Archivio istituzionale della ricerca - Università dell'Insubria
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Case report: multiple electrolyte disturbance with severe neurological manifestations induced by chronic use of PPIs
Get PDFImpact of thyroid disorders on flow-mediated dilation: a systematic review and meta-analysis
No full textBackground: Endothelial dysfunction may contribute to the increased cardiovascular risk associated with thyroid diseases. This systematic review and meta-analysis aimed to assess endothelial function, evaluated by flow-mediated dilation (FMD), in both hypo and hyperthyroidism, and its response to treatment. Methods: We searched Embase and PubMed (until April 2025) for studies on FMD in hypo- and hyperthyroidism (PROSPERO registration number: CRD42024629806). Risk of bias was assessed using Cochrane criteria. Mean differences (MD) with 95% confidence intervals (CI) were calculated using random-effects models. Statistical heterogeneity was assessed with I2 statistics. Analyses were conducted using Review Manager 5.4.1. Results: Forty-two studies (1,663 subjects with hypothyroidism, 247 with thyrotoxicosis/endogenous hyperthyroidism, and 1520 euthyroid controls) were included. FMD was significantly reduced in subjects with untreated hypothyroidism compared to euthyroid controls (MD -2.99, 95% CI, -3.83, -2.14; I2 = 99%), improved with levothyroxine treatment (MD 3.06, 95% CI: 1.94, 4.19; I2 = 91%) and reached values similar to controls upon restoration of euthyroidism (MD 0.22, 95% CI: -0.75, 1.18; I2 = 75%). A non-statistically significant difference emerged comparing untreated hyperthyroid subjects with controls (MD - 2.55; 95% CI: -5.38, 0.28; I2 = 98%), and low risk of bias studies showed reduced FMD in this subset (MD - 6.57; 95% CI: -7.53, - 5.60; I2 = 45%). Subclinical hyperthyroidism was associated with FMD impairment (MD - 4.21; 95% CI: -7.07, - 1.35; I2 = 97%). Conclusion: Hypothyroidism is associated with endothelial impairment, reversible after restoration of euthyroidism, highlighting the importance of appropriate management. Hyperthyroidism, especially subclinical, seems associated with FMD reduction, but larger, well-designed studies are needed
Il "cartello delle colpe" nel Giacobinismo: da procedura giuridica a strumento di dileggio morale.
No full textL'articolo analizza quanto, nel Giacobinismo degli anni 1793-94, la valutazione morale sulle azioni dei singoli prevalga su ogni altra prospettiva
Multigrid Methods for Computed Tomography
No full textWe consider the problem of computed tomography (CT). This ill-posed inverse problem arises when one wishes to investigate the internal structure of an object with a non-invasive and non-destructive technique. This problem is severely ill-conditioned, meaning it has infinite solutions and is extremely sensitive to perturbations in the collected data. This sensitivity produces the well-known semi-convergence phenomenon if iterative methods are used to solve it. In this work, we propose a multigrid approach to mitigate this instability and produce fast, accurate, and stable algorithms starting from unstable ones. We consider, in particular, symmetric Krylov methods, like lsqr, as smoother, and a symmetric projection of the coarse grid operator. However, our approach can be extended to any iterative method. Several numerical examples show the performance of our proposal
Bedaquiline and linezolid regimens for multidrug-resistant tuberculosis: a systematic review and meta-analysis
Get PDFObjective: Multidrug-resistant tuberculosis (MDR-TB) remains a global public health challenge, complicating treatment strategies and requiring advanced therapeutic approaches. The persistence of MDR-TB has led to a demand for regimens that are more effective in improving treatment outcomes and controlling transmission. This systematic review and meta-analysis sought to examine the efficacy of linezolid (LZD) and bedaquiline (BDQ) in MDR-TB treatment regimens, evaluating their roles in enhancing therapeutic success and informing optimized management of MDR-TB. Methods: A comprehensive search was conducted across MEDLINE (PubMed), EMBASE, the Cochrane Central Register of Controlled Trials, Scopus, and Web of Science for randomized controlled trials assessing the efficacy of LZD and BDQ in MDR-TB patients up to September 14, 2024. We analyzed treatment outcomes, reporting favorable outcomes (cured and treatment completed) and unfavorable outcomes (death, treatment failure, and loss to follow-up) with a 95% confidence interval. Results: Our analysis included 11 trials, with a total of 1,999 participants. The findings indicate that BDQ+LZD-containing regimens yield significantly higher favorable treatment outcomes (84.5%; 95% CI, 79.8%-88.2%) and lower unfavorable outcomes (15.4%; 95% CI, 11.6%-20.2%). In contrast, regimens lacking either LZD or BDQ show lower efficacy, with favorable outcomes at 66.8% (95% CI, 59.5%-73.4%) and unfavorable outcomes at 33.0% (95% CI, 25.6%-41.4%). Conclusions: MDR-TB treatment regimens including BDQ and LZD lead to significantly better patient outcomes. The combined bactericidal and protein synthesis-inhibiting effects of BDQ and LZD create a powerful therapeutic synergy. Adding pretomanid further enhances this effectiveness, highlighting its value in complex cases. Future research should focus on optimizing these regimens for safety and efficacy and explore adjunctive therapies to improve MDR-TB outcomes even further
Twin Beams for Sensitivity Enhancement in Time-Domain Spectroscopy
No full textWe show that quantum correlations in ultrafast twin beams suppress noise and double the sensitivity of time-resolved THz field detection. Our results highlight the potential of quantum resources to enhance time-domain spectroscopy via electro-optic sampling
Molecular and functional changes in GABAergic transmission during epileptogenesis in a rat model of post-traumatic epilepsy
No full textTraumatic brain injury (TBI) is one of the leading causes of structural epilepsy. Our objective was to investigate the molecular and functional dysregulation of GABAergic neurotransmission during a wide time window from acute to chronic phases of epileptogenesis after TBI. Perilesional and thalamic tissues sampled from a clinically relevant animal model of post-traumatic epilepsy induced by lateral fluid-percussion injury were investigated using in situ hybridization, immunohistochemistry and RNA sequencing. For functional analysis, we utilized a membrane microtransplantation technique in Xenopus oocytes in order to overcome the technical difficulties that would stem from recording directly from highly damaged lesional and perilesional brain tissues. Already at 6 to 24 h post-TBI we found a dysregulation in the expression of GABAAR beta 3- and delta-subunits, which persisted for up to 4 months. Further, gene set enrichment analysis revealed a negative enrichment of GABA receptor signaling in the perilesional cortex and ipsilateral thalamus. These changes occurred in parallel to the dysregulation of the two main cation-chloride cotransporter genes (Slc12a2 and Slc12a5) both in the perilesional cortex and the ipsilateral thalamus. Our functional analysis revealed that the GABA current reversal potential (EGABA) was shifted towards more depolarized values in the perilesional cortex and ipsilateral thalamus. Our data demonstrate a rapid onset and long-lasting duration of GABAergic dysfunction after TBI and support the hypothesis that an early treatment with agents modulating the GABAergic transmission in the thalamo-cortical-thalamic circuitry may suppress early seizures as well as prevent or slow down epileptogenesis after TBI
Bio-molecular cryptography for protecting nano-network transmissions in healthcare applications
No full textNano-technologies and communications at the nanoscale emerged as new approaches for data collection in many application domains, such as bio-medicine, healthcare, industry, agro-food, and military/defense. They usually entail a huge amount of continuous and real-time information to be processed from nano-devices, thus paving the way for the spreading of an innovation paradigm, represented by the Internet of Nano-Things (IoNT). The reliability of the envisioned IoNT applications still represents an open issue, due to the complexity of protecting the transmitted data at the nano-scale. In this context, this work proposes to adopt bio-molecular cryptography to secure data exchanges among the nano-devices in a nano-network, which integrates both molecular diffusion and electromagneticbased communication protocols. Bio-molecular cryptography is essentially based on the properties of DNA and proteins. Starting from such premises, a cryptographic algorithm is developed and its performance is evaluated on a reference IoNT scenario in the healthcare domain, along with the study of the behavior of different routing algorithms
Obstructive sleep apnea syndrome indexes in patients treated with oral appliances with different vertical dimension: a preliminary study
No full textBACKGROUND: Mandibular reposition devices (MRDs) are a viable option for addressing snoring and mild to moderate obstructive sleep apnea syndrome (OSAS) as another possibility to continuous positive airway pressure (CPAP) ventilation during sleep. The aim of the study was to evaluate the efficacy of OSAS MRDs with variation in vertical dimension, considering the OSAS indexes: Apnea Hypopnea Index (AHI), Oxygen Desaturation Index (ODI) and Snoring Index. METHODS: Eleven patients with different level of OSAS were enrolled in this study. The patients in the study were evaluated at three different times (T0, T1, T2). At T0 the patients underwent a basal polysomnography (PSG) without any oral appliance. At T1, the PSG was executed using MRD at 70% of protrusion and a vertical dimension consequent of protrusion. The vertical dimension determined by a protruded position is the one that is caused by the repositioning of the mandible. At the T2, the patients used the same appliance with 70% of protrusion, adding a uniform 6-mm bite resin plane between the existing upper and lower splints of the MRD, in the lateral area. The patients enrolled in this study did not tolerate the CPAP. T-test for paired samples was used to assess the possible statistical differences between AHI and ODI (T0, T1 and T2). The snoring indexes were analyzed through Friedman test for corelated sample. RESULTS: The mean value of AHI (T0) was 30.17 +/- 19.51. The mean AHI of T1 was 10.60 +/- 9.35, while the mean value of T2 was 5.41 +/- 3.25. The mean value of ODI (T0) was 29.02; SD +/- 20.74. The mean ODI of T1 was 10.46 +/- 9.48, while the mean value of T2 was 5.40 +/- 3.41. Analyzing AHI and ODI, there was a significant statistical difference between T0 and T1 (P<0.05), between T1 and T2 (P<0.05) and between T0 and T2 (P<0.05). There was not any statistical difference for snoring indexes between T0, T1 and T2. (P>0.05). CONCLUSIONS: According to the results of this study, the major improvement of AHI and ODI is reached through the usage of MRD with an increase of vertical dimension. Considering all the limits of the study, it is possible to affirm that research should still take account of the vertical dimension as a possible factor when treating OSAS with oral appliance
Molecular profiling of tissue- and circulating cancer related non coding RNAs in hepatocellular carcinoma
No full textHuman hepatocellular carcinoma (HCC) is the most common liver cancer and the third
leading cause of cancer-related death. Non-coding RNAs (ncRNAs), including miRNAs and
long ncRNAs (lncRNAs), play a role in almost all aspects of cancer biology and have emerged
as novel therapeutic targets and valuable candidates with clinical translational potential in
cancer management. In HCC, we have described the tumor suppressor roles of miR-193a-3p
and miR-23b-3p, and we have identified the dysregulation of lncRNA GAS5 and miR-126-3p in
HCC cells treated with sorafenib, a multikinase inhibitor used for the treatment of advanced
HCC. Here, to further elucidate the function of these ncRNAs in HCC and assess their
potential as molecular indicators, we evaluated the levels of the selected ncRNAs in tissue
and liquid biopsies of HCC patients. The expression of miR-193a-3p, miR-23b-3p, and
miR-126-3p was significantly reduced in HCCs compared to peritumoral tissues. Interestingly,
high miR-193a-3p levels in HCCs were associated with prolonged OS and DFS of patients.
Regarding the circulating levels of the selected ncRNAs, miR-193a-3p resulted undetectable,
whereas miR-23b-3p and GAS5 were lower and miR-126-3p was higher in plasma of HCC
patients versus healthy individuals. The ROC curve analysis underlined the diagnostic
relevance of all the aforementioned ncRNAs. Finally, miR-23b-3p, miR-126-3p and GAS5 were
preliminarily evaluated in longitudinally collected plasma from a small group of HCC patients
treated with sorafenib (n=7). The results showed variations in the levels of these ncRNAs
during the follow-up, and interestingly miR-23b-3p significantly increased one month after
sorafenib treatment. Overall, these data highlight the promising translational relevance of the
selected ncRNAs in HCC and their potential involvement in the response to sorafenib
treatmen