37 research outputs found
Long-term effects of intrathecal baclofen in multiple sclerosis
No full textObjectives Spasticity is associated with various neurological conditions. In this study the authors analyzed the long term effects of intrathecal baclofen therapy in multiple sclerosis and evalued the benefits of the treatment on spasticity, disability, pain, spasm frequency and rated the incidence of side effects. Patients and methods A records of 123 patients, with a severe, progressive and refractory to medical therapy spasticity from different causes, underwent baclofen pump placement, after a bolus test, from 2000 to 2012,under Department of Neurosurgery at the Second University of Naples/Italy. We present our experience in treating 28 subjects that was affected by multiple sclerosis. For all patients we reviewed long-term response to therapy, surgical technique, surgery-and pump-related complications. Every patients were evaluated by means of the Modified Ashworth Scale (MAS), Penn Spasm Frequency Scale (SFS), Visual analogue Scale For Pain (VAS), Barthel index (BI) and Self Rating Depression Scale (SDS) Results During follow up the mean MAS score for upper and lower extremities decrease significantly. Also SFS's decrease was statistically significant. This resulted in a dramatic improvement of BI. Furthermore, we observed a marked improvement in VAS and SDS. Conclusions Intrathecal baclofen provides effective long-term treatment of spasticity multiple sclerosis related. ITB therapy increases the quality of lifestyle and functional independence in appropriately selected cases
Modeling riboflavin transporter deficiency type 2: from iPSC-derived motoneurons to iPSC-derived astrocytes
No full textIntroduction: Riboflavin transporter deficiency type 2 (RTD2) is a rare neurodegenerative autosomal recessive disease caused by mutations in the SLC52A2 gene encoding the riboflavin transporters, RFVT2. Riboflavin (Rf) is the precursor of FAD (flavin adenine dinucleotide) and FMN (flavin mononucleotide), which are involved in different redox reactions, including the energetic metabolism processes occurring in mitochondria. To date, human induced pluripotent stem cells (iPSCs) have given the opportunity to characterize RTD2 motoneurons, which reflect the most affected cell type. Previous works have demonstrated mitochondrial and peroxisomal altered energy metabolism as well as cytoskeletal derangement in RTD2 iPSCs and iPSC-derived motoneurons. So far, no attention has been dedicated to astrocytes. Results and discussion: Here, we demonstrate that in vitro differentiation of astrocytes, which guarantee trophic and metabolic support to neurons, from RTD2 iPSCs is not compromised. These cells do not exhibit evident morphological differences nor significant changes in the survival rate when compared to astrocytes derived from iPSCs of healthy individuals. These findings indicate that differently from what had previously been documented for neurons, RTD2 does not compromise the morpho-functional features of astrocytes
Do Supply Chain Characteristics Influence a Rival Firm's Responses to a Focal Firm's Product Preannouncements? A Competitive Dynamics Perspective
No full textThis study investigates how supply chain characteristics influence a rival firm's response to a focal firm's product preannouncements from a competitive dynamics perspective. Indeed, many firms recognize that it is critical to leverage their supply chains to gain a competitive advantage. We propose that common suppliers enhance a rival firm's awareness of the focal firm's credibility, reducing competitive responses. In addition, a rival firm's strong supplier inventory performance will motivate rivals to respond more aggressively, while the rival's supply–chain partnerships enhance its capability to react to the focal firm. Using panel data from S&P 1500 firms between 2007 and 2015, our findings provide support for our hypotheses, illustrating that supply chain characteristics can significantly influence a rival firm's responses to the focal firm's preannouncements. This research contributes to the competitive dynamics and supply chain management literature by highlighting the strategic role of supply chain characteristics in interfirm competition, offering practical insights for managers on leveraging supply chain resources to effectively navigate competitive threats.This article is published as Guntuka, L., Cantor, D., Corsi, T., D'oria, L. and Grover, A. (2024), Do Supply Chain Characteristics Influence a Rival Firm's Responses to a Focal Firm's Product Preannouncements? A Competitive Dynamics Perspective. J Bus Logist, 45: e12395. https://doi.org/10.1111/jbl.12395 © 2024 The Author(s). Journal of Business Logistics published by Wiley Periodicals LLC.This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.Open access funding provided by the Iowa State University Library
Dataset from Garatti A, D'Ovidio M, Saitto G, Daprati A, Canziani A, Mossuto E, D'Oria V, Scarpanti M, De Vincentiis C, Parolari A, Menicanti L. Coronary artery bypass grafting in patients with concomitant solid tumours: early and long-term results. Eur J Cardiothorac Surg. 2020 Sep 1;58(3):528-536. doi: 10.1093/ejcts/ezaa114. PMID: 32474575.
No full textDataset from the article Garatti A, D'Ovidio M, Saitto G, Daprati A, Canziani A, Mossuto E, D'Oria V, Scarpanti M, De Vincentiis C, Parolari A, Menicanti L. Coronary artery bypass grafting in patients with concomitant solid tumours: early and long-term results. Eur J Cardiothorac Surg. 2020 Sep 1;58(3):528-536. doi: 10.1093/ejcts/ezaa114. PMID: 32474575.
Abstract
Objectives: Our goal was to analyse a consecutive series of patients with solid organ tumours undergoing coronary artery bypass grafting (CABG) by defining the risk factors for early and long-term outcomes.
Methods: Between 2005 and 2016, a consecutive series of 4079 patients underwent isolated CABG at our institution. Of 103 patients (2.5%) with active malignancy, we enrolled 82 patients (mean age 71 ± 7 years) with solid organ tumours, divided into 4 subgroups: lung (9 patients-11%), gastroenteric (16 patients-20%), urinary (48 patients-58%) and other solid tumours (9 patients-11%). A deterministic record linkage between the clinical database and the National Hospital Information System allowed identification of long-term survival rates and freedom from major adverse cardiovascular events (acute myocardial infarction, repeated admissions for percutaneous coronary intervention and heart failure).
Results: The most common forms of cancer were prostate, colon and carcinoma of the lung. Compared to patients without cancer, patients with neoplasms were significantly older and had a higher rate of comorbidities, without significant differences among the cancer subgroups. The 30-day mortality rate was significantly higher in patients with cancer compared to those without cancer (4.9% vs 1.8%). However, on logistic regression analysis, cancer was an independent risk factor for postoperative pulmonary dysfunction but not for in-hospital death. The median follow-up time was 58 ± 12 months. The overall 5-year survival rate was 60% [95% confidence interval (CI) 47-71%], with a dismal 32% (95% CI 5-65%) survival rate among patients who had lung tumours only. The 5-year freedom from major adverse cardiovascular events was 64% (95% CI 52-74%), without significant differences among subgroups, and was comparable to that of the non-cancer population. Resolution of coronary heart disease allowed safe cancer surgical resection in 80% of the population.
Conclusions: Based on the results from the present study, CABG should not be denied to patients with solid organ tumours by claiming a worse prognosis or less graft durability. Further studies with larger numbers are warranted
genES-MDA: a generic open-source software package to solve inverse problems via the Ensemble Smoother with Multiple Data Assimilation
No full text[EN] Ensemble Kalman filter methods have been successfully applied for data assimilation and parameter estimation through inverse modeling in various scientific fields. We have developed a new generic software package for the solution of inverse problems implementing the Ensemble Smoother with Multiple Data Assimilation (genES-MDA). It is an open-source, platform-independent Python-based program. Its aim is to facilitate the management and configuration of the ES-MDA through several programming tools that help in the preparation of the different steps of ES-MDA. genES-MDA has a flexible workflow that can be easily adapted for the implementation of different variants of the ensemble Kalman filter and for the solution of generic inverse problems. This paper presents a description of the package and some application examples. genES-MDA has been tested in three synthetic case studies: the solution of the reverse flow routing for the estimation of the inflow hydrograph to a river reach using observed water levels and a calibrated forward model of the river system, the identification of a hydraulic conductivity field using piezometric observations and a known forward flow model, and the estimation of the release history of a contaminant spill in an aquifer from measured concentration data and a known flow and transport model. The results of all these tests have demonstrated the flexibility of genES-MDA and its capabilities to efficiently solve different types of inverse problems.The fourth author would like to acknowledge grant PID2019-109131RB-I00 funded by the Spanish MCIN/AEI/10.13039/501100011033 and the University of Parma for hosting him as a visiting professor, during which time the paper was finalized. The authors are thankful to the anonymous Reviewers for their valuable comments.Todaro, V.; D'oria, M.; Tanda, MG.; Gómez-Hernández, JJ. (2022). genES-MDA: a generic open-source software package to solve inverse problems via the Ensemble Smoother with Multiple Data Assimilation. Computers & Geosciences. 167:1-11. https://doi.org/10.1016/j.cageo.2022.105210S11116
MicroRNAs delivery into human cells grown on 3D-printed PLA scaffolds coated with a novel fluorescent PAMAM dendrimer for biomedical applications
No full textMany advanced synthetic, natural, degradable or non-degradable materials have been employed to create scaffolds for cell culture for biomedical or tissue engineering applications. One of the most versatile material is poly-lactide (PLA), commonly used as 3D printing filament. Manufacturing of multifunctional scaffolds with improved cell growth proliferation and able to deliver oligonucleotides represents an innovative strategy for controlled and localized gene modulation that hold great promise and could increase the number of applications in biomedicine. Here we report for the first time the synthesis of a novel Rhodamine derivative of a poly-amidoamine dendrimer (G = 5) able to transfect cells and to be monitored by confocal microscopy that we also employed to coat a 3D-printed PLA scaffold. The coating do not modify the oligonucleotide binding ability, toxicity or transfection properties of the scaffold that is able to increase cell proliferation and deliver miRNA mimics (i.e., pre-mir-503) into human cells. Although further experiments are required to optimize the dendrimer/miRNA ratio and improve transfection efficiency, we demonstrated the effectiveness of this promising and innovative 3D-printed transfection system to transfer miRNAs into human cells for future biomedical applications. © 2018, The Author(s)
Mechanical Aortic Valve Replacement in Young Women Planning on Pregnancy Maternal and Fetal Outcomes Under Low Oral Anticoagulation, a Pilot Observational Study on a Comprehensive Pre-Operative Counseling Protocol
No full textObjectivesThis pilot prospective observational study aimed to evaluate the maternal and fetal outcomes of pregnancies under low-dose oral anticoagulation therapy after aortic mechanical replacement.BackgroundNeed for valve replacement is still an issue for young women with native valve disease who are planning on future pregnancy. Choice of replacement device is a challenging clinical task.MethodsA comprehensive pre-operative counseling protocol to guide choice of replacement device was developed. The pre-operative anticoagulation trial to determine the warfarin daily dosage needed to reach target international normalized ratio (INR) represented the main stem of such protocol. Pregnancies on low-dose anticoagulation therapy (target INR: 1.5 to 2.5) were allowed in a highly selected subset of mechanical aortic valve recipients.ResultsTwenty-two patients of 40 originally referred for native valve disease surgery requiring valve replacement, safely underwent the pre-operative anticoagulation challenge. No maternal or fetal complications were detected in 16 pregnancies under low oral anticoagulation. Patterns of warfarin daily dosage and induced INRs were characterized during pregnancy.ConclusionsIn this small sample observational study, a pre-operative anticoagulation therapy trial helped young women scheduled for valve replacement to acquire complete information as to the choice of prosthetic device. In selected third-generation mechanical aortic prosthesis recipients, low-dose anticoagulation therapy seems safe and feasible for both mother and fetus. Further studies are needed to validate this approach
Resting Energy Expenditure assessment in mechanically ventilated critically ill children: the importance of Indirect Calorimetry
No full textIntroduction. Malnutrition is common in critically ill children, and is considered a negative prognostic factor for their clinical outcomes1,2. Traditionally, Resting Energy Expenditure (REE) is calculated using predictive equations. These equations might be inaccurate in the critical scenario. Indirect Calorimetry (IC) is the gold standard to measure REE and allows tailored nutrition support3 .
Aim of the study was to evaluate the accuracy of commonly employed equations as compared to IC-derived values in critically ill children.
Methods. Children admitted to our unit between January 2017 and March 2019, aged <18 years and mechanically ventilated were enrolled. Endotracheal tube leak >10% and/or a fraction of inspired oxygen ≥0.6 constituted exclusion criteria. Harris-Benedict, Schofield and WHO formulae were applied to estimate REE. We performed IC for 30 minutes and REE was measured. The agreement between IC- and equation-based values of REE was assessed via paired t-test and BlandAltman analysis. Data are expressed as mean and standard deviation. Statistical significance was defined as p<0.05.
Results. Forty-four critically ill children (4.3±4.2 years, 18.1±16.4 kg) admitted for acute respiratory failure (n=24), neurological (n=13) or other diseases (n=7) were studied. Measured REE ranged between 16 and 89 kcal/kg/die (mean 43±15). Typically, all formulae significantly over-estimated the REE, as compared to IC (Table 1). Furthermore, the Bland-Altman analysis revealed wide limits of agreement, suggesting low accuracy of the prediction equations.
Conclusions. In critically ill, mechanically ventilated patients REE is on average significantly lower than predicted by currently applied equations. This finding might be explained by a reduced work of breathing and/or the use of sedatives and paralyzing agents. Measurement of REE through IC is essential to avoid over/underfeeding in this population.
References
1. Agostoni C et al. JPGN 2016
2. Taku Oshima et al. Clinical Nutr 2017
3. Smallwood CD et al. J Pediatr. 201
Fluid therapy in mechanically ventilated critically ill children: the sodium, chloride and water burden of fluid creep
No full textBackground: Fluid therapy is a cornerstone of pediatric intensive care medicine. We aimed at quantifying the load of water, sodium and chloride due to different fluid indications in our pediatric intensive care unit (PICU). We were particularly interested in the role of fluid creep, i.e. fluid administered mainly as the vehicle for drugs, and the association between sodium load and water balance.
Methods: Critically ill children aged ≤3 years and invasively ventilated for ≥48 h between 2016 and 2019 in a single tertiary center PICU were retrospectively enrolled. Need for renal replacement therapy, plasmapheresis or parenteral nutrition constituted exclusion criteria. Quantity, quality and indication of fluids administered intravenously or enterally, urinary output and fluid balance were recorded for the first 48 h following intubation. Concentrations of sodium and chloride provided by the manufacturers were used to compute the electrolyte load.
Results: Forty-three patients (median 7 months (IQR 3-15)) were enrolled. Patients received 1004 ± 284 ml of water daily (153 ± 36 ml/kg/day), mainly due to enteral (39%), creep (34%) and maintenance (24%) fluids. Patients received 14.4 ± 4.8 mEq/kg/day of sodium and 13.6 ± 4.7 mEq/kg/day of chloride, respectively. The majority of sodium and chloride derived from fluid creep (56 and 58%). Daily fluid balance was 417 ± 221 ml (64 ± 30 ml/kg/day) and was associated with total sodium intake (r2 = 0.49, p < 0.001).
Conclusions: Critically ill children are exposed, especially in the acute phase, to extremely high loads of water, sodium and chloride, possibly contributing to edema development. Fluid creep is quantitatively the most relevant fluid in the PICU and future research efforts should address this topic in order to reduce the inadvertent water and electrolyte burden and improve the quality of care of critically ill children
