Hemostasis in uncontrolled esophageal variceal bleeding by self-expanding metal stents. A systematic review

Aim: The aim of this systematic review was to evaluate the current reported efficacy and the mortality rate of SEMS treatment in uncontrolled bleeding patients. Background: Esophageal variceal bleeding (EVB) represents a life threatening pathology. Despite the adequate pharmacologic and endoscopic treatment, continuous or recurrent bleeding, named as uncontrolled bleeding, occurs in 10-20% of cases. A new removable, covered, and self-expanding metal stent (SEMS) was proposed to control the variceal bleeding. Materials and methods: The study was conducted according to the PRISMA statement. Studies were identified by searching MEDLINE (1989-present) and SCOPUS (1989-present) databases. The last search was run on 01 July 2015. Results: Nine studies (period range=2002-2015) met the inclusion criteria and were included in quantitative analysis. High rate of SEMS efficacy in controling acute bleeding was observed, with a reported percentage ranging from 77.7 to 100%. In 10% to 20% of patients, re-bleeding occurred with SEMS in situ. Stent deployment was successful in 77.8% to 100% of patients while 11 to 36.5% of patients experienced stent migration. Conclusion: SEMS could be effective and safe in control EVB and can be proposed as a reliable option to ballon tamponed for patient stabilization and as a bridging to other therapeutic approach. Keywords: Nonselective β-blockers, TIPSS, Endoscopic band ligation, Uncontrolled bleeding, Selfexpanding metal stent

Acoustic measurements of the Roman theatre of Pompei by mapping the sound reflections

The city of Pompei has been always subject to archaeological works during the last decades. However, the theatre that has been discovered in the urban environment has one of the best preserved cavea, although it lacks most of the scaenae frons. This paper deals with the acoustic measurements undertaken to study the behavior of this important monument through the main acoustic parameter outlined by ISO 3382-1, and to detect the direction of the early and late reflections characterizing the reverberation. This latest approach enabled the possibility to investigate the sound propagation thought the space with the employment of a multichannel spherical array microphone. The recorded impulse response (IR) has been analyzed in such a way to create an overlay video, given by the overlapping of the 360° image taken at the receiver position with the contour level of the sound decay after the impulse

Comparison Failure and Successful Methodologies for Diffusion Measurements Undertaken inside Two Different Testing Rooms

The scattering phenomenon is known to be of great importance for the acoustic quality of a performance arts space. The scattering of sound can be achieved in different ways: it can be obtained by the presence of architectural and/or decorating elements inside a room (e.g., columns, statues), by the geometry and roughness of a surface (e.g., Quadratic Residue Diffuser (QRD)) and by the diffraction effect occurring when a sound wave hits the edges of an obstacle. This article deals with the surface scattering effects and the diffusion phenomenon only related to MDF and plywood panels tested by disposing the wells both horizontally and vertically. The test results undertaken inside a semi-reverberant room and inside a large reverberant room have been compared to highlight the success and the failure of the measuring methodologies. In detail, according to the existing standards and regulations (i.e., ISO 17497—Part 2), diffusion measurements have been undertaken on a few selected types of panel: two QRD panels (made of Medium Density Fiberboard (MDF) and plywood) with and without a smooth painted solid wood placed behind the QRD. The panels have been tested inside two rooms of different characteristics: a semi-anechoic chamber (Room A) and a large reverberant room (Room B). The volume size influenced the results that have been analyzed for both chambers, showing an overlap of reflections on panels tested inside Room A and a clear diffusion response for the panels tested inside Room B. In terms of the diffusion coefficient in all the octave bands between 125 Hz and 8 kHz, results should not be considered valid for panels tested in Room A because they were negatively impacted by extraneous reflections, while they are reliable for panels tested in Room B

3dof representation of the acoustic measurements inside the Comunale-Pavarotti Theatre of Modena

The investigation of the acoustics inside the Italian Opera theatres has been undertaken by scholars in order to deepening their scientific studies on the architectural and cultural heritage. This paper deals with alternative ways of how to represent acoustic data, in particular by adding a 3dof representation of the impulse response (IR) besides the graphs related to the main acoustic parameters in line with the standard requirements. The 3dof screen shots have been undertaken by an overlay elaboration, showing the particular architectural components of the theatre that contribute to the early and late sound reflections. A brief introduction of the historical background related to the Comunale-Pavarotti theatre of Modena has been given to understand the architectural characteristics of the entire structure

Acoustic parameters of the Municipal Theatre of Piacenza shown on different ways of representation

The Italian Opera theatres are always subject to scientific studies that try to investigate as deeply as possible this historical heritage to preserve the architectural and acoustical information for future generations. This paper deals with two ways of data representations based on the outcomes derived from the variety of equipment used during the measurements. In particular, a methodology in line with standards and regulations has been introduced to representing the graphs of the main acoustical parameters; besides, a video of the real-time room impulse response (RIR) has been snapped with a few shots in place of visualizing the sound reflections that occurred inside the entire volume. After a brief description of the historical background of the Municipal theatre of Piacenza, the authors introduce the two methods just discussed to highlight the completeness of data representation regarding any type of room that is intended to be analyzed acoustically

Enzymatic and Electron Transfer Activities in Crystalline Protein Complexes

Enzymatic and electron transfer activities have been studied by polarized absorption spectroscopy in single crystals of both binary and ternary complexes of methylamine dehydrogenase (MADH) with its redox partners. Within the crystals, MADH oxidizes methylamine, and the electrons are passed from the reduced tryptophan tryptophylquinone (TTQ) cofactor to the copper of amicyanin and to the heme of cytochrome c551i via amicyanin. The equilibrium distribution of electrons among the cofactors, and the rate of heme reduction after reaction with substrate, are both dependent on pH. The presence of copper in the ternary complex is not absolutely required for electron transfer from TTQ to heme, but its presence greatly enhances the rate of electron flow to the heme

R-CVP versus R-CHOP versus R-FM for the initial treatment of patients with advanced-stage follicular lmphoma: results of the FOLL05 trial conducted by the Fondazione Italiana Linfomi

PURPOSE Although rituximab (R) is commonly used for patients with advanced follicular lymphoma (FL) requiring treatment, the optimal associated chemotherapy regimen has yet to be clarified. PATIENTS AND METHODS We conducted an open-label, multicenter, randomized trial among adult patients with previously untreated stages II to IV FL to compare efficacy of eight doses of R associated with eight cycles of cyclophosphamide, vincristine, and prednisone (CVP) or six cycles of cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) or six cycles of fludarabine and mitoxantrone (FM). The principal end point of the study was time to treatment failure (TTF). Results There were 534 patients enrolled onto the study. Overall response rates were 88%, 93%, and 91% for R-CVP, R-CHOP, and R-FM, respectively (P=.247). After a median follow-up of 34 months, 3-year TTFs were 46%, 62%, and 59% for the respective treatment groups (R-CHOP v R-CVP, P=.003; R-FM v R-CVP, P=.006; R-FM v R-CHOP, P=.763). Three-year progression-free survival (PFS) rates were 52%, 68%, and 63% (overall P=.011), respectively, and 3-year overall survival was 95% for the whole series. R-FM resulted in higher rates of grade 3 to 4 neutropenia (64%) compared with R-CVP (28%) and R-CHOP (50%; P< .001). Overall, 23 second malignancies were registered during follow-up: four in R-CVP, five in R-CHOP, and 14 in R-FM. CONCLUSION In this study, R-CHOP and R-FM were superior to R-CVP in terms of 3-year TTF and PFS. In addition, R-CHOP had a better risk-benefit ratio compared with R-FM

Increased Antibacterial and Antibiofilm Properties of Silver Nanoparticles Using Silver Fluoride as Precursor.

Silver nanoparticles were produced with AgF as the starting Ag(I) salt, with pectin as the reductant and protecting agent. While the obtained nanoparticles (pAgNP-F) have the same dimensional and physicochemical properties as those already described by us and obtained from AgNO3 and pectin (pAgNP-N), the silver nanoparticles from AgF display an increased antibacterial activity against E. coli PHL628 and Staphylococcus epidermidis RP62A (S. epidermidis RP62A), both as planktonic strains and as their biofilms with respect to pAgNP-N. In particular, a comparison of the antimicrobial and antibiofilm action of pAgNP-F has been carried out with pAgNP-N, pAgNP-N and added NaF, pure AgNO3, pure AgF, AgNO3 and added NaF and pure NaNO3 and NaF salts. By also measuring the concentration of the Ag+ cation released by pAgNP-F and pAgNP-N, we were able to unravel the separate contributions of each potential antibacterial agent, observing an evident synergy between p-AgNP and the F- anion: the F- anion increases the antibacterial power of the p-AgNP solutions even when F- is just 10 µM, a concentration at which F- alone (i.e., as its Na+ salt) is completely ineffective