115 research outputs found
New renderings reveal more details of The Fifth, Alberto Campo Baeza’s first U.S. office building
No full textSobre el Edificio de Oficinas en Miami, de Alberto Campo Baeza, en colaboración con Sumaida + Khurana y Bizzi & Partner
Indirect comparison of etanercept, infliximab, and adalumimab for psoriatic arthritis: mixed treatment comparison using placebo as common comparator
No full text[No abstract available
Children with Somatic Symptoms Disorders and Disruptive Behavior Disorder: Which is the Role of Anger to Caregivers?
No full textIntroductionThe quality of adult-infant interactions represents a critical context in which child adaptation problems could evolve, and child psychopathology could develop. Literature has investigated the role of attachment to caregivers, nevertheless, there is a paucity of studies on middle-childhood and early adolescence in patients with somatic symptoms disorders and disruptive behavior disorders.ObjectiveThis study investigates the attachment to caregivers in children with somatic symptoms disorders and disruptive behavior disorders, focusing on the role of Anger to mothers and fathers.AimsThe aims are to verify the presence of: – high frequency of insecure attachment;– an overrepresentation of attachment disorganization;– high levels of Anger to caregivers.MethodFifty-six patients with somatic symptoms disorders, and 42 patients with disruptive behavior disorders, aged from 8 to 15, are administered the child attachment interview.ResultsFindings show: – Insecure attachment in more than half of the patients;– a significant presence of disorganized attachment with respect to both parents;– higher levels of anger to father in children with somatic symptoms disorders.ConclusionConsidering the attachment to have a regulatory function, the knowledge of the different attachment strategies in middle-childhood and early adolescence may enhance our understanding and improve the management and the treatment of patients with somatic symptoms disorders and disruptive behavior disorders.Disclosure of interestThe author has not supplied his/her declaration of competing interest.</jats:sec
Disruptive Behavior Disorders in Childhood and Adolescence: Attachment Models and Post-traumatic Symptomatology
No full textIntroductionIn line with a consistent literature, young patients with disruptive behavior disorders in childhood and adolescence have experienced some traumatic events, such as abuse, rejection and violence assisted. Recent studies are focusing the attention on the role of attachment and post-traumatic symptomatology for a better evaluation of this clinical condition.ObjectiveThis study investigates attachment models and post-traumatic symptomatology in young patients with disruptive behavior disorders.Aim(s)The following objectives are set by the present study: – to evaluate attachment models in a group of children diagnosed with disruptive behavior disorders;– to evaluate their post-traumatic symptomatology;– to test the extent of the association between post-traumatic symptomatology and attachment organization in young patients with disruptive behavior disorders.MethodForty-two Italian patients aged from 8 to 15 previously diagnosed with disruptive behavior disorders are compared to 42 healthy control subjects. We administer the child attachment interview and trauma symptom checklist for children-adolescent.ResultsInsecure attachment are found in more than half of the patients diagnosed with disruptive behavior disorders and disorganization are highly over-represented. Furthermore, low levels of post-traumatic symptoms are found in young patients with disruptive behavior disorders.ConclusionThis study suggests that attachment organization may be a fundamental element to be assessed in the evaluation of disruptive behavior disorders in children and adolescents. Nevertheless, traumatic experiences do not seem expressed through psychic symptoms. The clinical implications are discussed.Disclosure of interestThe author has not supplied his/her declaration of competing interest.</jats:sec
Beclomethasone/formoterol fixed combination for the management of asthma: patient considerations
No full textGabriele Nicolini1, Nicola Scichilone2, Andrea Bizzi3, Alberto Papi4, Leonardo M Fabbri51Medical Department, Chiesi Farmaceutici, Parma, Italy; 2University of Palermo, DIMPEFINU, Palermo, Italy; 3Department of Scientific Affairs, Chiesi Farmaceutici, Parma, Italy; 4Research Center on Asthma and COPD, University of Ferrara, Ferrara, Italy; 5Section of Respiratory Diseases, University of Modena, Modena, ItalyAbstract: Drugs for asthma and other chronic obstructive diseases of the lungs should be preferably delivered by the inhalation route to match therapeutic effects with low systemic exposure. Inhaled drugs are delivered to the lungs via different devices, mainly metered dose inhalers and dry powder inhalers, each characterized by specific inhaler technique and instructions for use. The patient&ndash;device interaction is part of the prescribed therapy and can have a relevant impact on adherence and clinical outcomes. The most suitable device should be considered for each patient to assure the correct drug intake and adherence to the prescribed therapy. The development of new drugs/devices in the past decades improved the compliance with inhaler and possibly drug delivery to the bronchi. The present review focuses on the recently developed beclomethasone/formoterol extrafine fixed combination and technical aspects of drug delivery to the lungs in patient&rsquo;s perspective.Keywords: beclomethasone, formoterol, modulite, extrafin
Visual neglect as a disconnection syndrome? A confirmatory case report
No full textVisual neglect has classically been associated with right hemisphere injury in parietal, frontal, or temporal cortex, in the basal ganglia or in the thalamus. More recently, visual neglect has been associated with injury extended into fronto-parietal white matter tracts. However, in most published cases white and gray matter injuries were associated. We present the anatomo-clinical study of a patient presenting with severe acute left visual neglect due to ischemic infarct limited to the right cerebral hemisphere white matter. Magnetic resonance diffusion tensor imaging tractography was instrumental to accurately localize the injury to the right arcuate fasciculus that is a component of the large-scale networks controlling visuo-spatial attention. These results add to a growing appreciation that neglect may result from disruption of a distributed attentional network. Paolo Bartolomeo and Alberto Bizzi as senior authors equally contributed to this work
Indirect Comparison Between Subcutaneous Biologic Agents in Ankylosing Spondylitis
No full textThere are four efficacious subcutaneous anti-tumor necrosis factor alpha (TNF-alpha) agents used for the therapy of ankylosing spondilitis (AS), but apparently little or no differences in their effectiveness was proven. By this study, we aimed to compare Assessment in Ankylosing Spondylitis Response Criteria 20 response patterns (ASAS20) between subcutaneous approved biological agents in patients affected by ankylosing spondylitis by means of a mixed treatment comparison of different randomized controlled trials (RCTs) on the efficacy of biological therapies. A search in scientific literature was performed to identify the most complete collection of RCTs available on the selected topic. Similarly designed double-blind, randomized, placebo-controlled trials investigating the efficacy of the subcutaneous and approved TNF-alpha inhibitors such as etanercept, certolizumab pegol, golimumab and adalimumab in the treatment of ankylosing spondylitis patients were identified. The endpoint of interest was ASAS20 response criterium at 12 weeks. Results were analysed simultaneously using Bayesian mixed treatment comparison techniques. Results were expressed as odds ratio (OR) of positive ASAS20 response and associated 95 % credible intervals (CrIs). The probability of being the best treatment was also reported. Only five RCTs matched the inclusion criteria for consequent data extraction and analysis. Mixed treatment comparison of data from such RCTs demonstrated that all subcutaneous anti-TNF-alpha agents are more effective in inducing an ASAS20 response than placebo. Data from 24 weeks' follow-up were not taken into account as early escape granted in some of the studies made results at 24 weeks unmatchable. In our analysis, golimumab proved to be the drug that more probably represents the best choice for achieving ASAS20 response at 12 weeks, although no differences were observed when comparing directly every single subcutaneous anti-TNF-alpha agent against another. Even if the mixed treatment comparisons between adalimumab, golimumab, certolizumab pegol and etanercept did not show a statistically significant difference, this analysis, based on data from only five RCTs, suggests that golimumab, compared to placebo, may be the drug that provides the highest probability of achieving ASAS20 response in AS patients naive to biologic treatments at 12 weeks
Combining Multi-Shell Diffusion with Conventional MRI Improves Molecular Diagnosis of Diffuse Gliomas with Deep Learning
No full textThe WHO classification since 2016 confirms the importance of integrating molecular diagnosis for prognosis and treatment decisions of adult-type diffuse gliomas. This motivates the development of non-invasive diagnostic methods, in particular MRI, to predict molecular subtypes of gliomas before surgery. At present, this development has been focused on deep-learning (DL)-based predictive models, mainly with conventional MRI (cMRI), despite recent studies suggesting multi-shell diffusion MRI (dMRI) offers complementary information to cMRI for molecular subtyping. The aim of this work is to evaluate the potential benefit of combining cMRI and multi-shell dMRI in DL-based models. A model implemented with deep residual neural networks was chosen as an illustrative example. Using a dataset of 146 patients with gliomas (from grade 2 to 4), the model was trained and evaluated, with nested cross-validation, on pre-operative cMRI, multi-shell dMRI, and a combination of the two for the following classification tasks: (i) IDH-mutation; (ii) 1p/19q-codeletion; and (iii) three molecular subtypes according to WHO 2021. The results from a subset of 100 patients with lower grades gliomas (2 and 3 according to WHO 2016) demonstrated that combining cMRI and multi-shell dMRI enabled the best performance in predicting IDH mutation and 1p/19q codeletion, achieving an accuracy of 75 ± 9% in predicting the IDH-mutation status, higher than using cMRI and multi-shell dMRI separately (both 70 ± 7%). Similar findings were observed for predicting the 1p/19q-codeletion status, with the accuracy from combining cMRI and multi-shell dMRI (72 ± 4%) higher than from each modality used alone (cMRI: 65 ± 6%; multi-shell dMRI: 66 ± 9%). These findings remain when we considered all 146 patients for predicting the IDH status (combined: 81 ± 5% accuracy; cMRI: 74 ± 5%; multi-shell dMRI: 73 ± 6%) and for the diagnosis of the three molecular subtypes according to WHO 2021 (combined: 60 ± 5%; cMRI: 57 ± 8%; multi-shell dMRI: 56 ± 7%). Together, these findings suggest that combining cMRI and multi-shell dMRI can offer higher accuracy than using each modality alone for predicting the IDH and 1p/19q status and in diagnosing the three molecular subtypes with DL-based models
Efficacy of biological agents administered as monotherapy in rheumatoid arthritis: A Bayesian mixed-treatment comparison analysis
No full textBackground: Biological agents provide an important therapeutic alternative for rheumatoid arthritis patients refractory to conventional disease-modifying antirheumatic drugs. Few head-to-head comparative trials are available.
Purpose: The aim of this meta-analysis was to compare the relative efficacy of different biologic agents indicated for use as monotherapy in rheumatoid arthritis.
Methods: A systemic literature search was performed on electronic databases to identify articles reporting double-blind randomized controlled trials investigating the efficacy of biologic agents indicated for monotherapy. Efficacy was assessed using American College of Rheumatology (ACR) 20, 50, and 70 criteria at 16–24 weeks. Relative efficacy was estimated using Bayesian mixed-treatment comparison models. Outcome measures were expressed as odds ratio and 95% credible intervals.
Results: Ten randomized controlled trials were selected for data extraction and analysis. Mixed-treatment comparison analysis revealed that tocilizumab offered 100% probability of being the best treatment for inducing an ACR20 response versus placebo, methotrexate, adalimumab, or etanercept. Likewise, for ACR50 and ACR70 outcome responses, tocilizumab had a 99.8% or 98.7% probability of being the best treatment, respectively, compared to other treatments or placebo. Tocilizumab increased the relative probability of being the best treatment (vs methotrexate) by 3.2-fold (odds ratio: 2.1–3.89) for all ACR outcomes.
Conclusion: Tocilizumab offered the greatest possibility of obtaining an ACR20, ACR50, and ACR70 outcome vs other monotherapies or placebo
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