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The purpose of this study is to demonstrate that T2‐weighted imaging with very long echo time (TE > 300 ms) can provide relevant information in neurodegenerative/inflammatory disorder. Twenty patients affected by relapsing–remitting multiple sclerosis with stable disease course underwent 1.5 T 3D FLAIR, 3D T1‐weighted, and a multi‐echo sequence with 32 echoes (TE = 10–320 ms). Focal lesions (FL) were identified on FLAIR. T1‐images were processed to segment deep gray matter (dGM), white matter (WM), FL sub‐volumes with T1 hypo‐intensity (T1FL), and dGM volumes (atrophy). Clinical‐radiological parameters included Expanded Disability Status Scale (EDSS), disease duration, patient age, T1FL, and dGM atrophy. Correlation analysis was performed between the mean signal intensity (SI) computed on the non‐lesional dGM and WM at different TE versus the clinical‐radiological parameters. Multivariable linear regressions were fitted to the data to assess the association between the dependent variable EDSS and the independent variables obtained by T1FL lesion load and the mean SI of dGM and WM at the different TE. A clear trend is observed, with a systematic strengthening of the significance of the correlation at longer TE for all the relationships with the clinical‐radiological parameters, becoming significant (p < 0.05) for EDSS, T1FL volumes, and dGM atrophy. Multivariable linear regressions show that at shorter TE, the SI of the T2‐weighted sequences is not relevant for describing the EDSS variability while the T1FL volumes are relevant, and vice versa, at very‐long TEs (around 300 ms); the SI of the T2‐weighted sequences significantly (p < 0.05) describes the EDSS variability. By very long TE, the SI primarily originates from water with a T2 longer than 250 ms and/or free water, which may be arising from the perivascular space (PVS). Very‐long T2‐weighting might detect dilated PVS and represent an unexplored MR approach in neurofluid imaging of neurodegenerative/inflammatory diseases. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the study was to compare bone mineral density (BMD) in the lumbar spine (LSBMD) and the femoral neck (FBMD) in male road cyclists (RC n = 39), mountain cyclists (MC n = 30) and controls (C n = 27) and to determine the factors associated with BMD in the same group of participants. Methods: BMD, fat mass (FM) and fat-free mass (FFM) were measured using DXA. Calcium intake (Cal), exercise energy expenditure (EEE) and energy availability (EA) were assessed using self-reported questionnaires. Samples for circulating hormones were also obtained. VO2max was estimated by a cycloergometric test. Results: After adjustment for body mass, in cyclists LSBMD (RC 0.98 ± 0.12; MC 0.98 ± 0.10 g/cm2) was significantly lower than in C (1.11 ± 0.10; p <.001), while FBMD resulted in no significant difference in cyclists compared to C (p = 0.213). EA (kcal/FFM/day) was different in cyclists and in C (p <.05). In C, EEE and EA were positively associated with LSBMD (R = 0.561, R = 0.656, respectively, p <.01), whereas only EA was associated with FBMD (R = 0.554, p <.05); a positive association between EA and FBMD was found in MC (R = 0.464, p <.05). A negative relationship between VO2max and LSBMD in RC (R = -0.418, p <.05) and a positive one between EEE and LSBMD in MC were found (R = 0.605, p <.001). CaI, free testosterone and cortisol were unrelated to BMD. Conclusion: Both the RC and MC had lower LSBMD than C, whereas no difference was found between the two groups of cyclists. The factors associated with BMD are manifold, vary in relation to the measurement site and are likely different in RC, MC and C. [ABSTRACT FROM AUTHOR]

Background Patient accidental falls in a hospital environment are a serious problem for patient safety, and for the additional costs due to associated medical interventions. Objective The endpoints of this study were the assessment of the fall incidence in the hospital before and after the implementation of a multidisciplinary care-bundle, along with a cost-effectiveness evaluation. Design A stepped-wedge trial was conducted between April 2015 and December 2016 in Bologna University Hospital. Methods Incidence rates (IRs) of falls in both the control and intervention periods were calculated. A multilevel mixed-effects generalised linear model with logit link function, adjusted for age, sex, cluster cross-over timing and patients' clinical severity was used to estimate odds ratios (OR) of fall risk of patients of the intervention group respect to the controls. Intervention costs associated with the introduction of the care-bundle intervention were spread between patients per cluster-period-group of exposure. Incremental cost-effectiveness ratio was evaluated using total costs in the intervention and control groups. Results IRs of falls in control and intervention periods were respectively 3.15 and 2.58 for 1,000 bed-days. After adjustment, the subjects receiving the intervention had a statistically significant reduced risk of falling with respect to those who did not (OR = 0.71, 95% confidence interval: 0.60–0.84). According to the cost-effectiveness analysis, the incremental cost per fall prevented was €873.92 considering all costs, and €1644.45 excluding costs related falls. Conclusions Care-bundle had a protective effect on patients, with a statistically significant reduction of the fall risk. This type of intervention appears cost-effective compared to routine practices. [ABSTRACT FROM AUTHOR]