Muscular spasticity represents one of the most common motor disorder associated to lesions of the Central Nervous System, such as Stroke, and affects joint mobility up to the complete prevention of ...skeletal muscle voluntary control. Its clinical evaluation is hence of fundamental relevance for an effective rehabilitation of the affected subjects. Standard assessment protocols are usually manually performed by humans, and hence their reliability strongly depends on the capabilities of the clinical operator performing the procedures. To overcome this limitation, one solution is the usage of mechatronic devices based on the estimation of the Tonic Stretch Reflex Threshold, which allows for a quite reliable and operator-independent evaluation. In this work, we present the design and characterization of a novel mechatronic device that targets the estimation of the Tonic Stretch Reflex Threshold at the elbow level, and, at the same time, it can potentially act as a rehabilitative system. Our device can deliver controllable torque/velocity stimulation and record functional parameters of the musculo-skeletal system (joint position, torque, and multi-channel ElectroMyoGraphyc patterns), with the ultimate goals of: i) providing significant information for the diagnosis and the classification of muscular spasticity, ii) enhancing the recovery evaluation of patients undergoing through therapeutic rehabilitation procedures and iii) enabling a future active usage of this device also as therapeutic tool.Clinical relevance- The contribution presented in this work proposes a technological advancement for a device-based evaluation of motion impairment related to spasticity, with a major potential impact on both the clinical appraisal and the rehabilitation procedures.
Recent findings of increased isoprene emission in the exhaled breath of patients undergoing haemodialysis and experimental evidence of the potential toxic and cancerogenic effects of isoprene ...hydrocarbon led us to assess how long haemodialysis patients are exposed to how much isoprene after a single haemodialysis session. Patients with end-stage renal failure on regular 4-hour (from 08.00 to 12.00 h) maintenance haemodialysis three times weekly were monitored. The breath isoprene content was analyzed by gas chromatography. Intrapatient evaluations were performed by collecting samples before, during, and immediately after the haemodialysis session, during the following hours, and on the following nondialysis day. The breath isoprene content increased in all patients. Isoprene overproduction showing a biphasic pattern was first detected soon after the dialysis session ended. These data show that haemodialyzed patients seem to be consistently exposed to high endogenous isoprene concentrations. The mechanisms and implications of this endogenous isoprene overproduction need to be elucidated with regard to the mevalonic pathway and in the physiopathological setting of the uraemia-dialysis syndrome.
Hypereosinophilic syndromes (HES) represent a group of rare dis-immune conditions characterized by blood hyper-eosinophilia and eosinophilic related burden. Especially the idiopathic subtype (I-HES) ...is particularly difficult to diagnose because of its heterogeneous clinical presentation, the lack of specific findings on physical exam, lab tools and imaging informative enough to unequivocally confirm the diagnosis and the overlap with other entities, including eosinophilic organ-diseases or systemic dis-immune conditions other than I-HES (from atopy to EGPA, the last often extremely difficult to distinguish from HES). Taken together, all the features mentioned above account for an extremely difficult early recognition HES and on time referral to a specialized centre. The referral itself is challenging due to the a not univocal specialist identification, due to the variability of physicians managing HES in different settings and including allergist/clinical immunologist, haematologist, internal medicine doctors, pulmonologist, rheumatologist. Furthermore, the approach in terms of personalized treatment identification and follow-up plan (timing, organ assessment), is poorly standardized. Further translational and clinical research is needed to address the mentioned unmet needs, but on a practical ground increasing the overall clinicians’ awareness on HES and implementing healthcare pathways for HES patients represent a roadmap that every clinician might try to realize in his specific setting.
The present review aims at providing an overview about the current challenges and unmet needs in the practical approach to HES and rare hypereosinophilic allergo-immunological diseases, including a proposal for an innovative multidisciplinary organizational model.
Two different clones of Iris pallida Lam., male-fertile and male-sterile, are present in Tuscany. In the male-sterile clone, the degeneration of the fertile tissue takes place at the dyad or tetrad ...stage. Comparative analysis of the anthers, during microsporogenesis, revealed that the tapetal cells of the two clones behaved differently. In the male-fertile line the tapetum presents developmental stages ending in its final degeneration and disappearance. On the contrary, in the male-sterile line the tapetum maintains its initial aspect until necrosis takes place at the dyad or tetrad stage. The persistence of the inner tangential wall of the cells seems to hinder the orbicules from reaching the locular cavity.
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