L’emploi de la stabilométrie assistée par ordinateur dans le diagnostic des troubles crânio-mandibulaires (TCM)

The aim of this study was to evaluate the influence of the cervical region and the stomatognatic system on the balance control. We examined 35 healthy subjects and 201 balance disorder patients; of the 201 patients 60 suffered also from craniomandibular disorders (CMD) and 40 from cervical rachis disease. All cases were tested by computerized stabilometry executed in Romberg position: with closed eyes, retroflexed head and two cotton roles between the dental archs. The results show that cervical rachis disease and stomatognatic dysfunction have a significative influence on the balance control; however, this influence is smaller than that of vestibular disease; moreover, the computer stabilometry allows to measure the degree of ascending or descending correlation between the posture and stomatognatic system.Le but de cette étude a été d’évaluer l’influence de la région cervicale et de l’appareil stomatognatique sur le contrôle postural. On a examiné 35 sujets normaux et 201 patients avec troubles de l’équilibre, dont 60 présentaient aussi des troubles cranio-mandibulaires (TCM) et 40 une pathologie du rachis cervical. Tous les patients ont été soumis à un examen stabilométrique assisté par ordinateur, effectué en position de Romberg: les yeux fermés, la tête en rétroflexion, en occlusion modifiée par rouleaux interdentaires. Les résultats indiquent que les pathologies du rachis cervical et celles de l’appareil stomatognatique ont une influence significative sur le contrôle postural; toutefois, cette influence est nettement inférieure à celle des pathologies vestibulaires. Ils montrent également que la stabilométrie permet de mesurer le degré de corrélation ascendant ou descendant entre la posture et l’appareil stomatognatique

Rôle de la stabilométrie dans l’évaluation des corrélations entre les troubles crânio-mandibulaires (TCM) et les troubles de l’équilibre (TE)

We examined three groups:- 29 patients suffering from balance disorders and craniomandibular disorders but not from vestibular disease;- 21 patients suffering from balance disorders, craniomandibular disorders and vestibular disease;- 26 patients suffering from craniomandibular disorders but not from vestibular disease or balance sorders.All cases were examined by the odontologist and otoneurologist and tested by computerized stabilometry; they were reexamined after six months of therapy by an occlusal stabilization splint. The static analysis of the results shows a significative reduction of the postural oscillations in all patients.Trois groupes de patients ont été examinés :- 29 sujets présentant des TE et des TCM sans vestibulopathie;- 21 sujets présentant des TE et des TCM associés à une vestibulopathie;- 26 sujets avec TCM sans TE ni vestibulopathie.Après une visite odontologique et otoneurologique complétée par une stabilométrie assistée par ordinaeur, les 3 groupes ont tous été recontrôlés après 6 mois de thérapie avec plaque de stabilisation. L’analyse les données a permis de constater une réduction significative des oscillations posturales chez tous les patients

A New AAV10-U7-Mediated Gene Therapy Prolongs Survival and Restores Function in an ALS Mouse Model

One of the most promising therapeutic approaches for familial amyotrophic lateral sclerosis linked to superoxide dismutase 1 (SOD1) is the suppression of toxic mutant SOD1 in the affected tissues. Here, we report an innovative molecular strategy for inducing substantial, widespread, and sustained reduction of mutant human SOD1 (hSOD1) levels throughout the body of SOD1G93A mice, leading to therapeutic effects in animals. Adeno-associated virus serotype rh10 vectors (AAV10) were used to mediate exon skipping of the hSOD1 pre-mRNA by expression of exon-2-targeted antisense sequences embedded in a modified U7 small-nuclear RNA (AAV10-U7-hSOD). Skipping of hSOD1 exon 2 led to the generation of a premature termination codon, inducing production of a deleted transcript that was subsequently degraded by the activation of nonsense-mediated decay. Combined intravenous and intracerebroventricular delivery of AAV10-U7-hSOD increased the survival of SOD1G93A mice injected either at birth or at 50 days of age (by 92% and 58%, respectively) and prevented weight loss and the decline of neuromuscular function. This study reports the effectiveness of an exon-skipping approach in SOD1-ALS mice, supporting the translation of this technology to the treatment of this as yet incurable disease

Methodology to gauge a four-bar linkage prosthetic knee mechanism based on gait analysis and genetic algorithms

El objetivo de esta investigación es desarrollar una metodología para dimensionar un mecanismo policéntrico de rodilla de 4 barras para máxima estabilidad. Basado en el hecho de que la estabilidad del mecanismo durante la respuesta a la carga depende de la posición del centro instantáneo de rotación (CIR) respecto la fuerza de reacción del piso (FRP) durante la fase de apoyo, se desarrolló una plataforma de cómputo que representa el movimiento real de la pierna, el vector FRP y el mecanismo con su CIR. Para obtener los datos de entrada a la plataforma, se realizó un análisis de marcha a una paciente con amputación transfemoral unilateral, obteniendo la FRP, el ángulo de flexo-extensión de rodilla y la cinemática de los miembros inferiores. Por otra parte, a través de los algoritmos genéticos (AGs), se obtienen las dimensiones y configuración de los eslabones del mecanismo requeridas para iterar con la plataforma en la cual, comparando la ubicación de la FRP respecto al CIR en el plano sagital, se determinan las dimensiones funcionales adecuadas. El mecanismo se dimensionó exitosamente utilizando la metodología desarrollada, garantizando estabilidad de la rodilla después del contacto inicial y flexión voluntaria antes del despegue de punta.This research was aimed to develop a methodology for establishing the proper dimensions of a four-bar linkage prosthetic knee mechanism for maximum stability. Based on the fact that the stability of a four-bar knee during load-bearing is determined by the location of the instantaneous center of rotation (ICR) with respect to the ground reaction force (GRF) vector, a computational platform was developed to simulate the movement of the leg, the GRF vector and the position of the ICR of the mechanism. On one hand, a gait analysis was carried out on a subject with unilateral transfemoral amputation, from which the GRF, the knee flexion-extension angle and the kinematics of the lower limbs were determined. On the other hand, genetic algorithms (GAs) technique provided the dimensions and mechanism links configuration required to iterate with the platform on which, comparing the location of the GRF and the ICR in the sagittal plane, the functional dimensions of the mechanism were obtained. The polycentric knee mechanism was gauged successfully by ensuring knee stability during the initial contact and load response as well as the ability to initiate voluntary flexion toward late stance before the toe-off

Guida alla redazione degli atti amministrativi

La "Guida alla redazione degli atti amministrativi" intende fornire indicazioni per la redazione degli atti per tutti i funzionari della pubblica amministrazione. Si articola in tre parti: (a) la lingua degli atti, (b) la struttura del provvedimento amministrativo, (c) il rinvio ad altri atti. Ne è autore un gruppo di linguisti e giuristi facenti capo all'ITTIG-CNR (Istituto per le Tecniche e Tecnologie dell'Informazione Giuridica) e dell'Accademia della Crusca

Long-Term Arrhythmic Follow-Up and Risk Stratification of Patients With Desmoplakin-Associated Arrhythmogenic Right Ventricular Cardiomyopathy

Background: Patients with likely pathogenic/pathogenic desmoplakin (DSP) variants are poorly characterized. Some of them meet diagnostic criteria for arrhythmogenic right ventricular cardiomyopathy (ARVC), but it is unclear how risk stratification strategies for ARVC perform in this setting. / Objectives: The purpose of this study was to characterize arrhythmic outcomes and to test the performance of the recently validated ARVC risk calculator in patients with DSP likely pathogenic/pathogenic variants fulfilling definite 2010 ARVC Task Force Criteria (DSP-TFC+)./ Methods: DSP-TFC+ patients were enrolled from 20 institutions across 3 continents. Ventricular arrhythmias (VA), defined as a composite of sustained ventricular tachycardia (VT), appropriate implantable cardioverter defibrillator therapies, and ventricular fibrillation/sudden cardiac death events in follow-up, were reported as the primary outcome. We tested the performance of the ARVC risk calculator for VA prediction, reporting c-statistics. / Results: Among 252 DSP-TFC+ patients (age 39.6 ± 16.9 years, 35.3% male), 94 (37.3%) experienced VA over 44.5 [IQR: 19.6-78.3] months. Patients with left ventricle involvement (n = 194) were at higher VA risk (log-rank P = 0.0239). History of nonsustained VT (aHR 2.097; P = 0.004) showed the strongest association with VA occurrence during the first 5-year follow-up. Neither age (P = 0.723) nor male sex (P = 0.200) was associated with VAs at follow-up. In 204 patients without VA at diagnosis, incident VA rate was high (32.8%; 7.37%/y). The ARVC risk calculator performed poorly overall (c-statistic 0.604 [0.594-0.614]) and very poorly in patients with left ventricular disease (c-statistic 0.558 [0.556-0.560]). / Conclusions: DSP-TFC+ patients are at substantial risk for VAs. The ARVC risk calculator performs poorly in DSP-TFC+ patients suggesting need for a gene-specific risk algorithm. Meanwhile, DSP-TFC+ patients with nonsustained VT should be considered as high-risk

"Delirium Day": A nationwide point prevalence study of delirium in older hospitalized patients using an easy standardized diagnostic tool

Background: To date, delirium prevalence in adult acute hospital populations has been estimated generally from pooled findings of single-center studies and/or among specific patient populations. Furthermore, the number of participants in these studies has not exceeded a few hundred. To overcome these limitations, we have determined, in a multicenter study, the prevalence of delirium over a single day among a large population of patients admitted to acute and rehabilitation hospital wards in Italy. Methods: This is a point prevalence study (called "Delirium Day") including 1867 older patients (aged 65 years or more) across 108 acute and 12 rehabilitation wards in Italian hospitals. Delirium was assessed on the same day in all patients using the 4AT, a validated and briefly administered tool which does not require training. We also collected data regarding motoric subtypes of delirium, functional and nutritional status, dementia, comorbidity, medications, feeding tubes, peripheral venous and urinary catheters, and physical restraints. Results: The mean sample age was 82.0 \ub1 7.5 years (58 % female). Overall, 429 patients (22.9 %) had delirium. Hypoactive was the commonest subtype (132/344 patients, 38.5 %), followed by mixed, hyperactive, and nonmotoric delirium. The prevalence was highest in Neurology (28.5 %) and Geriatrics (24.7 %), lowest in Rehabilitation (14.0 %), and intermediate in Orthopedic (20.6 %) and Internal Medicine wards (21.4 %). In a multivariable logistic regression, age (odds ratio [OR] 1.03, 95 % confidence interval [CI] 1.01-1.05), Activities of Daily Living dependence (OR 1.19, 95 % CI 1.12-1.27), dementia (OR 3.25, 95 % CI 2.41-4.38), malnutrition (OR 2.01, 95 % CI 1.29-3.14), and use of antipsychotics (OR 2.03, 95 % CI 1.45-2.82), feeding tubes (OR 2.51, 95 % CI 1.11-5.66), peripheral venous catheters (OR 1.41, 95 % CI 1.06-1.87), urinary catheters (OR 1.73, 95 % CI 1.30-2.29), and physical restraints (OR 1.84, 95 % CI 1.40-2.40) were associated with delirium. Admission to Neurology wards was also associated with delirium (OR 2.00, 95 % CI 1.29-3.14), while admission to other settings was not. Conclusions: Delirium occurred in more than one out of five patients in acute and rehabilitation hospital wards. Prevalence was highest in Neurology and lowest in Rehabilitation divisions. The "Delirium Day" project might become a useful method to assess delirium across hospital settings and a benchmarking platform for future surveys