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152. Indicators predicting use of mental health services in Piedmont, Italy

Author

Tibaldi, G., Munizza, C., Pasian, S., Johnson, S., Luis Salvador-Carulla, Zucchi, S., Cesano, S., Testa, C., Scala, E., and Pinciaroli, L.

Abstract

Since the 1978 Italian reform, an integrated network of community mental health services has been introduced. With few exceptions, research on determinants of mental health service use at the district level has focused on inpatient activities and social deprivation indicators. The European Psychiatric Care Assessment Team (EPCAT) standardized methodology allows for an evidence-based comparison of mental health systems between geographical areas.

Published
2005

164. Difficult-to-treat pediatric obsessive-compulsive disorder: Feasibility and preliminary results of a randomized pilot trial of D-cycloserine-augmented behavior therapy

Author

Farrell, L., Waters, A., Boschen, M., Hattingh, Laetitia, McConnell, H., Milliner, E., Collings, N., Zimmer-Gembeck, M., Shelton, D., Ollendick, T., Testa, C., Storch, E., Farrell, L., Waters, A., Boschen, M., Hattingh, Laetitia, McConnell, H., Milliner, E., Collings, N., Zimmer-Gembeck, M., Shelton, D., Ollendick, T., Testa, C., and Storch, E.

Abstract

Background: This study examined the feasibility and preliminary effectiveness of d-cycloserine (DCS)–augmented cognitive behavioral therapy (CBT) for children and adolescents with difficult-to-treat Obsessive Compulsive Disorder, in a double-blind randomized controlled pilot trial (RCT).Methods: Seventeen children and adolescents (aged 8–18 years) with a primary diagnosis of OCD, which was deemed difficult-to-treat, were randomly assigned to either nine sessions of CBT including five sessions of DCS-augmented exposure and response prevention (ERP) [ERP + DCS] or nine sessions of CBT including five sessions of placebo-augmented ERP [ERP + PBO]. Weight-dependent DCS or placebo doses (25 or 50 mg) were taken 1 hour before ERP sessions.Results: At post treatment, both groups showed significant improvements with 94% of the entire sample classified as responders. However, a greater improvement in the ERP + DCS relative to the ERP + PBO condition was observed at 1-month follow-up on clinician-rated obsessional severity and diagnostic severity, and parent ratings of OCD severity. There were no changes across time or condition from 1- to 3-month follow-up.Conclusions: In this preliminary study, DCS-augmented ERP produced significant improvements in OCD severity from posttreatment to 1-month follow-up, relative to a placebo control condition, in severe and difficult-to-treat pediatric OCD. The significant effect on obsessional severity suggests that DCS augmentation might be associated with enhanced modification of obsessional thoughts during ERP, and warrants further investigation.

Published
2013

174. Optimisation and application of ICP-MS and alpha-spectrometry for determination of isotopic ratios of depleted uranium and plutonium in samples collected in Kosovo

Author

Boulyga, S. F., Testa, C., Desideri, D., and Becker, J. S.

Subjects
ddc:540
Abstract

The determination of environmental contamination with natural and artificial actinide isotopes and evaluation of their source requires precise isotopic determination of actinides, above all uranium and plutonium. This can be achieved by alpha spectrometry or by inductively coupled plasma mass spectrometry (ICP-MS) after chemical separation of actinides. The performance of a sector-field ICP-MS (ICP-SFMS) coupled to a low-flow micronebulizer with a membrane desolvation unit, "Aridus'', was studied with respect to precise isotopic measurements of uranium and plutonium at the ultratrace level. The UH+/U+ formation rate was about 3x10(-5) and a sensitivity for U-238 of up to 4x10(9) counts s(-1) ppm(-1) was achieved. The limit of quantification (LOQ, 10s) for U-236 and Pu-239 using the experimental arrangement described above was 0.6 pg l(-1) in aqueous solution and 0.13 pg g(-1) in soil, respectively. ICP-SFMS was used in comparison to alpha spectrometry to measure the U and Pu concentrations and isotopic compositions in two soil samples and in one penetrator collected in Kosovo. ICP-MS permitted the determination of U and Pu isotope ratios including the U-236 abundance and Pu-240/Pu-239 ratio at ultratrace levels in soil samples of up to 0.1 g. Depleted uranium (U-235/U-238= 0.00202 +/-0.00001) was determined in one penetrator and one soil sample. Pu concentrations of (5.5 +/-0.1) x 10(-13) g g(-1) and (4.4 +/-0.5) x 10(-13) g g(-1) (Pu-240/Pu-239=0.35 +/-0.10 and 0.27 +/-0.07, respectively) were found in both soil samples from Kosovo. Besides plutonium, U-236 (3.1x10(-5) g g(-1)) and Am-241 (1.7x10(-12) g g(-1)) were also detected in the penetrator sample, which indicates the previous existence of neutron-related processes and points to a possible presence of spent reactor uranium in munitions. However, the most probable plutonium contamination sources in analyzed soil samples from Kosovo are mixed fallout including spent reactor fuel due to the Chernobyl nuclear power plant accident in 1986 and plutonium due to nuclear weapon tests. Additional plutonium contamination could not be determined in the Kosovo soil sample containing depleted uranium with a detection limit of about 10(-13) g g(-1).

Published
2001
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179. SPECT/CT and additional radiation dose - A retrospective analysis in our department.

Author

Testa C. and Testa C.

Abstract

Since the introduction of the frst commercially available SPECT/CT system on the market in 2001, the implementation of these systems in nuclear medicine departments has rapidly grown both locally and globally. Similarly, the associated benefts of this technology in terms of diagnosis and patient management have been well communicated and documented. However, with the implementation of CT into a nuclear medicine study comes an additional radiation burden to the patient which must be justifed in line with their condition and demographics (for example age, gender, weight, etc.). The Philips Precedence SPECT/CT system is one of several on the market with adjustable CT exposure factors, and is capable of performing CT diag-nostically. This system was installed in the nuclear medicine department at Monash Medical Centre in February 2007. Since that time, the number of SPECT/CT examinations performed has risen from 92 patients in the frst 6 months to 150 in the most recent 6 month period. Alongside this, with appropriate training, physicians and technologists alike have garnered further experience and familiarity with this technology. This has seen an increase in the mean tube current from 63 to 75 milliamps (mA). The aim of this investigation was to assess the distribution of CT exposure factors across different nuclear medicine procedures. The resultant changes in diagnosis for selected patient cases will be discussed, along with other descriptive statistics for our department.

Published
2010

181. Unruptured intracranial aneurysms--risk of rupture and risks of surgical intervention

Author

Wiebers, D., Whisnant, J., Forbes, G., Meissner, I., Brown, R., Piepgras, D., Huston, J., Nichols, D., O Fallon, W., Peacock, J., Jaeger, L., Kassell, N., Kongable-Beckman, G., Torner, J., Rajput, M., Drake, C., Kurtzke, J., Marler, J., Walker, M., Meyer, F., Atkinson, J., Marsh, W., Thielen, K., Ferguson, G., Barr, H., Lownie, S., Hachinski, V., Fox, A., Sahjpaul, R., Parrent, A., Mayer, C., Lindsay, K., Teasdale, E., Bone, I., Fatukasi, J., Lindsay, M., Cail, W., Sagher, O., Davis, M., Sengupta, R., Bates, D., Gholkar, A., Murdy, J., Wilson, S., Praharaj, S., Partridge, G., Reynolds, C., Hind, N., Ogilvy, C., Crowell, R., Gress, D., Schaefer, P., Choi, I., Buckley, D., Sloan, K., King, D., Giannotta, S., Ameriso, S., Teitelbaum, T., Thomson, E., Fishback, D., Vajda, J., Nyary, I., Czirjak, S., Horvath, M., Szikora, I., Pasztor, E., Varady, P., Erdos, A., Edner, G., Wahlgren, N., Lindqvist, M., Antonsson, A., Da Pian, R., Pasqualin, A., Chioffi, F., Beltramello, A., Zampieri, G., Benati, A., Rossi, G., Ronkainen, A., Hernesniemi, J., Vapalahti, M., Rinne, J., Luukkonen, M., Vihavainen, M., Savolainen, S., Koivisto, T., Leivo, S., Helin, K., Steinberg, G., Marks, M., Vanefsky, M., Norbash, A., Thompson, R., Bell, T., Marcellus, M., Meyer, A., Kerr, R., Adams, C., Molyneux, A., Vinden, S., Bacon, F., Shrimpton, J., Parker, S., Day, A., Nadeau, S., Stachniak, J., Friedman, W., Fessler, R., Peters, K., Jacob, R., Roper, S., Smith, A., Lafrentz, P., Howard, M., Loftus, C., Adams, H., Crosby, D., Rogers, M., Broderick, J., Tew, J., Brott, T., Loveren, H., Yeh, H., Zuccarello, M., Tomsick, T., Gaskill-Shipley, M., Minneci, L., Mcmahon, N., Castel, J., Orgogozo, J., Loiseau, H., Bourgeois, P., Berge, J., Dousset, V., Cuny, E., Richard, M., Agbi, C., Hugenholtz, H., Benoit, B., Morrish, W., Wee, R., Grahovac, S., Pratt, L., Mortensen, M., Andreoli, A., Testa, C., Comani, V., Trevisan, C., Limoni, P., Carlucci, F., Leonardi, M., Sturiale, C., Pendl, G., Eder, H., Klein, G., Eder, M., Leber, K., Horner, T., Leipzig, T., Payner, T., Denardo, A., Scott, J., Redelman, K., Fisher, W., Rosner, M., Vitek, G., Hand, M., Flack, Wf, Sichez, J., Pertuiset, B., Fohanno, D., Marsault, C., Casasco, A., Biondi, A., Capelle, L., Duffau, H., Winn, H., Grady, M., Newell, D., Longstreth, W., Thompson, P., Bybee, H., Jones, D., Findlay, J., Petruk, K., Steinke, D., Ashforth, R., Stenerson, P., Schindel, D., Vanderhoven, H., Neves, J., Zager, E., Flamm, E., Raps, E., Hurst, R., Parrott, S., Sellers, M., Torchia, M., Anderson, B., West, M., Fewer, D., Hill, N., Sutherland, G., Ross, I., Mcclarty, B., Brownstone, R., Williams, O., Narotam, P., Christane, L., Mcginn, G., Gladish, D., Kirkpatrick, P., Pickard, J., Antoun, N., Simpson, D., Higgins, N., Turner, C., Tebbs, S., Holness, R., Malloy, D., Phillips, S., Maloney, W., Molina-De-Orozco, V., Baxter, B., Connolly-Campbell, K., Macdougall, A., Gentili, F., Wallace, M., Ter Brugge, K., Willinsky, R., Tymianski, M., Rickards, L., Tucker, W., Lambert, C., Montanera, W., Rychlewski, C., Flood, C., Villani, R., Sganzerla, E., Tomei, G., Bettinelli, A., Ceccarelli, G., Righini, A., Bello, L., Marras, C., Nelson, R., Lewis, T., Renowden, C., Clarke, Y., Varian, L., Chyatte, D., Sila, C., Perl, J., Masaryk, T., Porterfield, R., Shaw, M., Foy, P., Nixon, T., Dunn, L., Clitheroe, N., Smith, T., Eldridge, P., Humphrey, P., Wiseman, J., Hawkins, K., Owen, L., Ost, K., Saminaden, S., Mohr, G., Schondorf, R., Carlton, J., Maleki, M., Just, N., Brien, S., Entis, S., Tampieri, D., Simons, N., Mooij, J., Metzemackers, J., Hew, J., Beks, J., Veen, A., Bosma, I., Sprengers, M., Rinkel, G., Gijn, J., Ramos, L., Tulleken, C., Greebe, P., Vliet, F., Borgesen, S., Jespersen, B., Boge-Rasmussen, T., Willumsen, L., Homer, D., Eller, T., Carpenter, J., Meyer, J., Munson, R., Small, B., Nussbaum, E., Heros, R., Latchaw, R., Camarata, P., Lundgren, J., Mattsen, N., Whittle, I., Sellar, R., O Sullivan, M., Steers, A., Statham, P., Malcolm, G., Price, R., Hoffman, B., Yonas, H., Wechsler, L., Thompson-Dobkin, J., Jungreis, C., Kassam, A., Kirby, L., Parent, A., Lewis, A., Azordegan, P., Smith, R., Alexander, L., Gordon, D., Russell, W., Benashvili, G., Perry, R., Scalzo, D., Mandybur, G., Morgan, C., Karanjia, P., Madden, K., Kelman, D., Gallant, T., Vanderspek, H., Choucair, A., Neal, J., Mancl, K., Saveland, H., Brandt, L., Holtas, S., Trulsson, B., Macdonald, R., Weir, B., Mojtahedi, S., Amidei, C., Vermeulen, M., Bosch, D., Hulsmans, F., Albrecht, K., Roos, Y., Vet, A., Gorissen, A., Mechielsen, M., Martin, N., Gobin, Y., Saver, J., Vinuela, F., Duckwiler, G., Kelly, D., Frazee, J., Da Graca, R., Gravori, T., Illingworth, R., Richards, P., Wade, J., Colquhoun, I., Bashir, E., Shortt, S., Weaver, J., Fisher, M., Stone, B., Chaturvedi, S., Davidson, R., Davidson, K., Giombini, S., Solero, C., Boiardi, A., Cimino, C., Valentini, S., Antonio Silvani, Alberts, M., Friedman, A., Gentry, A., Hoffman, K., Hughes, R., Lillihei, K., Earnest, M., Nichols, J., Kindt, G., Anderson, A., Levy, S., Breeze, R., Noonan, V., Dowd, C., Vanwestrop, J., Wilson, C., Berger, M., Hannegan, L., Marcos, J., Ugarte, L., Kitchen, N., Taylor, W., Kumar, M., Grieve, J., Durity, F., Boyd, M., Fairholm, D., Griesdale, D., Honey, C., Redekop, G., Toyota, B., Turnbull, I., Woodhurst, W., Zwimpfer, T., Teal, P., Grabe, D., Brevner, A., Piepgras, A., Schmiedek, P., Schwartz, A., Weber, T., Biller, J., Brem, S., Cybulski, G., Chadwick, L., Bronstein, K., Pietila, T., Brock, M., Krug, D., Krznaric, I., and Kivisaari, R.

Subjects
Adult, Male, medicine.medical_specialty, International Subarachnoid Aneurysm Trial, Adolescent, Rupture rate, Aneurysm, Ruptured, Risk Factors, Intervention (counseling), Unruptured cerebral aneurysm, Medicine, Humans, Prospective Studies, Aged, Probability, Retrospective Studies, Aged, 80 and over, Rupture, Spontaneous, business.industry, Age Factors, Intracranial Aneurysm, General Medicine, Middle Aged, Subarachnoid Hemorrhage, Emergency medicine, Female, business, Vascular Surgical Procedures
Abstract

The management of unruptured intracranial aneurysms requires knowledge of the natural history of these lesions and the risks of repairing them.A total of 2621 patients at 53 participating centers in the United States, Canada, and Europe were enrolled in the study, which had retrospective and prospective components. In the retrospective component, we assessed the natural history of unruptured intracranial aneurysms in 1449 patients with 1937 unruptured intracranial aneurysms; 727 of the patients had no history of subarachnoid hemorrhage from a different aneurysm (group 1), and 722 had a history of subarachnoid hemorrhage from a different aneurysm that had been repaired successfully (group 2). In the prospective component, we assessed treatment-related morbidity and mortality in 1172 patients with newly diagnosed unruptured intracranial aneurysms.In group 1, the cumulative rate of rupture of aneurysms that were less than 10 mm in diameter at diagnosis was less than 0.05 percent per year, and in group 2, the rate was approximately 11 times as high (0.5 percent per year). The rupture rate of aneurysms that were 10 mm or more in diameter was less than 1 percent per year in both groups, but in group 1, the rate was 6 percent the first year for giant aneurysms (or =25 mm in diameter). The size and location of the aneurysm were independent predictors of rupture. The overall rate of surgery-related morbidity and mortality was 17.5 percent in group 1 and 13.6 percent in group 2 at 30 days and was 15.7 percent and 13.1 percent, respectively, at 1 year. Age independently predicted surgical outcome.The likelihood of rupture of unruptured intracranial aneurysms that were less than 10 mm in diameter was exceedingly low among patients in group 1 and was substantially higher among those in group 2. The risk of morbidity and mortality related to surgery greatly exceeded the 7.5-year risk of rupture among patients in group 1 with unruptured intracranial aneurysms smaller than 10 mm in diameter.

Published
1998

183. Prognostic value of brain proton MR spectroscopy and diffusion tensor imaging in newborns with hypoxic-ischemic encephalopathy treated by brain cooling

Author

Ancora, G., primary, Testa, C., additional, Grandi, S., additional, Tonon, C., additional, Sbravati, F., additional, Savini, S., additional, Manners, D. N., additional, Gramegna, L. L., additional, Tani, G., additional, Malucelli, E., additional, Corvaglia, L. T., additional, Faldella, G., additional, and Lodi, R., additional

Published
2013
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185. Tiltrotor cabin noise control through smart actuators.

Author

Bernardini, G., Testa, C., and Gennaretti, M.

Subjects
*INTELLIGENT actuators, *NOISE control, *OPTIMAL designs (Statistics), *AEROELASTICITY, *TILT rotor aircraft
Abstract

This paper deals with the abatement of the tonal noise inside the fuselage of a mid-range tiltrotor aircraft, as generated by the propulsive system. The problem is basically multidisciplinary, involving interactions among the exterior noise field, elastic fuselage dynamics, interior acoustics and control system. A stiffened fuselage, with piezoelectric patches embedded into the structure, is supposed to be impinged on by the aeroacoustic field generated by propellers and excited by the wing/pylon/proprotor vibratory loads at the wing–fuselage attachment. An optimal linear quadratic regulator cyclic control formulation, coupled with a genetic optimization algorithm, is applied to synthesize the control law driving the smart actuators so as to alleviate cabin noise. The aeroacoustoelastic model considered in the control problem is obtained by combining cabin interior acoustics, fuselage smart shell dynamics and wing/pylon/proprotor aeroelasticity described through modal approaches with the exterior pressure field provided by boundary element method solvers. Numerical results examine the effectiveness and robustness of the proposed active control strategy. [ABSTRACT FROM AUTHOR]

Published
2016
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196. Inhibition of left ventricular remodelling preserves chamber systolic function in pressure-overloaded mice

Author

Marano, G, Palazzesi, S, Vergari, Alessandro, Catalano, L, Gaudi, S, Testa, C, Canese, R, Carpinelli, G, Podo, F, Ferrari, Au, Vergari, Alessandro (ORCID:0000-0002-4909-3098), Marano, G, Palazzesi, S, Vergari, Alessandro, Catalano, L, Gaudi, S, Testa, C, Canese, R, Carpinelli, G, Podo, F, Ferrari, Au, and Vergari, Alessandro (ORCID:0000-0002-4909-3098)

Abstract

Controversy exists whether the development of left-ventricular hypertrophy (LVH) is a mechanism able to prevent cardiac dysfunction under conditions of pressure overload. In the present study we re-assessed the long-term effects of attenuating LVH by using L- and D-propranolol, which are equally able to inhibit the development of LVH induced by aortic banding. The aortic arch was banded proximal to the left common carotid artery in 71 CD-1 mice that were then assigned randomly to receive L-propranolol, D-propranolol (both 80 mg/kg per day) or vehicle. Concurrently, sham-operated mice were given L-propranolol, D-propranolol or vehicle. LV dimension and performance were evaluated under isoflurane anaesthesia by cine-magnetic resonance imaging, echocardiography and cardiac catheterization up to 8 weeks after surgery. After 2 weeks of pressure overload, the vehicle-treated banded mice had enhanced LV weight, normal chamber size and increased relative wall thickness (concentric hypertrophy), whereas L-propranolol- or D-propranolol-banded mice showed a markedly blunted hypertrophic response, i.e. normal chamber size and normal relative wall thickness, as well as preserved systolic LV chamber function. After 4 weeks, the vehicle-treated banded mice showed LV enlargement with a reduced relative wall thickness (eccentric remodelling) and a clear-cut deterioration in LV systolic function. In contrast, L-propranolol- or D-propranolol-treated banded mice showed normal chamber size with a normal relative wall thickness and preserved systolic function. A distinct histological feature was that in banded mice, L-or D-propranolol attenuated the development of cardiomyocyte hypertrophy but not the attendant myocardial fibrosis. At the 8-week stage, LV dysfunction was present in propranolol-treated banded mice although it was much less severe than in vehicle-treated banded mice. It is concluded that (i) deterioration of LV systolic performance is delayed if LV hypertrophy is inhibited

Published
2003

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