An evaluation of morphological and functional multi-parametric MRI sequences in classifying non-muscle and muscle invasive bladder cancer

Objectives: Our goal is to determine the ability of multi-parametric magnetic resonance imaging (mpMRI) to differentiate muscle invasive bladder cancer (MIBC) from non-muscle invasive bladder cancer (NMIBC). Methods: Patients underwent mpMRI before tumour resection. Four MRI sets, i.e. T2-weighted (T2W) + perfusion-weighted imaging (PWI), T2W plus diffusion-weighted imaging (DWI), T2W + DWI + PWI, and T2W + DWI + PWI + dif-fusion tensor imaging (DTI) were interpreted qualitatively by two radiologists, blinded to histology results. PWI, DWI and DTI were also analysed quantitatively. Accuracy was determined using histopathology as the reference standard. Results: A total of 82 tumours were analysed. Ninety-six percent of T1-labeled tumours by the T2W + DWI + PWI image set were confirmed to be NMIBC at histopathology. Overall accuracy of the complete mpMRI protocol was 94% in differentiating NMIBC from MIBC. PWI, DWI and DTI quantitative parameters were shown to be significantly different in cancerous versus non-cancerous areas within the bladder wall in T2-labelled lesions. Conclusions: MpMRI with DWI and DTI appears a reliable staging tool for bladder cancer. If our data are validated, then mpMRI could precede cystoscopic resection to allow a faster recognition of MIBC and accelerated treatment pathways. Key Points: • A critical step in BCa staging is to differentiate NMIBC from MIBC. • Morphological and functional sequences are reliable techniques in differentiating NMIBC from MIBC. • Diffusion tensor imaging could be an additional tool in BCa staging

Association Between Prehypertension, Metabolic And Inflammatory Markers, Decreased Adiponectin And Enhanced Insulinemia In Obese Subjects.

Obesity is associated with development of the cardiorenal metabolic syndrome, which is a constellation of risk factors, such as insulin resistance, inflammatory response, dyslipidemia, and high blood pressure that predispose affected individuals to well-characterized medical conditions such as diabetes, cardiovascular and kidney chronic disease. The study was designed to establish relationship between metabolic and inflammatory disorder, renal sodium retention and enhanced blood pressure in a group of obese subjects compared with age-matched, lean volunteers. The study was performed after 14 h overnight fast after and before OGTT in 13 lean (BMI 22.92 ± 2.03 kg/m(2)) and, 27 obese (BMI 36.15 ± 3.84 kg/m(2)) volunteers. Assessment of HOMA-IR and QUICKI index were calculated and circulating concentrations of TNF-α, IL-6 and C-reactive protein, measured by immunoassay. THE STUDY SHOWS THAT A HYPERINSULINEMIC (HI: 10.85 ± 4.09 μg/ml) subgroup of well-characterized metabolic syndrome bearers-obese subjects show higher glycemic and elevated blood pressure levels when compared to lean and normoinsulinemic (NI: 5.51 ± 1.18 μg/ml, P < 0.027) subjects. Here, the combination of hyperinsulinemia, higher HOMA-IR (HI: 2.19 ± 0.70 (n = 12) vs. LS: 0.83 ± 0.23 (n = 12) and NI: 0.98 ± 0.22 (n = 15), P < 0.0001) associated with lower QUICKI in HI obese when compared with LS and NI volunteers (P < 0.0001), suggests the occurrence of insulin resistance and a defect in insulin-stimulated peripheral action. Otherwise, the adiponectin measured in basal period was significantly enhanced in NI subjects when compared to HI groups (P < 0.04). The report also showed a similar insulin-mediated reduction of post-proximal urinary sodium excretion in lean (LS: 9.41 ± 0.68% vs. 6.38 ± 0.92%, P = 0.086), and normoinsulinemic (NI: 8.41 ± 0.72% vs. 5.66 ± 0.53%, P = 0.0025) and hyperinsulinemic obese subjects (HI: 8.82 ± 0.98% vs. 6.32 ± 0.67%, P = 0.0264), after oral glucose load, despite elevated insulinemic levels in hyperinsulinemic obeses. In conclusion, this study highlights the importance of adiponectin levels and dysfunctional inflammatory modulation associated with hyperinsulinemia and peripheral insulin resistance, high blood pressure, and renal dysfunction in a particular subgroup of obeses.112

Re-testing the JET-X Flight Module No. 2 at the PANTER facility

The Joint European X-ray Telescope (JET-X) was the core instrument of the Russian Spectrum-X-gamma space observatory. It consisted of two identical soft X-ray (0.3 - 10 keV) telescopes with focusing optical modules having a measured angular resolution of nearly 15 arcsec. Soon after the payload completion, the mission was cancelled and the two optical flight modules (FM) were brought to the Brera Astronomical Observatory where they had been manufactured. After 16 years of storage, we have utilized the JET-X FM2 to test at the PANTER X-ray facility a prototype of a novel X-ray polarimetric telescope, using a Gas Pixel Detector (GPD) with polarimetric capabilities in the focal plane of the FM2. The GPD was developed by a collaboration between INFN-Pisa and INAF-IAPS. In the first phase of the test campaign, we have re-tested the FM2 at PANTER to have an up-to-date characterization in terms of angular resolution and effective area, while in the second part of the test the GPD has been placed in the focal plane of the FM2. In this paper we report the results of the tests of the sole FM2, using an unpolarized X-ray source, comparing the results with the calibration done in 1996.Comment: Author's accepted manuscript posted to arXiv.org as permitted by Springer's Self-Archiving Policy. The final publication is available at http://rd.springer.com/article/10.1007%2Fs10686-013-9365-

TEORIA DO AUTOCUIDADO DE OREM DURANTE A GRAVIDEZ: APLICABILIDADE PARA O CUIDADO CLÍNICO DE ENFERMAGEM

Self-care consists of actions aimed at self-care, meeting needs and achieving well-being. This study mentioned self-care during the gestational period because it is a phase permeated by adaptations and requires special attention to achieve a healthy pregnancy. The objective was to know the scientific evidence about the applicability of Orem's Theory of Self-Care for clinical nursing care during pregnancy. This is an integrative review carried out in the databases Web of Science, Scopus, CINAHL, LILACS; MEDLINE/PUBMED and VHL from the controlled descriptors self care, nursing theory, pregnancy and pregnant woman between March and May 2022, including articles available electronically in full, without language restriction or time frame. Six studies, published between 1999 and 2015, were included, in which 25 self-care deficits were identified, in the developmental, universal and health deviation requirements, using partially compensatory, fully compensatory and support-education nursing systems. Orem's Self-Care Theory subsidized clinical nursing care in meeting the needs of pregnant women, providing the development of their potential for self-care, to promote the well-being of pregnant women and conceptuses, as well as strengthening the nursing process with care scientific and interactive.El autocuidado consiste en acciones encaminadas al autocuidado, a la satisfacción de necesidades y al logro del bienestar. Este estudio menciona el autocuidado durante el período gestacional porque es una fase permeada por adaptaciones y requiere especial atención para lograr un embarazo saludable. El objetivo fue conocer las evidencias científicas sobre la aplicabilidad de la Teoría del Autocuidado de Orem para el cuidado clínico de enfermería durante el embarazo. Esta es una revisión integradora realizada en las bases de datos Web of Science, Scopus, CINAHL, LILACS; MEDLINE/PUBMED y BVS de los descriptores controlados autocuidado, teoría de enfermería, embarazo y mujer embarazada entre marzo y mayo de 2022, incluidos los artículos disponibles electrónicamente en su totalidad, sin restricción de idioma ni franja horaria. Se incluyeron seis estudios, publicados entre 1999 y 2015, en los que se identificaron 25 déficits de autocuidado, en los requisitos evolutivos, universales y de desviación de la salud, utilizando sistemas de enfermería parcialmente compensatorios, totalmente compensatorios y de educación de apoyo. La Teoría del Autocuidado de Orem subsidia el cuidado clínico de enfermería en la satisfacción de las necesidades de las gestantes, propiciando el desarrollo de sus potencialidades para el autocuidado, para promover el bienestar de las gestantes y gestantes, así como fortalecer el proceso de enfermería con el cuidado científico e interactivo.O autocuidado constitui-se de ações que visam o cuidado de si, o atendimento de necessidades e o alcance de bem-estar. Mencionou-se neste estudo o autocuidado no período gestacional por ser uma fase permeada por adaptações e que requer atenção especial para o alcance de uma gestação saudável. Objetivou-se conhecer as evidências científicas acerca da aplicabilidade da Teoria do Autocuidado de Orem para o cuidado clínico de enfermagem durante a gravidez. Trata-se de revisão integrativa realizada nas bases Web of Science, Scopus, CINAHL, LILACS; MEDLINE/PUBMED e BVS a partir dos descritores controlados self care, nursing theory, pregnancy e pregnant womam entre março e maio 2022, incluindo artigos disponíveis eletronicamente na integra, sem restrição de idiomas ou recorte temporal. Foram incluídos seis estudos, publicados entre 1999 e 2015, nos quais foram identificados 25 déficits de autocuidado, nos requisitos desenvolvimental, universal e desvio de saúde, com utilização dos sistemas de enfermagem parcialmente compensatório, totalmente compensatório e apoio-educação. A Teoria de Autocuidado de Orem subsidiou o cuidado clínico de enfermagem no atendimento às necessidades das gestantes, proporcionando o desenvolvimento de suas potencialidades para o autocuidado, para promover bem-estar das gestantes e conceptos, bem como o fortalecimento do processo de enfermagem com um cuidado científico e interativo.O autocuidado constitui-se de ações que visam o cuidado de si, o atendimento de necessidades e o alcance de bem-estar. Mencionou-se neste estudo o autocuidado no período gestacional por ser uma fase permeada por adaptações e que requer atenção especial para o alcance de uma gestação saudável. Objetivou-se conhecer as evidências científicas acerca da aplicabilidade da Teoria do Autocuidado de Orem para o cuidado clínico de enfermagem durante a gravidez.. Revisão integrativa realizada nas bases Web of Science, Scopus, CINAHL, LILACS; MEDLINE/PUBMED e BVS a partir de descritores controlados entre março e maio 2022, incluindo artigos disponíveis eletronicamente na integra, sem restrição de idiomas ou recorte temporal. Foram incluídos seis estudos, publicados entre 1999 e 2015, nos quais foram identificados 25 déficits de autocuidado, nos requisitos desenvolvimental, universal e desvio de saúde, com utilização dos sistemas de enfermagem parcialmente compensatório, totalmente compensatório e apoio-educação. A Teoria de Autocuidado de Orem subsidiou o cuidado clínico de enfermagem no atendimento às necessidades das gestantes, proporcionando o desenvolvimento de suas potencialidades para o autocuidado, para promover bem-estar das gestantes e conceptos, bem como o fortalecimento do processo de enfermagem com um cuidado científico e interativo

Intratumor T helper type 2 cell infiltrate correlates with cancer-associated fibroblast thymic stromal lymphopoietin production and reduced survival in pancreatic cancer

Expression of TSLP in pancreatic cancer correlates with Th2 deviation of antitumor immunity that is associated with decrease of patient survival

Incidence and Predictors of Infections and All-Cause Death in Patients with Cardiac Implantable Electronic Devices: The Italian Nationwide RI-AIAC Registry

The incidence of infections associated with cardiac implantable electronic devices (CIEDs) and patient outcomes are not fully known. To provide a contemporary assessment of the risk of CIEDs infection and associated clinical outcomes. In Italy, 18 centres enrolled all consecutive patients undergoing a CIED procedure and entered a 12-months follow-up. CIED infections, as well as a composite clinical event of infection or all-cause death were recorded. A total of 2675 patients (64.3% male, age 78 (70-84)) were enrolled. During follow up 28 (1.1%) CIED infections and 132 (5%) deaths, with 152 (5.7%) composite clinical events were observed. At a multivariate analysis, the type of procedure (revision/upgrading/reimplantation) (OR: 4.08, 95% CI: 1.38-12.08) and diabetes (OR: 2.22, 95% CI: 1.02-4.84) were found as main clinical factors associated to CIED infection. Both the PADIT score and the RI-AIAC Infection score were significantly associated with CIED infections, with the RI-AIAC infection score showing the strongest association (OR: 2.38, 95% CI: 1.60-3.55 for each point), with a c-index = 0.64 (0.52-0.75), p = 0.015. Regarding the occurrence of composite clinical events, the Kolek score, the Shariff score and the RI-AIAC Event score all predicted the outcome, with an AUC for the RI-AIAC Event score equal to 0.67 (0.63-0.71) p < 0.001. In this Italian nationwide cohort of patients, while the incidence of CIED infections was substantially low, the rate of the composite clinical outcome of infection or all-cause death was quite high and associated with several clinical factors depicting a more impaired clinical status