Percutaneous injection of radiopaque gelified ethanol for the treatment of lumbar and cervical intervertebral disk herniations: experience and clinical outcome in 80 patients.

BACKGROUND AND PURPOSE: Chemonucleolysis represents a minimally invasive percutaneous technique characterized by an intradiskal injection of materials under fluoroscopic or CT guidance. Recently, a substance based on radiopaque gelified ethanol has been introduced. The purpose of this study was to describe the indications, procedure, safety, and efficacy of radiopaque gelified ethanol in the percutaneous treatment of cervical and lumbar disk herniations. MATERIALS AND METHODS: Between September 2010 and August 2013, 80 patients (32 women and 48 men; age range, 18–75 years) were treated for 107 lumbar disk herniations (L2–L3, n = 1; L3–L4, n = 15; L4–L5, n = 53; and L5–S1, n = 38) and 9 cervical disk herniations (C4–C5, n = 2; C5–C6, n = 2; C6–C7, n = 3; and C7–D1, n = 2) by percutaneous intradiskal injection of radiopaque gelified ethanol under fluoroscopic guidance. Thirty-six patients underwent a simultaneous treatment of 2 disk herniations. Patient symptoms were resistant to conservative therapy, with little or no pain relief after 4–6 weeks of physical therapy and drugs. All patients were evaluated by the Visual Analog Scale and the Oswestry Disability Index. RESULTS: Sixty-two of 73 (85%) patients with lumbar disk herniations and 6/7 (83%) patients with cervical disk herniations obtained significant symptom improvement, with a Visual Analog Scale reduction of at least 4 points and an Oswestry Disability Index reduction of at least 40%. Leakage of radiopaque gelified ethanol in the surrounding tissues occurred in 19 patients, however without any clinical side effects. CONCLUSIONS: In our experience, percutaneous intradiskal injection of radiopaque gelified ethanol is safe and effective in reducing the period of recovery from disabling symptoms

a sonographic quantitative cutoff value of cerebral venous outflow in neurologic diseases a blinded study of 115 subjects

BACKGROUND AND PURPOSE: The autonomic nervous system maintains constant cerebral venous blood outflow in changing positions. Alterations in cerebral autoregulation can be revealed by postural changes at quantitative color Doppler sonography. The aim of this study was to reach an optimal cutoff value of the difference between the cerebral venous blood outflow in the supine and seated positions that can discriminate healthy controls from patients with multiple sclerosis and those with other neurologic diseases and to evaluate its specificity, sensitivity, and diagnostic accuracy. MATERIALS AND METHODS: One hundred fifteen subjects (54 with MS, 31 healthy controls, 30 with other neurologic diseases) underwent a blinded quantitative color Doppler sonography evaluation of cerebral venous blood outflow in the supine and sitting positions. An optimal difference value between the supine and sitting positions of the cerebral venous blood outflow cutoff value was sought. RESULTS: The difference value between supine and sitting positions of the cerebral venous blood outflow was ≤ 503.24 in 38/54 (70.37%) patients with MS, 9/31 (29.03%) healthy controls, and 13/30 (43.33%) subjects with other neurological diseases. A difference value between supine and sitting positions of the cerebral venous blood outflow at a 503.24 cutoff reached a sensitivity at 70.37%, a 70.96% specificity, a 80.85% positive predictive value, and a 57.89% negative predictive value; the quantitative color Doppler sonography parameters yielded significant differences. The difference value between supine and sitting positions of cerebral venous blood outflow ≤ 503.24 assessed the significant difference between MS versus other neurological diseases. CONCLUSIONS: Alteration of cerebral venous blood outflow discriminated MS versus other neurologic diseases and MS versus healthy controls. The difference value between supine and sitting positions of cerebral venous blood outflow ≤ 503.24 was statistically associated with MS

Influenza D virus: Serological evidence in the Italian population from 2005 to 2017

Influenza D virus is a novel influenza virus, which was first isolated from an ailing swine in 2011 and later detected in cattle, suggesting that these animals may be a primary natural reservoir. To date, few studies have been performed on human samples and there is no conclusive evidence on the ability of the virus to infect humans. The aim of this serological study was to assess the prevalence of antibodies against influenza D virus in human serum samples collected in Italy from 2005 to 2017. Serum samples were analysed by haemagglutination inhibition and virus neutralization assays. The results showed that the prevalence of antibodies against the virus increased in the human population in Italy from 2005 to 2017, with a trend characterized by a sharp increase in some years, followed by a decline in subsequent years. The virus showed the ability to infect and elicit an immune response in humans. However, prevalence peaks in humans appear to follow epidemics in animals and not to persist in the human population

Integrated and patient-centred management of Parkinson’s disease:a network model for reshaping chronic neurological care

Contains fulltext : 221521.pdf (Publisher’s version ) (Closed access

Transmission of risks between energy and agricultural commodities: Frequency time-varying VAR, asymmetry and portfolio management

This paper examines energy and agricultural commodities' short-run and long-run connectedness by using the Time-varying parameter vector autoregressions (TVP-VAR). It applies the frequency version of the TVP-VAR model, which is a modified version of the dynamic TVP-VAR model. The frequency decomposition definition also decomposes into short-run and long-run connectedness. We further the analysis by investigating the effect of asymmetry in returns on connectedness. It also examines how portfolio management strategies would lead to a maximization of profits with minimal risks. Empirical evidence indicates that only 32.52% and 31.38% of connectedness in oil and gas, respectively, are transmitted to agricultural commodities, which suggests their weak tendencies in influencing agricultural commodities; the total connectedness index hovers around 40-60% in the 2018-2019 period; however, it dropped below 40% in 2020-2021 when the COVID-19 pandemic contributed to disintegrate the connectedness between energy and agricultural commodities but increased further during the 2022 Russia-Ukraine saga. The findings also indicate that corn, wheat, and flour are net transmitters of risks to oil and natural gas in the long and short-run, and wheat-flour pairwise connectedness is the strongest in the connectedness. Asymmetry is also pronounced in the network of connectedness. Portfolio analyses indicate that investors require a low proportion of energy in a portfolio of energy-agricultural commodities to achieve an optimum profit. The findings will offer exciting insights into the connectedness of agricultural and energy commodities, particularly during periods of high price uncertainty

The Wikiplantbase project: the role of amateur botanists in building up large online floristic databases

The Wikiplantbase project, started in 2013, provides a framework where the full set of georeferenced floristic records of Tuscany and Sardinia can be entered, stored, updated and freely accessed through the Internet. Mainly thanks to the collaboration of amateur botanists, data have accumulated quickly. All records entered by collaborators are submitted to the project coordinators, who are enabled to accept, modify, or reject them. As of 22 November 2016, Wikiplantbase #Toscana holds 116,402 verified floristic records (90% based on published literature, 5% on unpublished herbarium specimens, 5% on field observations), and Wikiplantbase #Sardegna 40,043 (77% published literature, 18% unpublished herbarium specimens, 5% on field observations ). The records include over 90% of the specific and subspecific taxa known for Tuscany and about 70% – but rapidly growing – of those known for Sardinia. The most recorded species are Quercus ilex L. (Fagaceae) for Tuscany and Pistacia lentiscus L. (Anacardiaceae) for Sardinia. With minor software tweaking, the online platform Wikiplantbase might be adopted in other contexts, resulting in a well connected network of regional floristic databases suited to exploit the involvement – still largely untapped – of nonacademic collaborators, as advocated by citizen science

Galactomannan testing of bronchoalveolar lavage fluid is useful for diagnosis of invasive pulmonary aspergillosis in hematology patients

<p>Abstract</p> <p>Background</p> <p>Invasive pulmonary aspergillosis (IPA) is a major cause of morbidity and mortality in patients with hematological malignancies in the setting of profound neutropenia and/or hematopoietic stem cell transplantation. Early diagnosis and therapy has been shown to improve outcomes, but reaching a definitive diagnosis quickly can be problematic. Recently, galactomannan testing of bronchoalveolar lavage (BAL) fluid has been investigated as a diagnostic test for IPA, but widespread experience and consensus on optical density (OD) cut-offs remain lacking.</p> <p>Methods</p> <p>We performed a prospective case-control study to determine an optimal BAL galactomannan OD cutoff for IPA in at-risk patients with hematological diagnoses. Cases were subjects with hematological diagnoses who met established definitions for proven or probable IPA. There were two control groups: subjects with hematological diagnoses who did not meet definitions for proven or probable IPA and subjects with non-hematological diagnoses who had no evidence of aspergillosis. Following bronchoscopy and BAL, galactomannan testing was performed using the Platelia <it>Aspergillus </it>seroassay in accordance with the manufacturer's instructions.</p> <p>Results</p> <p>There were 10 cases and 52 controls. Cases had higher BAL fluid galactomannan OD indices (median 4.1, range 1.1-7.7) compared with controls (median 0.3, range 0.1-1.1). ROC analysis demonstrated an optimum OD index cutoff of 1.1, with high specificity (98.1%) and sensitivity (100%) for diagnosing IPA.</p> <p>Conclusions</p> <p>Our results also support BAL galactomannan testing as a reasonably safe test with higher sensitivity compared to serum galactomannan testing in at-risk patients with hematological diseases. A higher OD cutoff is necessary to avoid over-diagnosis of IPA, and a standardized method of collection should be established before results can be compared between centers.</p

Selection of young ewe lambs according to their antral follicular count: response to exogenous hormonal stimulation and fertility at first breeding season

Anti-Mullerian Hormone (AMH), Antral Follicular Count (AFC) and the response to exogenous hormonal stimulation have been used, in adults, as suitable markers to determine the ovarian reserve (1-4), to predict oocyte quality (5,6) and a wide variety of fertility indices (6-9). This investigation aims to evaluate if animals selected according to their High or Low AFC at an early prepubertal age show different responses, in the number of follicles and AMH plasma levels, to exogenous hormonal stimulation; to verify whether differences are maintained over time until puberty; and to observe possible variations on fertility at first breeding season

The Wikiplantbase project: the role of amateur botanists in building up large online floristic databases

The Wikiplantbase project, started in 2013, provides a framework where the full set of georeferenced floristic records of Tuscany and Sardinia can be entered, stored, updated and freely accessed through the Internet. Mainly thanks to the collaboration of amateur botanists, data have accumulated quickly. All records entered by collaborators are submitted to the project coordinators, who are enabled to accept, modify, or reject them. As of 22 November 2016, Wikiplantbase #Toscana holds 116,402 verified floristic records (90% based on published literature, 5% on unpublished herbarium specimens, 5% on field observations), and Wikiplantbase #Sardegna 40,043 (77% published literature, 18% unpublished herbarium specimens, 5% on field observations ). The records include over 90% of the specific and subspecific taxa known for Tuscany and about 70% – but rapidly growing – of those known for Sardinia. The most recorded species are Quercus ilex L. (Fagaceae) for Tuscany and Pistacia lentiscus L. (Anacardiaceae) for Sardinia. With minor software tweaking, the online platform Wikiplantbase might be adopted in other contexts, resulting in a well connected network of regional floristic databases suited to exploit the involvement – still largely untapped – of nonacademic collaborators, as advocated by citizen science