Is Ginger an Effective Treatment for Reducing the Severity of Chemotherapy-Induced Nausea in Breast Cancer Patients?

Objective: The objective of this selective EBM review is to determine whether or not “Is ginger an effective treatment for reducing the severity of chemotherapy-induced nausea in breast cancer patients?” Study Design: The systematic review of three English language, peer reviewed, randomized control trials have been published between 2015 and 2016. Data Sources: Three randomized control trials were obtained using the PubMed database. One single-blind randomized control trial, one double-blinded randomized control trial, and one double-blind Phase II-III randomized control trial. Outcomes Measured: The participants of the trials graded the severity of nausea after the intervention of ginger or the control. Each study assessed patient-oriented outcomes. The outcomes measured were analyzed via visual analog scale, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, and self-reported severity of nausea questionnaire. Results: All three studies did not show a significant improvement in the severity of nausea in breast cancer patients receiving chemotherapy after the treatment of ginger. However, one study showed a positive benefit in the health-related quality of life after using ginger essential oil aromatherapy. Conclusion: The three randomized control trials used in this systematic review did not show an improvement in the severity of chemotherapy-induced nausea when using ginger as a treatment intervention. There were too many limitations determined in the three control trials which could have cause insignificant results. Although, participants in the single-blinded control trial reported positive improvement in the health-related quality of life

Gestione delle riacutizzazioni di BPCO in Pronto Soccorso

La broncopneumopatia cronica ostruttiva (BPCO) è una delle principali cause di morbilità e mortalità nel mondo. La storia di tale condizione patologica prevede il verificarsi di fenomeni di riacutizzazione, che sono i principali responsabili del progressivo aggravamento del quadro clinico e degli accessi in Pronto Soccorso (PS), con successivo eventuale ricovero in ambito ospedaliero. Lo scopo del presente studio osservazionale retrospettivo è stato quello di valutare nella popolazione di pazienti che sperimentavano un episodio di riacutizzazione di BPCO, afferiti al PS di Pontedera nell’arco di un anno (2014), le caratteristiche demografiche e cliniche, tali da permettere di individuare dei fattori predittivi di gravità. Abbiamo infatti reclutato 179 pazienti affetti da BPCO riacutizzata, di cui 115 uomini e 64 donne, sovrapponibili per caratteristiche demografiche e cliniche. Successivamente tale popolazione è stata suddivisa in base all’esito dell’accesso in PS (dimissione a domicilio-45 vs ricovero-127), rivalutando la diversa rappresentazione delle caratteristiche demografiche e cliniche nei due nuovi gruppi. I pazienti ricoverati si sono differenziati per la maggiore età anagrafica, per la presenza di comorbidità quali lo scompenso cardiaco e di una politerapia domiciliare specialistica cronica; sono risultati inoltre maggiormente tachipnoici, tachicardici ed ipossici all’ingresso in PS e hanno presentato più frequentemente diagnosi associate di “insufficienza respiratoria” e “polmonite”. Infine la popolazione totale è stata suddivisa in base alla mortalità a sei mesi dall’accesso in PS (viventi-146 vs deceduti-33), rivalutando nuovamente la diversa rappresentazione delle caratteristiche demografiche e cliniche nei due nuovi gruppi. I pazienti deceduti si sono differenziati per la maggiore età anagrafica e per il maggior utilizzo di ossigenoterapia domiciliare; sono risultati inoltre essere maggiormente ipercapnici, ipotesi ed ipossici all’ingresso in PS. L’analisi di regressione logistica multipla, eseguita dapprima considerando il ricovero ospedaliero come variabile dipendente, ha mostrato l’associazione statisticamente significativa con le seguenti variabili indipendenti: insufficienza respiratoria (OR [CI 95%] = 23,97 [6,32-90,80], P < 0,002), polmonite (OR [CI 95%] = 7,53 [1,42-39,87], P = 0,01), frequenza cardiaca (OR [CI 95%] = 1,03 [1,01-1,06], P = 0,005) e tachipnea (OR [CI 95%] = 4,02 [1,51-10,71], P = 0,005). L’analisi di regressione logistica multipla, eseguita successivamente considerando la mortalità entro sei mesi dall’accesso in PS come variabile dipendente, ha mostrato l’associazione statisticamente significativa con le seguenti variabili indipendenti: ipercapnia (OR [CI 95%] = 3,28 [1,19-8,98], P = 0,02), età (OR [CI 95%] = 1,07 [1,01-1,14], P = 0,01) ed ossigenoterapia domiciliare (OR [CI 95%] = 3,15 [1,18-8,40], P = 0,02). In conclusione, la presenza di diagnosi associate quali “insufficienza respiratoria acuta” e “polmonite”, di tachipnea e di frequenza cardiaca aumentata ha mostrato incrementare significativamente il rischio di ospedalizzazione. Parimenti, la presenza di età anagrafica avanzata, ipercapnia all’ingresso in PS e ossigenoterapia domiciliare cronica, ha determinato un aumento significativo della mortalità entro sei mesi dall’accesso in PS per l’evento acuto

Redefining the anthology : forms and affordances in digital culture

Alors que le modèle économique de la télévision américaine, longtemps dominant, a été mis au défi de diverses manières par les changements industriels et technologiques de ces dernières années, des formes narratives de plus en plus hétérogènes sont apparues, qui se sont ajoutées aux structures sérielles originaires. La diversité des formes télévisuelles est devenue particulièrement évidente depuis que les paysages télévisuels nationaux et locaux ont commencé à s’ouvrir aux marchés étrangers situés en dehors des États-Unis, pour finalement adopter une perspective transnationale et globale. La transition vers la télévision distribuée sur Internet a joué un rôle central dans cette fragmentation formelle et la nouvelle dynamique de la diffusion en ligne a ouvert une different perspective pour comprendre le flux mondial de contenus télévisuels, qui reflète aujourd'hui un environnement multimédia et numérique hautement interconnecté et mis en réseau. En effet, la multiplication des services de vidéo à la demande oblige la sérialité à s’adapter au paysage médiatique contemporain, donnant naissance à des produits audiovisuels pouvant être transférés en ligne et présentant des spécificités de production, de distribution et de réception. L’un des résultats de tels changements dans les séries télévisées américaines à l’aube du XXIe siècle est la série anthologique divisée en différentes saisons avec des histoires distinctes, et pourtant liées par le ton et le style. Ma recherche se situe dans un tel contexte technologique, industriel et culturel, où le contenu télévisuel est de plus en plus fragmenté. Compte tenu de cette fragmentation des contenus, cette thèse examine la manière dont les contenus télévisuels contemporains sont distribués, dans l'interaction entre les processus de recommandation basés sur des algorithmes et les pratiques éditoriales plus traditionnelles. L’objectif de ce projet est donc d’étudier la manière dont certaines structures narratives typiques de la forme de l’anthologie apparaissent dans le contexte de la sérialité de la télévision nord-américaine, à partir de conditions spécifiques de production, de distribution et de consommation dans l’industrie des médias. En se concentrant sur l'évolution (dimension temporelle et historique) et sur la circulation numérique (dimension spatiale, géographique) des séries d'anthologies américaines, et en observant les particularités de leur production et de leur style, ainsi que leurs réseaux de distribution et les modes de consommation qu'elles favorisent, cette thèse s’inscrit finalement dans une conversation plus vaste sur les études culturelles et numériques. L’objectif final est d’étudier la relation entre les formes anthologiques, les plateformes de distribution et les modèles de consommation, en proposant une approche comparative de l’anthologie qui soit à la fois cross-culturelle, crosshistorique, cross-genre et qui prenne en consideration les pratiques pre- et post-numériques pour l’organisation de contenus culturels.As the longtime dominant U.S. television business model has been challenged in various ways by industrial and technological changes in recent years, more heterogeneous narrative forms have emerged in addition to original serial structures. The diversity of televisual forms became particularly evident since national, local television landscapes started opening up to foreign markets outside of the U.S., finally embracing a transnational, global perspective and tracing alternative value-chains. The transition to internet-distributed television played a pivotal role in this formal fragmentation and new dynamics of online streaming opened up another path for understanding the flow of television content, which today reflects a highly interconnected, networked media and digital environment. Indeed, the proliferation of video-on-demand services is forcing seriality to adapt to the contemporary mediascape, giving rise to audiovisual products that can be transferred online and present specificities in production, distribution and reception. One of the outcomes of such changes in U.S. television series at the dawn of the twenty-first century is the anthology series divided in different seasons with separate stories, yet linked by tone and style. My research positions itself in such a technological, industrial and cultural context, where television content is increasingly fragmented. Given such a fragmentation, this thesis considers the ways contemporary television content is distributed in the interaction between algorithmic-driven recommendation processes and more traditional editorial practices. The aim of the project is to investigate the way certain narrative structures typical of the anthology form emerge in the context of U.S. television seriality, starting from specific conditions of production, distribution and consumption in the media industry. By focusing on the evolution (temporal, historical dimension) and on the digital circulation (spatial, geographic dimension) of U.S. anthology series, and observing the peculiarities in their production and style, as well as their distributional networks and the consumption patterns they foster, this thesis ultimately insert itself into a larger conversation on digital-cultural studies. The final purpose is to examine the relation between anthological forms, distribution platforms and consumption models, by proposing a comparative approach to the anthology that is at the same time cross-cultural, cross-historical, cross-genre and accounting for both pre- and post-digital practices for cultural content organization

Monocyte subsets, stanford-A acute aortic dissection, and carotid srtery stenosis. new evidences

Monocytes are a heterogeneous cell population distinguished into three subsets with distinctive phenotypic and functional properties: "classical" (CD14++CD16-), "intermediate" (CD14++CD16+), and "nonclassical" (CD14+CD16++). Monocyte subsets play a pivotal role in many inflammatory systemic diseases including atherosclerosis (ATS). Only a low number of studies evaluated monocyte behavior in patients affected by cardiovascular diseases, and data about their role in acute aortic dissection (AAD) are lacking. Thus, the aim of this study was to investigate CD14++CD16-, CD14++CD16+, and CD14+CD16++ cells in patients with Stanford-A AAD and in patients with carotid artery stenosis (CAS). Methods. 20 patients with carotid artery stenosis (CAS group), 17 patients with Stanford-A AAD (AAD group), and 17 subjects with traditional cardiovascular risk factors (RF group) were enrolled. Monocyte subset frequency was determined by flow cytometry. Results. Classical monocytes were significantly increased in the AAD group versus CAS and RF groups, whereas intermediate monocytes were significantly decreased in the AAD group versus CAS and RF groups. Conclusions. Results of this study identify in AAD patients a peculiar monocyte array that can partly explain depletion of T CD4+ lymphocyte subpopulations observed in patients affected by AAD.Monocytes are a heterogeneous cell population distinguished into three subsets with distinctive phenotypic and functional properties: classical (CD14++CD16-), intermediate (CD14++CD16+), and nonclassical (CD14+CD16++). Monocyte subsets play a pivotal role in many inflammatory systemic diseases including atherosclerosis (ATS). Only a low number of studies evaluated monocyte behavior in patients affected by cardiovascular diseases, and data about their role in acute aortic dissection (AAD) are lacking. Thus, the aim of this study was to investigate CD14++CD16-, CD14++CD16+, and CD14+CD16++ cells in patients with Stanford-A AAD and in patients with carotid artery stenosis (CAS). Methods. 20 patients with carotid artery stenosis (CAS group), 17 patients with Stanford-A AAD (AAD group), and 17 subjects with traditional cardiovascular risk factors (RF group) were enrolled. Monocyte subset frequency was determined by flow cytometry. Results. Classical monocytes were significantly increased in the AAD group versus CAS and RF groups, whereas intermediate monocytes were significantly decreased in the AAD group versus CAS and RF groups. Conclusions. Results of this study identify in AAD patients a peculiar monocyte array that can partly explain depletion of T CD4+ lymphocyte subpopulations observed in patients affected by AAD

A double nellix and chimney covered stents: challenging treatment of pararenal aortic aneurysm

A 77-year-old male patient presented with a symptomatic, 66-mm pararenal aortic aneurysm. The patient was classified as unsuitable for open surgery due to significant comorbidities. Fenestrated or branched endografts were contraindicated due to the poor iliac access (6 mm diameter). A double Nellix with chimney endovascular aneurysm sealing (ChEVAS) technique was selected to exclude the pararenal aortic aneurysm and to preserve renal arteries and the superior mesenteric artery. Technical preplanning considered the ideal proximal landing zone to be close to the origin of the almost occluded celiac trunk and the distal common iliac arteries as the ideal distal landing zone. The total length of the aorta to cover was estimated as >180 mm, requiring 2 aortic EVAS systems, bilaterally overlapped. Technical success was achieved, and the patient was discharged on postoperative day 8 in good general condition. Successful aneurysm exclusion and target vessel patency without endoleak or stent-graft kinking or migration were confirmed at angio-computed tomography at 6 months