Introduction: Crohn's disease (CD) is a chronic inflammatory disease which is frequently complicated by obstructive symptoms secondary to development of intestinal strictures. The aim of this "real ...life" study was to assess the effectiveness, safety and outcome of endoscopic balloon dilatation (EBD) in de novo vs. anastomotic stenoses. Patients and methods: Data of 93 EBDs in 46 CD patients were retrospectively analyzed. Technical success rate was defined as the ability of endoscope to traverse the stenosis after dilatation. Long-term clinical success rate was claimed if a patient remained asymptomatic and did not require surgery or further endoscopic dilatation following the technical success. Results: About 62.4% of strictures were de novo and 37.6% anastomotic. The elapsed time between diagnosis and the first balloon dilatation was 9.5 (0-35) years. About 73.1% of dilatations were successful over a short-term period without serious complications. About 47.8% of patients showed that EBD is effective over a long-term period. EBD of anastomotic strictures showed better outcome than that of de novo strictures, however biological therapy before or after dilatation, immunomodulatory therapy and the time between the diagnosis and the first dilatation had no influence on long-term effectiveness. Nine subjects required surgery due to strictures after balloon dilatation. Conclusion: The results of this study highlight that EBD is an effective therapy of short strictures in CD with low complication rate. Using this endoscopic method we can avoid surgical interventions in most of the cases. EBD of anastomotic stenosis may be more preferable than that of the de novo strictures.
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Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
We evaluated frontal brain activation during a Working Memory task with graded levels of difficulty in a group of 15 healthy subjects, by means of fNIRS technique. Brain activation (% signal change ...with respect to the baseline) was computed and load-related increases of blood oxygenation were found for the four different levels of task difficulty. Generalized Linear Models were applied to the data in order to evaluate the metabolic processes occurring during the mental effort and, possibly, their involvement in short term memorization. The Cognitive Failure Questionnaire was also administered in order to assess its diagnostic relevance in clinics. Results attest a monotous increase of brain oxygenation with WM load during the first half of task, persisting through the central resting period and prevailing in the left hemisphere. Decreasing WM load is also coupled with oxygenated hemoglobin decrease.
In clinical routine, the evaluation of sustained attention is often performed analyzing behavioral data collected during specific tests. It is not common to match such analyses with a detailed ...examination of the subject's simultaneous electroencephalographic (EEG) activity, and particularly its frequency content. In this study, 9 healthy volunteers underwent a modified Conners' CPT test, while their EEG was contemporarily recorded. Spectral power was calculated for each of the recorded EEG signals, with particular attention to frequency bands that are traditionally reported in literature. Then compressed spectral array (CSA) sequence of spectra was plotted, and the analysis of the variability of the rhythms was carried out. Evaluation of the obtained results shows that the nine subjects shared a progressive backshift of alpha rhythm during the accomplishment of the CPT test. Moreover, beta and gamma activities were stronger in the right than in the left hemisphere. An intense and widespread decrease in EEG spectral power during test performing became visible in many subjects. Statistical analysis provided evidence that EEG activity correlates with the test behavioral results in many cerebral areas. For this reason, we encourage further investigations of the combined employment of tests and EEG recording during the clinical assessment of sustained attention performance.
The aim of this work is to describe, using functional imaging techniques, the spatial and temporal distribution of neural activations ensuing from execution of cognitive functions and to find ...correlation in data coming from analysis modalities related to different physical properties. A 10-mm continuous performance test (CPT) was administered to a group of healthy subjects as measure of sustained attention. Images of electroencephalography (EEG) and of near infrared spectroscopy (NIRS) were recorded during the task. cerebral activation's measure is obtained from the recording of quantities linked with electrical neural activity for the EEG and with change in blood oxygenation for the NIRS system. Good agreement was found between the two modalities, both showing higher activation in the middle upper frontal region and similar temporal trend. A further understanding of the superior central nervous system behavior can be achieved from combined use of both imaging modalities
The study of cognitive functions is a major challenge of the modern functional imaging. Activation of specific cerebral area is obtained from the observation of physic characteristic affected by ...changes occurring in the blood flow resulting from an increased metabolic consumption. In this work two imaging techniques are used, the functional magnetic resonance (fMRI) and the near infrared spectroscopy (NIRS), in order to assess cerebral performance during the execution of a well known sustained attention task, the Conners' continuous performance test (CPT). With fMRI analysis were found activations in the frontal, parietal and supplementary motor areas, whereas NIRS system showed a region-wise difference in the variations of parameters and different activation trend localized in the middle-right frontal area. The combined analysis of the two techniques allows to obtain more detailed information and places itself as a first step toward a result of multimodal image integration
In clinical practice, the great potential of robots in extracting quantitative and meaningful data is not always exploited. The aim of the present paper is to propose a simple parameter that allows ...to follow the performance of subjects during upper limb robotic training with no additional effort for patients or clinicians. Armeo®Spring has been used to perform a training on 14 children affected by cerebral palsy (CP). Each session was evaluated with the new parameter allowing us to observe variations in subjects' performance over time. A preliminary validation of the parameter was performed by means of Melbourne clinical scale. Further studies are required to compare the results with kinematics data and other clinical scales.
Single-sweep visual evoked potential analysis would be useful in clinical electrophysiology practice because it would make possible the evaluation of transient phenomena, but recording single-sweep ...visual evoked potentials is difficult because of the low signal-noise ratio. To increase this ratio we used a filter based on an autoregressive with exogenous input model. We studied a group of 12 diabetic patients matched with a control group of 14 normal subjects. The model, in most cases, allowed us to extrapolate the P100 component from each single sweep of visual evoked potential. The visual evoked potential values obtained by means of averaging were not significantly different in the groups studied, but single-sweep analysis showed different distribution of the P100 component amplitude. The preliminary results of our study evidenced differences in the amplitude and latency distribution of normal and diabetic subjects, thus confirming the power of this new technique and its ability to obtain some information that is masked by the averaging method.
Supplice : le livre brûlé, la page censurée, la parole jugulée. Face à l'interdit, qu'il ressortisse au fait du Prince, à l'ordre de la loi ou au tabou fondateur, les littératures ont inventorié tous ...les registres de la transgression, de l'affrontement outrancier aux contournements les plus subtils – et, parfois, les plus douloureux. Délice : car toute écriture qui, au terme de ce face-à-face, demeure, ne garde le souvenir de l'interdit que pour mieux déployer la puissance de son texte. Au point, parfois, de fonder sur cette trace sa qualité d'œuvre littéraire. Si les 29 études de ce recueil, présentées au XXVe Congrès de la Société française de littérature générale et comparée à Rennes en 1995, ouvrent tout grand l'éventail des littératures du monde entier, c'est pour mieux scruter, du Japon à l'Afrique noire, de l'Europe aux Antilles, les formulations infiniment variées du même paradoxe : dire l'interdit, c'est toujours, en littérature, contraindre la contrainte, en l'acculant à ses propres significations.
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