607 research outputs found
Severe and polytraumatic injuries among recreational skiers and snowboarders: incidence, demographics and injury patterns in South Tyrol
Background Alpine skiing and snowboarding are popular winter sports. The practice of these sports is related to traumatic injuries, some of which are severe and/or life threatening.
Objectives To identify the incidence, injury patterns and associated risk factors of severe and polytraumatic injuries in South Tyrol.
Materials and methods During four consecutive winter seasons (2001-2005), data of every patient referred to our emergency department (Bolzano-Bozen) after a skiing or snowboarding accident were collected. One hundred and five patients with an Injury Severity Score of 16 or higher were identified (90 skiers, 15 snowboarders). Statistical descriptive analyses were carried out by producing frequency tables. Chi-square test was performed to verify possible association between injury severity and type of sport. Risk factors for severe injuries were evaluated using logistic regression with robust variance estimators.
Results Traumatic brain injury was the most common injury observed (51 cases), followed by vertebral injury (45 cases); 63% of the patients reported two or more associated injuries. We observed significant associations between severe spine injuries and the following risk factors: snowboarders who reported more severe injuries than skiers [odds ratio = 5.89, 95% confidence interval (CI) = 1.31, 26.44], age classes of 40-50 years and over 60 years showed an OR of 8.10 (95% CI = 1.87, 35.06) and 5.16 (95% CI = 1.27, 21.01), respectively, with respect to age class (20-40 years).
Conclusion Severe traumatic injuries occur among skiers and snowboarders, and preventive measures such as the use of helmets and educational programs, are necessary. European Journal of Emergency Medicine 19: 69-72 (C) 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Factors affecting injury severity among recreational skiers and snowboarders: an epidemiology study
Different results have been reported for skiing
and snowboarding injuries worldwide. Few studies consider the injury severity score (ISS) for the evaluation of
differences among injured skiers–snowboarders. The aim
of this study is to identify possible risk factors that affect
the severity of skiing and snowboarding injuries in three
winter seasons (2002–2005) in South Tyrol. For every
injured skier or snowboarder referred to our emergency
department in three consecutive seasons, the following data
were collected: date of birth, gender, self-declared technical skills level, place of residence (local/non-local), as well
as the date, time, and place of the accident. Type of injury
and ISS were retrospectively assigned. Data concerning the
snowfall in the last 24 h, average snow level, and outdoor
air temperature values were obtained from four weather
stations that were located inside the ski resorts. A multiple
linear regression model was used to evaluate the association between ISS and potential determinants. In the
analyzed seasons, 2,511 injured skiers and 843 injured
snowboarders were evaluated at our emergency department. There was a significant change in the ISS value
for subjects with different self-reported skills levels
(P.001). Men and non-local residents experienced
more severe injuries than women and local residents,
respectively (P.013, P.001). The ISS was higher
for people aged over 60 (P.001). Snowfalls brought
about a decrease in accident severity (P = 0.009). The
severity of the injuries increases with age. Prevention and
information programs should be targeted to people who are
at high risk of severe injury. A 24-h fresh snowfall seems to
reduce the severity of injuries. Very little is known about
snow conditions and winter sports injury. Further studies
are needed to explore this field
Gene profiling, biomarkers and pathways characterizing HCV-related hepatocellular carcinoma
<p>Abstract</p> <p>Background</p> <p>Hepatitis C virus (HCV) infection is a major cause of hepatocellular carcinoma (HCC) worldwide. The molecular mechanisms of HCV-induced hepatocarcinogenesis are not yet fully elucidated. Besides indirect effects as tissue inflammation and regeneration, a more direct oncogenic activity of HCV can be postulated leading to an altered expression of cellular genes by early HCV viral proteins. In the present study, a comparison of gene expression patterns has been performed by microarray analysis on liver biopsies from HCV-positive HCC patients and HCV-negative controls.</p> <p>Methods</p> <p>Gene expression profiling of liver tissues has been performed using a high-density microarray containing 36'000 oligos, representing 90% of the human genes. Samples were obtained from 14 patients affected by HCV-related HCC and 7 HCV-negative non-liver-cancer patients, enrolled at INT in Naples. Transcriptional profiles identified in liver biopsies from HCC nodules and paired non-adjacent non-HCC liver tissue of the same HCV-positive patients were compared to those from HCV-negative controls by the Cluster program. The pathway analysis was performed using the BRB-Array- Tools based on the "Ingenuity System Database". Significance threshold of <it>t</it>-test was set at 0.001.</p> <p>Results</p> <p>Significant differences were found between the expression patterns of several genes falling into different metabolic and inflammation/immunity pathways in HCV-related HCC tissues as well as the non-HCC counterpart compared to normal liver tissues. Only few genes were found differentially expressed between HCV-related HCC tissues and paired non-HCC counterpart.</p> <p>Conclusion</p> <p>In this study, informative data on the global gene expression pattern of HCV-related HCC and non-HCC counterpart, as well as on their difference with the one observed in normal liver tissues have been obtained. These results may lead to the identification of specific biomarkers relevant to develop tools for detection, diagnosis, and classification of HCV-related HCC.</p
Sledding injuries: is safety in this winter pastime overlooked? A three-year survey in South-Tyrol
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background: Sledding is a popular traditional pastime in northern countries. However it is only rarely thought as a potentially dangerous activity even though serious injuries and deaths do occur. The purpose of this study was to calculate the incidence, the severity and the pattern of sleddingrelated injuries in our area, in order to set up possible preventive measures. Results: In three consecutive winter seasons (Dec.–Apr.,2002–2005). 356 patients (182 males, 174 females, mean age 26.9 years, range 2 to 81) were referred directly to our ED after a sledding injury. One patient (male, age 21 years) was transferred from a community hospital and died on the following day. Two patients (males, age 47 and 28 years) were declared dead on the scene. In the majority of the cases the accident was due to a fall and collision with the ground or a standing object. The number of injuries showed a progressive increase during the observed seasons and all deadly accidents were observed in the last season. Injuries were divided into three severity classes: minor (ISS ≤ 3), intermediate (ISS ≥ 4 < 15), severe (ISS ≥ 15). Minor and intermediate injuries were equally distributed between males and females, whereas all severe and deadly accidents occurre
Questioning the Value of Fluorodeoxyglucose Positron Emission Tomography for Residual Lesions After Chemotherapy for Metastatic Seminoma: Results of an International Global Germ Cell Cancer Group Registry
Purpose Residual lesions after chemotherapy are frequent in metastatic seminoma. Watchful waiting is recommended for lesions < 3 cm as well as for fluorodeoxyglucose (FDG) positron emission tomography (PET)-negative lesions ≥ 3 cm. Information on the optimal management of PET-positive residual lesions ≥ 3 cm is lacking. Patients and Methods We retrospectively identified 90 patients with metastatic seminoma with PET-positive residual lesions after chemotherapy. Patients with elevated α-fetoprotein or nonseminomatous histology were excluded. We analyzed the post-PET management and its impact on relapse and survival and calculated the positive predictive value (PPV) for PET. Results Median follow-up time was 29 months (interquartile range [IQR], 10 to 62 months). Median diameter of the largest residual mass was 4.9 cm (range, 1.1 to 14 cm), with masses located in the retroperitoneum (77%), pelvis (16%), mediastinum (17%), and/or lung (3%). Median time from the last day of chemotherapy to PET was 6.9 weeks (IQR, 4.4 to 9.9 weeks). Post-PET management included repeated imaging in 51 patients (57%), resection in 26 patients (29%), biopsy in nine patients (10%) and radiotherapy in four patients (4%). Histology of the resected specimen was necrosis in 21 patients (81%) and vital seminoma in five patients (19%). No biopsy revealed vital seminoma. Relapse or progression occurred in 15 patients (17%) after a median of 3.7 months (IQR, 2.5 to 4.9 months) and was found in 11 (22%) of 51 patients on repeated imaging, in two (8%) of 26 patients after resection, and in two (22%) of nine patients after biopsy. All but one patient who experienced relapse were successfully treated with salvage therapy. The PPV for FDG-PET was 23%. Conclusion FDG-PET has a low PPV for vital tumor in residual lesions after chemotherapy in patients with metastatic seminoma. This cautions against clinical decisions based on PET positivity alone
Optimal electron propagation on a quantum chain by a topological phase
We study the quantum diffusion of an electron in a quantum chain starting
from an initial state localized around a given site. As the wavepacket
diffuses, the probability of reconstructing the initial state on another site
diminishes drastically with the distance. In order to optimize the state
transmission we find that a topological quantum phase can be introduced. The
effect of this phase is the reduction of wavepacket spreading together with
almost coherent group propagation. In this regime, the electron has a
quasi-linear dispersion and high fidelity can be achieved also over large
distances in terms of lattice spacing.Comment: 8 pages, 6 figure
Management of Germ Cell Tumors During the Outbreak of the Novel Coronavirus Disease-19 Pandemic:A Survey of International Expertise Centers
BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has become a public health emergency affecting frail populations, including patients with cancer. This poses the question of whether cancer treatments can be postponed or modified without compromising their efficacy, especially for highly curable cancers such as germ cell tumors (GCTs). MATERIALS AND METHODS: To depict the state-of-the-art management of GCTs during the COVID-19 pandemic, a survey including 26 questions was circulated by e-mail among the physicians belonging to three cooperative groups: (a) Italian Germ Cell Cancer Group; (b) European Reference Network-Rare Adult Solid Cancers, Domain G3 (rare male genitourinary cancers); and (c) Genitourinary Medical Oncologists of Canada. Percentages of agreement between Italian respondents (I) versus Canadian respondents (C), I versus European respondents (E), and E versus C were compared by using Fisher's exact tests for dichotomous answers and chi square test for trends for the questions with three or more options. RESULTS: Fifty-three GCT experts responded to the survey: 20 Italian, 6 in other European countries, and 27 from Canada. Telemedicine was broadly used; there was high consensus to interrupt chemotherapy in COVID-19-positive patients (I = 75%, C = 55%, and E = 83.3%) and for use of granulocyte colony-stimulating factor primary prophylaxis for neutropenia (I = 65%, C = 62.9%, and E = 50%). The main differences emerged regarding the management of stage I and stage IIA disease, likely because of cultural and geographical differences. CONCLUSION: Our study highlights the common efforts of GCT experts in Europe and Canada to maintain high standards of treatment for patients with GCT with few changes in their management during the COVID-19 pandemic. IMPLICATIONS FOR PRACTICE: Despite the chaos, disruptions, and fears fomented by the COVID-19 illness, oncology care teams in Italy, other European countries, and Canada are delivering the enormous promise of curative management strategies for patients with testicular cancer and other germ cell tumors. At the same time, these teams are applying safe and innovative solutions and sharing best practices to minimize frequency and intensity of patient contacts with thinly stretched health care capacity
Role of DNA repair machinery and p53 in the testicular germ cell cancer: a review
Notwithstanding the peculiar sensitivity to cisplatin-based treatment, resulting in a very high percentage of cures even in advanced stages of the disease, still we do not know the biological mechanisms that make Testicular Germ Cell Tumor (TGCT) "unique" in the oncology scene. p53 and MDM2 seem to play a pivotal role, according to several in vitro observations, but no correlation has been found between their mutational or expression status in tissue samples and patients clinical outcome. Furthermore, other players seem to be on stage: DNA Damage Repair Machinery (DDR) , especially Homologous Recombination (HR) proteins, above all Ataxia Telangiectasia Mutated (ATM), cooperates with p53 in response to DNA damage, activating apoptotic cascade and contributing to cell "fate". Homologous Recombination deficiency has been assumed to be a Germ Cell Tumor characteristic underlying platinum-sensitivity, whereby Poly(ADP-ribose) polymerase (PARP), an enzyme involved in HR DNA repair, is an intriguing target: PARP inhibitors have already entered in clinical practice of other malignancies and trials are recruiting TGCT patients in order to validate their role in this disease. This paper aims to summarize evidence, trying to outline an overview of DDR implications not only in TGCT curability, but also in resistance to chemotherapy
The prognostic value of the previous nephrectomy in pretreated metastatic renal cell carcinoma receiving immunotherapy: a sub-analysis of the Meet-URO 15 study
Nephrectomy is considered the backbone of managing patients with localized and selected metastatic renal cell carcinoma (mRCC). The prognostic role of nephrectomy has been widely investigated with cytokines and targeted therapy, but it is still unclear in the immunotherapy era
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