1,721,048 research outputs found
Methotrexate in early rheumatoid arthritis: Is the anchor drug still holding?
No full textTreat-to-target (T2T) is currently the most fashionable strategy for treatment-naïve, early rheumatoid arthritis (RA) patients. A T2T approach can lead to a complete and drug-free disease remission, whereas failure to obtain remission leads to damage early in the disease course. Hence, one should try to achieve high remission rates as early as possible, implementing the best therapeutic strategies available. Methotrexate (MTX) combined with glucocorticoid bridging is the mainstay of T2T. However, MTX is often used suboptimally in RA patients for many reasons, including poor tolerability, low compliance, and safety issues. Recent evidence has suggested that novel targeted synthetic DMARDs (tsDMARDs) such as the Janus-kinase (JAK) inhibitors in combination with glucocorticoids yielded better outcomes in early RA than conventional treatment. Such an approach may have advantages in terms of patients' outcomes, though some concerns about serious adverse events need to be addressed
Il tumore prostatico:cento anni di terapia
No full textNegli ultimi anni I'interesse nei confronti della patologia che qui sarà trattata
si è enfatizzato progressivamente,
dato I'incremento degli indici statistici
di morbilità e mortalità legati
al tumore prostatico, in relazione
soprattutto ad una più vasta gamma
di possibilità di screening e dunque
di diagnosi precoce, che si vanno
ad affiancare ad un ampio ventaglio
di opzioni terapeutiche in continua
evoluzione, che la comunità scientifica
ha reso e rende quotidianamente
oggetto di discussione.
Non manca rivista del settore che ad ognisua uscita non dedichi uno o più
articoli in appoggio alla più recente opzione, piuttosto che rivaluti qualche
terapia ormai caduta in disuso e che viene riabbracciata grazie alle più
sofisticate tecnologie dei materiali e, perché no, all'appoggio dell'ormai
sempre presente elaborazione cibernetica.
Scopo della simpatica rivisitazione è proprio quello di porre in rassegna
tutte le possibilità terapeutiche chirurgiche e non, che si sono succedute
negli anni, di valutarne i pro ed i contro motivandone l'eventuale scomparsa,
al fine, si spera, di fungere da rapida consultazione per Urologi,
Chirurghi Generali e Medicidi Base animatida curiosità scientifica.
ll tumore della prostata, più di altre patologie, ha offerto infatti in questo
secolo svariate opzioniterapeutiche, mediche, chirurgiche, radioterapiche,
in mono o in associazione, continua o intermittente.
Oggi addirittura si parla, per istologie particolari, di "wait and see", legittimando
I'esternazione del compianto professor Giuliani, Direttore della
Clinica Urologica diGenova, che neglianni'80, sultema si lasciò sfuggire
come neltumore della prostata si possa fare tutto o niente. Questo pensiero
mi ha sempre accompagnato.
Le tecniche chirurgiche attuali sono la rivalutazione di approcci concepiti
un secolo fa, poi abbandonati per le complicanze, spesso di carattere
infettivo, legate al periodo storico, attualmente facilmente owiabili.
lltesto non nasconde anche un ruolo di mera curiosità storica in rapporto
ai molteplici e multiformi sforzi profusi nella terapia dell'affezione da parte
dei cultori della materia.
Plauso grande ai miei preziosi collaboratori che hanno accolto con entusiasmo
il mio invito ad effettuare questa rivisitazione storica, che, sono
certo, sarà preziosa nell'affrontare "a viso aperto" le problematiche chirurgiche
di tutti i giorni.
Pro. Pietro Cortellini (Direttore U.O Urologia di Parma
Hyperinflammation after anti-SARS-CoV-2 mRNA/DNA vaccines successfully treated with anakinra: Case series and literature review
No full textThe current SARS-CoV-2 pandemic diffused worldwide has encouraged the rapid development of vaccines to counter the spread of the virus. At present in Italy, 75.01% of the population completed the vaccination course (AIFA.gov.it) and very few adverse events have been recorded by now. Side-effects related to a theoretical over-reaction of the immune system in response to vaccines administration have been described, and the possibility that an autoimmune or a hyperinflammatory condition may occur was recently observed. Herein, we report four cases of hyperinflammatory syndrome with features indicative of Adult-onset Still’s disease (AOSD) and macrophage activation syndrome (MAS), occurred after anti-SARS-CoV-2 vaccine injection and seen at our Unit between March and May 2021. Since interleukin (IL)-1 is one of the pivotal cytokines involved in AOSD pathogenesis, the inhibition of IL-1 is crucial in ameliorating the clinical symptoms of those patients. Moreover, it has been highlighted the central role of IL-1 as a hallmark of the hyperinflammatory status elicited by SARS-CoV-2 infection. In this case series, we successfully employed the IL-1 receptor antagonist anakinra to curb the cytokine release likely unleashed by the vaccine stimulation in potentially predisposed subjects. We also made a literature search to detect other patients with hyperinflammation temporally related to vaccines injection who benefited from IL-1 inhibition, while other AOSD/MAS-like described syndromes improved with other immunomodulatory strategies
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
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
Cardiovascular risk factors in patients with rheumatoid arthritis prescribed disease modifying anti-rheumatic drugs.
No full textIntroduction: Rheumatoid arthritis (RA) is associated with a heightened risk of cardiovascular disease (CVD), with both traditional CV risk factors and inflammation contributing to this risk.
Areas covered: This review highlights the burden of CVD in RA and associated traditional CV risk factors, including the complexity of dyslipidemia in RA and the so-called ‘lipid paradox.’ Furthermore, the recognized RA-disease-specific factors associated with higher risk of CVD and the role of systemic inflammation in the pathogenesis of CVD in RA will be addressed. With the advent of biologic and targeted synthetic therapies in the treatment of RA, the effect of conventional and newer generation disease modifying anti-rheumatic therapies (DMARDs) on CV risk and associated risk factors will also be discussed.
Expert opinion: Identifying the RA phenotype at greatest risk of CVD, understanding the interplay of increased traditional risk factors, common inflammatory processes and RA-specific factors, and personalized use of DMARDs according to disease phenotype and comorbidity to reduce this risk are key areas for future research
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