Progettazione e sintesi di nuovi probes per il TSPO a struttura Chinazolicarbosammidica

Il TSPO è una proteina evolutivamente conservata, di 18kDa, altamente idrofobica, costituita da 5 domini transmembranali ed espressa principalmente nella membrana esterna mitocondriale.1 Il TSPO riveste un ruolo chiave nella funzionalità cellulare: ad esso sono attribuite le funzioni di regolazione della proliferazione cellulare, trasporto di porfirine (protoporfirina IX, mesoporfirina IX, emina), sintesi dell’eme, immunomodulazione , regolazione della steroidogenesi e apoptosi. L’utilizzo di radioligandi specifici per il TSPO e della tecnica PET consente la visualizzazione di una eventuale perdita neuronale e della gravità della neuroinfiammazione e ciò può essere un valido strumento per determinare un differente trattamento per uno specifico paziente. Inoltre grazie alla localizzazione della microglia attivata è possibile anche determinare lo stadio della malattia 2. 1 Papadopoulos V.; Baraldi M.; Gilarte T. R.; Knudsen T. B.; Lacapère,J.; Lindermann P.; Noremberg M. D.; Nutt D.; Weizman A.; Zhang M.-R.; Gavish M.; Trends Pharmacol. Sci. 2006, 27, 402-409. 2. Scarf A. M.; Ittner L. M.; Kassiou M.; J. Med. Chem. 2009, 52, 581-592

Feasibility and predictive performance of the Hendrich Fall Risk Model II in a rehabilitation department: a prospective study

BACKGROUND:Falls are a common adverse event in both elderly inpatients and patients admitted to rehabilitation units. The Hendrich Fall Risk Model II (HIIFRM) has been already tested in all hospital wards with high fall rates, with the exception of the rehabilitation setting. This study's aim is to address the feasibility and predictive performances of HIIFRM in a hospital rehabilitation department. METHODS: A 6 months prospective study in a Italian rehabilitation department with patients from orthopaedic, pulmonary, and neurological rehabilitation wards. All admitted patients were enrolled and assessed within 24 h of admission by means of the HIIFRM. The occurrence of falls was checked and recorded daily. HIIFRM feasibility was assessed as the percentage of successful administrations at admission. HIIFRM predictive performance was determined in terms of area under the Receiver Operating Characteristic (ROC) curve (AUC), best cutoff, sensitivity, specificity, positive and negative predictive values, along with their asymptotic 95% confidence intervals (95% CI). RESULTS: One hundred ninety-one patents were admitted. HIIFRM was feasible in 147 cases (77%), 11 of which suffered a fall (7.5%). Failures in administration were mainly due to bedridden patients (e.g. minimally conscious state, vegetative state). AUC was 0.779(0.685-0.873). The original HIIFRM cutoff of 5 led to a sensitivity of 100% with a mere specificity of 49%(40-57%), thus suggesting using higher cutoffs. Moreover, the median score for non-fallers at rehabilitation units was higher than that reported in literature for geriatric non fallers. The best trade-off between sensitivity and specificity was obtained by using a cutoff of 8. This lead to sensitivity\u2009=\u200973%(46-99%), specificity\u2009=\u200972%(65-80%), positive predictive value\u2009=\u200917% and negative predictive value\u2009=\u200997%. These results support the use of the HIIFRM as a predictive tool. CONCLUSIONS: The HIIFRM showed satisfactory feasibility and predictive performances in rehabilitation wards. Based on both available literature and these results, the prediction of falls among all hospital wards, with high risk of falling, could be achieved by means of a unique tool and two different cutoffs: a standard cutoff of 5 in geriatric wards and an adjusted higher cutoff in rehabilitation units, with predictive performances similar to those of the best-preforming pathology specific tools for fall-risk assessmen

short term evaluation of the effects of orthodontic clear aligners on sleep bruxism activity

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Alcohol mixed with Energy Drinks (AmED) use among University Students:A Systematic Review and Meta-analysis

Abstract: In the last decades, there has been a huge increase in the consumption of both Energy Drinks (EDs) and alcohol and, concurrently, these two trends generated the additional practice of mixing ED with alcohol, known as Alcohol mixed with Energy Drink (AmED). One of the most important group of AmED consumers is represented by young. Indeed, the study population of the researches in this field are mainly represented by college students and the results evidence a great range of negative consequences for health. The purpose of the systematic review was to explore the prevalence of AmED consumption among undergraduate students, together with motivations to their use, adverse effects and health-related behaviors associated to AmEDs use. The review was conducted according to the PRISMA Statement and PubMed, Scopus and Web of Science were interrogated. 42 articles, published from 2008 to 2021, were included in the review. An overall prevalence rate of 37% was estimated for AmEDs use in undergraduates, with geographical differences. Although a decrease in consumption was observed throughout the studied period, a continuous monitoring on this phenomenon is needed for identifying those risk groups that could develop risky behaviors related to AmEDs consumption and provide them targeted educational intervention

Cost-effectiveness analysis of personalised versus standard dosimetry for selective internal radiation therapy with TheraSphere in patients with hepatocellular carcinoma

Aims: To perform a cost-effectiveness analysis (CEA) comparing personalised dosimetry with standard dosimetry in the context of selective internal radiation therapy (SIRT) with TheraSphere for the management of adult patients with locally advanced hepatocellular carcinoma (HCC) from the Italian Healthcare Service perspective. Materials and methods: A partition survival model was developed to project costs and the quality-adjusted life years (QALYs) over a lifetime horizon. Clinical inputs were retrieved from a published randomised controlled trial. Health resource utilisation inputs were extracted from the questionnaires administered to clinicians in three oncology centres in Italy, respectively. Cost parameters were based on Italian official tariffs. Results: Over a lifetime horizon, the model estimated the average QALYs of 1.292 and 0.578, respectively, for patients undergoing personalised and standard dosimetry approaches. The estimated mean costs per patient were €23,487 and €19,877, respectively. The incremental cost-utility ratio (ICUR) of personalised versus standard dosimetry approaches was €5,056/QALY. Conclusions: Personalised dosimetry may be considered a cost-effective option compared to standard dosimetry for patients undergoing SIRT for HCC in Italy. These findings provide evidence for clinicians and payers on the value of personalised dosimetry as a treatment option for patients with HCC

Consumption of energy drinks among Italian University students : a cross-sectional multicenter study

Purpose The aim of the study was to evaluate the caffeinated Energy Drinks (EDs) consumption among a large sample of Italian undergraduates and its association with some of the major lifestyle risk factors. Methods Students attending twelve public Italian universities were involved between October 2021 and May 2022. Information on socio-demographic characteristics, ED consumption, and on health-related behaviors of participants was collected by the use of a web-based questionnaire. Results A total of 2165 students participated in the study and 15.2% of them reported having used caffeinated EDs in the last six months, mainly once a month (41.5%). In comparison with non-users, ED users showed a higher proportion of males (p < 0.001) and a higher father’s educational level (p = 0.003), came mainly from Northern universities (p = 0.004) and life sciences degree courses (p < 0.001). Besides, ED users reported higher BMI values (p = 0.003), more particular dietary regimens (p < 0.001), higher levels of weekly moderate–vigorous physical activity (p < 0.001) and participation in sports (p < 0.001) and in team sports (p = 0.003), and higher proportion of smokers (p < 0.001) and alcohol drinkers (p = 0.005). ED use was negatively related with female gender (OR 0.546; 95% CI 0.374–0.798), the Mediterranean diet (OR 0.587; 95% CI 0.362–0.951) and coming from the center of Italy (OR 0.500; 95% CI 0.275–0.909) and positively associated with tobacco smoke (OR 1.712; 95% CI 1.176–2.492) and participation in a team sport (OR 1.686; 95% CI 1.051–2.707). Conclusion These findings could encourage figures engaged in education to increase the students’ awareness on this issue in order to prevent the excessive use of EDs and associated unhealthy behaviors, especially in the most interested subgroups

Predicting needlestick and sharps injuries in nursing students: Development of the SNNIP scale

© 2020 The Authors. Nursing Open published by John Wiley & Sons Ltd. Aim: To develop an instrument to investigate knowledge and predictive factors of needlestick and sharps injuries (NSIs) in nursing students during clinical placements. Design: Instrument development and cross-sectional study for psychometric testing. Methods: A self-administered instrument including demographic data, injury epidemiology and predictive factors of NSIs was developed between October 2018–January 2019. Content validity was assessed by a panel of experts. The instrument's factor structure and discriminant validity were explored using principal components analysis. The STROBE guidelines were followed. Results: Evidence of content validity was found (S-CVI 0.75; I-CVI 0.50–1.00). A three-factor structure was shown by exploratory factor analysis. Of the 238 participants, 39% had been injured at least once, of which 67.3% in the second year. Higher perceptions of “personal exposure” (4.06, SD 3.78) were reported by third-year students. Higher scores for “perceived benefits” of preventive behaviours (13.6, SD 1.46) were reported by second-year students

Update sulla chirurgia laparoscopica del surrene nel secondo decennio del secolo: “doubts no more?”

La chirurgia laparoscopica del surrene ha subito evoluzioni significative negli ultimi anni, che l'hanno resa il "Gold Standard" terapeutico per la maggior parte dei tumori del surrene. Tuttavia, alcuni dubbi restano ancora sulla sua applicabilità in determinate situazioni, come nel caso di tumori surrenalici maligni, primitivi o secondari, tumori molto vascolarizzati (tipo feocromocitoma), incidentalomi d’incerta natura. Con il presente studio ci siamo prefissi lo scopo di rivedere tutta la letteratura degli ultimi 3 anni (solo articoli muniti di abstract pubblicati online) secondo i criteri di selezione della Cochrane Library, alla ricerca di studi in grado o di rispondere con dimostrazioni certe (studi di classe I) o di fornire delle prove da comprovare (studi di classe II e III) sui vari temi di chirurgia laparoscopica del surrene. Sono stati selezionati 212 lavori, trai quali, quelli di classe I dimostrano che il trattamento laparoscopico del feocromocitoma è il Gold Standard terapeutico, indipendentemente dalle dimensioni, e che l'approccio laparoscopico anteriore e posteriore sono equivalenti a quello laterale come risultato a breve termine. Dubbi invece rimangono sulla opportunità di un trattamento laparoscopico delle metastasi, dei grossi feocromocitomi e degli incidentalomi di piccole dimensioni (rischio di over-treatement). Ancora del tutto inesplorato o comunque senza sicura risposta è il ruolo della laparoscopia surrenalica con tecnica "single incision laparoscopic system", quello della ablazione laparoscopica a radiofrequenza, il trattamento del carcinoma surrenalico di I e II stadio e dei tumori di grosse dimensioni (>8 cm), la gestione degli incidentalomi non funzionanti di 4-6 cm, l'uso del robot nella chirurgia laparoscopica del surrene, e l'approccio alle forme bilaterali. La conclusione è che, sebbene molti punti sulle indicazioni e sulle modalità di applicazione della laparoscopia nella surrenectomia siano stati definitivamente chiariti ed abbiano portato a dichiarare tale tecnica come "Gold Standard" nel trattamento dei tumori surrenalici, tuttavia molti dubbi rimangono ancora e molte sono le risposte che attendono di essere date su vari aspetti di tale metodica. Data però la velocità con cui si moltiplicano le pubblicazioni su tale argomento, ci dobbiamo aspettare in un prossimo futuro di assistere alla risoluzione della maggior parte degli interrogativi ancora insoluti