Cytokine release syndrome in COVID-19 patients, a new scenario for an old concern. The fragile balance between infections and autoimmunity

On 7 January 2020, researchers isolated and sequenced in China from patients with severe pneumonitis a novel coronavirus, then called SARS-CoV-2, which rapidly spread worldwide, becoming a global health emergency. Typical manifestations consist of flu-like symptoms such as fever, cough, fatigue, and dyspnea. However, in about 20% of patients, the infection progresses to severe interstitial pneumonia and can induce an uncontrolled host-immune response, leading to a life-threatening condition called cytokine release syndrome (CRS). CRS represents an emergency scenario of a frequent challenge, which is the complex and interwoven link between infections and autoimmunity. Indeed, treatment of CRS involves the use of both antivirals to control the underlying infection and immunosuppressive agents to dampen the aberrant pro-inflammatory response of the host. Several trials, evaluating the safety and effectiveness of immunosuppressants commonly used in rheumatic diseases, are ongoing in patients with COVID-19 and CRS, some of which are achieving promising results. However, such a use should follow a multidisciplinary approach, be accompanied by close monitoring, be tailored to patient’s clinical and serological features, and be initiated at the right time to reach the best results. Autoimmune patients receiving immunosuppressants could be prone to SARS-CoV-2 infections; however, suspension of the ongoing therapy is contraindicated to avoid disease flares and a consequent increase in the infection risk

Design of an innovative polymerase chain reaction device based on buoyancy driven flow

This paper was presented at the 2nd Micro and Nano Flows Conference (MNF2009), which was held at Brunel University, West London, UK. The conference was organised by Brunel University and supported by the Institution of Mechanical Engineers, IPEM, the Italian Union of Thermofluid dynamics, the Process Intensification Network, HEXAG - the Heat Exchange Action Group and the Institute of Mathematics and its Applications.Polymerase Chain Reaction (PCR) plays a central role in the field of molecular biology. The miniaturization of PCR systems is promising as it potentially minimizes costly reagent consumption and time required for analysis. In PCR microdevices a sample solution is usually handled by external pumps. An alternative solution relies on temperature-induced density difference in the presence of a body force to induce buoyancy driven flow. This alternative method is easy to be used and does not require expensive setup, but, to date, the thermo-fluid-dynamic field in the micro-channels still needs to be optimized. The present study focuses on the design of micro-channels, having innovative and optimized shapes to obtain proper fluid actuation and DNA sample amplification within buoyancy driven flow PCR devices. A parametric study is carried out by means of computational thermal fluid dynamic modeling: several channel geometry configurations were compared in terms of time required for analysis, temperature distribution and priming volume. The advantages and disadvantages of such configurations are discussed

Computational and experimental investigation of mixing in microchannels

This paper was presented at the 2nd Micro and Nano Flows Conference (MNF2009), which was held at Brunel University, West London, UK. The conference was organised by Brunel University and supported by the Institution of Mechanical Engineers, IPEM, the Italian Union of Thermofluid dynamics, the Process Intensification Network, HEXAG - the Heat Exchange Action Group and the Institute of Mathematics and its Applications.Mixing is a key process for the successful of all chemical or biochemical reactions, so effective micromixers represent essential components for micro total analysis systems (μTAS) or lab-on-a-chip. In the present study a combined computational and experimental approach was adopted to evaluate how the efficiency of a Y-mixer can be enhanced by modifying its downstream geometry. Three different geometries were studied and compared: Y-straight channel, Y-sine channel and Y-wrinkled wall channel. For each of them the influence of perfusing flow rates and channel cross section aspect ratio was investigated. Physical prototypes were built using a simple technique based on a xerographic process, and their mixing performance was experimentally evaluated. Computational models of the designed micromixers were generated: the Navier-Stokes equations for an incompressible Newtonian fluid and the advection-diffusion equation were solved with an uncoupled approach by means of the finite volume method. The computational and experimental results were critically compared, revealing Y-wrinkled wall mixer as the best performer among those considered and suggesting criteria of possible improvements and optimization

Sleep bruxism and sdb in albanian growing subjects: A cross-sectional study

BackgroundThe aim of this study was to evaluate a possible correlation between sleep bruxism and risk factors of developing obstructive sleep apnea syndrome (OSAS) in a sample of growing subjects and to assess parental awareness about sleep bruxism in their children. Methods: The sample was composed of 310 subjects (173 females and 137 males), with a mean age of 8.9 years, attending "Ndre Mjeda" school of Tirana (Albania). All parents of the children participating in the study were asked to fill in a questionnaire manually or via a digital version. The questionnaire was composed of three sections: personal data, sleep quality data, and OSAS risk factors, and it was filled out by both parents. Results: Of our samples, 41.3% presented with bruxism, and 16.5% of the parents ground their teeth. Oral breathing was reported in 11.9% of the subjects, and among these, 40% of the subjects were affected by bruxism (p > 0.05). Of the subjects, 18.7% snore overnight. Comparing it with sleep bruxism, the two phenomena are often related (p = 0.00). Conclusions: Heredity, night-sweating, nycturia, oral breathing, and snoring seem to have a significant correlation with bruxism

Enamel interproximal reduction during treatment with clear aligners: digital planning versus OrthoCAD analysis

Background The aim of the study was to compare the amount of interproximal enamel reduction (IPR) provided on ClinCheck software with the amount of IPR carried out by the orthodontist during treatment with clear aligners. Methods 30 subjects (14 males, 16 females; mean age of 24.53 +/- 13.41 years) randomly recruited from the Invisalign account of the Department of Orthodontics at the University of Rome "Tor Vergata" from November 2018 to October 2019, were collected according to the following inclusion criteria: mild to moderate dento-alveolar discrepancy (1.5-6.5 mm); Class I canine and molar relationship; full permanent dentition (excluding third molars); both arches treated only using Comprehensive Package by Invisalign system; treatment plan including IPR. Pre- (T0) and post-treatment (T1) digital models (.stl files), created from an iTero scan, were collected from all selected patients. The OrthoCAD digital software was used to measure tooth mesiodistal width in upper and lower arches before (T0) and at the end of treatment (T1) before any refinement. The widest mesio-distal diameter was measured for each tooth excluding molars by "Diagnostic" OrthoCAD tool. The total amount of IPR performed during treatment was obtained comparing the sum of mesio-distal widths of all measured teeth at T0 and T1. Significant T1-T0 differences were tested with dependent sample t-test (P < 0.05). Results In the upper arch, IPR was digitally planned on average for 0.62 mm while in the lower arch was on average for 1.92 mm. As for the amount of enamel actually removed after IPR performing, it was on average 0.62 mm in the maxillary arch. In the mandibular arch, the mean of IPR carried out was 1.93 mm. The difference between planned IPR and performed IPR is described: this difference was on average 0.00 mm in the upper arch and 0.01 in the lower arch. Conclusions The amount of enamel removed in vivo corresponded with the amount of IPR planned by the Orthodontist using ClinCheck software

Oral health conditions in an Albanian adolescent population: An epidemiological study

The aim of this study was to determine the oral health conditions of an adolescent population of Tirana

Efficacy and Safety of Axiostat® Hemostatic Dressing in Aiding Manual Compression Closure of the Femoral Arterial Access Site in Patients Undergoing Endovascular Treatments: A Preliminary Clinical Experience in Two Centers

Background: Hemostasis of the femoral arterial access site by manual compression or a vascular closure device is critical to the safe completion of any endovascular procedure. Previous investigations evaluated the hemostatic efficacy at the radial access site of some chitosan-based hemostatic pads. This study aims to assess the efficacy and safety of a new chitosan-based hemostatic dressing, namely Axiostat®, in aiding manual compression closure of the femoral arterial access site in patients undergoing endovascular treatments. Furthermore, the outcomes were compared with evidence on manual compression alone and vascular closure devices. Methods: This investigation is a two-center retrospective analysis of 120 consecutive patients who had undergone, from July 2022 to February 2023, manual compression closure of the femoral arterial access site aided by the Axiostat® hemostatic dressing. Endovascular procedures performed with introducer sheaths ranging from 4 Fr to 8 Fr were evaluated. Results: Primary technical success was achieved in 110 (91.7%) patients, with adequate hemostasis obtained in all cases of prolonged manual compression requirements. The mean time-to-hemostasis and time-to-ambulation were 8.9 (±3.9) and 462 (±199) minutes, respectively. Clinical success was achieved in 113 (94.2%) patients, with bleeding-related complications noted in 7 (5.8%) patients. Conclusions: Manual compression aided by the Axiostat® hemostatic dressing is effective and safe in achieving hemostasis of the femoral arterial access site in patients undergoing endovascular treatment with a 4–8 Fr introducer sheath

A comprehensive picture of baryons in groups and clusters of galaxies

(Abridged) Based on XMM-Newton, Chandra and SDSS data, we investigate the baryon distribution in groups and clusters and its use as a cosmological constraint. For this, we considered a sample of 123 systems, with total masses in the mass range M500 = ~ 10^13 - 4 x 10^15 h_70^-1 Msun. The gas masses and total masses are derived from X-ray data under the assumption of hydrostatic equilibrium and spherical symmetry. The stellar masses are based on SDSS-DR8 data. For the 37 systems out of 123 that had both optical and X-ray data available, we investigated the gas, stellar and total baryon mass fractions inside r2500 and r500, and the differential gas mass fraction within the spherical annulus between r2500 and r500, as a function of total mass. For the other objects, we investigated the gas mass fraction only. We find that the gas mass fraction inside r2500 and r500 depends on the total mass. However, the differential gas mass fraction does not show any dependence on total mass for systems with M500 > 10^14 Msun. We find that the total baryonic content increases with cluster mass. This led us to investigate the contribution of the ICL to the total baryon budget for lower mass systems, but we find that it cannot account for the difference observed. The gas mass fraction dependence on total mass observed for groups and clusters could be due to the difficulty of low-mass systems to retain gas inside the inner region. Due to their shallower potential well, non-thermal processes are more effective in expelling the gas from their central regions outwards. Since the differential gas mass fraction is nearly constant it provides better constraints for cosmology. Using our total f_b estimates, our results imply 0.17 < Omega_m < 0.55.Comment: Accepted for publication in A&A; 16 pages, 9 figures, 1 tabl

Intrauterine infusion of platelet-rich plasma for severe Asherman syndrome: a cutting-edge approach

Asherman syndrome (AS) consists of intrauterine adhesions development as a consequence of trauma, radiation, or infection in the endometrium. Clinical symptoms include menstrual alterations, infertility, and pregnancy complications, such as recurrent pregnancy loss or abnormal placentation. In this article, we performed a narrative review of the literature, searching electronic databases (i.e., Medline, Pubmed, and Google Scholar) to summarize the available pieces of evidence about epidemiology, pathophysiology, diagnosis, and treatment of AS. Hysteroscopy is essential for diagnosis and treatment, although adhesions may recur. Different postoperative therapies have been proposed to prevent recurrence and restore impaired endometrial function and promote endometrial regeneration, although these effects are usually temporary. We report a case of AS with adhesion recurrence and endometrial atrophy who was successfully treated with intrauterine autologous platelet–rich plasma (PRP) infusion. This therapy allowed endometrial tissue regeneration, leading to increased vascularity and endometrium thickness, and restoration of endometrial function that led to a successful pregnancy. Though there is limited experience supporting the use of PRP to improve endometrial function, it has been safely used in other fields of medicine; besides, it is easy to obtain, not expensive, and harmless being an autologous source. Future studies are encouraged to further assess this approach to treat AS