Impatto organizzativo di radio-223 nel trattamento del mCRPC

Le caratteristiche di radio-223 e i vincoli imposti dalle normative vigenti rendono necessari la definizione di un percorso clinico-assistenziale ottimale e di modelli operativi che garantiscano di poter gestire al meglio tutte le potenziali criticità legate all’utilizzo del farmaco nel trattamento del mCRP

Whole body MRI with diffusion weighted imaging versus 18F‑fuorodeoxyglucose‑PET/CT in the staging of lymphomas

Purpose To assess the diagnostic performance of Whole Body (WB)-MRI in comparison with 18F-Fluorodeoxyglucose-PET/CT (18F-FDG-PET/CT) in lymphoma staging and to assess whether quantitative metabolic parameters from 18F-FDG-PET/CT and Apparent Diffusion Coefficient (ADC) values are related. Materials and methods We prospectively enrolled patients with a histologically proven primary nodal lymphoma to undergo 18F-FDG-PET/CT and WB-MRI, both performed within 15 days one from the other, either before starting treatment (baseline) or during treatment (interim). Positive and negative predictive values of WB-MRI for the identification of nodal and extra-nodal disease were measured. The agreement between WB-MRI and 18F-FDG-PET/CT for the identification of lesions and staging was assessed through Cohen's coefficient k and observed agreement. Quantitative parameters of nodal lesions derived from 18F-FDG-PET/CT and WB-MRI (ADC) were measured and the Pearson or Spearman correlation coefficient was used to assess the correlation between them. The specified level of significance was p ≤ 0.05. Results Among the 91 identified patients, 8 refused to participate and 22 met exclusion criteria, thus images from 61 patients (37 men, mean age 30.7 years) were evaluated. The agreement between 18F-FDG-PET/CT and WB-MRI for the identification of nodal and extra-nodal lesions was 0.95 (95% CI 0.92 to 0.98) and 1.00 (95% CI NA), respectively; for staging it was 1.00 (95% CI NA). A strong negative correlation was found between ADCmean and SUVmean of nodal lesions in patients evaluated at baseline (Spearman coefficient rs = − 0.61, p = 0.001). Conclusion WB-MRI has a good diagnostic performance for staging of patients with lymphoma in comparison with 18F-FDG-PET/CT and is a promising technique for the quantitative assessment of disease burden in these patients

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

AUTORADIOGRAPHIC LOCALIZATION OF THE GABA-A-RECEPTOR AGONIST (3H)-MUSCIMOL IN THE RAT INTESTINAL MUSCULATURE

Radioreceptor-binding assay and autoradiography were used to study the pharmacological profile and the anatomical localization of GABA-A-receptor sites in sections of rat duodenum, jejunum and ileum. (H-3)-Muscimol, used as a ligand, was bound by sections of the intestinal portions investigated in a manner consistent with the labeling of GABA-A-receptor sites. The dissociation constant (K(d)) was about 12.5 nmol/l in the three different intestinal portions. The maximum density of binding sites (B(max)) was highest in the duodenum (118.9 +/- 7.4 fmol/mg tissue followed, in descending order, by the jejunum (105.8 +/- 6.3 fmol/mg tissue) and the ileum (67.8 +/- 5.9 fmol/mg tissue). Light microscope autoradiography revealed a dense accumulation of specific silver grains within intestinal smooth muscle. In the duodenum (H-3)-muscimol-binding sites were rather homogeneously distributed both in circular and longitudinal smooth muscle. In the jejunum the density of silver grains was similar to that seen in the duodenum in the circular musculature and lower in the longitudinal musculature. The ileum displayed the lowest accumulation of (H-3)-muscimol-binding sites, with no significant differences in the density of silver grains between the two muscular layers. The possible significance of the GABA-A-receptor sites observed in the intestinal musculature is discussed

Data Driven Approaches for Sustainable Development of E-Mobility in Urban Areas

This study focuses on a modeling framework to support mobility planners and energy providers in the sustainable development of electric mobility in urban areas. Specifically, models are provided to simulate measures for the optimal management of energy demand and thoughtful planning of charging infrastructures in order to avoid congestion on the power grid. The measures, and consequently the models, are classified according to short-term initiatives based on multimodality between electric vehicles and public transport (Park and Ride), as well as medium to long-term initiatives based on the development of an energy-oriented land use of the city. All the models are data-driven, and different sets of floating car data available for the city of Rome (Italy) have been exploited for this aim. The models are currently being implemented in an agent-based simulator for electric urban mobility adopted by the National Agency for Energy and Environment in Italy (ENEA)

A Data-Driven Approach to Analyze Mobility Patterns and the Built Environment: Evidence from Brescia, Catania, and Salerno (Italy)

Investigating the correlation between urban mobility patterns and the built environment is crucial to support an integrated approach to transportation and land-use planning in modern cities. In this study, we aim to conduct a data-driven analysis of these two interrelated parts of the urban environment through the estimation of a set of metrics to assist city planners in making well-informed strategic decisions. Metrics are computed by aggregating and correlating different types of data sources. Floating Car Data (FCD) are used to compute metrics on mobility demand and traffic patterns. The built environment metrics are mainly derived from population and housing census data, as well as by investigating the topology and the functional classification adopted in the OpenStreetMap Repository to describe the importance and the role of each street in the overall network. Thanks to this set of metrics, accessibility indexes are then estimated to capture and explain the interaction between traffic patterns and the built environment in three Italian cities: Brescia, Catania, and Salerno. The results confirm that the proposed data-driven approach can extract valuable information to support decisions leading to more sustainable urban mobility volumes and patterns. More specifically, the application results show how the physical shape of each city and the related street network characteristics affect the accessibility profiles of different city zones and, consequently, the associated traffic patterns and travel delays. In particular, the combined analysis of city layouts, street network distributions, and floating car profiles suggests that cities such as Brescia, which is characterized by a homogeneously distributed radial street system, exhibit a more balanced spread of activities and efficient mobility behaviors

Vasoactive intestinal polypeptide receptors in rat cerebral vessels: an autoradiographic study.

1. Localization and pharmacological properties of the vasoactive intestinal polypeptide (VIP) receptors in rat circle of Willis arteries and in the arteries of pial-arachnoid membrane were studied using light microscope autoradiography combined with radioreceptor binding techniques. 2. [125I]-VIP was specifically bound to sections of rat cerebral arteries with a dissociation constant value of 0.5 nM and a binding site density of 80 fmol mg protein-1. Radioreceptor binding experiments revealed that the binding characteristics of [125I]-VIP were consistent with the labelling of specific VIP receptors. The rank order of potency of various substances tested to inhibit [125I]-VIP binding was the following: VIP greater than peptide histidine methionine greater than secretin greater than glucagon. 3. Light microscope autoradiography revealed the localization of [125I]-VIP binding sites in the medial layer of circle of Willis and pial arteries. Quantitative determination of [125I]-VIP binding site density in the different circle of Willis arteries demonstrated a higher accumulation of silver grains in the anterior than in the posterior cerebral arteries. Pial arteries are richer in VIP receptor sites than circle of Willis arteries. 4. These results suggest that the physiological neurogenic vasodilation elicited by VIP on cerebral arteries is mediated by the interaction with specific receptor sites located primarily within cerebral vessels structures involved in the control of cerebrovascular resistances

QT interval and QT dispersion in systemic sclerosis (scleroderma)

J Intern Med. 1998 Feb;243(2):127-32. QT interval and QT dispersion in systemic sclerosis (scleroderma). Sgreccia A, Morelli S, Ferrante L, Perrone C, De Marzio P, De Vincentiis G, Scopinaro F. SourceInstitute of Clinical Medicine, La Sapienza University, Rome, Italy. Abstract OBJECTIVES: To measure QT interval and QT dispersion, and to evaluate possible relationships between these measurements, heart rate variability parameters, and early myocardial involvement in patients with systemic sclerosis (SSc). DESIGN: Prospective study. SETTING: Tertiary care centre, University 'La Sapienza', Rome, Italy. SUBJECTS: Thirty-eight patients with SSc (35 females and three males, mean age 47 +/- 11 years), 19 patients with the diffuse form of disease and 19 with the limited form, and 17 healthy controls (11 females and six males, mean age 43 +/- 10 years) were studied. INTERVENTIONS: Both patients and control subjects underwent resting 12-lead electrocardiogram and 24-hour Holter monitoring. Moreover, resting myocardial scintigraphy with 99 m Tc-sestamibi was performed in all SSc patients. MAIN OUTCOME MEASURES: Bazett's formula was used to obtain rate corrected value of QT interval (QTc). QT and QTc dispersion were defined as the difference between maximum and minimum QT or QTc interval, respectively. Twenty-four-hour heart rate variability was analysed both in the frequency and in the time domain. RESULTS: Twenty-three SSc patients (60.5%) had myocardial resting perfusion defects (group A) and 15 (39.5%) did not (group B). Maximum QTc interval, QT and QTc dispersion were significantly increased in SSc patients compared to the control subjects. No significant differences between group A and group B were observed for all QT measurements. Furthermore, maximum QTc interval, QT dispersion and QTc dispersion were significantly increased in group A patients compared to the control group. Total power, low-frequency, and high-frequency values were significantly lower in all SSc patients, whether in group A or group B, than in control subjects. On the other hand, low-frequency/high-frequency ratio was similar in all groups. Heart rate variability in time domain analysis showed no statistically significant differences between groups. CONCLUSIONS: Patients with SSc have increased QTc interval, QT dispersion, and QTc dispersion. The role of autonomic nervous system and myocardial involvement on ventricular repolarization in patients with SSc needs further investigation. PMID:9566641[PubMed - indexed for MEDLINE

Outcomes of Recurrent Acute Otitis Media in Children Treated for Dental Malocclusion: A Preliminary Report

Aim. To investigate the role of dental malocclusion treatment in the outcomes of Recurrent Acute Otitis Media (RAOM). Materials and Methods. The clinical outcome (number of acute recurrences in 12 months) of 61 consecutive children treated medically for RAOM was analysed. Children underwent an odontostomatologic evaluation, a fiberoptic endoscopy, and skin-prick tests. Results. 32 children (group A) were diagnosed with dental malocclusion and treated with a mandibular repositioning plate. Dental malocclusion was ruled out in the other 29 patients with RAOM, and they were used as controls (group B). The two groups were homogeneous in terms of sex, exposure to RAOM risk factors, skin test results, and adenoid hypertrophy, while age was significantly higher in group A. Age, sex, exposure to RAOM risk factors, adenoid hypertrophy, and skin test results were not associated with RAOM outcome. Children in group A treated for dental malocclusion were strongly associated with a lower number of acute episode recurrences at both univariate (p<0.0001) and multivariate analysis (p=0.001). Conclusions. RAOM showed better outcomes in children with dental malocclusion wearing a mandibular repositioning device. Dental malocclusion in children with RAOM may play a role in the pathogenesis of Eustachian tube dysfunction