Risk management in solitary agricultural work: new technologies for handling emergency and falls from great heights (SHADE)

Solitary work and agricultural activities are the scenarios of a large number of severe injuries and deaths, also because first aid may be difficult to achieve in isolated locations. This work proposes a technology available on smartphones that allows triggering an emergency call when a fall from height or an unconsciousness state is detected. The results of several tests, which include different detection algorithms and scenarios, are reported in this work. Tests performed with the aid of a dummy have allowed developing a reliable algorithm for the detection of dangerous situations. This system is available as an Android application

Lenalidomide before and after Autologous Hematopoietic Stem Cell Transplantation in Multiple Myeloma

Although multiple myeloma remains incurable outside of allogeneic hematopoietic stem cell transplantation, novel agents made available only in the last few decades have nonetheless tremendously improved the landscape of myeloma treatment. Lenalidomide, of the immunomodulatory class of drugs, is one of those novel agents. In the non-transplant and relapsed/refractory settings, lenalidomide clearly benefits patients in terms of virtually all meaningful outcomes including overall survival. Data supporting the usage of lenalidomide as part of treatment approaches incorporating high-dose chemotherapy with autologous stem cell support (ASCT) are less mature as pertains to such long-term outcomes and toxicity, and lenalidomide is not currently approved by regulatory agencies for use in the context of ASCT in either the United States or Europe. That said, relatively preliminary efficacy data describing lenalidomide as a component of ASCT-based treatment approaches to MM are indeed promising, and consequently lenalidomide's role in ASCT-based treatment strategies is growing. In this review we summarize existing data that pertains to lenalidomide in the specific context of ASCT, and we share our thoughts on how our own group applies these data to approach this complex issue clinically

Risk management in solitary agricultural work: new technologies for handling emergency and falls from great heights (SHADE)

Solitary work and agricultural activities are the scenarios of a large number of severe injuries and deaths, also because first aid may be difficult to achieve in isolated locations. This work proposes a technology available on smartphones that allows triggering an emergency call when a fall from height or an unconsciousness state is detected. The results of several tests, which include different detection algorithms and scenarios, are reported in this work. Tests performed with the aid of a dummy have allowed developing a reliable algorithm for the detection of dangerous situations. This system is available as an Android application

The impact of age, disease severity, and BMI on bone health and growth in children and young people with Crohn's disease.

OBJECTIVES: The objective of this study was to explore the correlation between paediatric Crohn's disease (CD) characteristics, bone health and growth parameters at diagnosis and follow-up. METHODS: Retrospective data was collected for 47 children aged 4-16 who were newly diagnosed with CD between January 2018 and December 2019. Mean follow-up time was 2.5 years. RESULTS: Eleven (24%) children had growth delay at diagnosis, which persisted in 4 (44%) of 9 recorded children at follow-up. Of the 35 children tested, 20 (57%) had inadequate Vitamin D levels (<50 mmol/L) at diagnosis. Thirty-seven (79%) children had a dual-energy X-ray absorptiometry scan at diagnosis, with 20 of them having at least 1 low Z-score. Children with poorer bone mineral density and bone mineral concentration Z-scores for age had a younger age at diagnosis (p = .042 and p = .021), more severe disease (p = .04 and p = .029) and a lower BMI (p < .001) at diagnosis. Children diagnosed with CD ≥11 years had a lower-than-expected height velocity (p < .0001 and p < .001). Multivariate regression analysis demonstrated an older age of diagnosis was a significant predictor of a lower height velocity at follow-up. CONCLUSION: Disease severity and age of diagnosis are important CD-related factors that influence bone health and growth. Vitamin D is an accessible component that if optimised can improve all three factors. Monitoring and optimising each aspect systematically has the potential to enable children to achieve their bone health and growth potentials

Reversed halo sign in pneumocystis pneumonia: a case report

<p>Abstract</p> <p>Background</p> <p>The reversed halo sign may sometimes be seen in patients with cryptogenic organizing pneumonia, but is rarely associated with other diseases.</p> <p>Case presentation</p> <p>We present a case study of a 32-year-old male patient with acquired immunodeficiency syndrome, who had previously been treated with chemotherapy for non-Hodgkin's lymphoma. A chest X-ray showed bilateral patchy infiltrates. High-resolution computed tomography revealed the reversed halo sign in both upper lobes. The patient was diagnosed with pneumocystis pneumonia, which was successfully treated with sulfamethoxazole trimethoprim; the reversed halo sign disappeared, leaving cystic lesions. Cases such as this one are rare, but show that the reversed halo sign may occur in patients who do not have cryptogenic organizing pneumonia.</p> <p>Conclusion</p> <p>Physicians can avoid making an incorrect diagnosis and prescribing the wrong treatment by carefully evaluating all clinical criteria rather than assuming that the reversed halo sign only occurs with cryptogenic organizing pneumonia.</p

How do cardiologists select patients for dual antiplatelet therapy continuation beyond 1 year after a myocardial infarction? Insights from the EYESHOT Post-MI Study

Background: Current guidelines suggest to consider dual antiplatelet therapy (DAPT) continuation for longer than 12 months in selected patients with myocardial infarction (MI). Hypothesis: We sought to assess the criteria used by cardiologists in daily practice to select patients with a history of MI eligible for DAPT continuation beyond 1 year. Methods: We analyzed data from the EYESHOT Post-MI, a prospective, observational, nationwide study aimed to evaluate the management of patients presenting to cardiologists 1 to 3 years from the last MI event. Results: Out of the 1633 post-MI patients enrolled in the study between March and December 2017, 557 (34.1%) were on DAPT at the time of enrolment, and 450 (27.6%) were prescribed DAPT after cardiologist assessment. At multivariate analyses, a percutaneous coronary intervention (PCI) with multiple stents and the presence of peripheral artery disease (PAD) resulted as independent predictors of DAPT continuation, while atrial fibrillation was the only independent predictor of DAPT interruption for patients both at the second and the third year from MI at enrolment and the time of discharge/end of the visit. Conclusions: Risk scores recommended by current guidelines for guiding decisions on DAPT duration are underused and misused in clinical practice. A PCI with multiple stents and a history of PAD resulted as the clinical variables more frequently associated with DAPT continuation beyond 1 year from the index MI

A existência de "sistema sensório-motor integrado" em recém-nascidos humanos

Este artigo discute a existência de um "sistema sensório-motor integrado" a partir da infl uência do estímulo oro-gustativo na incidência dos contatos das mãos com a região oral, em recém-nascidos de até 36 horas de vida, em diferentes estados comportamentais. Fizeram parte da amostra 90 recém-nascidos, divididos em dois grupos de estímulo (sacarose e água), submetidos a testes com procedimento duplo-cego e duração de 15 minutos. O experimento foi filmado em VHS, sendo registradas a freqüência e a duração (em segundos) dos Estados Comportamentais e Comportamentos Específi cos apresentados por cada recém-nascido. Observaram-no três juízes independentes, sendo aceitos os eventos registrados por pelo menos dois deles. Os dados foram tratados estatisticamente com a Análise de Variância (ANOVA), com nível de signifi cância de 5%. Os resultados obtidos evidenciaram que o grupo sacarose obteve respostas mais significantes em relação ao grupo água para os comportamentos de levar as mãos à região oral, sugerindo maior "integração sensório-motora" na presença de estímulo preferencial pelo recém-nascido. A diferença estatisticamente signifi cante entre os estímulos ocorreu apenas para comportamentos do lado direito do corpo, apontando para um maior controle manual desse lado