Optical response of strongly absorbing inhomogeneous materials: Application to paper degradation

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Association of kidney disease measures with risk of renal function worsening in patients with type 1 diabetes

Background: Albuminuria has been classically considered a marker of kidney damage progression in diabetic patients and it is routinely assessed to monitor kidney function. However, the role of a mild GFR reduction on the development of stage 653 CKD has been less explored in type 1 diabetes mellitus (T1DM) patients. Aim of the present study was to evaluate the prognostic role of kidney disease measures, namely albuminuria and reduced GFR, on the development of stage 653 CKD in a large cohort of patients affected by T1DM. Methods: A total of 4284 patients affected by T1DM followed-up at 76 diabetes centers participating to the Italian Association of Clinical Diabetologists (Associazione Medici Diabetologi, AMD) initiative constitutes the study population. Urinary albumin excretion (ACR) and estimated GFR (eGFR) were retrieved and analyzed. The incidence of stage 653 CKD (eGFR < 60 mL/min/1.73 m2) or eGFR reduction > 30% from baseline was evaluated. Results: The mean estimated GFR was 98 \ub1 17 mL/min/1.73m2 and the proportion of patients with albuminuria was 15.3% (n = 654) at baseline. About 8% (n = 337) of patients developed one of the two renal endpoints during the 4-year follow-up period. Age, albuminuria (micro or macro) and baseline eGFR < 90 ml/min/m2 were independent risk factors for stage 653 CKD and renal function worsening. When compared to patients with eGFR > 90 ml/min/1.73m2 and normoalbuminuria, those with albuminuria at baseline had a 1.69 greater risk of reaching stage 3 CKD, while patients with mild eGFR reduction (i.e. eGFR between 90 and 60 mL/min/1.73 m2) show a 3.81 greater risk that rose to 8.24 for those patients with albuminuria and mild eGFR reduction at baseline. Conclusions: Albuminuria and eGFR reduction represent independent risk factors for incident stage 653 CKD in T1DM patients. The simultaneous occurrence of reduced eGFR and albuminuria have a synergistic effect on renal function worsening

Liposarcoma mixoide del funicolo spermatico

The myxoid liposarcoma, a rare form of spermatic cord liposarcoma, is a neoplasia of adult men which arise from adipose tissue, with a slow and subdolous growth, showing good prognosis and low incidence of local or distant recurrence. The case came at our attention is the sixteenth described in literature. Orchifunicolectomy is the gold standard therapy, although in some cases in which this kind of surgery is not radical adjuvant inguinal or retroperithoneal and pelvic nodes radiotheraphy should be taken in consideratio

Theoretical optical spectroscopy of complex systems

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Interdisciplinary approach to develop a disposable real time monitoring tool for the cleaning of graphic artworks. Application on “le Nozze di Psiche”

Disposable non-invasive and compatible real time monitoring tool was developed in order to follow the cleaning process of paper artwork directly in situ. This tool was based on a biocompatible cleaning hydrogel coupled with flow electrochemical diagnostic tool, suitable to verify in situ and in a simple way the assessment of degradation of artwork and the efficiency of cleaning process. In this paper, the results obtained by applying this tool on a great format artwork with a lining as support, “Le Nozze di Psiche”, engraved by Diana Scultori, printed in 1613, are reported. This opera was affected by a structural and chromatic deterioration due to a strong oxidative degradation. Such deterioration was probably accelerated by the adhesive (a mixture of starch paste and animal glue) used in a previous lining intervention. In this case, the cleaning agents used are rigid hydrogels of Gellan gum, modified with hydrolytic enzymes. By using the flow sampling system, all materials removed by the gel was carried up to a thin layer cell containing a selective electrochemical biosensors, suitable to monitor both treatments, the cleaning process and the removal of lining. These were monitored, allowing understanding when both processes were completed, thus avoiding lengthy and unnecessary cleaning applications. The effectiveness of cleaning with Gellan gel was assessed quantitatively by using non-invasive optical reflectance spectroscopy by a portable instrumentation, elaborating data with an improved version of the Kubelka-Munk theory in order to recover the absorption coefficient of the cellulose fibers of “Le Nozze di Psiche”. The concentration of oxidized groups acting as chromophores was obtained by comparing the experimental optical absorption spectra to those simulated computationally by using TDDFT-based calculations. By following the cleaning with Gellan gel the results indicate a large decrease of the concentration of degradation product of cellulose. Moreover, chromatographic analysis were carried out in order to evaluate the amount of acid compound, produced during the aging and present on the graphic artwork, using the Gellan gel after cleaning step. The results obtained from the restoration of “Le Nozze di Psiche” have allowed the restorers to evaluate innovative methods for cleaning treatment of paper artworks with a highly specialized scientific-diagnostic approac

Ultrasound-Guided Erector Spinae Plane Block Versus Intercostal Nerve Block for Post-Minithoracotomy Acute Pain Management: A Randomized Controlled Trial

Objective: Several nerve block procedures are available for post-thoracotomy pain management. Design: In this randomized trial, the authors aimed to determine whether the analgesic effect of preoperative ultrasound-guided erector spinae plane block (ESPB) might be superior to that of intraoperative intercostal nerve block (ICNB) in pain control in patients undergoing minithoracotomy. Setting: University hospital. Participants: Sixty consecutive adult patients scheduled to undergo minithoracotomy for lung resection were enrolled. Interventions: Patients were allocated randomly in a 1:1 ratio to receive either single-shot ESPB or ICNB. Measurements and Main Results: The primary outcome was the intensity of postoperative pain at rest, assessed with the numeric rating scale (NRS). The secondary outcomes were (1) dynamic NRS values (during cough); (2) perioperative analgesic requirements; (3) patient satisfaction, on the basis of a verbal scale (Likert scale); and (4) respiratory muscle strength, considering the maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP) variation from baseline. The ESPB group showed lower postoperative static and dynamic NRS values than the ICNB group (p < 0.05). Total remifentanil consumption and requirements for additional analgesics were lower in the ESPB group (p < 0.05). Patient satisfaction was higher in the ESPB group (p < 0.001). A significant overall time effect was found in MIP and MEP variation (p < 0.001); ESPB values were higher at all points, reaching a statistically significant level at the first and sixth hours for MIP, and at the first, 12th, 24th, and 48th hours for MEP (p < 0.05). Conclusions: ESPB was demonstrated to provide superior analgesia, lower perioperative analgesic requirements, better patient satisfaction, and less respiratory muscle strength impairment than ICNB in patients undergoing minithoracotomy