45 research outputs found

    Can Cerebral Near-infrared Spectroscopy Predict Cerebral Ischemic Events in Neurosurgical Patients? A Narrative Review of the Literature

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    Cerebral near-infrared spectroscopy (NIRS) is considered a valuable noninvasive modality for cerebral oxygenation monitoring during cardiovascular surgery and cardiac arrest. We assessed the capability of cerebral NIRS to predict cerebral desaturation and the related neurological outcomes in neurosurgical patients. A literature search in different electronic medical databases was performed from inception to January 2018. A total of 286 citations were found and finally 48 studies were retrieved, only 7 of these were eligible and included for review. A meta-analysis was not feasible because of high heterogeneity of patients' groups, different NIRS techniques used in the studies and different outcome criteria selected. The qualitative assessment showed controversial data on the threshold value of cerebral near-infrared spectroscopy used for detecting cerebral ischemia in neurosurgical patients. The evidence on the selected studies is not strong enough, at the moment, to recommend cerebral NIRS as a mandatory monitor to detect cerebral deoxygenation able to predict the future neurological outcome in neurosurgical patients. Further studies are needed to validate a threshold value for cerebral ischemia and the relationship between NIRS-detected cerebral desaturation and clinical outcome in the neurosurgical population

    Investigating Reddit to detect subreddit and author stereotypes and to evaluate author assortativity

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    In recent years, Reddit has attracted the interest of many researchers due to its popularity all over the world. In this article, we aim at providing a contribution to the knowledge of this social network by investigating three of its aspects, interesting from the scientific viewpoint, and, at the same time, by analysing a large number of applications. In particular, we first propose a definition and an analysis of several stereotypes of both subreddits and authors. This analysis is coupled with the definition of three possible orthogonal taxonomies that help us to classify stereotypes in an appropriate way. Then, we investigate the possible existence of author assortativity in this social medium; specifically, we focus on co-posters, that is, authors who submitted posts on the same subreddit

    Pressure to Publish: Laura Terracina and her Editors

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    Laura Terracina (1519–c.1577) was the bestselling female author of sixteenth-century Italy, publishing eight poetry collections, several of which went through numerous reprints. While other female poets attained greater cultural prestige, none was as widely published, nor reflected so well the developing worlds of print, publication, and authorship from mid- to late Cinquecento. Her publication history problematizes the accepted narrative of how women came to print and of their relationship with their editors and publishers. From the time she first appeared in print in 1546 to the writing of her final manuscript in 1577, Terracina proved to be an engaged and headstrong author with a strong sense of ownership of her works. This article will explore Terracina’s relationships with her editors and publishers, analyzing her role in the publication process to argue that she took a much more active part in their production than has previously been appreciated

    Prevention and Treatment of Postoperative Pain after Lumbar Spine Procedures: A Systematic Review

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    Background and objective: In the past 2 decades, in developed countries, spine procedures (surgical and percutaneous) had the highest absolute increase in case volume trend. The optimal approach to prevent and treat postoperative pain is continuously evolving. This systematic literature review presents evidence on safety and efficacy of pharmacological and nonpharmacological therapies to prevent and treat postoperative pain after lumbar spine procedures. Databases and data treatment: Publications listed in PUBMED and EMBASE were considered to identify randomized clinical trials suitable for inclusion in this systematic review. Key words for literature search were selected, with authors' agreement, using the PICOS approach (participants, interventions, comparisons, outcomes, and study design). Results: Fifty-nine randomized clinical trials (involving a total of 4,238 patients, with ages ranging from 18 to 86 years) published between January 2012 and September 2017 were retrieved. Data are presented according to the timing of therapy administration. Conclusion and recommendations: Clinical evidence on perioperative pain management in patients undergoing spine procedures have significantly evolved after the review published in 2012. The aim of this systematic review was to report the latest evidence published. These include the preoperative use of dexamethasone, which was shown to be able to reduce pain at mobilization but not to reduce pain at rest or total morphine consumption; the use of gabapentinoids as part of a multimodal analgesic approach; and the safety and effectiveness of the intraoperative use of ketamine, dexketoprofen, and tramadol. Finally, electrical nerve stimulation is gaining interest and is potentially suitable for clinical needs

    Electrosprayed Poly-butyl-succinate microparticles for sustained release of Ciprofloxacin as an antimicrobial delivery system

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    The increasingly complex treatment of bacterial infections, and its relevance in the clinical setting, requires the development of innovative strategies to improve patients' quality of life. In this context, polymeric microparticles represents a versatile drug delivery system (DDS) capable of improving the antibiotics' efficacy in the treatments, by loading drugs while modifying their release profile. In this study we aimed to produce polymeric micro-particles by electrospraying using Poly-Butyl-Succinate (PBS), a biodegradable and biocompatible polyester. This versatile and easy-to-use technique enabled the incorporation of the poorly water-soluble Ciprofloxacin (CPX) into the polymer matrix. CPX is a fluoroquinolone antibiotic, inhibiting bacterial replication and effectively treating various infections. PBS is a well-known water-insoluble polymer with tuneable chemical-physical properties, also used for tissue regeneration and wound healing applications. An ex-vivo permeation study on porcine skin, serving as a model for human skin, was performed to assess potential enhancement in drug permeation. The microparticles were characterized by means of different techniques (SEM-EDX, XRD, ATR-FTIR, DSC), and their degradation rate was tested in DPBS and human plasma. Moreover, the as-produced DDS enabled the sustained release of CPX for several days, which proved effective against S. aureus and P. aeruginosa and also against a reference group of bacteria of skin microbiota often involved in pathological processes that make wounds chronic and difficult to heal. MIC and MBC assays were conducted using different culture media. Effective antibacterial activity was observed, along with inhibition of P. aeruginosa biofilm formation at sub-MIC concentrations
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