Purpose The purpose of this study was to investigate outcomes after hip arthroscopy in a consecutive series of patients aged 50 years or older and determine how long patients avoided total hip ...replacement. Methods Between 2006 and 2008, prospectively collected data were retrieved from our database on 153 patients aged 50 years or older undergoing hip arthroscopy for femoroacetabular impingement. Data collected included range of motion, Modified Harris Hip Score (MHHS), Hip Outcome Score (HOS) for activities of daily living, HOS for sports, and Short Form 12 score. Survivors were defined as patients not requiring total hip replacement (THR). Survivorship was analyzed by use of the Kaplan-Meier method. Results THR was required after the arthroscopic treatment in 20% of patients (31 of 153). At 3 years (with data available in 64 patients), patients with greater than 2 mm of joint space had survivorship of 90% whereas those with 2 mm or less had survivorship of 57% ( P = .001). In the patients who did not require THR, the MHHS improved from 58 to 84. The HOS for activities of daily living improved from 66 to 87 ( P = .001), and the HOS for sports improved from 42 to 72 ( P = .001). The physical component of the Short Form 12 improved from 38 to 49 ( P = .001), whereas the mental component did not change (54 preoperatively v 53 postoperatively, P = .53). Median patient satisfaction was 9. Conclusions On the basis of early results, patients with greater than 2 mm of joint space can expect improvement over preoperative status in pain and function after hip arthroscopy for femoroacetabular impingement. In patients aged 50 years or older with 2 mm of joint space or less and low preoperative MHHSs, early conversion to THR was seen. Level of Evidence Level IV, therapeutic case series.
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Open and hidden heavy-flavor physics in high-energy nuclear collisions are entering a new and exciting stage towards reaching a clearer understanding of the new experimental results with the ...possibility to link them directly to the advancement in lattice Quantum Chromo-Dynamics (QCD). Recent results from experiments and theoretical developments regarding open and hidden heavy-flavor dynamics have been debated at the Lorentz Workshop
Tomography of the Quark-Gluon Plasma with Heavy Quarks
, which was held in October 2016 in Leiden, The Netherlands. In this contribution, we summarize identified common understandings and developed strategies for the upcoming five years, which aim at achieving a profound knowledge of the dynamical properties of the quark-gluon plasma.
To successfully implement imaging-based pancreatic cancer (PC) surveillance, understanding the timeline and morphologic features of neoplastic progression is key. We aimed to investigate the ...progression to neoplasia from serial prediagnostic pancreatic imaging tests in high-risk individuals and identify factors associated with successful early detection.
We retrospectively examined the development of pancreatic abnormalities in high-risk individuals who were diagnosed with PC or underwent pancreatic surgery, or both, in 16 international surveillance programs.
Of 2552 high-risk individuals under surveillance, 28 (1%) developed neoplastic progression to PC or high-grade dysplasia during a median follow-up of 29 months after baseline (interquartile range IQR, 40 months). Of these, 13 of 28 (46%) presented with a new lesion (median size, 15 mm; range 7–57 mm), a median of 11 months (IQR, 8; range 3–17 months) after a prior examination, by which time 10 of 13 (77%) had progressed beyond the pancreas. The remaining 15 of 28 (54%) had neoplastic progression in a previously detected lesion (12 originally cystic, 2 indeterminate, 1 solid), and 11 (73%) had PC progressed beyond the pancreas. The 12 patients with cysts had been monitored for 21 months (IQR, 15 months) and had a median growth of 5 mm/y (IQR, 8 mm/y). Successful early detection (as high-grade dysplasia or PC confined to the pancreas) was associated with resection of cystic lesions (vs solid or indeterminate lesions (odds ratio, 5.388; 95% confidence interval, 1.525–19.029) and small lesions (odds ratio, 0.890/mm; 95% confidence interval 0.812–0.976/mm).
In nearly half of high-risk individuals developing high-grade dysplasia or PC, no prior lesions are detected by imaging, yet they present at an advanced stage. Progression can occur before the next scheduled annual examination. More sensitive diagnostic tools or a different management strategy for rapidly growing cysts are needed.
Almost half of pancreatic cancers develop rapidly and without warning signs on scans or endoscopy. The other half grow from earlier visible pancreatic cysts, which are difficult to discern from innocent cysts.
Aims
To systematically review the literature on the efficacy and tolerability of the major chronotherapeutic treatments of bipolar disorders (BD)—bright light therapy (LT), dark therapy (DT), ...treatments utilizing sleep deprivation (SD), melatonergic agonists (MA), interpersonal social rhythm therapy (IPSRT), and cognitive behavioral therapy adapted for BD (CBTI‐BP)—and propose treatment recommendations based on a synthesis of the evidence.
Methods
PRISMA‐based systematic review of the literature.
Results
The acute antidepressant (AD) efficacy of LT was supported by several open‐label studies, three randomized controlled trials (RCTs), and one pseudorandomized controlled trial. SD showed rapid, acute AD response rates of 43.9%, 59.3%, and 59.4% in eight case series, 11 uncontrolled, studies, and one RCT, respectively. Adjunctive DT obtained significant, rapid anti‐manic results in one RCT and one controlled study. The seven studies on MA yielded very limited data on acute antidepressant activity, conflicting evidence of both antimanic and maintenance efficacy, and support from two case series of improved sleep in both acute and euthymic states. IPSRT monotherapy for bipolar II depression had acute response rates of 41%, 67%, and 67.4% in two open studies and one RCT, respectively; as adjunctive therapy for bipolar depression in one RCT, and efficacy in reducing relapse in two RCTs. Among euthymic BD subjects with insomnia, a single RCT found CBTI‐BP effective in delaying manic relapse and improving sleep. Chronotherapies were generally safe and well‐tolerated.
Conclusions
The outcome literature on the adjunctive use of chronotherapeutic treatments for BP is variable, with evidence bases that differ in size, study quality, level of evidence, and non‐standardized treatment protocols. Evidence‐informed practice recommendations are offered.
•MNPs synthesized using green synthesis have potential for MRI contrast agent.•Latex coating increased the magnetization of the magnetic nanoparticles.•Nuclear relaxivity properties have different ...behaviors considering the latex content.
Early detection is prerequisite for a successful cancer treatment. Recent advances in nanoscience and imaging technology allow the application of nanomaterials for early cancer diagnosis. Magnetic resonance imaging (MRI) has become one of the most extensively used and powerful tool for noninvasive clinical diagnosis. This work reports the synthesis and characterization of iron oxide nanoparticles coated with natural rubber latex (NRL), as well as their incorporation in a gelatin matrix to be used as an MRI contrast agent. Nanoparticles physical properties were characterized using X-ray diffraction (XRD), transmission electronic microscope (TEM), dynamic light scattering (DLS), magnetometry and MRI. XRD profiles indicated that magnetic nanoparticles (Fe3O4) with spinel structure were formed. TEM images showed the formation of iron oxide nanoparticles with average size about 9–14 nm, depending on the NRL concentration. Magnetization curves demonstrated iron oxide nanoparticles having superparamagnetic characteristics with increased magnetization as a function of NRL concentration. The zero-field cooling (ZFC) and field cooling (FC) curves show decreased blocking temperature upon coating magnetic nanoparticles with NRL. MRI results showed proton nuclear relaxivity ratios (r2/r1) of prepared MNPs significantly decreased by increasing the amount of NRL in the synthesis. Therefore, it can be concluded that NRL coated MNPs can be considered as an effective contrast agent for MRI applications.
We aimed to determine the long-term yield of pancreatic cancer surveillance in hereditary predisposed high-risk individuals.
From 2006 to 2019, we prospectively enrolled asymptomatic individuals with ...an estimated 10% or greater lifetime risk of pancreatic ductal adenocarcinoma (PDAC) after obligatory evaluation by a clinical geneticist and genetic testing, and subjected them to annual surveillance with both endoscopic ultrasonography (EUS) and MRI/cholangiopancreatography (MRI/MRCP) at each visit.
366 individuals (201 mutation-negative familial pancreatic cancer (FPC) kindreds and 165 PDAC susceptibility gene mutation carriers; mean age 54 years, SD 9.9) were followed for 63 months on average (SD 43.2). Ten individuals developed PDAC, of which four presented with a symptomatic interval carcinoma and six underwent resection. The cumulative PDAC incidence was 9.3% in the mutation carriers and 0% in the FPC kindreds (p<0.001). Median PDAC survival was 18 months (range 1-32). Surgery was performed in 17 individuals (4.6%), whose pathology revealed 6 PDACs (3 T1N0M0), 7 low-grade precursor lesions, 2 neuroendocrine tumours <2 cm, 1 autoimmune pancreatitis and in 1 individual no abnormality. There was no surgery-related mortality. EUS detected more solid lesions than MRI/MRCP (100% vs 22%, p<0.001), but less cystic lesions (42% vs 83%, p<0.001).
The diagnostic yield of PDAC was substantial in established high-risk mutation carriers, but non-existent in the mutation-negative proven FPC kindreds. Nevertheless, timely identification of resectable lesions proved challenging despite the concurrent use of two imaging modalities, with EUS outperforming MRI/MRCP. Overall, surveillance by imaging yields suboptimal results with a clear need for more sensitive diagnostic markers, including biomarkers.
The Pixel Chamber project purpose is the production of the first solid state active target capable of performing continuous, high-resolution (O(μm)) 3D tracking. The aim is to create a bubble ...chamber-like high-granularity stack of hundreds of very thin monolithic active pixel sensors (MAPS) glued together. In this paper, the R&D to develop the first prototypes with ALPIDE sensors, designed for the ALICE experiment at the CERN LHC, will be presented. Tracking and vertexing algorithms were developed to reconstruct tracks and vertices inside Pixel Chamber. They were tested on Monte Carlo simulations which show that it is possible to obtain a high efficiency for the reconstruction of hadronic tracks, and for the primary and secondary vertices inside the detector. The tracking algorithm has been tested on test beam data to reconstruct long tracks produced in a single ALPIDE sensor parallel to a beam. Results show that it is possible to obtain very good performances in long track reconstruction on a single ALPIDE. Among the possible applications, Pixel Chamber used as an active target, has the potential to allow precision measurements of charm and beauty production. Even more interesting are possible medical and astrophysical applications. The usage of the Pixel Chamber as scatterer detector in Compton Cameras would reduce by orders of magnitude the numbers of gammas required for performing a precise source imaging, both for in vivo monitoring during hadron therapy and for astrophysics measurements.
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Human kallikreins 5 and 7 (KLK5 and KLK7) exhibit trypsin- and chymotrypsin-like activities and are involved in pathologies related to skin desquamation process. A series of new ...3-acyltetramic acids were developed as a novel class of inhibitors of KLK5, KLK7 and trypsin enzymes. The nature and length of the acyl chain is crucial to the KLK5, KLK7 and trypsin inhibition activities, and the most potent compounds (but not the most selective) 2b, 2c and 2g showed low micromolar IC50 values. While very few of the compounds were selective for KLK5, the selective inhibition of trypsin against chymotrypsin was achieved. Our molecular modelling studies revealed that the double bond in 2g provided the best fit in the binding site of KLK5, while the hydrogen bonding interactions modulated the best fit of 2c in the binding site of KLK7 due to the hydrophobicity of the cavity.
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