The pendulum test as a tool to evaluate passive knee stiffness and viscosity of patients with rheumatoid arthritis

BACKGROUND: The pendulum test of Wartenberg is a technique commonly used to measure passive knee motion with the aim to assess spasticity. We used this test to evaluate changes of the knee angular displacement, passive stiffness and viscosity in rheumatoid arthritis patients. Stiffness and viscosity represent passive resistances to joint motion associated with the structural properties of the joint tissue and of the muscular-tendon complex. Stiffness can be considered an intrinsic property of the tissues to resist deformation, while viscosity is related to cohesive forces between adjacent layers of tissues. Both parameters may influence the joint range of motion affecting angular displacement. METHODS: Nine women with rheumatoid arthritis were compared with a group of healthy women. With the subject half-lying, the relaxed knee was dropped from near-full extension and the characteristics of the ensuring damped unsustained knee oscillation evaluated. The kinematics of leg oscillations was recorded using ultrasonic markers (Zebris CMS HS 10) and the kinetic data were calculated from kinematic and anthropometric measures. RESULTS: Knee stiffness significantly increased (p < 0.001) in patients with respect to the control group, while differences in viscosity were not significant. Moreover, the amplitudes of first knee flexion (the maximal flexion excursion after knee release) and first knee extension (the maximal extension excursion after the first knee flexion) were significantly decreased (p < 0.001). A regression analysis showed that disease severity correlated moderately with stiffness (R(2 )= 0.68) and first flexion (R(2 )= 0.78). Using a multivariate regression, we found that increasing stiffness was the main factor for the reduction of flexion and extension motions. CONCLUSION: We showed that the Wartenberg test can be considered a practical tool to measure mechanical changes of knee caused by rheumatoid arthritis. This novel application of Wartenberg test could be useful to follow up the effects of pharmacological and rehabilitative interventions in this disease

Therapeutic approaches in the treatment of juvenile dermatomyositis in patients with recent-onset disease and in those experiencing disease flare: An international multicenter PRINTO study

Objective To evaluate response to therapy over a 24-month period in a large prospective international cohort of patients with juvenile dermatomyositis (DM). Methods The study included 145 patients with recent-onset juvenile DM and 130 juvenile DM patients experiencing disease flare, all of whom were \u3c18 years old. Disease activity parameters and therapeutic approaches in 4 geographic areas were analyzed at baseline and at 6, 12, and 24 months. Response was assessed according to the Pediatric Rheumatology International Trials Organization (PRINTO) juvenile DM response criteria, and data were reported as observed and in the intent-to-treat (ITT) population. Results Patients with recent-onset juvenile DM at baseline had higher baseline disease activity and greater improvement over 24 months when compared to juvenile DM patients experiencing disease flare at baseline. Methotrexate (MTX) or high-dose corticosteroids were administered more frequently to patients with recent-onset juvenile DM, compared to juvenile DM patients experiencing disease flare, who were more likely to receive cyclosporine. Compared to patients from Western and Eastern Europe, a higher proportion of patients from South and Central America and North America received pulse steroids, and the average steroid dosage was higher in the North American and South and Central American patients. The use of MTX was similar in all 4 regions, while cyclosporin A was more frequently used in Western Europe. In the as observed analysis, 57.9% of the patients with recent-onset juvenile DM and 36.4% of the patients experiencing disease flare (P \u3c 0.001) reached at least a 70% response by PRINTO criteria at 6 months; these proportions had increased at month 24 to 78.4% and 51.2%, respectively (P \u3c 0.001). Corresponding results of the ITT analysis were much lower, with only one-third of the patients able to maintain the initial assigned therapy over 24 months. Conclusion Patients with recent-onset juvenile DM are more likely to achieve significant clinical improvement over 24 months, when compared to patients experiencing flares of juvenile DM. Internationally, various therapeutic approaches are used to treat this disease. Copyright © 2011 by the American College of Rheumatology

Le nuove forma di cooperazione giudiziaria penale nell'ambito dell'Unione europea

Dottorato di ricerca in procedura penale. 6. ciclo. Coordinatore G. Tranchina. Tutore A. GalatiConsiglio Nazionale delle Ricerche - Biblioteca Centrale - P.le Aldo Moro, 7, Rome; Biblioteca Nazionale Centrale - P.za Cavalleggeri, 1, Florence / CNR - Consiglio Nazionale delle RichercheSIGLEITItal

Assessing the Effect of Pavement Distresses by Means of LiDAR Technology

The overtime assessment of pavement quality is a necessary condition to design maintenance and rehabilitation plans at network level. The wide extent of national road network suggests automated methods to overcome the time consuming surveys and traffic interfering methods. This study highlights as the accelerations on the vehicle can be considered an important indicator of pavement performance. In particular, by means of a software package, it is possible to predict the stresses on a vehicle in response to driver controls. The computation of the stresses are carried out making use of a Digital Elevation Model (DEM) of the road surface, obtained through the interpolation of a very dense point clouds surveyed with a mobile laser scanner. The collected data have been interpolated to obtain the numerical model of the road surface implementing some algorithms in a Matlab environment. With the aim of performing a reliability analysis of the proposed method, a comparison with a high speed, longitudinal road profiling has been carried out

Characterization Road Surface by Means of Laser Scanner Technologies

The monitoring of pavement distress takes a key role with respect to the functionality of a road structure, which is necessary to schedule maintenance works, optimizing the available resources. The identification, classification and quantification of different typology of distress involve complex practical activities and data processing that are sometimes inefficient and risky since interfere with road traffic. The aim of our work is the analysis and the three-dimensional reconstruction of the paved surface making use of innovative technologies of measure and computation, in order to obtain a complete and accurate data sets. With the evolving LiDAR (Light Detection And Ranging) technologies, including static and mobile laser scanners, it is possible to obtain very dense point clouds, that allow to build an accurate geometrical model of the road surface. The experimentation concerns a road segment whose surface has been surveyed by means of two static terrestrial laser scanners and a mobile mapping system to analyse their performances and compare the results in a test case. The collected data have been interpolated to obtain a digital elevation model of the road surface. The numerical model has been implemented in a software package that predicts the performance of vehicles in response to driver controls

Assessing of the Road Pavement Roughness by Means of LiDAR Technology

The assessment of the road roughness conditions plays an important role to ensure the required performances related to road safety and ride comfort, furthermore providing a tool for pavement maintenance and rehabilitation planning. In this work, the authors compared the roughness index (International Roughness Index, IRI) derived from high speed inertial profilometer with two other roughness indices, one dynamic and one geometric computed on a digital elevation model (DEM) built by using mobile laser scanner (MLS) data. The MLS data were acquired on an extra-urban road section and interpolated on the nodes of a DEM with a curvilinear abscissa, coinciding with the global navigation satellite system (GNSS) track of the profilometer. To estimate the grid cell elevation, we applied two interpolation methods, ordinary kriging (OK) and inverse distance weighting (IDW), over the same data. The roughness values computed on the surface of the DEM showed a similar trend and a high correlation with those acquired by the profilometer, higher for the dynamic index than for the geometric index. The differences between the IRI values by profilometer and those computed on the DEM were small enough not to significantly affect the judgments on the analyzed sections. Moreover, the road sub-sections derived from profilometer measure that were classified as critical coincided with those derived from light detection and ranging (LiDAR) surveys. The proposed method can be used to perform a network-level analysis. In addition, to evaluate the effects of vibrations on human comfort, we input the DEMs into a dynamic simulation software in order to compute the vertical accelerations, as specified in the UNI ISO 2631 standard. The values obtained were in line and correlated with those inferred from the standard methodology for profilometer measures

N-Glycomics of Human Erythrocytes

Glycosylation is a complex post-translational modification that conveys functional diversity to glycoconjugates. Cell surface glycosylation mediates several biological activities such as induction of the intracellular signaling pathway and pathogen recognition. Red blood cell (RBC) membrane N-glycans determine blood type and influence cell lifespan. Although several proteomic studies have been carried out, the glycosylation of RBC membrane proteins has not been systematically investigated. This work aims at exploring the human RBC N-glycome by high-sensitivity MALDI-MS techniques to outline a fingerprint of RBC N-glycans. To this purpose, the MALDI-TOF spectra of healthy subjects harboring different blood groups were acquired. Results showed the predominant occurrence of neutral and sialylated complex N-glycans with bisected N-acetylglucosamine and core- and/or antennary fucosylation. In the higher mass region, these species presented with multiple N-acetyllactosamine repeating units. Amongst the detected glycoforms, the presence of glycans bearing ABO(H) antigens allowed us to define a distinctive spectrum for each blood group. For the first time, advanced glycomic techniques have been applied to a comprehensive exploration of human RBC N-glycosylation, providing a new tool for the early detection of distinct glycome changes associated with disease conditions as well as for understanding the molecular recognition of pathogens