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1. Prior studies have suggested urinary oxygen tension ( Puo2) as a putative index of renal blood flow (RBF) and tissue oxygenation. 2. In the present study, we collected intraoperative data from eight anaemic, bladder-catheterized patients who received erythrocyte transfusions during various surgical procedures under general anaesthesia. Urinary and arterial blood gas analysis and co-oximetry were performed before and after transfusion, during an interval in which RBF was assumed to be constant. 3. Pre- and post-transfusion haematocrit levels were 23 ± 4.8 and 27 ± 6.4%, respectively, and arterial oxygen content (Cao2) was 10.5 ± 2.5 and 12.4 ± 3.1 mL/dL, respectively ( P = 0.012). Pre- and post-transfusion Puo2 was 90 ± 14 and 108 ± 20 mmHg, respectively ( P = 0.036). 4. These results, although limited, suggest that under conditions of stable haemodynamics, systemic oxygenation and renal function, intraoperative blood transfusion may increase Puo2 in anaemic anaesthetized patients. If confirmed by subsequent clinical and laboratory studies, Puo2 measurement could become a simple, non-invasive way to monitor renal medullary oxygenation and tissue oxygen availability and help determine whether red blood cells should be transfused. [ABSTRACT FROM AUTHOR]

This is a multicenter study on peroneal mononeuropathy (PM), in which a multidimensional protocol was performed to evaluate (1) the predisposing factors and their occurrence; (2) the relationships between the etiological, clinical, and neurophysiologic findings; and (3) disability and quality of life (QoL) in a wide sample with PM. Clinical and neurophysiologic evaluation was performed in all patients; moreover, the group adopted validated disability and QoL measurements to obtain more comprehensive and reliable data on PM. From November 2002 to January 2004, 69 patients were enrolled consecutively in 11 Italian centers. Our data showed that PM involves men more frequently than women (male : female = 4.1:1). PM was idiopathic (16%) or due to prolonged posture (23.1%), surgery (20.3%), weight loss (14.5%), trauma (11.6%), bedridden condition (7.3%), external compression from cast (5.8%), and arthrogenic cyst at the fibula (1.4%). Unexpectedly, peroneal nerve lesions were not only due to surgical operation close to the peroneal region but were also associated with thoracic-abdominal surgery. We observed conduction block in about 50–70% of postural and weight loss PM; in perioperative and idiopathic PM, conduction block or mixed damage was equally present; in PM due to trauma, we observed an exclusive axonal damage in about 60% of cases. Only in three cases (one postural PM, one idiopathic PM, and one weight loss PM), we observed a slowing of conduction velocity in the popliteal fossa-fibular head segment without conduction block. The comparison between QoL in patients with PM and in healthy subjects showed a significant involvement of physical and mental aspects. With regard to disability, 68% of patients walked with difficulty. Our data show that (1) most of the cases of PM are due to an identifiable predisposing factor; (2) there is a good correlation between predisposing factors and clinical-neurophysiologic findings; and (3) PM causes disability and deterioration of the physical and emotional aspects of QoL. [ABSTRACT FROM AUTHOR]

Background: Multiparametric MRI (mpMRI) is the "state of the art" management tool for patients with suspicion of prostate cancer (PCa). The role of non‐contrast MRI is investigated to move toward a more personalized, less invasive, and highly cost‐effective PCa diagnostic workup. Objective: To perform a non‐systematic review of the existing literature to highlight strength and flaws of performing non‐contrast MRI, and to provide a critical overview of the international scientific production on the topic. Materials and Methods: Online databases (Medline, PubMed, and Web of Science) were searched for original articles, systematic review and meta‐analysis, and expert opinion papers. Results: Several investigations have shown comparable diagnostic accuracy of biparametric (bpMRI) and mpMRI for the detection of PCa. The advantage of abandoning contrast‐enhanced sequences improves operational logistics, lowering costs, acquisition time, and side effects. The main limitations of bpMRI are that most studies comparing non‐contrast with contrast MRI come from centers with high expertise that might not be reproducible in the general community setting; besides, reduced protocols might be insufficient for estimation of the intra‐ and extra‐prostatic extension and regional disease. The mentioned observations suggest that low‐quality mpMRI for the general population might represent the main shortage to overcome. Discussion: Non‐contrast MRI future trends are likely represented by PCa screening and the application of artificial intelligence (AI) tools. PCa screening is still a controversial topic; bpMRI has become one of the most promising diagnostic applications, as it is a more sensitive test for PCa early detection, compared to serum PSA level test. Also, AI applications and radiomic have been the object of several studies investigating PCa detection using bpMRI, showing encouraging results. Conclusion: Today, the accessibility to MRI for early detection of PCa is a priority. Results from prospective, multicenter, multireader, and paired validation studies are needed to provide evidence supporting its role in the clinical practice. [ABSTRACT FROM AUTHOR]

Objective: This study applied a synovitis score obtained during routine care from ultrasound (US)–guided biopsies of synovial tissue (ST) in patients with rheumatoid arthritis (RA) and patients with other inflammatory and noninflammatory joint diseases to identify pretreatment synovial biomarkers associated with disease characteristics, and to integrate the findings into a multiparameter nomogram for use in baseline prediction of diagnosis and treatment response in treatment‐naive rheumatoid arthritis (RA) patients. Methods: The study enrolled a total of 1,015 patients with various autoimmune diseases (545 patients with RA, 167 patients with psoriatic arthritis [PsA], 199 patients with undifferentiated peripheral inflammatory arthritis [UPIA], 18 patients with crystal‐induced arthritis, 26 patients with connective tissue diseases, and 60 patients with osteoarthritis [OA] [as part of the SYNGem cohort]). All patients underwent a US‐guided ST biopsy at baseline, and patients were then stratified according to disease phase. The KSS, along with disease characteristics and clinical outcomes, were incorporated into a nomogram for prediction of achievement of clinical remission in RA patients who were previously naive to treatment. In patients in whom a treat‐to‐target strategy was applied, remission was defined as change in the Disease Activity Score in 28 joints (DAS28) at 6 months after treatment initiation. Results: The KSS significantly differed among RA patients, as well as PsA patients and UPIA patients, when compared to OA patients. In RA, the KSS directly correlated with the DAS28 and was related to autoantibody positivity in treatment‐naive RA patients. Moreover, at baseline, treatment‐naive RA patients achieving 6‐month remission according to DAS28 had a lower KSS, shorter duration of symptoms (very early RA [VERA]), and lower disease activity than treatment‐naive RA patients not achieving remission according to DAS28. Results of logistic regression analysis identified the following synergistic predictive factors of achievement of DAS28‐based disease remission at 6 months: having a short disease duration (VERA), not having high disease activity, and having a KSS of <5 at baseline. A nomogram integrating these baseline clinical and histologic characteristics in treatment‐naive RA patients yielded an up to 81.7% probability of achieving 6‐month remission according to the DAS28. Conclusion: The KSS is a reliable tool for synovitis assessment on US‐guided ST biopsy, contingent on the phase of the disease and the autoimmune profile of each patient. This tool could be integrated within a therapeutic response–predictive nomogram for the prediction of treatment response in RA patients who were previously naive to treatment. [ABSTRACT FROM AUTHOR]

Mental health problems are very common among university students. NoiBene is an evidence‐based intervention for the promotion of well‐being and the prevention of psychological distress among university students. NoiBene was tested in two studies. In study 1, a randomized controlled pilot trial was conducted to investigate the efficacy of NoiBene on students' well‐being, emotional awareness, emotion regulation and assertiveness. The degree of satisfaction with the intervention was also investigated. Students (n = 24) were assigned to either the NoiBene programme or a control condition. In study 2, to confirm the usefulness of NoiBene, we analysed data from the current use of NoiBene (n = 178). The effectiveness of NoiBene on transdiagnostic mechanisms (perfectionism, repetitive thinking and experiential avoidance) was also investigated. In study 1, NoiBene improved self‐acceptance and increased the ability to identify feelings. Students reported a good level of perceived usefulness. In study 2, the results confirmed findings from the first study and suggested that NoiBene can improve emotional awareness and decrease transdiagnostic mechanisms. NoiBene is a promising tool that can improve students' psychological well‐being. More control studies are mandatory. [ABSTRACT FROM AUTHOR]

Background In Parkinson's disease ( PD), gait disorders lead to increased risk of falls and patients' reduced participation and independence. Several observations suggest that a single session of focal muscle vibration ( fMV) applied to trunk or lower limb muscles during gait may improve several gait variables in patients with PD. The possible long-term beneficial effects of repetitive sessions of fMV (r- fMV) on gait of patients with PD have been investigated. Methods A randomized, controlled trial study has been conducted in an outpatient rehabilitation department. Twenty patients with PD diagnosis have been randomized in two groups: 'real' or 'sham' r- fMV application to quadriceps and paraspinal muscles in patients with PD. Gait was evaluated with objective gait analysis, and a number of variables, including velocity, step length, stride length, percentage of stance, double support duration, cadence, swing velocity, and step width, have been measured. Gait analysis was performed before and 24 hours and 1 and 3 weeks after r- fMV. Results After real, but not sham, r- fMV, patients with PD had significant gait improvement as a result of increased walking velocity and stride length. The r- fMV-induced beneficial after effects lasted at least 1 week after the end of stimulation. Conclusions Data emerging from our pilot randomized, controlled trial study suggest that r- fMV may improve gait disorders in patients with PD. r- fMV might be a feasible, safe approach for possibly improving gait disorders in patients with PD and might enhance the impact of specific rehabilitation programs in PD. [ABSTRACT FROM AUTHOR]

Deli R, Macrì LA, Radico P, Pantanali F, Grieco DL, Gualano MR, La Torre G. Orthodontic treatment attitude versus orthodontic treatment need: differences by gender, age, socio-economical status and geographical context. Community Dent Oral Community Dent Oral Epidemiol 2012; 40 (Suppl. 1): 71-76. © 2012 John Wiley & Sons A/S Abstract - Objectives: To investigate the relationship between the attitude towards orthodontic treatment and the objective level of orthodontic need, and variables like gender, socioeconomic status and geographical context, among 6- to 16-year-old children. Methods: The attitude of 2284 Italian children towards orthodontics was assessed using the Child Orthodontic Attitude Survey (COAS) questionnaire, previously validated for Italian-speaking children. The level of orthodontic need was evaluated by using the Risk of Malocclusion Assessment (ROMA) Index while socioeconomic status (SES) was based on parental job activities. The univariate analysis was performed using chi-square tests to find differences between groups for categorical variables, while multivariate analyses were conducted using logistic regression models. Results: Individuals with a higher SES had a statistically significant lower need of orthodontic treatment ( P = 0.003). Children with a very high SES were from northern (20.8%) and central Italy (65.9%), while only 13.3% lived in southern Italy ( P < 0.001). Logistic regression showed that females, older children, in-treatment subjects and children from the region of Puglia were more likely to have orthodontics (OR = 2.09; 95% CI: 1.66-2.64, OR = 1.08; 95% CI: 1.01-1.15, OR = 1.48, 95% CI: 1.11-1.97, OR = 1.43; 95% CI: 1.05-1.95, respectively). Conclusions: The orthodontic treatment attitude largely depends on age, gender and geographical context but is not influenced by the real level of orthodontic therapy need. [ABSTRACT FROM AUTHOR]

Introduction: So far no clinical or experimental evidences clearly explain how and which systemic sclerosis (SSc) patients will experience a functional and radiological progression of interstitial lung disease (ILD). Objectives: The aim of the study was to investigate whether any bronchoalveolar lavage fluid (BALF) characteristic, compared with clinical, functional and radiological parameters, is associated with the risk of progression of ILD and worse survival in SSc patients. Methods: Lung involvement was evaluated in 110 consecutively examined SSc patients with pulmonary function tests (PFTs) and high-resolution computed tomography (HRCT); 73 patients with evidence of ILD on HRCT underwent BAL. The progression of ILD was evaluated with PFTs and HRCT after 1-year follow-up. A 36-month survival analysis was assessed. Results: ILD patients with alveolitis had a higher risk to have restrictive lung disease and honeycombing, to experience a worsening in honeycombing score or to develop honeycombing. ILD progression was associated with the evidence of honeycombing on HRCT, with the presence of eosinophils, with an inverted CD4/CD8 ratio and with a higher CD19 percentage count in the BALF or with a positive BALF microbiological culture. The patients with ILD had a worse overall survival. The diffuse disease was the only independent risk factor of overall mortality, and the extent of honeycombing on HRCT was the only independent risk factor of lung disease-related mortality. Conclusion: Our study suggests the importance of evaluating ILD with HRCT and BAL in order to characterize the risk factors of SSc lung involvement progression. Please cite this paper as: De Santis M, Bosello SL, Peluso G, Pinnelli M, Alivernini S, Zizzo G, Bocci M, Capacci A, La Torre G, Mannocci A, Pagliari G, Varone F, Pistelli R, Danza FM and Ferraccioli G. Bronchoalveolar lavage fluid and progression of scleroderma interstitial lung disease. Clin Respir J 2012; 6; 9-17. [ABSTRACT FROM AUTHOR]

To asses the real contribution of pre-transplantation treatment in the incidence of secondary neoplasia after autologous transplant for lymphoproliferative disorders, we used stringent inclusion/exclusion criteria. One hundred and forty-two patients out of 323 that underwent autologous transplantation for lymphoproliferative disorders were studied. The risk factors that were evaluated with univariate and multivariate analysis included: gender, sex, age, diagnosis, radiotherapy, and chemotherapy prior to conditioning regimen, disease status at peripheral blood stem-cell transplantation (PBSCT) and type of harvest. Three patients developed secondary myelodysplastic syndrome/acute myeloid leukemia (sMDS/AML) and three patients developed solid neoplasia. By univariate analysis diagnosis chronic lymphocytic leukemia and use of fludarabine and monoclonal antibodies were the only variables significantly associated with the development of sMDS/AML. By multivariate analysis, the variables associated with sMDS/AML were the use of fludarabine and disease status at PBSCT. By univariate analysis, we found that radiotherapy and the use of monoclonal antibodies were significantly associated with the development of secondary solid neoplasia. Multivariate analysis confirmed that the only two variables significantly associated with new cancers were radiotherapy and prior treatment with monoclonal antibodies. We report the lowest incidence of sMDS/AML after autologous stem-cell transplantation for lymphoproliferative malignancies. Major reasons could be ascribed to the stringent inclusion/exclusion criteria used to establish the real incidence of sMDS/AML because of chemo-radiotherapy used before transplant procedure. The low incidence of secondary solid tumors could be caused by the absence of total body irradiation as part of the conditioning regimen or the short follow-up. [ABSTRACT FROM AUTHOR]

Purpose: Several studies have reported behavioral and electrophysiological evidence of visual impairment during the active stage of West syndrome. The underlying mechanisms are, however, poorly understood, and little has been reported about the correlation between visual impairment, EEG patterns, and brain lesions. The aim of the study was to assess visual function at the onset of spasm and 2 months thereafter and relate visual findings to brain lesions and EEG features. Methods: Twenty-five infants with West syndrome were enrolled and studied with (a) a full clinical assessment including a battery of tests specifically designed to assess visual function, (b) a video-polygraphic study, and (c) brain magnetic resonance imaging (MRI). Besides brain neuroimaging and EEG comparison with visual function, an intra-EEG analysis was performed to investigate the possible relation of EEG patterns to fluctuating visual behavior (fixation and following). Results: Twenty-two children had at least one abnormal result on one or more of the tests assessing visual function at T0. Visual impairment at the spasm onset was related to the sleep disorganization rather than to the hypsarrhythmic pattern in awake EEG. After 2 months, both EEG features become significantly linked to visual function. Visual function improved in several cases after 2 months, in parallel with the seizure regression. No relation was found between EEG patterns and fluctuating visual behavior. Conclusions: The study supplies new evidence of the involvement of visual function in West syndrome. The presence of abnormal visual findings in infants without lesions on brain MRI suggests that visual abnormalities are due not only to brain injury but also to epileptic disorder per se. New insight is also provided into the possible mechanisms underlying clinical and EEG abnormalities. [ABSTRACT FROM AUTHOR]