17 research outputs found
Sick and Injured Bodies : Medical Imagery and Media Practices of Care
Peer reviewedPublisher PD
Risk factors for gram-negative bacterial infection of cardiovascular implantable electronic devices: Multicentre observational study (CarDINe Study)
Background: Infections of cardiovascular implantable electronic devices (CIED) are mainly due to Gram-positive bacteria (GPB). Data about Gram-negative bacteria CIED (GNB-CIED) infections are limited. This study aimed to investigate risk factors, clinical and diagnostic characteristics, and outcome of patients with GNB-CIED. Methods: A multicentre, international, retrospective, case-control-control study was performed on patients undergoing CIED implantation from 2015 to 2019 in 17 centres across Europe. For each patient diagnosed with GNB-CIED, one matching control with GPB-CIED infection and two matching controls without infection were selected. Results: A total of 236 patients were enrolled: 59 with GNB-CIED infection, 59 with GPB-CIED infection and 118 without infection. No between-group differences were found regarding clinical presentation, diagnostic and therapeutic management. A trend toward a higher rate of fluorodeoxyglucose positron emission computed tomography (FDG PET/CT) positivity was observed among patients with GNB than in those with GPB-CIED infection (85.7% vs. 66.7%; P = 0.208). Risk factors for GNB-CIED infection were Charlson Comorbidity Index Score (relative risk reduction, RRR = 1.211; P = 0.011), obesity (RRR = 5.122; P = 0.008), ventricular-pacing ventricular-sensing inhibited-response pacemaker implantation (RRR = 3.027; P = 0.006) and right subclavian vein site of implantation (RRR = 5.014; P = 0.004). At 180-day survival analysis, GNB-CIED infection was associated with increased mortality risk (HR = 1.842; P = 0.067). Conclusions: Obesity, high number of comorbidities and right subclavian vein implantation site were associated with increased risk of GNB-CIED infection. A prompt therapeutic intervention that may be guided using FDG PET/CT is suggested in patients with GNB-CIED infection, considering the poorer outcome observed in this group
Predictive model for bacterial co-infection in patients hospitalized for COVID-19: a multicenter observational cohort study
Objective: The aim of our study was to build a predictive model able to stratify the risk of bacterial co-infection at hospitalization in patients with COVID-19. Methods: Multicenter observational study of adult patients hospitalized from February to December 2020 with confirmed COVID-19 diagnosis. Endpoint was microbiologically documented bacterial co-infection diagnosed within 72 h from hospitalization. The cohort was randomly split into derivation and validation cohort. To investigate risk factors for co-infection univariable and multivariable logistic regression analyses were performed. Predictive risk score was obtained assigning a point value corresponding to ÎČ-coefficients to the variables in the multivariable model. ROC analysis in the validation cohort was used to estimate prediction accuracy. Results: Overall, 1733 patients were analyzed: 61.4% males, median age 69 years (IQR 57-80), median Charlson 3 (IQR 2-6). Co-infection was diagnosed in 110 (6.3%) patients. Empirical antibiotics were started in 64.2 and 59.5% of patients with and without co-infection (pâ=â0.35). At multivariable analysis in the derivation cohort: WBCââ„â7.7/mm3, PCTââ„â0.2 ng/mL, and Charlson indexââ„â5 were risk factors for bacterial co-infection. A point was assigned to each variable obtaining a predictive score ranging from 0 to 5. In the validation cohort, ROC analysis showed AUC of 0.83 (95%CI 0.75-0.90). The optimal cut-point wasââ„2 with sensitivity 70.0%, specificity 75.9%, positive predictive value 16.0% and negative predictive value 97.5%. According to individual risk score, patients were classified at low (point 0), intermediate (point 1), and high risk (pointââ„â2). CURB-65ââ„â2 was further proposed to identify patients at intermediate risk who would benefit from early antibiotic coverage. Conclusions: Our score may be useful in stratifying bacterial co-infection risk in COVID-19 hospitalized patients, optimizing diagnostic testing and antibiotic use
Mouse aldehyde-oxidase-4 controls diurnal rhythms, fat deposition and locomotor activity
Aldehyde-oxidase-4 (AOX4) is one of the mouse aldehyde oxidase isoenzymes and its physiological function is unknown. The major source of AOX4 is the Harderian-gland, where the enzyme is characterized by daily rhythmic fluctuations. Deletion of the Aox4 gene causes perturbations in the expression of the circadian-rhythms gene pathway, as indicated by transcriptomic analysis. AOX4 inactivation alters the diurnal oscillations in the expression of master clock-genes. Similar effects are observed in other organs devoid of AOX4, such as white adipose tissue, liver and hypothalamus indicating a systemic action. While perturbations of clock-genes is sex-independent in the Harderian-gland and hypothalamus, sex influences this trait in liver and white-adipose-tissue which are characterized by the presence of AOX isoforms other than AOX4. In knock-out animals, perturbations in clock-gene expression are accompanied by reduced locomotor activity, resistance to diet induced obesity and to hepatic steatosis. All these effects are observed in female and male animals. Resistance to obesity is due to diminished fat accumulation resulting from increased energy dissipation, as white-adipocytes undergo trans-differentiation towards brown-adipocytes. Metabolomics and enzymatic data indicate that 5-hydroxyindolacetic acid and tryptophan are novel endogenous AOX4 substrates, potentially involved in AOX4 systemic actions
Biomedical imaging and rhetoric of diagnosis in medical dramas and docuseries
Since the Second World War, medical practice has undergone a profound transformation concerning the introduction of numerous and increasingly sophisticated medical imaging technologies, which have profoundly changed the diagnostic procedure and the doctor-patient relationship. In mirroring this process, biomedical images and technologies are frequently captured, represented, and revived in medical dramas and docuseries, significantly impacting popular culture and the collective imaginaries. Indeed, medical series shape the social perception of doctors and health care institutions, as well as the rhetoric codes and discursive construction for the bodyâs observation, diagnostic documentation, and care. On this level, it becomes particularly interesting to observe how the narrative models of medical drama have influenced the representation and narration of illness and healing in some recent docuseries. Accordingly, this essay aims to analyse two different television products, medical dramas and docuseries, which have both worked on the representation of illness and hospitals
Per una retorica della crisi. La minaccia dellâ home movie nel dibattito tecnico-industriale dal 1969 al 1975
The Representation and Care of Illness. Visual Culture, Trauma, and Medical Humanities
For a long time, scholars in the Humanities have been trying to move towards a boundary space that touches upon the medical and scientific disciplines. More than others, the topic of representation/visualisation, the relationship between ways of seeing, images, and the techniques to create them has emerged as a fertile and valuable ground for dialogue. This special issue of Cinema & Cie sets itself the ambitious goal of opening an interdisciplinary discussion reflecting on the images of illness, wound, pain, scar, and cure, which are shared today more than ever and go beyond the narrow medical field. In order to develop a new interdisciplinary methodology suitable for capturing the emotions, material dimensions, bodily practices, performative dynamics, and intersubjective systems that, as a whole, consolidate the mise en discourse of the body as an object of care, we have called upon the traditions of Trauma Studies, Medical Humanities and Visual Culture of science and medicine. In this perspective, images are not only the starting point for understanding knowledge production processes but also a valuable restorative tool for care and therapeutic practices
Sick and Injured Bodies: Medical Imagery and Media Practices of Care
Peer reviewedPublisher PD
Microstructure and phase evolution of micronized ceramic colorants from a pilot plant for inks production
The advent of inkjet printing as digital decoration of ceramic materials has irreversibly modified the industrial decoration technology, imposing companies to change the colorant production process. The inkjet application requires micronized particles in the ultrafine particle size range (smaller than 1 ÎŒm). Particles size reduction of ceramic colorants is performed by a high-energy comminution process in wet-operated bead mills, affecting colorants properties. Since a deep knowledge of milling-induced microstructural changes is still lacking, the micronization effects on a set of five industrial ceramic colorants are thoughtfully investigated in this work by simulating the industrial process at a pilot plant. Particle size distribution and energy consumption are monitored during the comminution process. The compositional (including crystallite size and microstrain analysis of the main phases) and morphological variation of four ceramic pigments (yellow zircon, brown spinel, pink malayaite, and green eskolaite) and one dye (blue olivine) is investigated by XRPD (Rietveld method) and SEM analyses. The analytical approach combined with a physical/semiempirical modelling of the colorants elastic features versus the energy demand for particle reduction has yielded details on the nature of the micronizationinduced microstructural changes in ceramic colorants. Specifically, the comminution efficiency as well as the crystalline phase stability are related to the intrinsic properties of each colorant. Brittle breakage rather than plastic deformation on comminution are also system dependent. When an euhedral to subhedral crystal habit is maintained a brittle fracture is preserved throughout the comminution progress, while the formation of flake-like particles and particle agglomeration are strong evidences of plastic deformation. The last evidence deals with the material elastic features. Materials with high bulk modulus convert the grinding energy to lattice defects that lead to particle breakage by brittle fractures, while materials with lower bulk modulus convert/dissipate part of the supplied energy in plastic deformations, drastically decreasing the comminution process efficiency
17q12 Microduplications: A Challenge for Clinicians
In the recent years, some cases of 17q12 deletions and duplications have been reported, but the clinical impact of these imbalances is still to be fully elucidated. In particular, 17q12 duplications elude syndrome classification, since they are associated with a wide phenotypic spectrum, ranging from very mild to quite severe phenotypes. Here, two unrelated patients with the same 1.2 Mb microduplication of 17q12 are reported. Comparing these patients' phenotype with those previously published, it emerges that the more patients reported, the more difficult is finding common characteristics, even in presence of exactly the same genetic anomaly. The role of the genes duplicated in this region and the impact of this chromosomal imbalance are discussed