963 research outputs found
TSH-Suppressive Therapy: A Thorny Issue
Thyroid stimulating hormone (TSH)-suppressive therapy with levothyroxine is a cornerstone of thyroid carcinoma follow-up therapy, but the achievement of therapeutic goals must be balanced against L-T4 side effects. We describe the case of a 64-year-old cardiopathic patient with papillary thyroid carcinoma and autoimmune thyroiditis, whose cardiac condition worsened during TSH-suppressive therapy. TSH concentrations also fluctuated widely because of changing intestinal absorption due to coeliac disease
Dolore toracico non traumatico. Attività 2010 dell'Unità operativa semplice Chest Pain Unit del Policlinico Umberto I di Roma
Revisión Integradora: Conceptos Y Métodos Utilizados En EnfermerÃa
Resumen 
La Revisión Integradora (RI) tiene una reputación internacional en la investigación en enfermerÃa y en la práctica basada en la evidencia. Esta RI tuvo como objetivo identificar y analizar los conceptos y los métodos indicados para la realización de una RI en enfermerÃa. Fueron consultados nueve recursos de información y fuentes de literatura gris. Se incluyeron diecisiete estudios de RI. Los resultados indican que: la mayorÃa de los estudios primarios fueron realizados en EE.UU.; es posible tener varias preguntas de investigación o hipótesis e incluir estudios primarios de diferentes perspectivas teóricas y metodologÃas; es un tipo de análisis que puede ir más allá de la sÃntesis de las conclusiones de los estudios primarios, permitiendo abarcar otras dimensiones de la investigación y finalmente presenta potencial para el desarrollo de nuevas teorÃas y problemas de investigación. En conclusión, la RI es comprendida como un tipo de revisión de naturaleza compleja que demanda métodos normalizados y sistemáticos para garantizar el rigor requerido en la investigación cientÃfica y por lo tanto la legitimidad de las evidencias establecidas.
Integrative review (IR) has an international reputation in nursing research and evidence-based practice. This IR aimed at identifying and analyzing the concepts and methods recommended to undertaking IR in nursing. Nine information resources,including electronic databases and grey literature were searched. Seventeen studies were included. The results indicate that: primary studies were mostly from USA; it is possible to have several research questions or hypotheses and include primary studies in the review from different theoretical and methodological approaches; it is a type of review that can go beyond the analysis and synthesis of findings from primary studies allowing exploiting other research dimensions, and that presents potentialities for the development of new theories and new problems for research. Conclusion: IR is understood as a very complex type of review and it is expected to be developed using standardized and systematic methods to ensure the required rigor of scientific research and therefore the legitimacy of the established evidence.
A revisão integrativa (RI) apresenta reputação internacional na pesquisa em enfermagem e na prática baseada em evidências. Esta RI objetivou identificar e analisar conceitos e métodos indicados para desenvolver uma RI na enfermagem. Nove recursos informacionais bibliográficos, incluindo fontes de literatura cinzenta, foram consultados. Dezessete estudos foram incluÃdos. Os resultados indicam que os estudos foram desenvolvidos majoritariamente nos EUA; é possÃvel ter várias questões de pesquisa ou hipóteses e incluir investigações desenvolvidas através de diferentes referenciais teóricos e metodológicos; trata-se de um tipo de revisão que permite realizar análises que extrapolam a sÃntese dos resultados dos estudos primários, abrangendo outras dimensões da pesquisa e que apresenta potencialidade para o desenvolvimento de novas teorias e problemas de pesquisa. Em conclusão, a RI é compreendida como um tipo de revisão de natureza complexa, que demanda métodos normatizados e sistemáticos para garantir o necessário rigor requerido na pesquisa cientÃfica e a legitimidade das evidências estabelecidas.
Identification of woods from museum archaeological collections: use of local and non-local wood in pre-Columbian societies from northwestern Argentina
Archaeological finds of uncharred wooden artefacts are particularly rare in Northwestern Argentina. In this respect, the museum collections from the sites of La Paya and El Churcal, in the Calchaqui Valley (Northwestern Argentina), are significant owing to their excellent conservation and diversity of their uncharred wooden artifacts. However, due to necessary current conservation policy in Argentina, researchers may have limited access to artifacts and sampling possibilities. We carried out the identification of woods used to manufacture artifacts from La Paya and El Churcal collections as part of our ongoing studies on the processes of production, circulation, and consumption of raw materials and goods in societies inhabiting the Calchaqui Valley during the late pre-Columbian period (ninth to sixteenth centuries). As a result, we acquired previously unknown information on woods used to manufacture artifacts in the Calchaqui Valley. Despite working with two museum collections that offered different possibilities for intervention and different levels of accuracy of identification, we were able to obtain successful results that show similar trends between the collections.Facultad de Ciencias Naturales y MuseoLaboratorio de Investigaciones en Mader
Towards Solving Text-based Games by Producing Adaptive Action Spaces
To solve a text-based game, an agent needs to formulate valid text commands
for a given context and find the ones that lead to success. Recent attempts at
solving text-based games with deep reinforcement learning have focused on the
latter, i.e., learning to act optimally when valid actions are known in
advance. In this work, we propose to tackle the first task and train a model
that generates the set of all valid commands for a given context. We try three
generative models on a dataset generated with Textworld. The best model can
generate valid commands which were unseen at training and achieve high
score on the test set
Haptic Glove and Platform with Gestural Control For Neuromorphic Tactile Sensory Feedback In Medical Telepresence †
Haptic Glove and Platform with Gestural Control For Neuromorphic Tactile Sensory Feedback In Medical Telepresence
Advancements in the study of the human sense of touch are fueling the field of haptics. This is paving the way for augmenting sensory perception during object palpation in tele-surgery and reproducing the sensed information through tactile feedback. Here, we present a novel tele-palpation apparatus that enables the user to detect nodules with various distinct stiffness buried in an ad-hoc polymeric phantom. The contact force measured by the platform was encoded using a neuromorphic model and reproduced on the index fingertip of a remote user through a haptic glove embedding a piezoelectric disk. We assessed the effectiveness of this feedback in allowing nodule identification under two experimental conditions of real-time telepresence: In Line of Sight (ILS), where the platform was placed in the visible range of a user; and the more demanding Not In Line of Sight (NILS), with the platform and the user being 50 km apart. We found that the entailed percentage of identification was higher for stiffer inclusions with respect to the softer ones (average of 74% within the duration of the task), in both telepresence conditions evaluated. These promising results call for further exploration of tactile augmentation technology for telepresence in medical interventions
Lenalidomide in Pretreated Mantle Cell Lymphoma Patients: An Italian Observational Multicenter Retrospective Study in Daily Clinical Practice (the Lenamant Study)
Background: Mantle cell lymphoma (MCL) has the worst prognosis of B-cell subtypes owing to its aggressive clinical disease course and incurability with standard chemo-immunotherapy. Options for relapsed MCL are limited, although several single agents have been studied. Lenalidomide is available in Italy for patients with MCL based on a local disposition of the Italian Drug Agency. Subjects, Materials, and Methods: An observational retrospective study was conducted in 24 Italian hematology centers with the aim to improve information on effectiveness and safety of lenalidomide use in real practice. Results: Seventy patients received lenalidomide for 21/28 days with a median of eight cycles. At the end of therapy, there were 22 complete responses (31.4%), 11 partial responses, 6 stable diseases, and 31 progressions, with an overall response rate of 47.1%. Eighteen patients (22.9%) received lenalidomide in combination with either dexamethasone (n = 13) or rituximab (n = 5). Median overall survival (OS) was reached at 33 months and median disease-free survival (DFS) at 20 months: 14/22 patients are in continuous complete response with a median of 26 months. Patients who received lenalidomide alone were compared with patients who received lenalidomide in combination: OS and DFS did not differ. Progression-free survivals are significantly different: at 56 months, 36% in the combination group versus 13% in patients who received lenalidomide alone. Toxicities were manageable, even if 17 of them led to an early drug discontinuation. Conclusion: Lenalidomide therapy for relapsed MCL patients is effective and tolerable even in a real-life context. Implication for Practice: Several factors influence treatment choice in relapsed/refractory mantle cell lymphoma (rrMCL), and the therapeutic scenario is continuously evolving. In fact, rrMCL became the first lymphoma for which four novel agents have been approved: temsirolimus, lenalidomide, ibrutinib, and bortezomib. The rrMCL therapeutic algorithm is not so well established because data in the everyday clinical practice are still poor. Lenalidomide for rrMCL patients is effective and tolerable even in a real-life context
Endocrine and bone disease in appropriately treated adult patients with beta-thalassemia major
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