Trigeminal sensory pathway function in patients with SUNCT

[IF 2.64] Objective: Short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT) is a rare primary headache whose origins are unclear. To seek information on its pathophysiology, we studied the trigeminal Ab and Ad pathways by recording trigeminal reflexes and laser evoked potentials (LEPs) in patients with SUNCT. Methods: Trigeminal reflexes and LEPs were recorded in 11 consecutive patients. Ten patients had neuroimaging evidence documenting idiopathic SUNCT and one had a posterior fossa tumour that compressed the trigeminal nerve thus causing symptomatic SUNCT. Results: Whereas the patients with idiopathic SUNCT had normal trigeminal reflex and LEP responses, the patient with symptomatic SUNCT had abnormal responses. Conclusions: Our neurophysiological findings show that idiopathic SUNCT spares the trigeminal sensory pathways whereas symptomatic SUNCT does not. Significance: Neurophysiological testing can easily differentiate the idiopathic and symptomatic forms of SUNCT. It also suggests that the two forms are pathophysiologically distinct entities

I nuovi media come dispositivi semiotecnici. Uno sguardo pedagogico

Sia in ambito umanistico, sia scientifico si continua a parlare di rivoluzione digitale. Il tema merita di essere approfondito per due ordini di ragioni: 1) per l'innegabile influenza che i nuovi media esercitano sulle relazioni sociali, sui comportamenti quotidiani e, in generale, sulle esperienze di vita degli individui; 2) perche le tecnologie emergenti, in uno specifico contesto storico-culturale, non sono semplicemente uno strumento ad uso degli uomini ma un medium attraverso cui si costruiscono significati e realta sociali. In ottica educativa diviene interessante chiedersi come le nuove tecnologie digitali influenzino e ristrutturino le esperienze di vita dei soggetti. A tal fine l'articolo propone una lettura pedagogica dei nuovi media come dispositivi semiotecnici (Foucault, 1976): ovvero insiemi codificati di idee, ideologie e rappresentazioni che influenzano e trasformano – insieme a specifici apparati materiali, attraverso i discorsi e facendo presa sui corpi – comportamenti sociali e processi di costruzione identitaria. Le tecnologie in tal senso sono mediatori esperienziali: esse co-creano routine e azioni quotidiane, modificano i rapporti tra individui, con gli oggetti, lo spazio, il tempo e i corpi, contribuendo a produrre nuove soggettivita

The c4 atriplex halimus vs. The c3 atriplex hortensis: Similarities and differences in the salinity stress response

open7noSoil properties and the ability to sustain agricultural production are seriously impaired by salinity. The cultivation of halophytes is seen as a solution to cope with the problem. In this framework, a greenhouse pot experiment was set up to assess salinity response in the perennial C4 species Atriplex halimus, and in the following three cultivars of the annual C3 Atriplex hortensis: green, red, and scarlet. The four genotypes were grown for 35 days with water salinity (WS) ranging from 0 to 360 mM NaCl. Plant height and fresh weight (FW) increased at 360 vs. 0 WS. The stomatal conductance (GS) and transpiration rate (E) were more severely affected by salinity in the C4 A. halimus than in the C3 species A. hortensis. This was reflected in a lower leaf water potential indicating stronger osmotic adjustment, and a higher relative water content associated with more turgid leaves, in A. halimus than A. hortensis. In a PCA including all the studied traits, the GS and E negatively correlated to the FW, which, in turn, positively correlated with Na concentration and intrinsic water use efficiency (iWUE), indicating that reduced gas exchange associated with Na accumulation contributed to sustain iWUE under salinity. Finally, FTIR spectroscopy showed a reduced amount of pectin, lignin, and cellulose under salinity, indicating a weakened cell wall structure. Overall, both species were remarkably adapted to salinity: From an agronomic perspective, the opposite strategies of longer vs. faster soil coverage, involved by the perennial A. halimus vs. the annual A. hortensis cv. scarlet, are viable natural remedies for revegetating marginal saline soils and increasing soil organic carbon.openCalone R.; Cellini A.; Manfrini L.; Lambertini C.; Gioacchini P.; Simoni A.; Barbanti L.Calone R.; Cellini A.; Manfrini L.; Lambertini C.; Gioacchini P.; Simoni A.; Barbanti L

Comparison of physical, microstructural, antioxidant and enzymatic properties of pineapple cubes treated with conventional heating, ohmic heating and high-pressure processing

Pineapple cubes in sugar syrup were treated with high-pressure processing (HPP), conventional (DIM) heating and ohmic heating (OHM). Samples were compared in terms of microstructural, physical (total soluble solids, sieve analysis, texture and colour) and residual pectin methylesterase activity (PME) and total antioxidant capacity. OHM yielded relevant changes in cellular microstructure and electroporation of the cell wall. The HPP treatment favoured the presence of soluble solids in the syrup, and the samples were less damaged in terms of shape and microstructure. in the samples were harder following HPP than they were with OHM and DIM, while HPP showed the highest colorimetric (ΔE) differences compared with RAW samples. The PME residual activity was the lowest in pineapple treated by DIM, while the antioxidant capacity was comparable among treated samples

Practical and clinical utility of non-invasive vagus nerve stimulation (nVNS) for the acute treatment of migraine. A post hoc analysis of the randomized, sham-controlled, double-blind PRESTO trial

Background: The PRESTO study of non-invasive vagus nerve stimulation (nVNS; gammaCore®) featured key primary and secondary end points recommended by the International Headache Society to provide Class I evidence that for patients with an episodic migraine, nVNS significantly increases the probability of having mild pain or being pain-free 2 h post stimulation. Here, we examined additional data from PRESTO to provide further insights into the practical utility of nVNS by evaluating its ability to consistently deliver clinically meaningful improvements in pain intensity while reducing the need for rescue medication. Methods: Patients recorded pain intensity for treated migraine attacks on a 4-point scale. Data were examined to compare nVNS and sham with regard to the percentage of patients who benefited by at least 1 point in pain intensity. We also assessed the percentage of attacks that required rescue medication and pain-free rates stratified by pain intensity at treatment initiation. Results: A significantly higher percentage of patients who used acute nVNS treatment (n = 120) vs sham (n = 123) reported a ≥ 1-point decrease in pain intensity at 30 min (nVNS, 32.2%; sham, 18.5%; P = 0.020), 60 min (nVNS, 38.8%; sham, 24.0%; P = 0.017), and 120 min (nVNS, 46.8%; sham, 26.2%; P = 0.002) after the first attack. Similar significant results were seen when assessing the benefit in all attacks. The proportion of patients who did not require rescue medication was significantly higher with nVNS than with sham for the first attack (nVNS, 59.3%; sham, 41.9%; P = 0.013) and all attacks (nVNS, 52.3%; sham, 37.3%; P = 0.008). When initial pain intensity was mild, the percentage of patients with no pain after treatment was significantly higher with nVNS than with sham at 60 min (all attacks: nVNS, 37.0%; sham, 21.2%; P = 0.025) and 120 min (first attack: nVNS, 50.0%; sham, 25.0%; P = 0.018; all attacks: nVNS, 46.7%; sham, 30.1%; P = 0.037). Conclusions: This post hoc analysis demonstrated that acute nVNS treatment quickly and consistently reduced pain intensity while decreasing rescue medication use. These clinical benefits provide guidance in the optimal use of nVNS in everyday practice, which can potentially reduce use of acute pharmacologic medications and their associated adverse events. Trial registration: ClinicalTrials.gov identifier: NCT02686034

A novel, comprehensive tool for predicting 30-day mortality after surgical aortic valve replacement

OBJECTIVES: We sought to develop and validate a novel risk assessment tool for the prediction of 30-day mortality after surgical aortic valve replacement incorporating a patient's frailty. METHODS: Overall, 4718 patients from the multicentre study OBSERVANT was divided into derivation (n=3539) and validation (n=1179) cohorts. A stepwise logistic regression procedure and a criterion based on Akaike information criteria index were used to select variables associated with 30-day mortality. The performance of the regression model was compared with that of European System for Cardiac Operative Risk Evaluation (EuroSCORE) II. RESULTS: At 30 days, 90 (2.54%) and 35 (2.97%) patients died in the development and validation data sets, respectively. Age, chronic obstructive pulmonary disease, concomitant coronary revascularization, frailty stratified according to the Geriatric Status Scale, urgent procedure and estimated glomerular filtration rate were independent predictors of 30-day mortality. The estimated OBS AVR score showed higher discrimination (area under curve 0.76 vs 0.70, P CONCLUSIONS: The OBS AVR risk score showed high discrimination and calibration abilities in predicting 30-day mortality after surgical aortic valve replacement. The addition of a simplified frailty assessment into the model seems to contribute to an improved predictive ability over the EuroSCORE II. The OBS AVR risk score showed a significant association with long-term mortality.Peer reviewe

Epidemiology and outcome of Clostridium difficile infections in patients hospitalized in Internal Medicine: findings from the nationwide FADOI-PRACTICE study.

BACKGROUND: Clostridium difficile (CD) is a leading cause of diarrhoea among hospitalized patients. The objective of this study was to evaluate the rate, the optimal diagnostic work-up, and outcome of CD infections (CDI) in Internal Medicine (IM) wards in Italy. METHODS: PRACTICE is an observational prospective study, involving 40 IM Units and evaluating all consecutive patients hospitalized during a 4-month period. CDI were defined in case of diarrhoea when both enzyme immunoassay for GDH, and test for A/B toxin were positive. Patients with CDI were followed-up for recurrences for 4 weeks after the end of therapy. RESULTS: Among the 10,780 patients observed, 103 (0.96 %) showed CDI, at admission or during hospitalization. A positive history for CD, antibiotics in the previous 4 weeks, recent hospitalization, female gender and age were significantly associated with CDI (multivariable analysis). In-hospital mortality was 16.5 % in CD group vs 6.7 % in No-CD group (p\u2009<\u20090.001), whereas median length of hospital stay was 16 (IQR\u2009=\u200913) vs 8 (IQR\u2009=\u20098) days (p\u2009<\u20090.001) among patients with or without CDI, respectively. Rate of CD recurrences was 14.6 %. As a post-hoc evaluation, 23 out of 34 GDH+/Tox- samples were toxin positive, when analysed by molecular method (a real-time PCR assay). The overall CD incidence rate was 5.3/10,000 patient-days. CONCLUSIONS: Our results confirm the severity of CDI in medical wards, showing high in-hospital mortality, prolonged hospitalization and frequent short-term recurrences. Further, our survey supports a 2-3 step algorithm for CD diagnosis: EIA for detecting GDH, A and B toxin, followed by a molecular method in case of toxin-negative samples

Tantalum nanoparticles enhance the osteoinductivity of multiscale composites based on poly(lactide-co-glycolide) electrospun fibers embedded in a gelatin hydrogel

Bioresorbable polymeric materials have risen great interest as implants for bone tissue regeneration, since they show substantial advantages with respect to conventional metal devices, including biodegradability, flexibility, and the possibility to be easily modified to introduce specific functionalities. In the present work, an innovative nanocomposite scaffold, properly designed to show biomimetic and osteoinductive properties for potential application in bone tissue engineering, was developed. The scaffold is characterized by a multi-layer structure, completely different with respect to the so far employed polymeric implants, consisting in a poly(D,L-lactide-co-glycolide)/polyethylene glycol electrospun nanofibrous mat sandwiched between two hydrogel gelatin layers enriched with tantalum nanoparticles (NPs). The composition of the electrospun fibers, containing 10 wt% of polyethylene glycol, was selected to ensure a proper integration of the fibers in the gel phase, essential to endow the composite with flexibility and to prevent delamination between the layers. The scaffold maintained its structural integrity after six weeks of soaking in physiological solutions, albeit the gelatin phase was partially released. The combined use of gelatin, bioresorbable electrospun fibers and tantalum NPs endows the final device with biomimetic and osteoinductive properties. Indeed, results of the in vitro tests demonstrate that the obtained scaffolds clearly represent a favorable milieu for normal human bone-marrow derived mesenchymal stem cells viability and osteoblastic differentiation; moreover, inclusion of tantalum NPs in the scaffold improves cell performance with particular regard to early and late markers of osteoblastic differentiation. (C) 2022 Elsevier Ltd. All rights reserved

Validation of a self-reported instrument to assess work-related difficulties in patients with migraine: the HEADWORK questionnaire

Background: The degree to which work-related difficulties are recognized in headache research is poor and often carried out with inadequate information such as "reduced ability to work as usual", which do not capture at all the variety of difficulties and the factors that impact over them. The aim of this paper is to present the validation of the HEADWORK questionnaire, which addresses the amount and severity of difficulties in work-related tasks and the factors that impact over them.Methods: We developed a set of items based on a previous literature review and patients' focus groups and tested it on a wide set of patients with episodic and chronic migraine attending eight different Italian headache centers. HEADWORK factor structure was assessed with exploratory and confirmatory factor analysis; internal consistency and construct validity were addressed as well.Results: The validation sample (N= 373) was mostly composed of patients with episodic migraine without aura (64.3%) and of females (81%). Factor analysis retrieved two different scales: "Work-related difficulties", composed of eleven items which explain 67.1% of the total variance, and "Factors contributing to work difficulties", composed of six items which explain 52.1% of the total variance. Both HEADWORK subscales have good measurement properties, with higher scores being associated to higher disability, lower quality of life, lower productivity, higher headache frequency and pain intensity.Conclusions: HEADWORK is a 17-item, two-scale questionnaire addressing the impact of migraine on work-related difficulties in terms of difficulties in general or specific skills, and the factors contributing to these difficulties, defined as negative impact on work tasks. It can be used to address disability weights for the purpose of calculating the burden of migraine, and to assess the balance between therapeutic and side effects of medication on productivity