Psychological complications in patients with acromegaly: relationships with sex, arthropathy, and quality of life

Current treatment of acromegaly restores a normal life expectancy in most cases. So, the study of persistent complications affecting patients' quality of life (QoL) is of paramount importance, especially motor disability and depression. In a large cohort of acromegalic patients we aimed at establishing the prevalence of depression, to look for clinical and sociodemographic factors associated with it, and to investigate the respective roles (and interactions) of depression and arthropathy in influencing QoL

Evaluation of appendicitis risk prediction models in adults with suspected appendicitis

Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent). Conclusion Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified

Arthrodesis and Hemiarthroplasty: Different Techniques in the Treatment of Hallux Rigidus—Surgery and Postoperative Rehabilitation

Hallux rigidus (HR) is a progressive degenerative pathology affecting the first metatarsophalangeal joint. The aim of the present study is to report our experience on the treatment of HR patients with two different surgical methods: arthrodesis and hemiarthroplasty. Twelve patients (14 HR) underwent surgery for HR from July 2004 to October 2009. Median age was 58 years (Interquartile Range (IQR) 52.75–65.0). At time of surgery, patients had different grades of HR, according to the Regnauld modified classification. The outcome was assessed using the American Orthopedic Foot and Ankle Society (AOFAS) Hallux Metatarsophalangeal-Interphalangeal (HMI) scale. Controls were performed at one month and then at mid-term follow-up (median 48 months; IQR 29.3–58.0). In the arthrodesis group (n = 6 HR) we observed a median improvement of 35.5 points (IQR 34.75–36.0; p = 0.036) at the early follow-up. In the hemiarthroplasty (n = 8 HR) group the median of differences at the one-month follow-up was 33 (IQR 30.5–33.0; p = 0.022). At mid-term follow-up the arthrodesis group showed the median difference score of 35 (IQR 33.0–35.25) in comparison with the hemiarthroplasty group which showed a median score of 30.5 (IQR 28.0–32.5). Our results are consistent with the current understanding of two surgical techniques for the treatment of HR: nowadays, arthrodesis is considered the treatment of choice in grade III and IV. Hemiarthroplasty seems to be a promising option. Management of pain and joint flexibility are fundamental to prevent relapses and restore the Range Of Motion (ROM) in dorsal flexion. This article is a retrospective case series with a level of evidence 4

A Phoenician Inscription from Cyprus in the Cesnola Collection at the Turin University Museum of Anthropology and Ethnography

International audienceA previously unpublished marble fragment from the Cesnola collection at the Turin University Museum of Anthropology and Ethnography bears an incomplete Phoenician inscription, a dedication to Eshmun-Melqart considered lost since 1869 (CIS I 26). The inscription allows to interpret the object bearing the dedication as a votive stone bowl from the late Classical Phoenician sanctuary of Kition-Batsalos in Cyprus, and it provides the opportunity to retrace the history of the Cesnola collection of Cypriote antiquities at the University Museum of Turin

Automatic generation of 3D animations from text and images

The understanding of information in a text description can be improved by visually accompanying it with images or videos. This opportunity is particularly relevant for books and other traditional instructional material. Videos or, more in general, (interactive) graphics contents, can help to increase the effectiveness of this material, by providing, e.g., an animated representation of the steps to be performed to carry out a given procedure. The generation of 3D animated contents, however, is still very labor-intensive and time-consuming. Systems able to speed up this process offering flexible and easy-to-use interfaces are becoming of paramount importance. Hence, this paper describes a system designed to automatically generate a computer graphics video by processing a text description and a set of associated images. The system combines Natural Language Processing and image analysis for extract- ing information needed to visually represent the procedure depicted in an instruction manual using 3D animations. It relies on a database of 3D models and preconfigured animations that are activated according to the information extracted from the said input. Moreover, by analyzing the images, the system can also generate new animations from scratch. Promising results have been obtained assessing the system performance in a specific use case focused on printers maintenance

Leptin, Leptin Receptor, KHDRBS1 (KH RNA Binding Domain Containing, Signal Transduction Associated 1), and Adiponectin in Bone Metastasis from Breast Carcinoma: An Immunohistochemical Study

Breast cancer patients are at a high risk of complications from bone metastasis. Molecular characterization of bone metastases is essential for the discovery of new therapeutic targets. Here, we investigated the expression and the intracellular distribution of KH RNA binding domain containing, signal transduction associated 1 (KHDRBS1), leptin, leptin receptor (LEPR), and adiponectin in bone metastasis from breast carcinoma and looked for correlations between the data. The expression of these proteins is known in breast carcinoma, but it has not been investigated in bone metastatic tissue to date. Immunohistochemical analysis was carried out on bone metastasis specimens, then semiquantitative evaluation of the results and the Pearson test were performed to determine eventual correlations. KHDRBS1 expression was significantly higher in the nuclei than in the cytosol of metastatic cells; LEPR was prevalently observed in the cytosol and the nuclei; leptin and adiponectin were found in metastatic cells and stromal cells; the strongest positive correlation was between nuclear KHDRBS1 and nuclear LEPR expression. Taken together, our findings support the importance of the leptin/LEPR/KHDRBS1 axis and of adiponectin in the progression of bone metastasis and suggest their potential application in pharmacological interventions

Low-Energy Extracorporeal Shock-Wave Therapy in the Treatment of Chronic Insertional Achilles Tendinopathy: A Case Series

Introduction. We report the results of a series of 40 patients with chronic insertional Achilles tendinopathy treated with low-energy ESWT after the failure of a 3-month program of eccentric exercises alone. Methods and Materials. 40 patients, 28 (70%) males and 12 (30%) females, were treated between January and December 2014. All patients were previously treated with only eccentric exercises for a 3-month period. The treatment protocol included 4 sessions of ESWT with a 2-week interval, from 800 shots in each one (4 Hz, 14 KeV), together with eccentric exercises. Visual Analogue Scale (VAS) and American Orthopedic Foot and Ankle Society (AOFAS) Hindfoot score were recorded. Results. At the 12-month follow-up, 26 (65.0%) patients did not complain about pain (VAS < 2), 11 (27.5%) patients got back to normal activities despite residual pain (VAS 2–4), and 3 (7.5%) of the patients still complained about pain (VAS > 4). There was no significative improvement in both scores after eccentric exercises alone. Mean VAS improvement was 5.8±1.3 SD points (P<0.001). Mean AOFAS Hindfoot score improvement was 19.8±5.0 SD points (P<0.001). Conclusions. ESWT is recommended, in combination with an eccentric exercise program, in patients with chronic Achilles tendinopathy being both insertional and not

Differentiated thyroid carcinoma presentation may be more aggressive in children and adolescents than in young adults

Abstract Background The available studies concerning the influence of age on the phenotypical expression of differentiated thyroid carcinoma (DTC) have hitherto compared DTC presentation either between pre-pubertal and pubertal children or between pediatric patients and aged adults; aim of this study was to ascertain for the first time whether presentation of DTC may significantly vary according to age, even within a peculiar study population covering only young patients aged less than 30 years. Methods The main clinical, biochemical and pathologic data at DTC diagnosis were retrospectively recorded in 2 selected cohorts including, respectively, 18 children and adolescents aged less than 18 years (Group A) or 45 young adults aged between 20 and 29.8 years (Group B). Results The statistical distribution of DTC cases in the different age ranges was found to progressively increase with increasing age; furthermore, the patients of Group A exhibited at diagnosis a more severe clinical involvement and a higher rate of extra-regional metastases; finally, also the association with both autoimmune thyroid diseases (AITDs) and a biochemical hypothyroid pattern was more common in Group A patients. Conclusions In a study population younger than 30 years: a) the risk of developing DTC increases with age, achieving its zenith during the 3rd decade of life; b) clinical presentation is more severe in children and adolescents younger than 18 years than in the patients aged between 20 and 30; c) in the cohort of children and adolescents DTC is more often associated with AITDs, which might play some role in conditioning the more aggressive phenotypical presentation of DTC in this patient group

The Influence of Food Regimes on Oxidative Stress: A Permutation-Based Approach Using the NPC Test

(1) Background: This paper aims to assess the existence of significant differences between two dietary regimes (omnivorous vs. semi-vegetarian) with reference to some oxidative stress markers (SOD, GPx, TRxR, GR, AGEs, and AOPPs) using non-parametric combination methodology based on a permutation test. (2) Methods: At the endocrinology unit of Messina University Hospital, two hundred subjects were asked to fill out a questionnaire about their dietary habits. None were under any pharmacological treatment. Using the NPC test, all comparisons were performed stratifying patients according to gender, age (≤40 or >40 years), BMI (normal weight vs. overweight), physical activity (sedentary vs. active lifestyle), TSH, FT4 levels in quartiles, and diagnosis of Hashimoto’s thyroiditis. We evaluated differences in oxidative stress parameters in relation to two examined dietary regimes (omnivorous vs. semi-vegetarian). (3) Results: The antioxidant parameters GPx and TRxR were significantly lower in subjects with an omnivorous diet than in semi-vegetarians, particularly in females, both age groups, subjects with normal weight, those not affected by Hashimoto’s thyroiditis, and both the sedentary and active lifestyle groups. Finally, the AGE and AOPP markers were significantly lower in semi-vegetarians. (4) Conclusion: Thanks to the NPC methodology, we can state that dietary patterns exert a significant influence on some oxidative stress parameters