Search

Summary: Our case report aims to highlight the multidisciplinary approach adopted for the avoidance of ICU-acquired weakness and the assessment of nutritional therapy in 16 weeks young pregnant with diagnosis of hyperemesis gravidarum complicated with central pontine myelinolysis, after the development of acute respiratory failure due to pneumonia.Thiamine and electrolytes were properly supplemented to minimize the high risk of developing refeeding syndrome. Due to severe nausea and vomiting, antiemetic therapy was started and a parenteral route was chosen during the first two days of non-invasive ventilation. On day three, the patient was intubated and mechanically ventilated due to severe respiratory failure, semi-elemental formula was started by enteral route while parenteral nutrition was supplemented and early rehabilitation was started. Antiemetic therapy was continued until day 28th when the pregnant woman was shifted to oral nutrition only. On day 87th the postpartum mother was transferred to the rehabilitation center for an intensive rehabilitative program based on the motor recovery of lower limb and swallowing recovery.

Introduction: Suicide represents a significant public health problem whose neurobiology is not yet fully understood. In many cases, suicidal behavior and psychiatric spectrum disorders are linked, in particular, to major depression. An emerging pathophysiological hypothesis underlines the role of neurotrophic factors, proteins involved in neurogenesis, in synaptic plasticity in response to stressors. Our research aims to evaluate the degree of expression of brain neurotrophic factor (BDNF) in brain areas involved in depressive disorder in suicidal subjects. Furthermore, we want to evaluate the expression of glial cell line-derived neurotrophic factor (GDNF) in suicidal subjects.Methods: We selected twenty confirmed cases of suicide among subjects with a clinical history of depressive pathology and possible psychopharmacological treatment, compared to ten controls of individuals who died of non-suicidal causes. For all selected cases and controls, immunohistochemical investigations were performed using a panel of antibodies against the BDNF and GDNF antigens on samples from the various brain areas.Results and discussion: The results show that BDNF was under-expressed in the cerebral parenchyma of subjects who died by suicide compared to controls, while there was an overexpression of GDNF in suicide victims, these data could be useful for a clinical application as potential markers for suicidal risk, to assess the severity of depression and development of specific pharmacological therapies for depression.

Abstract Pancreatic cancer, ranking as the third factor in cancer‐related deaths, necessitates enhanced diagnostic measures through early detection. In response, SiMoT‐Single‐molecule with a large Transistor multiplexing array, achieving a Technology Readiness Level of 5, is proposed for a timely identification of pancreatic cancer precursor cysts and is benchmarked against the commercially available chemiluminescent immunoassay SIMOA (Single molecule array) SP‐X System. A cohort of 39 samples, comprising 33 cyst fluids and 6 blood plasma specimens, undergoes detailed examination with both technologies. The SiMoT array targets oncoproteins MUC1 and CD55, and oncogene KRAS, while the SIMOA SP‐X planar technology exclusively focuses on MUC1 and CD55. Employing Principal Component Analysis (PCA) for multivariate data processing, the SiMoT array demonstrates effective discrimination of malignant/pre‐invasive high‐grade or potentially malignant low‐grade pancreatic cysts from benign non‐mucinous cysts. Conversely, PCA analysis applied to SIMOA assay reveals less effective differentiation ability among the three cyst classes. Notably, SiMoT unique capability of concurrently analyzing protein and genetic markers with the threshold of one single molecule in 0.1 mL positions it as a comprehensive and reliable diagnostic tool. The electronic response generated by the SiMoT array facilitates direct digital data communication, suggesting potential applications in the development of field‐deployable liquid biopsy.

Considering the variety of architectural Cultural Heritage typologies, systemic architectures require specific attention in the recovery process. The dimensions of "extension" and "recurrence" at geographic and technological levels affect the complexity of their knowledge process; they require systematic ways for their categorisation and comprehension to guarantee correct diagnosis and suitable rehabilitation. Recent applications involving Internet of Things (IoT) for the built Cultural Heritage have demonstrated the potentialities of three-dimensional (3D) geographic information system (GIS) models and structured databases in supporting complex degrees of knowledge for technicians, as well as management for administrators. Starting from such experiences, the work presents the setting up of a web-based platform to support the knowledge and management of systemic architectures, considering the geographical distribution of fabrics, natural and anthropic boundary conditions, and technical and administrative details. The platform takes advantage of digital models, machine and deep learning procedures and relational databases, in a GIS-based environment, for the recognition and categorisation of prevalent physical and qualitative features of systemic architectures, the recognition and qualification of dominant and recurrent decays and the management of recovery activities in a semi-automatic way. Specifically, the main digital objects used for testing the applied techniques and setting up the platform are based on Red-Green-Blue (RGB) and mapped point clouds of the historical Telegraphic Towers located along the Madrid-Valencia path, resulting from the on-site investigations. Their choice is motivated by the high level of knowledge about the cases reached in the last years by the authors, allowing them to test rules within the decision support systems and innovative techniques for their decay mapping. As the experience has demonstrated, the systematisation of technical details and operative pipeline of methods and tools allow the normalisation and standardisation of the intervention selection process; this offers policymakers an innovative tool based on traditional procedures for conservation plans, coherent with a priority-based practice.

Objective. Fragility fractures (FF) resulting from osteoporosis pose a significant public health challenge in Italy, with considerable socio-health and economic implications. Despite the availability of safe and effective drugs, osteoporosis remains underdiagnosed and undertreated, leaving over 2 million high-risk Italian women without treatment. This paper aims to identify and propose key improvements in the management of osteoporosis, focusing particularly on the critical issues related to the use of anabolic drugs in secondary prevention, according to the current Italian Medicines Agency (AIFA) Note 79. Methods. The Expert Panel, composed of nine recognized Italian experts in rheumatology, analyzed current practices, prescribing criteria, and the most recent literature. Three main reasons for revising the indications on pharmacological treatment of osteoporosis were identified: inadequate treatment of osteoporosis, new evidence regarding frontline placement of anabolics in high-risk conditions, and emerging sequential or combined strategies. Results. The proposed improvements include the adoption of the Derived Fracture Risk Assessment algorithm for accurate fracture risk assessment, revision of AIFA Note 79 to reflect current evidence, improved prescribing appropriateness, broader access to anabolic agents, and the provision of sequential therapies with antiresorptives for teriparatide. These changes aim to enhance patient outcomes, streamline healthcare processes, and address the high percentage of undertreated individuals. Conclusions. This expert opinion emphasizes the importance of the appropriate use of anabolic drugs to reduce FF and associated costs while ensuring the sustainability of the National Health Service. The proposed recommendations are in line with the latest scientific evidence, providing a comprehensive strategy to optimize the management of osteoporosis in Italy. On behalf of the Study Group on Osteoporosis and Skeletal Metabolic Diseases of the Italian Society of Rheumatology.

Aim: The study aimed to evaluate the shaping characteristics of ProTaper Ultimate (Dentsply Sirona) and BlueShaper (Zarc4Endo) using microcomputed tomographic imaging technology (micro-CT).Methods: Thirty mesial and distal canals of extracted second mandibular molars with similar anatomy were selected and scanned pre- and postoperatively by micro-CT scanning (SkyScan 1172, Bruker micro-CT) with a voxel size of 11 μm and shaped with two different procedures: ProTaper Ultimate (Group 1: n = 15) and BlueShaper (Group 2: n = 15) were used following the manufacturer’s recommendations up to final 30 apical size. Irrigation was ensured in all groups with 5.25% NaOCl and 10% EDTA during instrumentation. Canal transportation, the volume of removed dentin, and area of untreated surface were matched with preoperative values with Bruker CT Analyser (Bruker micro-CT). Data were statistically analyzed using Student’s t-test.Results: No significant differences were observed between Group 1 and Group 2 in terms of canal transportation, volume of removed dentin, and untreated surfaces. A significant difference (p < 0.05) in the amount of untreated surfaces was found between the mesial and distal canals in both groups.Conclusion: Shaping procedures with both ProTaper Ultimate and BlueShaper demonstrated similar canal enlargement volumes and similar canal transportation without evidence of significant preparation errors. Nevertheless, a high amount of untreated surface was reported for both systems, particularly in distal canals.

In this work, we report on the novel employment of lithium niobate tuning forks as acoustic transducers in photoacoustic spectroscopy for gas sensing. The lithium niobate tuning fork (LiNTF) exhibits a fundamental resonance frequency of 39196.6 Hz and a quality factor Q = 5900 at atmospheric pressure. The possibility to operate the LiNTF as a photoacoustic wave detector was demonstrated targeting a water vapor absorption line falling at 7181.14 cm−1 (1.39 µm). A noise equivalent concentration of 2 ppm was reached with a signal integration time of 20 s. These preliminary results open the path towards integrated photonic devices for gas sensing with LiNTF-based detectors on lithium niobate platforms.