377 research outputs found

    Methods for segmentation and characterization of multiple sclerosis cortical lesions from MRI data

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    This thesis deals with the automatic analysis of magnetic resonance images of the brain, acquired from people affected by multiple sclerosis. In particular, the primary aim of the analysis is to obtain a quantitative measure of the cortical lesion burden due to the specific disease. Besides, we propose a technique for the characterization of the different lesion types, based on their inflammatory activity. Multiple sclerosis is a chronic, inflammatory disease of the central nervous system, that causes a progressive demyelination of several areas of the brain and of the spinal cord. As far as diseases’ frequency is concerned, multiple sclerosis represents the second neurologic disease in the young adult, and it is even the first inflammatory chronic disease. Besides, it can also be considered as a social burden, with heavy direct and indirect costs: multiple sclerosis prevents people from working as much as they could without the disease, and can lead to the impossibility to live autonomously. Last but not least, the cost of treatment and care can be very high. Although the causes are still partly unclear, a lot has been achieved in the understanding of the different phases of the inflammatory process characterizing multiple sclerosis. Today it is possible to early diagnose the disease, thus allowing to limit symptoms by early therapies. The lesions caused by multiple sclerosis can be visualized in vivo thanks to magnetic resonance (MR) imaging. In particular in the latest decades several MR sequences have been designed in order to highlight white matter lesions. When studying gray matter lesions, instead, the available MR sequences are less numerous. This is partly due to the fact that the gray matter involvement in multiple sclerosis is a relatively recent finding. It is important to verify both the evolution and the appearance of new lesions: in this way it is possible to monitor the disease progression, which is particularly tricky in the case of multiple sclerosis. This disease is characterized by acute relapses alternated with remitting periods of variable length. For this reason patients are periodically examined acquiring MR images. The subsequent diagnosis made by the physician is based on the MR results. So, it is fundamental for the neurologist to be well trained in order to be able to properly evaluate different magnetic resonance sequences. Besides, he/she has to pay close attention not only to detect new lesions, but also to recognize those lesions that were already present in the previous examinations, and that might have changed their shape, their dimension or they activity. This process requires time and attention, but unfortunately, being human-based, it is strongly error prone. Unquestionably, the diagnose cannot prescind from the neurologist’s evaluation. Nonetheless, the advent of techniques for the automatic analysis of magnetic resonance images and for the detection of multiple sclerosis lesions would represent a valid support for the physicians, who could provide accurate evaluations in faster timing. In this thesis several MR techniques currently used for cortical lesions visualization will be described. Then a segmentation algorithm will be proposed, in order to find the region corresponding to gray matter. On this region a second algorithm will be presented, that detect multiple sclerosis cortical lesions. Finally, a first attempt to characterize cortical lesions based on their inflammatory activity will be described.Questa tesi tratta l’analisi automatica di immagini di risonanza magnetica cerebrale in soggetti affetti da sclerosi multipla. In particolare, l’analisi è volta sia a una stima quantitativa del carico di lesioni corticali presenti a causa del decorso della malattia, sia a una caratterizzazione del tipo di lesioni presenti basata sul loro grado di infiammazione. La sclerosi multipla è una malattia infiammatoria a decorso cronico che colpisce il sistema nervoso centrale, provocandone una progressiva distruzione della mielina in più aree. Per frequenza, nel giovane adulto è la seconda malattia neurologica e la prima di tipo infiammatorio cronico. Inoltre, la sclerosi multipla può essere considerata anche come malattia sociale, con un’elevata ricaduta economica, sia diretta che indiretta: la diminuzione o la perdita dell’autonomia porta alla progressiva impossibilità di svolgere una qualsiasi attività lavorativa fino all’incapacità di condurre una vita indipendente. A questo si aggiungano il costo delle cure e dell’assistenza necessarie. Benché le cause siano ancora in parte sconosciute, molto è stato fatto nel chiarire le diverse fasi del processo infiammatorio che caratterizza tale patologia, permettendo così di arrivare a una diagnosi e a un trattamento precoce che consentono di ridurre gli effetti della malattia. Le lesioni causate dalla sclerosi multipla risultano visibili grazie a particolari tecniche di acquisizione di immagini basate sulla risonanza magnetica. In particolare negli ultimi decenni si sono studiate e messe a punto diverse sequenze di risonanza ottimizzate per la visualizzazione delle lesioni in materia bianca. Il quadro delle tecniche a disposizione qualora si vogliano studiare lesioni in materia grigia risulta invece meno completo, soprattutto a causa del fatto che la scoperta di un coinvolgimento della materia grigia nella malattia è molto più recente. La verifica dell’evoluzione e della comparsa di nuove lesioni è importante dal momento che consente di monitorare il progredire di una malattia caratterizzata da fasi acute intervallate a periodi di quiescenza più o meno lunghi. Per questo motivo i soggetti affetti da sclerosi multipla vengono periodicamente sottoposti a esami di risonanza magnetica. Ogni successiva valutazione da parte del medico neurologo dipenderà da quanto evidenziato dalle immagini acquisite. In questo senso è fondamentale che il medico sia ben allenato nella valutazione di immagini di risonanza, e che ponga particolare attenzione non solo nell’individuare la comparsa di nuove lesioni, ma anche nel riconoscere la presenza di lesioni già presenti in esami precedenti, che possono essere progredite nella forma, nelle dimensioni e nel grado di attività. La lettura di un esame di risonanza magnetica richiede tempo e attenzione, ed è inevitabilmente soggetta all’errore umano che caratterizza qualsiasi valutazione manuale. Per questo, benché sia impensabile prescindere dalla valutazione del medico, una tecnica di analisi automatica di immagini di risonanza magnetica cerebrale che sia in grado di evidenziare la presenza di lesioni da sclerosi multipla può rappresentare un valido aiuto alla refertazione, sia in termini di tempo che di accuratezza. In questa tesi si descriveranno le tecniche di risonanza magnetica a disposizione per una miglior visualizzazione delle lesioni corticali. Su queste si procederà alla segmentazione del tessuto di interesse, ossia del volume di materia grigia. In seguito verrà descritta la tecnica proposta per il riconoscimento delle regioni patologiche corticali. Infine sarà descritto un primo tentativo di caratterizzazione delle diverse lesioni corticali, basato sulla valutazione del grado di attività di ciascuna lesione

    Scheda di catalogo: Paolo Caliari, il Veronese (ambito di), Ritratto di nobildonna, 1560 ca., collezione privata

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    Scheda di catalogo di un'opera dell'ambito di Paolo Calieri, il Veronese, 1560 ca., con il ritratto di nobildonna: analisi delle vesti, dei tessuti e dei gioielli raffigurati

    Boccaccio e un infelice amore veronese. La novella di Estore e Camilla

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    Il saggio prende in esame la novella, anonima e tuttora inedita, di Estore e Camilla che appartiene alla raccolta nota come «Refugio de’ miseri». Dopo una panoramica sui manoscritti che la trasmettono e sulla struttura della silloge in cui è inserita, si analizza il testo, mettendone in rilievo le molte memorie boccacciane e la particolare ambientazione veronese. Infine il saggio propone un possibile nesso tra la vicenda di Estore e Camilla e quella di Romeo e Giulietta, celebrata da Luigi da Porto. This article examines the anonymous and still unpublished novella of Estore and Camilla, which belongs to the collection known as «Refugio de’ miseri». After an overview of the manuscripts that transmit it, and of the structure of the collection in which it is inserted, the textual analysis emphasizes the abundant reminiscences of Boccaccio and the particular setting of Verona. Finally, a possible link between the story of Estore and Camilla and that of Romeo and Juliet, celebrated by Luigi da Porto, emerges

    Asymptomatic patients and immune subjects

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    first_page settings Open AccessEntry Asymptomatic Patients and Immune Subjects by Sheila Veronese * [ORCID] and Andrea Sbarbati Department of Neurosciences, Biomedicine and Movement Sciences, Verona University, 10 Sq. L.A.Scuro, 37134 Verona, Italy * Author to whom correspondence should be addressed. Academic Editor: Stephen Bustin Encyclopedia 2022, 2(1), 109-126; https://doi.org/10.3390/encyclopedia2010008 Received: 15 November 2021 / Revised: 21 December 2021 / Accepted: 7 January 2022 / Published: 11 January 2022 (This article belongs to the Collection Encyclopedia of COVID-19) Download PDF Browse Figures Citation Export Definition An asymptomatic patient is someone who contracts a disease but shows no symptoms. An immune subject is a person who is free from virus infection. Both of these categories of people experience the limitations of government imposed by a pandemic situation, with one important difference. Probably only the first subjects contribute, in spite of themselves, to the spread of the disease and to the contagion of the people most susceptible to the virus. This implies that their detection is essential to limit infections. Therefore, knowing the characteristics of these people and those immune to the virus can be extremely useful in mitigating the effects of the disease and/or defeating it

    An unusual cutaneous infection caused by Mycobacterium marinum

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    Introduction. Mycobacterium marinum is a non-tubercular mycobacterium residing in fresh or salt water (in tropical or temperate areas); it is a fish and human pathogen, and in immunocompromised patients can cause severe cutaneous and subcutaneous infections.Case presentation.A 46-year-old white man who underwent immunosuppressive therapy was admitted to our department in May 2016 for skin lesions previously diagnosed as 'unusual erysipelas'. We rejected the hypothesis of erysipelas, due to the clinical features, and our diagnostic hypotheses were oriented towards sporotrichosis, atypical mycobacteriosis, cutaneous tuberculosis and cutaneous sarcoidosis. Histological examination performed after a skin biopsy was compatible with a diagnosis of sporotrichosis. However, PCR performed on fresh tissue demonstrated the presence ofM. marinum.Conclusion.The case reported is interesting for the unusual clinical localization and modality of infection. The patient became infected by contact with contaminated remains or in the sea, in a geographical area not endemic forM.marinum. The previous state of immunosuppression favoured infection; however, the presence ofM. marinumin this area suggests a possible tropicalization of the water of the Mediterranean Sea. To our knowledge, this case is the only one reported in the literature with this modality of infection and in that geographical area

    Inflammatory Cutaneous Diseases in Renal Transplant Recipients.

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    Kidney transplant recipients frequently suffer from skin infections and malignancies, possibly due to the effects of long-term immunosuppressive therapy. While the relationships between immunosuppression and these pathological conditions have been widely investigated, little is known about the relative incidence and characteristics of inflammatory skin diseases in this type of patient. In this study, we analyze the incidence of a number of inflammatory cutaneous diseases in a cohort of patients who underwent kidney transplantation. Although our study shows a relatively low incidence of these pathologies in transplanted patients-in agreement with the general action of immunosuppressant therapies in reducing inflammation-we scored a different efficacy of the various immunosuppressive regimens on inflammatory and autoimmune skin diseases. This information can be key for designing immunosuppressive regimens and devising accurate follow-up protocols
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