An Attempt to Identify Meaningful Descriptors of Handgrip Strength Using a Novel Prototype: Preliminary Study

Handgrip strength (HGS) is an indicator of muscle condition and general health wellbeing. Usually, instruments measuring handgrip strength only identify its maximum value. This preliminary study is focused on identifying force vs. time parameters which could contribute to better describe individual strength. They were obtained during a Handgrip strength test of 15 s in a sample group of 94 university students. The tests were conducted with a smart multifunction novel prototype dynamometer, named BodyGrip. Mean values of quantities related to the ability to develop and to maintain strength in percentage of maximum handgrip strength, were extracted from the force vs time profile. Contrary to maximum HGS, such quantities were found to be independent of the participant's anthropometric characteristics. Individual comparisons based on those quantities are therefore not affected by the anthropometric characteristics. It was possible to identify individuals, differing on the development of HGS. Results suggest that the functionality of the BodyGrip tool enables a more thorough characterization of the time profile of the Handgrip strength that might influence the knowledge of the muscle functions, such as power development and endurance

Handgrip strength time profile and frailty: an exploratory study

This study aims to explore the use of force vs. time data obtained from an isometric handgrip test to match a frailty state based on the TFI score. BodyGrip, a novel prototype system, is used for handgrip strength over 10 s time interval tests. A cross-sectional study with a non-probabilistic sample of community-dwelling elderly women was conducted. The force/time data collected from the dominant handgrip strength test, together with the Tilburg Frailty Indicator (TFI) test results, were used to train artificial neural networks. Different models were tested, and the frailty matching of TFI scores reached a minimum accuracy of 75%. Despite the small sample size, the BodyGrip system appears to be a promising tool for exploring new frailty-related features. The adopted strategy foresees ultimately configuring the system to be used as an expedite mode for identifying individuals at risk, allowing an easy, quick, and frequent person-centered care approach. Additionally, it is suitable for following up of the elderly in particular, and it may assume a relevant role in the mitigation of the increase in frailty evolution during and after the imposed isolation of the COVID-19 pandemic. Further use of the system will improve the robustness of the artificial neural network algorithm.info:eu-repo/semantics/publishedVersio

QUESTIONI ATTUALI, PROBLEMATICHE E PROSPETTIVE DEL TRATTAMENTO PENITENZIARIO DOPO LA LEGGE 81/2014

Il novum normativo che ha portato alla chiusura degli OPG ed all’istituzione delle REMS ha prodotto significativi cambiamenti, da un lato, di ordine giuridico, dall’altro di tipo trattamentale. Riguardo i primi, l’assenza di modifiche al codice penale, al codice di procedura penale, nonché all’ordinamento penitenziario, ha determinato il nascere di situazioni limite, talora non assicurate da adeguati contesti normativi, che hanno generato difficoltà di gestione e rischi per i pazienti e la collettività. In tale contesto gli autori discuteranno le implicazioni clinico-giuridiche della previsione di limitazione della durata massima della misura di sicurezza detentiva, delle problematiche legate alla mancata sostituzione di alcune funzioni degli OPG da parte delle REMS (infermità psichica sopravvenuta al condannato) e le possibili soluzioni.&nbsp

A propensity score-weighted comparison between adalimumab originator and its biosimilars, ABP501 and SB5, in inflammatory bowel disease: a multicenter Italian study

Background: Adalimumab is an effective and safe biological drug for the treatment of inflammatory bowel disease (IBD). Nowadays, several biosimilar agents are available, but data regarding their efficacy and safety in patients with IBD are still lacking. We aimed to compare the effectiveness and tolerability between adalimumab originator, ABP501 and SB5 biosimilars in patients with IBD in the short term (after induction and after 6 months of treatment) through a propensity score-weighted multicenter cohort study. Methods: We included 156 patients with IBD, 69 patients with ulcerative colitis and 87 patients with Crohn's disease (CD) receiving ABP501 or SB5 biosimilars from January 2019 to April 2020 for moderate-to-severe disease. For comparison, a group of age- and sex-matched patients treated with adalimumab originator was used. We collected clinical and biochemical data after induction and at 6 months of treatment. Endoscopic data were recorded only at baseline. Results: Overall, clinical benefit was achieved by 86.4% and 85.3% after induction and at 6 months, respectively, without a statistically significant difference between the three treatment groups (p = 0.68 and p = 0.46). However, after induction, we found significant differences between the two types of the disease (ulcerative colitis or CD, p = 0.004), with a greater clinical benefit achieved by patients with CD. Also, the therapeutic optimization rate between the three drugs was not statistically significant different (p = 0.30). All treatments showed a good safety profile, with only 10 patients who needed to stop therapy because of adverse events. Conclusion: Adalimumab biosimilars seem to be as effective and safe as the originator in patients with IBD. Surely, they represent a great opportunity to reduce the costs of biological therapies, however larger and longer real-life studies are necessary

Ruxolitinib – better prognostic impact in low-intermediate 1 risk score: evaluation of the ‘rete ematologica pugliese’ (REP) in primary and secondary myelofibrosis

We evaluated ruxolitinib in 65 patients with myelofibrosis according to age, sex, time of diagnosis, grade of fibrosis, prognostic score risk, Janus kinase (JAK) status, primary or secondary myelofibrosis, previous treatment, and dosage. Outcome measures were response rate, time to response, duration of response, and event-free survival and survival. Kaplan and Meier curves show a significant difference in event-free survival according to the prognostic score, in favor of patients with low int1 (p = 0.0009). The Cox stepwise model confirmed the result, the int2 high-risk score being the most powerful negative independent parameter (0.001), followed by JAK (0.008); other parameters, such as diagnosis more than 5 years earlier, grade III–IV fibrosis, and ruxolitinib dose have a negligible impact. Time to response was shorter (p = 0.001) in primary myelofibrosis. In conclusion, ruxolitinib is effective, with a better outcome in patients with a low-int1 risk score. This may suggest considering an earlier administration in the disease course

Association between hypoxic volume and underlying hypoxia-induced gene expression in oropharyngeal squamous cell carcinoma (OPSCC):Hypoxia biomarkers from 64Cu-ATSM PET/CT imaging

Background: Hypoxia imaging is a promising tool for targeted therapy but the links between imaging features and underlying molecular characteristics of the tumour have not been investigated. The aim of this study was to compare hypoxia biomarkers and gene expression in oropharyngeal squamous cell carcinoma (OPSCC) diagnostic biopsies with hypoxia imaged with 64Cu-ATSM PET/CT. Methods: 64Cu-ATSM imaging, molecular and clinical data were obtained for 15 patients. Primary tumour SUVmax, tumour to muscle ratio (TMR) and hypoxic volume were tested for association with reported hypoxia gene signatures in diagnostic biopsies. A putative gene signature for hypoxia in OPSCCs (hypoxic volume-associated gene signature (HVS)) was derived. Results: Hypoxic volume was significantly associated with a reported hypoxia gene signature (rho=0.57, P=0.045), but SUVmax and TMR were not. Immunohistochemical staining with the hypoxia marker carbonic anhydrase 9 (CA9) was associated with a gene expression hypoxia response (rho=0.63, P=0.01). Sixteen genes were positively and five genes negatively associated with hypoxic volume (adjusted P<0.1; eight genes had adjusted P<0.05; HVS). This signature was associated with inferior 3-year progression-free survival (HR=1.5 (1.0–2.2), P=0.047) in an independent patient cohort. Conclusions: 64Cu-ATSM-defined hypoxic volume was associated with underlying hypoxia gene expression response. A 21-gene signature derived from hypoxic volume from patients with OPSCCs in our study may be linked to progression-free survival

Ações do enfermeiro da Estratégia Saúde da Família na promoção do envelhecimento saudável

O presente trabalho teve como personagens de pesquisa os enfermeiros, trabalhadores da Estratégia Saúde da Família (ESF) de um Município do Extremo Sul Catarinense- SC. Como protagonistas apresentamos os idosos, população esta crescente necessitando de cuidados e tratamentos específicos, buscando identificar ações do enfermeiro na ESF na Promoção de um Envelhecimento Saudável com qualidade de vida e autonomia. A questão do envelhecimento demográfico, relacionado ao aumento da expectativa de vida e uma diminuição das taxas de fecundidade, vem apresentando desafios ao setor saúde, despertando provocações aos enfermeiros das ESF e os demais trabalhadores da saúde, pois trabalham diretamente no cotidiano com esta demanda, necessitando desenvolver ações que promovam um envelhecimento saudável. O objetivo deste estudo foi de conhecer as ações do enfermeiro da ESF na promoção do envelhecimento saudável. Para isso foram realizadas entrevistas semiestruturadas, abrangendo 100% das equipes de ESFs de um Município do Extremo Sul Catarinense, com 05 enfermeiros, no período entre março e maio de 2015. Evidenciou-se a falta de ações específicas ao envelhecimento saudável no trabalho cotidiano dos enfermeiros nas ESF, pela falta de apoio ou incentivo para Atenção Primária de Saúde, com ações de promoção/prevenção contribuindo com um envelhecimento ativo, humanizado e com qualidade de vida

Ansiedade materna durante a pandemia do Covid-19 em maternidade escola de Natal/RN/ Maternal anxiety during the Covid-19 pandemic in a maternity teaching hospital

Objetivo: Avaliar a ansiedade materna no final da gestação em mulheres que deram à luz em maternidade escola da cidade de Natal - RN, durante a pandemia da COVID-19. Métodos: Estudo descritivo, de corte transversal, realizado no período de 01 de junho a 31 de julho de 2020. Foram incluídas puérperas que atenderam aos seguintes critérios: idade materna acima dos 18 anos, recém-nascido único, vivo e sem malformações, ausência de transtorno mental, acima de 36 semanas de gestação e sem complicações no parto. As participantes foram entrevistadas no puerpério, antes da alta hospitalar. Foi aplicado questionário sociodemográfico e a ansiedade foi avaliada pelo Beck Anxiety Inventory (BAI), validado para o português do Brasil, sobre sinais e sintomas observados nos sete dias antes do parto. Resultados: Foram entrevistadas 438 mulheres, e a ansiedade leve foi verificada em 7,5% e a moderada/grave em 1,1%. Foi verificada diferença significativa na proporção de ansiedade leve, moderada ou grave de acordo com a paridade (nulíparas 5,3% vs. multíparas 11.2%, P=0,02), com o estado marital (com parceiro 7,5% vs. sem parceiro 17,0%, P=0,02), com a idade gestacional no parto (36 a 37 semanas 25,6% vs. ≥ 37 semanas 6,8%, P&lt;0,001) e com o peso do recém-nascido (&lt; 2.500g 26,1% vs. ≥ 2.500g 7,7%, P=0,002). Na análise multivariada, foram identificados como fatores independentes associados com a ansiedade materna leve, moderada ou grave as variáveis: gestação de 36 a 37 semanas (ORa 4,10, IC 95% 1,75-9,58, P&lt;0,01), peso do recém-nascido &lt; 2.500g (ORa 3,15, IC 95% 1,05-9,48, P=0,04), cor branca (ORa 2,52, IC 95% 1,04-6,09, P=0,03) e nuliparidade (ORa 0,37, IC 95% 0,17-0,82, P=0,01). Conclusão: A ansiedade materna no final da gestação foi baixa na população analisada e foi associada com o parto ocorrido entre 36 a 37 semanas, baixo peso do recém-nascido e a cor branca. A nuliparidade mostrou ser fator protetor reduzindo a chance de ansiedade materna