Hylan G-F 20: Review of its Safety and Efficacy in the Management of Joint Pain in Osteoarthritis

BACKGROUND: Osteoarthritis (OA) is a chronic degenerative joint disease that is a clinically and economically important disease. The increased prevalence of OA with aging, coupled to the demographics of aging populations, make OA a high priority health care problem. Viscosupplementation (VS) is a well-established treatment option in knee OA that is included in the professional guidelines for treatment of this joint disease, and could potentially provide a useful alternative in treating such patients with painful OA. Theoretically VS is an approach that should apply to all synovial joints. OBJECTIVES: The aim of this review is to assess the efficacy and safety of viscosupplementation with Hylan GF-20 (Synvisc(®)) in the management of joint pain in osteoarthritis. METHODS: THE FOLLOWING DATABASES WERE SEARCHED: Medline, Database of Abstract on Reviews and Effectiveness, Cochrane Database of Systematic Reviews. Furthermore, the lists of references of retrieved publications were manually checked for additional references. The search terms Review, Viscosupplementation, Osteoarthritis, Hyaluronic acid, Hyaluronan, Sodium Hyaluronate, Hylan GF-20, Synvisc, intra-articular injection were used to identify all studies relating to the use of Synvisc(®) viscosupplementation therapy in OA. RESULTS: Hylan GF-20 is a safe and effective treatment for decreasing pain and improving function in patients suffering from knee and hip OA but new evidences are emerging for its use in other joints

The BeppoSAX WFC X-ray source catalogue

We present the catalogue of X-ray sources detected by the two Wide Field Cameras (WFCs) in complete observations on board BeppoSAX during its 6 years of operational lifetime, between April 1996 and April 2002. The BeppoSAX WFCs were coded mask instruments sensitive in the 2-28 keV energy band with a 40x40 square degree fields of view, pointing in opposite directions and perpendicularly to the BeppoSAX Narrow Field Instruments (NFI). The WFCs were usually operated simultaneously to NFI observations, each lasting up to several days. WFCs observed thus the entire sky several times with a typical sensitivity of 2 to 10 mCrab. A systematic analysis of all WFC observations in the BeppoSAX archive has been carried out using the latest post-mission release of the WFC analysis software and calibrations. The catalogue includes 253 distinct sources, obtained from a total sample of 8253 WFC detections. We describe the basic statistical properties of the sample and present a six-year history of two celestial calibration X-ray sources.Comment: 15 pages, 11 figures, Catalogue, Accepted for publication on A&

Cavernous malformation of the optic chiasm: An uncommon location

Cavernous malformations (CMs) of the optic chiasm are rare lesions often presenting with acute chiasmal syndrome or a progressive visual loss. The case of a 48-year-old female with an intrachiasmatic CM is presented

Malignant teratoma in Klippel-Feil syndrome: a case report and review of the literature

Introduction: Klippel-Feil syndrome is characterized by a congenital fusion of cervical vertebrae. Intracranial teratomas are nongerminomatous germ cell tumors and they account for 0.3 to 0.9% of all intracranial tumors. Teratomas with malignant transformation refer to lesions which give rise to malignant cancer of somatic type. The association between tumors of dermoid origin and Klippel-Feil malformation is extremely rare. Only 23 other cases have so far been reported, and only one case of dermoid tumor with areas of dedifferentiation on squamous cell carcinoma has been described. Case presentation: We report the case of a 72-year-old white man with a 2-year history of gait and balance disturbances. A brain magnetic resonance imaging revealed a fourth ventricle neoplastic process with infiltrative features. He was operated through a suboccipital craniectomy with a C1 laminotomy and bilateral vertebral artery transposition. At 6-months follow-up, magnetic resonance imaging showed an early regrowth of the fourth ventricle tumor, with the same radiological features. Conclusions: Patients with Klippel-Feil malformation could develop posterior fossa dermoid tumors. The malignant potential of such tumors must be considered and surgery is recommended. Particular attention must be focused on the histopathological analysis in order to identify possible foci of malignant transformation

Experimental Investigation on Innovative Stress Sensors for Existing Masonry Structures Monitoring

Historical masonry structures often suffer gradual deterioration that in many cases can compromise the safety levels and the operating conditions of the buildings. In this context, Structural Health Monitoring (SHM) is an effective tool for the prediction of the structural behaviour and the state of conservation of buildings. Although many monitoring systems have recently been proposed, there is a lack of practical application of low-cost systems. This paper presents an experimental study based on the use of two innovative stress sensors—capacitive stress sensor and ceramic stress sensor—for the monitoring of existing masonry elements. In order to reproduce the actual conditions of onsite masonry, sensors are post-installed in the mortar joints of two series of pre-stressed specimens made of calcarenite stone masonry and clay brick masonry. The best practice of post-installation of the two sensors is investigated. The reliability of the proposed sensors is evaluated through comparison with data recorded from classical measurement devices

Amarelli's Industry 4.0 Transformation with IoT and Digital Advertisement: Optimizing Operations and Engaging Customers

This paper presents a vertical IoT solution for Amarelli, a licorice producing company, aiming to optimize their operations and enhance their customer engagement through the integration of IoT technology, Enterprice Resource Planning (EPR) system, e-commerce and social media advertising. The proposed solution includes several key components, such as IoT-enabled production monitoring, warehouse monitoring, RFID tracking, and real-time data analysis. The solution also integrates an ERP system, to provide business intelligence and e-commerce combination to enhance online presence and customer engagement through social media advertising. This vertical solution will enable Amarelli to improve efficiency, productivity, and profitability, while also providing valuable insights into customer preferences and purchasing behavior. The implementation of this solution will position Amarelli at the forefront of Industry 4.0, and help the company to stay competitive in today's rapidly evolving marketplace

GLP-1 receptor agonists and renal outcomes in patients with diabetes mellitus type 2 and diabetic kidney disease: State of the art

Background: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are highly effective in improving glycaemic control either as monotherapy or in combination with other hypoglycaemic drugs, and have low incidence of side effects, such as hypoglycaemia, nausea and weight gain, thus increasing patients' adherence to therapy. Methods: In this review we report the most recent studies demonstrating the beneficial effects of GLP-1RAs on renal outcomes, and also discuss the direct and indirect mechanisms through which they confer kidney protection. Finally, we discuss the metabolic and anti-inflammatory effects of GLP-1RAs in diabetic patients with COVID-19 disease. Results: GLP-1RAs have a nephroprotective action, which is expressed through both indirect (improvement of blood pressure and glycaemic control, weight loss) and direct (restoration of normal intrarenal haemodynamics, prevention of ischaemic and oxidative damage) effects. They have shown also metabolic and anti-inflammation beneficial effects in patients with COVID-19 disease. Conclusions: GLP-1RAs prevent albuminuria and slow the decline of renal function towards end stage renal disease in patients with diabetic kidney disease. They might be an opportunity to break the typical inflammation processes of COVID-19 disease

Doppler ultrasound and renal artery stenosis: An overview

La malattia nefrovascolare \ue8 un disordine complesso e le cause pi\uf9 comuni sono la malattia aterosclerotica e la displasia fibromuscolare. Classicamente si presenta in una delle seguenti tre forme: stenosi dell'arteria renale (SAR) asintomatica, associata a ipertensione nefrovascolare e/o con nefropatia ischemica. La SAR su base aterosclerotica \ue8 una malattia progressiva che pu\uf2 determinare in maniera asintomatica o paucisintomatica perdita graduale della funzione renale. Per tale motivo, la diagnosi precoce di SAR \ue8 un obiettivo clinico importante poich\ue9 la terapia interventistica pu\uf2 migliorare o curare l'ipertensione e preservare la funzione renale. Lo screening per SAR \ue8 indicato nel sospetto di ipertensione nefrovascolare o di nefropatia ischemica al fine di identificare i pazienti in cui \ue8 indicato un intervento di rivascolarizzazione. I test di screening per SAR sono migliorati considerevolmente durante l'ultimo decennio. Mentre la scintigrafia con test al captopril \ue8 stata utilizzata quasi esclusivamente nel passato, l'ecocolorDoppler delle arterie renali, l'angioTC e/o l'angioRM hanno sostituito le altre modalit\ue0 di screening in molti centri. Per tale motivo l'arteriografia riveste sempre pi\uf9 un ruolo interventistico e solo di rado diagnostico. L'ecocolorDoppler \ue8 una procedura diagnostica non invasiva, ripetibile e relativamente economica che negli ultimi anni, in mani esperte, si \ue8 accreditata sempre pi\uf9 come ottimo strumento di screening di malattia nefrovascolare. Inoltre, la determinazione dell'indice di resistenza sembra essere utile nei pazienti con SAR per la capacit\ue0 di predire la risposta alla rivascolarizzazione. Tuttavia, quando esiste una discrepanza fra i dati clinici e i risultati dell'ecocolorDoppler \ue8 indicato il ricorso ad altre procedure diagnostiche.Renovascular disease is a complex disorder, most commonly caused by fibromuscular dysplasia and atherosclerotic diseases. It can be found in one of three forms: asymptomatic renal artery stenosis (RAS), renovascular hypertension, and ischemic nephropathy. Particularly, the atherosclerotic form is a progressive disease that may lead to gradual and silent loss of renal function. Thus, early diagnosis of RAS is an important clinical objective since interventional therapy may improve or cure hypertension and preserve renal function. Screening for RAS is indicated in suspected renovascular hypertension or ischemic nephropathy, in order to identify patients in whom an endoluminal or surgical revascularization is advisable. Screening tests for RAS have improved considerably over the last decade. While captopril renography was widely used in the past, Doppler ultrasound (US) of the renal arteries (RAs), angio-CT, or magnetic resonance angiography (MRA) have replaced other modalities and they are now considered the screening tests of choice. An arteriogram is rarely needed for diagnostic purposes only. Color-Doppler US (CDUS) is a noninvasive, repeatable, relatively inexpensive diagnostic procedure which can accurately screen for renovascular diseases if performed by an expert. Moreover, the evaluation of the resistive index (RI) at Doppler US may be very useful in RAS affected patients for predicting the response to revascularization. However, when a discrepancy exists between clinical data and the results of Doppler US, additional tests are mandatory

Early predictors of smoking cessation after myocardial infarction

The determinants of long-term smoking cessation were evaluated in 80 patients who smoked cigarettes and survived a myocardial infarction. All patients underwent a program of rehabilitation and secondary prevention including in-hospital counseling and physician-guided reinforcing sessions at 1, 3, and 6 months after discharge. At 18 months of follow-up, 53 patients (66.3%) had quit smoking. Variables associated with smoking cessation were duration of hospital stay greater than or equal to 19 days (79 vs. 48%; p less than 0.005) and peak creatine phosphokinase (CPK) elevation greater than or equal to 500 U/l (76 vs. 54%; p less than 0.05). Males tended to quit in higher proportion than females (68 vs. 44%). Age, prior myocardial infarction, other cardiovascular risk factors, infarction location, Killip class at entry, and duration of stay in coronary care unit did not significantly affect the quitting rates. Logistic regression analysis singled out the duration of hospital stay as a significant predictor of smoking cessation (p less than 0.005). Early and intensive secondary prevention during the hospital stay is crucial in promoting sustained smoking cessation after myocardial infarction