Russomando, Andrea; Sarti, Alessio; Sciubba, Adalberto; Senzacqua, Martina; Solfaroli-Camillocci, Elena; Toppi, Marco; Voena, Cecilia; Patera, Vincenzo

    2017-02-01

    Charged particle therapy is a technique for cancer treatment that exploits hadron beams, mostly protons and carbon ions. A critical issue is the monitoring of the beam range so to check the correct dose deposition to the tumor and surrounding tissues. The design of a new tracking device for beam range real-time monitoring in pencil beam carbon ion therapy is presented. The proposed device tracks secondary charged particles produced by beam interactions in the patient tissue and exploits the correlation of the charged particle emission profile with the spatial dose deposition and the Bragg peak position. The detector, currently under construction, uses the information provided by 12 layers of scintillating fibers followed by a plastic scintillator and a pixelated Lutetium Fine Silicate (LFS) crystal calorimeter. An algorithm to account and correct for emission profile distortion due to charged secondaries absorption inside the patient tissue is also proposed. Finally detector reconstruction efficiency for charged particle emission profile is evaluated using a Monte Carlo simulation considering a quasi-realistic case of a non-homogenous phantom. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  15. AISF-SIMTI Position Paper: The appropriate use of albumin in patients with liver cirrhosis.

    PubMed

    2016-01-01

    The use of human albumin is common in hepatology since international scientific societies support its administration to treat or prevent severe complications of cirrhosis, such as the prevention of post-paracentesis circulatory dysfunction after large-volume paracentesis and renal failure induced by spontaneous bacterial peritonitis, and the treatment of hepatorenal syndrome in association with vasoconstrictors. However, these indications are often disregarded, mainly because the high cost of human albumin leads health authorities and hospital administrations to restrict its use. On the other hand, physicians often prescribe human albumin in patients with advanced cirrhosis for indications that are not supported by solid scientific evidence and/or are still under investigation in clinical trials. In order to implement appropriate prescription of human albumin and to avoid its futile use, the Italian Association for the Study of the Liver (AISF) and the Italian Society of Transfusion Medicine and Immunohaematology (SIMTI) nominated a panel of experts, who reviewed the available clinical literature and produced practical clinical recommendations for the use of human albumin in patients with cirrhosis. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  16. Feasibility of spectral CT imaging for the detection of liver lesions with gold-based contrast agents - A simulation study.

    PubMed

    Müllner, Marie; Schlattl, Helmut; Hoeschen, Christoph; Dietrich, Olaf

    2015-12-01

    To demonstrate the feasibility of gold-specific spectral CT imaging for the detection of liver lesions in humans at low concentrations of gold as targeted contrast agent. A Monte Carlo simulation study of spectral CT imaging with a photon-counting and energy-resolving detector (with 6 energy bins) was performed in a realistic phantom of the human abdomen. The detector energy thresholds were optimized for the detection of gold. The simulation results were reconstructed with the K-edge imaging algorithm; the reconstructed gold-specific images were filtered and evaluated with respect to signal-to-noise ratio and contrast-to-noise ratio (CNR). The simulations demonstrate the feasibility of spectral CT with CNRs of the specific gold signal between 2.7 and 4.8 after bilateral filtering. Using the optimized bin thresholds increases the CNRs of the lesions by up to 23% compared to bin thresholds described in former studies. Gold is a promising new CT contrast agent for spectral CT in humans; minimum tissue mass fractions of 0.2 wt% of gold are required for sufficient image contrast. Copyright © 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  17. Self-expandable metal stents for malignant colonic obstruction: data from a retrospective regional SIED-AIGO study.

    PubMed

    Di Mitri, Roberto; Mocciaro, Filippo; Traina, Mario; Montalbano, Luigi Maria; Familiari, Luigi; D'Amore, Fabio; Raimondo, Dario; Virgilio, Clara; Tarantino, Ilaria; Barresi, Luca; Giunta, Marco; Borina, Eleonora; Borruto, Antonino; Marino, Antonino

    2014-03-01

    Self-expandable metal stents are a non-surgical option for the treatment of symptomatic malignant colorectal obstruction as palliative treatment or as a bridge to surgery. To report data from a regional study on self-expandable metal stent (SEMS) placement for malignant colorectal obstruction. Two hundred and four patients (male 54.9%, mean age of 69.5 ± 14.2) were retrospectively evaluated and data on technical and clinical success, and complications, were analyzed. Technical and clinical success rates were 99% and 94.6% respectively, with 36.7% treated on an emergency basis and 63.3% electively. Palliative treatment was administered to 70.1%, and as a bridge to surgery for 29.9%. Complications were 17 neoplastic ingrowths, 10 stent migrations, and 4 perforations. Palliative treatment was associated with a higher risk of stent ingrowth (p=0.003), and chemotherapy with a lower risk of stent ingrowth (p=0.009). This regional study, although it has certain limitations, confirms the positive role of self-expandable metal stents in the treatment of symptomatic malignant colorectal obstruction, and that chemotherapy decreases the risk of ingrowth. Copyright © 2013 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  18. A framework for the implementation of new radiation therapy technologies and treatment techniques in low-income countries.

    PubMed

    Brown, Derek W; Shulman, Adam; Hudson, Alana; Smith, Wendy; Fisher, Brandon; Hollon, Jon; Pipman, Yakov; Van Dyk, Jacob; Einck, John

    2014-11-01

    We present a practical, generic, easy-to-use framework for the implementation of new radiation therapy technologies and treatment techniques in low-income countries. The framework is intended to standardize the implementation process, reduce the effort involved in generating an implementation strategy, and provide improved patient safety by reducing the likelihood that steps are missed during the implementation process. The 10 steps in the framework provide a practical approach to implementation. The steps are, 1) Site and resource assessment, 2) Evaluation of equipment and funding, 3) Establishing timelines, 4) Defining the treatment process, 5) Equipment commissioning, 6) Training and competency assessment, 7) Prospective risk analysis, 8) System testing, 9) External dosimetric audit and incident learning, and 10) Support and follow-up. For each step, practical advice for completing the step is provided, as well as links to helpful supplementary material. An associated checklist is provided that can be used to track progress through the steps in the framework. While the emphasis of this paper is on addressing the needs of low-income countries, the concepts also apply in high-income countries. Copyright © 2014 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  19. Guidelines for the management of Helicobacter pylori infection in Italy: The III Working Group Consensus Report 2015.

    PubMed

    Zagari, Rocco Maurizio; Romano, Marco; Ojetti, Veronica; Stockbrugger, Reinhold; Gullini, Sergio; Annibale, Bruno; Farinati, Fabio; Ierardi, Enzo; Maconi, Giovanni; Rugge, Massimo; Calabrese, Carlo; Di Mario, Francesco; Luzza, Francesco; Pretolani, Stefano; Savio, Antonella; Gasbarrini, Giovanni; Caselli, Michele

    2015-11-01

    Knowledge on the role of Helicobacter pylori (HP) infection is continually evolving, and treatment is becoming more challenging due to increasing bacterial resistance. Since the management of HP infection is changing, an update of the national Italian guidelines delivered in 2007 was needed. In the III Working Group Consensus Report 2015, a panel of 17 experts from several Italian regions reviewed current evidence on different topics relating to HP infection. Four working groups examined the following topics: (1) "open questions" on HP diagnosis and treatment (focusing on dyspepsia, gastro-oesophageal reflux disease, non-steroidal anti-inflammatory drugs or aspirin use and extra-gastric diseases); (2) non-invasive and invasive diagnostic tests; (3) treatment of HP infection; (4) role of HP in the prevention of gastric cancer. Statements and recommendations were discussed and a consensus reached in a final plenary session held in February 2015 in Bologna. Recommendations are based on the best current evidence to help physicians manage HP infection in Italy. The guidelines have been endorsed by the Italian Society of Gastroenterology and the Italian Society of Digestive Endoscopy. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  20. Dose calculation algorithm of fast fine-heterogeneity correction for heavy charged particle radiotherapy.

    PubMed

    Kanematsu, Nobuyuki

    2011-04-01

    This work addresses computing techniques for dose calculations in treatment planning with proton and ion beams, based on an efficient kernel-convolution method referred to as grid-dose spreading (GDS) and accurate heterogeneity-correction method referred to as Gaussian beam splitting. The original GDS algorithm suffered from distortion of dose distribution for beams tilted with respect to the dose-grid axes. Use of intermediate grids normal to the beam field has solved the beam-tilting distortion. Interplay of arrangement between beams and grids was found as another intrinsic source of artifact. Inclusion of rectangular-kernel convolution in beam transport, to share the beam contribution among the nearest grids in a regulatory manner, has solved the interplay problem. This algorithmic framework was applied to a tilted proton pencil beam and a broad carbon-ion beam. In these cases, while the elementary pencil beams individually split into several tens, the calculation time increased only by several times with the GDS algorithm. The GDS and beam-splitting methods will complementarily enable accurate and efficient dose calculations for radiotherapy with protons and ions. Copyright © 2010 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  1. Artificial Optical Radiation photobiological hazards in arc welding.

    PubMed

    Gourzoulidis, G A; Achtipis, A; Topalis, F V; Kazasidis, M E; Pantelis, D; Markoulis, A; Kappas, C; Bourousis, C A

    2016-08-01

    Occupational Health and Safety (OHS) is associated with crucial social, economic, cultural and technical issues. A highly specialized OHS sector deals with the photobiological hazards from artificial optical radiation (AOR), which is divided into visible light, UV and IR emitted during various activities and which is legally covered by European Directive 2006/25/EC. Among the enormous amount of sources emitting AOR, the most important non-coherent ones to consider for health effects to the whole optical range, are arcs created during metal welding. This survey presents the effort to assess the complicated exposure limits of the Directive in the controlled environment of a welding laboratory. Sensors covering the UV and blue light range were set to measure typical welding procedures reproduced in the laboratory. Initial results, apart from apparently justifying the use of Personal Protective Equipment (PPE) due to even subsecond overexposures measured, also set the basis to evaluate PPE's properties and support an integrated risk assessment of the complex welding environment. These results can also improve workers' and employer's information and training about radiation hazards, which is a crucial OHS demand. Copyright © 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  2. Early-stage gastric cancers represented as dysplasia in a previous forceps biopsy: the importance of clinical management.

    PubMed

    Park, Jin Seok; Hong, Su Jin; Han, Jae Pil; Kang, Myung Soo; Kim, Hee Kyung; Kwak, Jeong Ja; Ko, Bong Min; Cho, Joo Young; Lee, Joon Seong; Lee, Moon Sung

    2013-02-01

    Because histological examination of gastric lesions by forceps biopsy is of limited accuracy, management on the basis of histological results is occasionally controversial. We examined the characteristics of early gastric cancers that presented as dysplasia resulting from a previous forceps biopsy. Between April 2007 and December 2010, 341 gastric adenocarcinoma lesions from 330 patients previously diagnosed histologically via endoscopic submucosal dissection were examined. We retrospectively assessed the characteristics of early gastric cancer according to their initial forceps biopsy results. In total, 183 EGCs were diagnosed as dysplasia (53.7%; 89 low-grade and 94 high-grade) and 158 (46.3%) as carcinoma by forceps biopsy before endoscopic submucosal dissection. Significant differences were noted with respect to histologic differentiation of carcinomas, Lauren histologic type, depth of invasion, lymphovascular invasion, and en bloc resection between the dysplastic group and carcinoma group, based on forceps biopsy results. A forceps biopsy result is not fully representative of the entire lesion and, thus, endoscopic submucosal dissection should be considered for lesions diagnosed as dysplasia via forceps biopsy in order to avoid the risk of missed carcinomas. Copyright © 2012 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  3. Enteroscopy and radiology for the management of celiac disease complications: Time for a pragmatic roadmap.

    PubMed

    Branchi, Federica; Locatelli, Martina; Tomba, Carolina; Conte, Dario; Ferretti, Francesca; Elli, Luca

    2016-06-01

    Celiac disease is the most common autoimmune enteropathy in Western countries, and is usually associated with a good response to the gluten free diet and an excellent prognosis. However, a minority of patients develop complications of the disease, such as refractory celiac disease, ulcerative jejunoileitis and neoplastic complications such as adenocarcinoma of the small bowel and enteropathy associated T cell lymphoma. Neoplastic complications described in association with celiac disease have a high mortality rate, due to their aggressive behavior and to the usual advanced stage at the time of diagnosis. In recent years, the detection of small bowel lesions has dramatically improved thank to the availability of highly performing radiologic and endoscopic techniques. The diagnostic delay of malignant complications in patients with celiac disease may be improved by establishing a pragmatic flowchart for the identification and follow up of "at risk" patients. We performed a comprehensive review of the articles published on this issue in order to promote a roadmap to be applied when facing with celiac patients with suspected small bowel complications. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  4. Intestinal metaplasia in Barrett's oesophagus: An essential factor to predict the risk of dysplasia and cancer development.

    PubMed

    Salemme, Marianna; Villanacci, Vincenzo; Cengia, Gianpaolo; Cestari, Renzo; Missale, Guido; Bassotti, Gabrio

    2016-02-01

    To date, there is still uncertainty on the role of specialized intestinal metaplasia in the carcinogenic process of Barrett's oesophagus (BE); this fact seems of importance for planning adequate surveillance programs. To predict the risk of progression towards dysplasia/cancer based on typical morphological features by evaluating the importance of intestinal metaplasia in BE patients. 647 cases with a histological diagnosis of BE, referred to the Endoscopy Unit of a tertiary centre between 2000 and 2012 were retrospectively identified, and divided into two groups according to the presence/absence of intestinal metaplasia. For each patient, all histological reports performed during a follow-up of 4-8 years were analyzed. Overall, 537 cases (83%) with intestinal metaplasia and 110 cases (17%) without intestinal metaplasia were included. During the follow-up period, none of the patients without intestinal metaplasia developed dysplasia/cancer nor progressed to metaplasia, whereas 72 patients with intestinal metaplasia (13.4%) showed histological progression of the disease. The histological identification of intestinal metaplasia seems to be an essential factor for the progression towards dysplasia and cancer in BE patients. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  5. A prospective study on the clinical effectiveness of the stainless steel crown Herbst appliance.

    PubMed

    Latkauskiene, Dalia; Jakobsone, Gundega; McNamara, James A

    2012-09-01

    To evaluate the clinical performance of the stainless steel crown Herbst (cHerbst) used as a single appliance for a single phase therapy. A total of 180 consecutive Class II patients were treated with cHerbst for one year and followed up one year after the end of treatment. Class I relationship was achieved in all 175 patients who finished the functional phase of treatment, 58 patients continued treatment with fixed appliances while 21 patients (12%) showed relapse. Seventy two patients (41.1%) obtained and maintained stable Class I relationship one year after treatment with the cHerbst appliance used as a single appliance. Altogether 46 episodes of appliance breakages were observed and most of them could be repaired at the chair side. Patients' questionnaire revealed that in general the appliance was easy to tolerate and did not cause esthetic or functional problems. The crown Herbst appliance is a viable therapeutical option in patients with Class II malocclusions and it is characterized by low complication rate along with good patient compliance. Copyright © 2011 Società Italiana di Ortodonzia SIDO. Published by Elsevier Srl. All rights reserved.

  6. Design of a multimodal fibers optic system for small animal optical imaging.

    PubMed

    Spinelli, Antonello E; Pagliazzi, Marco; Boschi, Federico

    2015-02-01

    Small animals optical imaging systems are widely used in pre-clinical research to image in vivo the bio-distribution of light emitting probes using fluorescence or bioluminescence modalities. In this work we presented a set of simulated results of a novel small animal optical imaging module based on a fibers optics matrix, coupled with a position sensitive detector, devoted to acquire bioluminescence and Cerenkov images. Simulations were performed using GEANT 4 code with the GAMOS architecture using the tissue optics plugin. Results showed that it is possible to image a 30 × 30 mm region of interest using a fiber optics array containing 100 optical fibers without compromising the quality of the reconstruction. The number of fibers necessary to cover an adequate portion of a small animal is thus quite modest. This design allows integrating the module with magnetic resonance (MR) in order to acquire optical and MR images at the same time. A detailed model of the mouse anatomy, obtained by segmentation of 3D MRI images, will improve the quality of optical 3D reconstruction. Copyright © 2014 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  7. 3D reconstruction based on compressed-sensing (CS)-based framework by using a dental panoramic detector.

    PubMed

    Je, U K; Cho, H M; Hong, D K; Cho, H S; Park, Y O; Park, C K; Kim, K S; Lim, H W; Kim, G A; Park, S Y; Woo, T H; Cho, S I

    2016-01-01

    In this work, we propose a practical method that can combine the two functionalities of dental panoramic and cone-beam CT (CBCT) features in one by using a single panoramic detector. We implemented a CS-based reconstruction algorithm for the proposed method and performed a systematic simulation to demonstrate its viability for 3D dental X-ray imaging. We successfully reconstructed volumetric images of considerably high accuracy by using a panoramic detector having an active area of 198.4 mm × 6.4 mm and evaluated the reconstruction quality as a function of the pitch (p) and the angle step (Δθ). Our simulation results indicate that the CS-based reconstruction almost completely recovered the phantom structures, as in CBCT, for p≤2.0 and θ≤6°, indicating that it seems very promising for accurate image reconstruction even for large-pitch and few-view data. We expect the proposed method to be applicable to developing a cost-effective, volumetric dental X-ray imaging system. Copyright © 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  8. Refinement of ERCP by using the Olympus V-scope system with a 0.025 in. compatible and complete fixable Visiglide(®) guidewire.

    PubMed

    Raithel, Martin; Naegel, Andreas; Seidel, Sebastian; Raithel, Sandra; Diebel, Hiwot; Neurath, Markus F; Maiss, Juergen

    2011-10-01

    Prospective evaluation of the new 0.025 in. Visiglide(®) guidewire to facilitate endoscopic retrograde cholangiopancreaticography using the Olympus V-scope. Interventional endoscopic retrograde cholangiopancreaticography was performed in 9 patients with the Olympus V-scope and the 0.025 in. Visiglide(®) guidewire (VS group), whilst 9 other patients underwent endoscopic retrograde cholangiopancreaticography with a conventional Olympus duodenoscope using 0.035 in. conventional guidewires (controls). Exchange time of accessories, X-ray time, dose and endoscopic retrograde cholangiopancreaticography examination time were investigated. The VS group showed a significantly lower exchange time of endoscopic retrograde cholangiopancreaticography accessories (9; 4-10s, p<0.0001) than controls (29; 19-44s). The Visiglide(®) guidewire was complete fixable by the elevator in 35/36 instrument exchanges (97%) compared to 16/31 exchanges (52%) using conventional guidewires. Single-centre study, small patient numbers, two investigators. Endoscopic retrograde cholangiopancreaticography using the Olympus V-scope with the new 0.025 in. Visiglide(®) guidewire enables a 3-fold faster exchange of accessories due to a nearly complete fixation of the guidewire. Copyright © 2011 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  9. Fog scavenging of organic and inorganic aerosol in the Po Valley

    NASA Astrophysics Data System (ADS)

    Gilardoni, S.; Massoli, P.; Giulianelli, L.; Rinaldi, M.; Paglione, M.; Pollini, F.; Lanconelli, C.; Poluzzi, V.; Carbone, S.; Hillamo, R.; Russell, L. M.; Facchini, M. C.; Fuzzi, S.

    2014-07-01

    The interaction of aerosol with atmospheric water affects the processing and wet removal of atmospheric particles. Understanding such interaction is mandatory to improve model description of aerosol lifetime and ageing. We analyzed the aerosol-water interaction at high relative humidity during fog events in the Po Valley within the framework of the Agenzia Regionale per la Prevenzione e l'Ambiente (ARPA) - Emilia Romagna supersite project. For the first time in this area, the changes in particle chemical composition caused by fog are discussed along with changes in particle microphysics. During the experiment, 14 fog events were observed. The average mass scavenging efficiency was 70% for nitrate, 68% for ammonium, 61% for sulfate, 50% for organics, and 39% for black carbon. After fog formation, the interstitial aerosol was dominated by particles smaller than 200 nm Dva (vacuum aerodynamic diameter) and enriched in carbonaceous aerosol, mainly black carbon and water-insoluble organic aerosol. For each fog event, the size-segregated scavenging efficiency of nitrate and organic aerosol (OA) was calculated by comparing chemical species size distribution before and after fog formation. For both nitrate and OA, the size-segregated scavenging efficiency followed a sigmoidal curve, with values close to zero below 100 nm Dva and close to 1 above 700 nm Dva. OA was able to affect scavenging efficiency of nitrate in particles smaller than 300 nm Dva. A linear correlation between nitrate scavenging and particle hygroscopicity (κ) was observed, indicating that 44-51% of the variability of nitrate scavenging in smaller particles (below 300 nm Dva) was explained by changes in particle chemical composition. The size-segregated scavenging curves of OA followed those of nitrate, suggesting that organic scavenging was controlled by mixing with water-soluble species. In particular, functional group composition and OA elemental analysis indicated that more oxidized OA was scavenged

  10. Derivation of critical rainfall thresholds for landslide in Sicily

    NASA Astrophysics Data System (ADS)

    Caracciolo, Domenico; Arnone, Elisa; Noto, Leonardo V.

    2015-04-01

    Rainfall is the primary trigger of shallow landslides that can cause fatalities, damage to properties and economic losses in many areas of the world. For this reason, determining the rainfall amount/intensity responsible for landslide occurrence is important, and may contribute to mitigate the related risk and save lives. Efforts have been made in different countries to investigate triggering conditions in order to define landslide-triggering rainfall thresholds. The rainfall thresholds are generally described by a functional relationship of power in terms of cumulated or intensity event rainfall-duration, whose parameters are estimated empirically from the analysis of historical rainfall events that triggered landslides. The aim of this paper is the derivation of critical rainfall thresholds for landslide occurrence in Sicily, southern Italy, by focusing particularly on the role of the antecedent wet conditions. The creation of the appropriate landslide-rainfall database likely represents one of main efforts in this type of analysis. For this work, historical landslide events occurred in Sicily from 1919 to 2001 were selected from the archive of the Sistema Informativo sulle Catastrofi Idrogeologiche, developed under the project Aree Vulnerabili Italiane. The corresponding triggering precipitations were screened from the raingauges network in Sicily, maintained by the Osservatorio delle Acque - Agenzia Regionale per i Rifiuti e le Acque. In particular, a detailed analysis was carried out to identify and reconstruct the hourly rainfall events that caused the selected landslides. A bootstrapping statistical technique has been used to determine the uncertainties associated with the threshold parameters. The rainfall thresholds at different exceedance probability levels, from 1% to 10%, were defined in terms of cumulated event rainfall, E, and rainfall duration, D. The role of rainfall prior to the damaging events was taken into account by including in the analysis

  11. [Health expenditure for prevention in Italy (2006-2013): descriptive analysis, regional trends and international comparisons].

    PubMed

    Signorelli, Carlo; Odone, Anna; Bianco, Daniela; Di Vivo, Natalia; Bevere, Francesco

    2016-01-01

    Il dato dell'Organizzazione per la cooperazione e lo sviluppo economico (OCSE) del 2012, che indicava l'Italia come il Paese con la più bassa spesa in prevenzione sanitaria, ha dato lo spunto per una raccolta sistematica e un'analisi critica dei flussi disponibili sulla spesa per le attività di prevenzione in Italia. Le statistiche correnti di spesa sanitaria sono raccolte centralmente dall'Agenzia nazionale per i servizi sanitari regionali (Agenas) attraverso i modelli di rilevazione dei costi dei livelli essenziali di assistenza (LEA) delle aziende USL. Le tre macroaree dei LEA sono: assistenza distrettuale, assistenza ospedaliera e assistenza sanitaria collettiva in ambiente di vita e di lavoro. Le spese per la prevenzione rientrano in quest'ultima e sono ripartite nelle seguenti voci: attività di prevenzione rivolte alle persone, igiene degli alimenti e della nutrizione, igiene e sanità pubblica, prevenzione e sicurezza negli ambienti di lavoro, sanità pubblica veterinaria, attività medico-legale per finalità pubblica. Tra il 2006 e il 2013, ultimo dato disponibile, la spesa per le attività di prevenzione del Servizio sanitario nazionale (SSN) è rimasta costante in rapporto alla spesa sanitaria totale (4,2%), pari a 4,9 miliardi nel 2013. Nel periodo di studio considerato (2006-2013) appaiono in aumento le spese per le attività rivolte alle persone (+8,7%), attribuibili soprattutto a vaccinazioni e screening, e in diminuzione le attività di igiene pubblica (-5,7%) e quelle della sanità pubblica veterinaria (-3,8%). I confronti internazionali indicano una spesa per la prevenzione del 2,9% rispetto alla spesa sanitaria totale, costante negli anni e nella media dei Paesi OCSE. Per la prevenzione, l'Italia spende tanto quanto i Paesi che non possiedono un servizio sanitario pubblico; il dato risulta inferiore del 5% rispetto alla programmazione nazionale, con poche eccezioni e molta variabilità regionale all'interno delle componenti delle voci di spesa

  12. Evaluation of the return periods of water crises and evaporation in Monte Cotugno reservoir (Southern Italy)

    NASA Astrophysics Data System (ADS)

    Copertino, Vito; Lo Vecchio, Giuseppina; Marotta, Lucia; Pastore, Vittoria; Ponzio, Giuseppe; Scavone, Giuseppina; Telesca, Vito; Vita, Michele

    2010-05-01

    In the past water resources management has been dealt and solved increasing water availabilities; today such opportunities have been considerably reduced and the technical-scientific perspectives are addressed above all to improve water system effectiveness and to promote an use of water resources that holds account of the droughts frequency and based on a correct estimate of the hydrologic balance. In this work a study on the water stored in Monte Cotugno reservoir in Sinni river - Basilicata (Southern Italy) - is proposed, estimating water crises return periods and reservoir evaporation. For such purpose the runs method was applied, based on the comparison between the temporal series of the "water volume" hydrological variable and a threshold representative of the "normal" conditions regarding which the availability in excess or defect was estimated. This allowed to individualize the beginning and the end of a water crisis event and to characterize the droughts in terms of duration, sum deficit and intensity. Therefore the return period was evaluated by means of the methodology proposed by Shiau and Shen in 2001, turned out equal approximately to 6 years. Such value was then verified with a frequency analysis of the "water volume" random variable, using the Weibull's distribution. Subsequently, the Fourier's analysis in the last twenty years was carried out, obtaining the same result of the previous methods. Moreover, in proximity of the Monte Cotugno reservoir the weather station of Senise is located, managed by ALSIA (Agenzia Lucana di Sviluppo e Innovazione in Agricultura), that provides in continuous measurements of air temperature and humidity, wind speed and direction, and global solar radiation since 2000. Such parameters allowed to apply five methods for reservoir evaporation estimate selected from those proposed in the literature, of which the first three, the Jensen-Haise's method, Makkink's method and Stephens-Stewart's one are based on solar radiation

  13. A methodology for system-of-systems design in support of the engineering team

    NASA Astrophysics Data System (ADS)

    Ridolfi, G.; Mooij, E.; Cardile, D.; Corpino, S.; Ferrari, G.

    2012-04-01

    Space missions have experienced a trend of increasing complexity in the last decades, resulting in the design of very complex systems formed by many elements and sub-elements working together to meet the requirements. In a classical approach, especially in a company environment, the two steps of design-space exploration and optimization are usually performed by experts inferring on major phenomena, making assumptions and doing some trial-and-error runs on the available mathematical models. This is done especially in the very early design phases where most of the costs are locked-in. With the objective of supporting the engineering team and the decision-makers during the design of complex systems, the authors developed a modelling framework for a particular category of complex, coupled space systems called System-of-Systems. Once modelled, the System-of-Systems is solved using a computationally cheap parametric methodology, named the mixed-hypercube approach, based on the utilization of a particular type of fractional factorial design-of-experiments, and analysis of the results via global sensitivity analysis and response surfaces. As an applicative example, a system-of-systems of a hypothetical human space exploration scenario for the support of a manned lunar base is presented. The results demonstrate that using the mixed-hypercube to sample the design space, an optimal solution is reached with a limited computational effort, providing support to the engineering team and decision makers thanks to sensitivity and robustness information. The analysis of the system-of-systems model that was implemented shows that the logistic support of a human outpost on the Moon for 15 years is still feasible with currently available launcher classes. The results presented in this paper have been obtained in cooperation with Thales Alenia Space—Italy, in the framework of a regional programme called STEPS. STEPS—Sistemi e Tecnologie per l'EsPlorazione Spaziale is a research

  14. A Search for High-Energy Gamma-Rays from Supernova SN1987A.

    NASA Astrophysics Data System (ADS)

    Waldron, Liam Edwin

    1992-01-01

    The Australian Defence Force Academy (ADFA) balloon -borne gamma-ray astronomy telescope was flown successfully from Alice Springs Australia twice during 1987 and 1988 (flights 87-2-19 and 88-1-5) with the aim of measuring the gamma-ray flux, in the energy range 50 to 500 MeV, from Supernova SN1987A in the Large Magellanic Cloud. The two flights corresponded to day 55 and day 407 respectively of remnant evolution. The instrument was complemented by a hard X-ray proportional counter, designed and constructed by the Istituto di Astrofisica Spaziale, CNR, Frascati Italy, and sensitive to the 10 to 250 KeV energy range. In this thesis, an account is given of the physical processes responsible for the production of gamma-rays astrophysical environments and their relation to supernovae and cosmic-rays. A description is then given of the main features of the gamma-ray telescope and its principle of operation, the most important part of the telescope being a spark-chamber used to determine the direction of arrival of incident gamma-rays. Data obtained during each flight was recorded as spark-chamber tacks on photographic film. A detailed account of the methods of subsequent data reduction and analysis, as carried out by the author, are given. The principal results of this work were that 3-sigma upper limits to the gamma-ray flux from Supernova SN1987A of 2.2 times 10^ {-5} photons cm^{ -2} s^{-1} and 3.4 times 10^{-5} photons cm^{-2} s^ {-1} were obtained for days 55 and 407 of remnant evolution respectively, these limits being somewhat lower than previously reported in the literature from a preliminary analysis of the data. The above two upper limits are consistent with Supernova SN1987A being an atypical Type-II supernova. That is, the progenitor was a blue, rather than a red, supergiant. The limits are compared with theoretical predictions related to current models of gamma-ray emission from young Type -II supernovae.

  15. A Search for High-Energy Gamma Rays from Supernova 1987A

    NASA Astrophysics Data System (ADS)

    Waldron, Liam Edwin

    1993-01-01

    The Australian Defense Force Academy (ADFA) balloon-borne gamma-ray astronomy telescope was flown successfully from Alice Springs, Australia, twice during 1987 and 1988 (Flights 87-2-19 and 88-1-5) with the aim of measuring the gamma-ray flux, in the energy range 50-500 MeV, from Supernova 1987A in the Large Magellanic Cloud. The two flights correspond to day 55 and 407, respectively, of remnant evolution. The instrument was complemented by a hard X-ray proportional counter, designed and constructed by the Istituto di Astrofisica Spaziale, CNR, Frascati, Italy, and sensitive to the 10-250 keV energy range. In this thesis, an account is given of the physical processes responsible for the production of gamma rays in astrophysical environments and their relation to supernovae and cosmic rays. A description is then given of main features of the gamma-ray telescope and its principles of operation, the most important part of the telescope being a spark chamber used to determine the direction of arrival of incident gamma rays. Data obtained during each flight were recorded as spark-chamber tracks on the photographic film. A detailed account of the methods of subsequent data reduction and analysis, as carried out by the author, is given. The principal results of this work were that 3-sigma upper limits to the gamma-ray flux from SN 1987A of 2.2 and 3.4 X 10^-5 photons cm^-2s^-1 were obtained for days 55 and 407 of remnant evolution, respectively, these limits being somewhat lower than previously reported in the literature from a preliminary analysis of the data. The above two upper limits are consistent with SN 1987A being an atypical Type II supernova. That is, the progenitor was a blue, rather than a red, supergiant. The limits are compared with theoretical predictions related to current models of gamma-ray emission from young Type II supernovae. (SECTION: Dissertation Abstracts)

  16. Applied design methodology for lunar rover elastic wheel

    NASA Astrophysics Data System (ADS)

    Cardile, Diego; Viola, Nicole; Chiesa, Sergio; Rougier, Alessandro

    2012-12-01

    In recent years an increasing interest in the Moon surface operations has been experienced. In the future robotic and manned missions of Moon surface exploration will be fundamental in order to lay the groundwork for more ambitious space exploration programs. Surface mobility systems will be the key elements to ensure an efficient and safe Moon exploration. Future lunar rovers are likely to be heavier and able to travel longer distances than the previously developed Moon rover systems. The Lunar Roving Vehicle (LRV) is the only manned rover, which has so far been launched and used on the Moon surface. Its mobility system included flexible wheels that cannot be scaled to the heavier and longer range vehicles. Thus the previously developed wheels are likely not to be suitable for the new larger vehicles. Taking all these considerations into account, on the basis of the system requirements and assumptions, several wheel concepts have been discussed and evaluated through a trade-off analysis. Semi-empirical equations have been utilized to predict the wheel geometrical characteristics, as well as to estimate the motion resistances and the ability of the system to generate thrust. A numerical model has also been implemented, in order to define more into the details the whole wheel design, in terms of wheel geometry and physical properties. As a result of the trade-off analysis, the ellipse wheel concept has shown the best behavior in terms of stiffness, mass budget and dynamic performance. The results presented in the paper have been obtained in cooperation with Thales Alenia Space-Italy and Sicme motori, in the framework of a regional program called STEPS . STEPS-Sistemi e Tecnologie per l'EsPlorazione Spaziale is a research project co-financed by Piedmont Region and firms and universities of the Piedmont Aerospace District in the ambit of the P.O.R-F.E.S.R. 2007-2013 program.

  17. A simple modification of TG-43 based brachytherapy dosimetry with improved fitting functions: application to the selectSeed source.

    PubMed

    Juan-Senabre, Xavier J; Porras, Ignacio; Lallena, Antonio M

    2013-06-01

    A variation of TG-43 protocol for seeds with cylindrical symmetry aiming at a better description of the radial and anisotropy functions is proposed. The TG-43 two dimensional formalism is modified by introducing a new anisotropy function. Also new fitting functions that permit a more robust description of the radial and anisotropy functions than usual polynomials are studied. The relationship between the new anisotropy function and the anisotropy factor included in the one-dimensional TG-43 formalism is analyzed. The new formalism is tested for the (125)I Nucletron selectSeed brachytherapy source, using Monte Carlo simulations performed with PENELOPE. The goodness of the new parameterizations is discussed. The results obtained indicate that precise fits can be achieved, with a better description than that provided by previous parameterizations. Special care has been taken in the description and fitting of the anisotropy factor near the source. The modified formalism shows advantages with respect to the usual one in the description of the anisotropy functions. The new parameterizations obtained can be easily implemented in the clinical planning calculation systems, provided that the ratio between geometry factors is also modified according to the new dose rate expression. Copyright © 2012 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  18. The ASTRI/CTA mini-array software system

    NASA Astrophysics Data System (ADS)

    Tosti, Gino; Schwarz, Joseph; Antonelli, Lucio Angelo; Trifoglio, Massimo; Catalano, Osvaldo; Maccarone, Maria Concetta; Leto, Giuseppe; Gianotti, Fulvio; Canestrari, Rodolfo; Giro, Enrico; Fiorini, Mauro; La Palombara, Nicola; Pareschi, Giovanni; Stringhetti, Luca; Vercellone, Stefano; Conforti, Vito; Tanci, Claudio; Bruno, Pietro; Grillo, Alessandro; Testa, Vincenzo; di Paola, Andrea; Gallozzi, Stefano

    2014-07-01

    ASTRI (Astrofisica con Specchi a Tecnologia Replicante Italiana) is a Flagship Project financed by the Italian Ministry of Education, University and Research, and led by INAF, the Italian National Institute of Astrophysics. The main goals of the ASTRI project are the realization of an end-to-end prototype of a Small Size Telescope (SST) for the Cherenkov Telescope Array (CTA) in a dual- mirror configuration (SST-2M) and, subsequently, of a mini-array comprising seven SST-2M telescopes. The mini-array will be placed at the final CTA Southern Site, which will be part of the CTA seed array, around which the whole CTA observatory will be developed. The Mini-Array Software System (MASS) will provide a comprehensive set of tools to prepare an observing proposal, to perform the observations specified therein (monitoring and controlling all the hardware components of each telescope), to analyze the acquired data online and to store/retrieve all the data products to/from the archive. Here we present the main features of the MASS and its first version, to be tested on the ASTRI SST-2M prototype that will be installed at the INAF observing station located at Serra La Nave on Mount Etna in Sicily.

  19. A consumer's guide for probiotics: 10 golden rules for a correct use.

    PubMed

    Toscano, Marco; De Grandi, Roberta; Pastorelli, Luca; Vecchi, Maurizio; Drago, Lorenzo

    2017-11-01

    Probiotics are used all over the world as their beneficial effects on the human organism have been widely demonstrated. Certain probiotics can down-regulate production of pro-inflammatory cytokines and promote intestinal epithelial barrier functions, increasing an anti-inflammatory response and contributing to the host's overall health. The main mechanisms by which probiotic microorganisms can interact with the host are by modulating the immune system and the epithelial cell functions and interacting with intestinal gut microbiota. To date, hundreds of different microorganisms are used for the formulation of numerous probiotic products; therefore, it is very difficult to choose the best probiotic product for specific or more general needs. Therefore, physicians are getting more and more confused due to the high number of commercial products which are often lacking healthy effects on the host. Therefore, the aim of this paper is to demonstrate the main characteristics that probiotic microorganisms and products should possess to have a positive impact on the host's health. To this purpose, this review suggests "10 golden rules" or "commandments" that clinicians should follow to properly select the optimal probiotic product and avoid misidentifications, mislabelling and "pie in the sky" stories. Copyright © 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  20. Lo Gnomone Clementino Astronomia Meridiana in Basilica

    NASA Astrophysics Data System (ADS)

    Sigismondi, Costantino

    2014-05-01

    Costruito per chiara volontà del papa 70 anni dopo il caso Galileo, lo Gnomone Clementino è un grande telescopio solare che non fa uso di lenti a 92 anni dall’invenzione del cannocchiale. Queste due caratteristiche basterebbero da sole a giustificare l’interesse verso questo strumento. L’astronomia meridiana è alla base dell’astrometria e dell’astrofisica moderna. Lo Gnomone Clementino sta oggi all’astronomia, come il veliero “Amerigo Vespucci” sta alla Marina Italiana. E’ possibile svolgere ogni genere di osservazione e studio su questo strumento, e dal 2002 vi tengo lezioni teorico-pratiche del corso di Storia dell’Astronomia e La Terra nel Sistema Solare della Sapienza, Università di Roma, Facoltà di Lettere e Filosofia. Questo testo aggiunge alcuni tasselli alla ricerca storica sulla meridiana, appoggiandosi, com’è naturale, sulle spalle di giganti che mi hanno preceduto in questi studi. In particolare la misura dell’azimut della meridiana, ed il suo inquadramento tra gli strumenti simili ed alcuni studi di astrometria sui dati del 1701-1703 di Bianchini, che sono apparsi fin’ora soltanto su riviste specializzate ed in Inglese vengono qui proposti in Italiano e semplificati, per valorizzare sempre più questa straordinaria opera d’arte e di scienza.

  1. Irritant and sensitizing potential of eight surfactants commonly used in skin cleansers: an evaluation of 105 patients.

    PubMed

    Corazza, Monica; Lauriola, Maria Michela; Bianchi, Anna; Zappaterra, Mario; Virgili, Annarosa

    2010-01-01

    Irritation from surfactants contained in detergents is a frequent adverse reaction to cosmetics. Sensitization to surfactants is also possible. In the literature, comparative studies about irritant and sensitizing potential of different surfactants are heterogeneous and inconclusive about the best molecules to use. We compared the irritant and sensitizing potential of some surfactants that are usual components in marketed synthetic detergents (syndets) to obtain practical information regarding commonly used detergents. We patch-tested eight surfactants of the different types (anionic, cationic, amphoteric, and non-ionic) in 105 patients. Assessment of allergic reactions of tested surfactants was carried out in accordance with the recommendations of the International Contact Dermatitis Research Group; assessment of irritant power followed the amended Draize classification. None of the eight surfactants in our series gave positive allergic reactions. Only cocamidopropyl betaine from the Italian standard (Società Italiana di Dermatologia Allergologica, Professionale e Ambientale [SIDAPA]) series gave five positive reactions among 105 patients. None of the eight studied surfactants induced skin irritation. The most tolerated are two new mild anionics (sodium cocoyl glutamate and sodium lauroyl oat amino acids) and an amphoteric agent (disodium cocoamphodiacetate). From this study, we deduce that cosmetic companies' efforts to search for and market new products with very mild surfactants have been generally successful.

  2. Factors predictive of risk for complications in patients with oesophageal foreign bodies.

    PubMed

    Sung, Sang Hun; Jeon, Seong Woo; Son, Hyuk Su; Kim, Sung Kook; Jung, Min Kyu; Cho, Chang Min; Tak, Won Young; Kweon, Young Oh

    2011-08-01

    Reports on predictive risk factors associated with complications of ingested oesophageal foreign bodies are rare. The aim of this study was to determine the predictive risk factors associated with the complications of oesophageal foreign bodies. Three hundred sixteen cases with foreign bodies in the oesophagus were retrospectively investigated. The predictive risk factors for complications after foreign body ingestion were analysed by multivariate logistic regression, and included age, size and type of foreign body ingested, duration of impaction, and the level of foreign body impaction. The types of oesophageal foreign bodies included fish bones (37.0%), food (19.0%), and metals (18.4%). The complications associated with foreign bodies were ulcers (21.2%), lacerations (14.9%), erosions (12.0%), and perforation (1.9%). Multivariate analysis showed that the duration of impaction (p<0.001), and the type (p<0.001) and size of the foreign bodies (p<0.001) were significant independent risk factors associated with the development of complications in patients with oesophageal foreign bodies. In patients with oesophageal foreign bodies, the risk of complications was increased with a longer duration of impaction, bone type, and larger size. Copyright © 2011 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  3. [Bartter syndrome, severe rare orphan kidney disease: a step towards therapy through pharmacogenetic and epidemiological studies].

    PubMed

    Conte, Elena; Imbrici, Paola; Sahbani, Dalila; Liantonio, Antonella; Conte, Diana

    2018-05-01

    Bartter syndromes (BS) types 1-5 are rare salt-losing tubulopathies presenting with overlapping clinical phenotypes including marked salt wasting and hypokalemia leading to polyuria, polydipsia, volume contraction, muscle weakness and growth retardation. These diseases are due to an impairment of sodium, potassium, chloride reabsorption caused by mutations in genes encoding for ion channel or transporters expressed in specific nephron tubule segments. Particularly, BS type 3 is a clinically heterogeneous form caused by mutations in CLCNKB gene which encodes the ClC-Kb chloride channel involved in NaCl reabsorption in the renal tubule. Specific therapy for BS is lacking and the only pharmacotherapy up today available is purely symptomatic and characterized by limiting side effects. The improvement of our understanding of the phenotype/genotype correlation and of the precise pathogenic mechanisms associated with BS type 3 as well as the pharmacological characterization of ClC-K chloride channels are fundamental to design therapies tailored upon patients' mutation. This mini review focused on recent studies representing relevant forward steps in the field as well as noteworthy examples of how basic and clinical research can cooperate to gain insight into the pathophysiology of this renal channelopathy, paving the way for a personalized therapy. Copyright by Società Italiana di Nefrologia SIN, Rome, Italy.

  4. Biophysical characterization of gold nanoparticles-loaded liposomes.

    PubMed

    Mady, Mohsen Mahmoud; Fathy, Mohamed Mahmoud; Youssef, Tareq; Khalil, Wafaa Mohamed

    2012-10-01

    Gold nanoparticles were prepared and loaded into the bilayer of dipalmitoylphosphatidylcholine (DPPC) liposomes, named as gold-loaded liposomes. Biophysical characterization of gold-loaded liposomes was studied by transmission electron microscopy (TEM) and Fourier transform infrared (FTIR) spectroscopy as well as turbidity and rheological measurements. FTIR measurements showed that gold nanoparticles made significant changes in the frequency of the CH(2) stretching bands, revealing that gold nanoparticles increased the number of gauche conformers and create a conformational change within the acyl chains of phospholipids. The transmission electron micrographs (TEM) revealed that gold nanoparticles were loaded in the liposomal bilayer. The zeta potential of DPPC liposomes had a more negative value after incorporating of Au NPs into liposomal membranes. Turbidity studies revealed that the loading of gold nanoparticles into DPPC liposomes results in shifting the temperature of the main phase transition to a lower value. The membrane fluidity of DPPC bilayer was increased by loading the gold nanoparticles as shown from rheological measurements. Knowledge gained in this study may open the door to pursuing liposomes as a viable strategy for Au NPs delivery in many diagnostic and therapeutic applications. Copyright © 2011 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  5. Amarone: a modern wine coming from an ancient production technology.

    PubMed

    Paronetto, Lanfranco; Dellaglio, Franco

    2011-01-01

    Amarone wine is a renowned dry red wine produced in Valpolicella (Verona, Northern Italy). It is made from local grapes varieties (Corvina, Rondinella, and Molinara) that are slowly dried under natural conditions during the fall into winter. After the postharvest drying, carried out for several weeks in dedicated lofts called fruttaio, the grapes are vinified: crushed, given prefermentative cold maceration, undergo alcoholic fermentation on the skins, malolactic fermentation, and finally maturation. The partially dried grapes are traditionally crushed during the second half of January to February. Because cellar conditions are unfavorable for either alcohol or malolactic fermentation, selected microbial cultures (yeasts and malolactic bacteria) are often necessary to correctly manage fermentation. The progress of both fermentation processes needs constant surveillance. During maturation conducted in vessels or wooden containers (tonneau in durmast oak), clarification and stabilization lead to improvements in quality. Product specifications require that Amarone not be bottled before the wine has been aged for 2years (Anonymous (2010). Disciplinare di produzione dei vini a denominazione di Origine Controllata e Garantita "Amarone della Valpolicella". Gazzetta Ufficiale della Repubblica Italiana. Serie generale n. 84. April 12). Amarone achieved its DOCG (Controlled and Guaranteed Denomination) status in 2010. Copyright © 2011 Elsevier Inc. All rights reserved.

  6. Cholangiocarcinoma: A position paper by the Italian Society of Gastroenterology (SIGE), the Italian Association of Hospital Gastroenterology (AIGO), the Italian Association of Medical Oncology (AIOM) and the Italian Association of Oncological Radiotherapy (AIRO).

    PubMed

    Alvaro, Domenico; Cannizzaro, Renato; Labianca, Roberto; Valvo, Francesca; Farinati, Fabio

    2010-12-01

    The incidence of Cholangiocellular carcinoma (CCA) is increasing, due to a sharp increase of the intra-hepatic form. Evidence-ascertained risk factors for CCA are primary sclerosing cholangitis, Opistorchis viverrini infection, Caroli disease, congenital choledocal cist, Vater ampulla adenoma, bile duct adenoma and intra-hepatic lithiasis. Obesity, diabetes, smoking, abnormal biliary-pancreatic junction, bilio-enteric surgery, and viral cirrhosis are emerging risk factors, but their role still needs to be validated. Patients with primary sclerosing cholangitis should undergo surveillance, even though a survival benefit has not been clearly demonstrated. CCA is most often diagnosed in an advanced stage, when therapeutic options are limited to palliation. Diagnosis of the tumor is often difficult and multiple imaging techniques should be used, particularly for staging. Surgery is the standard of care for resectable CCA, whilst liver transplantation should be considered only in experimental settings. Metal stenting is the standard of care in inoperable patients with an expected survival >4 months. Gemcitabine or platinum analogues are recommended in advanced CCA whilst there are no validated neo-adjuvant treatments or second-line chemotherapies. Even though promising results have been obtained in CCA with radiotherapy, further randomized controlled trials are needed. Copyright © 2010 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  7. The prognostic value of biological markers in paediatric Hodgkin lymphoma.

    PubMed

    Farruggia, Piero; Puccio, Giuseppe; Sala, Alessandra; Todesco, Alessandra; Buffardi, Salvatore; Garaventa, Alberto; Bottigliero, Gaetano; Bianchi, Maurizio; Zecca, Marco; Locatelli, Franco; Pession, Andrea; Pillon, Marta; Favre, Claudio; D'Amico, Salvatore; Provenzi, Massimo; Trizzino, Angela; Zanazzo, Giulio Andrea; Sau, Antonella; Santoro, Nicola; Murgia, Giulio; Casini, Tommaso; Mascarin, Maurizio; Burnelli, Roberta

    2016-01-01

    Many biological and inflammatory markers have been proposed as having a prognostic value at diagnosis of Hodgkin lymphoma (HL), but very few have been validated in paediatric patients. We explored the significance of these markers in a large population of 769 affected children. By using the database of patients enrolled in A.I.E.O.P. (Associazione Italiana di Emato-Oncologia Pediatrica) trial LH2004 for paediatric HL, we identified 769 consecutive patients treated with curative intent from 1st June 2004 to 1st April 2014 with ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine), or hybrid COPP/ABV (cyclophosphamide, vincristine, prednisone, procarbazine, doxorubicin, bleomycin and vinblastine) regimens. On multivariate analysis with categorical forms, the 5-year freedom from progression survival was significantly lower in patients with stage IV or elevated value of platelets, eosinophils and ferritin at diagnosis. Furthermore, stage IV and eosinophils seem to maintain their predictive value independently of interim (after IV cycles of chemotherapy) positron emission tomography. Using the combination of four simple markers such as stage IV and elevated levels of platelets, ferritin and eosinophils, it is possible to classify the patients into subgroups with very different outcomes. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Occupational exposures during abdominal fluoroscopically guided interventional procedures for different patient sizes - A Monte Carlo approach.

    PubMed

    Santos, William S; Belinato, Walmir; Perini, Ana P; Caldas, Linda V E; Galeano, Diego C; Santos, Carla J; Neves, Lucio P

    2018-01-01

    In this study we evaluated the occupational exposures during an abdominal fluoroscopically guided interventional radiology procedure. We investigated the relation between the Body Mass Index (BMI), of the patient, and the conversion coefficient values (CC) for a set of dosimetric quantities, used to assess the exposure risks of medical radiation workers. The study was performed using a set of male and female virtual anthropomorphic phantoms, of different body weights and sizes. In addition to these phantoms, a female and a male phantom, named FASH3 and MASH3 (reference virtual anthropomorphic phantoms), were also used to represent the medical radiation workers. The CC values, obtained as a function of the dose area product, were calculated for 87 exposure scenarios. In each exposure scenario, three phantoms, implemented in the MCNPX 2.7.0 code, were simultaneously used. These phantoms were utilized to represent a patient and medical radiation workers. The results showed that increasing the BMI of the patient, adjusted for each patient protocol, the CC values for medical radiation workers decrease. It is important to note that these results were obtained with fixed exposure parameters. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  9. Bone marrow involvement is rare in superficial gastric mucosa-associated lymphoid tissue lymphoma.

    PubMed

    Park, Jae Yong; Kim, Sang Gyun; Kim, Joo Sung; Jung, Hyun Chae

    2016-01-01

    The initial staging work-up of gastric mucosa-associated lymphoid tissue (MALT) lymphoma includes bone marrow examination. Since gastric MALT lymphoma is mostly detected in early stages with the national cancer screening programme in Korea, bone marrow is rarely involved. To investigate the incidence of bone marrow involvement in gastric MALT lymphomas and the role of bone marrow examination for an initial staging work-up. Patients diagnosed with gastric MALT lymphoma at Seoul National University Hospital from January 2005 to July 2014 were enrolled. Clinical databases of the patients were retrospectively reviewed. Out of 105 patients, 91 (86.7%) were classified as stage IE1. Among these patients, 78 patients with Helicobacter pylori infection underwent eradication therapy, and complete remission was achieved in 74 cases (94.9%). Twelve out of 13 patients (92.3%) without H. pylori infection underwent radiotherapy or surgery and all achieved complete remission. Bone marrow involvement was proven in only one patient (1.0%). Bone marrow involvement was rare in patients with only superficial gastric MALT lymphoma without extragastric invasion. Further studies are warranted to identify the risk factors of bone marrow involvement in gastric MALT lymphoma. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  10. Expert consensus paper on the use of Vedolizumab for the management of patients with moderate-to-severe Inflammatory Bowel Disease.

    PubMed

    Armuzzi, Alessandro; Gionchetti, Paolo; Daperno, Marco; Danese, Silvio; Orlando, Ambrogio; Lia Scribano, Maria; Vecchi, Maurizio; Rizzello, Fernando

    2016-04-01

    Crohn's Disease (CD) and Ulcerative Colitis (UC) are chronic, relapsing conditions resulting from uncontrolled inflammation of the intestinal mucosa. Both conditions are associated with significant disability and patients with CD face higher mortality rates compared to the general population. The increasing understanding of the immunological basis of the disease led to the introduction of biologic therapies targeting key pathways of the natural and adaptive immune response such as Tumor Necrosis Factor α (TNF-α) inhibitors and, more recently, integrin-receptor antagonists. Treatment with TNF-α inhibitors improved clinical and patient-reported outcomes for many patients who did not benefit from conventional therapy. However, a sizeable share of patients still face suboptimal outcomes due to primary or secondary therapy failure. With the introduction of VDZ, a biologic treatment targeting novel IBD-relevant biologic pathways, it is crucial to understand how to integrate such innovations into current clinical practice. To this end, a panel of 14 Italian experts in the management of IBD met for a roundtable discussion. Recommendations concerning the management of moderate-to-severe IBD based on experts' opinions and literature review are discussed in the present report. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  11. Treatment of type 2 diabetes mellitus by viral eradication in chronic hepatitis C: Myth or reality?

    PubMed

    Vanni, Ester; Bugianesi, Elisabetta; Saracco, Giorgio

    2016-02-01

    Chronic hepatitis C is a systemic disease inducing metabolic alterations leading to extrahepatic consequences. In particular, hepatitis C virus (HCV) infection seems to increase the risk of incident type 2 diabetes mellitus in predisposed individuals, independently of liver disease stage. The mechanisms through which hepatitis C induces T2DM involve direct viral effects, insulin resistance, pro-inflammatory cytokines and other immune-mediated processes. Many studies have reported the clinical consequences of type 2 diabetes mellitus on hepatitis C outcome, but very few studies have addressed the issue of microangiopathic complications among patients with hepatitis C only, who develop type 2 diabetes mellitus. Moreover, clinical trials in HCV-positive patients have reported improvement in glucose metabolism after antiviral treatment; recent studies have suggested that this metabolic amelioration might have a clinical impact on type 2 diabetes mellitus-related complications. These observations raise the question as to whether the HCV eradication may also have an impact on the future morbidity and mortality due to type 2 diabetes mellitus. The scope of this review is to summarise the current evidence linking successful antiviral treatment and the prevention of type 2 diabetes mellitus and its complications in hepatitis C-infected patients. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  12. Biological optimization of simultaneous boost on intra-prostatic lesions (DILs): sensitivity to TCP parameters.

    PubMed

    Azzeroni, R; Maggio, A; Fiorino, C; Mangili, P; Cozzarini, C; De Cobelli, F; Di Muzio, N G; Calandrino, R

    2013-11-01

    The aim of this investigation was to explore the potential of biological optimization in the case of simultaneous integrated boost on intra-prostatic dominant lesions (DIL) and evaluating the impact of TCP parameters uncertainty. Different combination of TCP parameters (TD50 and γ50 in the Poisson-like model), were considered for DILs and the prostate outside DILs (CTV) for 7 intermediate/high-risk prostate patients. The aim was to maximize TCP while constraining NTCPs below 5% for all organs at risk. TCP values were highly depending on the parameters used and ranged between 38.4% and 99.9%; the optimized median physical doses were in the range 94-116 Gy and 69-77 Gy for DIL and CTV respectively. TCP values were correlated with the overlap PTV-rectum and the minimum distance between rectum and DIL. In conclusion, biological optimization for selective dose escalation is feasible and suggests prescribed dose around 90-120 Gy to the DILs. The obtained result is critically depending on the assumptions concerning the higher radioresistence in the DILs. In case of very resistant clonogens into the DIL, it may be difficult to maximize TCP to acceptable levels without violating NTCP constraints. Copyright © 2012 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  13. A comprehensive SWOT audit of the role of the biomedical physicist in the education of healthcare professionals in Europe.

    PubMed

    Caruana, C J; Wasilewska-Radwanska, M; Aurengo, A; Dendy, P P; Karenauskaite, V; Malisan, M R; Meijer, J H; Mihov, D; Mornstein, V; Rokita, E; Vano, E; Weckstrom, M; Wucherer, M

    2010-04-01

    Although biomedical physicists provide educational services to the healthcare professions in the majority of universities in Europe, their precise role with respect to the education of the healthcare professions has not been studied systematically. To address this issue we are conducting a research project to produce a strategic development model for the role using the well-established SWOT (Strengths, Weaknesses, Opportunities, Threats) methodology. SWOT based strategic planning is a two-step process: one first carries out a SWOT position audit and then uses the identified SWOT themes to construct the strategic development model. This paper reports the results of a SWOT audit for the role of the biomedical physicist in the education of the healthcare professions in Europe. Internal Strengths and Weaknesses of the role were identified through a qualitative survey of biomedical physics departments and biomedical physics curricula delivered to healthcare professionals across Europe. External environmental Opportunities and Threats were identified through a systematic survey of the healthcare, healthcare professional education and higher education literature and categorized under standard PEST (Political, Economic, Social-Psychological, Technological-Scientific) categories. The paper includes an appendix of terminology. Defined terms are marked with an asterisk in the text. Copyright 2009 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  14. Proposal for SICSeG guidelines for rehabilitation after anatomical shoulder prosthesis in concentric shoulder osteoarthritis.

    PubMed

    Fusaro, I; Orsini, S; Stignani, S; Creta, D; Cava, F C; Benedetti, M G

    2013-06-01

    The purpose of this paper is to provide up-to-date guidelines on rehabilitation after anatomical shoulder prosthesis for concentric shoulder osteoarthritis, as previous guidelines date back to late 1970s and are no longer adequate due to the evolution of prosthesis models and surgical techniques. The physiatric committee of the Italian Society of Shoulder and Elbow Surgery (SICSeG-Società Italiana di Chirurgia della Spalla e del Gomito) performed a search for all the existing literature related to rehabilitation after shoulder replacement. A total of 29 papers concerning shoulder rehabilitation were reviewed. In addition, the main Italian orthopedic surgeons and physiatrists dealing with shoulder surgery and rehabilitation were interviewed to obtain indications when literature was not conclusive. From literature evaluation and expert consultation, we produced guidelines concerning: patient evaluation by means of adequate rating scales, preoperative treatment, early intermediate and advanced postoperative phases, rehabilitation of scapulo-thoracic joint, return to work and sports, length of rehabilitation and follow-up. This proposal for guidelines was presented during the 11th SICSeG Congress on May 2012 and to the main scientific societies concerned in shoulder surgery and rehabilitation. A consensus conference is needed in order to formalize and make them usable from all the professional figures involved in this field.

  15. [Improving vaccination social marketing by monitoring the web].

    PubMed

    Ferro, A; Bonanni, P; Castiglia, P; Montante, A; Colucci, M; Miotto, S; Siddu, A; Murrone, L; Baldo, V

    2014-01-01

    Immunisation is one of the most important and cost- effective interventions in Public Health because of their significant positive impact on population health.However, since Jenner's discovery there always been a lively debate between supporters and opponents of vaccination; Today the antivaccination movement spreads its message mostly on the web, disseminating inaccurate data through blogs and forums, increasing vaccine rejection.In this context, the Società Italiana di Igiene (SItI) created a web project in order to fight the misinformation on the web regarding vaccinations, through a series of information tools, including scientific articles, educational information, video and multimedia presentations The web portal (http://www.vaccinarsi.org) was published in May 2013 and now is already available over one hundred web pages related to vaccinations Recently a Forum, a periodic newsletter and a Twitter page have been created. There has been an average of 10,000 hits per month. Currently our users are mostly healthcare professionals. The visibility of the site is very good and it currently ranks first in the Google's search engine, taping the word "vaccinarsi" The results of the first four months of activity are extremely encouraging and show the importance of this project; furthermore the application for quality certification by independent international Organizations has been submitted.

  16. [Vascular calcifications in subjects with and without chronic renal failure: types, sites and risk factors].

    PubMed

    Marinelli, Annibale; Di Napoli, Anteo

    2017-04-01

    Vascular calcifications worse outcomes in the general population and in patients on dialysis. We investigated 146 patients on chronic hemodialysis and 63 healthy controls with normal renal function under 65 years of age. All subjects underwent B-mode ultrasonography of common and internal carotid artery, abdominal aorta, common and superficial femoral artery and posterior tibial artery to assess the presence of intimal and medial calcifications. Intimal and media calcifications were present at the level of the carotid vessel, the abdominal aorta, the common femoral artery, the superficial femoral artery and the posterior tibial artery, respectively in 45%, 50%, 45%, 50%, 42% of patients on dialysis and in 5%, 15%, 24%, 5%, 2% of controls (p <0,01). On multivariate logistic analysis of regression, after adjustment for potential confounders, carotid intimal calcification, abdominal aortic calcification, medial calcification of the superficial femoral artery and posterior tibial artery calcification were associated with dialysis and with cardiovascular disease. Only intimal arterial calcification were associated with older age and smoking. Vascular calcifications are extremely common in middle-aged patients on chronic hemodialysis. Ultrasonography currently available in Nephrology, is a sensitive, reproducible, inexpensive imaging technique to identify arterial intimal and medial calcification in high-risk cardiovascular subjects. Copyright by Società Italiana di Nefrologia SIN, Rome, Italy.

  17. Seronegative celiac disease: Shedding light on an obscure clinical entity.

    PubMed

    Volta, Umberto; Caio, Giacomo; Boschetti, Elisa; Giancola, Fiorella; Rhoden, Kerry J; Ruggeri, Eugenio; Paterini, Paola; De Giorgio, Roberto

    2016-09-01

    Although serological tests are useful for identifying celiac disease, it is well established that a minority of celiacs are seronegative. To define the prevalence and features of seronegative compared to seropositive celiac disease, and to establish whether celiac disease is a common cause of seronegative villous atrophy. Starting from 810 celiac disease diagnoses, seronegative patients were retrospectively characterized for clinical, histological and laboratory findings. Of the 810 patients, fourteen fulfilled the diagnostic criteria for seronegative celiac disease based on antibody negativity, villous atrophy, HLA-DQ2/-DQ8 positivity and clinical/histological improvement after gluten free diet. Compared to seropositive, seronegative celiac disease showed a significantly higher median age at diagnosis and a higher prevalence of classical phenotype (i.e., malabsorption), autoimmune disorders and severe villous atrophy. The most frequent diagnosis in the 31 cases with seronegative flat mucosa was celiac disease (45%), whereas other diagnoses were Giardiasis (20%), common variable immunodeficiency (16%) and autoimmune enteropathy (10%). Although rare seronegative celiac disease can be regarded as the most frequent cause of seronegative villous atrophy being characterized by a high median age at diagnosis; a close association with malabsorption and flat mucosa; and a high prevalence of autoimmune disorders. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  18. Characterization of OSL dosimeters for use in dose assessment in Computed Tomography procedures.

    PubMed

    Giansante, Louise; Santos, Josilene C; Umisedo, Nancy K; Terini, Ricardo A; Costa, Paulo R

    2018-03-01

    This study describes the characterization of an Al 2 O 3 :C OSLD (Landauer's Luxel™ tape) for dose evaluation in Computed Tomography. The irradiations were conducted using both a constant potential X-ray equipment and a 64-slice clinical CT scanner, and the readouts were performed using a Risø TL/OSL reader. The following aspects were studied: batch homogeneity, energy response, linearity of dose response, reproducibility, reusability, and effect of uncertainties with the normalization of OSL signals per their response to beta radiation. A group of 330 dosimeters from the 452 irradiated with the same dose presented OSL signals within the interval of 4.7% from the average. The dosimeters presented energy-dependent response in good agreement with results found in the literature. The air kerma response of the OSL signal showed a linear trend for both the constant potential X-ray device and the clinical CT scanner, with differences in their slopes of approximately 10%. Reproducibility, reusability, and effect of beta normalization were analyzed by separating 72 dosimeters in 3 groups. The results obtained in this study together with those of previous works indicate that this type of dosimeter is adequate for dose evaluation in CT clinical applications. Copyright © 2018 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  19. Emergency endoscopic needle-knife precut papillotomy in acute severe cholangitis resulting from impacted common bile duct stones at duodenal papilla.

    PubMed

    Zheng, Mingwei; Liu, Xufeng; Li, Ning; Li, Wei-Zhi

    2018-03-01

    To evaluate the efficacy and safety of emergency endoscopic needle-knife precut papillotomy in acute severe cholangitis resulting from impacted common bile duct stones at duodenal papilla. Between January 2010 and January 2015, 118 cases of acute severe cholangitis with impacted common bile duct stones at the native papilla underwent emergency endoscopic retrograde cholangiopancreatography (ERCP) and early needle-knife precut papillotomy in a tertiary referral center. Precut techniques were performed according to the different locations of stones in the duodenal papilla. Clinical data about therapy and recovery of the 118 patients were recorded and analyzed. One hundred and eighteen patients underwent emergency ERCP within 24 h after hospitalization, with a total success rate of 100%. The mean operating time was 6.4 ± 4.1 min. Postoperative acute physiology and chronic health evaluation (APACHE) II scores, white blood cell count and liver function improved significantly. The complication rate was 4.2% (5/118); two with hemorrhage and three with acute pancreatitis. There was no procedure-related mortality. Emergency endoscopic needle-knife precut papillotomy is effective and safe for acute severe cholangitis resulting from impacted common bile duct stones at the duodenal papilla. Copyright © 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  20. Chronic viral hepatitis: the histology report.

    PubMed

    Guido, Maria; Mangia, Alessandra; Faa, Gavino

    2011-03-01

    In chronic viral hepatitis, the role of liver biopsy as a diagnostic test has seen a decline, paralleled by its increasing importance for prognostic purposes. Nowadays, the main indication for liver biopsy in chronic viral hepatitis is to assess the severity of the disease, in terms of both necro-inflammation (grade) and fibrosis (stage), which is important for prognosis and therapeutic management. Several scoring systems have been proposed for grading and staging chronic viral hepatitis and there is no a general consensus on the best system to be used in the daily practice. All scoring systems have their drawbacks and all may be affected by sampling and observer variability. Whatever the system used, a histological score is a reductive approach since damage in chronic viral hepatitis is a complex biological process. Thus, scoring systems are not intended to replace the detailed, descriptive, pathology report. In fact, lesions other than those scored for grading and staging may have clinical relevance and should be assessed and reported. This paper aims to provide a systematic approach to the interpretation of liver biopsies obtained in cases of chronic viral hepatitis, with the hope of helping general pathologists in their diagnostic practice. Copyright © 2011 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd.. All rights reserved.

  1. Transition of gastroenterological patients from paediatric to adult care: A position statement by the Italian Societies of Gastroenterology.

    PubMed

    Elli, Luca; Maieron, Roberto; Martelossi, Stefano; Guariso, Graziella; Buscarini, Elisabetta; Conte, Dario; di Giulio, Emilio; Staiano, Annamaria; Barp, Jacopo; Bassotti, Gabrio; Bianco, Maria Antonia; Buri, Luigi; Carrara, Maurizio; Ghidini, Benedetta; Giannini, Olivia; Knafelz, Daniela; Miele, Erasmo; Peralta, Sergio; Riccio, Elisabetta; Tomba, Carolina; Zilli, Maurizio; Guadagnini, Tiziana

    2015-09-01

    In 2013, four Italian Gastroenterological Societies (the Italian Society of Paediatric Gastroenterology, Hepatology and Nutrition, the Italian Society of Hospital Gastroenterologists and Endoscopists, the Italian Society of Endoscopy, and the Italian Society of Gastroenterology) formed a joint panel of experts with the aim of preparing an official statement on transition medicine in Gastroenterology. The transition of adolescents from paediatric to adult care is a crucial moment in managing chronic diseases such as celiac disease, inflammatory bowel disease, liver disease and liver transplantation. Improved medical treatment and availability of new drugs and surgical techniques have improved the prognosis of many paediatric disorders, prolonging survival, thus making the transition to adulthood possible and necessary. An inappropriate transition or the incomplete transmission of data from the paediatrician to the adult Gastroenterologist can dramatically decrease compliance to treatment and prognosis of a young patient, particularly in the case of severe disorders. For these reasons, the Italian gastroenterological societies decided to develop an official shared transition protocol. The resulting document discusses the factors influencing the transition process and highlights the main points to accomplish to optimize compliance and prognosis of gastroenterological patients during the difficult transition from childhood to adolescence and adulthood. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  2. Polymer gel dosimeters for pretreatment radiotherapy verification using the three-dimensional gamma evaluation and pass rate maps.

    PubMed

    Hsieh, Ling-Ling; Shieh, Jiunn-I; Wei, Li-Ju; Wang, Yi-Chun; Cheng, Kai-Yuan; Shih, Cheng-Ting

    2017-05-01

    Polymer gel dosimeters (PGDs) have been widely studied for use in the pretreatment verification of clinical radiation therapy. However, the readability of PGDs in three-dimensional (3D) dosimetry remain unclear. In this study, the pretreatment verifications of clinical radiation therapy were performed using an N-isopropyl-acrylamide (NIPAM) PGD, and the results were used to evaluate the performance of the NIPAM PGD on 3D dose measurement. A gel phantom was used to measure the dose distribution of a clinical case of intensity-modulated radiation therapy. Magnetic resonance imaging scans were performed for dose readouts. The measured dose volumes were compared with the planned dose volume. The relative volume histograms showed that relative volumes with a negative percent dose difference decreased as time elapsed. Furthermore, the histograms revealed few changes after 24h postirradiation. For the 3%/3mm and 2%/2mm criteria, the pass rates of the 12- and 24-h dose volumes were higher than 95%, respectively. This study thus concludes that the pass rate map can be used to evaluate the dose-temporal readability of PGDs and that the NIPAM PGD can be used for clinical pretreatment verifications. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  3. Entropy as a collective variable

    NASA Astrophysics Data System (ADS)

    Parrinello, Michele

    Sampling complex free energy surfaces that exhibit long lived metastable states separated by kinetic bottlenecks is one of the most pressing issues in the atomistic simulations of matter. Not surprisingly many solutions to this problem have been suggested. Many of them are based on the identification of appropriate collective variables that span the manifold of the slow varying modes of the system. While much effort has been put in devising and even constructing on the fly appropriate collective variables there is still a cogent need of introducing simple, generic, physically transparent, and yet effective collective variables. Motivated by the physical observation that in many case transitions between one metastable state and another result from a trade off between enthalpy and entropy we introduce appropriate collective variables that are able to represent in a simple way these two physical properties. We use these variables in the context of the recently introduced variationally enhanced sampling and apply it them with success to the simulation of crystallization from the liquid and to conformational transitions in protein. Department of Chemistry and Applied Biosciences, ETH Zurich, and Facolta' di Informatica, Istituto di Scienze Computazionali, Universita' della Svizzera Italiana, Via G. Buffi 13, 6900 Lugano, Switzerland.

  4. A decade of drilling developments pays off in offshore Italian oil field

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Dussert, P.; Santoro, G.; Soudet, H.

    1988-02-29

    As the only oil field in the world producing systematically through horizontal wells, Rospo Mare, the Italian oil field in the Adriatic, is s ''first.'' Rospo Mare is an uncommon oil field because the nature of its reservoir and the characteristics of its oil prevent it from being produced through conventional vertical wells. But thanks to horizontal drilling techniques developed since 1977 by Elf Aquitaine and the Institut Francaise du Petrole (IFP), the field was producing 22,00 b/d of crude oil on Jan. 1, 1988. Of this, 19,000 b/d came from six horizontal wells and 3,000 b/d from three verticalmore » or deviated wells. For comparison, on Jan. 1, 1987, the field produced only 4,300 b/d through a single horizontal well, two vertical wells, and one deviated well. Rospo Mare is a joint venture of Elf Italiana (61.7%), the operator, and AGIP (38.3%). A description in this article of the challenge of Rospo Mare and the results to date set the stage for a series of articles in coming weeks. They will cover the state of the art in not only drilling, but horizontal completions, production, log interpretation, and other aspects of this major oil industry technology.« less

  5. Three months of simvastatin therapy vs. placebo for severe portal hypertension in cirrhosis: A randomized controlled trial.

    PubMed

    Pollo-Flores, Priscila; Soldan, Mônica; Santos, Ubiratan Cassano; Kunz, Danielle Gobbi; Mattos, Denise Espindola; da Silva, Alexandre Cerqueira; Marchiori, Roberta Cabral; Rezende, Guilherme Ferreira da Motta

    2015-11-01

    Pleiotropic effects of statins decrease intrahepatic resistance and portal hypertension. We evaluated the effects of simvastatin on hepatic venous pressure gradient (HVPG) and azygos vein blood flow in cirrhotic patients. A 3-month prospective, randomized, triple-blind trial with simvastatin (40 mg/day) vs. placebo was conducted in patients with cirrhotic portal hypertension. HVPG and azygos blood flow, measured by colour Doppler endoscopic ultrasound, were assessed before and after treatment. The primary endpoint was a decrease in the HVPG of at least 20% from baseline or to ≤12 mmHg after the treatment. 34 patients were prospectively enrolled, and 24 completed the protocol. In the simvastatin group 6/11 patients (55%) presented a clinically relevant decrease in the HVPG; no decrease was observed in the placebo group (p=0.036). Patients with medium/large oesophageal varices and previous variceal bleeding had a higher response rate to simvastatin. HVPG and azygos blood flow values were not correlated. No significant adverse events occurred. Simvastatin lowers portal pressure and may even improve liver function. The haemodynamic effect appears to be more evident in patients with severe portal hypertension. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  6. The role of emergency neurology in Italy: outcome of a consensus meeting for a Intersociety position.

    PubMed

    Micieli, Giuseppe; De Falco, Fabrizio A; Consoli, Domenico; Inzitari, Domenico; Sterzi, Roberto; Tedeschi, Gioacchino; Toni, Danilo

    2012-04-01

    A possible definition of clinical, educational and organizing aspects of emergency neurology in Italy is reported in this position paper of Emergency Neurology Intersociety Group, created in 2008 among the two neurological Societies in Italy: Società Italiana di Neurologia and Società di Neuroscienze Ospedaliere. The aim of this Group has been the evaluation of the role of neurologist in the emergency setting of Italian hospitals, as well as of the description of different scenarios in which a ward dedicated to a semi-intensive care of neurological emergencies could have a role in the actual organization of academic or general hospitals in our Country. The actual great relevance of neurologist activity in the inpatients treatment, in fact, is actually misleaded as it is the considerable significance of neurological expertise, techniques and support in hospital care pathways also involving neurological manifestations throughout the course of other diseases. Finally, the possible contents of educational programs orienting neurological specialty towards a better comprehension and management of emergency neurological problems either in terms of specific formation or of techniques to be learned by emergency neurologist, are reported as a results of the Consensus Workshop hold in Castiglioncello (LI) in September 12th, 2009.

  7. On-line integration of computer controlled diagnostic devices and medical information systems in undergraduate medical physics education for physicians.

    PubMed

    Hanus, Josef; Nosek, Tomas; Zahora, Jiri; Bezrouk, Ales; Masin, Vladimir

    2013-01-01

    We designed and evaluated an innovative computer-aided-learning environment based on the on-line integration of computer controlled medical diagnostic devices and a medical information system for use in the preclinical medical physics education of medical students. Our learning system simulates the actual clinical environment in a hospital or primary care unit. It uses a commercial medical information system for on-line storage and processing of clinical type data acquired during physics laboratory classes. Every student adopts two roles, the role of 'patient' and the role of 'physician'. As a 'physician' the student operates the medical devices to clinically assess 'patient' colleagues and records all results in an electronic 'patient' record. We also introduced an innovative approach to the use of supportive education materials, based on the methods of adaptive e-learning. A survey of student feedback is included and statistically evaluated. The results from the student feedback confirm the positive response of the latter to this novel implementation of medical physics and informatics in preclinical education. This approach not only significantly improves learning of medical physics and informatics skills but has the added advantage that it facilitates students' transition from preclinical to clinical subjects. Copyright © 2011 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  8. Medical Physics: Forming and testing solutions to clinical problems.

    PubMed

    Tsapaki, Virginia; Bayford, Richard

    2015-11-01

    According to the European Federation of Organizations for Medical Physics (EFOMP) policy statement No. 13, "The rapid advance in the use of highly sophisticated equipment and procedures in the medical field increasingly depends on information and communication technology. In spite of the fact that the safety and quality of such technology is vigorously tested before it is placed on the market, it often turns out that the safety and quality is not sufficient when used under hospital working conditions. To improve safety and quality for patient and users, additional safeguards and related monitoring, as well as measures to enhance quality, are required. Furthermore a large number of accidents and incidents happen every year in hospitals and as a consequence a number of patients die or are injured. Medical Physicists are well positioned to contribute towards preventing these kinds of events". The newest developments related to this increasingly important medical speciality were presented during the 8th European Conference of Medical Physics 2014 which was held in Athens, 11-13 September 2014 and hosted by the Hellenic Association of Medical Physicists (HAMP) in collaboration with the EFOMP and are summarized in this issue. Copyright © 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  9. The origins of medical physics.

    PubMed

    Duck, Francis A

    2014-06-01

    The historical origins of medical physics are traced from the first use of weighing as a means of monitoring health by Sanctorius in the early seventeenth century to the emergence of radiology, phototherapy and electrotherapy at the end of the nineteenth century. The origins of biomechanics, due to Borelli, and of medical electricity following Musschenbroek's report of the Leyden Jar, are included. Medical physics emerged as a separate academic discipline in France at the time of the Revolution, with Jean Hallé as its first professor. Physiological physics flowered in Germany during the mid-nineteenth century, led by the work of Adolf Fick. The introduction of the term medical physics into English by Neil Arnott failed to accelerate its acceptance in Britain or the USA. Contributions from Newton, Euler, Bernoulli, Nollet, Matteucci, Pelletan, Gavarret, d'Arsonval, Finsen, Röntgen and others are noted. There are many origins of medical physics, stemming from the many intersections between physics and medicine. Overall, the early nineteenth-century definition of medical physics still holds today: 'Physics applied to the knowledge of the human body, to its preservation and to the cure of its illnesses'. Copyright © 2014 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  10. The evaluation of the neutron dose equivalent in the two-bend maze.

    PubMed

    Tóth, Á Á; Petrović, B; Jovančević, N; Krmar, M; Rutonjski, L; Čudić, O

    2017-04-01

    The purpose of this study was to explore the effect of the second bend of the maze, on the neutron dose equivalent, in the 15MV linear accelerator vault, with two bend maze. These two bends of the maze were covered by 32 points where the neutron dose equivalent was measured. There is one available method for estimation of the neutron dose equivalent at the entrance door of the two bend maze which was tested using the results of the measurements. The results of this study show that the neutron equivalent dose at the door of the two bend maze was reduced almost three orders of magnitude. The measured TVD in the first bend (closer to the inner maze entrance) is about 5m. The measured TVD result is close to the TVD values usually used in the proposed models for estimation of neutron dose equivalent at the entrance door of the single bend maze. The results also determined that the TVD in the second bend (next to the maze entrance door) is significantly lower than the TVD values found in the first maze bend. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  11. A new isocentric technique for exact geometric matching in the radiotherapy of the breast and ipsilateral supraclavicular fossa using dual asymmetric jaws.

    PubMed

    Romeo, Nando

    2012-10-01

    In some clinical situations breast or chest wall radiotherapy for cancer is given in association with supraclavicular fossa irradiation. Often the treatment is delivered by two tangential fields to the breast or chest wall and an anterior field that irradiates the supraclavicular region. The tissue between the breast or chest wall and the supraclavicular region may be under or overdosed, because of the junction between the two tangential fields and the anterior field. To present a new isocentric technique for exact geometric matching between the two tangential fields and the anterior field. Patients are positioned with both arms raised. Using three-dimensional trigonometry, two half-fields, with isocenter between the breast and the supraclavicular region, are easily matched. The tangential fields have a collimator rotation to protect the lung without additional shielding. The correct gantry, collimator and couch positions are defined for the anterior field to match the tangential fields. A general formula for exact geometric matching in radiotherapy of the breast and supraclavicular fossa is presented. The method does not require additional shielding to eliminate divergence other than the four independent jaws. The result is simple to implement in modern delivery facilities. Copyright © 2011 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  12. Opinion of gastroenterologists towards quality assurance in endoscopy.

    PubMed

    de Jonge, Vincent; Kuipers, Ernst J; van Leerdam, Monique E

    2011-03-01

    Quality assurance has become an important issue. Many societies are adopting quality assurance programs in order to monitor and improve quality of care. To assess the opinion of gastroenterologists towards quality assurance on the endoscopy department. A survey was sent to all gastroenterologists (n=319) in the Netherlands. It assessed their opinion on a quality assurance program for endoscopy units, including its design, logistics, and content. 200 gastroenterologists (63%) completed the questionnaire. 95% had a positive opinion towards quality assurance and 67% supposed an increase in quality. 28% assumed a negative impact on the time available for patient contact by introducing a quality assurance program and 35% that the capacity would decrease. A negative attitude towards disclosure of results to insurance companies (23%) and media (53%) was reported. Female gastroenterologists were less positive to share the results with other stakeholders (p<0.05). Most important quality measurements were assessment of complications (97%), standardised reporting (96%), and adequate patient information (95%). Gastroenterologists have a positive attitude towards quality assurance. However, concerns do exist about time investment and disclosure of results to others. Information provision and procedure characteristics were considered the most important aspects of quality assurance. Copyright © 2010 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  13. The intelligent, painless, "germ-free" colonoscopy: A Columbus' egg for increasing population adherence to colorectal cancer screening?

    PubMed

    Perri, Francesco; Iacobellis, Angelo; Gentile, Marco; Tumino, Emanuele; Andriulli, Angelo

    2010-12-01

    Colorectal cancer (CRC) represents a major cause of morbidity and mortality. Although it is widely accepted that CRC screening in average risk populations lowers CRC incidence and mortality, a disappointedly low adherence rate to both faecal occult blood testing and colonoscopy-based screening programs has been observed in Italy and in other European countries. Main reasons for the low acceptance of colonoscopy-based CRC screening has been ascribed to lack of recommendations given by general practitioners, fear of discomfort or complications, embarrassment, and avoidance of unpleasant preparation. New advances in endoscopic technology such as colon capsule and robotic colonoscopy might represent the ideal tool for CRC screening since they reduce or eliminate procedure-related pain and discomfort. Moreover, no disinfection between procedures is required. Motion of the new probes along the gastrointestinal tract is achieved either in passive modality by utilizing the gut peristalsis (colon capsule) or in active "intelligent" modality by means of computer-assisted propulsion (robotic colonoscopy). In this review, the preliminary clinical results obtained with the new devices are summarized. It is expected that the new instruments will be soon available in clinical practice with the hope of increasing adherence to CRC screening programs. Copyright © 2010 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  14. Conditional net survival: Relevant prognostic information for colorectal cancer survivors. A French population-based study.

    PubMed

    Drouillard, Antoine; Bouvier, Anne-Marie; Rollot, Fabien; Faivre, Jean; Jooste, Valérie; Lepage, Côme

    2015-07-01

    Traditionally, survival estimates have been reported as survival from the time of diagnosis. A patient's probability of survival changes according to time elapsed since the diagnosis and this is known as conditional survival. The aim was to estimate 5-year net conditional survival in patients with colorectal cancer in a well-defined French population at yearly intervals up to 5 years. Our study included 18,300 colorectal cancers diagnosed between 1976 and 2008 and registered in the population-based digestive cancer registry of Burgundy (France). We calculated conditional 5-year net survival, using the Pohar Perme estimator, for every additional year survived after diagnosis from 1 to 5 years. The initial 5-year net survival estimates varied between 89% for stage I and 9% for advanced stage cancer. The corresponding 5-year net survival for patients alive after 5 years was 95% and 75%. Stage II and III patients who survived 5 years had a similar probability of surviving 5 more years, respectively 87% and 84%. For survivors after the first year following diagnosis, five-year conditional net survival was similar regardless of age class and period of diagnosis. For colorectal cancer survivors, conditional net survival provides relevant and complementary prognostic information for patients and clinicians. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  15. Pathology report assessment of incidental gallbladder carcinoma diagnosed from cholecystectomy specimens: results of a French multicentre survey.

    PubMed

    Chatelain, Denis; Fuks, David; Farges, Olivier; Attencourt, Christophe; Pruvot, François René; Regimbeau, Jean-Marc

    2013-12-01

    To assess the accuracy of pathology reports on gallbladder specimens from patients operated on for incidental gallbladder carcinoma. Demographic data, details on pathological reports including gross and microscopic features section were recorded in 100 selected patients with incidental gallbladder carcinoma diagnosed from 2004 to 2007. Pathology reports had a conventional format in 93% of cases, without any standardization. Turnaround time ranged from 1 to 35 days. Frozen sections were performed in 20% of cases. The reports failed to give information on prognostic histological factors: exact tumour site (missing in 55% of cases), depth of tumour infiltration within the gallbladder wall (missing in 10%), surgical margins (missing in 40% for the cystic duct margin), tumour differentiation (missing in 28%), vascular invasion (missing in 52%) and perineural invasion (missing in 51%). Lymph node status could be assessed in 44% of cases. Distances between the tumour and the cystic duct and circumferential margins were not specified in 68% and 84% of cases. Only 29% of the reports clearly stated the pTNM stage in the conclusion section. The pT stage with margin status and tumour site was only mentioned in 30% of the reports. Pathology reports on gallbladder carcinoma from participating centres frequently lacked important information on key prognostic histological factors. Copyright © 2013 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  16. The High-Level Interface Definitions in the ASTRI/CTA Mini Array Software System (MASS)

    NASA Astrophysics Data System (ADS)

    Conforti, V.; Tosti, G.; Schwarz, J.; Bruno, P.; Cefal‘A, M.; Paola, A. D.; Gianotti, F.; Grillo, A.; Russo, F.; Tanci, C.; Testa, V.; Antonelli, L. A.; Canestrari, R.; Catalano, O.; Fiorini, M.; Gallozzi, S.; Giro, E.; Palombara, N. L.; Leto, G.; Maccarone, M. C.; Pareschi, G.; Stringhetti, L.; Trifoglio, M.; Vercellone, S.; Astri Collaboration; Cta Consortium

    2015-09-01

    ASTRI (Astrofisica con Specchi a Tecnologia Replicante Italiana) is a Flagship Project funded by the Italian Ministry of Education, University and Research, and led by INAF, the Italian National Institute of Astrophysics. Within this framework, INAF is currently developing an end-to-end prototype, named ASTRI SST-2M, of a Small Size Dual-Mirror Telescope for the Cherenkov Telescope Array, CTA. A second goal of the project is the realization of the ASTRI/CTA mini-array, which will be composed of seven SST-2M telescopes placed at the CTA Southern Site. The ASTRI Mini Array Software System (MASS) is designed to support the ASTRI/CTA mini-array operations. MASS is being built on top of the ALMA Common Software (ACS) framework, which provides support for the implementation of distributed data acquisition and control systems, and functionality for log and alarm management, message driven communication and hardware devices management. The first version of the MASS system, which will comply with the CTA requirements and guidelines, will be tested on the ASTRI SST-2M prototype. In this contribution we present the interface definitions of the MASS high level components in charge of the ASTRI SST-2M observation scheduling, telescope control and monitoring, and data taking. Particular emphasis is given to their potential reuse for the ASTRI/CTA mini-array.

  17. Sarcopenia is a risk factor for elevated aminotransferase in men independently of body mass index, dietary habits, and physical activity.

    PubMed

    Yoo, Ki Deok; Jun, Dae Won; Lee, Kang Nyeong; Lee, Hang Lak; Lee, Oh Young; Yoon, Byung Chul; Choi, Ho Soon

    2015-04-01

    Aminotransferase activity is a surrogate marker of liver injury showing strong correlations with obesity and metabolic syndrome. However, elevated aminotransferase activity is not uncommon in non-obese and non-alcoholic patients in clinical practice. To examine the relationship between sarcopenia and aminotransferase activity in a large population-based cohort. Data from the Korean National Health and Nutrition Examinations were used. A total of 13,431 subjects were included. A whole-body dual X-ray absorptiometry scan was performed on each patient to measure total and regional muscle mass. Appendicular skeletal muscle mass indices were also obtained. The prevalence of sarcopenia was significantly higher in the group with elevated aminotransferase levels than in the normal liver enzyme group (males: 26.5% vs. 16.9%; females: 38.3% vs. 22.1%, p<0.05). The skeletal muscle index was negatively correlated with most cardiometabolic risk factors, including fasting glucose and cholesterol levels. The frequency of elevated aminotransferase increased in male patients with sarcopenia after adjusting for potential confounding factors including age, body mass index, fasting glucose level, dietary, and exercise habits. However, the correlation was no longer observed in women after adjusting for body mass index. Sarcopenia is a risk factor for elevated aminotransferase in men, independently of body mass index, dietary habits, and physical activity. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  18. Helicobacter infections with rare bacteria or minimal gastritis: Expecting the unexpected.

    PubMed

    Glickman, Jonathan N; Noffsinger, Amy; Nevin, Daniel T; Ray, Mukunda; Lash, Richard H; Genta, Robert M

    2015-07-01

    The routine use of special stains for detection of Helicobacter remains controversial. To determine the frequency of histologically atypical Helicobacter infection. All gastric biopsies received at a large pathology reference laboratory over a 6-month period were stained for Helicobacter, and the histologic and clinicopathologic parameters evaluated. Amongst 7663 Helicobacter-positive biopsies, 823 (10.7%) did not show typical chronic active gastritis with numerous Helicobacter organisms, and were therefore considered histologically atypical. Rare Helicobacter pylori organisms accounted for 58.0% of all atypical infections; the next most common atypical Helicobacter infection was that with minimal or no gastric inflammation (23.3% of atypical infections). Patients in these groups did not differ demographically from those with other forms of atypical or typical Helicobacter infection, although a small subgroup (6%) was more likely to have had a previously treated infection. In many of these atypical infections, Helicobacter would not have been suspected based on the histologic findings alone, and would have been missed without routine special stains. Performing a sensitive stain could prevent additional testing and allow prompt treatment of the affected patients, thus substantially reducing the risk for peptic ulcer and gastric cancer and preventing the transmission of the infection to family members. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  19. Serum transglutaminase 3 antibodies correlate with age at celiac disease diagnosis.

    PubMed

    Salmi, Teea T; Kurppa, Kalle; Hervonen, Kaisa; Laurila, Kaija; Collin, Pekka; Huhtala, Heini; Saavalainen, Päivi; Sievänen, Harri; Reunala, Timo; Kaukinen, Katri

    2016-06-01

    Transglutaminase (TG)2 is the autoantigen in celiac disease, but also TG3 antibodies have been detected in the serum of celiac disease patients. To investigate the correlations between serum TG3 antibodies and clinical and histological manifestations of celiac disease and to assess gluten-dependency of TG3 antibodies. Correlations between serum TG3 antibody levels measured from 119 adults and children with untreated coeliac disease and the demographic data, clinical symptoms, celiac antibodies, histological data and results of laboratory tests and bone mineral densities were tested. TG3 antibodies were reinvestigated in 97 celiac disease patients after 12 months on a gluten-free diet (GFD). TG3 antibody titers were shown to correlate with the age at celiac disease diagnosis. Further, negative correlation with TG3 antibodies and intestinal γδ+ cells at diagnosis and on GFD was detected. Correlations were not detected with the clinical manifestation of celiac disease, TG2 or endomysial autoantibodies, laboratory values, severity of mucosal villous atrophy, associated diseases or complications. TG3 antibody titers decreased on GFD in 56% of the TG3 antibody positive patients. Serum TG3 antibody positivity in celiac disease increases as the diagnostic age rises. TG3 antibodies did not show similar gluten-dependency as TG2 antibodies. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  20. Gastrointestinal symptoms and quality of life in screen-detected celiac disease.

    PubMed

    Paavola, Aku; Kurppa, Kalle; Ukkola, Anniina; Collin, Pekka; Lähdeaho, Marja-Leena; Huhtala, Heini; Mäki, Markku; Kaukinen, Katri

    2012-10-01

    Active serological screening has proved an effective means of increasing the diagnostic rate in celiac disease. The effects of a long-term gluten-free diet on possible gastrointestinal symptoms and psychological well-being in screen-detected patients have nevertheless remained obscure. Abdominal symptoms and quality of life were measured in a large cohort of treated screen-detected celiac adults. Comparisons were made with corresponding symptom-detected patients and with non-celiac controls. Dietary adherence was assessed both by structured interview and by serological testing. In both screen- and symptom-detected celiac groups, 88% of the patients were adherent. On a diet, both screen- and symptom-detected patients reported significantly more gastrointestinal symptoms than non-celiac controls. Those screen-detected patients who reported having no symptoms at the time of diagnosis, also remained asymptomatic during the diet. Despite persistent symptoms, psychological well-being in screen-detected patients was comparable with that in non-celiac controls, whereas the symptom-detected patients showed lower quality of life. Long-term treated screen-detected celiac patients, especially women, suffer from gastrointestinal symptoms on a gluten free diet similarly to symptom-detected patients. However, despite a similar frequency of persistent symptoms, the quality of life was unimpaired in the screen found, but remained low in the symptom-detected group. Copyright © 2012 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  1. Serial C-reactive protein measurements in patients treated for suspected abdominal tuberculosis.

    PubMed

    Sharma, Vishal; Mandavdhare, Harshal S; Lamoria, Sandeep; Singh, Harjeet; Kumar, Amit

    2018-06-01

    Response to treatment is often used as a criterion for the diagnosis of abdominal tuberculosis. To determine utility of serum C reactive protein (CRP) in assessment of response to anti-tubercular therapy (ATT) in abdominal tuberculosis (ATB). We retrospectively analysed the database of patients with suspected ATB (intestinal and/or peritoneal). Response to ATT was assessed using subjective and objective (ulcer healing or ascites resolution) parameters. Serum CRP levels were estimated at baseline and then at 2 months and 6 months of ATT. One hundred and twelve patients were included in the analysis. The mean age was 36.57 ± 15.04 years and 54.46% (61/112) were males. Sixty-six patients (58.92%) had intestinal, 28 (25%) had peritoneal and 18 (16.07%) had both. Eleven patients had a normal CRP at baseline while 101 had elevated levels. The CRP levels declined in 94 patients at 6 months. One patient with increased levels at 2 months had multi-drug resistant TB. Seven patients showed elevated or plateaued CRP levels on follow-up. These patients had underlying Crohn's disease (3 patients), peritoneal carcinomatosis (1), inter-current infection (1), lymphoma (1) and non-healing ulcers (1). Lack of decline in CRP may suggest alternative diagnosis or drug-resistant tuberculosis. Copyright © 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  2. Nomenclature and diagnosis of gluten-related disorders: A position statement by the Italian Association of Hospital Gastroenterologists and Endoscopists (AIGO).

    PubMed

    Elli, Luca; Villalta, Danilo; Roncoroni, Leda; Barisani, Donatella; Ferrero, Stefano; Pellegrini, Nicoletta; Bardella, Maria Teresa; Valiante, Flavio; Tomba, Carolina; Carroccio, Antonio; Bellini, Massimo; Soncini, Marco; Cannizzaro, Renato; Leandro, Gioacchino

    2017-02-01

    "Gluten-related disorders" is a term that encompasses different diseases induced by the ingestion of gluten-containing food. Because of their incidence the scientific community has been intensively studying them. To support gastroenterologists with a correct nomenclature and diagnostic approach to gluten-related disorders in adulthood. The Italian Association of Hospital Gastroenterologists and Endoscopists (AIGO) commissioned a panel of experts to prepare a position statement clarifying the nomenclature and diagnosis of gluten-related disorders, focusing on those of gastroenterological interest. Each member was assigned a task and levels of evidence/recommendation have been proposed. The panel identified celiac disease, wheat allergy and non-celiac gluten sensitivity as the gluten-related disorders of gastroenterological interest. Celiac disease has an autoimmune nature, wheat allergy is IgE-mediated while the pathogenesis of non-celiac gluten sensitivity is still unknown as is the case of non-IgE mediated allergy. Diagnosis should start with the serological screening for celiac disease and wheat allergy. In case of normal values, the response to a gluten-free diet should be evaluated and a confirmatory blind food challenge carried out. Gluten-related disorders are clinically heterogeneous. Patients should be carefully managed and specific protocols applied for a correct differential diagnosis in gastroenterological setting. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  3. A strategic development model for the role of the biomedical physicist in the education of healthcare professionals in Europe.

    PubMed

    Caruana, C J; Wasilewska-Radwanska, M; Aurengo, A; Dendy, P P; Karenauskaite, V; Malisan, M R; Mattson, S; Meijer, J H; Mihov, D; Mornstein, V; Rokita, E; Vano, E; Weckstrom, M; Wucherer, M

    2012-10-01

    This is the third of a series of articles targeted at biomedical physicists providing educational services to other healthcare professions, whether in a university faculty of medicine/health sciences or otherwise (e.g., faculty of science, hospital-based medical physics department). The first paper identified the past and present role of the biomedical physicist in the education of the healthcare professions and highlighted issues of concern. The second paper reported the results of a comprehensive SWOT (strengths, weaknesses, opportunities, threats) audit of that role. In this paper we present a strategy for the development of the role based on the outcomes of the SWOT audit. The research methods adopted focus on the importance of strategic planning at all levels in the provision of educational services. The analytical process used in the study was a pragmatic blend of the various theoretical frameworks described in the literature on strategic planning research as adapted for use in academic role development. Important results included identification of the core competences of the biomedical physicist in this context; specification of benchmarking schemes based on experiences of other biomedical disciplines; formulation of detailed mission and vision statements; gap analysis for the role. The paper concludes with a set of strategies and specific actions for gap reduction. Copyright © 2011 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  4. Comparison of efficacy and safety of levofloxacin-containing versus standard sequential therapy in eradication of Helicobacter pylori infection in Korea.

    PubMed

    Lee, Hyuk; Hong, Sung Noh; Min, Byung-Hoon; Lee, Jun Haeng; Rhee, Poong-Lyul; Lee, Yong Chan; Kim, Jae J

    2015-02-01

    Declining of eradication rates for Helicobacter pylori in Korea may be partly from the increasing prevalence of antibiotic resistance, especially clarithromycin resistance. To compare the efficacy and the safety of using 10-day standard sequential therapy and levofloxacin-containing sequential therapy as a first-line treatment for Helicobacter pylori eradication in Korea. A total of 200 patients with proven Helicobacter pylori infection randomly received 10-day standard sequential therapy (n = 100) or levofloxacin-containing sequential therapy (n = 100). The standard sequential therapy group received rabeprazole and amoxicillin for 5 days, followed by rabeprazole, clarithromycin, and metronidazole for 5 more days. The levofloxacin-containing sequential therapy group was treated with rabeprazole and amoxicillin for 5 days, followed by rabeprazole, levofloxacin, and metronidazole for 5 more days. Intention-to-treat eradication rates were 79.0% and 78.0% for groups of standard sequential and levofloxacin-containing sequential therapy, respectively (P = 0.863). Per-protocol eradication rates were 84.9% and 81.3%, respectively, for these two therapies (P = 0.498). There were no significant differences between the groups in regard to the eradication rates and adverse events. The 10-day levofloxacin-containing sequential regimen and the standard sequential regimen showed the similar eradication rates of Helicobacter pylori in Korea. Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  5. Mitochondrial DNA variants of Podolian cattle breeds testify for a dual maternal origin.

    PubMed

    Di Lorenzo, Piera; Lancioni, Hovirag; Ceccobelli, Simone; Colli, Licia; Cardinali, Irene; Karsli, Taki; Capodiferro, Marco Rosario; Sahin, Emine; Ferretti, Luca; Ajmone Marsan, Paolo; Sarti, Francesca Maria; Lasagna, Emiliano; Panella, Francesco; Achilli, Alessandro

    2018-01-01

    Over the past 15 years, 300 out of 6000 breeds of all farm animal species identified by the Food and Agriculture Organization of the United Nations (FAO) have gone extinct. Among cattle, many Podolian breeds are seriously endangered in various European areas. Podolian cattle include a group of very ancient European breeds, phenotypically close to the aurochs ancestors (Bos primigenius). The aim of the present study was to assess the genetic diversity of Podolian breeds and to reconstruct their origin. The mitochondrial DNA (mtDNA) control-regions of 18 Podolian breeds have been phylogenetically assessed. Nine non-Podolian breeds have been also included for comparison. The overall analysis clearly highlights some peculiarities in the mtDNA gene pool of some Podolian breeds. In particular, a principal component analysis point to a genetic proximity between five breeds (Chianina, Marchigiana, Maremmana, Podolica Italiana and Romagnola) reared in Central Italy and the Turkish Grey. We here propose the suggestive hypothesis of a dual ancestral contribution to the present gene pool of Podolian breeds, one deriving from Eastern European cattle; the other arising from the arrival of Middle Eastern cattle into Central Italy through a different route, perhaps by sea, ferried by Etruscan boats. The historical migration of Podolian cattle from North Eastern Europe towards Italy has not cancelled the mtDNA footprints of this previous ancient migration.

  6. Different Antibiotic No Culture Eradicating (DANCE) strategy: an easy way to manage H. pylori eradication.

    PubMed

    Roccarina, Davide; Franceschi, Francesco; Zocco, Maria Assunta; Garcovich, Matteo; Gasbarrini, Giovanni; Gasbarrini, Antonio

    2012-11-01

    Treatment of Helicobacter pylori infection is becoming a very relevant problem especially in industrialized Countries. Although different therapeutic regimens are currently available, treatment failure remains a growing problem in daily medical practice. Several factors could play a role in the eradication failure, but the most relevant are antibiotic resistance and patient's compliance. While Helicobacter pylori resistance to amoxicillin is rare, clarithromycin and metronidazole resistance varies significantly from close to zero up to 25%. However, metronidazole in vitro resistance exhibits a lower impact on eradication success because resistance in vitro does not reflect that in vivo. Specific guidelines have then been published, mostly based on antibiotic resistance among different geographic areas. Basically, first-line and second-line regimens have been well defined; concerning third-line treatment Maastricht III guidelines suggest to adopt a culture-based approach. Culture is, however, expensive, invasive and available only in few specialized centres. An alternative approach may be to use an empirical strategy, based on the avoidance of repeating similar eradicating schemes in the same patients during the course of different eradicating regimens. For this approach we propose the acronym DANCE (Different Antibiotic No Culture Eradicating) strategy. When correctly applied, this approach showed to reach successful eradication in up to 99.5% of Helicobacter pylori-positive patients. Copyright © 2012 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  7. Transperineal ultrasonography: First level exam in IBD patients with perianal disease.

    PubMed

    Terracciano, Fulvia; Scalisi, Giuseppe; Bossa, Fabrizio; Scimeca, Daniela; Biscaglia, Giuseppe; Mangiacotti, Michele; Valvano, Maria Rosa; Perri, Francesco; Simeone, Anna; Andriulli, Angelo

    2016-08-01

    A pelvic magnetic resonance imaging (MRI) represents the front-line method for evaluating perianal disease in patients with inflammatory bowel disease (IBD). Recently, transperineal ultrasonography (TPUS) has been proposed as a simple, safe, time-sparing and useful diagnostic technique to assess different pathological conditions of the pelvic floor. The aim of this prospective single centre study was to evaluate the accuracy of TPUS versus MRI for the detection and classification of perineal disease in IBD patients. From November 2013 to November 2014, 28 IBD patients underwent either TPUS or MRI. Fistulae and abscesses were classified according to Parks' and AGA's classification methods. A concordance was assessed by k statistics. Overall, 33 fistulae and 8 abscesses were recognized by TPUS (30 and 7 by MRI, respectively). The agreement between TPUS and MRI was 75% according to Parks' classification (k=0.67) and 86% according to AGA classification (k=0.83), while it was 36% (k=0.34) for classifying abscesses. TPUS proved to be as accurate as MRI for detecting superficial and small abscesses and for classifying perianal disease. Both examinations may be performed at the initial presentation of the patient, but TPUS is a cheaper, time-sparing procedure. The optimal use of TPUS might be in follow-up patients. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  8. Community-acquired Clostridium difficile infection in children: A retrospective study.

    PubMed

    Borali, Elena; Ortisi, Giuseppe; Moretti, Chiara; Stacul, Elisabetta Francesca; Lipreri, Rita; Gesu, Giovanni Pietro; De Giacomo, Costantino

    2015-10-01

    Community acquired-Clostridium difficile infection (CDI) has increased also in children in the last years. To determine the incidence of community-acquired CDI and to understand whether Clostridium difficile could be considered a symptom-triggering pathogen in infants. A five-year retrospective analysis (January 2007-December 2011) of faecal specimens from 124 children hospitalized in the Niguarda Ca' Granda Hospital for prolonged or muco-haemorrhagic diarrhoea was carried out. Stool samples were evaluated for common infective causes of diarrhoea and for Clostridium difficile toxins. Patients with and without CDI were compared for clinical characteristics and known risk factors for infection. Twenty-two children with CDI were identified in 5 years. An increased incidence of community-acquired CDI was observed, ranging from 0.75 per 1000 hospitalizations in 2007 to 9.8 per 1000 hospitalizations in 2011. Antimicrobial treatment was successful in all 19 children in whom it was administered; 8/22 CDI-positive children were younger than 2 years. No statistically significant differences in clinical presentation were observed between patients with and without CDI, nor in patients with and without risk factors for CDI. Our study shows that Clostridium difficile infection is increasing and suggests a possible pathogenic role in the first 2 years of life. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  9. Association between oral habits, mouth breathing and malocclusion.

    PubMed

    Grippaudo, C; Paolantonio, E G; Antonini, G; Saulle, R; La Torre, G; Deli, R

    2016-10-01

    The ratio of bad habits, mouth breathing and malocclusion is an important issue in view of prevention and early treatment of disorders of the craniofacial growth. While bad habits can interfere with the position of the teeth and normal pattern of skeletal growth, on the other hand obstruction of the upper airway, resulting in mouth breathing, changes the pattern of craniofacial growth causing malocclusion. Our crosssectional study, carried out on 3017 children using the ROMA index, was developed to verify if there was a significant correlation between bad habits/mouth breathing and malocclusion. The results showed that an increase in the degree of the index increases the prevalence of bad habits and mouth breathing, meaning that these factors are associated with more severe malocclusions. Moreover, we found a significant association of bad habits with increased overjet and openbite, while no association was found with crossbite. Additionally, we found that mouth breathing is closely related to increased overjet, reduced overjet, anterior or posterior crossbite, openbite and displacement of contact points. Therefore, it is necessary to intervene early on these aetiological factors of malocclusion to prevent its development or worsening and, if already developed, correct it by early orthodontic treatment to promote eugnatic skeletal growth. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale, Rome, Italy.

  10. A phase III study evaluating oral glutamine and transforming growth factor-beta 2 on chemotherapy-induced toxicity in patients with digestive neoplasm.

    PubMed

    Khemissa, Faïza; Mineur, Laurent; Amsellem, Caroline; Assenat, Eric; Ramdani, Mohamed; Bachmann, Patrick; Janiszewski, Chloé; Cristiani, Isabelle; Collin, Fideline; Courraud, Julie; de Forges, Hélène; Dechelotte, Pierre; Senesse, Pierre

    2016-03-01

    Patients with gastrointestinal (GI) cancer are exposed to cachexia, which is highly correlated with chemotherapy-induced side effects. Research suggests that specific immunonutrients could prevent such toxicities. The primary objective of this phase III study was to evaluate the efficacy of glutamine and transforming growth factor-β2 (TGF-β2) in the prevention of grade 3-4 non-hematological toxicities induced by chemotherapy in patients with GI cancer. We designed a double-blind, randomized, controlled and multicenter trial stratified according to center, type of chemotherapy, presence of cachexia, and age. Patients were randomized to receive either Clinutren Protect(®) (CP) or a control isocaloric diet (without TGF-β2 or glutamine). Between November 2007 and October 2011, 210 patients were enrolled in the study, of which 201 were included in the intention-to-treat analysis. Grade 3-4 non-hematological toxicities were not significantly different between the CP and control groups when evaluated by univariate and multivariate analyses. Likewise, no difference was observed regarding grade 3-4 hematological toxicities or reasons for treatment interruption. This randomized study does not support the hypothesis that oral glutamine and TGF-β2 supplementation is effective to reduce grade 3 or 4 non-hematological toxicities induced by chemotherapy in patients with GI neoplasm. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  11. Changing prevalence patterns in endoscopic and histological diagnosis of gastritis? Data from a cross-sectional Central European multicentre study.

    PubMed

    Wolf, Eva-Maria; Plieschnegger, Wolfgang; Geppert, Michael; Wigginghaus, Bernd; Höss, Gabriele M; Eherer, Andreas; Schneider, Nora I; Hauer, Almuthe; Rehak, Peter; Vieth, Michael; Langner, Cord

    2014-05-01

    Traditionally, Helicobacter infection is considered to be the most common cause of gastritis. In the cross-sectional Central European histoGERD trial, we assessed the prevalence of different types of gastritis, correlating histological and endoscopic diagnoses. A total of 1123 individuals participated in an observational multicentre study. Endoscopists classified individuals as positive or negative for gastritis and rendered the putative cause. Pathologists evaluated biopsy specimens based upon the Updated Sydney System. Histological diagnosis of gastritis was made in 639 (56.9%) participants. In all, 210 (18.7%) individuals were diagnosed with Helicobacter gastritis, 215 (19.1%) with post Helicobacter gastritis, 234 (20.8%) with reactive gastropathy, 26 (2.3%) with autoimmune gastritis, and 6 (0.5%) with focally enhanced gastritis related to Crohn's disease. In 46 out of 639 (7.2%) individuals diagnosed with gastritis, combinations of different histological subtypes were noted the most common being reactive gastropathy and post Helicobacter gastritis. Endoscopic diagnosis of gastritis was made in 534 (47.6%) individuals. Reactive gastropathy was more common than active Helicobacter gastritis, and the majority of cases attributable to Helicobacter infection were no longer ongoing, i.e. post Helicobacter gastritis. Agreement between histological and endoscopic diagnoses was better in reactive gastropathy than in Helicobacter gastritis. Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  12. Radioprotective activity of Polyalthia longifolia standardized extract against X-ray radiation injury in mice.

    PubMed

    Jothy, Subramanion L; Saito, Tamio; Kanwar, Jagat R; Chen, Yeng; Aziz, Azlan; Yin-Hui, Leong; Sasidharan, Sreenivasan

    2016-01-01

    The radioprotective effect of Polyalthia longifolia was studied in mice. P. longifolia treatment showed improvement in mice survival compared to 100% mortality in the irradiated mice. Significant increases in hemoglobin concentration, and red blood cell, white blood cell and platelet counts were observed in the animals pretreated with leaf extract. Pre-irradiation administration of P. longifolia leaf extract also increased the CFU counts of the spleen colony and increased the relative spleen size. A dose-dependent decrease in lipid peroxidation levels was observed in the animals pretreated with P. longifolia. However, although the animals pretreated with P. longifolia exhibited a significant increase in superoxide dismutase and catalase activity, the values remained below normal in both liver and the intestine. Pre-irradiation administration of P. longifolia also resulted in the regeneration of the mucosal crypts and villi of the intestine. Moreover, pretreatment with P. longifolia leaf extract also showed restoration of the normal liver cell structure and a significant reduction in the elevated levels of ALT, AST and bilirubin. These results suggested the radioprotective ability of P. longifolia leaf extract, which is significant for future investigation for human applications in developing efficient, economically viable, non-toxic natural and clinically acceptable novel radioprotectors. Copyright © 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  13. IEC 61267: Feasibility of type 1100 aluminium and a copper/aluminium combination for RQA beam qualities.

    PubMed

    Leong, David L; Rainford, Louise; Zhao, Wei; Brennan, Patrick C

    2016-01-01

    In the course of performance acceptance testing, benchmarking or quality control of X-ray imaging systems, it is sometimes necessary to harden the X-ray beam spectrum. IEC 61267 specifies materials and methods to accomplish beam hardening and, unfortunately, requires the use of 99.9% pure aluminium (Alloy 1190) for the RQA beam quality, which is expensive and difficult to obtain. Less expensive and more readily available filters, such as Alloy 1100 (99.0% pure) aluminium and copper/aluminium combinations, have been used clinically to produce RQA series without rigorous scientific investigation to support their use. In this paper, simulation and experimental methods are developed to determine the differences in beam quality using Alloy 1190 and Alloy 1100. Additional simulation investigated copper/aluminium combinations to produce RQA5 and outputs from this simulation are verified with laboratory tests using different filter samples. The results of the study demonstrate that although Alloy 1100 produces a harder beam spectrum compared to Alloy 1190, it is a reasonable substitute. A combination filter of 0.5 mm copper and 2 mm aluminium produced a spectrum closer to that of Alloy 1190 than Alloy 1100 with the added benefits of lower exposures and lower batch variability. Copyright © 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  14. Comparison of staging diagnosis by two magnifying endoscopy classification for superficial oesophageal cancer.

    PubMed

    Ebi, Masahide; Shimura, Takaya; Murakami, Kenji; Yamada, Tomonori; Hirata, Yoshikazu; Tsukamoto, Hironobu; Mizoshita, Tsutomu; Tanida, Satoshi; Kataoka, Hiromi; Kamiya, Takeshi; Joh, Takashi

    2012-11-01

    Due to the possibility of lymph node metastasis, surgical resection is indicated for superficial oesophageal cancer with invasion to a depth greater than the muscularis mucosa. Although two magnifying endoscopy classifications are currently used to diagnose the depth of invasion, which classification is more suitable remains controversial. To compare and evaluate the clinical outcomes of two classifications for superficial oesophageal squamous cell carcinoma. This cross-sectional study consists of 44 superficial oesophageal squamous cell carcinoma lesions with magnification image-enhanced endoscopy images. Only magnifying endoscopic images were displayed to two experienced endoscopists who independently diagnosed the depth of invasion according to both classifications. The sensitivity of invasion greater than the muscularis mucosa tended to be higher in Inoue's classification than Arima's classification (78.3±6.2% vs. 50.0±3.0%; P=0.144), whereas the specificity was significantly lower in Inoue's classification than in Arima's classification (61.9±0.0% vs. 97.6±3.4%; P=0.043). For both classifications, rates of concordance were 90.9% and 84.4%, and κ statistics were 0.81 and 0.66, respectively. Our results suggest that Arima's classification is suitable for general screening before treatment to avoid unnecessary surgery. Inoue's classification is appropriate for assessing wide lesion. Copyright © 2012 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  15. Evaluation and clinical implementation of in vivo dosimetry for kV radiotherapy using radiochromic film and micro-silica bead thermoluminescent detectors.

    PubMed

    Palmer, Antony L; Jafari, Shakardokht M; Mone, Ioanna; Muscat, Sarah

    2017-10-01

    kV radiotherapy treatment calculations are based on flat, homogenous, full-scatter reference conditions. However, clinical treatments often include surface irregularities and inhomogeneities, causing uncertainty. Therefore, confirmation of actual delivered doses in vivo is valuable. The current study evaluates, and implements, radiochromic film and micro silica bead TLD for in vivo kV dosimetry. The kV energy and dose response of EBT3 film and silica bead TLD was established and uncertainty budgets determined. In vivo dosimetry measurements were made for a consecutive series of 30 patients using the two dosimetry systems. Energy dependent calibration factors were required for both dosimetry systems. The standard uncertainty estimate for in vivo measurement with film was 1.7% and for beads was 1.5%. The mean measured dose was -2.1% for film and -2.6% for beads compared to prescription. Deviations up to -9% were found in cases of large surface irregularity, or with underlying air cavities or bone. Dose shielding by beads could be clinically relevant at low kV energies and superficial depths. Both film and beads may be used to provide in vivo verification of delivered doses in kV radiotherapy, particularly for complex situations that are not well represented by standard reference condition calculations. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  16. Immunohistochemical analysis of metaplastic non-goblet columnar lined oesophagus shows phenotypic similarities to Barrett's oesophagus: a study in an Asian population.

    PubMed

    Srivastava, Supriya; Liew, Mei Shan; McKeon, Frank; Xian, Wa; Yeoh, Khay Guan; Ho, Khek Yu; Teh, Ming

    2014-02-01

    Barrett's oesophagus is a premalignant condition, predisposing to oesophageal adenocarcinoma. However, some adenocarcinoma may arise in columnar lined oesophagus without goblet cells. Our aim was to evaluate the biological properties of non-goblet columnar lined oesophagus only and elucidate its relationship with Barrett's oesophagus and associated neoplasia. Endoscopic biopsies from patients with Barrett's oesophagus (n=30), non-goblet columnar lined oesophagus (n=14), Barrett's oesophagus associated high grade dysplasia (n=6) and adenocarcinoma (n=4) were selected. Immunostaining for villin, claudin 3 and MUC4 was performed. Statistical analysis was performed and a p value <0.05 was considered significant. Villin and MUC4 were positive in 42%, 100% each and 50% in non-goblet columnar lined oesophagus, Barrett's oesophagus, high grade dysplasia and adenocarcinoma respectively, while claudin 3 was 100% positive in all the groups. In non-goblet columnar lined oesophagus, six cases that were villin immunopositive, showed positive expression for claudin 3 and/or MUC4 and there was no difference from the high grade dysplasia or adenocarcinoma (p>0.05). Our results indicate that a subset of non-goblet columnar lined oesophagus shows an intestinal phenotype representing an early stage of Barrett's oesophagus. This subset probably harbours the potential to change into adenocarcinoma in the long term. Copyright © 2013 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  17. Abdomen/pelvis computed tomography in staging of pediatric Hodgkin Lymphoma: is it always necessary?

    PubMed

    Farruggia, Piero; Puccio, Giuseppe; Sala, Alessandra; Todesco, Alessandra; Terenziani, Monica; Mura, Rosamaria; D'Amico, Salvatore; Casini, Tommaso; Mosa, Clara; Pillon, Marta; Boaro, Maria Paola; Bottigliero, Gaetano; Burnelli, Roberta; Consarino, Caterina; Fedeli, Fausto; Mascarin, Maurizio; Perruccio, Katia; Schiavello, Elisabetta; Trizzino, Angela; Ficola, Umberto; Garaventa, Alberto; Rossello, Mario

    2016-09-01

    The purpose of the study was to determine if abdomen/pelvis computed tomography (CT) can be safety omitted in the initial staging of a subgroup of children affected by Hodgkin Lymphoma (HL). Every participating center of A.I.E.O.P (Associazione Italiana di Ematologia ed Oncologia Pediatrica) sent local staging reports of 18F-fluorodeoxyglucose positron emission tomography (PET) and abdominal ultrasound (US) along with digital images of staging abdomen/pelvis CT to the investigation center where the CT scans were evaluated by an experienced pediatric radiologist. The local radiologist who performed the US was unaware of local CT and PET reports (both carried out after US), and the reviewer radiologist examining the CT images was unaware of local US, PET and CT reports. A new abdominal staging of 123 patients performed on the basis of local US report, local PET report, and centralized CT report was then compared to a simpler staging based on local US and PET. No additional lesion was discovered by CT in patients with abdomen/pelvis negativity in both US and PET or isolated spleen positivity in US (or US and PET), and so it seems that in the initial staging, abdomen/pelvis CT can be safety omitted in about 1/2 to 2/3 of children diagnosed with HL. © 2016 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  18. Recent insights in the therapeutic management of patients with gastric cancer.

    PubMed

    de Mestier, Louis; Lardière-Deguelte, Sophie; Volet, Julien; Kianmanesh, Reza; Bouché, Olivier

    2016-09-01

    Gastric cancer remains frequent and one of the most lethal malignancies worldwide. In this article, we aimed to comprehensively review recent insights in the therapeutic management of gastric cancer, with focus on the surgical and perioperative management of resectable forms, and the latest advances regarding advanced diseases. Surgical improvements comprise the use of laparoscopic surgery including staging laparoscopy, a better definition of nodal dissection, and the development of hyperthermic intraperitoneal chemotherapy. The best individualized perioperative management should be assessed before curative-intent surgery for all patients and can consists in perioperative chemotherapy, adjuvant chemo-radiation therapy or adjuvant chemotherapy alone. The optimal timing and sequence of chemotherapy and radiation therapy with respect to surgery should be further explored. Patients with advanced gastric cancer have a poor prognosis. Nevertheless, they can benefit from doublet or triplet chemotherapy combination, including trastuzumab in HER2-positive patients. Upon progression, second-line therapy can be considered in patients with good performance status. Although anti-HER2 (trastuzumab) and anti-VEGFR (ramucirumab) may yield survival benefit, anti-EGFR and anti-HGFR therapies have failed to improve outcomes. Nevertheless, combination regimens containing cytotoxic drugs and targeted therapies should be further evaluated; keeping in mind that gastric cancer biology is different between Asia and the Western countries. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  19. Post-recurrence survival in hepatocellular carcinoma after percutaneous radiofrequency ablation.

    PubMed

    Facciorusso, Antonio; Del Prete, Valentina; Antonino, Matteo; Crucinio, Nicola; Neve, Viviana; Di Leo, Alfredo; Carr, Brian I; Barone, Michele

    2014-11-01

    Overall survival in hepatocellular carcinoma patients treated with percutaneous radiofrequency ablation is influenced by both recurrence and successive treatments. We investigated post-recurrence survival after radiofrequency ablation. Data on 103 early/intermediate patients initially treated with radiofrequency ablation and followed for a median of 78 months (range 68-82) were retrospectively analysed. If intrahepatic disease recurrence occurred within or contiguous to the previously treated area it was defined as local, otherwise as distant; recurrence classified as Barcelona Clinic Liver Cancer stage C was defined by neoplastic portal vein thrombosis or metastases. A total of 103 patients were included (82.5% male; median age 70 years, range 39-86). During follow-up, 64 recurrences were observed. Median overall survival was 62 months (95% confidence interval: 54-78) and survival rates were 97%, 65% and 52% at 1, 4 and 5 years, respectively. Median post-recurrence survival was 22 months (95% confidence interval: 16-35). Child-Pugh score, performance status, sum of tumour diameters at recurrence and recurrence patterns were independent predictors of post-recurrence survival. In patients with hepatocellular carcinoma after radiofrequency ablation, clinical and tumour parameters assessed at relapse, in particular the type of recurrence pattern, influence post-recurrence survival. Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  20. Worthwhile optical method for free-form mirrors qualification

    NASA Astrophysics Data System (ADS)

    Sironi, G.; Canestrari, R.; Toso, G.; Pareschi, G.

    2013-09-01

    We present an optical method for free-form mirrors qualification developed by the Italian National Institute for Astrophysics (INAF) in the context of the ASTRI (Astrofisica con Specchi a Tecnologia Replicante Italiana) Project which includes, among its items, the design, development and installation of a dual-mirror telescope prototype for the Cherenkov Telescope Array (CTA) observatory. The primary mirror panels of the telescope prototype are free-form concave mirrors with few microns accuracy required on the shape error. The developed technique is based on the synergy between a Ronchi-like optical test performed on the reflecting surface and the image, obtained by means of the TraceIT ray-tracing proprietary code, a perfect optics should generate in the same configuration. This deflectometry test allows the reconstruction of the slope error map that the TraceIT code can process to evaluate the measured mirror optical performance at the telescope focus. The advantages of the proposed method is that it substitutes the use of 3D coordinates measuring machine reducing production time and costs and offering the possibility to evaluate on-site the mirror image quality at the focus. In this paper we report the measuring concept and compare the obtained results to the similar ones obtained processing the shape error acquired by means of a 3D coordinates measuring machine.

  1. Differences in liver stiffness values obtained with new ultrasound elastography machines and Fibroscan: A comparative study.

    PubMed

    Piscaglia, Fabio; Salvatore, Veronica; Mulazzani, Lorenzo; Cantisani, Vito; Colecchia, Antonio; Di Donato, Roberto; Felicani, Cristina; Ferrarini, Alessia; Gamal, Nesrine; Grasso, Valentina; Marasco, Giovanni; Mazzotta, Elena; Ravaioli, Federico; Ruggieri, Giacomo; Serio, Ilaria; Sitouok Nkamgho, Joules Fabrice; Serra, Carla; Festi, Davide; Schiavone, Cosima; Bolondi, Luigi

    2017-07-01

    Whether Fibroscan thresholds can be immediately adopted for none, some or all other shear wave elastography techniques has not been tested. The aim of the present study was to test the concordance of the findings obtained from 7 of the most recent ultrasound elastography machines with respect to Fibroscan. Sixteen hepatitis C virus-related patients with fibrosis ≥2 and having reliable results at Fibroscan were investigated in two intercostal spaces using 7 different elastography machines. Coefficients of both precision (an index of data dispersion) and accuracy (an index of bias correction factors expressing different magnitudes of changes in comparison to the reference) were calculated. Median stiffness values differed among the different machines as did coefficients of both precision (range 0.54-0.72) and accuracy (range 0.28-0.87). When the average of the measurements of two intercostal spaces was considered, coefficients of precision significantly increased with all machines (range 0.72-0.90) whereas of accuracy improved more scatteredly and by a smaller degree (range 0.40-0.99). The present results showed only moderate concordance of the majority of elastography machines with the Fibroscan results, preventing the possibility of the immediate universal adoption of Fibroscan thresholds for defining liver fibrosis staging for all new machines. Copyright © 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  2. Screening prior to biological therapy in Crohn's disease: adherence to guidelines and prevalence of infections. Results from a multicentre retrospective study.

    PubMed

    van der Have, Mike; Belderbos, Tim D G; Fidder, Herma H; Leenders, Max; Dijkstra, Gerard; Peters, Charlotte P; Eshuis, Emma J; Ponsioen, Cyriel Y; Siersema, Peter D; van Oijen, Martijn G H; Oldenburg, Bas

    2014-10-01

    Screening for opportunistic infections prior to starting biological therapy in patients with inflammatory bowel disease is recommended. To assess adherence to screening for opportunistic infections prior to starting biological therapy in Crohn's disease patients and its yield. A multicentre retrospective study was conducted in Crohn's disease patients in whom infliximab or adalimumab was started between 2000 and 2010. Screening included tuberculin skin test, interferon-gamma release assay or chest X-ray for tuberculosis. Extended screening included screening for tuberculosis and viral infections. Patients were followed until three months after ending treatment. Primary endpoints were opportunistic and serious infections. 611 patients were included, 91% on infliximab. 463 (76%) patients were screened for tuberculosis, of whom 113 (24%) underwent extended screening. Screening for tuberculosis and hepatitis B increased to, respectively, 90-97% and 36-49% in the last two years. During a median follow-up of two years, 64/611 (9%, 3.4/100 patient-years) opportunistic infections and 26/611 (4%, 1.6/100 patient-years) serious infections were detected. Comorbidity was significantly associated with serious infections (hazard ratio 3.94). Although screening rates for tuberculosis and hepatitis B increased, screening for hepatitis B was still suboptimal. More caution is required when prescribing biologicals in patients with comorbid conditions. Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  3. A model-based approach of scatter dose contributions and efficiency of apron shielding for radiation protection in CT.

    PubMed

    Weber, N; Monnin, P; Elandoy, C; Ding, S

    2015-12-01

    Given the contribution of scattered radiations to patient dose in CT, apron shielding is often used for radiation protection. In this study the efficiency of apron was assessed with a model-based approach of the contributions of the four scatter sources in CT, i.e. external scattered radiations from the tube and table, internal scatter from the patient and backscatter from the shielding. For this purpose, CTDI phantoms filled with thermoluminescent dosimeters were scanned without apron, and then with an apron at 0, 2.5 and 5 cm from the primary field. Scatter from the tube was measured separately in air. The scatter contributions were separated and mathematically modelled. The protective efficiency of the apron was low, only 1.5% in scatter dose reduction on average. The apron at 0 cm from the beam lowered the dose by 7.5% at the phantom bottom but increased the dose by 2% at the top (backscatter) and did not affect the centre. When the apron was placed at 2.5 or 5 cm, the results were intermediate to the one obtained with the shielding at 0 cm and without shielding. The apron effectiveness is finally limited to the small fraction of external scattered radiation. Copyright © 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  4. High definition plus colonoscopy combined with i-scan tone enhancement vs. high definition colonoscopy for colorectal neoplasia: A randomized trial.

    PubMed

    Hoffman, Arthur; Loth, Linn; Rey, Johannes Wilhelm; Rahman, Fareed; Goetz, Martin; Hansen, Torsten; Tresch, Achim; Niederberger, Theresa; Galle, Peter Robert; Kiesslich, Ralf

    2014-11-01

    High definition endoscopy is the accepted standard in colonoscopy. However, an important problem is missed polyps. Our objective was to assess the additional adenoma detection rate between high definition colonoscopy with tone enhancement (digital chromoendoscopy) vs. white light high definition colonoscopy. In this prospective randomized trial patients were included to undergo a tandem colonoscopy. The first exam was a white light colonoscopy with removal of all visualized polyps. The second examination was randomly assigned in a 1:1 ratio as either again white light colonoscopy (Group A) or colonoscopy with tone enhancement (Group B). Primary endpoint was the adenoma detection rate during the second withdrawal (sample size calculation - 40 per group). 67 lesions (Group A: n=34 vs. Group B: n=33) in 80 patients (mean age 61 years, male 64%) were identified on the first colonoscopy. The second colonoscopy detected 78 additional lesions: n=60 with tone enhancement vs. n=18 with white light endoscopy (p<0.001). Tone enhancement found more additional adenomas (A n=20 vs. B n=6, p=0.006) and identified significantly more missed adenomas per subject (0.5 vs. 0.15, p=0.006). High definition plus colonoscopy with tone enhancement detected more adenomas missed by white light colonoscopy. Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  5. Rifaximin and diverticular disease: Position paper of the Italian Society of Gastroenterology (SIGE).

    PubMed

    Cuomo, Rosario; Barbara, Giovanni; Annibale, Bruno

    2017-06-01

    Management of diverticular disease has significantly improved in the last decade. Antibiotic treatment is used for symptom relief and prevention of complications. In Italy, the non-absorbable antibiotic rifaximin is one of the most frequently used drugs, and it is perceived as the reference drug to treat symptomatic diverticular disease. Its non-systemic absorption and high faecal concentrations have oriented rifaximin use to the gastrointestinal tract, where rifaximin exerts eubiotic effects representing an additional value to its antibiotic activity. This position paper was commissioned by the Italian Society of Gastroenterology governing board for a panel of experts (RC, GB, BA) to highlight the indications for treatment of diverticular disease. There is a lack of rationale for drug use for the primary prevention of diverticulitis in patients with diverticulosis; thus, rifaximin use should be avoided. The cyclic use of rifaximin, in association with high-fibre intake, is safe and useful for the treatment of symptomatic uncomplicated diverticular disease, even if the cost-efficacy of long-term treatment remains to be determined. The use of rifaximin in the prevention of diverticulitis recurrence is promising, but the low therapeutic advantage needs to be verified. No evidence is available on the efficacy of rifaximin treatment on acute uncomplicated diverticulitis. Copyright © 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  6. Gastric metastasis of breast cancer: a single centre retrospective study.

    PubMed

    Almubarak, Maher M; Laé, Marick; Cacheux, Wulfran; de Cremoux, Patricia; Pierga, Jean-Yves; Reyal, Fabien; Bennett, Simon P; Falcou, Marie-Christine; Salmon, Remy J; Baranger, Bernard; Mariani, Pascale

    2011-10-01

    Digestive metastasis of breast cancer are rare but when they do occur the stomach is one of the commoner sites. To describe the clinical, endoscopic, pathological features and treatment. 35 cases of gastric metastasis were identified retrospectively between 1980 and 2008. The location of the gastric metastasis was fundus (n=15, 43%), antrum (n=15, 43%) or both (n=5, 14%). The histological subtype of primary breast cancer was invasive lobular carcinoma in 34 patients (97%). Hormonal receptors were positive in 19 out of 24 cases (79%), two out of 22 analysed were HER2 positive (9%). There were 16 (46%) patients with peritoneal carcinosis. The treatment was chemotherapy (n=13, 37%), hormonotherapy (n=2, 6%) or both (n=13, 37%). The 2-year survival rate after gastric metastasis diagnosis was 53% with a median follow up of 31 months [7-84 months]. Ninety-seven percent of gastric metastasis from breast cancers are derived from invasive lobular carcinoma. Seventy-nine percent of these are HER+ and comparison with the original histopathological slides of primary breast carcinoma should be performed to differentiate gastric metastasis from primary gastric carcinoma. Peritoneal carcinomatosis accompanied gastric metastasis in almost half the cases in this series and treatment was generally chemotherapy. Copyright © 2011 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  7. Multi-modality image fusion based on enhanced fuzzy radial basis function neural networks.

    PubMed

    Chao, Zhen; Kim, Dohyeon; Kim, Hee-Joung

    2018-04-01

    In clinical applications, single modality images do not provide sufficient diagnostic information. Therefore, it is necessary to combine the advantages or complementarities of different modalities of images. Recently, neural network technique was applied to medical image fusion by many researchers, but there are still many deficiencies. In this study, we propose a novel fusion method to combine multi-modality medical images based on the enhanced fuzzy radial basis function neural network (Fuzzy-RBFNN), which includes five layers: input, fuzzy partition, front combination, inference, and output. Moreover, we propose a hybrid of the gravitational search algorithm (GSA) and error back propagation algorithm (EBPA) to train the network to update the parameters of the network. Two different patterns of images are used as inputs of the neural network, and the output is the fused image. A comparison with the conventional fusion methods and another neural network method through subjective observation and objective evaluation indexes reveals that the proposed method effectively synthesized the information of input images and achieved better results. Meanwhile, we also trained the network by using the EBPA and GSA, individually. The results reveal that the EBPGSA not only outperformed both EBPA and GSA, but also trained the neural network more accurately by analyzing the same evaluation indexes. Copyright © 2018 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  8. Screen-detected gallstone disease and autoimmune diseases - A cohort study.

    PubMed

    Shabanzadeh, Daniel Mønsted; Linneberg, Allan; Skaaby, Tea; Sørensen, Lars Tue; Jørgensen, Torben

    2018-06-01

    Gallstone disease is highly prevalent and is associated with systemic inflammation. To determine whether screen-detected gallstones or cholecystectomy are associated with the occurrence of autoimmune and autoinflammatory diseases and the most common subgroups thereof. A cohort study of three randomly selected general population samples from Copenhagen was performed. Participants (n = 5928) were examined in the period 1982-1992, underwent abdominal ultrasound examination to detect gallstone disease, and followed through national registers until December 2014 (median 24.7 years) for occurrence of immunological diseases. Multivariable Cox regression analyses were performed. Gallstone disease was identified in 10% (591/5928) of participants, of whom 6.8% had gallstones and 3.2% had cholecystectomy at baseline. Gallstone disease was associated with incidence of autoimmune diseases (12.9% versus 7.92%; hazard ratio 1.46; 95% confidence interval [CI], [1.11;1.91]), diabetes mellitus type 1 (5.95% versus 3.67%; 1.53; [1.02;2.30]), and autoimmune thyroid disease (3.70% versus 1.59%; 2.06; [1.26;3.38]). Rheumatoid arthritis, autoinflammatory diseases, or any subgroups thereof were not associated. In a large general population sample, screen-detected gallstone disease was associated with the development of autoimmune diseases during long-term follow-up. Future research efforts are needed to further explore common disease mechanisms. Copyright © 2018 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  9. Mediterranean report/heated pipeline offloads tankers

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Not Available

    1979-08-01

    The first heated submarine pipeline in Europe, according to Anonima Petroli Italiana, is now in operation from their Falconara Refinery near Ancona, Italy, to an existing offshore loading facility. The 3850 m long, 24 inch wide line, laid on the seabottom at 3-14 m depths, was built to offload high pour/high viscosity crudes requiring a minimum constant discharge temperature of 45-65 C. Four 3.5 mm heating pipes (three operating and one spare) were stretch-welded to the outside of the line at 45 degree angles to each other; they are heated at about 100 m/m by a parasitic current formed onmore » the pipe while 1500 volt current is passed through a cable inside the pipe. The heating system is equipped with an electric feeding installation, automatic power regulation, and remote sensors applied along the sea line. The heating pipes were protected with a coat of epoxy tar paint, a 50 mm thick and 70 kg/cm dense sprayed-on urethane foam coat, a sheath of butyric elastomer covered with an adhering 3 mm coat of polyethylene, and a concrete coat for protection and weighting. Specially designed water stops were placed at both ends of every line section under the waterproofing. Industria Construzioni Opere Publiche prefabricated the line on shore and laid it from shore.« less

  10. Improving the time efficiency of the Fourier synthesis method for slice selection in magnetic resonance imaging.

    PubMed

    Tahayori, B; Khaneja, N; Johnston, L A; Farrell, P M; Mareels, I M Y

    2016-01-01

    The design of slice selective pulses for magnetic resonance imaging can be cast as an optimal control problem. The Fourier synthesis method is an existing approach to solve these optimal control problems. In this method the gradient field as well as the excitation field are switched rapidly and their amplitudes are calculated based on a Fourier series expansion. Here, we provide a novel insight into the Fourier synthesis method via representing the Bloch equation in spherical coordinates. Based on the spherical Bloch equation, we propose an alternative sequence of pulses that can be used for slice selection which is more time efficient compared to the original method. Simulation results demonstrate that while the performance of both methods is approximately the same, the required time for the proposed sequence of pulses is half of the original sequence of pulses. Furthermore, the slice selectivity of both sequences of pulses changes with radio frequency field inhomogeneities in a similar way. We also introduce a measure, referred to as gradient complexity, to compare the performance of both sequences of pulses. This measure indicates that for a desired level of uniformity in the excited slice, the gradient complexity for the proposed sequence of pulses is less than the original sequence. Copyright © 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  11. Esophageal chemical clearance and baseline impedance values in patients with chronic autoimmune atrophic gastritis and gastro-esophageal reflux disease.

    PubMed

    Tenca, Andrea; de Bortoli, Nicola; Mauro, Aurelio; Frazzoni, Marzio; Savarino, Edoardo; Massironi, Sara; Russo, Salvatore; Bertani, Lorenzo; Marchi, Santino; Penagini, Roberto

    2017-09-01

    The factors influencing new markers of gastro-esophageal reflux disease detected by impedance-pH monitoring - mean nocturnal baseline impedance (MNBI) and post-reflux swallow-induced peristaltic wave (PSPW) index - need to be evaluated. To compare endoscopy-negative heartburn with chronic autoimmune atrophic gastritis (CAAG). 24 patients with CAAG, 25 with non-erosive reflux disease (NERD) and 25 with functional heartburn (FH) were included. In all patients the main impedance-pH monitoring parameters were calculated. CAAG and NERD patients had a number of reflux events (non-acid ones being more common among the former group) which was higher than that found in FH (p<0.001). MNBI decreased progressively in FH (>3000Ohm), CAAG (>2000Ohm) and NERD (<1000Ohm) patients (p=0.0046). The PSPW index was similar between CAAG and NERD patients but significantly lower in comparison to FH (p<0.0001). Patients with CAAG have evidence of non-acid reflux based on the high number of reflux events and confirmed by low values of MNBI and PSPW index. MNBI is a strong marker of acid/non-acid reflux-induced mucosal damage, whereas the PSPW index can reliably discriminate patients with reflux from those with FH, independently of the acidity of refluxate. Copyright © 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  12. Underuse of brachytherapy for the treatment of dysphagia owing to esophageal cancer. An Italian survey.

    PubMed

    Fuccio, Lorenzo; Guido, Alessandra; Hassan, Cesare; Frazzoni, Leonardo; Arcelli, Alessandra; Farioli, Andrea; Giaccherini, Lucia; Galuppi, Andrea; Mandolesi, Daniele; Cellini, Francesco; Mantello, Giovanna; Macchia, Gabriella; de Bortoli, Nicola; Repici, Alessandro; Valentini, Vincenzo; Bazzoli, Franco; Morganti, Alessio Giuseppe

    2016-10-01

    International guidelines strongly recommend brachytherapy as valid alternative or in addition to stenting in patients with dysphagia owing to esophageal cancer. However, for not well understood reasons, brachytherapy is definitively underused for the palliative treatment of malignant dysphagia. Aim of the current survey was to investigate the use of brachytherapy for the treatment of malignant dysphagia in Italy. A structured questionnaire was submitted to the 1510 members of the Italian Association of Radiation Oncologists (AIRO). These members refer to 177 centres of radiotherapy across Italy and in 68 (38.4%) of them brachytherapy is routinely performed. Of the 1510 invited members, 178 completed the survey (11.7%). The answers provided by the 178 participants allowed to get information on 40 out of 68 brachytherapy centres (58.8%). Seven out of 40 (17.5%) centres perform brachytherapy of the oesophagus, in 3 out of 40 (7.5%) centres brachytherapy represents the first line of treatment. The main reason why brachytherapy is not routinely performed is the lack of experience. Despite the strong recommendations of the international guidelines and the wide diffusion of brachytherapy centres across Italy, only very few of them routinely considered brachytherapy for the treatment of dysphagia due to esophageal cancer. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  13. Comparison between videofluoroscopy, fiberoptic endoscopy and scintigraphy for diagnosis of oro-pharyngeal dysphagia.

    PubMed

    Fattori, B; Giusti, P; Mancini, V; Grosso, M; Barillari, M R; Bastiani, L; Molinaro, S; Nacci, A

    2016-10-01

    The purpose of this study was to compare videofluoroscopy (VFS), fiberoptic endoscopic evaluation of swallowing (FEES) and oro-pharyngo- oesophageal scintigraphy (OPES) with regards to premature spillage, post-swallowing residue and aspiration to assess the reliability of these tests for detection of oro-pharyngeal dysphagia. Sixty patients affected with dysphagia of various origin were enrolled in the study and submitted to VFS, FEES and OPES using a liquid and semi-solid bolus. As a reference, we used VFS. Both the FEES and the OPES showed good sensitivity with high overall values (≥ 80% and ≥ 90% respectively). The comparison between FEES vs VFS concerning drop before swallowing showed good specificity (84.4% for semi-solids and 86.7% for liquids). In the case of post-swallowing residue, FEES vs VFS revealed good overall validity (75% for semi-solids) with specificity and sensitivity well balanced for the semi-solids. OPES vs. VFS demonstrated good sensitivity (88.6%) and overall validity (76.7%) for liquids. The analysis of FEES vs. VFS for aspiration showed that the overall validity was low (≤ 65%). On the other hand, OPES demonstrated appreciable overall validity (71.7%). VFS, FEES and OPES are capable of detecting oro-pharyngeal dysphagia. FEES gave significant results in the evaluation of post-swallowing residues. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale, Rome, Italy.

  14. Celiac disease or positive tissue transglutaminase antibodies in patients undergoing renal biopsies.

    PubMed

    Nurmi, Rakel; Metso, Martti; Pörsti, Ilkka; Niemelä, Onni; Huhtala, Heini; Mustonen, Jukka; Kaukinen, Katri; Mäkelä, Satu

    2018-01-01

    An association between celiac disease and renal diseases has been suggested, but the results are controversial. To investigate the prevalence of celiac disease autoimmunity among individuals undergoing renal biopsies and to evaluate whether co-existent celiac autoimmunity influences the clinical outcome of the renal disease. The prevalence of celiac autoimmunity (previous diagnosis of celiac disease or positive tissue transglutaminase antibodies) was determined in 827 consecutive patients undergoing kidney biopsies due to clinical indications. Up to 15 years' follow-up data on kidney function and co-morbidities were obtained. Celiac autoimmunity was found in 45 (5.4%) patients. Among the IgA nephropathy patients, 8.2% of had celiac autoimmunity. At the time of kidney biopsy and after a median follow-up of 5 to 6 years, renal function measured by estimated glomerular filtration rate (eGFR) was inferior in IgA nephropathy patients with celiac autoimmunity compared to those without it (P=0.048 and P=0.022, respectively). The prevalence of celiac autoimmunity seems to be high in patients undergoing renal biopsies, especially in patients with IgA nephropathy. Such autoimmunity may be associated with worse renal function in IgA nephropathy. Hence the co-existence of celiac disease should be taken into consideration when treating patients with renal diseases. Copyright © 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  15. Dose profiles for lung and breast regions at prospective and retrospective CT coronary angiography using optically stimulated luminescence dosimeters on a 64-detector CT scanner.

    PubMed

    Funama, Yoshinori; Taguchi, Katsuyuki; Utsunomiya, Daisuke; Oda, Seitaro; Murasaki, Hiroo; Yamashita, Yasuyuki; Awai, Kazuo

    2012-01-01

    The purpose of our study was to acquire dose profiles at critical organs of lung and breast regions using optically stimulated luminescence (OSL) dosimeters; assess the actual radiation dose delivered at retrospective and prospective computed tomography coronary angiography (CTCA). Using a chest CT phantom we applied a prospectively-gated step-and-shoot- and a retrospectively-gated helical mode on a 64-detector row CT scanner. Retrospective scan mode was used with and without electrocardiogram (ECG) based tube current modulation. OSL dosimeters were used to measure dose profiles. In the both scan modes we acquired dose profiles and determined the mean and maximum dose in left lung and in left breast regions. In prospective mode, the mean dose was 21.53 mGy in left lung- and 23.59 mGy in left breast region. With respect to the retrospective mode, the mean dose with tube current modulation was 38.63 mGy for left lung- and 46.02 mGy for left breast region, i.e. 0.56 and 0.55 times lower than the mean dose without modulation. The OSL dosimeter is useful for measurement of the actual radiation dose along z-axis at lung and breast regions in the prospective and the retrospective CTCA. Copyright © 2011 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  16. Prevalence and characteristics of acid gastro-oesophageal reflux disease in Jackhammer oesophagus.

    PubMed

    Mallet, Anne-Laure; Ropert, Alain; Bouguen, Guillaume; Siproudhis, Laurent; Boutroux, Dominique; Bretagne, Jean-François; Brochard, Charlène

    2016-10-01

    An association between acid gastro-oesophageal reflux disease (GERD) and Jackhammer oesophagus has been suggested. To assess the prevalence and characteristics of acid-GERD in Jackhammer oesophagus and the efficacy of proton pump inhibitors. Data and outcomes of patients with Jackhammer oesophagus were assessed. Two groups were compared: (i) GERD, defined by endoscopic oesophagitis or by an increase in acid exposure time or by an acid-hypersensitive oesophagus and (ii) non-GERD defined by normal oesophageal acid exposure without acid-hypersensitive oesophagus. Among the 1994 high-resolution manometries performed, 44 Jackhammer oesophagus (2.2%) were included (sex ratio M/F: 19/25; median age: 66 [61-75] years). Nineteen patients (43.2%) had GERD, 16 (36.4%) had no GERD and 9 patients (20.4%) were undetermined. Dysphagia was the predominant symptom (37/43 (86%)). After a median follow-up of 25.3 months [9.6-31.4], dysphagia was improved in 22/36 (61.1%) patients. Dysphagia improvement as well as other symptoms improvement was not associated with GERD status or proton-pump inhibitors use. The prevalence of GERD is high among patients with Jackhammer oesophagus. The rates of symptom improvement in Jackhammer oesophagus were high regardless of the use of proton-pump inhibitors treatment or of the presence of GERD. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  17. Tuberculous peritonitis: analysis of 211 cases in Taiwan.

    PubMed

    Yeh, Hsiu-Fen; Chiu, Te-Fa; Chen, Jih-Chang; Ng, Chip-Jin

    2012-02-01

    Tuberculosis infection caused by Mycobacterium tuberculosis or other Mycobacterium species is a major communicable disease worldwide. We evaluated the epidemiology of tuberculous peritonitis to determine diagnostic features and factors related to late diagnosis. We retrospectively reviewed 211 tuberculous peritonitis cases diagnosed between January 1999 and December 2009. Clinical features, laboratory data, and diagnostic methods were analysed. Subjects included 115 males (54.5%) and 96 females (45.5%) with median age 61.0 years (range 43-72) and 29.2 days mean duration from symptoms to diagnosis. Disease histories included end-stage renal disease (20.9%), pulmonary tuberculosis (36.0%) and liver cirrhosis (23.7%). Most common symptoms were abdominal distension (80.1%), abdominal pain (68.7%) and weight loss (45.5%). Most common signs were ascites (62.6%) and fever (55.5%). One-year survival rate was 89.9%; 21 patients died during follow-up. Mortality risk was higher in patients with more concomitant diseases, including liver cirrhosis, AIDS, chronic steroid use, alcoholism, GI bleeding, haemoptysis, period from symptom presentation to treatment, secondary bacterial peritonitis requiring emergent operation. Increased duration between symptoms and definitive diagnosis increases mortality risk. Early diagnosis and prompt initiation of anti-tuberculosis therapy improve prognosis. Neutrophil-predominant ascites influences poor prognosis when correlated with secondary bacterial peritonitis. Copyright © 2011 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  18. Modelling the influence of thermal effects induced by radio frequency electric field on the dynamics of the ATPase nano-biomolecular motors.

    PubMed

    Lohrasebi, A; Mohamadi, S; Fadaie, S; Rafii-Tabar, H

    2012-07-01

    We model the dynamics of the F(0) component of the F(0)F(1)-ATPase mitochondrion-based nano-motor operating in a stochastically-fluctuating medium that represents the intracellular environment. The stochastic dynamics are modeled via Langevin equation of motion wherein fluctuations are treated as white noise. We have investigated the influence of an applied alternating electric field on the rotary motion of the F(0) rotor in such an environment. The exposure to the field induces a temperature rise in the mitochondrion's membrane, within which the F(0) is embedded. The external field also induces an electric potential that promotes a change in the mitochondrion's transmembrane potential (TMP). Both the induced temperature and the change in TMP contribute to a change in the dynamics of the F(0). We have found that for external fields in the radio frequency (RF) range, normally present in the environment and encountered by biological systems, the contribution of the induced thermal effects, relative to that of the induced TMP, to the dynamics of the F(0) is more significant. The changes in the dynamics of the F(0) part affect the frequency of the rotary motion of the F(0)F(1)-ATPase protein motor which, in turn, affects the production rate of the ATP molecules. Copyright © 2011 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  19. Patients with mild enteropathy have apoptotic injury of enterocytes similar to that in advanced enteropathy in celiac disease.

    PubMed

    Das, Prasenjit; Gahlot, Gaurav P S; Mehta, Ritu; Makharia, Archita; Verma, Anil K; Sreenivas, Vishnubhatla; Panda, Subrat K; Ahuja, Vineet; Gupta, Siddhartha Datta; Makharia, Govind K

    2016-11-01

    Severity of villous atrophy in celiac disease (CeD) is the cumulative effect of enterocyte loss and cell regeneration. Gluten-free diet has been shown to benefit even in patients having a positive anti-tissue transglutaminase (tTG) antibody titre and mild enteropathy. We explored the balance between mucosal apoptotic enterocyte loss and cell regeneration in mild and advanced enteropathies. Duodenal biopsies from patients with mild enteropathy (Marsh grade 0 and 1) (n=26), advanced enteropathy (Marsh grade ≥2) (n=41) and control biopsies (n=12) were subjected to immunohistochemical staining for end-apoptotic markers (M30, H2AX); markers of cell death (perforin, annexin V); and cell proliferation (Ki67). Composite H-scores based on the intensity and distribution of markers were compared. End-apoptotic markers and marker of cell death (perforin) were significantly up-regulated in both mild and advanced enteropathies, in comparison to controls; without any difference between mild and advanced enteropathies. Ki67 labelling index was significantly higher in crypts of mild enteropathy, in comparison to controls, suggesting maintained regenerative activity in the former. Even in patients with mild enteropathy, the rate of apoptosis is similar to those with advanced enteropathy. These findings suggest the necessity of reviewing the existing practice of not treating patients with mild enteropathy. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  20. Liver precancerous lesions and hepatocellular carcinoma: the histology report.

    PubMed

    Roncalli, Massimo; Terracciano, Luigi; Di Tommaso, Luca; David, Ezio; Colombo, Massimo

    2011-03-01

    The current ability to increase the survival of patients with hepatocellular carcinoma (HCC) relies upon the surveillance of cirrhotic patients. Surveillance allows HCC precursors (dysplastic nodules) and malignant tumors to be recognized at an earlier stage making cure possible. Radiology plays a major role in HCC diagnosis because HCC is characterized by neoarterial vascularisation with a typical imaging pattern. Current international guidelines have restricted the use of the liver biopsy to the characterization of hepatocellular nodules which remain diagnostically equivocal after imaging. Thus pathologists are today facing very challenging and often well differentiated lesions, leading to difficulties in distinguishing high grade dysplasia and well differentiated HCC. In this scenario novel concepts obtained through international consensus have been proposed with emphasis on HCC of small size (up to 2 cm) which includes 2 distinct types, the early and progressed HCC. In this paper we will report the main histopathological criteria of a biopsy which allow the differentiation of HCC precursors (dysplastic nodules) from well differentiated HCC with attention to the role and weight of both classical histopathological criteria and novel immunocytochemical markers. The second part of the paper is devoted to the histopathology report of HCC on surgical specimens including explanted livers and on the differential diagnosis between HCC and liver metastasis. Copyright © 2011 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd.. All rights reserved.

  1. Gastritis: the histology report.

    PubMed

    Rugge, Massimo; Pennelli, Gianmaria; Pilozzi, Emanuela; Fassan, Matteo; Ingravallo, Giuseppe; Russo, Valentina M; Di Mario, Francesco

    2011-03-01

    Gastritis is defined as inflammation of the gastric mucosa. In histological terms, it is distinguishable into two main categories, i.e. non-atrophic and atrophic. In the gastric mucosa, atrophy is defined as the loss of appropriate glands. There are several etiological types of gastritis, their different etiology being related to different clinical manifestations and pathological features. Atrophic gastritis (resulting mainly from long-standing Helicobacter pylori infection) is a major risk factor for the onset of (intestinal type) gastric cancer. The extent and site of the atrophic changes correlate significantly with the cancer risk. The current format for histology reporting in cases of gastritis fails to establish an immediate link between gastritis phenotype and risk of malignancy. Building on current knowledge of the biology of gastritis, an international group of pathologists [Operative Link for Gastritis Assessment (OLGA)] has proposed a system for reporting gastritis in terms of its stage (the OLGA Staging System): this system places the histological phenotypes of gastritis on a scale of progressively increasing gastric cancer risk, from the lowest (Stage 0) to the highest (Stage IV). The aim of this tutorial is to provide unequivocal information on how to standardize histology reports on gastritis in diagnostic practice. Copyright © 2011 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd.. All rights reserved.

  2. Interfaith education: An Islamic perspective

    NASA Astrophysics Data System (ADS)

    Pallavicini, Yahya Sergio Yahe

    2016-08-01

    According to a teaching of the Prophet Muhammad, "the quest for knowledge is the duty of each Muslim, male or female", where knowledge is meant as the discovery of the real value of things and of oneself in relationship with the world in which God has placed us. This universal dimension of knowledge is in fact a wealth of wisdom of the traditional doctrine naturally linked to the cultural and spiritual heritage of every human being and every believer of every faith. It allows for the respect of internal and external differences as positive elements of the cultural and spiritual heritage of mankind. In this sense, intercultural and interfaith education plays a fundamental role and fits naturally within the Islamic religious education framework. The author of this article is Vice-President and Imam of the Islamic Religious Community in Italy (Comunità Religiosa Islamica [COREIS] Italiana), an organisation which has been providing teachers and students with training on Islam and interfaith dialogue for almost twenty years with the support of the regional and national offices of the Italian Ministry of Public Education. Referring to existing interreligious and intercultural societies such as Azerbaijan, and a number of successful initiatives and projects, several of which COREIS is involved in, he demonstrates how interfaith education can effectively contribute to preventing the diffusion of anti-Semitism, Islamophobia and radicalism.

  3. A prospective comparison of performance during back-to-back, anterograde manual spiral enteroscopy and double-balloon enteroscopy.

    PubMed

    Despott, Edward J; Murino, Alberto; Bourikas, Leonidas; Nakamura, Masanao; Ramachandra, Vino; Fraser, Chris

    2015-05-01

    Spiral enteroscopy is a recently introduced technology alternative to balloon-assisted enteroscopy for examination of the small bowel. To compare small bowel insertion depths and procedure duration by spiral enteroscopy and double-balloon enteroscopy performed in the same cohort of patients, in immediate succession, using the same method of insertion depth estimation. A prospective, back-to-back comparative study was performed in 15 patients. Spiral enteroscopy procedures were performed first and a tattoo was placed to mark the most distal point. Double-balloon enteroscopy passed the tattoo placed at spiral enteroscopy in 14/15 cases (93%). Median insertion depths for double-balloon enteroscopy and spiral enteroscopy were 265cm and 175cm, respectively (P=0.004). Median time to achieve maximal depth of insertion was significantly shorter for spiral enteroscopy compared with double-balloon enteroscopy (24min vs. 45min, respectively; P=0.0005). However, in 14 patients no differences were found in median time to reach the same insertion depth (P=0.28). Double-balloon enteroscopy achieved significantly greater small bowel insertion depth than spiral enteroscopy. Although overall double-balloon enteroscopy procedure duration was longer, the time taken to reach the same small bowel insertion depth by both spiral enteroscopy and double-balloon enteroscopy was similar. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  4. Barrett's oesophagus and associated dysplasia are not equally distributed within the esophageal circumference.

    PubMed

    Bibbò, Stefano; Ianiro, Gianluca; Ricci, Riccardo; Arciuolo, Damiano; Petruzziello, Lucio; Spada, Cristiano; Larghi, Alberto; Riccioni, Maria Elena; Gasbarrini, Antonio; Costamagna, Guido; Cammarota, Giovanni

    2016-09-01

    A careful endoscopic surveillance of Barrett's oesophagus is warranted to prevent esophageal cancer. To identify the preferred location of non-circumferential Barrett's oesophagus and associated dysplasia within the esophageal circumference. We retrospectively reviewed a prospectively maintained database of patients with non-circumferential lesions. The location of metaplastic lesions and dysplastic lesions within the esophageal circumference was identified as on a clock face, and their distribution in the 4 quadrants was compared. Of overall 443 patients with Barrett's oesophagus, 192 (43%) were eligible for our study. Multiple lesions were diagnosed in 110 (57%) of them, for a total amount of 352 metaplastic areas. Barrett's oesophagus lesions were located significantly more in the posterior wall of the oesophagus (38.4%), rather than in the right wall (28.8%), the anterior wall (22.6%), or the left wall (10.2%) (P<0.0001). Among all metaplastic lesions, 28 were associated with dysplasia (7.9%), and one with adenocarcinoma (0.3%). Dysplastic lesions were significantly more common in the posterior wall (39.3%) than, respectively, in the anterior wall (35.8%), the right wall (21.4%) or the left wall (3.5%) (P=0.03). Our results show that the posterior wall of the oesophagus is the preferential location of both Barrett's oesophagus and associated dysplasia. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  5. Confocal laser endomicroscopy for in vivo diagnosis of Barrett's oesophagus and associated neoplasia: a pilot study conducted in a single Italian centre.

    PubMed

    Trovato, Cristina; Sonzogni, Angelica; Ravizza, Davide; Fiori, Giancarla; Tamayo, Darina; De Roberto, Giuseppe; de Leone, Annalisa; De Lisi, Stefania; Crosta, Cristiano

    2013-05-01

    Diagnosis and management of Barrett's oesophagus are controversial. Technical improvements in real-time recognition of intestinal metaplasia and neoplastic foci provide the chance for more effective target biopsies. Confocal laser endomicroscopy allows to analyze living cells during endoscopy. To assess the diagnostic accuracy, inter- and intra-observer variability of endomicroscopy for detecting in vivo neoplasia (dysplasia and/or early neoplasia) in Barrett's oesophagus. Prospective pilot study. Patients referred for known Barrett's oesophagus were screened. Endomicroscopy was carried out in a circular fashion, every 1-2 cm, on the whole columnar-lined distal oesophagus. Visible lesions, when present, were analyzed first. Targeted biopsies were taken. Confocal images were classified according to confocal Barrett classification. Endomicroscopic and histological findings were compared. Forty-eight out of 50 screened patients underwent endomicroscopy. Visible lesions were observed in 3 patients. In a per-biopsy analysis, Barrett's-oesophagus-associated neoplasia could be predicted with an accuracy of 98.1%. The agreement between endomicroscopic and histological results was substantial (κ=0.76). This study suggests that endomicroscopy can provide in vivo diagnosis of Barrett's oesophagus-associated neoplasia. Because it allows for the study of larger surface areas of the mucosa, endomicroscopy may lead to significant improvements in the in vivo screening and surveillance of Barrett's oesophagus. Copyright © 2013 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  6. Personalized cost-effectiveness of boceprevir-based triple therapy for untreated patients with genotype 1 chronic hepatitis C.

    PubMed

    Petta, Salvatore; Cabibbo, Giuseppe; Enea, Marco; Macaluso, Fabio Salvatore; Plaia, Antonella; Bruno, Raffaele; Gasbarrini, Antonio; Bruno, Savino; Craxì, Antonio; Cammà, Calogero

    2014-10-01

    We assessed the cost-effectiveness of boceprevir-based triple therapy compared to peginterferon alpha and ribavirin dual therapy in untreated patients with genotype 1 chronic hepatitis C; patients were discriminated according to the combination of baseline plus on-treatment predictors of boceprevir-based triple therapy. Cost-effectiveness analysis performed according to data from the available published literature. The target population was composed of untreated Caucasian patients, aged 50 years, with genotype 1 chronic hepatitis C, and these were evaluated over a lifetime horizon by Markov model. The study was carried out from the perspective of the Italian National Health Service. Outcomes included discounted costs (in euro, at 2013 value), life-years gained, quality-adjusted life year, and incremental cost-effectiveness ratio. The robustness of the results was evaluated by multivariable probabilistic sensitivity analyses. According to the baseline predictors of sustained virological response (genotype 1b, low viral load, fibrosis F0-F3, and body mass index) and the 1Log drop of HCV-RNA after the dual therapy lead-in period, boceprevir was cost-effective in different patient profiles. In untreated genotype 1b chronic hepatitis C patients, the cost-effectiveness of boceprevir-based triple therapy widely ranges according to different profiles of sustained virological response predictors, allowing optimization and personalization of triple therapy. Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  7. Discovering genetic variants in Crohn's disease by exploring genomic regions enriched of weak association signals.

    PubMed

    D'Addabbo, Annarita; Palmieri, Orazio; Maglietta, Rosalia; Latiano, Anna; Mukherjee, Sayan; Annese, Vito; Ancona, Nicola

    2011-08-01

    A meta-analysis has re-analysed previous genome-wide association scanning definitively confirming eleven genes and further identifying 21 new loci. However, the identified genes/loci still explain only the minority of genetic predisposition of Crohn's disease. To identify genes weakly involved in disease predisposition by analysing chromosomal regions enriched of single nucleotide polymorphisms with modest statistical association. We utilized the WTCCC data set evaluating 1748 CD and 2938 controls. The identification of candidate genes/loci was performed by a two-step procedure: first of all chromosomal regions enriched of weak association signals were localized; subsequently, weak signals clustered in gene regions were identified. The statistical significance was assessed by non parametric permutation tests. The cytoband enrichment analysis highlighted 44 regions (P≤0.05) enriched with single nucleotide polymorphisms significantly associated with the trait including 23 out of 31 previously confirmed and replicated genes. Importantly, we highlight further 20 novel chromosomal regions carrying approximately one hundred genes/loci with modest association. Amongst these we find compelling functional candidate genes such as MAPT, GRB2 and CREM, LCT, and IL12RB2. Our study suggests a different statistical perspective to discover genes weakly associated with a given trait, although further confirmatory functional studies are needed. Copyright © 2011 Editrice Gastroenterologica Italiana S.r.l. All rights reserved.

  8. Multivariate analysis of factors influencing medical costs of acute pancreatitis hospitalizations based on a national administrative database.

    PubMed

    Murata, Atsuhiko; Matsuda, Shinya; Mayumi, Toshihiko; Okamoto, Kohji; Kuwabara, Kazuaki; Ichimiya, Yukako; Fujino, Yoshihisa; Kubo, Tatsuhiko; Fujimori, Kenji; Horiguchi, Hiromasa

    2012-02-01

    Little information is available on the analysis of medical costs of acute pancreatitis hospitalizations. This study aimed to determine the factors affecting medical costs of patients with acute pancreatitis during hospitalization using a Japanese administrative database. A total of 7193 patients with acute pancreatitis were referred to 776 hospitals. We defined "patients with high medical costs" as patients whose medical costs exceeded the 90th percentile in medical costs during hospitalization and identified the independent factors for patients with high medical costs with and without controlling for length of stay. Multiple logistic regression analysis demonstrated that necrosectomy was the most significant factor for medical costs of acute pancreatitis during hospitalization. The odds ratio of necrosectomy was 33.64 (95% confidence interval, 14.14-80.03; p<0.001). Use of an intensive care unit was the most significant factor for medical costs after controlling for LOS. The OR of an ICU was 6.44 (95% CI, 4.72-8.81; p<0.001). This study demonstrated that necrosectomy and use of an ICU significantly affected the medical costs of acute pancreatitis hospitalization. These results highlight the need for health care implementations to reduce medical costs whilst maintaining the quality of patient care, and targeting patients with severe acute pancreatitis. Copyright © 2011 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  9. Efficacy and safety of granulocyte and monocyte adsorption apheresis for ulcerative colitis: a meta-analysis.

    PubMed

    Yoshino, Takuya; Nakase, Hiroshi; Minami, Naoki; Yamada, Satoshi; Matsuura, Minoru; Yazumi, Shujiro; Chiba, Tsutomu

    2014-03-01

    Safe and effective treatments are required for patients with ulcerative colitis. It was suggested that granulocyte and monocyte adsorption apheresis might play an important role for ulcerative colitis. Therefore, a meta-analysis was performed. Medline and the Cochrane controlled trials register were used to identify randomized controlled trials comparing granulocyte and monocyte adsorption apheresis with corticosteroids, and comparing intensive with conventional apheresis in patients with ulcerative colitis. Nine randomized trials were eligible for inclusion criteria. According to pooled data, granulocyte and monocyte adsorption apheresis is effective for inducing clinical remission in patients with ulcerative colitis compared with corticosteroids (odds ratio, 2.23; 95% confidence interval: 1.38-3.60). However, the efficacy of granulocyte and monocyte adsorption apheresis was not dependent on the number of apheresis sessions. The intensive apheresis (≥2 sessions per week) is more effective for inducing clinical remission than weekly apheresis (odds ratio, 2.10; 95% confidence interval: 1.12-3.93). The rate of adverse events by apheresis was significantly lower than that by corticosteroids (odds ratio, 0.24; 95% confidence interval: 0.15-0.37). Our meta-analysis reveals that intensive granulocyte and monocyte adsorption apheresis is a safe and effective treatment with higher rates of clinical remission and response for ulcerative colitis compared with corticosteroids. Copyright © 2013 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  10. Implementation of new physics models for low energy electrons in liquid water in Geant4-DNA.

    PubMed

    Bordage, M C; Bordes, J; Edel, S; Terrissol, M; Franceries, X; Bardiès, M; Lampe, N; Incerti, S

    2016-12-01

    A new alternative set of elastic and inelastic cross sections has been added to the very low energy extension of the Geant4 Monte Carlo simulation toolkit, Geant4-DNA, for the simulation of electron interactions in liquid water. These cross sections have been obtained from the CPA100 Monte Carlo track structure code, which has been a reference in the microdosimetry community for many years. They are compared to the default Geant4-DNA cross sections and show better agreement with published data. In order to verify the correct implementation of the CPA100 cross section models in Geant4-DNA, simulations of the number of interactions and ranges were performed using Geant4-DNA with this new set of models, and the results were compared with corresponding results from the original CPA100 code. Good agreement is observed between the implementations, with relative differences lower than 1% regardless of the incident electron energy. Useful quantities related to the deposited energy at the scale of the cell or the organ of interest for internal dosimetry, like dose point kernels, are also calculated using these new physics models. They are compared with results obtained using the well-known Penelope Monte Carlo code. Copyright © 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  11. Risk of intestinal lymphoma in undiagnosed coeliac disease: results from a registered population with different coeliac disease prevalence.

    PubMed

    Elli, Luca; Contiero, Paolo; Tagliabue, Giovanna; Tomba, Carolina; Bardella, Maria Teresa

    2012-09-01

    Coeliac disease is often undiagnosed, early diagnosis and treatment could be relevant to avoid fearful complications as intestinal lymphoma. Our aim is to estimate the risk of intestinal lymphoma in undiagnosed coeliac patients, evaluating the real incidences and applying different theoretical settings of coeliac prevalence. We collected cases of intestinal lymphomas from the Lombardy Cancer Registry and coeliac patients through computerized search of all Pathology Departments; duodenal pathological reports compatible with a Marsh 3 grade were included. The lymphoproliferative risk was calculated for theoretical different settings of coeliac prevalence (from 1:50 to 1:200), relative risks for intestinal lymphomas and compared to the real incidence of the lymphomas in this population. Population consisted in 815,362 inhabitants; during the investigated period of time, 237 intestinal lymphomas and 326 coeliac patients were diagnosed. None of the coeliac patients had lymphoma. In the different scenarios calculated and compared with the real lymphoma incidence the relative risks of undiagnosed celiac disease for gastrointestinal B- and T-cell lymphomas ranges from 1.0 to 2.0 for 1:100 coeliac disease prevalence. Undiagnosed coeliac patients have no increased risk of developing intestinal lymphoma; population screening programmes, aimed at early diagnosis of lymphoma may not be useful in this setting. Copyright © 2012 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  12. Coeliac disease in autoimmune liver disease: a cross-sectional study and a systematic review.

    PubMed

    Mirzaagha, Foroozandeh; Azali, Sepideh Hagh; Islami, Farhad; Zamani, Farhad; Khalilipour, Elias; Khatibian, Morteza; Malekzadeh, Reza

    2010-09-01

    Several studies have reported an association between coeliac disease and autoimmune liver disease, but there is little information on the prevalence of coeliac disease in certain autoimmune liver diseases, particularly from non-European, non-American countries. To investigate prevalence of coeliac disease in autoimmune liver disease in Iran and to summarize previous literature. We investigated prevalence of coeliac disease among 100 autoimmune liver disease patients and compared it with the prevalence in healthy individuals. We also performed an extensive search of the English literature in PubMed Database. We found substantially elevated prevalence of coeliac disease in patients with overlap syndrome (10-15%) compared to the general population (0.1-1%). To a lesser extent, the prevalence was high in patients with autoimmune hepatitis (2-4%). In our systematic review, prevalence of coeliac disease in autoimmune hepatitis in the majority of studies was 4% or more; several studies also reported such prevalence in primary biliary cirrhosis. Since coeliac disease is common among patients with autoimmune liver disease, screening autoimmune liver disease patients for coeliac disease is indicated. Although the magnitude of benefit from a gluten-free diet in reversing autoimmune liver disease in patients with coeliac disease is controversial, it may reduce the risk of further complications of coeliac disease. Copyright (c) 2010 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  13. A simple uniformity test for ultrasound phased arrays.

    PubMed

    Dudley, Nicholas J; Woolley, Darren J

    2016-09-01

    It is difficult to test phased array ultrasound transducers for non functioning elements. We aimed to modify a widely performed test to improve its ease and effectiveness for these arrays. A paperclip was slowly moved along the transducer array, with the scanner operating in M-mode, imaging at a fundamental frequency with automatic gain and grey scale adjustment disabled. Non-functioning elements are identified by a dark vertical line in the image. The test was repeated several times for each transducer, looking for consistency of results. 2 transducers, with faults already shown by electronic transducer testing, were used to validate the method. 23 transducers in clinical use were tested. The results of the modified test on the 2 faulty transducers agreed closely with electronic transducer testing results. The test indicated faults in 5 of the 23 transducers in clinical use: 3 with a single failed element and 2 with non-uniform sensitivity. 1 transducer with non-uniform sensitivity had undergone lens repair; the new lens was visibly non-uniform in thickness and further testing showed a reduction in depth of penetration and a loss of elevational focus in comparison with a new transducer. The modified test is capable of detecting non-functioning elements. Further work is required to provide a better understanding of more subtle faults. Copyright © 2016 Associazione Italiana di Fisica Medica. All rights reserved.

  14. Systematic review of guidelines for management of intermediate hepatocellular carcinoma using the Appraisal of Guidelines Research and Evaluation II instrument.

    PubMed

    Holvoet, Tom; Raevens, Sarah; Vandewynckel, Yves-Paul; Van Biesen, Wim; Geboes, Karen; Van Vlierberghe, Hans

    2015-10-01

    Hepatocellular carcinoma is the second leading cause of cancer-related mortality worldwide. Multiple guidelines have been developed to assist clinicians in its management. We aimed to explore methodological quality of these guidelines focusing on treatment of intermediate hepatocellular carcinoma by transarterial chemoembolization. A systematic search was performed for Clinical Practice Guidelines and Consensus statements for hepatocellular carcinoma management. Guideline quality was appraised using the Appraisal of Guidelines Research and Evaluation II instrument, which rates guideline development processes across 6 domains: 'Scope and purpose', 'Stakeholder involvement', 'Rigour of development', 'Clarity of presentation', 'Applicability' and 'Editorial independence'. Thematic analysis of guidelines was performed to map differences in recommendations. Quality of 21 included guidelines varied widely, but was overall poor with only one guideline passing the 50% mark on all domains. Key recommendations as (contra)indications and technical aspects were inconsistent between guidelines. Aspects on side effects and health economics were mainly neglected. Methodological quality of guidelines on transarterial chemoembolization in hepatocellular carcinoma management is poor. This results in important discrepancies between guideline recommendations, creating confusion in clinical practice. Incorporation of the Appraisal of Guidelines Research and Evaluation II instrument in guideline development may improve quality of future guidelines by increasing focus on methodological aspects. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  15. Health-related quality of life is a prognostic factor for survival in older patients after colorectal cancer diagnosis: A population-based study.

    PubMed

    Fournier, Evelyne; Jooste, Valérie; Woronoff, Anne-Sophie; Quipourt, Valérie; Bouvier, Anne-Marie; Mercier, Mariette

    2016-01-01

    Studies carried out in the context of clinical trials have shown a relationship between survival and health-related quality of life in colorectal cancer patients. We assessed the prognostic value of health-related quality of life at diagnosis and of its longitudinal evolution on survival in older colorectal cancer patients. All patients aged ≥65 years, diagnosed with new colorectal cancer between 2003 and 2005 and registered in the Digestive Cancer Registry of Burgundy were eligible. Patients were asked to complete the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 at inclusion, three, six and twelve months after. Multivariate regression models were used to evaluate the prognostic value of health-related quality of life scores at diagnosis and their deterioration on relative survival. In multivariate analysis, a role functioning dimension lower than median was predictive of lower survival (hazard ratio=3.1, p=0.015). After three and six months of follow-up, patients with greater appetite loss were more likely to die, with hazard ratios of 4.7 (p=0.013) and 3.7 (p=0.002), respectively. Health-related quality of life assessments at diagnosis are independently associated with older colorectal cancer patients' survival. Its preservation should be a major management goal for older cancer patients. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  16. Medical physics practice and training in Ghana.

    PubMed

    Amuasi, John H; Kyere, Augustine K; Schandorf, Cyril; Fletcher, John J; Boadu, Mary; Addison, Eric K; Hasford, Francis; Sosu, Edem K; Sackey, Theophilus A; Tagoe, Samuel N A; Inkoom, Stephen; Serfor-Armah, Yaw

    2016-06-01

    Medical physics has been an indispensable and strategic stakeholder in the delivery of radiological services to the healthcare system of Ghana. The practice has immensely supported radiation oncology and medical imaging facilities over the years, while the locally established training programme continues to produce human resource to feed these facilities. The training programme has grown to receive students from other African countries in addition to local students. Ghana has been recognised by the International Atomic Energy Agency as Regional Designated Centre for Academic Training of Medical Physicists in Africa. The Ghana Society for Medical Physics collaborates with the School of Nuclear and Allied Sciences of the University of Ghana to ensure that training offered to medical physicists meet international standards, making them clinically qualified. The Society has also worked together with other bodies for the passage of the Health Profession's Regulatory Bodies Act, giving legal backing to the practice of medical physics and other allied health professions in Ghana. The country has participated in a number of International Atomic Energy Agency's projects on medical physics and has benefited from its training courses, fellowships and workshops, as well as those of other agencies such as International Organization for Medical Physics. This has placed Ghana's medical physicists in good position to practice competently and improve healthcare. Copyright © 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  17. Evaluation of size, morphology, concentration, and surface effect of gold nanoparticles on X-ray attenuation in computed tomography.

    PubMed

    Khademi, Sara; Sarkar, Saeed; Kharrazi, Sharmin; Amini, Seyed Mohammad; Shakeri-Zadeh, Ali; Ay, Mohammad Reza; Ghadiri, Hossein

    2018-01-01

    Increasing attention has been focused on the use of nanostructures as contrast enhancement agents in medical imaging, especially in computed tomography (CT). To date, gold nanoparticles (GNPs) have been demonstrated to have great potential as contrast agents for CT imaging. This study was designed to evaluate any effect on X-ray attenuation that might result from employing GNPs with a variety of shapes, sizes, surface chemistries, and concentrations. Gold nanorods (GNRs) and spherical GNPs were synthesized for this application. X-ray attenuation was quantified by Hounsfield unit (HU) in CT. Our findings indicated that smaller spherical GNPs (13 nm) had higher X-ray attenuation than larger ones (60 nm) and GNRs with larger aspect ratio exhibited great effect on X-ray attenuation. Moreover, poly ethylene glycol (PEG) coating on GNRs declined X-ray attenuation as a result of limiting the aggregation of GNRs. We observed X-ray attenuation increased when mass concentration of GNPs was elevated. Overall, smaller spherical GNPs can be suggested as a better alternative to Omnipaque, a good contrast agent for CT imaging. This data can be also considered for the application of gold nanostructures in radiation dose enhancement where nanoparticles with high X-ray attenuation are applied. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  18. Patterns of adjuvant chemotherapy for stage II and III colon cancer in France and Italy.

    PubMed

    Bouvier, Anne-Marie; Minicozzi, Pamela; Grosclaude, Pascale; Bouvier, Véronique; Faivre, Jean; Sant, Milena

    2013-08-01

    European guidelines recommend adjuvant chemotherapy for stage III colon cancer but not for stage II. To determine the extent to which adjuvant chemotherapy was used in Italy and France. A common retrospective database of 2186 colon cancers diagnosed between 2003 and 2005 was analysed according to age, stage and presenting features. 38.9% of patients with stage II and 64.6% with stage III received chemotherapy in Italy, 21.7% and 65.1% in France. For stage II, the association between country and chemotherapy was only significant in patients diagnosed out of emergency (ORItaly/France: 3.05 [2.12-4.37], p<0.001) whereas patients diagnosed in emergency were as likely to receive chemotherapy in both countries. For stage III, there was a trend to a higher administration of chemotherapy for elderly patients in France compared to Italy. French patients were more likely than Italian to receive chemotherapy (OR: 1.91[1.32-2.78], p=0.001). Chemotherapy for stage III colon cancer was as extensively used in Italy as in France for young patients. Its administration could be increased in patients over 75. Stage II patients with a lower risk of relapse received chemotherapy more often in Italy than in France. Copyright © 2013 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  19. Portal vein aneurysm: What to know.

    PubMed

    Laurenzi, Andrea; Ettorre, Giuseppe Maria; Lionetti, Raffaella; Meniconi, Roberto Luca; Colasanti, Marco; Vennarecci, Giovanni

    2015-11-01

    Portal vein aneurysm is an unusual vascular dilatation of the portal vein, which was first described by Barzilai and Kleckner in 1956 and since then less than 200 cases have been reported. The aim of this article is to provide an overview of the international literature to better clarify various aspects of this rare nosological entity and provide clear evidence-based summary, when available, of the clinical and surgical management. A systematic literature search of the Pubmed database was performed for all articles related to portal vein aneurysm. All articles published from 1956 to 2014 were examined for a total of 96 reports, including 190 patients. Portal vein aneurysm is defined as a portal vein diameter exceeding 1.9 cm in cirrhotic patients and 1.5 cm in normal livers. It can be congenital or acquired and portal hypertension represents the main cause of the acquired version. Surgical indication is considered in case of rupture, thrombosis or symptomatic aneurysms. Aneurysmectomy and aneurysmorrhaphy are considered in patients with normal liver, while shunt procedures or liver transplantation are the treatment of choice in case of portal hypertension. Being such a rare vascular entity its management should be reserved to high-volume tertiary hepato-biliary centres. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  20. Editorial: The role of medical physics in lung SBRT.

    PubMed

    Mancosu, Pietro; Nisbet, Andrew; Jornet, Núria

    2018-01-01

    Stereotactic body radiation therapy (SBRT) has become a standard treatment for non-operable patients with early stage non-small cell lung cancer (NSCLC). In this context, medical physics community has largely helped in the starting and the growth of this technique. In fact, SBRT requires the convergence of many different features for delivering large doses in few fractions to small moving target in an heterogeneous medium. The special issue of last month, was focused on the different physics challenges in lung SBRT. Eleven reviews were presented, covering: imaging for treatment planning and for treatment assessment; dosimetry and planning optimization; treatment delivery possibilities; image guidance during delivery; radiobiology. The current cutting edge role of medical physics was reported. We aimed to give a complete overview of different aspects of lung SBRT that would be of interest to both physicists implementing this technique in their institutions and more experienced physicists that would be inspired to start research projects in areas that still need further developments. We also feel that the role that medical physicists have played in the development and safe implementation of SBRT, particularly in lung region, can be taken as an excellent example to be translated to other areas, not only in Radiation Oncology but also in other health sectors. Copyright © 2018 Associazione Italiana di Fisica Medica. All rights reserved.

  1. Recommendations for the prevention, diagnosis, and treatment of chronic hepatitis B and C in special population groups (migrants, intravenous drug users and prison inmates).

    PubMed

    Almasio, Piero L; Babudieri, Sergio; Barbarini, Giorgio; Brunetto, Maurizia; Conte, Dario; Dentico, Pietro; Gaeta, Giovanni B; Leonardi, Claudio; Levrero, Massimo; Mazzotta, Francesco; Morrone, Aldo; Nosotti, Lorenzo; Prati, Daniele; Rapicetta, Maria; Sagnelli, Evangelista; Scotto, Gaetano; Starnini, Giulio

    2011-08-01

    The global spread of hepatitis B virus (HBV) and hepatitis C virus (HCV), their high chronicity rates and their progression to cirrhosis and hepatocellular carcinoma, are major public health problems. Research and intervention programmes for special population groups are needed in order to assess their infection risk and set up suitable prevention and control strategies. Aim of this paper is to give health care professionals information on HBV and HCV infections amongst migrants, drug users and prison inmates. The manuscript is an official Position Paper on behalf of the following Scientific Societies: Italian Association for the Study of the Liver (A.I.S.F.), Italian Society of Infectious and Tropical Diseases (S.I.M.I.T.), Italian Federation Department's Operators and Addiction Services (FederSerD), Italian Prison Medicine and Healthcare Society (S.I.M.S.Pe.). The considered population groups, having a high prevalence HBV and HCV infections, require specific interventions. In this context, the expression "special population" refers to specific vulnerable groups at risk of social exclusion, such as migrants, prison inmates, and intravenous drug users. When dealing with special population groups, social, environmental and clinical factors should be considered when selecting candidates for therapy as indicated by national and international guidelines. Copyright © 2010 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  2. Patient doses and occupational exposure in a hybrid operating room.

    PubMed

    Andrés, C; Pérez-García, H; Agulla, M; Torres, R; Miguel, D; Del Castillo, A; Flota, C M; Alonso, D; de Frutos, J; Vaquero, C

    2017-05-01

    This study aimed to characterize the radiation exposure to patients and workers in a new vascular hybrid operating room during X-ray-guided procedures. During one year, data from 260 interventions performed in a hybrid operating room equipped with a Siemens Artis Zeego angiography system were monitored. The patient doses were analysed using the following parameters: radiation time, kerma-area product, patient entrance reference point dose and peak skin dose. Staff radiation exposure and ambient dose equivalent were also measured using direct reading dosimeters and thermoluminescent dosimeters. The radiation time, kerma-area product, patient entrance reference point dose and peak skin dose were, on average, 19:15min, 67Gy·cm 2 , 0.41Gy and 0.23Gy, respectively. Although the contribution of the acquisition mode was smaller than 5% in terms of the radiation time, this mode accounted for more than 60% of the effective dose per patient. All of the worker dose measurements remained below the limits established by law. The working conditions in the hybrid operating room HOR are safe in terms of patient and staff radiation protection. Nevertheless, doses are highly dependent on the workload; thus, further research is necessary to evaluate any possible radiological deviation of the daily working conditions in the HOR. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  3. Digestive system dysfunction in cystic fibrosis: challenges for nutrition therapy.

    PubMed

    Li, Li; Somerset, Shawn

    2014-10-01

    Cystic fibrosis can affect food digestion and nutrient absorption. The underlying mutation of the cystic fibrosis trans-membrane regulator gene depletes functional cystic fibrosis trans-membrane regulator on the surface of epithelial cells lining the digestive tract and associated organs, where Cl(-) secretion and subsequently secretion of water and other ions are impaired. This alters pH and dehydrates secretions that precipitate and obstruct the lumen, causing inflammation and the eventual degradation of the pancreas, liver, gallbladder and intestine. Associated conditions include exocrine pancreatic insufficiency, impaired bicarbonate and bile acid secretion and aberrant mucus formation, commonly leading to maldigestion and malabsorption, particularly of fat and fat-soluble vitamins. Pancreatic enzyme replacement therapy is used to address this insufficiency. The susceptibility of pancreatic lipase to acidic and enzymatic inactivation and decreased bile availability often impedes its efficacy. Brush border digestive enzyme activity and intestinal uptake of certain disaccharides and amino acids await clarification. Other complications that may contribute to maldigestion/malabsorption include small intestine bacterial overgrowth, enteric circular muscle dysfunction, abnormal intestinal mucus, and intestinal inflammation. However, there is some evidence that gastric digestive enzymes, colonic microflora, correction of fatty acid abnormalities using dietary n-3 polyunsaturated fatty acid supplementation and emerging intestinal biomarkers can complement nutrition management in cystic fibrosis. Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  4. The Poisson-Helmholtz-Boltzmann model.

    PubMed

    Bohinc, K; Shrestha, A; May, S

    2011-10-01

    We present a mean-field model of a one-component electrolyte solution where the mobile ions interact not only via Coulomb interactions but also through a repulsive non-electrostatic Yukawa potential. Our choice of the Yukawa potential represents a simple model for solvent-mediated interactions between ions. We employ a local formulation of the mean-field free energy through the use of two auxiliary potentials, an electrostatic and a non-electrostatic potential. Functional minimization of the mean-field free energy leads to two coupled local differential equations, the Poisson-Boltzmann equation and the Helmholtz-Boltzmann equation. Their boundary conditions account for the sources of both the electrostatic and non-electrostatic interactions on the surface of all macroions that reside in the solution. We analyze a specific example, two like-charged planar surfaces with their mobile counterions forming the electrolyte solution. For this system we calculate the pressure between the two surfaces, and we analyze its dependence on the strength of the Yukawa potential and on the non-electrostatic interactions of the mobile ions with the planar macroion surfaces. In addition, we demonstrate that our mean-field model is consistent with the contact theorem, and we outline its generalization to arbitrary interaction potentials through the use of a Laplace transformation. © EDP Sciences / Società Italiana di Fisica / Springer-Verlag 2011

  5. US quality control in Italy: present and future

    NASA Astrophysics Data System (ADS)

    Balbis, S.; Musacchio, C.; Guiot, C.; Spagnolo, R.

    2011-02-01

    US diagnostic equipments are widely diffused in Italy but, in spite of recommendations (e.g. ISPESL-Ministry of Health (1999) and SIRM (Società Italiana di Radiologia Medica, 2004), US quality controls are restricted to only a few public sanitary structure and a national (or even regional) quality assurance program for testing the performances of the US equipments is still missing. A joint Research Centre among the three Piedmontese Universities and INRIM, partially funded by Regione Piemonte, has been established in 2009 as Reference Centre for Medical Ultrasounds (CRUM). In addition to research, development and training tasks, the Centre aims at the local diffusion of the quality assurance in clinical US equipments. According to data from the Ministry of Health (2006), around 7 % of the Italian US diagnostic equipments (946 over 13526) are located in Piedmont: mostly (75.6%) in public hospitals, 9.3 % in conventionated hospitals, 4.3% in public and 10.8% in private territorial structures. The goal is the provision of a regional database, which progressively includes data related to acceptance test, status and QC tests and maintenance, in order to drive equipment turnover and carefully monitoring the overall equipment efficiency. Moreover, facilities are available at CRUM for monitoring both beam geometry and acoustic power and performing quantitative assessment of the delivered energy intensity.

  6. Early prognostic markers for fatal fulminant hepatic failure cases with viral hepatitis: proton nuclear magnetic resonance spectroscopic studies of serum.

    PubMed

    Bala, Lakshmi; Mehrotra, Mayank; Mohindra, Samir; Saxena, Rajan; Khetrapal, Chunni Lal

    2013-02-01

    Fulminant hepatic failure is associated with liver metabolic derangements which could have fatal consequences. The aim of the present study is to identify serum markers for early prediction of the outcome. Proton nuclear magnetic resonance spectroscopic studies of serum of fulminant hepatic failure patients due to viral hepatitis with grade II/III of encephalopathy (twenty-four: ten prospective and fourteen retrospective) and twenty-five controls were undertaken. Of the twenty-four patients, fifteen survived with medical management alone while nine had fatal outcome. The results demonstrated significantly elevated indices of amino acids (alanine, lysine, glutamine, histidine, tyrosine, phenylalanine and 1,2-propanediol) in fatal cases compared to survivors and controls. Principal component analysis showed clear separation of fatal and surviving cases. Liver function parameters were significantly deranged in patients but they failed to provide early significant differences between surviving and fatal cases. Compared to model for end-stage liver disease scores, principal component analysis appear to be better as an early prognostic indicator. Biochemical mapping of pathways suggested interruptions in amino acid metabolism and urea cycle. Proton nuclear magnetic resonance studies of serum have the potential of rapidly identifying patients with irreversible fulminant hepatic failure requiring liver transplantation as life saving option. Copyright © 2012 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  7. Seroprevalence and risk factors for hepatitis C virus infection among blood donors in Serbia: A multicentre study.

    PubMed

    Mitrovic, Nikola; Delic, Dragan; Markovic-Denic, Ljiljana; Jovicic, Milica; Popovic, Natasa; Bojovic, Ksenija; Simonovic Babic, Jasmina; Svirtlih, Neda

    2015-07-01

    The epidemiological characteristics of hepatitis C virus (HCV) infection have not yet been described in Serbia. To determine the prevalence of anti-HCV-positive individuals among first-time blood donors and the risk factors for hepatitis C transmission. A multicentre case-control study nested within a prospective cohort study was conducted at 10 main transfusion centres in Serbia in 2013 and 27,160 blood donors who gave blood for the first time were included. Blood donors with confirmed anti-HCV positivity and seronegative controls were enrolled to determine the risk factors. Of 27,160 blood donors 52 were anti-HCV-positive; seroprevalence was 0.19%. By univariate analysis, marital status, educational level, drug use, previous transfusion, tattooing, non-use of condoms and number of sexual partners, were risk factors for hepatitis C. In the final multivariate analysis, three factors remained independently predictive: drug use, tattooing and previous blood transfusion. In total, 87.5% of cases had at least one of the risk factors for HCV transmission; 20.9% presumed that they knew when the infection occurred. HCV seroprevalence in Serbia is higher than in developed European countries. Preventive measures need to be directed towards drug use and tattooing facilities. The admission questionnaire for blood donors should be improved. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  8. Virtual chromoendoscopy improves the diagnostic yield of small bowel capsule endoscopy in obscure gastrointestinal bleeding.

    PubMed

    Boal Carvalho, Pedro; Magalhães, Joana; Dias de Castro, Francisca; Gonçalves, Tiago Cúrdia; Rosa, Bruno; Moreira, Maria João; Cotter, José

    2016-02-01

    Small bowel capsule endoscopy represents the initial investigation for obscure gastrointestinal bleeding. Flexible spectral imaging colour enhancement (FICE) is a virtual chromoendoscopy technique designed to enhance mucosal lesions, available in different settings according to light wavelength-- FICE1, 2 and 3. To compare the diagnostic yield of FICE1 and white light during capsule endoscopy in patients with obscure gastrointestinal bleeding. Retrospective single-centre study including 60 consecutive patients referred for small bowel capsule endoscopy for obscure gastrointestinal bleeding. Endoscopies were independently reviewed in FICE1 and white light; findings were then reviewed by another researcher, establishing a gold standard. Diagnostic yield was defined as the presence of lesions with high bleeding potential (P2) angioectasias, ulcers or tumours. Diagnostic yield using FICE1 was significantly higher than white light (55% vs. 42%, p=0.021). A superior number of P2 lesions was detected with FICE1 (74 vs. 44, p=0.003), particularly angioectasias (54 vs. 26, p=0.002), but not ulcers or tumours. FICE1 was significantly superior to white light, resulting in a 13% improvement in diagnostic yield, and potentially bleeding lesions particularly angioectasias were more often observed. Our results support the use of FICE1 while reviewing small bowel capsule endoscopy for obscure gastrointestinal bleeding. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  9. Gastroesophageal reflux disease: impact on work productivity and daily-life activities of daytime workers. A French cross-sectional study.

    PubMed

    Bruley des Varannes, Stanislas; Ducrotté, Philippe; Vallot, Thierry; Garofano, Anna; Bardoulat, Isabelle; Carrois, Frédéric; Ricci, Léa

    2013-03-01

    Few studies have evaluated the impact of gastroesophageal reflux disease symptoms on work productivity and no French data are available. To compare the impact of typical symptoms of nocturnal vs diurnal gastroesophageal reflux disease on work productivity and daily activities. A French prospective, multicenter, observational study was performed in primary care setting. Patient characteristics, symptomatology and treatment were reported. Work productivity loss was assessed using the work productivity and activity impairment questionnaire, predictors were identified using multivariate regression models, and estimated cost was calculated. 716 eligible patients (mean age: 46.3 years) were included by 407 physicians. Nocturnal symptoms were reported in 50.8% of patients and exclusively diurnal symptoms in 49.2%. Mean work productivity and daily activities decreased by 31.4% and 32.6%, respectively (both p<0.001). Work productivity was influenced by symptom intensity, diurnal symptoms occurrence, regurgitation and diurnal sleepiness. The mean associated cost per patient/week (€313) was higher in patients with diurnal symptoms (without (€346) or with nocturnal (€312) symptoms) than in patients with exclusive nocturnal symptoms (€253) (p<0.001). Gastroesophageal reflux disease incurs high work productivity loss especially in patients with diurnal symptoms. Further medico-economic analyses are needed to estimate the cost effectiveness ratio according to therapeutic strategies. Copyright © 2012 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  10. The multidisciplinary management of gastro-oesophageal junction tumours: European Society of Digestive Oncology (ESDO): Expert discussion and report from the 16th ESMO World Congress on Gastrointestinal Cancer, Barcelona.

    PubMed

    Van Laethem, J-L; Carneiro, F; Ducreux, M; Messman, H; Lordick, F; Ilson, D H; Allum, W H; Haustermans, K; Lepage, C; Matysiak-Budnik, T; Cats, A; Schmiegel, W; Cervantes, A; Van Cutsem, E; Rougier, Ph; Seufferlein, Th

    2016-11-01

    The management of GOJ cancers remains controversial and may vary between countries. Evidence-based attitudes and guidelines are not easy to elaborate since most of the trials and studies reported mixed cases of oesophageal (both adenocarcinoma and squamous cell tumours), GOJ and gastric cancers. The aim of this expert discussion and position paper is to elaborate practical recommendations that integrate evidence-reported literature and experience-based attitude covering all clinical aspects of GOJ cancer across different specialities and countries in Europe. Opinion leaders, selected on scientific merit were asked to answer to a prepared set of questions covering the approach of GOJ tumours from definition to therapeutic strategies. All answers were then discussed during a plenary session and reported here in providing a well-balanced reflection of both clinical expertise and updated evidence-based medicine. Definition, classification, diagnosis and staging of GOJ tumours were updated and debated. Therapeutic aspects including endoscopic therapy, surgical management, both multimodal curative and palliative management were also reviewed for proposing practical and consensual positions and recommendations whenever possible. GOJ tumours deserve specific attention,not only for uniformising clinical management across countries but also for performing specific clinical and translational research,mainly in the curative perioperative setting. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  11. How can recovery be enhanced after single-stage laparoscopic management of CBD stones? Endoscopic treatment versus laparoscopic surgery.

    PubMed

    Chapuis-Roux, Emilie; Pellissier, Laurent; Browet, Francois; Berthou, Jean Charles; Hakim, Sami; Brazier, Franck; Cosse, Cyril; Delcenserie, Richard; Regimbeau, Jean Marc

    2017-07-01

    Single-stage management of CBD stones comprises simultaneous common bile duct (CBD) clearance and cholecystectomy. The CBD can be cleared by using endoscopic treatment (ET) or laparoscopic surgery (LS) alone. To determine the most rapid recovery after the single-stage laparoscopic management of CBD stones. Patients with CBD stones treated at either of two centers (one performing ET only and one performing LS only for single-stage treatment) were included. The primary endpoint was "the textbook outcome". The feasibility rate was 74% for ET and 100% for LS (p≤0.001). The proportion of cases with the textbook outcome was higher in the ET group than in the LS-only group (73% vs. 10%; p<0.001). The CBD clearance rate was similar in the ET and LS-only groups (100% vs. 96.6%, respectively; p=0.17). The overall morbidity rate was lower in the ET group than in the LS-only group (23% vs. 29%, p=0.05). Both ET and LS are feasible, safe and effective for clearance of the CBD. ET was better than LS in terms of a less frequent requirement for drainage and a shorter length of hospital stay. LS was associated with a shorter operating time. Copyright © 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  12. Pediatric parenteral nutrition-associated liver disease and cholestasis: Novel advances in pathomechanisms-based prevention and treatment.

    PubMed

    Orso, Giuseppe; Mandato, Claudia; Veropalumbo, Claudio; Cecchi, Nicola; Garzi, Alfredo; Vajro, Pietro

    2016-03-01

    Parenteral nutrition constitutes a life-saving therapeutic tool in patients unable to ingest/absorb oral or enteral delivered nutrients. Liver function tests abnormalities are a common therapy-related complication, thus configuring the so-called Parenteral Nutrition Associated Liver Disease (PNALD) or cholestasis (PNAC). Although the damage is frequently mild, and resolves after discontinuation of parenteral nutrition, in some cases it progresses into cirrhotic changes, especially in neonates and infants. We present a literature review focusing on the pathogenetic mechanisms-driven prevention and therapies for the cases where parenteral nutrition cannot be discontinued. Ursodeoxycholic acid has been proposed in patients with cholestatic hepatopathy, but its efficacy needs to be better established. Little evidence is available on efficacy of anti-oxidants, antibiotics, probiotics and anti TNFα. Lipid emulsions based on fish oil with a high content of long-chain polyunsaturated fatty acids ω-3 appear effective both in decreasing intrahepatic inflammation and in improving biliary flow. Most recent promising variations such as soybean/MCT/olive/fish oil emulsion [third generation lipid emulsion (SMOFlipid)] are under investigation. In conclusion, we remark the emergence of a number of novel pathomechanisms underlying the severe liver impairment damage (PNALD and PNAC) in patients treated with parenteral nutrition. Only few traditional and innovative therapeutic strategies have hitherto been shown promising. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  13. Clinical strategies for the management of intestinal obstruction and pseudo-obstruction. A Delphi Consensus study of SICUT (Società Italiana di Chirurgia d'Urgenza e del Trauma).

    PubMed

    Costa, Gianluca; Ruscelli, Paolo; Balducci, Genoveffa; Buccoliero, Francesco; Lorenzon, Laura; Frezza, Barbara; Chirletti, Piero; Stagnitti, Franco; Miniello, Stefano; Stella, Francesco

    2016-01-01

    Intestinal obstructions/pseudo-obstruction of the small/large bowel are frequent conditions but their management could be challenging. Moreover, a general agreement in this field is currently lacking, thus SICUT Society designed a consensus study aimed to define their optimal workout. The Delphi methodology was used to reach consensus among 47 Italian surgical experts in two study rounds. Consensus was defined as an agreement of 75.0% or greater. Four main topic areas included nosology, diagnosis, management and treatment. A bowel obstruction was defined as an obstacle to the progression of intestinal contents and fluids generally beginning with a sudden onset. The panel identified four major criteria of diagnosis including absence of flatus, presence of >3.5 cm ileal levels or >6 cm colon dilatation and abdominal distension. Panel also recommended a surgical admission, a multidisciplinary approach, and a gastrografin swallow for patients presenting occlusions. Criteria for immediate surgery included: presence of strangulated hernia, a >10 cm cecal dilatation, signs of vascular pedicles obstructions and persistence of metabolic acidosis. Moreover, rules for non-operative management (to be conducted for maximum 72 hours) included a naso-gastric drainage placement and clinical and laboratory controls each 12 hours. Non-operative treatment should be suspended if any suspects of intra-abdominal complications, high level of lactates, leukocytosis (>18.000/mm3 or Neutrophils >85%) or a doubling of creatinine level comparing admission. Conversely, consensus was not reached regarding the exact timing of CT scan and the appropriateness of colonic stenting. This consensus is in line with current international strategies and guidelines, and it could be a useful tool in the safe basic daily management of these common and peculiar diseases. Delphi study, Intestinal obstruction, Large bowel obstruction, Pseudo-obstruction, Small bowel.

  14. A Comparison of the Conditioning Regimens BEAM and FEAM for Autologous Hematopoietic Stem Cell Transplantation in Lymphoma: an Observational Study on Patients From Fondazione Italiana Linfomi (Fil).

    PubMed

    Olivieri, Jacopo; Mosna, Federico; Pelosini, Matteo; Fama, Angelo; Rattotti, Sara; Giannoccaro, Margherita; Carli, Giuseppe; Tisi, Maria Chiara; Ferrero, Simone; Sgherza, Nicola; Mazzone, Anna Maria; Marino, Dario; Calimeri, Teresa; Loseto, Giacomo; Saraceni, Francesco; Tomei, Gabriella; Sica, Simona; Perali, Giulia; Codeluppi, Katia; Billio, Atto; Olivieri, Attilio; Orciuolo, Enrico; Matera, Rossella; Stefani, Piero Maria; Borghero, Carlo; Ghione, Paola; Cascavilla, Nicola; Lanza, Francesco; Chiusolo, Patrizia; Finotto, Silvia; Federici, Irene; Gherlinzoni, Filippo; Centurioni, Riccardo; Fanin, Renato; Zaja, Francesco

    2018-05-29

    Carmustine (BCNU)-Etoposide-Citarabine-Melphalan (BEAM) chemotherapy is the standard conditioning regimen for autologous stem cell transplantation (ASCT) in lymphomas. Owing to BCNU shortages, many centers switched to Fotemustine-substituted BEAM (FEAM), lacking proof of equivalence. We conducted a retrospective cohort study in 18 Italian centers to compare safety and efficacy of BEAM and FEAM regimens for ASCT in lymphomas performed from 2008 to 2015. We enrolled 1038 patients (BEAM n=607, FEAM n=431), of which 27% had Hodgkin's lymphoma (HL), 14% indolent Non-Hodgkin's lymphoma (iNHL) and 59% aggressive NHL (aNHL). Baseline characteristics including age, sex, stage, B-symptoms, extranodal involvement, previous treatments, response before ASCT, overall conditioning intensity, were well balanced between BEAM and FEAM; notable exceptions were: ASCT year (median: BEAM=2011 vs FEAM=2013, p<0.001), Sorror score (≥3: BEAM=15% vs FEAM=10%, p=0.017), radiotherapy use (BEAM=18% vs FEAM=10%, p<0.001). FEAM conditioning resulted in higher rates of gastrointestinal and infectious toxicities, including severe oral mucositis (grade ≥3: BEAM=31% vs FEAM=44%, p<0.001), and sepsis from Gram-negative bacteria (mean isolates/patient: BEAM=0.1 vs FEAM=0.19, p<0.001). Response status at day 100 post-ASCT (overall response: BEAM=91% vs FEAM=88%, p=0.42), 2-years Overall Survival (83.9%, 95%CI:81.5%-86.1%) and Progression-free Survival (70.3%, 95%CI:67.4%-73.1%) were not different in the two groups. Mortality from infection was higher in the FEAM group (SHR 1.99; 95%CI:1.02-3.88, p=0.04). BEAM and FEAM do not appear different in terms of survival and disease control. However, due to concerns of higher toxicity, Fotemustine substitution in BEAM does not seem justified, if not for easier supply. Copyright © 2018. Published by Elsevier Inc.

  15. Lifestyle and specific dietary habits in the Italian population: focus on sugar intake and association with anthropometric parameters-the LIZ (Liquidi e Zuccheri nella popolazione Italiana) study.

    PubMed

    Marangoni, Franca; Brignoli, Ovidio; Cricelli, Claudio; Poli, Andrea

    2017-06-01

    In order to collect information on food intake, lifestyle and health status of the Italian population, a random cohort of about 2000 adults was selected in collaboration with the Italian society of general practitioners' network (SIMG). Cohort subjects underwent a full clinical evaluation, by their family doctor, who also collected anthropometric data and information on the prevalence of cardiovascular disease risk factors; they were also administered diary forms developed to assess dietary use of simple sugars, of sugar-containing food and of selected food items. Data obtained indicate that the consumption of simple sugars (either added or as natural part of food) by the Italian adult population is, on average, not high (65 and 67 g/day, among women and men, respectively) and mostly derived from food items such as fruit, milk and yogurt. In addition, no correlations were found, in this low-sugar-consuming cohort, between sugar intake and weight, body mass index and waist circumference. Intakes of simple sugars in the LIZ cohort are not associated with weight, BMI and waist circumference. Prospective data, from cohorts like the LIZ one, might shed further light on the contribution of simple sugar intake to health in countries like Italy.

  16. Enabling technologies for space exploration systems: The STEPS project results and perspectives

    NASA Astrophysics Data System (ADS)

    Messidoro, Piero; Perino, Maria Antonietta; Boggiatto, Dario

    2013-05-01

    The project STEPS (Sistemi e Tecnologie per l'EsPlorazione Spaziale) is a joint development of technologies and systems for Space Exploration supported by Regione Piemonte, the European Regional Development Fund (E.R.D.F.) 2007-2013, Thales Alenia Space Italia (TAS-I), SMEs, Universities and public Research Centres belonging to the network "Comitato Distretto Aerospaziale del Piemonte" the Piedmont Aerospace District (PAD) in Italy. The project first part terminated in May 2012 with a final demonstration event that summarizes the technological results of research activities carried-out during a period the three years and half. The project developed virtual and hardware demonstrators for a range of technologies for the descent, soft landing and surface mobility of robotic and manned equipment for Moon and Mars exploration. The two key hardware demonstrators—a Mars Lander and a Lunar Rover—fit in a context of international cooperation for the exploration of Moon and Mars, as envisaged by Space Agencies worldwide. The STEPS project included also the development and utilization of a system of laboratories equipped for technology validation, teleoperations, concurrent design environments, and virtual reality simulation of the Exploration Systems in typical Moon and Mars environments. This paper presents the reached results in several technology domains like: vision-based GNC for the last portion of Mars Entry, Descent and Landing sequence, Hazard avoidance and complete spacecraft autonomy; Autonomous Rover Navigation, based on the determination of the terrain morphology by a stereo camera; Mobility and Mechanisms providing an Integrated Ground Mobility System, Rendezvous and Docking equipment, and protection from Environment effects; innovative Structures such as Inflatable, Smart and Multifunction Structures, an Active Shock Absorber for safe landing, balance restoring and walking; Composite materials Modelling and Monitoring; Human-machine interface features of a

  17. SOHO celebrates its first year in space with new results on the solar wind

    NASA Astrophysics Data System (ADS)

    1996-12-01

    degrees, in contrast with the temperature of less than 6000 degrees C of the visible surface. Acronyms : CDS : Coronal Diagnostic Spectrometer (PI : R. Harrison, RAL, England) CELIAS : Charge, Element and Isotope Analysis System (PI : P. Bochsler, Bern University, Switzerland) COSTEP : Comprehensive SupraThermal and Energetic Particle analyser (PI : H. Kunow, University of Kiel, Germany) EIT : Extreme-ultraviolet Imaging Telescope (PI : J.P. Delaboudini[re, IAS Orsay, France) ERNE : Energetic and Relativistic Nuclei and Electron experiment (PI : J. Torsti, University of Turku, Finland) GOLF : Global Oscillations at Low Frequencies (PI: A. Gabriel, IAS Orsay, France) LASCO : Large Angle Spectroscopic Coronagraph (PI: G. Brueckner, NRL Washington, USA) MDI : Michelson Doppler Imager (PI : P. Scherrer, Stanford University, USA) SUMER : Solar Ultraviolet Measurements of Emitted Radiation (PI : K. Wilhelm, MPAe Lindau, Germany) SWAN : Solar Wind Anisotropies (PI : J.L. Bertaux, SA Verri[res le Buisson, France) UVCS : UltraViolet Coronagraph Spectrometer (PI: J. Kohl, SAO, Cambridge, USA) VIRGO : Variability of solar Irradiance and Gravity Oscillations (PI: C. Froehlich, PMOD/WRC Davos, Switzerland) SOHO : Solar and Heliospheric Observatory Figure: The Sun's outer atmosphere Photo credits : SOHO : (UVCS and EIT consortia) : ESA, NASA UVCS : Smithsonian Astrophysical Observatory, University of Florence and Agenzia Spaziale Italiana (Italy) EIT : Institut d'Astrophysique Spatiale, Orsay, France, Centre Spatial de Li[ge, Belgium, Naval Research Laboratory, Goddard Space Flight Center SOHO is a project of international cooperation between ESA and NASA

  18. Front-line window therapy with cisplatin in patients with primary disseminated Ewing sarcoma: A study by the Associazione Italiana di Ematologia ed Oncologia Pediatrica and Italian Sarcoma Group.

    PubMed

    Luksch, Roberto; Grignani, Giovanni; D'Angelo, Paolo; Prete, Arcangelo; Puma, Nadia; Podda, Marta; Casanova, Michela; Ferrari, Andrea; Morosi, Carlo; Fagioli, Franca; Aglietta, Massimo; Ferrari, Stefano; Picci, Piero; Massimino, Maura

    2017-12-01

    The aim was to assess the activity of cisplatin (CDDP) in Ewing sarcoma (ES). The study consisted of front-line window therapy with CDDP 120 mg/sqm every 3 weeks for two courses in children and young adults with primary disseminated ES. Response was assessed using the Response Evaluation Criteria in Solid Tumours criteria, and Simon's two-stage design was applied. Twelve consecutive patients were enrolled in stage 1. Only one objective response was observed. Since the target response rate was not achieved, accrual was stopped and CDDP as a single agent in ES was judged unworthy of further assessment. © 2017 Wiley Periodicals, Inc.

  19. Spleen stiffness is positively correlated with HVPG and decreases significantly after TIPS implantation.

    PubMed

    Buechter, Matthias; Manka, Paul; Theysohn, Jens M; Reinboldt, Marcus; Canbay, Ali; Kahraman, Alisan

    2018-01-01

    Transjugular intrahepatic portosystemic shunt (TIPS) is indicated in patients with decompensated portal hypertension (PH). Hepatic venous pressure gradient (HVPG) is considered gold standard for assessment of PH. Because HVPG measurement is invasive, non-invasive methods for evaluating severity of PH are warranted. We retrospectively correlated spleen stiffness as measured by FibroScan with HVPG in patients who underwent TIPS. Twenty-four patients with spleen stiffness measurement (SSM) one day before (D-1), one day after (D+1) and 28 days after TIPS (D+28) were included. SSM was positively correlated with pre-TIPS HVPG (HVPG <13mmHg, median SSM: 19.7±8.6kPa; HVPG 13-24mmHg, median SSM: 45.0±15.7kPa; HVPG >24mmHg, median SSM: 75.0±6.2kPa; p<0.05]; r 2 =0.72; p<0.001) and decreased significantly after TIPS implantation (D-1, median SSM: 67.1±17.3kPa; D+1, median SSM: 44.7±18.5kPa; D+28, median SSM: 35.6±17.0kPa; p<0.05), while liver stiffness measurement decrease was not statistically significant. Our study highlights the utility of SSM as non-invasive tool in patients with chronic liver disease in evaluating degree of PH potentially offering a confirmable additional parameter in surveillance of patients undergoing TIPS procedure. Copyright © 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  20. Simulated gamma-ray pulse profile of the Crab pulsar with the Cherenkov Telescope Array

    NASA Astrophysics Data System (ADS)

    Burtovoi, A.; Zampieri, L.

    2016-07-01

    We present simulations of the very high energy (VHE) gamma-ray light curve of the Crab pulsar as observed by the Cherenkov Telescope Array (CTA). The CTA pulse profile of the Crab pulsar is simulated with the specific goal of determining the accuracy of the position of the interpulse. We fit the pulse shape obtained by the Major Atmospheric Gamma-Ray Imaging Cherenkov (MAGIC) telescope with a three-Gaussian template and rescale it to account for the different CTA instrumental and observational configurations. Simulations are performed for different configurations of CTA and for the ASTRI (Astrofisica con Specchi a Tecnologia Replicante Italiana) mini-array. The northern CTA configuration will provide an improvement of a factor of ˜3 in accuracy with an observing time comparable to that of MAGIC (73 h). Unless the VHE spectrum above 1 TeV behaves differently from what we presently know, unreasonably long observing times are required for a significant detection of the pulsations of the Crab pulsar with the high-energy-range sub-arrays. We also found that an independent VHE timing analysis is feasible with Large Size Telescopes. CTA will provide a significant improvement in determining the VHE pulse shape parameters necessary to constrain theoretical models of the gamma-ray emission of the Crab pulsar. One of such parameters is the shift in phase between peaks in the pulse profile at VHE and in other energy bands that, if detected, may point to different locations of the emission regions.

  1. Usability of a home-based test for the measurement of fecal calprotectin in asymptomatic IBD patients.

    PubMed

    Bello, Caroline; Roseth, Arne; Guardiola, Jordi; Reenaers, Catherine; Ruiz-Cerulla, Alexandra; Van Kemseke, Catherine; Arajol, Claudia; Reinhard, Christian; Seidel, Laurence; Louis, Edouard

    2017-09-01

    The aim of our work was to test the usability of fecal calprotectin (FC) home-based test in inflammatory bowel disease (IBD) patients. IBD patients were prospectively recruited. They had to measure FC with a dedicated tool and smartphone application, 5 times at two weeks intervals over an 8 weeks period. They had to fill in a usability questionnaire at the first and the last FC measurement. A System Usability Scale (SUS: 0-100) and the Global Score of Usability (GSU: 0-85) were calculated. FC was also centrally measured by ELISA. Fifty-eight patients were recruited. Forty-two performed at least one FC measurement and 27 performed all the FC requested measurements. The median (IQR) SUS (0-100) at the first and last use were 85 (78-90) and 81 (70-88), respectively; the median (IQR) GSU (0-85) at the first and last use were 74 (69-80) and 77 (68-83), respectively. Adherence to the planned measurements and usability of the tool were higher in females and in less severe disease. The intra-class correlation coefficient between home-based and centrally measured FC was 0.88. The adherence to home-based measurement of FC was fair. Usability scores for the home-based test were high. There was a good correlation with the centrally measured FC by ELISA. Copyright © 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  2. Ethical assessment of hepatitis C virus treatment: The lesson from first generation protease inhibitors.

    PubMed

    Sacchini, Dario; Craxì, Lucia; Refolo, Pietro; Minacori, Roberta; Cicchetti, Americo; Gasbarrini, Antonio; Cammà, Calogero; Spagnolo, Antonio G

    2015-05-01

    Since chronic hepatitis C has mostly become curable, issues concerning choice and allocation of treatment are of major concern. We assessed the foremost ethical issues in hepatitis C virus therapy with 1st generation protease inhibitors using the personalist ethical framework within the health technology assessment methodology. Our aim was to identify values at stake/in conflict and to support both the physicians' choices in hepatitis C therapy and social (macro-) allocation decision-making. The ethical assessment indicates that: (1) safety/effectiveness profile of treatment is guaranteed if its use is restricted to the patients subgroups who may benefit from it; (2) patients should be carefully informed, particularly on treatment deferral, and widespread information on these therapies should be implemented; (3) since treatment was proven to be cost-effective, its use is acceptable respecting resource macro-allocation. Concerning individual (micro-) location criteria: (a) criteria for eligibility to treatment should be clearly identified and updated periodically; (b) information on criteria for eligibility/deferral to treatment for specific patients' subgroups should be made widely known. Interferon-based regimens will disappear from use within the next year, with the introduction of highly effective/tolerable combination regimens of direct-acting antivirals, thus profoundly changing social choices. Nonetheless, our model could support future ethical assessment since the evaluation pertaining ethical domains remains generally applicable. Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  3. Assessment of the neutron dose field around a biomedical cyclotron: FLUKA simulation and experimental measurements.

    PubMed

    Infantino, Angelo; Cicoria, Gianfranco; Lucconi, Giulia; Pancaldi, Davide; Vichi, Sara; Zagni, Federico; Mostacci, Domiziano; Marengo, Mario

    2016-12-01

    In the planning of a new cyclotron facility, an accurate knowledge of the radiation field around the accelerator is fundamental for the design of shielding, the protection of workers, the general public and the environment. Monte Carlo simulations can be very useful in this process, and their use is constantly increasing. However, few data have been published so far as regards the proper validation of Monte Carlo simulation against experimental measurements, particularly in the energy range of biomedical cyclotrons. In this work a detailed model of an existing installation of a GE PETtrace 16.5MeV cyclotron was developed using FLUKA. An extensive measurement campaign of the neutron ambient dose equivalent H ∗ (10) in marked positions around the cyclotron was conducted using a neutron rem-counter probe and CR39 neutron detectors. Data from a previous measurement campaign performed by our group using TLDs were also re-evaluated. The FLUKA model was then validated by comparing the results of high-statistics simulations with experimental data. In 10 out of 12 measurement locations, FLUKA simulations were in agreement within uncertainties with all the three different sets of experimental data; in the remaining 2 positions, the agreement was with 2/3 of the measurements. Our work allows to quantitatively validate our FLUKA simulation setup and confirms that Monte Carlo technique can produce accurate results in the energy range of biomedical cyclotrons. Copyright © 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  4. The chemist, that madman! How children perceive science.

    PubMed

    Luraschi, Michela; Rezzonico, Riccardo; Pellegri, Giovanni

    2012-01-01

    He is grown-up, not young, often bald, strictly male, often a chemist, wearing odd clothes and working on mysterious things, conducting projects which sometimes help save the world, sometimes harm our natural environment. He lives and works - often into the small hours - in a grey laboratory, alone, no colleagues, utterly isolated from the outside world. His 'space' looks like a laboratory equipped with test tubes, with reactive substances but also magic portions; mostly a windowless space, and any windows there are have iron bars. This is how, broadly speaking, and stereotypically, children see scientists. Chemistry and biology are the two most popular branches. Only rarely do we associate these images - which appear to be a simple figment of a child's imagination - to the problem of staff shortages in the 'MINT' sectors in Switzerland and to the shortfall in the number of women scientists. Nonetheless, some of the ideas presented in this article suggest that a child's outlook on science, fairly deep-rooted from as early as 9 or 10 years of age (and surprisingly unchanged by the time these kids reach secondary school) may have an impact on their future career choices. L'ideatorio, at Università della Svizzera italiana, is committed to counteracting this distorted view, in particular by creating particular spaces where children can meet science - not a 'crazy', but a normal and also female, science. In these spaces, chemistry is not synonymous with bad smells and pollution, but with benefits and discovery.

  5. On-site audits to investigate the quality of radiation physics of radiation therapy institutions in the Republic of Korea.

    PubMed

    Park, Jong Min; Park, So-Yeon; Chun, Minsoo; Kim, Sang-Tae

    2017-08-01

    To investigate and improve the domestic standard of radiation therapy in the Republic of Korea. On-site audits were performed for 13 institutions in the Republic of Korea. Six items were investigated by on-site visits of each radiation therapy institution, including collimator, gantry, and couch rotation isocenter check; coincidence between light and radiation fields; photon beam flatness and symmetry; electron beam flatness and symmetry; physical wedge transmission factors; and photon beam and electron beam outputs. The average deviations of mechanical collimator, gantry, and couch rotation isocenter were less than 1mm. Those of radiation isocenter were also less than 1mm. The average difference between light and radiation fields was 0.9±0.6mm for the field size of 20cm×20cm. The average values of flatness and symmetry of the photon beams were 2.9%±0.6% and 1.1%±0.7%, respectively. Those of electron beams were 2.5%±0.7% and 0.6%±1.0%, respectively. Every institutions showed wedge transmission factor deviations less than 2% except one institution. The output deviations of both photon and electron beams were less than ±3% for every institution. Through the on-site audit program, we could effectively detect an inappropriately operating linacs and provide some recommendations. The standard of radiation therapy in Korea is expected to improve through such on-site audits. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  6. An audit of a hospital-based Doppler ultrasound quality control protocol using a commercial string Doppler phantom.

    PubMed

    Cournane, S; Fagan, A J; Browne, J E

    2014-05-01

    Results from a four-year audit of a Doppler quality assurance (QA) program using a commercially available Doppler string phantom are presented. The suitability of the phantom was firstly determined and modifications were made to improve the reliability and quality of the measurements. QA of Doppler ultrasound equipment is very important as data obtained from these systems is used in patient management. It was found that if the braided-silk filament of the Doppler phantom was exchanged with an O-ring rubber filament and the velocity range below 50 cm/s was avoided for Doppler quality control (QC) measurements, then the maximum velocity accuracy (MVA) error and intrinsic spectral broadening (ISB) results obtained using this device had a repeatability of 18 ± 3.3% and 19 ± 3.5%, respectively. A consistent overestimation of the MVA of between 12% and 56% was found for each of the tested ultrasound systems. Of more concern was the variation of the overestimation within each respective transducer category: MVA errors of the linear, curvilinear and phased array probes were in the range 12.3-20.8%, 32.3-53.8% and 27-40.7%, respectively. There is a dearth of QA data for Doppler ultrasound; it would be beneficial if a multicentre longitudinal study was carried out using the same Doppler ultrasound test object to evaluate sensitivity to deterioration in performance measurements. Copyright © 2013 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  7. Systemic thrombolysis of portal vein thrombosis in cirrhotic patients: a pilot study.

    PubMed

    De Santis, Adriano; Moscatelli, Rosanna; Catalano, Carlo; Iannetti, Antonio; Gigliotti, Francesca; Cristofari, Francesca; Trapani, Silvia; Attili, Adolfo F

    2010-06-01

    Portal vein thrombosis is a frequent complication in liver cirrhosis. Encouraging reports of systemic thrombolysis in non-cirrhotic patients suffering from acute portal vein thrombosis led us to start a pilot study on the efficacy and safety of systemic low dose recombinant tissue plasminogen activator (Actilyse, Boheringer Ingelheim, Florence, Italy). Nine cirrhotic patients (6 males and 3 females) with recent portal vein thrombosis were enrolled. Exclusion criteria were portal cavernomatosis, recent (30 days) surgery, active bleeding, hepatocellular carcinoma and cancer in other sites. All cases were treated for a maximum of 7 days by continuous i.v. infusion of 0.25mg/kg/die of r-tPA plus subcutaneous low molecular weight heparin. Efficacy was evaluated by colour doppler sonography monitoring and confirmed by contrast enhanced computerized tomography. The combined r-tPA/LMWH treatment was well tolerated without clinically significant side effects. Complete resolution of thrombosis occurred in 4 cases, partial regression in 4 and none in 1. Retreatment of a complete recurrence in 1 patient was successful. Variceal pressure dropped from 30.7+/-4.5 mmHg to 21.2+/-6.6 mmHg (p=0.012). Our preliminary data demonstrate that thrombolytic treatment of recent portal vein thrombosis with i.v. r-tPA and LMWH in patients with cirrhosis appears to be safe and effective and can significantly reduce pressure in oesophageal varices. Copyright 2009 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  8. Macroscopy predicts tumor progression in gastric cancer: A retrospective patho-historical analysis based on Napoleon Bonaparte's autopsy report.

    PubMed

    Dawson, Heather; Novotny, Alexander; Becker, Karen; Reim, Daniel; Langer, Rupert; Gullo, Irene; Svrcek, Magali; Niess, Jan H; Tutuian, Radu; Truninger, Kaspar; Diamantis, Ioannis; Blank, Annika; Zlobec, Inti; Riddell, Robert H; Carneiro, Fatima; Fléjou, Jean-François; Genta, Robert M; Lugli, Alessandro

    2016-11-01

    The cause of Napoleon Bonaparte's death remains controversial. Originally suggested to be gastric cancer, whether this was truly neoplastic or a benign lesion has been recently debated. To interpret findings of original autopsy reports in light of the current knowledge of gastric cancer and to highlight the significance of accurate macroscopy in modern-day medicine. Using original autopsy documents, endoscopic images and data from current literature, Napoleon's gastric situation was reconstructed. In a multicenter collection of 2071 gastric cancer specimens, the relationship between tumor size and features of tumor progression was assessed. Greater tumor size was associated with advanced pT, nodal metastases and Borrmann types 3-4 (p<0.001). The best cut-off for predicting pT3-4 tumors was 6.5cm (AUC 0.8; OR 1.397, 95% CI 1.35-1.446), and 6cm for lymph node metastases (AUC 0.775; OR 1.389, 95% CI 1.338-1.442). The 6cm cut-off of had a positive predictive value of 0.820 for nodal metastases and a negative predictive value of 0.880 for distant metastases. This analysis combines Napoleon's autopsy with present-day knowledge to support gastric cancer as his terminal illness and emphasizes the role of macroscopy, which may provide valuable information on gastric cancer progression and aid patient management. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  9. Linear array ultrasonography to stage rectal neoplasias suitable for local treatment.

    PubMed

    Ravizza, Davide; Tamayo, Darina; Fiori, Giancarla; Trovato, Cristina; De Roberto, Giuseppe; de Leone, Annalisa; Crosta, Cristiano

    2011-08-01

    Because of the many therapeutic options available, a reliable staging is crucial for rectal neoplasia management. Adenomas and cancers limited to the submucosa without lymph node involvement may be treated locally. The aim of this study is to evaluate the diagnostic accuracy of endorectal ultrasonography in the staging of neoplasias suitable for local treatment. We considered all patients who underwent endorectal ultrasonography between 2001 and 2010. The study population consisted of 92 patients with 92 neoplasias (68 adenocarcinomas and 24 adenomas). A 5 and 7.5MHz linear array echoendoscope was used. The postoperative histopathologic result was compared with the preoperative staging defined by endorectal ultrasonography. Adenomas and cancers limited to the submucosa were considered together (pT0-1). The sensitivity, specificity, overall accuracy rate, positive predictive value, and negative predictive value of endorectal ultrasonography for pT0-1 were 86%, 95.6%, 91.3%, 94.9% and 88.7%. Those for nodal involvement were 45.4%, 95.5%, 83%, 76.9% and 84%, with 3 false positive results and 12 false negative. For combined pT0-1 and pN0, endorectal ultrasonography showed an 87.5% sensitivity, 95.9% specificity, 92% overall accuracy rate, 94.9% positive predictive value and 90.2% negative predictive value. Endorectal linear array ultrasonography is a reliable tool to detect rectal neoplasias suitable for local treatment. Copyright © 2011 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  10. Motivational interviewing in inflammatory bowel disease patients: a useful tool for outpatient counselling.

    PubMed

    Mocciaro, Filippo; Di Mitri, Roberto; Russo, Giuseppina; Leone, Salvo; Quercia, Valerio

    2014-10-01

    Most inflammatory bowel disease patients miss follow-up visits and are non-adherent to therapy due to the lack of an engaging patient-physician relationship. Motivational interviewing is a patient-centred counselling method used to elicit/strengthen motivation towards change. The aim of this study was to assess the role of motivational interviewing in patients affected by inflammatory bowel disease. The study included consecutive patients with inflammatory bowel disease presenting for the first consultation (June 2012-February 2013). All consultations were carried out applying the motivational interviewing approach. After each consultation, patients filled out a questionnaire asking demographic data, and their past and current experience. Overall, 23 males (51.1%) and 22 females (48.9%), mean age 36.1±15.2 years, were enrolled. Before and after experiencing the motivational interviewing approach (mean visit duration 41.5±8.7min) "overall satisfaction rate", "physician's communication skills", and "perceived empathy" were 60% vs 100%, 40% vs 95.6%, and 40% vs 100%, respectively. Satisfaction was lower in patients affected by indeterminate colitis (p=0.004), and of younger age (p=0.02). The motivational interview approach is appreciated by inflammatory bowel disease patients. Despite being time-consuming, the motivational interview appears considerably worthwhile at the first visit and in younger patients. Motivational interviewing can help physicians to deal with their patients, moving from "cure" to "care". Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  11. A didactic experiment showing the Compton scattering by means of a clinical gamma camera.

    PubMed

    Amato, Ernesto; Auditore, Lucrezia; Campennì, Alfredo; Minutoli, Fabio; Cucinotta, Mariapaola; Sindoni, Alessandro; Baldari, Sergio

    2017-06-01

    We describe a didactic approach aimed to explain the effect of Compton scattering in nuclear medicine imaging, exploiting the comparison of a didactic experiment with a gamma camera with the outcomes from a Monte Carlo simulation of the same experimental apparatus. We employed a 99m Tc source emitting 140.5keV photons, collimated in the upper direction through two pinholes, shielded by 6mm of lead. An aluminium cylinder was placed on the source at 50mm of distance. The energy of the scattered photons was measured on the spectra acquired by the gamma camera. We observed that the gamma ray energy measured at each step of rotation gradually decreased from the characteristic energy of 140.5keV at 0° to 102.5keV at 120°. A comparison between the obtained data and the expected results from the Compton formula and from the Monte Carlo simulation revealed a full agreement within the experimental error (relative errors between -0.56% and 1.19%), given by the energy resolution of the gamma camera. Also the electron rest mass has been evaluated satisfactorily. The experiment was found useful in explaining nuclear medicine residents the phenomenology of the Compton scattering and its importance in the nuclear medicine imaging, and it can be profitably proposed during the training of medical physics residents as well. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  12. Work productivity and activity impairment in gastroesophageal reflux disease in Korean full-time employees: a multicentre study.

    PubMed

    Shin, Woon Geon; Kim, Heung Up; Kim, Sang Gyun; Kim, Gwang Ha; Shim, Ki-Nam; Kim, Jeong Wook; Kim, Jin Il; Kim, Jae Gyu; Kim, Jae J; Yim, Da-Hae; Park, Sue K; Park, Soo-Heon

    2012-04-01

    The costs of gastroesophageal reflux disease have not been assessed in Asia, even though the prevalence of gastroesophageal reflux disease is gradually increasing. We evaluated work presenteeism and absenteeism as indirect costs of gastroesophageal reflux disease in Korea. This was a cross-sectional and multicentre study using patient-reported outcome instruments. A total of 1009 full-time employees who visited the gastrointestinal department for any reason (281 patients with gastroesophageal reflux disease and 728 controls) were included. Main outcomes were presenteeism and absenteeism measured as work productivity loss and monetary cost per week. Absenteeism and presenteeism were significantly higher in the gastroesophageal reflux disease than the control group (1.49% vs. 0.46%, P=0.0010; 34.13% vs. 9.23%, P<0.0001). Loss of work productivity was significantly greater in the gastroesophageal reflux disease than the control group (33.09% vs. 9.02%; P<0.0001). This loss of work productivity difference between the two groups represented an additional productivity loss of 11.7h/week in the gastroesophageal reflux disease group compared with the control group. Assuming average hourly wages of $14.12, the weekly burden of gastroesophageal reflux disease reached $165.07 per person. Gastroesophageal reflux disease was associated with substantial work productivity loss, mainly due to presenteeism rather than absenteeism, in Korean full-time employees. Copyright © 2011 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  13. Focus on the legislative approach to short half life radioactive hospital waste releasing.

    PubMed

    Petrucci, Caterina; Traino, Antonio Claudio

    2015-11-01

    We propose to summarize the advancements introduced by the new Directive 2013/59/Euratom concerning the concept of clearance, for which the radioactive medical waste represents a typical candidate. We also intend to spotlight disputable points in the regulatory scheme in force in Italy, as well to make a contribution to evaluate whether the practice of patients' urine storing, stated by it, can be regarded to be proper. With directing our interest to radionuclides used in Nuclear Medicine, we first present an overview of how the clearance concept, and that of exemption closely related to it, have been developed from the previous Directive 96/29 to the new one; then we describe the implementation of these concepts in the Italian legislation. Subsequently we estimate the exposure due both to keeping the effluent on site and to direct discharging it to the environment. In line with a well established international consensus, the Directive 2013/59 drives simple and harmonized regulation of clearance. On the contrary, some complexity and lack of consistency can be found in the framework of the national legislation affecting the radioactive medical waste handling. In addition the practice of excreta storing is disputed not to be really beneficial. The opportunity should be taken to make the whole system of these requirements simpler and more consistent and effective when it is revised to transpose the new Directive. Copyright © 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  14. Sox9 expression in carcinogenesis and its clinical significance in intrahepatic cholangiocarcinoma.

    PubMed

    Matsushima, Hajime; Kuroki, Tamotsu; Kitasato, Amane; Adachi, Tomohiko; Tanaka, Takayuki; Hirabaru, Masataka; Hirayama, Takanori; Kuroshima, Naoki; Hidaka, Masaaki; Soyama, Akihiko; Takatsuki, Mitsuhisa; Kinoshita, Naoe; Sano, Kazunori; Nishida, Noriyuki; Eguchi, Susumu

    2015-12-01

    Intrahepatic cholangiocarcinomas develop through a multi-step carcinogenesis. Precancerous lesions are defined as biliary intraepithelial neoplasia. Sex determining region Y-box9 (Sox9) is required for the normal differentiation of the biliary tract. To evaluate the Sox9 expression in carcinogenesis and its correlation with clinicopathological features in intrahepatic cholangiocarcinoma. Sox9 expression in normal epithelium, biliary intraepithelial neoplasia, and intrahepatic cholangiocarcinoma were investigated immunohistochemically using 43 specimens of intrahepatic cholangiocarcinoma. Sox9 expression in intrahepatic cholangiocarcinoma was compared with the clinicopathological features. The molecular effects of Sox9 were investigated by gene transfection to intrahepatic cholangiocarcinoma cell lines. Sox9 expression was decreased from the normal epithelium to the biliary intraepithelial neoplasia in a stepwise fashion. In 51.2% (22/43) of the patients with intrahepatic cholangiocarcinoma, Sox9 expression was positive, and Sox9 expression was significantly associated with the biliary infiltration (P=0.034) and poor overall survival (P=0.039). Upregulation of Sox9 promoted the cell migration and invasion, and decreased the E-cadherin expression and increased the vimentin and α-SMA expression in cell lines. Decreased Sox9 expression may be related to the early stage of the carcinogenesis of intrahepatic cholangiocarcinoma. Sox9 overexpression in intrahepatic cholangiocarcinoma is related to biliary infiltration and poorer prognosis, and it promotes cell migration and invasion, via the epithelial-to-mesenchymal transition. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  15. Adalimumab in active ulcerative colitis: a "real-life" observational study.

    PubMed

    Armuzzi, Alessandro; Biancone, Livia; Daperno, Marco; Coli, Alessandra; Pugliese, Daniela; Annese, Vito; Aratari, Annalisa; Ardizzone, Sandro; Balestrieri, Paola; Bossa, Fabrizio; Cappello, Maria; Castiglione, Fabiana; Cicala, Michele; Danese, Silvio; D'Incà, Renata; Dulbecco, Pietro; Feliciangeli, Giuseppe; Fries, Walter; Genise, Stefania; Gionchetti, Paolo; Gozzi, Stefano; Kohn, Anna; Lorenzetti, Roberto; Milla, Monica; Onali, Sara; Orlando, Ambrogio; Papparella, Luigi Giovanni; Renna, Sara; Ricci, Chiara; Rizzello, Fernando; Sostegni, Raffaello; Guidi, Luisa; Papi, Claudio

    2013-09-01

    The effectiveness of adalimumab in the treatment of ulcerative colitis is under debate. Although controlled trials have shown that adalimumab is significantly better than placebo, the absolute clinical benefit is modest. We report data on the effectiveness of adalimumab in a cohort of ulcerative colitis patients treated in 22 Italian centres. All patients with active disease treated with adalimumab were retrospectively reviewed. Co-primary endpoints were clinical remission at weeks 4, 12, 24 and 54. Secondary endpoints were sustained clinical remission, steroid discontinuation, endoscopic remission and need for colectomy. Eighty-eight patients were included. Most patients had received previous infliximab treatment. Clinical remission rates were 17%, 28.4%, 36.4% and 43.2% at 4, 12, 24 and 54 weeks respectively. Twenty-two patients required colectomy. Clinical remission and low C-reactive protein at week 12 predicted clinical remission at week 54 (OR 4.17, 95% CI 2.36-19.44; OR 2.63, 95% CI 2.32-14.94, respectively). Previous immunosuppressant use was associated with a lower probability of clinical remission at week 54 (OR 0.67, 95% CI 0.08-0.66) and with a higher rate of colectomy (HR 9.7, 95% CI 1.46-9.07). In this large "real-life" experience adalimumab appears effective in patients with otherwise medically refractory ulcerative colitis. Patients achieving early remission can expect a better long-term outcome. Copyright © 2013 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  16. Sorafenib and FH535 in combination act synergistically on hepatocellular carcinoma by targeting cell bioenergetics and mitochondrial function.

    PubMed

    Turcios, Lilia; Vilchez, Valery; Acosta, Luis F; Poyil, Pratheeshkumar; Butterfield, David Allan; Mitov, Mihail; Marti, Francesc; Gedaly, Roberto

    2017-06-01

    Treatment of advanced hepatocellular carcinoma (HCC) remains a challenge due to the high tumor heterogeneity. In the present study, we aim to evaluate the impact of the β-catenin inhibitor, FH535, alone or in combination with the Ras/Raf/MAPK inhibitor Sorafenib, on the bioenergetics profiles of the HCC cell lines Huh7 and PLC/PRF/5. Single low-dose treatments with FH535 or Sorafenib promoted different effects on mitochondrial respiration and glycolysis in a cell type specific manner. However, the combination of these drugs significantly reduced both mitochondrial respiration and glycolytic rates regardless of the HCC cells. The significant changes in mitochondrial respiration observed in cells treated with the Sorafenib-FH535 combination may correspond to differential targeting of ETC complexes and changes in substrate utilization mediated by each drug. Moreover, the bioenergetics changes and the loss of mitochondrial membrane potential that were evidenced by treatment of HCC cells with the combination of FH535 and Sorafenib, preceded the induction of cell apoptosis. Overall, our results demonstrated that Sorafenib-FH535 drug combination induce the disruption of the bioenergetics of HCC by the simultaneous targeting of mitochondrial respiration and glycolytic flux that leads the synergistic effect on inhibition of cell proliferation. These findings support the therapeutic potential of combinatory FH535-Sorafenib treatment of the HCC heterogeneity by the simultaneous targeting of different molecular pathways. Copyright © 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  17. Air density dependence of the response of the PTW SourceCheck 4pi ionization chamber for 125I brachytherapy seeds.

    PubMed

    Torres Del Río, J; Tornero-López, A M; Guirado, D; Pérez-Calatayud, J; Lallena, A M

    2017-06-01

    To analyze the air density dependence of the response of the new SourceCheck 4pi ionization chamber, manufactured by PTW. The air density dependence of three different SourceCheck 4pi chambers was studied by measuring 125 I sources. Measurements were taken by varying the pressure from 746.6 to 986.6hPa in a pressure chamber. Three different HDR 1000 Plus ionization chambers were also analyzed under similar conditions. A linear and a potential-like function of the air density were fitted to experimental data and their achievement in describing them was analyzed. SourceCheck 4pi chamber response showed a residual dependence on the air density once the standard pressure and temperature factor was applied. The chamber response was overestimated when the air density was below that under normal atmospheric conditions. A similar dependence was found for the HDR 1000 Plus chambers analyzed. A linear function of the air density permitted a very good description of this residual dependence, better than with a potential function. No significant variability between the different specimens of the same chamber model studied was found. The effect of overestimation observed in the chamber responses once they are corrected for the standard pressure and temperature may represent a non-negligible ∼4% overestimation in high altitude cities as ours (700m AMSL). This overestimation behaves linearly with the air density in all cases analyzed. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  18. Early results of urothelial carcinoma screening in a risk population of coke workers: urothelial carcinoma among coke workers.

    PubMed

    Giberti, C; Gallo, F; Schenone, M; Genova, A

    2010-08-01

    To present the protocol and the early results of a urothelial carcinoma (UC) screening analysis performed in a risk population of coke workers. Between June 2006 and October 2008, 171 male workers (mean age 43 years), employed in a Ligurian coke plant (Italiana Coke S.r.l) and exposed to polycyclic aromatic hydrocarbons (PAHs) for a median period of 16 years, underwent screening for UC. Urological evaluation included medical history, physical examination, routine laboratory tests, urine analysis, urinary cytology and uCyt+ assay. In the event of signs and symptoms suggestive of UC or positive urinary tests, the workers were also subjected to urinary ultrasonography and cystoscopy with biopsy of any suspicious lesions. Regarding the laboratory tests, 19/171 (11%) uCyt+ samples were considered inadequate and were excluded from the outcomes assessment. Overall, urine analysis, cytology and uCyt+ were positive in 18/152 (12%) subjects who showed no evidence of UC at the scheduled check-ups. No significant association was identified between marker positivity and occupational activity. Our results fail to show an increased risk of UC among the coke workers evaluated. However, they will need to be confirmed in the future by a larger enrollment and a longer follow-up in order to assess the definitive risk for UC after exposure to coke. Copyright © 2010 The Editorial Board of Biomedical and Environmental Sciences. Published by Elsevier B.V. All rights reserved.

  19. Apple polyphenols extract (APE) improves colon damage in a rat model of colitis.

    PubMed

    D'Argenio, Giuseppe; Mazzone, Giovanna; Tuccillo, Concetta; Ribecco, Maria T; Graziani, Giulia; Gravina, Antonietta G; Caserta, Sergio; Guido, Stefano; Fogliano, Vincenzo; Caporaso, Nicola; Romano, Marco

    2012-07-01

    Searching for alternative therapies that are effective, safe and less expensive of those currently used for ulcerative colitis, we investigated the efficacy of a polyphenol extract from apple in rat colitis. Rats with trinitrobenzensulphonic acid-induced colitis were treated daily with rectal administration of apple polyphenols 10(-4) M for 14 days. COX-2, TNF-α, tissue transglutaminase and calpain in colon mucosa samples were assessed by reverse transcription-polymerase chain reaction and western blot analyses. To ascertain the role of tissue transglutaminase in mucosal healing, wounded rat fibroblasts were incubated with cystamine (a tissue transglutaminase activity inhibitor). Colitis was associated with increased COX-2, TNF-α, calpain, and tissue transglutaminase mRNA. The protein expression of COX-2, TNF-α and calpain was increased whilst tissue transglutaminase was decreased. Apple extract treatment reduced the severity of colitis (p<0.05) and restored all the considered biomarkers at the baseline level. Apple polyphenols reduced the degradation of tissue transglutaminase protein occurring through calpain action. Apple polyphenols-treated wounded fibroblast recovered within 24h showing intense immunoreactivity for tissue transglutaminase. The efficacy of apple extract is mediated by its effects on COX-2 and TNF-α. The unbalance between calpain and tissue transglutaminase may play a role in colonic damage and future therapeutic interventions in ulcerative colitis can target this mechanisms. Copyright © 2012 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  20. A commercial project for private investments. Update of the 280 MW api Energia IGCC plant construction in central Italy.

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Del Bravo, R.; Pinacci, P.; Trifilo, R.

    1998-07-01

    This paper has the aim to give a general overview of the api Energia IGCC project starting from the project background in 1992 and ending with the progress of construction. api Energia S.p.A., a joint VENTURE between api anonima petroli italiana S.p.A., Roma, Italy (51%), ABB Sae Sadelmi S.p.A., Milano, Italy (25%) and Texaco Development Corporation (24%), is building a 280 MW Integrated Gasification Combined Cycle plant in the api refinery at Falconara Marittima, on Italy' s Adriatic coast, using heavy oil residues. The plant is based on the modern concept of employing a highly efficient combined cycle power plantmore » fed with a low heating value fuel gas produced by gasifying heavy refinery residues. This scheme provides consistent advantages in terms of efficiency and environmental impact over alternative applications of the refinery residues. The electric power produced will feed the national grid. The project has been financed using the ``project financing'' scheme: over 1,000 billion Lira, representing 75% of the overall capital requirement, have been provided by a pool of international banks. In November 1996 the project reached financial closure and immediately after the detailed design and procurement activities started. Engineering, Procurement and Construction activities, carried out by a Consortium of companies of the ABB group, are totally in line with the schedule. Commercial operation of the plant, is scheduled for November 1999.« less

  1. Transrectal implantation and stability of gold markers in prostate bed for salvage radiotherapy of macroscopic recurrences.

    PubMed

    Shakir, Shakir I; Udrescu, Corina; Enachescu, Ciprian; Rouviere, Olivier; Arion, Simona; Caraivan, Ionela; Chapet, Olivier

    2016-11-01

    The objective of the study was to verify the stability of gold markers in the prostatic bed (PB) during salvage radiotherapy. Seven patients, diagnosed with a macroscopic nodule visible on MRI, underwent targeted MRI-guided biopsies. Three gold markers were implanted into the PB close to the relapsing nodule for CT/MRI fusion. A dose of 60Gy was delivered using IMRT to the PB followed by a dose escalation up to 72Gy to the macroscopic nodule. Daily anterior and left-lateral kV-images were acquired for repositioning. The coordinates of the center of each marker were measured on the two kV-images. The distance variations (Dvar) of the markers in the first session and the subsequent ones were compared. No marker was lost during treatment. The average distance between markers was 7.8mm. The average Dvar was 0.8mm, in absolute value. A total of 380/528 (72%) Dvar were ⩽1mm. A Dvar greater than 2mm was observed in 5.7% of measurements, with a maximum value of 4.8mm. Despite the absence of the prostate, the implantation of gold markers in the PB remains feasible, with Dvar often less than 2mm, and could be used to develop new approaches of salvage focal radiotherapy on the macroscopic relapse after prostatectomy. Copyright © 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  2. Prevalence and risk factors of Clostridium difficile infection in patients hospitalized for flare of inflammatory bowel disease: a retrospective assessment.

    PubMed

    Regnault, Helene; Bourrier, Anne; Lalande, Valerie; Nion-Larmurier, Isabelle; Sokol, Harry; Seksik, Philippe; Barbut, Frederic; Cosnes, Jacques; Beaugerie, Laurent

    2014-12-01

    Recent studies have identified a high frequency of Clostridium difficile infections in patients with active inflammatory bowel disease. To retrospectively assess the determinants and results of Clostridium difficile testing upon the admission of patients hospitalized with active inflammatory bowel disease in a tertiary care centre and to determine the predicting factors of Clostridium difficile infections. We reviewed all admissions from January 2008 and December 2010 for inflammatory bowel disease flare-ups. A toxigenic culture and a stool cytotoxicity assay were performed for all patients tested for Clostridium difficile. Out of 813 consecutive stays, Clostridium difficile diagnostic assays have been performed in 59% of inpatients. The independent predictive factors for the testing were IBD (ulcerative colitis: OR 2.0, 95% CI 1.5-2.9; p<0.0001) and colonic involvement at admission (OR 2.2, 95% CI 1.5-3.1, p<0.0001). Clostridium difficile infection was present in 7.0% of the inpatients who underwent testing. In a multivariate analysis, the only independent predictor was the intake of nonsteroidal anti-inflammatory drugs within the two months before admission (OR 3.8, 95% CI 1.2-12.3; p=0.02). Clostridium difficile infection is frequently associated with active inflammatory bowel disease. Our study suggests that a recent intake of nonsteroidal anti-inflammatory drugs is a risk factor for inflammatory bowel disease -associated Clostridium difficile infection. Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  3. Visceral fat area predicts survival in patients with advanced hepatocellular carcinoma treated with tyrosine kinase inhibitors.

    PubMed

    Nault, Jean-Charles; Pigneur, Frédéric; Nelson, Anaïs Charles; Costentin, Charlotte; Tselikas, Lambros; Katsahian, Sandrine; Diao, Guoqing; Laurent, Alexis; Mallat, Ariane; Duvoux, Christophe; Luciani, Alain; Decaens, Thomas

    2015-10-01

    Anthropometric measurements have been linked to resistance to anti-angiogenic treatment and survival. Patients with advanced hepatocellular carcinoma treated with sorafenib or brivanib in 2008-2011 were included in this retrospective study. Anthropometric measurements were assessed using computed tomography and were correlated with drug toxicity, radiological response, and overall survival. 52 patients were included, Barcelona Clinic Liver Classification B (38%) and C (62%), with a mean value of α-fetoprotein of 29,554±85,654 ng/mL, with a median overall survival of 10.5 months. Sarcopenia was associated with a greater rate of hand-foot syndrome (P=0.049). Modified Response Evaluation Criteria In Solid Tumours (mRECIST) and Choi criteria were significantly associated with survival, but RECIST criteria were not. An absence of hand-foot syndrome and high-visceral fat area were associated with progressive disease as assessed by RECIST and mRECIST criteria. In multivariate analyses, high visceral fat area (HR=3.6; P=0.002), low lean body mass (HR=2.4; P=0.015), and presence of hand-foot syndrome (HR=1.8; P=0.004) were significantly associated with overall survival. In time-dependent multivariate analyses; only high visceral fat area was associated with survival. Visceral fat area is associated with survival and seems to be a predictive marker for primary resistance to tyrosine kinase inhibitors in patients with advanced hepatocellular carcinoma. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  4. Clinical and Organizational Issues in the Management of Surviving Breast and Colorectal Cancer Patients: Attitudes and Feelings of Medical Oncologists

    PubMed Central

    Numico, Gianmauro; Pinto, Carmine; Gori, Stefania; Ucci, Giovanni; Di Maio, Massimo; Cancian, Maurizio; De Lorenzo, Francesco; Silvestris, Nicola

    2014-01-01

    Background The fast growing demand and the shortage of resources are pushing toward more efficient models of survivorship care delivery. The Associazione Italiana di Oncologia Medica (AIOM) established an interdisciplinary working group with the purpose of promoting organizational improvements at the national level. A survey aimed at assessing attitudes and feelings of oncologists was considered preliminary to further initiatives. Methods A 25-item questionnaire, sent to the mailing list of the Society, explored the following issues on the practice of breast and colorectal cancer patients' follow up: 1) organization; 2) clinical features; 3) feelings about the different meanings of follow-up. Results Ninety-one oncologists of 160 institutions (57%) answered to the questionnaire. Although follow up is considered a distinct oncological activity in 68%, a fully shared organization between specialists is not common and communications with Primary Care Physicians are not structured in the majority of the cases. Fifty-five and 30% of the oncologists follow breast and colorectal cancer patients indefinitely. In case of discharge a survivorship care plan is delivered in only 9%. The majority of respondents do not hold a role of follow up in mortality reduction. Conclusions Although survivorship care represents a significant part of the oncologists' workload, an “oncology-centered” model is largely adopted and established care pathways are still incomplete. Survivorship care needs to be put at the center of an educational policy and of a widespread organizational effort, directed at improving appropriateness and quality. PMID:24983237

  5. Clinical and organizational issues in the management of surviving breast and colorectal cancer patients: attitudes and feelings of medical oncologists.

    PubMed

    Numico, Gianmauro; Pinto, Carmine; Gori, Stefania; Ucci, Giovanni; Di Maio, Massimo; Cancian, Maurizio; De Lorenzo, Francesco; Silvestris, Nicola

    2014-01-01

    The fast growing demand and the shortage of resources are pushing toward more efficient models of survivorship care delivery. The Associazione Italiana di Oncologia Medica (AIOM) established an interdisciplinary working group with the purpose of promoting organizational improvements at the national level. A survey aimed at assessing attitudes and feelings of oncologists was considered preliminary to further initiatives. A 25-item questionnaire, sent to the mailing list of the Society, explored the following issues on the practice of breast and colorectal cancer patients' follow up: 1) organization; 2) clinical features; 3) feelings about the different meanings of follow-up. Ninety-one oncologists of 160 institutions (57%) answered to the questionnaire. Although follow up is considered a distinct oncological activity in 68%, a fully shared organization between specialists is not common and communications with Primary Care Physicians are not structured in the majority of the cases. Fifty-five and 30% of the oncologists follow breast and colorectal cancer patients indefinitely. In case of discharge a survivorship care plan is delivered in only 9%. The majority of respondents do not hold a role of follow up in mortality reduction. Although survivorship care represents a significant part of the oncologists' workload, an "oncology-centered" model is largely adopted and established care pathways are still incomplete. Survivorship care needs to be put at the center of an educational policy and of a widespread organizational effort, directed at improving appropriateness and quality.

  6. The influence of plan modulation on the interplay effect in VMAT liver SBRT treatments.

    PubMed

    Hubley, Emily; Pierce, Greg

    2017-08-01

    Volumetric modulated arc therapy (VMAT) uses multileaf collimator (MLC) leaves, gantry speed, and dose rate to modulate beam fluence, producing the highly conformal doses required for liver radiotherapy. When targets that move with respiration are treated with a dynamic fluence, there exists the possibility for interplay between the target and leaf motions. This study employs a novel motion simulation technique to determine if VMAT liver SBRT plans with an increase in MLC leaf modulation are more susceptible to dosimetric differences in the GTV due to interplay effects. For ten liver SBRT patients, two VMAT plans with different amounts of MLC leaf modulation were created. Motion was simulated using a random starting point in the respiratory cycle for each fraction. To isolate the interplay effect, motion was also simulated using four specific starting points in the respiratory cycle. The dosimetric differences caused by different starting points were examined by subtracting resultant dose distributions from each other. When motion was simulated using random starting points for each fraction, or with specific starting points, there were significantly more dose differences in the GTV (maximum 100cGy) for more highly modulated plans, but the overall plan quality was not adversely affected. Plans with more MLC leaf modulation are more susceptible to interplay effects, but dose differences in the GTV are clinically negligible in magnitude. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  7. Cholangiocarcinoma in Italy: A national survey on clinical characteristics, diagnostic modalities and treatment. Results from the "Cholangiocarcinoma" committee of the Italian Association for the Study of Liver disease.

    PubMed

    Alvaro, Domenico; Bragazzi, Maria Consiglia; Benedetti, Antonio; Fabris, Luca; Fava, Giammarco; Invernizzi, Pietro; Marzioni, Marco; Nuzzo, Gennaro; Strazzabosco, Mario; Stroffolini, Tommaso

    2011-01-01

    Very few studies assessed cholangiocarcinoma clinical characteristics. To evaluate the clinical characteristics of intra-hepatic (IH) and extra-hepatic (EH)-CCA. We performed a national survey based on a questionnaire. 218 cholangiocarcinomas were observed (47% EH-CCA, 53% IH-CCA) with an age at the diagnosis higher for EH-CCA. Coexistence of cirrhosis or viral cirrhosis was more frequent in IH-CCA than EH-CCA. An incidental asymptomatic presentation occurred in 28% of IH-CCA vs 4% EH-CCA whilst, 74% EH-CCA vs 28% IH-CCA presented with jaundice. 91% of IH-CCA presented as a single intra-hepatic mass, whilst 50% of EH-CCA was peri-hilar. In the diagnostic work-up, 70% of all cholangiocarcinoma cases received at least 3 different imaging procedures. Tissue-proven diagnosis was obtained in 80% cholangiocarcinoma. Open surgery with curative intent was performed in 45% of IH-CCA and 29% EH-CCA. 18% IH-CCA vs 4% EH-CCA did not received treatment. In Italy IH-CCA is managed as frequently as EH-CCA. In comparison to EH-CCA, IH-CCA occurs at younger age and is more frequently associated with cirrhosis and with an incidental asymptomatic presentation. In contrast, most EH-CCAs are jaundiced at the diagnosis. Cholangiocarcinoma diagnostic management is cost- and time-consuming with curative surgical treatment applicable more frequently in IH-CCA. Copyright © 2010 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  8. A phantom study on bladder and rectum dose measurements in brachytherapy of cervix cancer using FBX aqueous chemical dosimeter.

    PubMed

    Bansal, Anil K; Semwal, Manoj K; Arora, Deepak; Sharma, D N; Julka, P K; Rath, G K

    2013-06-01

    The ferrous sulphate-benzoic acid-xylenol orange (FBX) chemical dosimeter, due to its aqueous form can measure average volume doses and hence may overcome the limitations of point dosimetry. The present study was undertaken to validate the use of FBX dosimeter for rectum and bladder dose measurement during intracavitary brachytherapy (ICBT) and transperineal interstitial brachytherapy (TIB). We filled cylindrical polypropylene tubes (PT) and Foley balloons (FB) with FBX solution and used them as substitutes for rectum and bladder dose measurements respectively. A water phantom was fabricated with provision to place the Fletcher-type ICBT and MUPIT template applicators, and FBX filled PT and FB within the phantom. The phantom was then CT scanned for treatment planning and subsequent irradiation. Our results show that the average difference between DVH derived dose value and FBX measured dose is 3.5% (PT) and 13.7% (FB) for ICBT, and 9% (PT) and 9.9% (FB) for TIB. We believe that the FBX system should be able to provide accuracy and precision sufficient for routine quality assurance purposes. The advantage of the FBX system is its water equivalent composition, average volume dose measuring capability, and energy and temperature independent response as compared to TLD or semiconductor dosimeters. However, detailed studies will be needed with regards to its safety before actual in-vivo dose measurements are possible with the FBX dosimeter. Copyright © 2012 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  9. Ursodeoxycholic acid treatment in patients with cystic fibrosis at risk for liver disease.

    PubMed

    Siano, Maria; De Gregorio, Fabiola; Boggia, Bartolo; Sepe, Angela; Ferri, Pasqualina; Buonpensiero, Paolo; Di Pasqua, Antonio; Raia, Valeria

    2010-06-01

    Meconium ileus has been detected as a risk factor for development of liver disease in cystic fibrosis, with influence on morbidity and mortality. To evaluate the effect of early treatment with ursodeoxycholic acid in patients with cystic fibrosis and meconium ileus to prevent chronic hepatic involvement and to explore the potential role of therapy on clinical outcomes. 26 cystic fibrosis patients with meconium ileus (16 M, mean age 8,4 years, range 3,5-9) were assigned to two groups: group 1 (14 patients) treated early with ursodeoxycholic acid (UDCAe); group 2 (12 patients) treated with ursodeoxycholic acid at the onset of cystic fibrosis liver disease (UDCAd). Anthropometric data, pulmonary function tests, pancreatic status, complications such as diabetes, hepatic involvement and Pseudomonas aeruginosa colonisation were compared among groups. A higher prevalence of cystic fibrosis chronic liver disease was observed in the UDCAd group with a statistically significant difference at 9 years of age (p<0.05). Chronic infection by P. aeruginosa was found in 7% of UDCAe and 33% of UDCAd (p<0.05). No differences were observed in nutritional status and other complications. Early treatment with ursodeoxycholic acid may be beneficial in patients at risk of developing cystic fibrosis chronic liver disease such as those with meconium ileus. Multicentre studies should be encouraged to confirm these data. Copyright 2009 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  10. C-reactive protein as a prognostic indicator for rebleeding in patients with nonvariceal upper gastrointestinal bleeding.

    PubMed

    Lee, Han Hee; Park, Jae Myung; Lee, Soon-Wook; Kang, Seung Hun; Lim, Chul-Hyun; Cho, Yu Kyung; Lee, Bo-In; Lee, In Seok; Kim, Sang Woo; Choi, Myung-Gyu

    2015-05-01

    In patients with acute nonvariceal upper gastrointestinal bleeding, rebleeding after an initial treatment is observed in 10-20% and is associated with mortality. To investigate whether the initial serum C-reactive protein level could predict the risk of rebleeding in patients with acute nonvariceal upper gastrointestinal bleeding. This was a retrospective study using prospectively collected data for upper gastrointestinal bleeding. Initial clinical characteristics, endoscopic features, and C-reactive protein levels were compared between those with and without 30-day rebleeding. A total of 453 patients were included (mean age, 62 years; male, 70.9%). The incidence of 30-day rebleeding was 15.9%. The mean serum C-reactive protein level was significantly higher in these patients than in those without rebleeding (P<0.001). The area under the receiver operating characteristics curve with a cutoff value of 0.5mg/dL was 0.689 (P<0.001). High serum C-reactive protein level (odds ratio, 2.98; confidence interval, 1.65-5.40) was independently associated with the 30-day rebleeding risk after adjustment for the main confounding risk factors, including age, blood pressure, and initial haemoglobin level. The serum C-reactive protein was an independent risk factor for 30-day rebleeding in patients with acute nonvariceal upper gastrointestinal bleeding, indicating a possible role as a useful screening indicator for predicting the risk of rebleeding. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  11. Determining skeletal maturation using insulin-like growth factor I (IGF-I) test.

    PubMed

    Gupta, Shreya; Jain, Sandhya; Gupta, Puneet; Deoskar, Anuradha

    2012-11-01

    To investigate the validity of Insulin like Growth Factor -1(IGF-1) as a skeletal maturity indicator by comparing serum IGF-1 levels with the stages in cervical vertebral maturation (CVM) and in the middle phalanx of the third finger (MP3). The study population was selected by using simple random sampling technique and consisted of 30 female subjects in the age range of 8-23 years who had blood sample, cephalometric and MP3 radiographs taken on the same day. Serum IGF-I estimation was carried out on the blood samples using chemiluminescence immunoassay (CLIA) method. CVM was evaluated using method by Baccetti et al and MP3 staging was done using Rajagopal & Kansal method. Mean IGF-1 level between the stages was compared by Kruskal-Wallis and Mann Whitney test. Serum IGF-1 levels in females correlate well with skeletal maturity determined by CVM and MP3 stages and increase sharply during early pubertal stages followed by a decrease in late puberty. In addition we hypothesis that serum IGF-1 testing can be undertaken as a preliminary screening test in patients in whom the orthodontist predicts the possibility of using myofunctional appliance but in whom the chronologic age is not suggestive for a growth modification therapy. The finding of the study highlights the fact that the serum IGF-1 estimation can be a valuable tool in assessing skeletal maturation. Copyright © 2012 Società Italiana di Ortodonzia SIDO. Published by Elsevier Srl. All rights reserved.

  12. Decreasing trends in hospitalizations during anti-TNF therapy are associated with time to anti-TNF therapy: Results from two referral centres.

    PubMed

    Mandel, Michael D; Balint, Anita; Golovics, Petra A; Vegh, Zsuzsanna; Mohas, Anna; Szilagyi, Blanka; Szabo, Agnes; Kurti, Zsuzsanna; Kiss, Lajos S; Lovasz, Barbara D; Gecse, Krisztina B; Farkas, Klaudia; Molnar, Tamas; Lakatos, Peter L

    2014-11-01

    Hospitalization is an important outcome measure and a major driver of costs in patients with inflammatory bowel disease. We analysed medical and surgical hospitalization rates and predictors of hospitalization before and during anti-TNF therapy. Data from 194 consecutive patients were analysed retrospectively (males, 45.4%, median age at diagnosis, 24.0 years, infliximab/adalimumab: 144/50) in whom anti-TNF therapy was started after January 1, 2008. Total follow-up was 1874 patient-years and 474 patient-years with anti-TNF exposure. Hospitalization rates hospitalization decreased only in Crohn's disease (odds ratio: 0.59, 95% confidence interval: 0.51-0.70, median 2-years' anti-TNF exposure) with a same trend for surgical interventions (p=0.07), but not in ulcerative colitis. Need for hospitalization decreased in Crohn's disease with early (within 3-years from diagnosis, p=0.016 by McNemar test), but not late anti-TNF exposure. At logistic regression analysis complicated disease behaviour (p=0.03), concomitant azathioprine (p=0.02) use, but not anti-TNF type, gender, perianal disease or previous surgeries were associated with the risk of hospitalization during anti-TNF therapy. Hospitalization rate decreased significantly in patients with Crohn's disease but not ulcerative colitis after the introduction of anti-TNF therapy and was associated with time to therapy. Complicated disease phenotype and concomitant azathioprine use were additional factors defining the risk of hospitalization. Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  13. Basal values and changes of liver stiffness predict the risk of disease progression in compensated advanced chronic liver disease.

    PubMed

    Pons, Mònica; Simón-Talero, Macarena; Millán, Laura; Ventura-Cots, Meritxell; Santos, Begoña; Augustin, Salvador; Genescà, Joan

    2016-10-01

    Transient elastography has been proposed as a tool to predict the risk of decompensation in patients with chronic liver disease. We aimed to identify risk groups of disease progression, using a combination of baseline liver stiffness measurement (LSM) and its change over time (delta-LSM) in patients with compensated advanced chronic liver disease (cACLD). Ninety-four patients with baseline LSM ≥10kPa, Child-Pugh score 5 and without previous decompensation were included. A second LSM was performed during follow-up and data on liver function and liver-related events were collected. The primary endpoint was a composite that included death, liver decompensation and impairment in at least 1 point in Child-Pugh score. After a median follow-up of 43.6 months, 15% of patients presented the primary endpoint. Multivariate analysis identified baseline LSM (OR 1.12, P=0.002) and delta-LSM (OR 1.02, P=0.048) as independent predictors of the primary endpoint. A high risk group represented by patients with baseline LSM ≥21kPa and delta-LSM ≥10% (risk of progression 47.1%, 95% CI: 23-71%) was identified, while patients with LSM <21kPa and delta-LSM <10% presented zero risk of progression (P=0.03). Simple classification rules using baseline LSM and delta-LSM identify cACLD patients at low or high risk of disease progression. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  14. Conformable covered versus uncovered self-expandable metallic stents for palliation of malignant gastroduodenal obstruction: a randomized prospective study.

    PubMed

    Lim, Sun Gyo; Kim, Jin Hong; Lee, Kee Myung; Shin, Sung Jae; Kim, Chan Gyoo; Kim, Kyung Ho; Kim, Ho Gak; Yang, Chang Heon

    2014-07-01

    A conformable self-expandable metallic stent was developed to overcome the limitation of previous self-expandable metallic stents. The aim of this study was to evaluate outcomes after placement of conformable covered and uncovered self-expandable metallic stents for palliation of malignant gastroduodenal obstruction. A single-blind, randomized, parallel-group, prospective study were conducted in 4 medical centres between March 2009 and July 2012. 134 patients with unresectable malignant gastroduodenal obstruction were assigned to a covered double-layered (n=66) or uncovered unfixed-cell braided (n=68) stent placement group. Primary analysis was performed to compare re-intervention rates between two groups. 120 patients were analysed (59 in the covered group and 61 in the uncovered group). Overall rates of re-intervention were not significantly different between the two groups: 13/59 (22.0%) in the covered group vs. 13/61 (21.3%) in the uncovered group, p=0.999. Stent migration was more frequent in the covered group than in the uncovered group (p=0.003). The tumour ingrowth rate was higher in the uncovered group than in the covered group (p=0.016). The rates of re-intervention did not significantly differ between the two stents. Conformable covered double-layered and uncovered unfixed-cell braided stents were associated with different patterns of stent malfunction. Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  15. The real-world effectiveness of vedolizumab on intestinal and articular outcomes in inflammatory bowel diseases.

    PubMed

    Macaluso, Fabio Salvatore; Orlando, Rosalba; Fries, Walter; Scolaro, Mariangela; Magnano, Antonio; Pluchino, Dario; Cappello, Maria; Morreale, Gaetano Cristian; Siringo, Sebastiano; Privitera, Antonino Carlo; Ferracane, Concetta; Belluardo, Nunzio; Alberghina, Nadia; Ventimiglia, Marco; Rizzuto, Giulia; Renna, Sara; Cottone, Mario; Orlando, Ambrogio

    2018-03-01

    The effectiveness of vedolizumab in real-world practice is under evaluation, while its role in inflammatory bowel disease-associated spondyloarthritis is still unclear. To report real-world data about the effectiveness of vedolizumab on intestinal and articular symptoms after 10 and 22 weeks of treatment. Web-based data from the cohort of the Sicilian Network for Inflammatory Bowel Disease (SN-IBD) were extracted to perform a prospective multicentre observational study. 163 patients (84 with Crohn's disease and 79 with ulcerative colitis) were included. At week 10, a steroid-free remission was achieved in 71 patients (43.6%), while at week 22 a steroid-free remission was obtained in 40.8% of patients. A response on articular symptoms was reported after 10 weeks of treatment in 17 out of 43 (39.5%) patients with active spondyloarthritis at baseline, and in 10 out of 22 (45.4%) patients at week 22. The only factor associated with articular response was the coexistence of clinical benefit on intestinal symptoms (at week 10: OR 8.471, p = 0.05; at week 22: OR 5.600, p = 0.08). Vedolizumab showed good effectiveness after 10 and 22 weeks of treatment. A subset of patients reported improvement also on articular symptoms, probably as a consequence of the concomitant control of gut inflammation. Copyright © 2018 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  16. Comparative investigation of the detective quantum efficiency of direct and indirect conversion detector technologies in dedicated breast CT.

    PubMed

    Kuttig, Jan D; Steiding, Christian; Kolditz, Daniel; Hupfer, Martin; Karolczak, Marek; Kalender, Willi A

    2015-06-01

    To investigate the dose saving potential of direct-converting CdTe photon-counting detector technology for dedicated breast CT. We analyzed the modulation transfer function (MTF), the noise power spectrum (NPS) and the detective quantum efficiency (DQE) of two detector technologies, suitable for breast CT (BCT): a flat-panel energy-integrating detector with a 70 μm and a 208 μm thick gadolinium oxysulfide (GOS) and a 150 μm thick cesium iodide (CsI) scintillator and a photon-counting detector with a 1000 μm thick CdTe sensor. The measurements for GOS scintillator thicknesses of 70 μm and 208 μm delivered 10% pre-sampled MTF values of 6.6 mm(-1) and 3.2 mm(-1), and DQE(0) values of 23% and 61%. The 10% pre-sampled MTF value for the 150 μm thick CsI scintillator 6.9 mm(-1), and the DQE(0) value was 49%. The CdTe sensor reached a 10% pre-sampled MTF value of 8.5 mm(-1) and a DQE(0) value of 85%. The photon-counting CdTe detector technology allows for significant dose reduction compared to the energy-integrating scintillation detector technology used in BCT today. Our comparative evaluation indicates that a high potential dose saving may be possible for BCT by using CdTe detectors, without loss of spatial resolution. Copyright © 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  17. GATA6 expression in Barrett's oesophagus and oesophageal adenocarcinoma.

    PubMed

    Pavlov, Kirill; Honing, Judith; Meijer, Coby; Boersma-van Ek, Wytske; Peters, Frans T M; van den Berg, Anke; Karrenbeld, Arend; Plukker, John T M; Kruyt, Frank A E; Kleibeuker, Jan H

    2015-01-01

    Barrett's oesophagus can progress towards oesophageal adenocarcinoma through a metaplasia-dysplasia-carcinoma sequence, but the underlying mechanisms are poorly understood. The transcription factor GATA6 is known to be involved in columnar differentiation and proliferation, and GATA6 gene amplification was recently linked with poor survival in oesophageal adenocarcinoma. To study the expression of GATA6 during Barrett's oesophagus development and malignant transformation. To determine the prognostic value of GATA6 in oesophageal adenocarcinoma. Two retrospective cohorts were derived from the pathological archive of the University Medical Center Groningen. The first cohort contained 130 tissue samples of normal squamous epithelium, metaplasia, dysplasia and oesophageal adenocarcinoma. The second cohort consisted of a tissue microarray containing tissue from 92 oesophageal adenocarcinoma patients. Immunohistochemistry was used to examine GATA6 protein expression and to correlate GATA6 expression in oesophageal adenocarcinoma with overall and disease-free survival. The percentage of GATA6-positive cells was low in squamous epithelium (10%) but increased progressively in Barrett's oesophagus (30%, P < 0.001) and high-grade dysplasia (82%, P = 0.005). GATA6 expression was not associated with overall or disease-free survival in oesophageal adenocarcinoma patients (P = 0.599 and P = 0.700 respectively). GATA6 expression is progressively increased during Barrett's oesophagus development and its malignant transformation. However, no prognostic value of GATA6 expression could be found in oesophageal adenocarcinoma. Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  18. Diagnostic and therapeutic management of eosinophilic oesophagitis in children and adults: results from a Spanish registry of clinical practice.

    PubMed

    Lucendo, Alfredo J; Arias, Ángel; Molina-Infante, Javier; Rodríguez-Sánchez, Joaquín; Rodrigo, Luis; Nantes, Óscar; Pérez-Arellano, Elena; de la Riva, Susana; Pérez-Aisa, Ángeles; Barrio, Jesús

    2013-07-01

    Eosinophilic oesophagitis has emerged as a common cause of oesophageal symptoms. To document practice variation in care provided to eosinophilic oesophagitis patients in Spain and to assess adherence to available guidelines. A prospective survey-based registry including data from all patients receiving care from gastroenterologists and allergists throughout Spain was developed. Data from 705 patients (82% adults, male:female ratio 4.1:1) were collected from 26 Spanish hospitals. 42.7% received care in teaching hospitals. Adults presented dysphagia and food impaction more frequently; vomiting and weight loss predominated in children (p < 0.01). A mean diagnostic delay of 54.7 and 28.04 months was documented for adults and children, respectively. Normal endoscopic exams were reported in 27.6% and directly related to the experience in managing the disease (p < 0.05). Paediatric patients, non-teaching hospitals and greater experience in managing eosinophilic oesophagitis were associated with increased frequency in eosinophil count reports and with taking gastric and duodenal biopsies (p < 0.001). Initial therapy consisted of topical steroids (61.7% of patients), proton pump inhibitors (52.4%), dietary modifications (51.26%) and endoscopic dilation (7.2%). Referrals to allergy units occurred more frequently in teaching hospitals (p = 0.003) where food restrictions generally followed allergy test results (p < 0.001). Availability of facilities and the physician's experience constituted the most important factors in explaining differences in patient management. Copyright © 2013 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  19. Transjugular local thrombolysis with/without TIPS in patients with acute non-cirrhotic, non-malignant portal vein thrombosis.

    PubMed

    Klinger, Christoph; Riecken, Bettina; Schmidt, Arthur; De Gottardi, Andrea; Meier, Benjamin; Bosch, Jaime; Caca, Karel

    2017-12-01

    Therapeutic anticoagulation is the standard treatment in patients with acute non-cirrhotic portal vein thrombosis (PVT). In critically ill patients, anticoagulation only may not suffice to achive rapid and stable recanalization. This study evaluates efficacy and safety of transjugular interventional therapy in acute non-cirrhotic PVT. This retrospective study includes 17 consecutive patients with acute noncirrhotic, non-malignant PVT. Main indication for interventional therapy was imminent intestinal infarction (n=10). Treatment consisted of a combination of transjugular thrombectomy, local fibrinolysis and - depending on thrombus resolution - transjugular intrahepatic portosystemic shunt. Recanalization was successful in 94.1%. One- and two-year secondary PV patency rates were 88.2%. Major complications (n=3) resolved spontaneously in all but one patient (heparin induced thrombocytopenia type 2 with intestinal infarction). Symptoms improved in all patients. However, segmental bowel resection had to be performed in two (11.8%). During a median follow-up of 28.6 months, no patient experienced portal hypertensive complications. Presence of JAK2 V617F mutation predicted both short-term and long-term technical success. Transjugular recanalization is safe and effective in patients with acute non-cirrhotic, non-malignant PVT. It should be considered especially in patients with imminent bowel infarction and low likelihood of recanalization following therapeutic anticoagulation. Patients with JAK2 mutation ought to be followed meticulously. Copyright © 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  20. A SMAD4 mutation indicative of juvenile polyposis syndrome in a family previously diagnosed with Menetrier's disease.

    PubMed

    Burmester, James K; Bell, Lauren N; Cross, Deanna; Meyer, Patrick; Yale, Steven H

    2016-10-01

    Menetrier's disease (MD) is a rare disease with unknown aetiology, characterized by hypertrophic folds within the fundus and body of the stomach. We investigated mutations of the candidate genes SMAD4, BMPR1A, TGF-α, and PDX1 within a family with MD. A large 4-generation family with MD was identified. This family had 5 cases of MD, 1 case of MD and juvenile polyposis syndrome (JPS) and 3 cases of JPS. Participants provided saliva for DNA extraction and completed a health questionnaire designed to assess conditions that may be found in patients with MD. Following pedigree analysis, we sequenced the coding regions of the SMAD4 and BMPR1A genes and the regulatory regions of the TGF-α and PDX1 genes in affected and non-affected family members. No mutations were identified in the sequenced regions of BMPR1A, TGF-α, or PDX1. A dominant 1244_1247delACAG mutation of SMAD4 was identified in each of the subjects with JPS as well as in each of the subjects with MD. Although this mutation segregated with disease, there were also unaffected/undiagnosed carriers. The 1244_1247delACAG mutation of SMAD4 is the cause of JPS and the likely cause of MD in a large family initially diagnosed with MD. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  1. Current status of cleaning and disinfection for gastrointestinal endoscopy in China: a survey of 122 endoscopy units.

    PubMed

    Zhang, Xiuli; Kong, Jinyan; Tang, Ping; Wang, Shufang; Hyder, Qurratulain; Sun, Gang; Zhang, Rugang; Yang, Yunsheng

    2011-04-01

    Adequate compliance with the existing guidelines for cleaning and disinfection of gastrointestinal endoscopes and accessories is necessary to obtain high-level disinfection and prevent pathogen transmission. To investigate cleaning and disinfection practice in China. A questionnaire with 21 questions concerning gastrointestinal endoscopy reprocessing was sent by e-mail to 189 endoscopy units in China. One hundred and twenty-two (80.39%) of the 189 units responded. Compared with the low-workload units (<5000 procedures/year), the high-workload units (≥5000 procedures/year) had a significantly higher number of gastrointestinal endoscopes (25.8 ± 3.6 vs. 4.7 ± 1.8, p < 0.01) and the higher possessing rate of automated endoscope reprocessors (43.9% vs. 3.1%, p<0.01). Glutaraldehyde was the most commonly employed disinfectant (88.5%) in all the units. In 23/122 (18.8%) units, the exposure time to glutaraldehyde was <45 min in the case of infectious disease patients. Eighty-six of 122 (70.5%) units reused disposable materials, of which 21/86 (24.4%) reused disposable forceps and disposable polypectomy hooks, and 2/86 (1.6%) reused disposable injection needles intermittently. Although gastrointestinal endoscopy has developed rapidly in China in the past decade, there is still room for improvement in the practice of endoscopy reprocessing, especially in middle-sized and small cities. Copyright © 2011 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  2. Long-term effect of faecal occult blood screening on incidence and mortality from colorectal cancer.

    PubMed

    Hamza, Samia; Cottet, Vanessa; Touillon, Nassime; Dancourt, Vincent; Bonithon-Kopp, Claire; Lepage, Côme; Faivre, Jean

    2014-12-01

    Several randomized trials have shown a reduction of colorectal cancer mortality by screening using guaiac-based faecal occult blood tests. However, little is known on the long-term effect of screening at the population level in everyday practice. Small-sized geographic areas including a total of 91,199 individuals were allocated to either biennal screening using the Hemoccult-II test or no screening. The expected mortality and incidence in the cohort invited to screening was determined using mortality and incidence in the non-screened population. Colorectal cancer mortality was significantly lower in the population invited to screening than in the non-screened population after 11 screening rounds (standardized mortality ratio: 0.87; 0.80-0.94). The standardized mortality ratio remained significant whatever the duration of follow-up. This reduction in colorectal cancer mortality was more pronounced in those who participated in the first screening campaign, who were regular participants in screening rounds (standardized mortality ratio: 0.67; 0.59-0.76). In contrast, colorectal cancer incidence was not different between the screened and non-screened populations (standardized incidence ratio: 1.01; 0.96-1.06). Our findings confirm, in the long term, that screening with Hemoccult can reduce colorectal cancer mortality. The data also highlight the benefit of regular participation in screening and the absence of effect of screening on colorectal cancer incidence. Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  3. Improved 5-year survival of patients with immunochemical faecal blood test-screen-detected colorectal cancer versus non-screening cancers in northern Italy.

    PubMed

    Parente, Fabrizio; Vailati, Cristian; Boemo, Cinzia; Bonoldi, Emanuela; Ardizzoia, Antonio; Ilardo, Antonina; Tortorella, Franco; Cereda, Danilo; Cremaschini, Marco; Moretti, Roberto

    2015-01-01

    Colorectal cancer screening may reduce disease-related mortality by early-stage detection of cancers. To study the effect of a single immunochemical faecal occult blood test (i-FOBt) screening round on reduction in colorectal cancer-related-mortality among average risk subjects. Comparison of 5-year mortality rates in 3 cohorts from a Northern Italian province: (1) colorectal cancers detected at the 1st biennial round of a mass-screening programme targeting 50-69 years old subjects, (2) non-screening cancers symptomatically diagnosed during the same time period, and (3) cancers detected in the pre-screening biennium. Multivariate analyses were performed with the Cox regression model including tumour node metastasis (TNM) stage at diagnosis, anatomical distribution of cancers, age at diagnosis, gender and patient group. Kaplan-Meyer survival estimates and log-rank test for equality of survivor functions were calculated. Stage distribution significantly differed between screening and non-screening colorectal cancers: 73% of screen-detected colorectal cancers were stages I and II versus 43% and 40% of non-screening and pre-screening colorectal cancers. Cumulative 5-year mortality rate was significantly lower in screening compared to non-screening or pre-screening colorectal cancers patients (19% versus 37% and 41%, p < 0.001). Colorectal cancers were detected at earlier stages in i-FOBT-positive subjects in comparison with non-screening patients; colorectal cancers found at screening had a significantly improved 5-year survival. Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  4. Enhanced recovery program (ERP) in major laryngeal surgery: building a protocol and testing its feasibility.

    PubMed

    Gemma, M; Toma, S; Lira Luce, F; Beretta, L; Braga, M; Bussi, M

    2017-12-01

    Enhanced recovery programs (ERP) represent a multimodal approach to perioperative patient care. The benefits of ERP are well demonstrated in colorectal surgery and Enhanced Recovery After Surgery (ERAS®) programs, that epitomise the ERP concept, have being introduced in different specialties, including vascular, gastric, pancreatic, urogynecologic and orthopaedic surgery. However, no ERP has been proposed for head and neck surgery. We developed an expert-opinion-based ERP for laryngeal surgery based on the key principles of colorectal surgery ERAS®. Twenty-four patients undergoing major laryngeal surgery (total and partial laryngectomies or surgical removal of oropharyngeal tumour with muscle flap reconstruction) were treated according to such an ERP protocol, which differed under several respects from our previous standard practice (described in 70 consecutive patients who underwent major laryngeal surgery before ERP implementation. The adherence rate to the different ERP items is reported. Adherence to ERP items was high. Nutritional assessment, antibiotic prophylaxis, postoperative nausea and vomit (PONV) prophylaxis and postoperative speech therapy targets were applied as required in 100% of cases. Some ERP items (antibiotic prophylaxis, intraoperative infusion rate, and postoperative speech therapy) were already frequently implemented before ERP adoption. Postoperative medical complications occurred in 8.3% of patients. Our expert opinion-based ERP protocol for major laryngeal surgery proved feasible. The degree of benefit deriving from its implementation has yet to be assessed. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale, Rome, Italy.

  5. Impact of age at diagnosis on natural history of patients with elderly-onset ulcerative colitis: A French population-based study.

    PubMed

    Duricova, Dana; Pariente, Benjamin; Sarter, Hélène; Fumery, Mathurin; Leroyer, Ariane; Charpentier, Cloe; Armengol-Debeir, Laura; Peyrin-Biroulet, Laurent; Savoye, Guillaume; Gower-Rousseau, Corinne

    2018-04-22

    Recent population-based study of elderly-onset Crohn's disease patients reported age-related differences in disease phenotype and outcome. The aim was to assess the impact of age at diagnosis on natural history of elderly-onset ulcerative colitis patients with emphasis on disease presentation, phenotype and treatment. Elderly-onset patients with ulcerative colitis (≥60 years at diagnosis) registered in a French population-based Registry EPIMAD (1988-2006) were included. Demographic and clinical data at diagnosis and at maximal follow-up were collected using predefined questionnaire. Four-hundred and sixty-five elderly-onset ulcerative colitis patients were included (median follow-up 6.2 years); 276 (59%) were <70 and 189 (41%) ≥70 years at diagnosis. Patients aged <70 years presented with more rectal bleeding (86% vs. 79%, p = .06) and abdominal pain (44% vs. 34%, p = .04) while those ≥70 years had higher rate of left-sided colitis (62% vs. 49%; p = .02). Cumulative exposure to 5-ASA, corticosteroids and immunosuppressants was similar between the groups as well as surgery rate. However, patients <70 years were significantly more steroid-resistant than older individuals (12% vs. 3%, p < .05) while no significant difference in steroid-dependency was observed. Patients with elderly-onset ulcerative colitis differed in presentation, disease phenotype and response to medication with respect to age at diagnosis. Copyright © 2018 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  6. How to predict a high rate of inappropriateness for upper endoscopy in an endoscopic centre?

    PubMed

    Buri, L; Bersani, G; Hassan, C; Anti, M; Bianco, M A; Cipolletta, L; Di Giulio, E; Di Matteo, G; Familiari, L; Ficano, L; Loriga, P; Morini, S; Pietropaolo, V; Zambelli, A; Grossi, E; Intraligi, M; Tessari, F; Buscema, M

    2010-09-01

    Inappropriateness of upper endoscopy (EGD) indication causes decreased diagnostic yield. Our aim of was to identify predictors of appropriateness rate for EGD among endoscopic centres. A post-hoc analysis of two multicentre cross-sectional studies, including 6270 and 8252 patients consecutively referred to EGD in 44 (group A) and 55 (group B) endoscopic Italian centres in 2003 and 2007, respectively, was performed. A multiple forward stepwise regression was applied to group A, and independently validated in group B. A <70% threshold was adopted to define inadequate appropriateness rate clustered by centre. discrete variability of clustered appropriateness rates among the 44 group A centres was observed (median: 77%; range: 41-97%), and a <70% appropriateness rate was detected in 11 (25%). Independent predictors of centre appropriateness rate were: percentage of patients referred by general practitioners (GP), rate of urgent examinations, prevalence of relevant diseases, and academic status. For group B, sensitivity, specificity and area under receiver operating characteristic curve of the model in detecting centres with a <70% appropriateness rate were 54%, 93% and 0.72, respectively. A simple predictive rule, based on rate of patients referred by GPs, rate of urgent examinations, prevalence of relevant diseases and academic status, identified a small subset of centres characterised by a high rate of inappropriateness. These centres may be presumed to obtain the largest benefit from targeted educational programs. Copyright (c) 2010 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  7. Worldwide risks of animal diseases: introduction.

    PubMed

    Pearson, J E

    2006-01-01

    Animal diseases impact food supplies, trade and commerce, and human health and well-being in every part of the world. Outbreaks draw the attention of those in agriculture, regulatory agencies, and government, as well as the general public. This was demonstrated by the 2000-2001 foot and mouth disease (FMD) outbreaks that occurred in Europe, South America, Asia and Africa and by the recent increased occurrence of emerging diseases transmitted from animals to humans. Examples of these emerging zoonotic diseases are highly pathogenic avian influenza, bovine spongiform encephalopathy, West Nile virus and severe acute respiratory syndrome. There is also the risk of well-known and preventable zoonotic diseases, such as rabies, brucellosis, leishmaniasis, and echinococcosis/hydatidosis, in certain countries; these diseases have a high morbidity with the potential for a very high mortality. Animal agriculturalists should have a global disease awareness of disease risks and develop plans of action to deal with them; in order to better respond to these diseases, they should develop the skills and competencies in politics, media interactions, and community engagement. This issue of Veterinaria Italiana presents information on the risk of animal diseases; their impact on animals and humans at the international, national, industry, and societal levels; and the responses to them. In addition, specific information is provided on national and international disease monitoring, surveillance and reporting, the risk of spread of disease by bioterrorism and on import risk analysis.

  8. Evaluation of the factors influencing brain language laterality in presurgical planning.

    PubMed

    Batouli, Seyed Amir Hossein; Hasani, Nafiseh; Gheisari, Sara; Behzad, Ebrahim; Oghabian, Mohammad Ali

    2016-10-01

    Brain lesions cause functional deficits, and one treatment for this condition is lesion resection. In most cases, presurgical planning (PSP) and the information from laterality indices are necessary for maximum preservation of the critical functions after surgery. Language laterality index (LI) is reliably estimated using functional magnetic resonance imaging (fMRI); however, this measure is under the influence of some external factors. In this study, we investigated the influence of a number of factors on language LI, using data from 120 patients (mean age=35.65 (±13.4) years) who underwent fMRI for PSP. Using two proposed language tasks from our previous works, brain left hemisphere was showed to be dominant for the language function, although a higher LI was obtained using the "Word Generation" task, compared to the "Reverse Word Reading". In addition, decline of LIs with age, and lower LI when the lesion invaded brain language area were observed. Meanwhile, gender, lesion side (affected hemisphere), LI calculation strategy, and fMRI analysis Z-values did not statistically show any influences on the LIs. Although fMRI is widely used to estimate language LI, it is shown here that in order to present a reliable language LI and to correctly select the dominant hemisphere of the brain, the influence of external factors should be carefully considered. Copyright © 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  9. The persistent microbicidal effect in water exposed to the corona discharge.

    PubMed

    Julák, Jaroslav; Scholtz, Vladimír; Kotúčová, Soňa; Janoušková, Olga

    2012-07-01

    This article describes and particularly explains a new phenomenon of persistent microbicidal effect of water previously exposed to the low-temperature plasma, which cannot be attributed to the acidification only. The direct microbicidal action of plasma is well documented, being mediated by number of reactive particles with a short lifetime. However, we observed the microbicidal effect also in exposed water stored for a month, where it must be mediated by stable particles. In water and in phosphate-buffered saline, the formation of NO(x) and corresponding acids, H(2)O(2) and O(3) was confirmed after exposition to the low-temperature plasma generated in air by DC negative glow corona and positive streamer discharge. The time course of acidification, H(2)O(2) and O(3) formation were deremined. Except uncertain traces of HCN, SIFT-MS analysis of exposed liquids reveals no additional reactive compounds. The microbicidal effect persists almost unchanged during 4 weeks of storage, although O(3) completely and H(2)O(2) almost disappears. Staphylococcus epidermidis and Escherichia coli were inactivated within 10 min of incubation in exposed liquids, Candida albicans needs at least 1 h. The solutions prepared by artificial mixing of reactive compounds mimic the action of exposed water, but in lesser extent. The acid milieu is the main cause of the microbicidal effect, but the possibility of still unidentified additional compound remains open. Copyright © 2011 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  10. Celiac disease and the risk of kidney diseases: A systematic review and meta-analysis.

    PubMed

    Wijarnpreecha, Karn; Thongprayoon, Charat; Panjawatanan, Panadeekarn; Thamcharoen, Natanong; Pachariyanon, Pavida; Nakkala, Kiran; Cheungpasitporn, Wisit

    2016-12-01

    Previous epidemiologic studies attempting to demonstrate the risk of kidney diseases among patients with celiac disease (CD) have yielded inconsistent results. This meta-analysis was conducted with the aims to summarize all available evidence. A literature search was performed using MEDLINE and EMBASE from inception to May 2016. Studies that provided relative risks, odd ratios, or hazard ratios examining the risk of kidney diseases among patients with CD versus individuals without CD were included. Pooled risk ratios (RR) and 95% confidence interval (CI) were calculated using a random-effect, generic inverse variance method. Eight studies met our eligibility criteria and were included in our analysis. A pooled RR of overall kidney diseases in patients with CD was 2.01 (95% CI, 1.44-2.81, I 2 =76%). The pooled RR of end-stage renal disease in patients with CD was 2.57 (95% CI, 2.03-3.24). Subgroup analyses showed that significant risks were increased for diabetic nephropathy (pooled RR of 1.49, 95% CI, 1.09-2.02) and IgA nephropathy (pooled RR of 2.62, 95% CI, 1.27-5.42) in patients with CD. Our study demonstrates a significantly increased risk of kidney diseases among patients with CD. These findings may influence clinical management and primary prevention of kidney diseases in patients with CD. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  11. Parotid tumours: clinical and oncologic outcomes after microscope-assisted parotidectomy with intraoperative nerve monitoring.

    PubMed

    Carta, F; Chuchueva, N; Gerosa, C; Sionis, S; Caria, R A; Puxeddu, R

    2017-10-01

    Temporary and permanent facial nerve dysfunctions can be observed after parotidectomy for benign and malignant lesions. Intraoperative nerve monitoring is a recognised tool for the preservation of the nerve, while the efficacy of the operative microscope has been rarely stated. The authors report their experience on 198 consecutive parotidectomies performed on 196 patients with the aid of the operative microscope and intraoperative nerve monitoring. 145 parotidectomies were performed for benign lesions and 53 for malignancies. Thirteen patients treated for benign tumours experienced temporary (11 cases) or permanent facial palsy (2 cases, both of House-Brackmann grade II). Ten patients with malignant tumour presented with preoperative facial nerve weakness that did not improve after treatment. Five and 6 patients with malignant lesion without preoperative facial nerve deficit experienced postoperative temporary and permanent weakness respectively (the sacrifice of a branch of the nerve was decided intraoperatively in 2 cases). Long-term facial nerve weakness after parotidectomy for lesions not directly involving or originating from the facial nerve (n = 185) was 2.7%. Patients treated for benign tumours of the extra facial portion of the gland without inflammatory behaviour (n = 91) had 4.4% facial nerve temporary weakness rate and no permanent palsy. The combined use of the operative microscope and intraoperative nerve monitoring seems to guarantee facial nerve preservation during parotidectomy. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale, Rome, Italy.

  12. Cancer risk estimation in Digital Breast Tomosynthesis using GEANT4 Monte Carlo simulations and voxel phantoms.

    PubMed

    Ferreira, P; Baptista, M; Di Maria, S; Vaz, P

    2016-05-01

    The aim of this work was to estimate the risk of radiation induced cancer following the Portuguese breast screening recommendations for Digital Mammography (DM) when applied to Digital Breast Tomosynthesis (DBT) and to evaluate how the risk to induce cancer could influence the energy used in breast diagnostic exams. The organ doses were calculated by Monte Carlo simulations using a female voxel phantom and considering the acquisition of 25 projection images. Single organ cancer incidence risks were calculated in order to assess the total effective radiation induced cancer risk. The screening strategy techniques considered were: DBT in Cranio-Caudal (CC) view and two-view DM (CC and Mediolateral Oblique (MLO)). The risk of cancer incidence following the Portuguese screening guidelines (screening every two years in the age range of 50-80years) was calculated by assuming a single CC DBT acquisition view as standalone screening strategy and compared with two-view DM. The difference in the total effective risk between DBT and DM is quite low. Nevertheless in DBT an increase of risk for the lung is observed with respect to DM. The lung is also the organ that is mainly affected when non-optimal beam energy (in terms of image quality and absorbed dose) is used instead of an optimal one. The use of non-optimal energies could increase the risk of lung cancer incidence by a factor of about 2. Copyright © 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  13. High definition endoscopy with or without I-Scan increases the detection of celiac disease during routine endoscopy.

    PubMed

    Penny, Hugo A; Mooney, Peter D; Burden, Mitchell; Patel, Nisha; Johnston, Alexander J; Wong, Simon H; Teare, Julian; Sanders, David S

    2016-06-01

    Celiac disease remains underdiagnosed at endoscopy. We aimed to assess the utility of I-Scan (virtual chromo-endoscopy) to improve sensitivity of endoscopy to detect markers of villous atrophy in this condition. Patients from 2 UK hospitals were studied in 3 groups. Group 1: standard high definition, white light endoscopy (WLE); Group 2: WLE plus I-Scan; Group 3: non-high definition control group. The presence of endoscopic markers was recorded. At least 4 duodenal biopsies were taken from all patients. Serology was performed concurrently and observations were compared with histology. 758 patients (62% female, mean age 52) were recruited (Group 1: 230; Group 2: 228; Group 3: 300). 135 (17.8%) new diagnoses of coeliac disease were made (21 Group 1; 24 Group 2; 89 Group 3). The sensitivity for detection of endoscopic markers of villous atrophy was significantly higher in both Group 1 (85.7%, p=0.0004) and Group 2 (75%, p=0.005) compared to non-high definition controls (41.6%). There was no significant difference between high definition only and I-Scan groups (p=0.47). In non-high definition endoscopy a missed diagnosis was associated with lesser degrees of villous atrophy (p=0.019) and low tTG titre (p=0.007). High definition endoscopy with or without I-Scan increases the detection of celiac disease during routine endoscopy. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  14. Evaluation of a LED-based flatbed document scanner for radiochromic film dosimetry in transmission mode.

    PubMed

    Lárraga-Gutiérrez, José Manuel; García-Garduño, Olivia Amanda; Treviño-Palacios, Carlos; Herrera-González, José Alfredo

    2018-03-01

    Flatbed scanners are the most frequently used reading instrument for radiochromic film dosimetry because its low cost, high spatial resolution, among other advantages. These scanners use a fluorescent lamp and a CCD array as light source and detector, respectively. Recently, manufacturers of flatbed scanners replaced the fluorescent lamp by light emission diodes (LED) as a light source. The goal of this work is to evaluate the performance of a commercial flatbed scanner with LED based source light for radiochromic film dosimetry. Film read out consistency, response uniformity, film-scanner sensitivity, long term stability and total dose uncertainty was evaluated. In overall, the performance of the LED flatbed scanner is comparable to that of a cold cathode fluorescent lamp (CCFL). There are important spectral differences between LED and CCFL lamps that results in a higher sensitivity of the LED scanner in the green channel. Total dose uncertainty, film response reproducibility and long-term stability of LED scanner are slightly better than those of the CCFL. However, the LED based scanner has a strong non-uniform response, up to 9%, that must be adequately corrected for radiotherapy dosimetry QA. The differences in light emission spectra between LED and CCFL lamps and its potential impact on film-scanner sensitivity suggest that the design of a dedicated flat-bed scanner with LEDs may improve sensitivity and dose uncertainty in radiochromic film dosimetry. Copyright © 2018 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  15. A single-centre prospective, cohort study of the natural history of acute pancreatitis.

    PubMed

    Cavestro, Giulia Martina; Leandro, Gioacchino; Di Leo, Milena; Zuppardo, Raffaella Alessia; Morrow, Olivia B; Notaristefano, Chiara; Rossi, Gemma; Testoni, Sabrina Gloria Giulia; Mazzoleni, Giorgia; Alessandri, Matteo; Goni, Elisabetta; Singh, Satish K; Giliberti, Aurore; Bianco, Margherita; Fanti, Lorella; Viale, Edi; Arcidiacono, Paolo Giorgio; Mariani, Alberto; Petrone, Maria Chiara; Testoni, Pier Alberto

    2015-03-01

    The natural history of acute pancreatitis is based on clinical studies that aim to elucidate the course of disease on the basis of predicted risk factors. To evaluate the long-term occurrence of recurrent acute pancreatitis and chronic pancreatitis in a cohort of patients following an initial episode of acute pancreatitis. 196 patients were enrolled consecutively and studied prospectively. Clinical characteristics, exogenously/endogenously-associated factors, and evolution to recurrent acute pancreatitis and chronic pancreatitis were analyzed. 40 patients developed recurrent acute pancreatitis 13 of whom developed chronic pancreatitis. In a univariate analysis, recurrent acute pancreatitis was associated with an idiopathic aetiology (p<0.001), pancreas divisum (p=0.001), and higher usage of cigarettes and alcohol (p<0.001; p=0.023). Chronic pancreatitis was associated with a severe first episode of acute pancreatitis (p=0.048), PD (p=0.03), and cigarette smoking (p=0.038). By multivariate analysis, pancreas divisum was an independent risk factor for recurrent acute pancreatitis (OR 11.5, 95% CI 1.6-83.3). A severe first-episode of acute pancreatitis increased the risk of progressing to chronic pancreatitis by nine-fold. Special attention should be given to patients who experience a severe first attack of acute pancreatitis as there appears to be an increased risk of developing chronic pancreatitis over the long term. Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  16. Association between F508 deletion in CFTR and chronic pancreatitis risk.

    PubMed

    Zhao, Dong; Xu, Yanzhen; Li, Jiatong; Fu, Shien; Xiao, Feifan; Song, Xiaowei; Xie, Zhibin; Jiang, Min; He, Yan; Liu, Chengwu; Wen, Qiongxian; Yang, Xiaoli

    2017-09-01

    The cystic fibrosis transmembrane conductance regulator (CFTR) has been reported to influence individual susceptibility to chronic pancreatitis (CP), but the results of previous studies are controversial. We performed a study to demonstrate the relationship between CFTR and CP. We searched PubMed, Scopus, and Embase for studies of patients with CP. Seven studies from 1995 to 2016 were identified, and included 64,832 patients. Pooled prevalence and 95% confidence intervals (CIs) were calculated. F508 deletion in CFTR was significantly positively associated with CP risk in the overall analysis (odds ratio [OR]=3.20, 95% CI: 2.30-4.44, I 2 =31.7%). In subgroup analysis stratified by ethnicity, F508 deletion was significantly associated with CP risk in Indian populations, using a fixed effects model (ORs=5.45, 95% CI: 2.52-11.79, I 2 =0.0%), and in non-Indian populations, using a random effects model (ORs=3.59, 95% CI: 1.73-7.48, I 2 =60.9%). At the same time, we found that Indians with F508 deletion had much higher CP prevalence than non-Indians. Interestingly, F508 deletion was also associated with CP and idiopathic CP risk in subgroup analysis stratified by aeitiology, using the fixed effects model. Based on current evidence, F508 deletion is a risk factor for CP, and Indians with F508 deletion have much higher CP morbidity. Copyright © 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  17. Prevalence of chronic pancreatitis: Results of a primary care physician-based population study.

    PubMed

    Capurso, Gabriele; Archibugi, Livia; Pasquali, Piera; Aceti, Alessandro; Balducci, Paolo; Bianchi, Patrizia; Buono, Francesco; Camerucci, Stefano; Cantarini, Rosanna; Centofanti, Sergio; Colantonio, Patrizia; Cremaschi, Riccarda; Crescenzi, Sergio; Di Mauro, Caterina; Di Renzi, Davide; Filabozzi, Andrea; Fiorillo, Alfonso; Giancaspro, Giuseppe; Giovannetti, Paola; Lanna, Giuseppe; Medori, Claudio; Merletti, Emilio; Nunnari, Enzo; Paris, Francesca; Pavone, Marco; Piacenti, Angela; Rossi, Almerindo; Scamuffa, Maria Cristina; Spinelli, Giovanni; Taborchi, Marco; Valente, Biagio; Villanova, Antonella; Chiriatti, Alberto; Delle Fave, Gianfranco

    2017-05-01

    Data on chronic pancreatitis prevalence are scanty and usually limited to hospital-based studies. Investigating chronic pancreatitis prevalence in primary care. Participating primary care physicians reported the prevalence of chronic pancreatitis among their registered patients, environmental factors and disease characteristics. The data were centrally reviewed and chronic pancreatitis cases defined according to M-ANNHEIM criteria for diagnosis and severity and TIGAR-O classification for etiology. Twenty-three primary care physicians participated in the study. According to their judgment, 51 of 36.401 patients had chronic pancreatitis. After reviewing each patient data, 11 turned out to have definite, 5 probable, 19 borderline and 16 uncertain disease. Prevalence was 30.2/100.000 for definite cases and 44.0/100.000 for definite plus probable cases. Of the 16 patients with definite/probable diagnosis, 8 were male, with mean age of 55.6 (±16.7). Four patients had alcoholic etiology, 5 post-acute/recurrent pancreatitis, 6 were deemed to be idiopathic. Four had pancreatic exocrine insufficiency, 10 were receiving pancreatic enzymes, and six had pain. Most patients had initial stage and non-severe disease. This is the first study investigating the prevalence of chronic pancreatitis in primary care. Results suggest that the prevalence in this context is higher than in hospital-based studies, with specific features, possibly representing an earlier disease stage. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  18. The Mar Piccolo of Taranto: an interesting marine ecosystem for the environmental problems studies.

    PubMed

    Cardellicchio, Nicola; Annicchiarico, Cristina; Di Leo, Antonella; Giandomenico, Santina; Spada, Lucia

    2016-07-01

    The National Project RITMARE (la Ricerca ITaliana per il MARE-Italian Research for the sea) started from 1 January 2012. It is one of the national research programs funded by the Italian Ministry of University and Research. RITMARE is coordinated by the National Research Council (CNR) and involves an integrated effort of most of the scientific community working on marine and maritime issues. Within the project, different marine study areas of strategic importance for the Mediterranean have been identified: Among these, the coastal area of Taranto (Ionian Sea, Southern Italy) was chosen for its different industry settlements and the relative impact on the marine environment. In particular, the research has been concentrated on the Mar Piccolo of Taranto, a complex marine ecosystem model important in terms of ecological, social, and economic activities for the presence also of extensive mussel farms. The site has been selected also because the Mar Piccolo area is a characteristic "on field" laboratory suitable to investigate release and diffusion mechanisms of contaminants, evaluate chemical-ecological risks towards the marine ecosystem and human health, and suggest and test potential remediation strategies for contaminated sediments. In this context, within the project RITMARE, a task force of researchers has contributed to elaboration a functioning conceptual model with a multidisciplinary approach useful to identify anthropogenic forcings, its impacts, and solutions of environmental remediation. This paper describes in brief some of the environmental issues related to the Mar Piccolo basin.

  19. Empowering the family during the first months after identification of permanent hearing impairment in children.

    PubMed

    Ciciriello, E; Bolzonello, P; Marchi, R; Falzone, C; Muzzi, E; Orzan, E

    2016-02-01

    The latest international guidelines highlight the importance of involving the family in the diagnostic and rehabilitation process of children affected by permanent hearing impairment. This emphasises how meaningful this approach is for the development of the deaf child. So far, there is very little evidence about this approach in Italy, and there are still some barriers to its practical management. The aim of this paper is to report the results of a strategic analysis, which identifies the strengths, weaknesses, opportunities and threats of the family empowerment process during early auditory diagnosis and rehabilitation. The audiology programme should have the goal to offer information and support to families in order to achieve a conscious decision about the use and type of auditory prosthesis and rehabilitation choice within three months after audiologic diagnosis. Within the framework of the Ministry of Health project CCM 2013 "Preventing Communication Disorders: a Regional Program for Early Identification, Intervention and Care of Hearing Impaired Children", a group of professionals identified three main recommendations that can be useful to foster the natural communicative development of the child by strengthening the therapeutic alliance and empowerment of the family. The recommendations obtained with this analysis can help to develop new Italian guidelines with the aim to foster natural communicative development of the child by strengthening the therapeutic alliance and empowerment of the family. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale.

  20. The elderly and direct antiviral agents: Constraint or challenge?

    PubMed

    Fabrizio, Claudia; Saracino, Annalisa; Scudeller, Luigia; Milano, Eugenio; Dell'Acqua, Raffaele; Bruno, Giuseppe; Lo Caputo, Sergio; Monno, Laura; Milella, Michele; Angarano, Gioacchino

    2017-09-01

    Direct antiviral agents (DAAs) for chronic hepatitis C showed great effectiveness and good safety profile. So far, few data are available about their use in elderly subjects. To assess management, safety and outcome of DAAs treatments in the elderly. This retrospective, single-centre study enrolled all patients aged ≥65 years, compared by age (group A: 65-74 years, group B: ≥75 years), who completed DAAs between February 2015-November 2016. Variables potentially associated to adverse events (AEs) were analyzed. Sustained virological response (SVR) was evaluated at 12-weeks follow-up. DAAs were administered to 221 patients aged ≥65 years (males: 112; group A: 130, group B: 91). Prescribed regimens were: sofosbuvir-based: 44 patients (19.9%), simeprevir-based: 25 (15%), ledipasvir-based: 49 (22.2%), daclatasvir-based: 12 (5.4%), paritaprevir/ritonavir+ombitasvir±dasabuvir: 91 (41.2%). Ribavirin was used in 121 patients. In 58 subjects co-medications were adjusted due to drug interactions. At least one AE occurred in 130 patients, including 13 SAEs, mainly in older subjects (p=0.04). Female sex (p=0.04), liver stiffness (p=0.023), use of simeprevir (p=0.03) and ribavirin (p=0.009) were associated with AEs. SVR-12 was achieved in 96,9% of subjects. A careful baseline evaluation and a strict monitoring allow to optimise management and outcome of DAAs in elderly. Copyright © 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  1. HCV clearance after direct-acting antivirals in patients with cirrhosis by stages of liver impairment: The ITAL-C network study.

    PubMed

    Ippolito, Antonio Massimo; Milella, Michele; Messina, Vincenzo; Conti, Fabio; Cozzolongo, Raffaele; Morisco, Filomena; Brancaccio, Giuseppina; Barone, Michele; Santantonio, Teresa; Masetti, Chiara; Tundo, Paolo; Smedile, Antonina; Carretta, Vito; Gatti, Pietro; Termite, Antonio Patrizio; Valvano, Maria Rosa; Bruno, Giuseppe; Fabrizio, Claudia; Andreone, Pietro; Zappimbulso, Marianna; Gaeta, Giovanni Battista; Napoli, Nicola; Fontanella, Luca; Lauletta, Gianfranco; Cuccorese, Giuseppe; Metrangolo, Antonio; Francavilla, Ruggiero; Ciracì, Emanuela; Rizzo, Salvatore; Andriulli, Angelo

    2017-09-01

    Sustained virological response (SVR12) rates at 12 weeks after treatment for HCV-infected patients with decompensated cirrhosis are used when referring to those with moderate functional impairment, while few data are available for those with more severe impairment. The use of the cirrhosis staging system proposed by D'Amico might provide new insights on timing for antiviral therapy. We investigated efficacy (SVR12), safety, and post-treatment variations in clinical and laboratory parameters in 2612 patients with advanced fibrosis (n=575) or cirrhosis (n=2037). Cirrhosis was in the compensated phase (without/with varices) or had previously been in the decompensated stage. Different direct-acting antiviral (DAA) regimens were administered in accordance with scientific guidelines. The SVR12 rate was 97.6% in patients with advanced fibrosis. For patients with cirrhosis, the rate was 96.5% in stage 1, 95.1% in stage 2, 100% in stage 3, 95.7% in stage 4, and 93.6% in stage 5. These rates were independent of gender, age, HCV genotype, and treatment schedule. Positive changes in biochemical parameters and CPT classes following therapy were evident in compensated and previously decompensated patients. Our findings support the use of DAAs in patients with advanced cirrhosis (stages 3-5) who are at greatest risk and have the most to gain from therapy. Copyright © 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  2. Endolymphatic sac tumour in von Hippel-Lindau disease: management strategies.

    PubMed

    Zanoletti, E; Girasoli, L; Borsetto, D; Opocher, G; Mazzoni, A; Martini, A

    2017-10-01

    Endolymphatic sac tumour (ELST) is infrequent, as emerges from small series reported in the literature. It is a slow-growing malignancy with local aggressiveness and a low risk of distant metastases. It is often misdiagnosed because of the late onset of symptoms and difficulty in obtaining a biopsy. Its frequency is higher in von Hippel-Lindau (VHL) disease (a genetic systemic syndrome involving multiple tumours), with a prevalence of around 25%. The diagnosis is based on radiology, with specific patterns on contrast-enhanced MRI and typical petrous bone erosion on bone CT scan. Our experience of ELST in the years between 2012-2015 concerns 7 cases, one of which was bilateral, in patients with VHL disease. Four of the 7 patients underwent 5 surgical procedures at our institution. Each case is described in detail, including clinical symptoms, and the intervals between symptom onset, diagnosis and therapy. Postoperative morbidity was low after early surgery on small tumours, whereas extensive surgery for large tumours was associated with loss of cranial nerve function (especially VII, IX, X). The critical sites coinciding with loss of neurological function were the fallopian canal, jugular foramen, petrous apex and intradural extension into the posterior cranial fossa. Early surgery on small ELST is advocated for patients with VHL disease, in whom screening enables a prompt diagnosis and consequently good prognosis. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale, Rome, Italy.

  3. Is it possible to define the ideal lips?

    PubMed

    Kar, M; Muluk, N B; Bafaqeeh, S A; Cingi, C

    2018-02-01

    The lips are an essential component of the symmetry and aesthetics of the face. Cosmetic surgery to modify the lips has recently gained in popularity, but the results are in some cases disasterous. In this review, we describe the features of the ideal lips for an individual's face. The features of the ideal lips with respect to facial anatomy, important anatomical landmarks of the face, the facial proportions of the lips and ethnic and sexual differences are described. The projection and relative sizes of the upper and lower lips are as significant to lip aesthetics as the proportion of the lips to the rest of the facial structure. Robust, pouty lips are considered to be sexually attractive by both males and females. Horizontal thirds and the golden ratio describe the proportions that contribute to the beauty and attractiveness of the lips. In young Caucasians, the ideal ratio of the vertical height of the upper lip to that of the lower lip is 1:1.6. Blacks, genetically, have a greater lip volume. The shape and volume of a person's lips are of great importance in the perception of beauty by humans. The appearance of the lips in part determines the attractiveness of a person's face. In females, fuller lips in relation to facial width as well as greater vermilion height are considered to be attractive. Copyright © 2018 Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale, Rome, Italy.

  4. Natural history of patients with non cirrhotic portal hypertension: Comparison with patients with compensated cirrhosis.

    PubMed

    Gioia, Stefania; Nardelli, Silvia; Pasquale, Chiara; Pentassuglio, Ilaria; Nicoletti, Valeria; Aprile, Francesca; Merli, Manuela; Riggio, Oliviero

    2018-01-31

    The knowledge of natural history of patients with portal hypertension (PH) not due to cirrhosis is less well known than that of cirrhotic patients. To describe the clinical presentation and the outcomes of 89 patients with non-cirrhotic PH (25 with non-cirrhotic portal hypertension, INCPH, and 64 with chronic portal vein thrombosis, PVT) in comparison with 77 patients with Child A cirrhosis. The patients were submitted to a standardized clinical, laboratory, ultrasonographic and endoscopic follow-up. Variceal progression, incidence of variceal bleeding, portal vein thrombosis, ascites and survival were recorded. At presentation, the prevalence of varices, variceal bleeding and ascites was similar in the 3 groups. During follow-up, the rate of progression to varices at risk of bleeding (p < 0.0001) and the incidence of first variceal bleeding (p = 0.02) were significantly higher in non-cirrhotic then in cirrhotic patients. A PVT developed in 32% of INCPH patients and in 18% of cirrhotics (p = 0.02). In the patients with non-cirrhotic PH variceal progression is more rapid and bleeding more frequent than in cirrhotics. Patients with INCPH are particularly prompt to develop PVT. This observational study suggests that the management of patients with non-cirrhotic PH should take into consideration the natural history of portal hypertension in these patients and cannot be simply derived by the observation of cirrhotic patients. Copyright © 2018 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  5. Hepatic encephalopathy in patients with non-cirrhotic portal hypertension: Description, prevalence and risk factors.

    PubMed

    Nicoletti, Valeria; Gioia, Stefania; Lucatelli, Pierleone; Nardelli, Silvia; Pasquale, Chiara; Nogas Sobrinho, Stefano; Pentassuglio, Ilaria; Greco, Francesca; De Santis, Adriano; Merli, Manuela; Riggio, Oliviero

    2016-09-01

    Hepatic encephalopathy (HE) is a common complication of cirrhosis but it is less studied in patients with non-cirrhotic portal hypertension (NCPH). To describe the prevalence of cognitive impairment (overt and covert HE) in NCPH patients and to identify the risk factors for its development. 51 patients with NCPH, 35 with chronic portal vein thrombosis (PVT) and 16 with idiopathic non-cirrhotic portal hypertension (INCPH), were evaluated for the presence of previous or present overt HE (OHE). The psychometric hepatic encephalopathy score and the SCAN battery were used to detect the presence of covert HE (CHE). 34 compensated cirrhotic patients were used as control. In NCPH patients, abdominal scans were performed to detect the presence of shunts. None of the patients experienced OHE at evaluation while 5.7% of PVT and 12.5% of INCPH patients referred at least one documented episode of previous OHE, similarly to patients with cirrhosis (14.7%). Even if lower than in patients with cirrhosis (64.7%), a considerable proportion of patients with chronic PVT (34.3%) and INCPH (25%) had CHE (p=0.008). The presence of a large portal-systemic shunt was the only factor significantly correlated to cognitive impairment in NCPH patients. HE is a tangible complication of NCPH and is mainly related to the presence of portal-systemic shunts. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  6. Pneumococcal and influenza vaccine uptake in adults with inflammatory bowel disease in France: Results from a web-based study.

    PubMed

    Loubet, Paul; Verger, Pierre; Abitbol, Vered; Peyrin-Biroulet, Laurent; Launay, Odile

    2018-06-01

    Despite specific immunization guidelines for immunocompromised patients, there is a dearth of studies on inflammatory bowel disease (IBD) population in France. To estimate the prevalence and predictors of influenza and pneumococcal vaccination rates in a sample of French IBD adults. An anonymous online survey was submitted to members of several French immunocompromised patients' associations during the winter 2016. Overall, there were 199/1625 (12%) participants with an IBD. Among these, 32% were <30 years old, 85% were male, and 62% were treated with immunosuppressive therapy. Self-reported influenza vaccine uptake was 34% (95% CI [28-41]) and 38% (95% CI [31-44]) for pneumococcal vaccines. Healthcare provider's (HCP) recommendation for vaccination (adjusted OR 12.7 95% CI [5.6-28.8]), immunosuppressive therapy (aOR 2.3 [1.1-5.3]), better knowledge of vaccination (aOR 3.2 [1.1-9.2]) and favorable attitudes towards vaccination (aOR 3.4 [1.2-9.5]) were positively associated with influenza vaccine uptake. Vaccine recommendation by HCPs was the only independently associated factor with pneumococcal vaccines uptake (OR 187.7 [24.8-1422.5]). Immunization rates in our sample do not reach recommended levels. Factors associated with vaccination included high knowledge, favorable attitudes towards vaccination and recommendation for vaccination. This underlines the role of health care providers in contact with IBD patients. Copyright © 2018 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  7. Efficacy of tumour necrosis factor antagonists on remission, colectomy and hospitalisations in ulcerative colitis: Meta-analysis of placebo-controlled trials.

    PubMed

    Lopez, Anthony; Ford, Alexander C; Colombel, Jean-Frédéric; Reinisch, Walter; Sandborn, William J; Peyrin-Biroulet, Laurent

    2015-05-01

    The potential for disease modification of tumour necrosis factor antagonists in ulcerative colitis remains debated. We searched MEDLINE, the Cochrane Library and EMBASE. Clinical response/remission, mucosal healing, colectomy, disease-related hospitalisations, and adverse events were analysed by the methods of Peto and Der Simonian and Laird. Five trials enrolled 3654 patients (anti-tumour necrosis factor=2338). Anti-tumour necrosis factor therapy was more effective than placebo to induce and maintain clinical remission, with a number needed to treat of 12 (95% confidence interval [CI], 7-35) and 6 (95% CI, 4-12) for adalimumab and infliximab, respectively. Anti-tumour necrosis factor therapy was more effective than placebo to induce and maintain mucosal healing, with number needed to treat of 9 (95% CI, 5-48), 7 (95% CI, 5-17), 4 (95% CI, 3-6) for adalimumab, golimumab and infliximab, respectively. Only infliximab was associated with a reduced need for colectomy. Both infliximab and adalimumab were associated with less hospitalisations. Anti-tumour necrosis factor therapy did not increase the risk of adverse events. Anti-tumour necrosis factor therapy is more effective than placebo to induce and maintain clinical remission and mucosal healing. Both infliximab and adalimumab are associated with less hospitalisations. Infliximab reduces the need for colectomy. Anti-tumour necrosis factor therapy does not increase the risk of adverse events. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  8. Low testosterone in non-responsive coeliac disease: A case series, case-control study with comparisons to the National Health and Nutrition Examination Survey.

    PubMed

    Kurada, Satya; Veeraraghavan, Gopal; Kaswala, Dharmesh; Hansen, Josh; Cohen, David; Kelly, Ciaran; Leffler, Daniel

    2016-10-01

    Adults with coeliac disease (CD) often report persistent fatigue, even when CD appears well controlled for unknown reasons. To evaluate common indications for testosterone panel (TP) testing and prevalence of low testosterone (T) in CD. In our case series, we determined common indications for checking TP in CD. Next, we conducted a case-control study to compare TP in CD vs. healthy controls (HC). We compared mean total T (TT), free T (FT) based on serologic, histologic disease activity. Finally, we assessed TT in tissue transglutaminase (tTG)+ vs. tTG- subjects and CD vs. HC obtained from the National Health and Nutrition Examination Survey (NHANES). 53 coeliac males had TP tested. Common indications included osteoporosis and fatigue. Low FT was observed in 7/13 men with osteoporosis and 5/6 with fatigue. In our case-control study (n=26 each), there was no difference in mean TT or FT between CD vs. HC, tTG+ vs tTG- or Marsh 0 vs. Marsh 3 groups. NHANES data showed no difference in mean TT between tTG+ vs tTG- (n=16 each) or CD vs. HC subjects (n=5 each). Low T occurs in CD patients at a similar rate as the general population. Common presentations of low T may mimic non-responsive CD symptoms. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  9. Low incidence but poor prognosis of complicated coeliac disease: a retrospective multicentre study.

    PubMed

    Biagi, Federico; Gobbi, Paolo; Marchese, Alessandra; Borsotti, Edoardo; Zingone, Fabiana; Ciacci, Carolina; Volta, Umberto; Caio, Giacomo; Carroccio, Antonio; Ambrosiano, Giuseppe; Mansueto, Pasquale; Corazza, Gino R

    2014-03-01

    Coeliac disease is a chronic enteropathy characterized by an increased mortality caused by its complications, mainly refractory coeliac disease, small bowel carcinoma and abdominal lymphoma. Aim of the study was to study the epidemiology of complications in patients with coeliac disease. Retrospective multicenter case-control study based on collection of clinical and laboratory data. The incidence of complicated coeliac disease was studied among coeliac patients directly diagnosed in four Italian centres. Patients referred to these centres after a diagnosis of coeliac disease and/or complicated coeliac disease in other hospitals were therefore excluded. Between 1/1999 and 10/2011, 1840 adult coeliac patients were followed up for 7364.3 person-years. Fourteen developed complications. Since five patients died, at the end of the observation period (10/2011), the prevalence of complicated coeliac disease was 9/1835 (1/204, 0.49%, 95% CI 0.2-0.9%). The annual incidence of complicated coeliac disease in the study period was 14/7364 (0.2%, 95% CI 0.1-0.31%). Although complications tend to occur soon after the diagnosis of coeliac disease, Kaplan-Meier curve analysis showed that they can actually occur at any time after the diagnosis of coeliac disease. Complications of coeliac disease in our cohort were quite rare, though characterised by a very high mortality. Copyright © 2013 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  10. Potential coeliac disease markers and autoimmunity in olmesartan induced enteropathy: A population-based study.

    PubMed

    Esteve, Maria; Temiño, Rocío; Carrasco, Anna; Batista, Lissette; Del Val, Adolfo; Blé, Michel; Santaolaria, Santos; Molina-Infante, Javier; Soriano, Germán; Agudo, Sandra; Zabana, Yamile; Andújar, Xavier; Aceituno, Montserrat; Ribes, Josepa; Madridejos, Rosa; Fernández-Bañares, Fernando

    2016-02-01

    (1) Assess the population-based incidence of severe olmesartan-associated enteropathy. (2) To describe patients of the Spanish registry. (3) Evaluate markers of potential coeliac disease and associated autoimmunity. Crude incidence rates in the area of Terrassa (Catalonia) were calculated. Clinical characteristics of patients in the Spanish registry were collected. Duodenal lymphocyte subpopulations and anti-TG2 IgA deposits were assessed in a subset of patients. Annual incidence rates (2011-2014) ranged from 0 to 22 cases per 10(4) treated patients. Twenty patients were included in the Spanish registry. Nineteen (95%) exhibited villous atrophy and 16 (80%) had severe enteropathy. Lupus-like disease occurred during olmesartan treatment in 3 patients. HLA-DQ2/DQ8 was positive in 64%. Markers of potential coeliac disease were present in 4 out of 8 patients (positive anti-TG2 deposits and/or increased CD3+gammadelta+ intraepithelial lymphocytes and reduced CD3-). Histopathological changes and clinical manifestations including autoimmune disorders improved after olmesartan discontinuation but not after gluten-free diet, irrespective of the presence or absence of coeliac markers. Incidence of severe olmesartan-associated enteropathy was low. Autoimmune phenomena were present in a subset of cases and reversed after olmesartan removal. A genetic coeliac disease background and the presence of potential coeliac markers might uncover predisposing factors. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  11. A survey on the perception of allergy specialists about the reimbursed grass pollen tablets for seasonal allergic rhinitis in Italy.

    PubMed

    Massaro, Ilaria; Rossi, Oliviero; Incorvaia, Cristoforo; Lombardi, Carlo

    2017-01-01

    Sublingual immunotherapy (SLIT) is a feasible option to classical subcutaneous immunotherapy to treat respiratory allergy and is increasingly prescribed in Europe. However, the lack of reimbursement may limit its prescription. In 2015, the 5-grass pollen tablets was authorized by the European Medicine Agency to treat grass-pollen induced rhinitis and was approved in Italy for full reimbursement. We evaluated the opinions of allergy specialists after the availability of the reimbursed 5-grass pollen tablets. A multiple choice questionnaire composed by six questions was used to assess the specialists opinion. The questionnaire was uploaded on the free access online platform SurveyMonkey. The link to access the platform was sent to all members of the Società Italiana di Asma, Allergologia e Immunologia Clinica (SIAAIC). The access to the questionnaire was anonymous. At survey ending, the access was closed and data were downloaded directly from SurveyMonkey website. The questionnaire was filled by 70 allergists. The majority of allergists felt as most important the concept of SLIT as a drug, the content of allergen extract mirroring the natural exposure, the pre-coseasonal schedule as the most patient's oriented, the very good profile of tolerability and safety, the importance of the build-up phase, and the importance of checking the patient after starting immunotherapy. The opinions of the Italian allergy specialists about the reimbursed 5-grass-pollen tablets are very positive and make likely an appropriate prescription of SLIT for grass-pollen induced rhinitis in the next years.

  12. Symptoms, endoscopic findings and reflux monitoring results in candidates for bariatric surgery.

    PubMed

    Heimgartner, Benjamin; Herzig, Marcus; Borbély, Yves; Kröll, Dino; Nett, Philipp; Tutuian, Radu

    2017-07-01

    Gastroesophageal reflux disease (GERD) is common in patients with obesity. Diagnosing GERD is important as bariatric operations have different influence on GERD. We assessed reflux symptoms and objective findings prior to surgery. Work-up included esophageal symptoms quantification by VAS-scores, esophagogastroduodenoscopy (EGD) and 24-h impedance-pH (imp-pH) monitoring off PPI therapy. Imp-pH was classified as abnormal if either %time pH<4 was abnormal, total number of reflux episodes was elevated or symptom index (SI) was positive. Among 100 consecutive patients (68F, age 40±11years, BMI 44.9±6.9kg/m 2 ) 54% reported heartburn and/or regurgitation, 71% had objective evidence of GERD (38% endoscopic lesions and 33% only abnormal imp-pH results). Imp-pH was superior to EGD in identifying GERD (sensitivity 85% vs. 54%, p<0.01). Symptomatic and asymptomatic patients had similar prevalence of esophageal lesions (37% vs. 39%) and abnormal imp-pH findings (68% vs. 50%). Sixty nine percent of patients with abnormal %time pH<4 had a normal number of reflux episodes. Half of patients with obesity reported typical GERD symptoms and >70% had evidence of GERD. Poor acid clearance was the main mechanisms. Since typical reflux symptoms don't predict objective findings, endoscopy and reflux monitoring should be part of the surgery work-up especially before restrictive procedures. Copyright © 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  13. Combined multichannel intraluminal impedance and pH monitoring is helpful in managing children with suspected gastro-oesophageal reflux disease.

    PubMed

    Rossi, Paolo; Isoldi, Sara; Mallardo, Saverio; Papoff, Paola; Rossetti, Danilo; Dilillo, Anna; Oliva, Salvatore

    2018-04-05

    Gastro-oesophageal reflux is very common in the paediatric age group. There is no single and reliable test to distinguish between physiologic and pathological gastro-oesophageal reflux, and this lack of clear distinction between disease and normal can have a negative impact on the management of children. To evaluate the usefulness of 24-h oesophageal pH-impedance study in infants and children with suspected gastro-oesophageal reflux disease. Patients were classified by age groups (A-C) and reflux-related symptoms (typical and atypical). All underwent pH-impedance study. If the latter suggested an abnormal reflux, patients received therapy in accordance with NASPGHAN/ESPGHAN recommendations, while those with normal study had an additional diagnostic work-up. The efficacy of therapy was evaluated with a specific standardized questionnaire for different ages. The study was abnormal in 203/428 patients (47%) while normal in 225/428 (53%). Of those with abnormal study, 109 exhibited typical symptoms (54%), and 94 atypical (46%). The great majority of the patients with abnormal study were responsive to medical anti-reflux therapy. We confirm the utility of prolonged oesophageal pH-impedance study in detecting gastro-oesophageal reflux disease in children and in guiding therapy. Performing oesophageal pH-impedance monitoring in children with suspected gastro-oesophageal reflux disease is helpful to establish the diagnosis and avoid unnecessary therapy. Copyright © 2018 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  14. Bowel ultrasound imaging in patients with cystic fibrosis: Relationship with clinical symptoms and CFTR genotype.

    PubMed

    Fraquelli, Mirella; Baccarin, Alessandra; Corti, Fabiola; Conti, Clara Benedetta; Russo, Maria Chiara; Della Valle, Serena; Pozzi, Roberta; Cressoni, Massimo; Conte, Dario; Colombo, Carla

    2016-03-01

    Ultrasound imaging is used to assess bowel abnormalities in gastrointestinal diseases. We aimed to assess the rate of predefined bowel ultrasound signs and their relationship with gastrointestinal symptoms and the cystic fibrosis transmembrane conductance regulator (CFTR) genotype in cystic fibrosis patients in regular follow-up. Prospective study of 70 consecutive patients with cystic fibrosis and 45 controls who underwent abdominal ultrasound; pertinent findings were related to gastrointestinal symptoms and, in cystic fibrosis patients, to pancreatic status, malabsorption degree, lipase intake, CFTR genotype (classified as severe or mild against functional class of CFTR mutations). 96% patients showed at least one abnormal bowel ultrasound sign. Most frequent signs were lymph node enlargement (64%), bowel loop dilatation (55%), thick corpuscular intraluminal content (49%), bowel wall hypervascularization (26%), thickened bowel wall (22%) and intussusception (17%). Patients with recurrent abdominal pain showed more bowel wall hypervascularization than patients without recurrent pain (47% vs. 19%, respectively; p = 0.02) and intussusception (58% vs. 17%, respectively; p < 0.01). Genotype was not associated to specific bowel ultrasound signs. Patients with bowel loop intussusception showed greater lipase intake than those without intussusception (8.118 ± 2.083 vs. 5.994 ± 4.187, respectively; p < 0.01). Cystic fibrosis patients present a higher rate of bowel ultrasound abnormalities than controls. Bowel ultrasound abnormalities are associated with abdominal symptoms. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  15. 22nd International Conference on Medical Physics 2016, Bangkok, Thailand; Medical physics propelling global health.

    PubMed

    Tsapaki, Virginia; Ibbott, Geoff; Krisanachinda, Anchali; Ng, Kwan-Hoong; Suh, Tae-Suk; Tabakov, Slavik; Damilakis, John

    2017-12-01

    As medical technology evolves and patient needs increase, the need for well-trained and highly professional medical physicists (MPs) becomes even more urgent. The roles and responsibilities of MPs in various departments within the hospital are diverse and demanding. It is obvious that training, continuing education and professional development of MPs have become essential. One of the ways for an MP to advance his or her knowledge is to participate in conferences and congresses. Last year, the 22nd International Conference of Medical Physics (ICMP 2016) took place in Bangkok, Thailand. The event attracted 584 delegates with most of the participants coming from Asia. It attracted also delegates from 42 countries. The largest delegations were from Thailand, Japan and South Korea. ICMP 2016 included 367 oral presentations and e-posters, most of these being in the fields of Radiation Therapy, Medical Imaging and Radiation Safety. All abstracts were published as an e-book of Abstracts in a supplement to the official IOMP Journal. Many companies had exhibition stands at ICMP2016, thus allowing the participants to see the latest developments in the medical physics-related industry. The conference included 42 mini-symposia, part of the first "IOMP School" activity, covering various topics of importance for the profession and this special issue follows from the success of the conference. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  16. The medical physics specialization system in Poland.

    PubMed

    Bulski, Wojciech; Kukołowicz, Paweł; Skrzyński, Witold

    2016-07-01

    This paper presents the situation of the profession of medical physicists in Poland. The official recognition of the profession of medical physicist in Polish legislation was in 2002. In recent years, more and more Universities which have Physics Faculties introduce a medical physics specialty. At present, there are about 15 Universities which offer such programmes. These Universities are able to graduate about 150 medical physicists per year. In 2002, the Ministry of Health introduced a programme of postgraduate specialization in medical physics along the same rules employed in the specialization of physicians in various branches of medicine. Five institutions, mostly large oncology centres, were selected as teaching institutions, based on their experience, the quality of the medical physics professionals, staffing levels, equipment availability, lecture halls, etc. The first cycle of the specialization programme started in 2006, and the first candidates completed their training at the end of 2008, and passed their official state exams in May 2009. As of January 2016, there are 196 specialized medical physicists in Poland. Another about 120 medical physicists are undergoing specialization. The system of training of medical physics professionals in Poland is well established. The principles of postgraduate training and specialization are well defined and the curriculum of the training is very demanding. The programme of specialization was revised in 2011 and is in accordance with EC and EFOMP recommendations. Copyright © 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  17. Treatment planning systems dosimetry auditing project in Portugal.

    PubMed

    Lopes, M C; Cavaco, A; Jacob, K; Madureira, L; Germano, S; Faustino, S; Lencart, J; Trindade, M; Vale, J; Batel, V; Sousa, M; Bernardo, A; Brás, S; Macedo, S; Pimparel, D; Ponte, F; Diaz, E; Martins, A; Pinheiro, A; Marques, F; Batista, C; Silva, L; Rodrigues, M; Carita, L; Gershkevitsh, E; Izewska, J

    2014-02-01

    The Medical Physics Division of the Portuguese Physics Society (DFM_SPF) in collaboration with the IAEA, carried out a national auditing project in radiotherapy, between September 2011 and April 2012. The objective of this audit was to ensure the optimal usage of treatment planning systems. The national results are presented in this paper. The audit methodology simulated all steps of external beam radiotherapy workflow, from image acquisition to treatment planning and dose delivery. A thorax CIRS phantom lend by IAEA was used in 8 planning test-cases for photon beams corresponding to 15 measuring points (33 point dose results, including individual fields in multi-field test cases and 5 sum results) in different phantom materials covering a set of typical clinical delivery techniques in 3D Conformal Radiotherapy. All 24 radiotherapy centers in Portugal have participated. 50 photon beams with energies 4-18 MV have been audited using 25 linear accelerators and 32 calculation algorithms. In general a very good consistency was observed for the same type of algorithm in all centres and for each beam quality. The overall results confirmed that the national status of TPS calculations and dose delivery for 3D conformal radiotherapy is generally acceptable with no major causes for concern. This project contributed to the strengthening of the cooperation between the centres and professionals, paving the way to further national collaborations. Copyright © 2013 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  18. Ursodeoxycholic acid therapy in intrahepatic cholestasis of pregnancy: Results in real-world conditions and factors predictive of response to treatment.

    PubMed

    Bacq, Yannick; le Besco, Matthieu; Lecuyer, Anne-Isabelle; Gendrot, Chantal; Potin, Jérôme; Andres, Christian R; Aubourg, Alexandre

    2017-01-01

    Ursodeoxycholic acid (UDCA) therapy is commonly used in intrahepatic cholestasis of pregnancy (ICP). To evaluate the efficacy and tolerance of UDCA in real-world conditions and to search for factors predictive of response to treatment. This observational study included 98 consecutive patients suffering from pruritus during pregnancy associated with increased ALT levels or total bile acid (TBA) concentrations, without other causes of cholestasis. The entire ABCB4 gene coding sequence was analyzed by DNA sequencing. UDCA was prescribed until delivery in all patients (mean dose 14.0mg/kg/day; mean duration 30.4 days). Pruritus improved in 75/98 (76.5%) patients, and totally disappeared before delivery in 25/98 (25.5%). After 2-3 weeks of treatment, ALT levels decreased by more than 50% of base line in 67/86 (77.9%) patients and normalized in 34/86 (39.5%), and TBA concentrations decreased in 28/81 (34.6%). Only one patient stopped the treatment before delivery. On multivariate analysis, ALT >175IU/l before treatment was associated with improvement of pruritus (OR 2.97, 95% CI 1.12-7.89, P=0.029) and with decreased ALT (OR 18.61, 95% CI 3.94-87.99, P=0.0002). ABCB4 gene mutation was not associated with response to treatment. This study supports the use of UDCA as first line therapy in ICP. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  19. Measuring dose from radiotherapy treatments in the vicinity of a cardiac pacemaker.

    PubMed

    Peet, Samuel C; Wilks, Rachael; Kairn, Tanya; Crowe, Scott B

    2016-12-01

    This study investigated the dose absorbed by tissues surrounding artificial cardiac pacemakers during external beam radiotherapy procedures. The usefulness of out-of-field reference data, treatment planning systems, and skin dose measurements to estimate the dose in the vicinity of a pacemaker was also examined. Measurements were performed by installing a pacemaker onto an anthropomorphic phantom, and using radiochromic film and optically stimulated luminescence dosimeters to measure the dose in the vicinity of the device during the delivery of square fields and clinical treatment plans. It was found that the dose delivered in the vicinity of the cardiac device was unevenly distributed both laterally and anteroposteriorly. As the device was moved distally from the square field, the dose dropped exponentially, in line with out-of-field reference data in the literature. Treatment planning systems were found to substantially underestimate the dose for volumetric modulated arc therapy, helical tomotherapy, and 3D conformal treatments. The skin dose was observed to be either greater or lesser than the dose received at the depth of the device, depending on the treatment site, and so care should be if skin dose measurements are to be used to estimate the dose to a pacemaker. Square field reference data may be used as an upper estimate of absorbed dose per monitor unit in the vicinity of a cardiac device for complex treatments involving multiple gantry angles. Copyright © 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  20. White paper of Italian Gastroenterology: delivery of services for digestive diseases in Italy: weaknesses and strengths.

    PubMed

    Buscarini, Elisabetta; Conte, Dario; Cannizzaro, Renato; Bazzoli, Franco; De Boni, Michele; Delle Fave, Gianfranco; Farinati, Fabio; Ravelli, Paolo; Testoni, Pier Alberto; Lisiero, Manola; Spolaore, Paolo

    2014-07-01

    In 2011 the three major Italian gastroenterological scientific societies (AIGO, the Italian Society of Hospital Gastroenterologists and Endoscopists; SIED, the Italian Society of Endoscopy; SIGE, the Italian Society of Gastroenterology) prepared their official document aimed at analysing medical care for digestive diseases in Italy, on the basis of national and regional data (Health Ministry and Lombardia, Veneto, Emilia-Romagna databases) and to make proposals for planning of care. Digestive diseases were the first or second cause of hospitalizations in Italy in 1999-2009, with more than 1,500,000 admissions/year; however only 5-9% of these admissions was in specialized Gastroenterology units. Reported data show a better outcome in Gastroenterology Units than in non-specialized units: shorter average length of stay, in particular for admissions with ICD-9-CM codes proxying for emergency conditions (6.7 days versus 8.4 days); better case mix (higher average diagnosis-related groups weight in Gastroenterology Units: 1 vs 0.97 in Internal Medicine units and 0.76 in Surgery units); lower inappropriateness of admissions (16-25% versus 29-87%); lower in-hospital mortality in urgent admissions (2.2% versus 5.1%); for patients with urgent admissions due to gastrointestinnal haemorrhage, in-hospital mortality was 2.3% in Gastroenterology units versus 4.0% in others. The present document summarizes the scientific societies' official report, which constitutes the "White paper of Italian Gastroenterology". Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.