4,651 research outputs found

    Clinical evaluation of seven tumour markers in lung cancer diagnosis: can any combination improve the results?

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    In this study we compared the diagnostic utility of: (1) neuron-specific enolase (NSE); (2) squamous cell carcinoma antigen (SCC); (3) carcinoembryonic antigen (CEA); and (4) cytokeratin markers (CYFRA 21-1, TPA, TPM, TPS) in patients with small-cell lung cancer (SCLC) (21 cases) and non-small-cell lung cancer (94 cases). For comparison we also studied 66 patients with benign lung diseases and nine with pleural mesothelioma. NSE levels in SCLC patients were significantly higher than those in all the other groups studied. No significant variations were found among the SCC levels in all groups. CEA levels in patients with adenocarcinoma were significantly higher than those in all other groups studied. CYFRA 21-1 serum levels significantly increased in patients with squamous cell carcinoma and mesothelioma, while TPA, TPS and TPM increased in patients with lung cancer irrespective of the histological type. In patients with SCLC, high levels of all markers except SCC were found when the disease was extensive. In patients with non-SCLC, the highest levels of all tumour markers were usually found in those with advanced disease, although CYFRA 21-1 gave a sensitivity of 44% when a specificity of 95% was fixed in stage I non-SCLC patients. An analysis of receiver operating characteristic curves revealed that the highest diagnostic accuracies in distinguishing benign from malignant lung diseases were achieved with TPM (81%), CYFRA 21-1 (72%), CEA (78%) or TPA (78%) when using cut-off values of 46 Ul-1, 3.0 micrograms l-1, 2.0 micrograms l-1 and 75 Ul-1 respectively. When all patients were considered, the combined evaluation of more than one marker did not significantly improve the results obtained with TPM alone. However, taking into consideration the fact that CYFRA 21-1 is the most sensitive index of early lung tumours and that its combined determination with TPM did not worsen the overall sensitivity and specificity of the latter, the combined use of these two markers may be suggested as a useful took for the diagnosis of lung tumours

    Role of ventricular tachycardia ablation in arrhythmogenic right ventricular cardiomyopathy

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    Arrhythmogenic right ventricular cardiomyopathy (ARVC) is characterized by progressive fibro-fatty replacement of the myocardium that represents the substrate for recurrent sustained ventricular tachycardia (VT). These arrhythmias characterize the clinical course of a sizeable proportion of patients and have significant implications for their quality of life and long-term prognosis. Antiarrhythmic drugs are often poorly tolerated and usually provide incomplete control of arrhythmia relapses. Catheter ablation is a potentially effective strategy to treat frequent VT episodes and ICD shocks in ARVC patients. The aims of this review are to discuss the electrophysiological and electroanatomic substrates of ventricular tachycardia in patients with ARVC and to analyze the role of catheter ablation in their management with particular reference to selection of patients, technical issues, potential complications and outcomes

    Prevalence of type 2 diabetes and impaired fasting glucose in patients affected by rheumatoid arthritis

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    Although the better management of rheumatoid arthritis (RA) has significantly improved the long-term outcome of affected patients, a significant proportion of these may develop associated comorbidities including cardiometabolic complications. However, it must be pointed out that a comprehensive cardiometabolic evaluation is still poorly integrated into the management of RA patients, due to a limited awareness of the problem, a lack of appropriate clinical studies, and optimal strategies for cardiovascular (CV) risk reduction in RA. In addition, although several studies investigated the possible association between traditional CV risk factors and RA, conflicting results are still available. On this basis, we planned this cross-sectional study, aimed at investigating the prevalence of type 2 diabetes (T2D) and impaired fasting glucose (IFG) in RA patients compared with age- and gender- matched control individuals. Furthermore, we analyzed the role of both traditional and RA-related CV risk factors in predicting T2D and IFG. We observed an increased prevalence of T2D in RA patients when compared with age- and gender-matched controls. Regression analyses demonstrated that the presence of high blood pressure (HBP), a longer disease duration, and exposure to corticosteroids (CCS) were significantly associated with an increased likelihood of being classified as T2D. In addition, we observed an increased prevalence of IFG in RA patients when compared with age- and gender-matched controls. Regression analyses demonstrated that a higher body mass index (BMI), the presence of metabolic syndrome (MetS), higher levels of total cholesterol, the presence of radiographic damage, and higher serum levels of C-reactive protein (CRP) were significantly associated with an increased likelihood of presenting IFG. In this cross-sectional study, we observed an increased prevalence of T2D and IFG in an Italian cohort of RA patients when compared with age- and gender-matched control individuals. Interestingly, both RA-specific features, such as disease duration, CCS exposure, and radiographic damage, and traditional CV risk factors, such as HBP and MetS, were significantly associated with glucose metabolism abnormalities

    A possible cause of misdiagnosis in tumors of the axilla: schwannoma of the brachial plexus

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    The Authors report a rare case of a 57 years old man affected by a left radial nerve schwannoma that occurred as an asymptomatic lesion of the axilla. At clinical examination the lump was undistinguishable from the most common axillary lymphadenopathy. A lymphoadenopathy was erroneously diagnosed with ultrasonography (US). This mistake was due to the low specificity of the instrumental methodology and to the rarity of an asymptomatic schwannoma of the infraclavicular brachial plexus. The neoplasia was excised without using the microscope. In the early post-operative follow up, a “falling” attitude of the wirst, the hand and the fingers appeared, peculiar for a lesion of the radial nerve. Furthermore a hypoaesthesia of the skin of first finger and of the first interosseus space was associated. The sensitive and motor electromyography showed a radial nerve suffering. The “stupor” of the nerve trunk was treated with steroid therapy for 7 days and the patient underwent to some series of neuro-rehabilitative physical therapy for 12 weeks. The postoperative total body CT, showed that the lesion was unique: therefore it was possible to exclude the diagnosis of neurofibromatosis. After 28 months electromyography and axillary US were performed showing the complete resolution of the motor and sensitive deficit and the absence of local recurrence

    The two-step treatment for giant hepatic hemangiomas

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    The aim of the present study is to analyze the feasibility and the impact of a two-step approach in the treatment of giant hemangiomas (GH) i.e., exceeding 10 cm in maximum diameter, con-sisting of transarterial embolization (TAE) followed by laparoscopic liver resection (LLR). Ten patients with 11 GH were treated with TAE and subsequent LLR between 2017 and 2020 (Group A). A matched cohort of 10 patients with GH treated with upfront LLR between 2014 and 2017 was identified for comparison (Group B). Data were analyzed regarding intraoperative and postoperative outcomes, including successful completion of LLR, morbidity, and mortality. Successful microparticle emboliza-tion of the GH-feeding arteries was performed in all patients in group A. In three cases a liquid embolic agent (Squid-18) was also injected to obtain complete embolization. No complications were observed after TAE. Successful surgery was performed after a mean time interval of 2.2 days from TAE without any case of conversion to laparotomy. Statistically significant differences between group A and group B were found in intraoperative blood loss (250 \ub1 200 vs. 400 \ub1 300 mL, p = 0.039), operative time (245 \ub1 60 vs. 420 \ub1 60 min, p = 0.027), and length of stay (5 \ub1 1 vs. 8 \ub1 2 days, p = 0.046). Our data suggest that two-step TAE + LLR might be a safe and effective option for surgical treatment of GH >10 cm

    Performance of crossbred cows under grazing supplemented with soybean oil.

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    This work aimed to evaluate effect of soybean oil supplementation on dairy production of crossbred dairy cows under grazing. Twenty ½ and ¾ Holstein x Gyr cows with average of 77 days of lactation and 19.8 kg of daily milk yield were used under grazing of palisade grass (Brachiaria brizantha cv. Marandu) managed by intermittent stocking. In a 2 x 2 crossover trial, cows were homogeneously distributed between two experimental groups: 1) Control (C) ? supplementation with concentrate ration without soybean oil; and 2) Soybean oil (SO) ? addition 3% of soybean oil in concentrate ration (dry matter basis). Inclusion of soybean oil did not affect daily milk yield (P>0.05) in relation to control group. However, considering cost of oil inclusion and only the milk yield, this feed strategy is not economically viabl

    Comparative efficacy and acceptability of pharmacological treatments for insomnia in adults: A systematic review and network meta-analysis

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    This is the protocol for a review and there is no abstract. The objectives are as follows: 1) To compare individual pharmacological treatments for insomnia in adults in terms of: efficacy, measured as self-rated quality of sleep or satisfaction with sleep; and acceptability of treatment. 2) To generate a clinically-useful hierarchy of available pharmacological treatments for insomnia in adults, according to their efficacy and acceptability

    Vigor de plântulas de pupunha em função de doses de giberlina aplicadas como tratamento pré-germinativo.

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    Este trabalho teve como objetivo avaliar o efeito do tratamento de sementes de pupunha com GA3 no vigor das plântulas

    Response of microchannel plates in ionization mode to single particles and electromagnetic showers

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    Hundreds of concurrent collisions per bunch crossing are expected at future hadron colliders. Precision timing calorimetry has been advocated as a way to mitigate the pileup effects and, thanks to their excellent time resolution, microchannel plates (MCPs) are good candidate detectors for this goal. We report on the response of MCPs, used as secondary emission detectors, to single relativistic particles and to electromagnetic showers. Several prototypes, with different geometries and characteristics, were exposed to particle beams at the INFN-LNF Beam Test Facility and at CERN. Their time resolution and efficiency are measured for single particles and as a function of the multiplicity of particles. Efficiencies between 50% and 90% to single relativistic particles are reached, and up to 100% in presence of a large number of particles. Time resolutions between 20ps and 30ps are obtained.Comment: 20 pages, 9 figures. Paper submitted to NIM

    Development of advanced Thomson spectrometers for nuclear fusion experiments initiated by laser

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    Thomson Spectrometers are devices capable to separate the several particle species (with distinct charge-to-mass ratio and energy) produced by the different regimes of laser-matter experiments. In this work we describe the development of advanced spectrometers for low and medium energy particles. In particular, they are suitable for protons in the 5 keV–2 MeV and 100 keV–10 MeV energy ranges, respectively. The new prototypes of spectrometers have been designed and built to have a high sensitivity and be adaptable to many experimental situations and configurations, and are tailored to the characterization of charged particles and products of nuclear fusion reactions initiated by high energy and intensity lasers. Details on the realized prototypes, on their characterization and testing, together with the first experimental results are discussed
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