Is hypnosis a valid alternative to spontaneous breathing general anesthesia for claustrophobic patients undergoing MR exams? A preliminary retrospective study

Abstract Background The purpose of our retrospective study was to assess the termination rate and the image quality of MR exams performed in claustrophobic patients under medical hypnosis, as compared to patients undergoing MR under spontaneous breathing general anesthesia. Methods Our study was approved by the ethics committee. The “hypnosis group” included consecutive patients that had previously interrupted an MR exam because of claustrophobia. The “control group” included patients undergoing MR under pharmacologic sedation. Two experienced radiologists assessed, randomly, independently and blinded the image quality of the two groups using a symmetrical Likert scale: 0 = non-diagnostic images; 1 = bad image quality; 2 = fair image quality; 3 = good image quality; 4 = very good image quality. Descriptive statistics was performed. Results Eighty patients were included, equally distributed between the two groups. Every patient was able to complete the MR exam. Ratings 3 and 4 represented the majority of ratings. Both readers rated the MR exams with score 3 or 4 in 66.25% (53/80) of MR exams. Only 5% (4/80) of MR exams were rated below score 2. The majority of the MR exams showed good or very good image quality. No significant difference was found in image quality between the two (p = 0.06) groups. The agreement between the two readers according to the k score was 0.105. Conclusions Medical hypnosis is a valid alternative to spontaneous breathing general anesthesia in patients unable to undergo MR due to claustrophobia, allowing good quality images

Computed tomography based radiomics as a predictor of survival in ovarian cancer patients: a systematic review

The objective of this systematic review was to assess the results of radiomics for prediction of overall survival (OS) and progression free survival (PFS) in ovarian cancer (OC) patients. A secondary objective was to evaluate the findings of papers that based their analyses on inter-site heterogeneity. This systematic review was conducted according to the PRISMA statement. After the initial retrieval of 145 articles, the final systematic review comprised six articles. Association between radiomic features and OS was evaluated in 3/6 studies (50%); all articles showed a significant association between radiomic features and OS. Association with PFS was evaluated in 5/6 (83%) articles; the period of follow-up ranged between six and 36 months. All the articles showed significant association between radiomic models and PFS. Inter-site textural features were used for analysis in 2/6 (33%) articles. They demonstrated that high levels of inter-site textural heterogeneity were significantly associated with incomplete surgical resection in breast cancer gene-negative patients, and that lower heterogeneity was associated with complete resectability. There were some differences among papers in methodology; for example, only 3/6 (50%) articles included validation cohorts. In conclusion, radiomic models have demonstrated promising results as predictors of survival in OC patients, although larger studies are needed to allow clinical applicabilit

Carbazoles: Role and Functions in Fighting Diabetes

Carbazole derivatives have gained a lot of attention in medicinal chemistry over the last few decades due to their wide range of biological and pharmacological properties, including antibacterial, antitumor, antioxidant, and anti-inflammatory activities. The therapeutic potential of natural, semi-synthetic or synthetic carbazole-containing molecules has expanded considerably owing to their role in the pathogenesis and development of diabetes. Several studies have demonstrated the ability of carbazole derivatives to reduce oxidative stress, block adrenergic hyperactivation, prevent damage to pancreatic cells and modulate carbohydrate metabolism. In this survey, we summarize the latest advances in the synthetic and natural carbazole-containing compounds involved in diabetes pathways

Body composition assessment: comparison of quantitative values between magnetic resonance imaging and computed tomography.

Background The primary objective of this study was to compare measurements of skeletal muscle index (SMI), visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) at the level of L3, on subjects who underwent computed tomography (CT) and magnetic resonance imaging (MRI) examinations within a three-month period. The secondary objective was to compare the automatic and semi-automatic quantifications of the same values for CT images. Methods Among subjects who underwent CT and MRI at our Institution between 2011 and 2020, exclusion criteria were: presence of extensive artifacts; images not including the whole waist circumference; CT acquired with low-dose technique and lack of non-contrast images. A set of three axial images (CT, MRI T1-weighted and T2-weighted) were used to extract the following measurements with semi-automatic segmentations: SMI [calculated normalizing skeletal muscle area (SMA) by the square height], SAT, VAT. For the CT images only, the same values were also calculated by using automatic segmentation. Statistical analysis was performed comparing quantitative MRI and CT measurements by Pearson correlation analysis and by Bland-Altman agreement analysis. Results A total of 123 patients were included. By performing linear regression analysis, CT and MRI measurements of SMI showed a high correlation (r2=0.81 for T1, r2=0.89 for T2), with a mean logarithmic difference between CT and MRI quantitative values of 0.041 for T1-weighted and 0.072 for T2-weighted images. CT and MRI measurements of SAT showed high correlation (r2=0.81 for T1; r2=0.81 for T2), with a mean logarithmic difference between CT and MRI values of 0.0174 for T1-weighted and 0.201 for T2-weighted images. CT and MRI measurements of VAT showed high correlation (r2=0.94 for T1; r2=0.93 for T2), with a mean logarithmic difference of 0.040 for T1-weighted and -0.084 for T2-weighted images. The comparison of values extracted by semi-automatic and automatic segmentations were highly correlated. Conclusions Quantification of body composition values at MRI from T1-weighted and T2-weighted images was highly correlated to same values at CT, therefore quantitative values of body composition among patients who underwent either one of the examinations may be compared. CT body composition values extracted by semi-automatic and automatic segmentations showed high correlation

Antibiofilm activity and NMR-based metabolomic characterization of cell-free supernatant of Limosilactobacillus reuteri DSM 17938

The microbial biofilm has been defined as a "key virulence factor" for a multitude of microorganisms associated with chronic infections. Its multifactorial nature and variability, as well as an increase in antimicrobial resistance, suggest the need to identify new compounds as alternatives to the commonly used antimicrobials. The aim of this study was to assess the antibiofilm activity of cell-free supernatant (CFS) and its sub-fractions (SurE 10 K with a molecular weight <10 kDa and SurE with a molecular weight <30 kDa), produced by Limosilactobacillus reuteri DSM 17938, vs. biofilm-producing bacterial species. The minimum inhibitory biofilm concentration (MBIC) and the minimum biofilm eradication concentration (MBEC) were determined via three different methods and an NMR metabolomic analysis of CFS and SurE 10K was performed to identify and quantify several compounds. Finally, the storage stability of these postbiotics was evaluated by a colorimetric assay by analyzing changes in the CIEL*a*b parameters. The CFS showed a promising antibiofilm activity against the biofilm developed by clinically relevant microorganisms. The NMR of CFS and SurE 10K identifies and quantifies several compounds, mainly organic acids and amino acids, with lactate being the most abundant metabolite in all the analyzed samples. The CFS and SurE 10 K were characterized by a similar qualitative profile, with the exception of formate and glycine detected only in the CFS. Finally, the CIEL*a*b parameters assess the better conditions to analyze and use these matrices for the correct preservation of bioactive compounds

Risk of latent tuberculosis infection among healthcare workers in Italy: a retrospective study with Quantiferon Test

OBJECTIVE. The latent tuberculosis infection (LTBI) is a state of persistent immune response to stimulation by Mycobacterium Tuberculosis antigens without clinical manifestation: the healthcare workers (HCWs) have a higher exposure risk so prevention is an important challenge for occupational medicine. The aim of our study is to evaluate the prevalence of LTBI among HCWs of the Foundation Policlinic “Tor Vergata”. METHODS. This is a retrospective study conducted by analyzing the clinical records of 825 HCWs of the PTV, from January 1st to December 31th 2016. To evaluate the TB infection we used the Quantiferon TB Gold interferon-gamma release assay. RESULTS. Our study underline the low prevalence of LTBI in the Italian healthcare workers. CONCLUSION. Although the LTBI status is not contagious, the diagnosis and the safety strategies require specific clinical and preventive considerations

Radiation Macular Edema after Ru-106 Plaque Brachytherapy for Choroidal Melanoma Resolved by an Intravitreal Dexamethasone 0.7-mg Implant

Purpose: To report the effective treatment of radiation macular edema following ruthenium-106 plaque brachytherapy for a choroidal melanoma with a dexamethasone 0.7-mg (Ozurdex®) intravitreal implant. Methods: An interventional case report with optical coherence tomography (OCT) scans. Results: A 65-year-old Caucasian woman was suffering from radiation macular edema following ruthenium-106 plaque brachytherapy for a choroidal melanoma on her left eye. She had undergone one intravitreal injection of 0.5 mg bevacizumab (Avastin®, Genentech/Roche) in the following months without functional or anatomical improvement. Seven months after the development of radiation macular edema, she received a single intravitreal injection of dexamethasone 0.7 mg (Ozurdex). Four weeks following the injection, her best-corrected visual acuity improved from 0.3 to 0.5. Radiation macular edema resolved with a reduction of central retinal thickness from 498 µm before Ozurdex injection to 224 µm after Ozurdex injection, as measured by OCT scan. Conclusion: Dexamethasone 0.7 mg (Ozurdex) has proven to be an effective treatment option in retinal vein occlusion and noninfectious uveitis. It can also be considered as off-label treatment in radiation macular edema following ruthenium-106 plaque brachytherapy for a choroidal melanoma

Is Computed-Tomography-Based Body Composition a Reliable Predictor of Chemotherapy-Related Toxicity in Pancreatic Cancer Patients?

BACKGROUND Malnutrition, loss of weight and of skeletal muscle mass are frequent in pancreatic cancer patients, a majority of which will undergo chemotherapy over the course of their disease. Available data suggest a negative prognostic role of these changes in body composition on disease outcomes; however, it is unclear whether tolerance to chemotherapeutic treatment is similarly and/or negatively affected. We aimed to explore this association by retrospectively assessing changes in body composition and chemotherapy-related toxicity in a cohort of advanced pancreatic cancer patients. METHODS Body composition was evaluated through clinical parameters and through radiological assessment of muscle mass, skeletal muscle area, skeletal muscle index and skeletal muscle density; and an assessment of fat distribution by subcutaneous adipose tissue and visceral adipose tissue. We performed descriptive statistics, pre/post chemotherapy comparisons and uni- and multivariate analyses to assess the relation between changes in body composition and toxicity. RESULTS Toxicity risk increased with an increase of skeletal muscle index (OR: 1.03) and body mass index (OR: 1.07), whereas it decreased with an increase in skeletal muscle density (OR: 0.96). Multivariate analyses confirmed a reduction in the risk of toxicity only with an increase in skeletal muscle density (OR: 0.96). CONCLUSIONS This study suggests that the retrospective analysis of changes in body composition is unlikely to be useful to predict toxicity to gemcitabine-nab-paclitaxel

Physical activity and exercise in dementia : an umbrella review of intervention and observational studies

Background: Dementia is a common condition in older people. Among the potential risk factors, increasing attention has been focused on sedentary behaviour. However, synthesizing literature exploring whether physical activity/exercise can affect health outcomes in people with dementia or with mild cognitive impairment (MCI) is still limited. Therefore, the aim of this umbrella review, promoted by the European Geriatric Medicine Society (EuGMS), is to understand the importance of physical activity/exercise for improving cognitive and non-cognitive outcomes in people with dementia/MCI. Methods: Umbrella review of systematic reviews (SR) (with or without meta-analyses) of randomized controlled trials (RCTs) and observational (prospective and case-control in people with MCI) studies based on a systematic literature search in several databases. The certainty of evidence of statistically significant outcomes attributable to physical activity/exercise interventions was evaluated using Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Results: Among 1,160 articles initially evaluated, 27 systematic reviews (4 without meta-analysis) for a total of 28,205 participants with dementia/MCI were included. No observational study on physical activity/exercise in MCI for preventing dementia was included. In SRs with MAs, physical activity/exercise was effective in improving global cognition in Alzheimer’s disease and in all types of dementia (very low/low certainty of evidence). Moreover, physical activity/ exercise significantly improved global cognition, attention, executive function, and memory in MCI, with a certainty of evidence varying from low to moderate. Finally, physical activity/exercise improved non-cognitive outcomes in people with dementia including falls and neuropsychiatric symptoms. SRs, without meta-analysis, corroborated these results. Conclusions: Supported by very low to moderate certainty of evidence, physical activity/exercise has a positive effect on several cognitive and non-cognitive outcomes in people with dementia and MCI, but RCTs, with low risk of bias/confounding, are still needed to confirm these findings

Benign splenosis mimicking peritoneal seeding in a bladder cancer patient: a case report

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