Conservative Surgical Treatment of Tongue Hemangiopericytoma

Hemangiopericytoma is a vascular tumor that is believed to arise from the Zimmermann's pericytes, smooth muscles cells localized around the blood vessels. This tumor presents as a slowly enlarging painless mass with a clear predilection for the musculoskeletal system. The aim of this work was to introduce a peculiar case of a tongue hemangiopericytoma managed by conservative surgical treatment

Epidemiology of maxillofacial trauma in the elderly: a European multicenter study

ABSTRACT Introduction: The progressive aging of European population seems to determine a change in the epidemiology, incidence and etiology of maxillofacial fractures with an increase in the frequency of old patients sustaining craniofacial trauma. The objective of the present study was to assess the demographic variables, causes, and patterns of facial fractures in elderly population (with 70 years or more). Materials and Methods: The data from all geriatric patients (70 years or more) with facial fractures between January 1, 2013, and December 31, 2017, were collected. The following data were recorded for each patient: gender, age, voluptuary habits, comorbidities, etiology, site of facial fractures, synchronous body injuries, Facial Injury Severity Score (FISS). Results: A total of 1334 patients (599 male and 735 female patients) were included in the study. Mean age was 79.3 years, and 66% of patients reported one or more comorbidities. The most frequent cause of injury was fall and zygomatic fractures were the most frequently observed injuries. Falls were associated with a low FISS value (p<.005). Concomitant injuries were observed in 27.3% of patients. Falls were associated with the absence of concomitant injuries. The ninth decade (p <.05) and a high FISS score (p <.005) were associated with concomitant body injuries too. Conclusions: This study confirms the role of falls in the epidemiology of facial trauma in the elderly, but also highlights the frequency of involvement of females, and the high frequency of zygomatic fractures.Peer reviewe

Fatality rate and predictors of mortality in an Italian cohort of hospitalized COVID-19 patients

Clinical features and natural history of coronavirus disease 2019 (COVID-19) differ widely among different countries and during different phases of the pandemia. Here, we aimed to evaluate the case fatality rate (CFR) and to identify predictors of mortality in a cohort of COVID-19 patients admitted to three hospitals of Northern Italy between March 1 and April 28, 2020. All these patients had a confirmed diagnosis of SARS-CoV-2 infection by molecular methods. During the study period 504/1697 patients died; thus, overall CFR was 29.7%. We looked for predictors of mortality in a subgroup of 486 patients (239 males, 59%; median age 71 years) for whom sufficient clinical data were available at data cut-off. Among the demographic and clinical variables considered, age, a diagnosis of cancer, obesity and current smoking independently predicted mortality. When laboratory data were added to the model in a further subgroup of patients, age, the diagnosis of cancer, and the baseline PaO2/FiO2 ratio were identified as independent predictors of mortality. In conclusion, the CFR of hospitalized patients in Northern Italy during the ascending phase of the COVID-19 pandemic approached 30%. The identification of mortality predictors might contribute to better stratification of individual patient risk

Mesure de dose ionisante en champs de rayonnement mixte

The Total Ionizing Dose (TID) monitoring is nowadays a crucial task for a wide range of applications running in harsh radiation environments. In view of the High-Luminosity upgrade for the Large Hadron Collider, the monitoring of radiation levels along the CERN’s accelerator complex will become even more challenging. To this extent, a more detailed knowledge of the radiation field in the accelerator tunnel and its adjacent areas becomes necessary to design installation, relocation or shielding requirements of electronics sensitive to radiation. Aiming to improve the monitoring of the TID delivered by the mixed radiation field generated within the accelerator system, investigations on new suitable dosimeters have been carried out.With this research, two devices have been studied and characterized to be employed as dosimeter and possibly to complete the use of the silicon sensor currently employed at CERN for TID monitoring, i.e. the RADiation-sensitive Field Effect Transistor (RADFET): a commercial NMOS, and an ASIC (Application-Specific Integrated Circuit) named FGDOS. The devices have been selected following two opposite approaches: on the one hand, reducing the costs would allow the density of the deployed sensors to increase. As a direct consequence, a more detailed dose map would be obtained for large distributed systems like the LHC. On the other hand, the radiation monitoring can be further improved by deploying more sensitive detectors, which would allow to measure the dose where the levels are too low for the RADFET. Moreover, sensors with higher resolution would permit the characterization of the radiation field in a shorter time, which means within a lower integrated luminosity.The first approach has been accomplished by searching for alternative solutions based on COTS (Commercial Off-The-Shelf) devices, which would significantly reduce the costs and guarantee unlimited availability on the market. For this aim, investigations on a commercial discrete NMOS transistor, which was found to be very sensitive to the radiation, has been carried out.The need for improving the resolution of TID monitoring led to investigate the FGDOS, which is an innovative silicon dosimeter with a very high sensitivity that permits to detect extremely low doses.The calibration of the NMOS and the FGDOS have been performed by exposing the dosimeters to γ-ray. Their radiation response has been characterized in terms of linearity, batch-to-batch variability, and dose rate effect. The influence of the temperature has been studied and a method to compensate the temperature effect has been developed and implemented.Being the FGDOS is a System-On-Chip with several features that make the dosimeter an extremely flexible system, the characterization of its operational modes (Active, Passive and Autonomous) have been performed. Following the first characterization, some questions arose concerning the sensitivity degradation mechanisms affecting the dosimeter. To investigate this phenomenon, radiation experiments were performed with a test chip embedding only the radiation sensitive circuit of the FGDOS. The analysis of the experiments allowed the understating of the processes responsible for the sensitivity degradation, by separating the contribution of the reading transistor and the floating gate capacitor. The results of this investigation led us to considerer new design solution and compensation methods.The suitability of the NMOS and the FGDOS for TID measurement in the mixed radiation field produced by the CERN’s accelerator complex has been verified by performing accelerated radiation tests at the Cern High energy AcceleRator Mixed field facility (CHARM). The consistency of both sensors with the RADFET measurement has been demonstrated. The high sensitivity of the FGDOS leads to a significant improvement in terms of TID measurement in mixed radiation fields with respect to the RadFET, especially for low radiation intensities.La mesure de la dose ionisante est aujourd'hui une tâche cruciale pour une large gamme d'applications fonctionnant dans des environnements de rayonnement sévères. Dans le contexte de l'amélioration de la luminosité du grand collisionneur de hadrons (LHC), la mesure des niveaux de rayonnement le long du complexe d'accélérateurs du CERN va devenir encore plus difficile. A cet effet, une connaissance plus détaillée du champ de rayonnement dans le tunnel de l'accélérateur et ses zones adjacentes devient nécessaire pour définir les exigences d'installation, de déplacement ou de blindage de l'électronique sensible au rayonnement. Dans l’objectif d’améliorer la mesure de la dose absorbée par les systèmes exposés au champ de rayonnement mixte généré par l’accélérateur, des investigations sur des nouveaux dosimètres ont été menées.Dans le cadre de cette recherche, deux dispositifs ont été étudiés et caractérisés pour être utilisés comme dosimètres et éventuellement pour compléter l'utilisation du dosimètre au silicium actuellement utilisé au CERN, à savoir le RADFET (RADiation-sensitive Field Effect Transistor) : un NMOS commercial et un ASIC (Application-specific Integrated Circuit) nommé FGDOS. Les dispositifs ont été sélectionnés selon deux approches opposées : d'une part, la réduction des coûts permettrait d'augmenter la densité des capteurs déployés. En conséquence directe, une carte des doses plus détaillée serait obtenue pour les grands systèmes distribués comme le LHC. D'autre part, la dosimétrie peut être améliorée en déployant des détecteurs plus sensibles, ce qui permettrait de mesurer la dose lorsque les niveaux sont trop faibles pour le RADFET. De plus, des capteurs à plus haute résolution permettraient de caractériser le champ de rayonnement dans un temps plus court, c'est-à-dire avec une luminosité intégrée plus faible.La première approche a été réalisée en recherchant des solutions alternatives basées sur des dispositifs COTS (Commercial Off-The-Shelf), qui réduiraient considérablement les coûts et garantiraient une disponibilité illimitée sur le marché. À cette fin, des recherches ont été menées sur un transistor NMOS discret commercial, qui s'est révélé très sensible au rayonnement.La nécessité d'améliorer la résolution de la mesure de dose a conduit à étudier le FGDOS, un dosimètre en silicium innovant à très haute sensibilité qui permet de détecter des doses extrêmement faibles.La calibration du transistor NMOS et du FGDOS a été effectuées en exposant les dosimètres à des rayons gamma. Leur réponse au rayonnement a été caractérisée en termes de linéarité, de variabilité d'un lot à l'autre et d'effet du débit de dose. L'influence de la température a été étudiée et une méthode pour compenser l'effet de la température a été développée et mise en œuvre.Le FGDOS étant un système sur puce (SoC) avec plusieurs caractéristiques qui font du dosimètre un système extrêmement flexible, la caractérisation de ses différents modes de fonctionnement (actif, passif et autonome) a été effectuée. Suite à la première caractérisation, des questions se sont posées concernant les mécanismes de dégradation de la sensibilité affectant le dosimètre. Pour étudier ce phénomène, des campagnes d’irradiations ont été effectuées avec une puce d'essai incorporant seulement le circuit sensible au rayonnement du FGDOS. L'analyse des expériences a permis de comprendre les processus responsables de la dégradation de la sensibilité, en séparant la contribution du transistor de lecture de celle du condensateur à grille flottante. Les résultats de cette étude nous ont amenés à envisager de nouvelles solutions de conception et des méthodes de compensation.L’aptitude du transistor NMOS et du FGDOS à mesurer la dose ionisante dans les champs de rayonnement mixtes produits par le complexe d’accélérateurs du CERN a été vérifiée à l’aide de test radiatifs accélérés effectués dans le centre de tests en champs mixte à haute énergie du CERN (CHARM)