41.
42.
43.
44.
A study of friction, wear and particulate emissions during the bedding stage of a Cu-free friction material
Candeo, S.; Nogueira, A.P.; Leonardi, M. ...
Wear,
12/2021, Letnik:
486-487
Journal Article
In this study, the tribological behaviour and airborne particulate emissions during a bedding procedure for a Cu-free friction material for brake applications were investigated. Different ...
tribological stages were identified. During the first stage, called run-in, friction coefficient, system wear, and emissions increased. At the end of the first stage, the friction coefficient reached a stable value. On the other hand, wear continued to increase, albeit at an increasingly lower rate, and the emissions of airborne particles started decreasing. Subsequently, also system wear and the emission of airborne particles reached a steady-state stage. The obtained results were explained considering the evolution of the characteristics of the friction layer that forms on the friction material during braking.
•Friction coefficient stabilizes after 150 brake stops.•System wear and PM emissions stabilize after 350 brake stops.•During the transition stage the PM emission decreases with the brake stops.•The observed behaviour depends on the characteristics of the friction layer.
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45.
The cost and the value of treatment of medication overuse headache in Italy: a longitudinal study based on patient‐derived data
Raggi, A.; Leonardi, M.; Sansone, E. ...
European journal of neurology,
January 2020, 2020-01-00, 20200101, Letnik:
27, Številka:
1
Journal Article
Background and purpose
The cost of medication overuse headache (MOH) is underestimated. Our aim was to address the cost‐effectiveness of a structured treatment protocol and to present annual cost ...
estimates.
Methods
Patients were enrolled on the occasion of a structured treatment protocol, were administered a research protocol addressing direct and indirect costs and were followed up for 3 months.
Results
Of 176 enrolled patients, 138 completed the study. The 3‐month cost per patient fell from €2989 to €1160: the difference was €696 per month for patients treated in the ward and €466 for those treated in day‐hospital; thus it takes 2–3 months to compensate for the protocol's cost. The per‐person annual costs of MOH were €10 533 (95% confidence interval €8700–12 406): direct healthcare costs accounted for 44.8% and indirect costs for 51.5% of the total MOH cost. The annual MOH cost for Italy is estimated at €13.5 billion (95% confidence interval €11.1–15.9 billion).
Conclusion
The cost of MOH around the period of a structured treatment protocol is much higher compared to previous estimates. Our protocol is cost‐effective for reducing the economic burden of MOH.
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46.
47.
Diagnostic accuracy of transvaginal ultrasound for detection of endometriosis using International Deep Endometriosis Analysis (IDEA) approach: prospective international pilot study
Leonardi, M.; Uzuner, C.; Mestdagh, W. ...
Ultrasound in obstetrics & gynecology,
September 2022, 2022-09-00, 20220901, Letnik:
60, Številka:
3
Journal Article
ABSTRACT
Objective
To evaluate the diagnostic accuracy of transvaginal ultrasound (TVS) in predicting deep endometriosis (DE) following the International Deep Endometriosis Analysis (IDEA) consensus ...
methodology.
Methods
This was an international multicenter prospective diagnostic accuracy study involving eight centers across six countries (August 2018–November 2019). Consecutive participants with endometriosis suspected based on clinical symptoms or historical diagnosis of endometriosis were included. The index test was TVS performed preoperatively in accordance with the IDEA consensus statement. At each center, the index test was interpreted by a single sonologist. Reference standards were: (1) direct visualization of endometriosis at laparoscopy, as determined by a non‐blinded surgeon with expertise in endometriosis surgery; and (2) histological assessment of biopsied/excised tissue. Surgery was performed within 12 months following the index TVS. Accuracy, sensitivity, specificity, positive and negative predictive values (PPV and NPV) and positive and negative likelihood ratios (LR+ and LR–) of TVS in the diagnosis of DE were calculated.
Results
Included in the study were 273 participants with complete clinical, TVS, laparoscopic and histological data. Of these, based on histology, 256 (93.8%) were confirmed to have endometriosis, including superficial endometriosis, and 190 (69.6%) were confirmed to have DE. Based on surgical visualization, 207/273 (75.8%) patients had DE. For DE overall, the diagnostic performance of TVS based on surgical visualization as the reference standard was as follows: accuracy, 86.1%; sensitivity, 88.4%; specificity, 78.8%; PPV, 92.9%; NPV, 68.4%; LR+, 4.17; LR–, 0.15, and the diagnostic performance of TVS based on histology as the reference standard was as follows: accuracy, 85.9%; sensitivity, 89.8%; specificity, 75.9%; PPV, 90.4%; NPV, 74.6%; LR+, 3.72; LR–, 0.13.
Conclusions
Using the IDEA consensus methodology provides strong diagnostic accuracy for TVS assessment of DE. We found a higher TVS detection rate of DE overall than that reported by the most recent meta‐analysis on the topic (sensitivity, 79%), albeit with a lower specificity. © 2022 International Society of Ultrasound in Obstetrics and Gynecology.
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48.
Prevalence of negative sliding sign representing pouch of Douglas obliteration during pelvic transvaginal ultrasound for any indication
Leonardi, M.; Martins, W. P.; Espada, M. ...
Ultrasound in obstetrics & gynecology,
December 2020, Letnik:
56, Številka:
6
Journal Article
ABSTRACT
Objectives
Pouch of Douglas (POD) obliteration can be predicted with a high degree of certainty and reproducibility using the dynamic transvaginal ultrasound (TVS) sliding‐sign technique. So ...
far, studies on POD obliteration prediction have focused on tertiary‐care populations with high prevalence of endometriosis; however, POD obliteration may exist in individuals with asymptomatic endometriosis or other conditions. Our primary aim was to determine the prevalence of a negative sliding sign, representing POD obliteration, in a cohort of patients undergoing TVS for any gynecological indication.
Methods
This was a prospective observational study of consecutive women with an indication for gynecological TVS, conducted at a high‐volume ultrasound practice between July and August 2018. Clinical and surgical history, indication for TVS and TVS findings were documented. The prevalence of TVS‐confirmed POD obliteration, determined by interpretation of the sliding sign, was calculated for the entire cohort and for the subgroups of women with and without risk factors for endometriosis. High risk for endometriosis was defined as having (1) a TVS referral for endometriosis‐like pelvic pain or endometriosis specifically and/or (2) clinical symptoms or signs suggestive of endometriosis. Low risk was defined as the absence of these characteristics.
Results
During the study period, 1043 consecutive women underwent TVS. After excluding those who underwent transabdominal ultrasound, had a history of hysterectomy or with missing data, 909 women were analyzed. The prevalence of a negative sliding sign in the entire cohort was 47/909 (5.2%). A negative sliding sign was observed in 22/639 (3.4%) women with a low risk for endometriosis and 25/243 (10.3%) of those with a high risk for endometriosis (difference in proportions, 6.9% (95% CI 2.8–10.9%); P < 0.001).
Conclusions
We have demonstrated an overall prevalence of a negative sliding sign, suggesting POD obliteration, of 5.2% (or 1/20) in women seeking TVS for a gynecological indication. The prevalence of negative sliding sign in low‐risk women is not negligible (3.4% or 1/29 women). These women are most likely to have asymptomatic endometriosis or another important etiology of POD obliteration. The prevalence of a negative sliding sign is approximately three‐times higher in women with signs and/or symptoms of endometriosis (10.3% vs 3.4%). Copyright © 2020 ISUOG. Published by John Wiley & Sons Ltd.
RESUMEN
Resultado de supervivencia en una hernia diafragmática congénita grave del lado izquierdo, con y sin oclusión traqueal endoscópica fetal en un país con un tratamiento neonatal subóptimo
Objetivos
La obliteración del fondo de saco de Douglas (FSD) puede predecirse con un alto grado de certeza y reproducibilidad usando la técnica del signo deslizante en una ecografía transvaginal dinámica (TVS, por sus siglas en inglés). Hasta ahora, los estudios sobre la predicción de la obliteración del FSD se han centrado en las poblaciones de atención terciaria con alta prevalencia de endometriosis; sin embargo, la obliteración del FSD puede ocurrir en personas con endometriosis asintomática u otras afecciones. El objetivo principal fue determinar la prevalencia de un signo deslizante negativo, como indicador de la obliteración del FSD, en una cohorte de pacientes que se sometieron a TVS por cualquier indicación ginecológica.
Métodos
Se trató de un estudio observacional prospectivo de mujeres en una lista consecutiva a quienes se les indicó una TVS ginecológica, realizada en una consulta de ecografía de gran volumen de pacientes entre julio y agosto de 2018. Se documentaron los antecedentes clínicos y quirúrgicos, las indicaciones para la TVS y los hallazgos de la TVS. La prevalencia de la obliteración del FSD confirmada por la TVS, determinada por la interpretación del signo deslizante, se calculó para toda la cohorte y para subgrupos de mujeres con y sin factores de riesgo de endometriosis. El riesgo elevado de endometriosis se definió como el hecho de tener (1) una remisión para TVS debido a dolor pélvico similar a la endometriosis o endometriosis específicamente y/o (2) síntomas o indicios clínicos que sugerían endometriosis. El riesgo bajo se definió como la ausencia de estas características.
Resultados
Durante el período de estudio, 1043 mujeres se sometieron a TVS de forma consecutiva. Se analizaron 909 mujeres, tras excluir a las que se sometieron a una ecografía abdominal, las que tenían antecedentes de histerectomía o aquellas para las que faltaban datos. La prevalencia de un signo deslizante negativo en toda la cohorte fue de 47/909 (5,2%). Se observó un signo deslizante negativo en 22/639 (3,4%) de las mujeres con bajo riesgo de endometriosis y en 25/243 (10,3%) de aquellas con alto riesgo de endometriosis (diferencia de proporciones, 6,9% (IC 95%: 2,8–10,9%); P<0,001).
Conclusiones
Se demuestra una prevalencia general de un signo deslizante negativo, que sugiere la obliteración del FSD en el 5,2% (o 1/20) de mujeres que se someten a TVS para una indicación ginecológica. La prevalencia del signo deslizante negativo en las mujeres de bajo riesgo no es desdeñable (3,4% o 1/29 mujeres). Estas mujeres son las más propensas a tener endometriosis asintomática u otra etiología importante de obliteración del FSD. La prevalencia de un signo deslizante negativo es aproximadamente tres veces mayor en mujeres con signos y/o síntomas de endometriosis (10,3% vs 3,4%). Copyright © 2020 ISUOG. Published by John Wiley & Sons Ltd.
摘要
在因任何指征而进行经阴道盆腔超声期间提示直肠子宫陷凹(Douglas窝)封闭的“滑动征”阴性的患病率
目的
使用动态经阴道超声(TVS)“滑动征”技术预测直肠子宫陷凹(Douglas窝，POD)封闭，具有一定的确定性和重复性。迄今为止，有关POD封闭预测的研究集中于有子宫内膜异位症高患病率的三级护理人群。然而，POD封闭有可能存在于无症状子宫内膜异位症患者或其它疾病患者中。我们的主要目的是，在因妇科指征而进行TVS检查的患者群体中，确定提示POD封闭的“滑动征”阴性的患病率。
方法
这是一项前瞻性观察研究，在2018年7月和8月之间对因一项妇科指征而进行TVS的女性，进行了大量的超声检查。记录了临床和手术病史、TVS指征和TVS检查结果。对参与研究的整个群体以及有/无子宫内膜异位症风险的女性亚组，就由TVS确定的POD封闭(通过解读“滑动征”来确定)的患病率进行了计算。子宫内膜异位症的高风险被定义为:(1)有一次因类似于子宫内膜异位症的盆腔疼痛或因特定子宫内膜异位症而进行的转诊，且/或(2)有提示子宫内膜异位症的临床症状或体征。无这些特征则被定义为低风险。
结果
在研究期间，连续有1043名女性进行了TVS。在排除了那些经腹部超声检查的、有子宫切除史的或缺失数据的之后，对909名女性进行了分析。在整个研究群体中，“滑动征”阴性的患病率为47/909(5.2%)。在子宫内膜异位症低风险群体中观察到的“滑动征”阴性为22/639(3.4%)，而在子宫内膜异位症高风险群体中观察到的“滑动征”阴性为25/243(10.3%)(比例差异，6.9%(95% CI 2.8‐10.9%)；P<0.001)。
结论
我们在因妇科指征而进行TVS的女性中论证了提示POD封闭的“滑动征”阴性的总体患病率为5.2%(或1/20)。在低风险女性群体中，“滑动征”阴性的患病率并不可以忽略(占3.4%或1/29)。这些女性最可能患有无症状的子宫内膜异位症或POD封闭的另一种重要病因。在患有子宫内膜异位症体征和/或症状的女性中，“滑动征”阴性的患病率大约高三倍(10.3% vs 3.4%)。版权 © 2020 ISUOG。由威利父子公司(John Wiley & Sons Ltd)出版。
This article's has been translated into Spanish and Chinese. Follow the links from the to view the translations.
A video of this article is available online here.
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49.
50.
Assessment of ectomycorrhizal fungal communities in the natural habitats of Tuber magnatum (Ascomycota, Pezizales)
Leonardi, M; Iotti, M; Oddis, M ...
Mycorrhiza,
07/2013, Letnik:
23, Številka:
5
Journal Article
The ectomycorrhizal (ECM) fungal communities of four natural Tuber magnatum truffle grounds, located in different Italian regions (Abruzzo, Emilia-Romagna, Molise, and Tuscany), were studied. The ...
main objective of this study was to characterize and compare the ECM fungal communities in the different regions and in productive (where T. magnatum ascomata were found) and nonproductive points. More than 8,000 (8,100) colonized root tips were counted in 73 soil cores, and 129 operational taxonomic units were identified using morphological and molecular methods. Although the composition of the ECM fungal communities studied varied, we were able to highlight some common characteristics. The most plentiful ECM fungal taxa belong to the Thelephoraceae and Sebacinaceae families followed by Inocybaceae and Russulaceae. Although several ectomycorrhizas belonging to Tuber genus were identified, no T. magnatum ectomycorrhizas were found. The putative ecological significance of some species is discussed.
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