Cerebral amyloid angiopathy (CAA) is recognized as a cause of cognitive impairment, but its cognitive profile needs to be characterized, also respect to hypertension-related microangiopathy (HA). We ...aimed at comparing difference or similarity of CAA and HA patients' cognitive profiles, and their associated factors. Participants underwent an extensive clinical, neuropsychological, and neuroimaging protocol. HA patients (n = 39) were more frequently males, with history of vascular risk factors than CAA (n = 32). Compared to HA, CAA patients presented worse performance at MoCA (p = 0.001) and semantic fluency (p = 0.043), and a higher prevalence of amnestic MCI (46% vs. 68%). In univariate analyses, multi-domain MCI was associated with worse performance at MoCA, Rey Auditory Verbal Learning Test (RAVLT), and semantic fluency in CAA patients, and with worse performance at Symbol Digit Modalities Test (SDMT) and phonemic fluency in HA ones. In multivariate models, multi-domain deficit remained as the only factor associated with RAVLT (β = - 0.574) in CAA, while with SDMT (β = - 0.364) and phonemic fluency (β = - 0.351) in HA. Our results highlight different patterns of cognitive deficits in CAA or HA patients. While HA patients' cognitive profile was confirmed as mainly attentional/executive, a complex cognitive profile, characterized also by deficit in semantic memory, seems the hallmark of CAA patients.
Herein, we report the first paper-based microfluidic device encompassing the filter paper to manage the flow and to load the reagents for a reagent-free competitive magnetic-bead-based immunosensor ...for cortisol analysis in sweat. The paper-based microfluidic pattern was made using wax printing and laser-cutter techniques, for the delivery of capillary-driven microfluidics. The presence of magnetic beads functionalized with monoclonal antibodies for the recognition of the cortisol in the reaction zone allows for the specific measurement of the target analyte. The competitive reaction between the target cortisol and the labeled cortisol with acetylcholinesterase enzyme gives a response inversely proportional to the target cortisol in the range of 10 and 140 ng/mL, by simply folding the pad loaded with the enzymatic substrate. The paper-based microfluidic device was successively combined with a Near-Field Communication wireless module to develop a flexible integrated wearable analytical tool for cortisol detection in sweat. The paper-based integrated device was successfully applied to determine the level of cortisol in sweat in one volunteer during cycling activities at two different times, demonstrating the reliability of this sustainable paper-based device.
•Wearable electrochemical paper-based immunosensor for cortisol detection.•Sweat analysis by exploiting filter paper for capillary-driven flow and reagents loading.•Origami configuration for immunoassay without washing step and reagent addition.•Wireless and battery-free wearable device.
Points-of-care (PoCs) augment healthcare systems by performing care whenever needed and are becoming increasingly crucial for the well-being of the worldwide population. Personalized medicine, ...chronic illness management, and cost reduction can be achieved thanks to the widespread adoption of PoCs. Significant incentives for PoCs deployment are nowadays given by wearable devices and, in particular, by RFID (RadioFrequency IDentification) and NFC (Near Field Communication), which are rising among the technological cornerstones of the healthcare Internet of Things (H-IoT). To fully exploit recent technological advancements, this paper proposes a system architecture for RFID- and NFC-based PoCs. The architecture comprises in a unitary framework both interfaces to benefit from their complementary features, and gathered data are shared with medical experts through secure and user-friendly interfaces that implement the Fast Health Interoperability Resource (FHIR) emerging healthcare standard. The selection of the optimal UHF and NFC components is discussed concerning the employable sensing techniques. The secure transmission of sensitive medical data is addressed by developing a user-friendly "PoC App" that is the first Web app exploiting attribute-based encryption (ABE). An application example of the system for monitoring the pH and cortisol levels in sweat is implemented and preliminarily tested by a healthy volunteer.
•In adults and elderly patients with seizure cluster after i.v. brivaracetam administration no other rescue medications were needed in 77% of the cases.•A lower risk of evolution into status ...epilepticus was observed when BRV was used as first-line drug.•The underlyng etiology was one of the main outcome predictors of response of the seizure cluster.•No severe treatment emergent adverse events were observed after i.v. brivaracetam.
Nearly half of people with epilepsy (PWE) are expected to develop seizure clusters (SC), with the subsequent risk of hospitalization. The aim of the present study was to evaluate the use, effectiveness and safety of intravenous (IV) brivaracetam (BRV) in the treatment of SC.
Retrospective multicentric study of patients with SC (≥ 2 seizures/24 h) who received IV BRV. Data collection occurred from January 2019 to April 2022 in 25 Italian neurology units. Primary efficacy outcome was seizure freedom up to 24 h from BRV administration. We also evaluated the risk of evolution into Status Epilepticus (SE) at 6, 12 and 24 h after treatment initiation. A Cox regression model was used to identify outcome predictors.
97 patients were included (mean age 62 years), 74 (76%) of whom had a history of epilepsy (with drug resistant seizures in 49% of cases). BRV was administered as first line treatment in 16% of the episodes, while it was used as first or second drug after benzodiazepines failure in 49% and 35% of episodes, respectively. On the one hand, 58% patients were seizure free at 24 h after BRV administration and no other rescue medications were used in 75 out of 97 cases (77%) On the other hand, SC evolved into SE in 17% of cases. A higher probability of seizure relapse and/or evolution into SE was observed in patients without a prior history of epilepsy (HR 2.0; 95% CI 1.03 – 4.1) and in case of BRV administration as second/third line drug (HR 3.2; 95% CI 1.1 – 9.7). No severe treatment emergent adverse events were observed.
In our cohort, IV BRV resulted to be well tolerated for the treatment of SC and it could be considered as a treatment option, particularly in case of in-hospital onset. However, the underlying etiology seems to be the main outcome predictor.
Flexible and epidermal sensing devices are becoming vital to enable precision medicine and telemonitoring systems. The NFC (Near Field Communication) protocol is also becoming increasingly important ...for this application since it is embedded in most smartphones that can be used as pervasive and low-cost readers. Furthermore, the responder can be passive and can harvest enough power to perform electromagnetic sensing. Finally, the NFC coils are robust to bending and to the human body's presence. This contribution details the design of a new flexible device, including an electrochemical sensor communicating through the NFC protocol. A spiral NFC antenna is designed, and a manufactured prototype is experimentally tested to quantify the robustness to the inter-wearer variability and the bending. Lastly, the sensory data retrieval is validated by comparison with a portable potentiostat. The realized sensor can be comfortably worn and be easily read by smartphones independently from the wearer and from the point of application and could be used in future for estimating the user's psycho-physical health by analyzing the body's sweat.
Among the multiple healthcare applications and systems exploiting sensing RFID boards, monitoring sweat's pH can be extremely useful for sportsmen and sportswomen. Furthermore, given the multiple ...known benefits that sports yield, measuring pH during physical activity can be integrated with points-of-care (PoCs) for patients who need working out. This contribution details the experimental testing of an RFID sensor for measuring sweat's pH during sporting activity. The electromagnetic (EM) performances are quantified over multiple wearers, and new, low-cost microfluidics made of absorbent paper is manufactured, characterized, and tested so that the use of the tag during exercise is proven feasible.
Points-of-care (PoCs) augment healthcare systems by performing care whenever needed and are becoming increasingly crucial for the well-being of the worldwide population. Personalized medicine, ...chronic illness management, and cost reduction can be achieved thanks to the widespread adoption of PoCs. Significant incentives for PoCs deployment are nowadays given by wearable devices and, in particular, by RFID (RadioFrequency IDentification) and NFC (Near Field Communications), which are rising among the technological cornerstones of the healthcare internet of things (H-IoT). To fully exploit recent technological advancements, this paper proposes a system architecture for RFID- and NFC-based PoCs. The architecture comprises in a unitary framework both interfaces to benefit from their complementary features, and gathered data are shared with medical experts through secure and user-friendly interfaces that implement the Fast Health Interoperability Resource (FHIR) emerging healthcare standard. The selection of the optimal UHF and NFC components is discussed concerning the employable sensing techniques. The secure transmission of sensitive medical data is addressed by developing a user-friendly "PoC App" that is the first web app exploiting attribute-based encryption (ABE). An application example of the system for monitoring the pH and cortisol levels in sweat is implemented and preliminarily tested by a healthy volunteer.
Flexible and epidermal sensing devices are becoming vital to enable precision medicine and telemonitoring systems. The NFC (Near Field Communication) protocol is also becoming increasingly important ...for this application since it is embedded in most smartphones that can be used as pervasive and low-cost readers. Furthermore, the responder can be passive and can harvest enough power to perform electromagnetic sensing. Finally, the NFC coils are robust to bending and to the human body's presence. This contribution details the design of a new flexible device, including an electrochemical sensor communicating through the NFC protocol. A spiral NFC antenna is designed, and a manufactured prototype is experimentally tested to quantify the robustness to the inter-wearer variability and the bending. Lastly, the sensory data retrieval is validated by comparison with a portable potentiostat. The realized sensor can be comfortably worn and be easily read by smartphones independently from the wearer and from the point of application and could be used in future for estimating the user's psycho-physical health by analyzing the body's sweat.
In recent years, body-worn RFID and NFC (near field communication) devices have become one of the principal technologies concurring to the rise of healthcare internet of thing (H-IoT) systems. ...Similarly, points of care (PoCs) moved increasingly closer to patients to reduce the costs while supporting precision medicine and improving chronic illness management, thanks to timely and frequent feedback from the patients themselves. A typical PoC involves medical sensing devices capable of sampling human health, personal equipment with communications and computing capabilities (smartphone or tablet) and a secure software environment for data transmission to medical centers. Hybrid platforms simultaneously employing NFC and ultra-high frequency (UHF) RFID could be successfully developed for the first sensing layer. An application example of the proposed hybrid system for the monitoring of acute myocardial infarction (AMI) survivors details how the combined use of NFC and UHF-RFID in the same PoC can support the multifaceted need of AMI survivors while protecting the sensitive data on the patient's health.
