1,720,967 research outputs found
The Knowledge of Contextual Factors as Triggers of Placebo and Nocebo Effects in Patients With Musculoskeletal Pain: Findings From a National Survey
Full text linkBackgrounds: Contextual factors (CFs) have been recently proposed as triggers of placebo and nocebo effects in musculoskeletal pain. CFs encompass the features of the clinician (e.g. uniform), patient (e.g. expectations), patient-clinician relationship (e.g. verbal communication), treatment (e.g. overt therapy), and healthcare setting (e.g. design). To date, the researchers' understanding of Italian patients' knowledge about the role of CFs in musculoskeletal pain is lacking.Objectives: The aim of this study was to investigate attitudes and beliefs of Italian patients with musculoskeletal pain about the use of CFs in clinical practice.Methods: A national sample of Italian patients with musculoskeletal pain was recruited from 12 outpatient private clinics in Italy. An invitation to participate in an online survey was sent to patients: a) exhibiting musculoskeletal pain; b) aged 18-75; c) with a valid e-mail account; and d) understanding Italian language. Survey Monkey software was used to deliver the survey. The questionnaire was self-reported and included 17 questions and 2 clinical vignettes on the patients' behavior, beliefs, and attitudes towards the adoption of CFs in clinical practice. Descriptive statistics and frequencies described the actual number of respondents to each question.Results: One thousand one hundred twelve patients participated in the survey. Five hundred seventy-four participants were female (52%). The average age of patients was 41.7 +/- 15.2 years. Patients defined CFs as an intervention with an unspecific effect (64.3%), but they believed in their clinical effectiveness. They identified several therapeutic effects of CFs for different health problems. Their use was considered ethically acceptable when it exerts beneficial psychological effects (60.4%), but it was banned if considered deceptive (51.1%). During clinical practice, patients wanted to be informed about the use of CFs (46.0%) that are accepted as an addition to other interventions to optimize clinical responses (39.3%). Moreover, patients explained the power of CFs through body-mind connections (37.1%).Conclusion: Patients with musculoskeletal pain had positive attitudes towards the use and effectiveness of CFs when associated with evidence-based therapy. They mostly perceived the adoption of CFs in clinical practice as ethical
L’approccio agli aneurismi infiammatori iuxtarenali
No full textThe incidence of inflammatory abdominal aortic aneurysm (IAAA) in a late review of the literature is estimated about 2-15% overall aortic aneurysms. In our data this type of aneurysm is 3.6 overall aortic aneurysms treated. In the majority of the cases, IAAA is juxtarenal or infrarenal. Ethiopathogenesis of IAAA till today is not certain. Recent hypothesis on IAAA attribute the same ethiopathogenesis in both atherosclerotic and inflammatory aneurysm. The interaction of genetic, environmental and infective factors should be able to determine an autoimmune inflammatory reaction of variable severity. 80% of the patients suffering from IAAA present abdominal or lumbar pain, loss of weight and increase of the RC sedimentation velocity. The IAAA's natural history goes to rupture. Entrapment of nearstanding organs totally involved in the fibrotic process is the most frequent complication. Usually there is a compression of the ureter and the duodenum with consequenced hydroureteronephrosis and bowel obstruction. Preoperative diagnosis is possible; CT scan and MRI guarantee and accuracy about 90%. Intraoperatively the external wall of IAAA appears whitish and translucent and always there are tenacious adhesion given by the avventital wounds inflammation. Confirm is given by the histological examination of the aneurysmatic wall and peravventitial tissues. Our experience and a late review of the literature concorde that surgical indication for the treatment of IAAA is the same for the atherosclerotic one. This conviction is supported by the fact that the diagnostic methodical evolution and the improvement in mininvasive surgical technique lowered perioperating morbility and mortaliy. We prefer, according with many authors, retroperitoneal approach to juxtarenal IAAA, instead of standardized transperitoneal access with xifo-pubical or transversal under costal incision. This approach offers some advantages as easier exposition of aorta, whose postero-lateral wall is hardly ever involved in inflammatory process, little duodenum's and left renal veins manipulation and low incidence of paralytic ileum and respiratory disease. Endovascular surgery hasn't in this moment any role in juxtarenal IAAA treatment because this type of aneurysm has inadequate proximal neck. In the future, probably, endovascular repair will be possible using a new type of endograft with renal legs. Often surgical treatment is inadequate to control retroperitorenal fibrosis and so surgeon has to use perioperating pharmacolocical therapy
DILATAZIONE DEL COLLETTO PROSSIMALE E MIGRAZIONI CORRELATE ALLA FORZA RADIALE DELLE ENDOPROTESI: nostra esperienza nel follow up dell' AEG
No full textValutazione della dilatazione del colletto prossimale e migrazioni correlate alla forza radiale delle endoprotesi nella nostra esperienza del follow-up dell’AEG
Endovascular laser treatment of varicose vein: a three years personal experience
No full textEndovenous Laser Treatment of the GSV seems to offer a safer alternatìve to traditional surgery (ligation and stripping). Early and mid term results of Endovenous Laser Treatment of incompetent greater and lesser saphenous veins have been promising. This minimally invasive technique appears to be and a 600 pm laser fiber (Bioliteco) was inserted at the end of the 5-F intoducer sheath. The sheath was then withdrawn up to a site mark indicating the last 2 cm of the laser fibre. The correct position of the fibre tip was confirmed by direct visualization of the red transluminant líght beam of the laser fibre through the skin. Tumescent local anesthesia (45 ml of 0.25 % Mepivacaine hydrochloride, neutralized with sodium bicarbonate) was delivered along the perivenous space under sonographic guidance in order to avoid accidental puncture of the vein. In order to obtain a non-thrombotic occlusion of the vein, laser energy was delìvered at 810 nm wavelength in 11 0 patients and at 980nm in 46 patients, using a 600 pm laser fìbre. Instrument setíìngs were: power 12W, pulse duration 1 sec, interval between pulses 1 sec. Rio, October 2" to 7", 2005 a Dimitrios J. Kontothanassis safe, easy to períorm, well tolerated, with lower rates of complication and the avoidance of general or epidural anaesthesia. Continued evaluation with a larger numbers of patients and longer-term follow-up are needed to further define the role of endovenous techniques as treatment alternatives in patients with cronic vein insufficiency
DEVELOPMENT OF A BSL-2 TOOL BASED ON THE PSEUDOTYPED VESICULAR STOMATITIS VIRUS TO STUDY CCHFV SERO-EPIDEMIOLOGY AND FOR ANTIVIRAL DISCOVERY
No full textAim of the study: The Crimean-Congo Hemorrhagic Fever Virus (CCHFV) causes a
viral zoonosis that progresses without symptoms in animals, but gives rise to a lethal
threat for humans. The CCHFV is a group IV biological hazard and, for this reason, it
requires a BSL-4 containment facility to be manipulated, which is a great dampening
for conducting any research on it. Anyway, there are different approaches that permit
to bypass the BSL-4 restrictions, like using a nonpathogenic pseudotyped virus,
where the envelope protein of the heterologous virus (i.e. glycoprotein Gc and Gn of
CCHFV) are assembled into the membrane of the nonpathogenic virus. Since it presents
only the glycoproteins of CCHFV, it acquires the immunogenicity and the tropism
of CCHFV but can be manipulated in a BSL-2 containment facility. Our work
focuses on the development of a BSL-2 executable tool for serological studies and
the identification of entry inhibitors of the CCHFV.
Methods: As viral model we selected a recombinant Vesicular Stomatitis Virus (rVSV-
ΔG-GFP), in which the glycoprotein gene was replaced with a reporter gene, i.e. in
our case this gene was the GFP. The rVSV-ΔG-GFP is characterize by an high profile
of biosafety because it is single cycle replication virus.
Results and conclusion: First, we have optimized a protocol for the preparation of the
rVSV-ΔG-GFP pseudotyped with the CCHFV’s glycoprotein (rVSV-CCHFVG). Human
cells HEK293T previously transfected with pC-G, a pCAGGS/MCS plasmid containing
the CCHFV-M segment’s cDNA, were infected with the rVSV-ΔG-GFP containing
the native G glycoprotein. The pseudotyped viral particles released in the cell culture
medium are collected and ultracentrifugated in a sucrose cushion to concentrate and
clean the viral stock. Then, the viral stock is titrated by serial dilution and evaluation
of the GFP positive cells.
Second, the rVSV-CCHFVG has been used in a serum neutralization assay using a
panel of sera (collected by people from a non-endemic area) and the serum of a Bulgarian
laboratory worker vaccinated for the CCHF, as positive control. The results
show that the rVSV-CCHFVG is correctly neutralized only by the serum of the vaccinated
worker and the neutralization titer correlate with data published evaluating the
efficacy of the Bulgarian vaccine against the CCHFV.
Overall, the results support the feasibility of the rVSV-CCHFVG based assay for serological
studies
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
Unraveling Negative Expectations and Nocebo-Related Effects in Musculoskeletal Pain
No full textThis Perspective adapts the ViolEx Model, a framework validated in several clinical conditions, to better understand the role of expectations in the recovery and/or maintenance of musculoskeletal (MSK) pain. Here, particular attention is given to the condition in which dysfunctional expectations are maintained despite no longer being supported by confirmatory evidence (i.e., belief-lifting the arm leads to permanent tendon damage; evidence-after the patient lifts the arm no tendon damage occurs). While the ViolEx Model suggests that cognitive immunization strategies are responsible for the maintenance of dysfunctional expectations, we suggest that such phenomenon can also be understood from a Bayesian Brain perspective, according to which the level of precision of the priors (i.e., expectations) is the determinant factor accounting for the extent of priors' updating (i.e., we merge the two frameworks, suggesting that highly precise prior can lead to cognitive immunization responses). Importantly, this Perspective translates the theory behind these two frameworks into clinical suggestions. Precisely, it is argued that different strategies should be implemented when treating MSK pain patients, depending on the nature of their expectations (i.e., positive or negative and the level of their precision)
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