451 research outputs found
Dermoscopy and methyl aminolevulinate: A study for detection and evaluation of field cancerization
Actinic keratosis (AK) is a keratinocyte intraepidermal neoplasia UV light
â
induced that frequently appears in
sun-exposed areas of the skin. Although historically AK was de
fi
ned as
â
precancerous
â
, actually it is considered
as the earliest stage of squamous cell carcinoma (SCC) in situ. Since AKs can progress into invasive SCC, their
treatment isrecommended. AKsrarely developasa singlelesion;usually multiplelesions commonly affect anen-
tire area of chronically actinic damaged skin. This has led to the concept of
â
fi
eld cancerization
â
, an area chroni-
cally sun-exposed that surrounds peripherally visible lesions, in which are individualized subclinical alterations.
One of the main principles endpoint in the management of AKs is the evaluation and the treatment of
fi
eld
cancerization. In this view, in order to detect and quantify
fi
eld cancerization, we employed a method based
on the topical application of methyl aminolevulinate (MAL) and the detection of the
fl
uorescence emitted by
its metabolite Protoporphyrin IX (PpIX); then, considering the extension and the intensity of measured
fl
uores-
cence, we create a score of
fi
eld cancerization. The results show that patients underwent to daylight PDT had a
reduction of total score, from T0 to T2. Whereas in the group untreated we observed a stability of total score or
a slightly worse. So, the method and the score used allows to evaluate with a good approximation the dimension
of
fi
eld cancerization and show the modi
fi
cation of it after treatment
Generalization and Robustness Implications in Object-Centric Learning
The idea behind object-centric representation learning is that natural scenes
can better be modeled as compositions of objects and their relations as opposed
to distributed representations. This inductive bias can be injected into neural
networks to potentially improve systematic generalization and learning
efficiency of downstream tasks in scenes with multiple objects. In this paper,
we train state-of-the-art unsupervised models on five common multi-object
datasets and evaluate segmentation accuracy and downstream object property
prediction. In addition, we study systematic generalization and robustness by
investigating the settings where either single objects are out-of-distribution
-- e.g., having unseen colors, textures, and shapes -- or global properties of
the scene are altered -- e.g., by occlusions, cropping, or increasing the
number of objects. From our experimental study, we find object-centric
representations to be generally useful for downstream tasks and robust to
shifts in the data distribution, especially if shifts affect single objects
The role of EGFR inhibitors in nonsmall cell lung cancer
The epidermal growth factor receptor is a cell membrane receptor that plays a key role in cancer development and progression. Ligand-activated epidermal growth factor receptor-dependent signaling is involved in cell proliferation, apoptosis, angiogenesis, invasion, and metastasis. Targeting the epidermal growth factor receptor represents a promising molecular approach in cancer treatment. Several antiepidermal growth factor receptor agents are in clinical development. This review focuses on the available clinical data on epidermal growth factor receptor-targeting drugs in the treatment of nonsmall cell lung cancer
Theatre is a valid add-on therapeutic intervention for emotional rehabilitation of parkinson's disease patients
Conventional medical treatments of Parkinson's disease (PD) are effective on motor disturbances but may have little impact on nonmotor symptoms, especially psychiatric ones. Thus, even when motor symptomatology improves, patients might experience deterioration in their quality of life. We have shown that 3 years of active theatre is a valid complementary intervention for PD as it significantly improves the well-being of patients in comparison to patients undergoing conventional physiotherapy. Our aim was to replicate these findings while improving the efficacy of the treatment. We ran a single-blinded pilot study lasting 15 months on 24 subjects with moderate idiopathic PD. 12 were assigned to a theatre program in which patients underwent "emotional" training. The other 12 underwent group physiotherapy. Patients were evaluated at the beginning and at the end of their treatments, using a battery of eight clinical and five neuropsychological scales. We found that the emotional theatre training improved the emotional well-being of patients, whereas physiotherapy did not. Interestingly, neither of the groups showed improvements in either motor symptoms or cognitive abilities tested by the neuropsychological battery. We confirmed that theatre therapy might be helpful in improving emotional well-being in PD
The frequency of polidrug use in a driving population in Rome
In Italy the illicit substances routinely tested are cannabinoids, cocaine, opiates, amphetamines / methamphetamine, MDMA and similar but these substances are not the most use in our country. In particular, the consumption of ketamine represents an emerging problem. Ketamine is a anesthetic with hallucinogenic and dissociative effects and these are the ones sought for the voluptuary pur-pose, while the amnesic effect are exploited for drug facilitated sexual assault. Our study was car-ried out to assess the positivity for the illicit substances routinely tested and also for ketamine in a population of 182 patients arrived at the emergency room of the Hospital âSan Camillo Forlaniniâ of Rome, for which have been required toxicological tests on the basis of Articles 186 and 187 of the New Highway Code.
The choice of this kind of population allows to have an accurate and reliable epidemiological data about the real diffusion of voluptuary use of drugs. The study examines 182 samples subjected to routine toxicological investigations in the period be-tween October 2011 and August 2012. The Authors have researched the presence of ethanol, cannabinoids, cocaine, opiates, amphetamines and benzodiazepines with the use of âADVIA Chemistry Systems â, while the ketamine is tested by a single-phase tests on urine [Sure Screen Diagnostic (Di. Ra.Lab)] with a cut-off level of this method is 1000ng/ml. During this period we have considered 182 patients (males 78%, females 22%). The mean age was 34 years (standard deviation 13, minimum 15, maximum 80). Most of the admission were during the last days of the week (Thursday 17%, Friday 15%, Saturday 15% and Sunday 17%). With re-spect to the clinical needs of subjects admitted, 42% were admitted with a red code. Considering a single substance analysis, 46 subjects resulted positive to alcohol (25%), 38 to can-nabinoids (21%), 24 to opioids (13%), 20 to cocaine (11%), 19 to benzodiapezine (10%) and 7 to ketamine (4%). Among those who resulted positive to at least one substance (95, 52% of the sample) 55 subjects re-sulted positive to one substance (58%), 27 to two substances (28%) and 13 to three or more substances (13%). Poly-use was evaluated with an indicator previously proposed by Fabi et al in 2013. This resulted in a polydrug-use score equal to 2.93 (standard deviation 1.7, minimum 1.5, maximum 9.25)
Superficial Peritoneal Endometriosis Vaporization Using a CO2 Laser: A Long-Term Single-Center Experience
Background: The validation of laser usage during laparoscopic procedures, notably by Camran Nezhat in the late 1980s, has been significant. Lasers offer precision and depth control in tissue Vaporization without bleeding. Surgical intervention remains central in managing endometriosisassociated pain and infertility, especially for patients unresponsive to hormonal therapy. Methods: This retrospective cohort study included 200 patients with superficial peritoneal endometriosis (SPE) who underwent laparoscopic laser vaporization. Surgery was performed using a CO2 laser, and histological confirmation of endometriosis was obtained for all cases. Pain scores and SF-36 questionnaire domains were assessed preoperatively and postoperatively. Fertility outcomes were evaluated among patients desiring pregnancy. Results: Significant improvements in pain score and SF-36 questionnaire domains were observed postoperatively (p-value < 0.01), indicating enhanced quality of life. Among infertile patients with an active desire for pregnancy, surgical treatment showed an overall pregnancy
rate after surgery of 93.7% (p-value < 0.01), including 75.7% natural pregnancies and 24.3% IVF. Laser vaporization enabled precise lesion removal with minimal tissue damage, short operative time, and minimal blood loss. Conclusions: Laparoscopic laser vaporization is an effective treatment for SPE, offering pain relief, improved quality of life, and favorable fertility outcomes. Further research is needed to validate these results in terms of pain control and fertility
Efficacy and safety of rituximab in type II mixed cryoglobulinemia
Abstract
The best treatment of type II mixed cryoglobulinemia (MC) has still to be defined. Antiviral treatment for the frequent underlying infectious trigger hepatitis C virus (HCV) may be ineffective, contraindicated, or not tolerated in a fraction of cases, whereas current immunosuppressive treatments may lead to relevant complications. Selective B-cell blockade with rituximab was used in this study, based on favorable results in preliminary experience. Fifteen consecutive patients with type II MC (HCV-related in 12 of 15) were treated with rituximab, 375 mg/m2 intravenously weekly for 4 weeks. Only medium- to low-dose steroids were allowed, if already administered at the time of recruitment. All patients had active disease, poorly controlled or difficult to manage with previous treatments, including corticosteroids in all. Efficacy and safety of rituximab therapy were evaluated in the following 6 months. The overall follow-up after rituximab treatment ranged from 9 to 31 months. Rituximab proved effective on skin vasculitis manifestations (ulcers, purpura, or urticaria), subjective symptoms of peripheral neuropathy, low-grade B-cell lymphoma, arthralgias, and fever. Nephritis of recent onset went into remission in one case. Laboratory features, that is, significantly decreased serum rheumatoid factor and cryoglobulins and increased C4, were consistent with the clinical efficacy. Treatment was well tolerated, with no infectious complications. Thrombosis of retinal artery or self-limiting panniculitis occurred in one patient each. Rituximab may represent a safe and effective alternative to standard immunosuppression in type II MC. Controlled studies are needed to better define drug indications and the cost-efficacy profile in the different systemic manifestations
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