881 research outputs found
Three-dimensional CAD/CAM reconstruction of the iliac bone following DCIA composite flap harvest
This article reports a new technique to restore iliac bone integrity with a customized titanium device designed by CAD/CAM, in patients undergoing deep circumflex iliac artery (DCIA) composite flap harvest. Eight consecutive patients who underwent the repair of major head and neck defects with DCIA flaps were enrolled retrospectively. Computed tomography scans of the pelvis were obtained preoperatively. Starting from DICOM data, each personalized device was designed using modelling software and was finally made by additive manufacturing using a laser sintering machine. After surgery, the patients were followed up at 3-month intervals to evaluate the incidence of complications and the long-term outcome at the donor site. A subcutaneous seroma developed in one patient and an inguinal skin burn occurred in another. At a median follow-up of 12 months, the patients did not report pain, or any gait or sensory disturbance at the donor site. There was no occurrence of bulging, herniation, or instability or inflammation near the device for the entire follow-up duration. All patients were satisfied with the aesthetic result. In conclusion, reconstruction of the iliac bone with a customized device is safe and well tolerated. We recommend use of this device in patients deemed at high risk of herniation. Further studies are needed to confirm the stability of the device in the long term
Relationship between fatty liver and glucose metabolism: A cross-sectional study in 571 obese children
BACKGROUND AND AIMS: Early onset type 2 diabetes mellitus (T2DM) is associated with obesity, insulin resistance and impaired beta-cell function. Non-alcoholic fatty liver disease (NAFLD) may be an independent risk factor for T2DM. We investigated the relationship between NAFLD and glucose metabolism in a large sample of obese children. METHODS AND RESULTS: A total of 571 obese children (57% males and 43% females) aged 8-18 years were consecutively studied at a tertiary care centre specialised in paediatric obesity. Liver ultrasonography was used to diagnose NAFLD after exclusion of hepatitis B and C and alcohol consumption. Oral-glucose tolerance testing (OGTT) was performed; insulin sensitivity was evaluated by using the insulin sensitivity index (ISI) and beta-cell function by using the ratio between the incremental areas under the curve (AUC) of insulin and glucose (incAUCins/incAUCglu). A total of 41% of the obese children had NAFLD. Impaired glucose tolerance or T2DM was present in 25% of the children with NAFLD versus 8% of those without it (p<0.001). Children with NAFLD had higher body mass index (BMI), fasting glucose, 120-min OGTT glucose, incAUCins/incAUCglu and lower ISI as compared with children without NAFLD (p</=0.002). At bootstrapped multivariable median regression analysis controlling for gender, age, pubertal status and BMI, NAFLD was an independent predictor of 120-min OGTT glucose and ISI, but not of incAUCins/incAUCglu. Similar findings were obtained using continuous liver steatosis as the predictor, instead of dichotomous NAFLD. CONCLUSION: NAFLD was present in 41% of our obese children and was associated with higher insulin resistance, but not with impaired beta-cell function
A complementary compact laser based neutron source
Several experiments of neutron generation using high intensity laser sources,
with a power exceeding 10^19W/cm^2 via TNSA (Target Normal Sheath Acceleration)
or other similar methods, have been performed in the past years in different
laboratories. However, so far there is no one running neutron source based on
such a technology. In the framework of the Conceptual Report Design of a new
accelerator in the Eupraxia project we are studying the possibility to have a
laser-based neutron source, not only by TNSA but also from self-injection
schemes. We focus our attention on the applications in cultural heritage
studies as well also on the complementary role that such a source can have in
the framework of large facilities devoted to radiation production.Comment: 4 pages, two figures, 3rd European Advanced Accelerators Concept
Body water distribution in severe obesity and its assessment from eight-polar bioelectrical impedance analysis
Objective: To measure body water distribution and to evaluate the accuracy of eight-polar bioelectrical impedance analysis (BIA) for the assessment of total body water (TBW) and extracellular water (ECW) in severe obesity. Design: Cross-sectional study. Setting: Obesity clinic. Subjects: In all, 75 women aged 18-66 y, 25 with body mass index (BMI) between 19.1 and 29.9 kg/m(2) (ie not obese), 25 with BMI between 30.0 and 39.9 kg/m(2) (ie class I and II obese), and 25 with BMI between 40.0 and 48.2 kg/m(2) (ie class III obese). Methods: TBW and ECW were measured by (H2O)-H-2 and Br dilution. Body resistance (R) was obtained by summing the resistances of arms, trunk and legs as measured by eight-polar BIA (InBody 3.0, Biospace, Seoul, Korea). The resistance index at a frequency of x kHz (RIx) was calculated as height 2/R-x. Results: ECW: TBW was similar in women with class III (46 +/- 3%, mean +/- s.d.) and class I-II obesity (45 +/- 3%) but higher than in nonobese women (39 +/- 3%, P < 0.05). In a random subsample of 37 subjects, RI500 explained 82% of TBW variance (P < 0.0001) and cross-validation of the obtained algorithm in the remaining 38 subjects gave a percent root mean square error (RMSE%) of 5% and a pure error (PE) of 2.1 l. In the same subjects, RI5 explained 87% of ECW variance (P < 0.0001) and cross-validation of the obtained algorithm gave a RMSE% of 8% and a PE of 1.4 l. The contribution of weight and BMI to the prediction of TBW and ECW was nil or negligible on practical grounds. Conclusions: ECW: TBW is similar in women with class I-II and class III obesity up to BMI values of 48.2 kg/m(2). Eight-polar BIA offers accurate estimates of TBW and ECW in women with a wide range of BMI (19.1-48.2 kg/m(2)) without the need of population-specific formulae
Prevenzione e management odontoiatrico dei pazienti oncologici a rischio di osteonecrosi delle ossa mascellari da farmaci
non disponibil
L\u2019odontoiatria a misura del paziente con patologia osteometabolica a rischio di osteonecrosi delle ossa mascellari da farmaci.
L\u2019osteonecrosi delle ossa mascellari
(ONJ) da farmaci \ue8 una severa patologia
odontoiatrica, recentemente defi nita
come \uabuna reazione avversa farmacocorrelata,
caratterizzata dalla progressiva
distruzione e necrosi dell\u2019osso
mandibolare e/o mascellare di soggetti
esposti al trattamento con farmaci per
cui sia accertato un aumentato rischio
di malattia, in assenza di un pregresso
trattamento radiante\ubb1-3. I pazienti
osteometabolici a rischio di sviluppare
l\u2019ONJ sono quelli sottoposti a terapia
con bisfosfonati (in particolare aminobisfosfonati
o Nitrogen-containing
BisPhosphonate/NBP) e, pi\uf9 recentemente,
con denosumab (anticorpo monoclonale
anti-RANKL)4. Tali farmaci
antiriassorbitivi caratterizzati da una
prevalente azione inibitoria sul metabolismo
dell\u2019osso, sono ampiamente
prescritti per la cura di patologie osteometaboliche,
prevalentemente osteoporosi
primaria o secondaria, oltre che
per la prevenzione e il trattamento di
lesioni scheletriche in pazienti con patologia
onco-ematologica1,5-7
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