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Clearance mucociliare e citologia nasale nella rinosinusite cronica con poliposi nasale: il ruolo della terapia biologica
No full textBackground
La rinosinusite cronica con poliposi nasale (CRSwNP) è una patologia infiammatoria cronica e recidivante del naso e dei seni paranasali che determina una significativa riduzione della qualità di vita dei soggetti affetti. La fisiopatologia della malattia non è ancora del tutto nota ma l’infiammazione di tipo 2, responsabile anche della patologia asmatica, è stata identificata come la via infiammatoria predominante nei pazienti con CRSwNP. Il processo infiammatorio cronico determina un alterato funzionamento del sistema di clearance mucociliare (MCC), meccanismo di fondamentale importanza per la difesa delle alte vie aeree, ed una modifica del quadro citologico della mucosa nasale. Ad oggi, farmaci biologici mirati al trattamento dell’asma hanno dimostrato la loro efficacia anche nel controllo dei segni e sintomi della poliposi nasale grave. Questo studio ha lo scopo di analizzare le modifiche che la terapia biologica con l’anticorpo monoclonale Dupilumab (inibitore di IL4Rα) induce sulla clearance mucociliare e sul pattern citologico (alterazioni numeriche e morfologiche) dei pazienti affetti da poliposi nasale.
Materiali e metodi
Durante il seguente studio, condotto presso l’ospedale A. Fiorini di Terracina e l’ospedale S.M. Goretti di Latina - “Sapienza” Università di Roma, sono stati arruolati, da dicembre 2021 ad agosto 2024, 63 pazienti con diagnosi di CRSwNP grave. In base ai criteri di prescrivibilità dell’anticorpo monoclonale Dupilumab, tutti i pazienti hanno intrapreso la terapia biologica (300mg di Dupilumab in un’unica somministrazione sottocutanea ogni 14 giorni) e sono stati valutati a tempo zero (prima di iniziare la terapia) e successivamente dopo 4, 8 e 12 settimane dalla data di prima somministrazione del farmaco. Durante ogni valutazione i pazienti sono stati sottoposti a questionario SNOT22, a fibrorinoscopia con calcolo del punteggio NPS ed a Saccharin Test per la valutazione della clearance mucociliare. Durante la prima ed ultima valutazione ogni paziente si è sottoposto anche a scraping nasale per l’analisi citologica della mucosa nasale. I dati riguardanti il tempo di transito mucociliare della saccarina e il quadro citologico nasale, raccolti nei diversi tempi cadenzati dallo studio, sono stati statisticamente confrontati.
Risultati
L'analisi statistica ha confermato che nei pazienti con CRSwNP grave si osserva un aumento del tempo di transito mucociliare e un'alterazione del rapporto tra cellule ciliate e cellule mucipare, con una prevalenza di queste ultime, come già descritto in letteratura. Durante la terapia biologica con Dupilumab, i risultati del Saccharin Test hanno evidenziato un progressivo miglioramento del tempo di transito mucociliare, il quale si riduce significativamente, a testimonianza dell'efficacia del trattamento nel favorire la clearance mucociliare nasale. Inoltre, i dati raccolti indicano che, dopo tre mesi di trattamento con l'anticorpo monoclonale Dupilumab, si è osservato un cambiamento nella composizione cellulare della mucosa, con un aumento delle cellule ciliate rispetto a quelle mucipare, suggerendo un possibile ripristino dell'equilibrio fisiologico della mucosa nasale
Conclusioni
In conclusione, i risultati del nostro studio dimostrano che la terapia biologica con Dupilumab permette di raggiungere un miglioramento significativo dell’attività di clearance mucociliare nasale ed un rimodellamento citologico con un ripristino del normale rapporto tra cellule mucipare e cellule ciliate. Questi risultati appaiono essere incoraggianti sull’utilizzo di tale trattamento medico, il quale risulta efficace e sicuro per pazienti con CRSwNP grave
Spontaneous jamming of horizontal semicircular canal combined with canalolithiasis of contralateral posterior semicircular canal
Full text linkSpontaneous canalith jam is an uncommon form of benign paroxysmal positional vertigo mimicking acute vestibular neuritis. We described for the first time a spontaneous horizontal semicircular canalith jam associated with a typical canalolithiasis involving contralateral posterior semicircular canal (PSC), illustrating how the latter condition modified direction-fixed nystagmus during head movements. An 81-year-old woman with persistent vertigo referred to our center. Video-Frenzel examination showed horizontal direction-fixed right-beating nystagmus in primary gaze position, inhibited by visual fixation. She exhibited corrective saccades after leftward head impulses. Chin-to-chest positioning at the head-pitch test did not modify spontaneous nystagmus, whereas slight torsional components with the top pole of the eye beating toward the right ear appeared in backward head-bending, resulting in mixed horizontal-torsional nystagmus. At supine positioning tests, direction-fixed nystagmus turned into direction-changing geotropic horizontal nystagmus, which was stronger on the left side, while overlapping upbeat nystagmus with torsional right-beating components appeared on the right. Primary clinical findings were consistent with a left horizontal semicircular canalith jam, inducing a persistent utriculofugal cupular displacement, combined with a typical right-sided PSC-canalolithiasis. Once canalith jam crumbled, resulting in a non-ampullary arm canalolithiasis of the horizontal semicircular canal, both involved canals were freed by debris with appropriate repositioning procedures
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Use of Irrigation Device for Duct Dilatation during Sialendoscopy
Full text linkBackground: Continuous irrigation of the duct with isotonic saline is one of the fundamental stages of a successful sialendoscopic procedure. It allows for an adequate luminal distension for the removal of debris and mucous plugs and for the conservative treatment of strictures. This procedure, which commonly involves the use of a medical syringe, can be laborious, and it is often necessary to interrupt irrigation during surgery due to the high resistance to saline. Setting: Academic university hospital. Method: We propose the use of an irrigation device which consists of a high-pressure syringe barrel, an ergonomic piston handle, and a gauge used to monitor the inflation and deflation of balloon catheters. The system allows for a simple and safe dilation, ensuring good visualization of the salivary duct lumen during sialendoscopy. Conclusions: The irrigation system described can be widely used to perform a diagnostic or interventional sialendoscopy more effectively than with a typical manual irrigation procedure
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
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