Search

Background: Atherosclerosis is a chronic inflammatory disease. The balance between proand anti-inflammatory factors, acting on the arterial wall, promotes less or more coronary plaque macro-calcification, respectively. We investigated the association between monocyte phenotypic polarization and CTCA-assessed plaque dense-calcium volume (DCV) in patients with stable coronary artery disease (CAD). Methods: In 55 patients, individual DCV component was assessed by quantitative CTCA and normalized to total plaque volume. Flow cytometry expression of CD14, CD16, CD18, CD11b, HLA-DR, CD163, CCR2, CCR5, CX3CR1 and CXCR4 was quantified. Adhesion molecules and cytokines were measured by ELISA. Results: DCV values were significantly associated, by multiple regression analysis, with the expression (RFI) of CCR5 (p = 0.04), CX3CR1 (p = 0.03), CCR2 (p = 0.02), CD163 (p = 0.005) on all monocytes, and with the phenotypic M2-like polarization ratio, RFI CCR5/CD11b (p = 0.01). A positive correlation with the increased expression of chemokines receptors CCR2, CCR5 and CX3CR1 on subsets Mont was also present. Among cytokines, the ratio between IL-10 and IL-6 was found to be strongly associated with DCV (p = 0.009). Conclusions: The association between DCV and M2-like phenotypic polarization of circulating monocytes indicates that plaque macro-calcification in stable CAD may be partly modulated by an anti-inflammatory monocyte functional state, as evidenced by cell membrane receptor patterns.

Descrizione del flusso di funzionamento della piattaforma di telemedicina TiAssisto: aggiornamenti ed estensioni.

A pilot study was conducted in the framework of the Save the Mountains initiative, an education and sustainability project, promoted by Italian Alpine Club of Bergamo, Bergamo section of the National Alpine Association, Province of Bergamo, Observatory for the Bergamasque Mountains and Alpine and Speleological Rescue. As a part of this study, an anonymous online questionnaire was designed and prepared, collecting lifestyle information (eating habits, alcohol, tobacco, sleep, exercise) of the mountaineers in order to recommend specific measures useful for staying in mountain areas and for preventing individual risk factors related to lifestyle and Acute Mountain Sickness (AMS): http://altamontagna.isti.cnr.it:8080/Stiledivita/. The study will continue the collection of questionnaire responses until at least the end of Summer 2021; at the time of writing (February 2021), 804 questionnaire responses were already collected and analyzed. The initial sample refers to the people who attended mountain huts in the Orobie Alps; then the online questionnaire form was publicly extended to other regions. About 99% of the interviewed people are Italian; the rest are Swiss, Polish, British and French people. Mean age is 48 years(+/-15), 62% males and 38% females. Only 8.8% of them answered they suffered from altitude sickness, but self-reported Lake Louise Score (LLS) classified the 21.3% of people with Acute Mountain Sickness (AMS), light AMS 15,4% and severe AMS 5,8% (To assess AMS the original LLS questionnaire was used: AMS is classified as severe when a headache is present and the LLS is greater than 5, it is instead light when there is a headache and the LLS is between 3 and 5, else is normal). The Mediterranean Diet's adherence, collected as the frequency of food items consumption, was assessed by the MEDI-LITE score, a validated questionnaire, ranging from 0 to 13. In this sample, a median score of 8 was found, while the 25th percentile corresponds to a score lower than 6 and the 75th percentile to a score greater than 9. The 14% of the sample resulted in being not adherent to the Mediterranean diet, the 51% was in the mean, the 35% was adherent. This study confirms that the predisposing factor most associated with the AMS is "having had the same episode in the past" (OR 2.50, CI 1.88/3.13), having sleep disturbs (OR 1.29, CI 1.03 /1.55), age (OR -0.03, CI -0.35/-0.02). Moreover, it underlines that lifestyle is important with respect to risk to develop the AMS: actually, despite the structural limitations of surveys, this study pointed out that lifestyle contributes to mitigating the risk of developing the AMS (Mediterranean diet score OR - 0.34, CI -0.64 -> - 0.55). Gender, smoke and high physical activity are instead not significant. Future studies should investigate more deeply how lifestyle can change the impact on high altitude diseases.

Lo scopo di questo rapporto è quello di estendere le precedenti descrizioni del flusso di funzionamento della piattaforma di telemedicina TiAssisto e di porre l'attenzione sui punti rimasti da definire.

La variation des visiteurs de montagne ces dernières années modifie de manière significative les problèmes du territoire montagnard: si d'une part le nombre de visiteurs temporaires augmente (touristes, travailleurs, etc ...), d'autre part le nombre d'habitants diminue. Le premier, parmi les divers, élève la maladie aiguë de haute montagne (MAM) à un problème de santé publique non négligeable; le second conduit à une gestion moindre du territoire générant des problèmes directs et indirects, parmi ceux-ci, également favorisés par le réchauffement climatique, ainsi que la prolifération des tiques. Cette recherche a spécifiquement examiné les facteurs de risque individuels liés au mode de vie et à la MAM.

Report Finale progetto RadIoPoGe.

Il volume presenta i risultati del progetto RadIoPoGe "Radiazioni Ionizzanti, Popolazione Generale", promosso dall'Istituto di Fisiologia Clinica (IFC) e dall'Istituto di Scienza e Tecnologie dell'Informazione "A. Faedo" (ISTI) del CNR di Pisa e coordinato dall'Azienda Ospedaliero Universitaria Pisana (AOUP). RadIoPoGe si è mosso in due direzioni: descrivere il grado di conoscenza da parte della popolazione rispetto alle radiazioni ionizzanti impiegate nella diagnostica medica e dare agli operatori sanitari gli strumenti per demistificare idee preconcette fornendo un'informazione mirata ai pazienti. Il progetto ha coinvolto per alcuni anni molti centri Italiani e migliaia di nostri concittadini hanno regalato un po' del loro tempo per consentire la raccolta dei dati che sono presentati in questo volume. I risultati ottenuti costituiscono un prezioso riferimento per Medici, TSRM e Fisici Sanitari che possono trovarvi spunti utili per comunicare efficacemente ai pazienti il proprio impegno volto a minimizzare i rischi delle ra- diazioni ionizzanti e a massimizzare i livelli di qua- lità dei servizi di diagnostica per immagini.

Il presente documento descrive lo stato di avanzamento del progetto "Conoscenza della popolazione sulla radioprotezione e sulla dose radiante delle principali procedure radiologiche" (RadioPoGe) al 20/12/2019

Correlare in un gruppo di cantanti la sintomatologia indicativa di reflusso faringo-laringeo (LPR) valutata attraverso il Reflux Symptom Index (RSI) con l'impatto fisico-socio-emozionale ed economico dei disturbi vocali studiato tramite l'indice S-VHI.

Acquisizione e Classificazione dati

STATO DELL'ARTE NELL'ANALISI DELLA VOCE

Nel corso degli ultimi decenni stiamo assistendo ad una rapida evoluzione delle tecniche di indagine radiologica, al fine di fornire prestazioni sempre più elevate e performanti. Il frequente e sistematico ricorso alle tecniche di diagnostica per immagini ha fatto sì che queste abbiano assunto il ruolo di strumento indispensabile per definire il corretto percorso terapeutico dei pazienti. Tutte queste metodiche tuttavia, se da un lato aumentano la capacità diagnostica delle procedure, dall'altro possono tendere ad esporre il paziente ad elevate quantità di radiazioni ionizzanti. Spesso il luogo comune associa alla parola "radiazioni" qualcosa di pericoloso. Limitata è però la consapevolezza relativa a quante radiazioni vengono impiegate per le diverse procedure diagnostiche e a quante ciascun individuo è quotidianamente esposto anche a causa del fondo naturale di radiazione.

La variazione dei frequentatori della montagna degli ultimi anni sta significativamente cambiando le problematiche del territorio montano: se da un lato aumenta il numero delle presenze temporanee (turisti, lavoratori, etc...), dall'altro diminuisce quello degli abitanti. Il primo, tra le varie, sta elevando il Male Acuto di alta Montagna (MAM) a problema di salute pubblica non trascurabile; il secondo porta ad una minore gestione del territorio generando problemi diretti ed indiretti, tra questi, favorito altresì dal riscaldamento globale, anche la proliferazione delle zecche. Questa ricerca ha esaminato in particolare I fattori di rischio individuale relativo allo stile di vita e al MAM.

Il presente documento fornisce la descrizione dell'indagine per la valutazione delle qualità psicometriche dello screening I-RSI-revised, base per la specifica della piattaforma Web di supporto alla gestione della raccolta ed elaborazione dei dati. Il lavoro è frutto della collaborazione tra l'Unità Operativa Otorinolaringoiatria, Audiologia e Foniatria dell'Università di Pisa, dagli Istituti di Fisiologia Clinica e da quello di Scienza e Tecnologie dell'Informazione.

Una applicazione sul Male Acuto di Montagna per il frequentatore delle montagne

Tavola rotonda sulle Nuove frontiere nell'analisi della voce

The purpose of this study was to compare videofluoroscopy (VFS), fiberoptic endoscopic evaluation of swallowing (FEES) and oro-pharyngo- oesophageal scintigraphy (OPES) with regards to premature spillage, post-swallowing residue and aspiration to assess the reliability of these tests for detection of oro-pharyngeal dysphagia. Sixty patients affected with dysphagia of various origin were enrolled in the study and submitted to VFS, FEES and OPES using a liquid and semi-solid bolus. As a reference, we used VFS. Both the FEES and the OPES showed good sensitivity with high overall values (≥ 80% and ≥ 90% respectively). The comparison between FEES vs VFS concerning drop before swallowing showed good specificity (84.4% for semi-solids and 86.7% for liquids). In the case of post-swallowing residue, FEES vs VFS revealed good overall validity (75% for semi-solids) with specificity and sensitivity well balanced for the semi-solids. OPES vs. VFS demonstrated good sensitivity (88.6%) and overall validity (76.7%) for liquids. The analysis of FEES vs. VFS for aspiration showed that the overall validity was low (≤ 65%). On the other hand, OPES demonstrated appreciable overall validity (71.7%). VFS, FEES and OPES are capable of detecting oro-pharyngeal dysphagia. FEES gave significant results in the evaluation of post-swallowing residues.L’obiettivo di questo studio era quello di confrontare la Videofluoroscopia (VFS), la valutazione endoscopica a fibre ottiche della deglutizione (FEES) e la scintigrafia oro-faringo-esofagea (OPES) per quanto riguarda la caduta pre-deglutitoria, il ristagno post-deglutitorio e l’aspirazione, al fine di valutare l’attendibilità di questi test nel rilevare la disfagia orofaringea. Sessanta pazienti, affetti da disfagia di varia origine, sono stati arruolati nello studio e sottoposti a VFS, FEES e OPES utilizzando un bolo liquido e uno semi-solido. Abbiamo usato la VFS come esame di riferimento. La FEES e la OPES hanno entrambe mostrato una buona sensibilità, con valori complessivi elevati (rispettivamente ≥ 80% e ≥ 90%). Il confronto tra FEES e VFS relativamente alla caduta pre-deglutitoria ha evidenziato una buona specificità (84,4% per i semi-solidi e 86,7% per i liquidi). Nel caso di ristagni post-deglutitori, il confronto tra FEES e VFS ha rivelato una buona validità complessiva (75% per i semi-solidi), con specificità e sensibilità ben equilibrate per i semi-solidi. Il confronto tra OPES e VFS ha dimostrato buona sensibilità (88,6%) e validità complessiva (76,7%) per i liquidi. Il confronto dei dati ottenuti tra FEES e VFS, relativamente all’ aspirazione, ha evidenziato una bassa validità complessiva (≤ 65%). D’altra parte, la OPES ha mostrato una validità complessiva apprezzabile (71,7%). VFS, FEES e OPES sono in grado di rilevare la disfagia oro-faringea. La FEES ha fornito risultati significativi nella valutazione dei ristagni post-deglutitori.

Scopo: Nell'ambito del progetto e-Rés@mont (Interreg Alcotra) è stato sviluppato un sistema di teleconsulto per migliorare l'assistenza sanitaria per turisti e residenti in montagna. Metodi: In 5 rifugi della Valle d'Aosta e presso 2 distretti sanitari (1533 - 3500 metri) 5 infermieri formati erano disponibili per valutare pazienti tramite raccolta della storia clinica e di parametri fisiologici, elettrocardiogramma, ecografia. Il sistema forniva un sistema di video-conferenza realizzato ad-hoc e permetteva, tramite tablet dotato di connessione mobile, di registrare e inviare le informazioni a un medico all'ospedale di Aosta. In caso di connessione non disponibile, un sistema di supporto alle decisioni forniva all'infermiere score di rischio per valutare la gravità e decidere di chiamare il sistema di emergenza. Tutti i dati registrati e salvati localmente alla riconnessione venivano inviati all'ospedale. Il sistema permetteva anche la valutazione automatica del male acuto di alta quota in base al Lake Louise Score. Risultati: Nel periodo estivo e invernale del 2017 sono stati effettuati 702 teleconsulti. Il 100% dei casi è stato correttamente ricevuto in ospedale e nei casi necessari è stata effettuata anche una valutazione specialistica. Il tempo medio di diagnosi è stato di 32 minuti: 333 codici bianchi, 356 gialli, 13 rossi; in 12 casi questo sistema ha evitato inappropriati interventi di soccorso in elicottero. Conclusioni: Il teleconsulto e-Res@mont è stato efficace nei trattamenti di emergenza, soprattutto per la riduzione dei tempi di valutazione in aree remote. Ulteriori studi sono necessari per valutare l'impatto sulla spesa sanitaria e sulle lista di attesa.

A teleconsultation system was developed as part of the of e-Rés@mont (European Interreg Alcotra) project, aimed to improve the healthcare for mountain inhabitants and tourists. Accessing a Web system, through a tablet equipped with a mobile 3G/4G connection, trained nurses from remote shelters of north-west Italian mountain area (between 1544 and 3500 m) can send multimedia data (physiological parameters, electrocardiogram, echography, etc.) to the hospital (Aosta, Italy) where a doctor determined a diagnosis. This system provided an ad hoc videoconference built using the most recent technologies with autoadapting videoband. When connection was not available, a decision support system, on an off-line app, provides scores and suggestions to the nurse to evaluate the severity, to dispense emergency aids, and to call rescue services when needed. When the connection turned available, locally stored data were sent to the hospital. On the basis of acquired information, the presence of acute mountain sickness was also automatically assessed. A total of 702 teleconsultations were performed during last summer and winter. The system fully performed the functions it was designed for in mountain areas: all data were correctly received at the hospital and teleconsultations allowed specialist checks. The average diagnosis time was 42 minutes: 333 white, 356 yellow, and 13 red severity; moreover, in 12 cases, this system avoided inappropriate helicopter rescue intervention. Our mountain teleconsultation system was effective in improving people emergency treatments, allowing proper diagnoses and reducing waiting time. Further studies are needed to establish the effectiveness of this system in a high-altitude setting (>3500 m).

In recent years, there has been an increase in the attendance of people at high altitudes for both tourism and work, so high-altitude diseases represent a non-negligible public health problem. This research examined cross-sectional and prospective associations of lifestyle, individual risk factors, and acute mountain sickness (AMS) in a community-based sample recruited in the cross-border area (Switzerland, Italy, and France Alps). Questionnaires were administered in the five mountain locations in Aosta Valley between 1500 and 3500 m. Data were analyzed from 1002 subjects (males 68.7%, females 31.3%; mean age 42 ± 14 years) in a cross-sectional study (session T0) and from 1112 interviews in a longitudinal study on three consecutive days (session T1-T2-T3), n = 631 in T1, n = 300 in T2, and n = 181 in T3. According to Lake Louise Score self-reported, at session T0, 35.9% of the subjects were classified as mild AMS and 17.5% as moderate-severe AMS. Among the subjects enrolled in the prospective study, 36.5% were classified as mild or moderate/severe AMS in at least one of the 3 days. Predisposing factors to AMS detected in the prospective study were gender (male; odds ratio [OR] = 1.4, confidence interval [CI]: 2.9-11.7; p = 0.001), history of strenuous physical activity (>3 times per week) (OR = 3.1, CI: 2.1-8.7; p = 0.001), smoking >5 cigarettes per day (OR = 2.4, CI: 2.0-6.5; p = 0.001), difficulty sleeping (

The purpose of this study was to compare videofluoroscopy (VFS), fiberoptic endoscopic evaluation of swallowing (FEES) and oro-pharyngo-oesophageal scintigraphy (OPES) with regards to premature spillage, post-swallowing residue and aspiration to assess the reliability of these tests for detection of oro-pharyngeal dysphagia. Sixty patients affected with dysphagia of various origin were enrolled in the study and submitted to VFS, FEES and OPES using a liquid and semi-solid bolus. As a reference, we used VFS. Both the FEES and the OPES showed good sensitivity with high overall values (≥ 80% and ≥ 90% respectively). The comparison between FEES vs VFS concerning drop before swallowing showed good specificity (84.4% for semi-solids and 86.7% for liquids). In the case of post-swallowing residue, FEES vs VFS revealed good overall validity (75% for semi-solids) with specificity and sensitivity well balanced for the semi-solids. OPES vs. VFS demonstrated good sensitivity (88.6%) and overall validity (76.7%) for liquids. The analysis of FEES vs. VFS for aspiration showed that the overall validity was low (≤ 65%). On the other hand, OPES demonstrated appreciable overall validity (71.7%). VFS, FEES and OPES are capable of detecting oro-pharyngeal dysphagia. FEES gave significant results in the evaluation of post-swallowing residues.

Il gioco d'azzardo è vietato ai minori di 18 anni, anche quello "legale", e, nonostante i divieti, anche i giovanissimi, sempre in cerca di nuove sfide ed emozioni, ne sono coinvolti. Il capitolo evidenzia i risultati dello studio EPSAD ITALIA 2013, condotto dal Consiglio Nazionale delle Ricerche.

BACKGROUND: Strenuous and chronic exercise training can have detrimental effects on cardiac morphology and function. Our aim was to evaluate the cardiac adaptation between 2 different specialties' endurance athletes: marathon runners (M) and ultra-trailers (UT). METHODS: 47 M (age 45±7, men 32; training: 18 (9-53) years*days/week), 41 UT (age 42±9, men 38, training: 30 (15-66) years*days/week) were submitted in rest condition to conventional 2D echocardiography and Speckle-Tracking echo (STE) (Beyond Diogenes 2.0, AMID) during agonistic season and compared with 15 age matched sedentary individuals (S) (age 43±6, men 10). RESULTS: Left ventricle (LV) global longitudinal strain (GLS) and global radial strain (GRS) were increased in M and UT compared to S (see table) without differences in LV anatomy and function. Right ventricle (RV) end-diastolic area (p=0.026), fractional area changing (p=0.008) and RV GLS were increased in UT compared to M. Moreover UT showed larger right atrium (RA) volume compared to M (p=0.03) and S (p=0.003). RA GLS was reduced in UT compared to M while the RA Global Circumferential Strain was significantly increased in UT. After adjusted for age, sex and HR as covariates, UT showed a reduced RA GLS (OR 0.907; CI 0.856-0.961) and increased RV FAC (OR 1.172; CI: 1.044-1.317) compared to M; while when compared to S subjects, UT showed increased RA volume (OR 1.048; CI 1.002-1.096) and RV GLS (OR 0.667; CI 0.490-0.907). CONCLUSION: UT showed higher RV and RA morphological and functional remodeling in comparison with M. 2D-STE is a useful tool to investigate the deformation dynamic in different sport specialties. Further studies will be necessary to clarify the long-term consequences for cardiac health due to myocardial perturbations.

This report describes the work carried out in Task 9.2 and aims a) to summarize the data collected during the Wize Mirror (WM) validation campaign in WP9 and b) to outline the main results obtained from data analysis. In this framework, this reports provides: 1. A description of all data collected in the three validation sites; 2. Statistical analysis of data in relation to reference measurements; 3. Analysis of correlation of the SEMEOTICONS Wellness Index (WI) with validated medical scores.

The present document reports the achievements of Task 6.3 - Personalized user's guidance. The objective of Task 6.3 is to develop a personalized guidance system which supports the user towards behavioural change, through tailored coaching messages. The Personalized User Guidance implemented by SEMEOTICONS' Wize Mirror, also referred to as Wize Guidance, is designed to allow normal people achieve and maintain a correct lifestyle, so as to reduce their cardio-metabolic risk and improve their quality of life. Indeed, cardio-metabolic risk factors are mainly related to modifiable factors pertaining to people's lifestyle.

Si Re Mi is an interactive audio system proposed as a game in which the main actors are the autistic child and an adult operator. The goal is to develop social and problem solving skills. In this intervention we considered the sensory profile of the infant that undergoes interactive sound stimulation. Four children (4-8 years) participated to the study. Three psychologists have observed recorded videos of the sessions completing an observation grid for each session. A statistical analysis has been performed on the first eight sessions, assessing the progression in time. The analysis of variance was used to assess eventual improvement in specific symptomatic areas. The results of the pilot study revealed a significant increase in skills. These variations in behavioral expressions reflect a relational evolution indicating the beginning of an opening attempt to perceive «the other» as positive entity and not as a threat.