Palmar-plantar erythrodysesthesia (PPE), also called hand-foot syndrome or hand-to-foot syndrome, is a distinctive and relatively frequent dermatologic toxic reaction associated with certain ...chemotherapeutic agents. Pegylated liposomal doxorubicin (PLD), a long-circulating formulation of doxorubicin in which doxorubicin hydrochloride is encapsulated within pegylated liposomes, is approved to treat patients with metastatic breast cancer, advanced ovarian cancer, and acquired immunodeficiency syndrome-related Kaposi's sarcoma. The incidence of PPE is increased in patients receiving PLD compared with conventional doxorubicin. In studies that utilized the currently approved dose of PLD (50 mg/m2 every 4 weeks), ∼50% of all patients receiving PLD experienced PPE, and ∼20% experienced grade 3 PPE. The pathophysiology of PPE, as it occurs with any drug with which it is associated, is not well understood. Studies evaluating the development of PPE specifically associated with PLD have not fully elucidated the mechanism; however, data support the roles of drug excretion in sweat and local pressure as contributors. When PPE develops, clinical interventions with respect to altering PLD administration include dose reduction, less frequent dosing, and ultimately, drug withdrawal with several consequences on treatment efficacy. This article will review the available data regarding the etiology and potential management strategies of PPE associated with PLD.
The Arctic climate is influenced by the interaction of shortwave (SW) and longwave (LW) radiation with the atmosphere and the surface. The comprehensive evolution of the Surface Radiative Fluxes ...(SRF) on different time scales is of paramount importance to understanding the complex mechanisms governing the Arctic climate. However, only a few sites located in the Arctic region provide long-term time series of SRF allowing for capturing of the seasonality of atmospheric and surface parameters and for carrying out validation of satellite products and/or reanalyses.
The aim of this study was to investigate the effects of high-intensity aerobic training (AT) and high-intensity aerobic training combined with resistance training (ie, combined training CT) on ...cognitive function in patients with COPD.
Twenty-eight Caucasian male patients (68.35±9.64 years; mean ± SD) with COPD were recruited and randomized into two groups, AT and CT. Both groups performed physical reconditioning for 4 weeks, with a frequency of five training sessions per week. The CT group completed two daily sessions of 30 minutes: one aerobic session and one strength session, respectively; The AT group performed two 30-minute aerobic endurance exercise sessions on treadmill. Physical and cognitive function tests were performed before and after the training intervention performances.
Exercise training improved the following cognitive functions: long-term memory, verbal fluency, attentional capacity, apraxia, and reasoning skills (P<0.01). Moreover, the improvements in the CT group were significantly greater than those in the AT group in long-term memory, apraxia, and reasoning skills (P<0.05).
CT may be a possible strategy to prevent cognitive decline and associated comorbidities in male patients with COPD.
The association between PrP gene variations and scrapie susceptibility was studied in a single herd of Ionica breed goats. The entire herd comprised 100 animals, 11 of which were clinically affected ...and showed pathological prion protein (PrP(Sc)) deposition in both their central nervous system (CNS) and lymphoreticular system (LRS). Among asymptomatic goats, nine harboured PrP(Sc) in both CNS and LRS, 19 showed PrP(Sc) only at the LRS level and 61 animals had no PrP(Sc) deposition. Genetic analysis of the PrP gene coding sequence revealed the presence of several polymorphisms, namely G37V, T110P, H143R, R154H, Q222K and P240S. Silent polymorphisms were also found at codons 42, 138, 219 and 232. The effect of PrP polymorphism on scrapie susceptibility was assessed by comparing the genotype distribution at each locus among animals with different pathogenetic and clinical disease stages. Significant differences in the distribution of genotypes were observed for codons 154 and 222, with polymorphism at codon 154 modulating susceptibility to scrapie and lysine at codon 222 being associated with scrapie resistance. The allelic variant encoding lysine at position 222 could be a valuable candidate to select in the framework of appropriate breeding programmes for scrapie resistance in goats.
Background
Overall mortality is a relevant indicator of the population burden during COVID-19 pandemic, reflecting the overload and preparedness of the healthcare system. This study aimed to analyse ...the distribution of deaths in SARS-CoV-2 positive patients between pandemic phases and to evaluate the characteristics of COVID-19 patients deceased during the year.
Methods
Data on confirmed COVID-19 cases were collected from the recording system of the Department of Prevention of the Local Health Authority of Abruzzo Region, Italy. The course of the epidemic was stratified in 4 phases: the first wave (March-May 2020), the low incidence phase (June-September 2020), the second wave (October 2020-December 2021), and the variants spread phase in our region (January-March 2021).
Results
From March 2020 to March 2021 we registered 17,082 cases of SARS-CoV-2 infection, of these patients 571 (3.35%) had a fatal outcome. The mortality was the highest during the first ‘peak' phase, interesting the 14.20% of the notified cases, and the lowest during the last phase (2.50%). Mortality due to COVID-19 mainly affected men (54.99%) and geriatric patients (median age: 84; IQR: 75-90). Women dying for SARS-CoV-2 infection had a more advanced median age (87; IQR: 79-92) than men (81; IQR: 73-87). The lowest median age was registered in patients deceased during the low incidence phase (75.5; IQR: 71-82). The median time span, in days, from a SARS-CoV-2 positive test to death was significant lower in the phase 1 (days:10; IQR:4-20) then in phase 4 (days:14; IQR:8-22) (p < 0.001).
Conclusions
Our results showed that mortality markedly decreased during the COVID-19 epidemic, and this could be likely related to an improved organisation and delivery of care, in addition to a better knowledge of disease treatment. Elderly patients were more likely to progress toward fatal outcome. The healthcare systems should pay special attention to them in order to effectively manage possible future pandemics.
Key messages
The COVID-19 mortality reduction highlights an improvement of health care; the elderly remains at major risk of death.
Providing pandemic prevention and care models focused also on vulnerable groups is a major public health challenge.
Computer-aided dental implant placement seems to be useful for placing implants by using a flapless approach. However, evidence supporting such applications is scarce. The aim of this study is to ...evaluate the accuracy of and complications that arise from the use of selective laser sintering surgical guides for flapless dental implant placement and immediate definitive prosthesis installation.
Sixty implants and 12 prostheses were installed in 12 patients (four males and eight females; age range: 41 to 71 years). Lateral (coronal and apical) and angular deviations between virtually planned and placed implants were measured. The patients were followed up for 30 months, and surgical and prosthetic complications were documented.
The mean ± SD angular, coronal, and apical deviations were 6.53° ± 4.31°, 1.35 ± 0.65 mm, and 1.79 ± 1.01 mm, respectively. Coronal and apical deviations of <2 mm were observed in 82.67% and 58.33% of the implants, respectively. The total complication rate was 34.41%; this rate pertained to complications such as pulling of the soft tissue from the lingual surface during drilling, insertion of an implant that was wider than planned, implant instability, prolonged pain, midline deviation of the prosthesis, and prosthesis fracture. The cumulative survival rates for implants and prostheses were 98.33% and 91.66%, respectively.
The mean lateral deviation was <1.8 mm, and the mean angular deviation was 6.53°. However, 41.67% of the implants had apical deviation >2 mm. The complication rate was 34.4%. Hence, computer-aided dental implant surgery still requires improvement and should be considered as in the developmental stage.
Abstract
Background
In Italy, the loss of confidence in vaccines has resulted in low vaccination coverage also among healthcare workers (HCWs). Low vaccination coverage among HCWs may lead to ...dangerous outbreaks and may increase absenteeism. The aim of this study was to investigate vaccine coverage and the attitudes toward vaccination among HCWs.
Methods
A multicenter cross-sectional study was conducted from August to November 2019 among HCWs referring to all the hospitals of the Local Health Authority 02 of Abruzzo Region, Italy. The survey was based on the questionnaire proposed by the H-ProImmune Project, aiming at investigating vaccination coverage and beliefs towards vaccination. Besides a descriptive analysis of the results, a logistic regression analysis was performed to evaluate the association between vaccine coverage and type of occupation (medical doctor, nurse, obstetric nurse, other).
Results
A total of 347 HCWs were enrolled in the study. The 57.3% reported to have missed diphtheritis-tetanus-pertussis (DTP) vaccination, the 50.1% reported to have missed measles-mumps-rubella (MPR) vaccination, and the 62.5% reported to have missed flu vaccination. In comparison with medical doctors, obstetric nurses were more likely to be associated to MPR vaccination (OR 2.8;95%CI 1.1-7.6; p = 0.047). As far as flu vaccination was concerned, both nurses and obstetric nurses showed lower confidence (respectively OR 0.2; 95%CI 0.1-0.3; p < 0.001 and OR 0.1; 95%CI 0.1-0.5; p = 0.003). Moreover, other healthcare professionals reported to believe in natural immunization more than in vaccination (26.5%; p < 0.001) and they were also worried about long-term effects of vaccination (10.2%; p = 0.044). Differently, nurses were more frequently worried about vaccine side effects (24%; p < 0.001).
Conclusions
This survey shows that the vaccination coverage taken into consideration results to be below the 95% threshold. Training on vaccine and mandatory measures may be necessary in order to achieve better coverage.
Key messages
Among HCW all vaccination coverage considered resulted below the threshold. Training on vaccine and mandatory measures may be needed in order to achieve better coverage.
User interaction has the potential to greatly facilitate the exploration and understanding of 3D medical images for diagnosis and treatment. However, in certain specialized environments such as in an ...operating room (OR), technical and physical constraints such as the need to enforce strict sterility rules, make interaction challenging. In this paper, we propose to facilitate the intraoperative exploration of angiographic volumes by leveraging the motion of a tracked surgical pointer, a tool that is already manipulated by the surgeon when using a navigation system in the OR. We designed and implemented three interactive rendering techniques based on this principle. The benefit of each of these techniques is compared to its non-interactive counterpart in a psychophysics experiment where 20 medical imaging experts were asked to perform a reaching/targeting task while visualizing a 3D volume of angiographic data. The study showed a significant improvement of the appreciation of local vascular structure when using dynamic techniques, while not having a negative impact on the appreciation of the global structure and only a marginal impact on the execution speed. A qualitative evaluation of the different techniques showed a preference for dynamic chroma-depth in accordance with the objective metrics but a discrepancy between objective and subjective measures for dynamic aerial perspective and shading.
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