Clinical significance of the buccal fat pad: how to determine the correct surgical indications based on preoperative analysis

Background: Despite the multitude of clinical and aesthetic uses, the correct surgical indications for buccal fat pad (BFP) removal have yet to be fully elucidated. Although the procedure is widely performed and promoted for aesthetic purpose, literature lacks of studies accounting for a proper evaluation of patients undergoing BFP removal. Methods: Between 2012 and 2016 patients seeking an improvement of the malar contour by reduction of the submalar prominence have been visited at the Department of Plastic Surgery of the Institution. A preoperative MRI was requested in order to correctly identify the volume of the BFP and the presence of a masseter muscle (MM) hypertrophy. Results: According to clinical examination and the results of the preoperative imaging, patients were offered different treatment options: patients with BFP hypertrophy underwent BFP removal through an itraoral approach; patients with MM hypertrophy received injection of 50 UI of botulinum toxin (BTX). No complications were observed in the postoperative period and all patients were satisfied with the results. Conclusions: According to the experience, midface contouring procedures should take account of both surgeons’ experience, patients’ expectations and anatomical evaluation. As such, there is no given approach suitable for all cases. Suggested visual criteria, clinical examination and imaging analysis are useful in establishing patient’s condition and determining the appropriate methods of treatment to enhance the facial profile

FRP-RC/PC members subjected to combined actions

The capacity provisions of conventional Reinforced Concrete (RC) and Prestressed Concrete (PC) beams subjected to combined action of torsion, shear and flexure are well known and stated by international/national codes. Similar provisions lack for concrete members containing Fibre Reinforced Polymer (FRP) reinforcements. In general, there is paucity of research on the treatment of torsion combined with other stress resultants for FRP-RC/PC members. In this paper the theoretical method proposed by the Canadian standard CSA S806 for FRP-RC/PC structures is presented. The critical issues, related to this topic, such as the appropriate strength and inclination of the diagonal struts and failure criteria are critically analyzed and addressed. In order to assess the reliability of this study a comparison between available experimental data regarding FRP-RC/PC beams subjected to combined actions and their corresponding theoretical provisions derived by the CSA S806 standard is shown. Furthermore, another approach, available in literature, which is based on the space truss model, is examined and used for comparison in order to evaluate the theoretical provisions offered by this model against the tests value of the set of the beams analyzed in this study. Based on the critical analysis of the results, it can be highlighted that the CSA method is able to conservatively predict the capacity of these beams

translational challenges from the 2014 gastrointestinal cancers symposium toward a true tailored therapy through effective research

Gastrointestinal Cancers Symposium 2014, San Francisco, CA, USA, 16–18 January 2014 The Gastrointestinal Cancers Symposium represents an indisputable occasion for sharing results and research opportunities for investigators around the globe. Across the years along with clinical trials presentations the meeting increasingly acquired a distinct role as a scientific arena for translational research. Also, this year the need for predictive markers for first-generation targeted agents and research about novel biologically driven therapeutic options characterized most of the studies presented. We focus here on reports from the 2014 American Society of Clinical Oncology (ASCO) Gastrointestinal Cancers Symposium indicating an opportunity for biological selection of either the pharmacological target or the patient population in order to enhance clinical outcome

Retrospective exploratory analysis of VEGF polymorphisms in the prediction of benefit from first-line FOLFIRI plus bevacizumab in metastatic colorectal cancer

<p>Abstract</p> <p>Background</p> <p>Molecular predictors of bevacizumab efficacy in colorectal cancer have not been identified yet. Specific <it>VEGF </it>polymorphisms may affect gene transcription and therefore indirectly influence the efficacy of bevacizumab.</p> <p>Methods</p> <p>Genomic DNA of 111 consecutive metastatic colorectal cancer patients treated with first-line FOLFIRI plus bevacizumab was obtained from blood samples. <it>VEGF </it>-2578 C/A, -1498 C/T, + 405 C/G, + 936 C/T polymorphisms were analyzed by means of PCR-RFLP. DNA samples from 107 patients treated with FOLFIRI alone served as historical control group. The relation of <it>VEGF </it>polymorphisms with PFS, evaluated through Kaplan-Meier method and log-rank test, was the primary end-point. An interaction test with a Cox model has been performed in order to demonstrate the heterogeneity of the effect of <it>VEGF </it>-1498 C/T polymorphism between bevacizumab-and control group.</p> <p>Results</p> <p>In the bevacizumab-group median PFS and OS of patients carrying <it>VEGF </it>-1498 C/C, C/T and T/T allelic variants were, respectively, 12.8, 10.5, 7.5 months (p = 0.0046, log-rank test) and 27.3, 20.5, 18.6 months (p = 0.038, log-rank test). <it>VEGF </it>-1498 T/T genotype was associated with shorter PFS (HR = 2.13, [1.41-5.10], p = 0.0027). In the control group no significant association of <it>VEGF </it>-1498 C/T allelic variants and PFS or OS was found. Interaction between <it>VEGF </it>-1498 C/T variants and treatment effect suggested that the relation of <it>VEGF </it>-1498 T/T genotype with shorter PFS was caused by the effect of bevacizumab (p = 0.011). Other investigated polymorphisms did not affect the outcome.</p> <p>Conclusions</p> <p>These data suggest a possible role for <it>VEGF </it>-1498 C/T variants in predicting the efficacy of bevacizumab in the up-front treatment of metastatic colorectal cancer patients. A molecular tool for selecting subjects candidate to benefit from the anti-VEGF could be important for clinical practice. The retrospective and exploratory design of the present study, coupled with the non-randomized nature of the comparison between treated and untreated patients, imply that these results should be considered as hypothesis generators. A prospective validating trial is currently ongoing.</p

Retrospective exploratory analysis of VEGF polymorphisms in the prediction of benefit from first-line FOLFIRI plus bevacizumab in metastatic colorectal cancer

<p>Abstract</p> <p>Background</p> <p>Molecular predictors of bevacizumab efficacy in colorectal cancer have not been identified yet. Specific <it>VEGF </it>polymorphisms may affect gene transcription and therefore indirectly influence the efficacy of bevacizumab.</p> <p>Methods</p> <p>Genomic DNA of 111 consecutive metastatic colorectal cancer patients treated with first-line FOLFIRI plus bevacizumab was obtained from blood samples. <it>VEGF </it>-2578 C/A, -1498 C/T, + 405 C/G, + 936 C/T polymorphisms were analyzed by means of PCR-RFLP. DNA samples from 107 patients treated with FOLFIRI alone served as historical control group. The relation of <it>VEGF </it>polymorphisms with PFS, evaluated through Kaplan-Meier method and log-rank test, was the primary end-point. An interaction test with a Cox model has been performed in order to demonstrate the heterogeneity of the effect of <it>VEGF </it>-1498 C/T polymorphism between bevacizumab-and control group.</p> <p>Results</p> <p>In the bevacizumab-group median PFS and OS of patients carrying <it>VEGF </it>-1498 C/C, C/T and T/T allelic variants were, respectively, 12.8, 10.5, 7.5 months (p = 0.0046, log-rank test) and 27.3, 20.5, 18.6 months (p = 0.038, log-rank test). <it>VEGF </it>-1498 T/T genotype was associated with shorter PFS (HR = 2.13, [1.41-5.10], p = 0.0027). In the control group no significant association of <it>VEGF </it>-1498 C/T allelic variants and PFS or OS was found. Interaction between <it>VEGF </it>-1498 C/T variants and treatment effect suggested that the relation of <it>VEGF </it>-1498 T/T genotype with shorter PFS was caused by the effect of bevacizumab (p = 0.011). Other investigated polymorphisms did not affect the outcome.</p> <p>Conclusions</p> <p>These data suggest a possible role for <it>VEGF </it>-1498 C/T variants in predicting the efficacy of bevacizumab in the up-front treatment of metastatic colorectal cancer patients. A molecular tool for selecting subjects candidate to benefit from the anti-VEGF could be important for clinical practice. The retrospective and exploratory design of the present study, coupled with the non-randomized nature of the comparison between treated and untreated patients, imply that these results should be considered as hypothesis generators. A prospective validating trial is currently ongoing.</p

Concurrent Influence of Different Natural Sources on the Particulate Matter in the Central Mediterranean Region during a Wildfire Season

Wildfire occurrence and severity in the Mediterranean region during the summer season is increasing, being favoured by climate change-induced conditions (i.e., drought, heatwaves). Moreover, additional natural sources frequently impact this region, particularly Saharan dust intrusions. This study focuses on the combined effect of wildfires and Saharan dust on the air quality of the central Mediterranean Basin (CMB) during 2017, an exceptional year for forested burned areas in southern Italy. The annual behaviors of PM2.5, PM10, CO, benzene, and benzo(a)pirene measurements that were recorded at a rural regional-background station located in southern Italy, highlighted a concentration increase during summer. Both Saharan dust and wildfire events were identified while using Navy Aerosol Analysis and Prediction System (NAAPS) model maps, together with high-resolution Weather Research and Forecast—Hybrid Single-Particle Lagrangian Integrated Trajectory (WRF-HYSPLIT) back-trajectories. Additionally, Visible Infrared Imaging Radiometer Suite (VIIRS) satellite detections were considered to establish the enrichment of air masses by wildfire emissions. Finally, the occurrence of these natural sources, and their influence on particulate matter, were examined. In this case study, both PM2.5 and PM10 exceedances occurred predominantly in conjunction with wildfire events, while Saharan dust events mainly increased PM10 concentration when overlapping with wildfire effects

Impiego strutturale dei calcestruzzi fibro rinforzati modellazioni teoriche e verifiche sperimentali

Dottorato di Ricerca in Ingegneria dei Materiali e delle Strutture, Ciclo XX SSD, a.a. 2007Recently researches, in the field of civil engineering, have been addressed to study high performance concrete materials. In particular Fiber Reinforced Concrete (FRC) materials are very promising. With the addition of fibers into the concrete matrix, a brittle material like concrete can be modified towards a composite material with some ductility properties, able to absorb notable impact energy due to the dynamic or cyclic actions, like the seismic action, in the “during and post” cracking stage. Although, several studies were developed further research is needed to investigate some topics. The present work deals with the study of FRC materials used for structural applications with reference to the material and structural behaviour. Initially, the compressive and the tensile behaviour of the FRC material were analyzed by experimental, theoretical and numerical approaches. Specifically, an experimental investigation and a numerical analysis were carried out with the aim to identify the parameters like fiber types and contents, that are able to improve the performance of FRC material with reference to the structural behaviour. The implications on the use of fibers added into the concrete matrix on the workability at the fresh state and on the toughness at the hardened state were also considered. The aim of the experimental investigation was to analyze and compare the mechanical and the fracture properties of FRC materials by varying some main parameters like matrix compressive strength, fiber types (steel/polypropylene), fiber volume content (Vf) and the length of steel fibers (Lf). Through the numerical analysis it was possible to investigate the influence of high steel fiber content on the tensile post-peak behaviour. The numerical results obtained were compared with the experimental ones and the reliability of the numerical procedure was checked. A comparative study was carried out between experimental and theoretical stress-strain relationships available in literature, with particular reference to compressive behaviour of FRC. The aim was to evaluate the reliability of the proposed models and their range of validity. Several experimental data available in literature were analyzed and collected in a database. The above database was integrated with further experimental results obtained in the Laboratory of the Department of Structural Engineering at the University of Calabria. At the same time, the analytical uniaxial stress-strain relationship available in literature were analyzed and collected. Each theoretical model was critically analyzed and the reliability was checked through a comparison with the experimental curves of the same author and other available in literature. Subsequently, the structural behaviour was studied. With reference to the behaviour of eccentrically loaded FRC columns interaction diagrams axial load (N) – bending moment (M) of the cross section were computed to highlight the role of some main parameters on the strength. The theoretical models proposed in the Italian guideline CNR-DT 204 (2006) and other models available in literature were used in the analysis. The reliability of the theoretical models to describe the real behaviour of fiber reinforced concrete elements was checked through a comparison with some experimental data on steel fiber reinforced concrete columns subjected to eccentric loads available in literature. With reference to a rectangular FRC cross section, symmetrically reinforced, interactions diagrams, using the relationships proposed in the CNR-DT 204 (2006), were computed by varying some parameters like fiber geometrical properties and contents. The aim was to provide interaction diagrams which can be useful to design/check the strength of the concrete members reinforced with fibers and traditional steel reinforcement. Keywords: Experimental investigation; Fiber reinforced concrete; Post-peak behaviour; Eccentric loads; Stress-strain relationships.Università degli Studi della Calabria Dottorato di Ricerca in Ingegneria dei Materiali e delle Strutture, Ciclo XX SSD ICAR/09200

Safety of transvenous lead extraction according to centre volume: A systematic review andmeta-analysis

Background: Transvenous lead extraction (TLE) is a complex invasive procedure and the experience of the operator and the team is a major determinant of procedural outcomes. Aim: Because of very limited data available on minimum procedural volumes to enable training and ongoing competency for TLEs, we performed a meta-analysis aimed at assessing the outcomes of TLE in the centres with low, medium, and high volume of procedures. Methods: Of the 280 papers initially retrieved until February 2013, 66 observational studiesmet inclusion criteria and were included in at least one stratified meta-analysis: 17 were prospective studies; 47 had a retrospective design; and 2 were defined 'experience studies'. We included only articles published after the introduction of laser technique (year 1999). We divided the studies in low, medium, and high volume centres utilizing either the European Heart Rhythm Association (EHRA) or Lexicon classification criteria. Results: When meta-analyses were carried out separately for the studies with larger and smaller sample sizes, either using EHRA or Lexicon classification criteria, no clear differences emerged in the combined rate of major complications or intraoperative deaths. In contrast, both minor complications and mortality at 30 days decreased as centre volume increased. Conclusions: In our meta-analysis of observational studies, patientswhohave been treated in higher volume centres have a lower probability of minor complications and death at 30 days regardless of the infection rate, length of lead duration, type of device, and type of extraction. Published on behalf of the European Society of Cardiology. All rights reserved