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1.
Article in English | MEDLINE | ID: mdl-38679157

ABSTRACT

BACKGROUND: Allergic rhinitis (AR) is a common respiratory disease encompassing a variety of phenotypes. Patients can be sensitized to 1 or more allergens. There are indications that polysensitization is associated with more severe disease. However, the extent to which the level of sensitization is associated with clinical disease variability, underlying the distinct nature of AR from AR+ conjunctivitis or AR+ asthma, is not known. OBJECTIVE: To evaluate phenotypical differences between monosensitized and polysensitized patients with AR and to quantify their symptomatic variability. METHODS: A total of 565 patients with a confirmed diagnosis of AR were included in this cross-sectional study. Of those, 155 were monosensitized and 410 were polysensitized. Interactions between sensitization levels and the reporting of different symptoms of AR and co-morbidities, disease duration, and impact were assessed. Furthermore, patients were stratified into monosensitized, oligosensitized, and polysensitized to assess whether the effect of sensitization on the phenotype was ranked. RESULTS: Polysensitized patients reported itchy eyes significantly more often (P = .001) and had a higher number of ocular (P = .005), itch-related (P = .036), and total symptoms (P = .007) than monosensitized patients. In addition, polysensitized adults and children more often reported wheeze (P = .015) and throat-clearing (P = .04), respectively. Polysensitization was associated with more burdensome AR based on a visual analog scale (P = .005). Increased sensitization level was reflected in more itchy eyes, a higher number of ocular, itch-related, and total number of symptoms, and disease burden. CONCLUSION: With an increasing number of sensitizations, patients with AR experience an increased diversity of symptoms. Multimorbidity-related symptoms increase with sensitization rank, suggesting organ-specific thresholds.

2.
Microorganisms ; 12(4)2024 Apr 12.
Article in English | MEDLINE | ID: mdl-38674730

ABSTRACT

Assyrtiko is a rare ancient grape variety of Greece, which is known to produce Protected Designation of Origin (PDO) Santorini white wines. Besides the famous character of the volcanic terroir, Assyrtiko of Santorini is also marked by a low pH value and sharp acidity. The aim of the present study was to apply a new inoculation procedure that modulates the fermentation process by maintaining the unique sensorial characteristics of Assyrtiko wines based on acidity. For this purpose, the Lachancea thermotolerans species, known for the formation of lactic acid, was tested in sequential fermentation with three different Saccharomyces cerevisiae strains. At the end of the fermentation process, implantation control for S. cerevisiae strains (interdelta sequence profile analysis) was performed, oenological parameters were determined according to the OIV protocols, and the volatile compounds produced were measured by gas chromatography-mass spectrometry (GC/MS). Finally, all produced wines were evaluated by quantitative descriptive analysis by two groups of experts; the Greek team of oenologists from Santorini Island specialized in Assyrtiko wines, and the French team of oenologists specialized in wine from Bordeaux. As expected, the inoculated strain was the one that dominated the fermentation process, but nine S. cerevisiae indigenous strains were also identified in the produced wines. Lachancea thermotolerans produced 1 g/L of lactic and also modulated the volatile profile of the wines independently of the S. cerevisiae strain used. The origin of the panelists played an important role in bringing up sensorial traits, such as acidity. Our results led to a new interesting application of L. thermotolerans for white wine production adapted to climate change claims.

3.
Bioengineering (Basel) ; 11(4)2024 Apr 15.
Article in English | MEDLINE | ID: mdl-38671803

ABSTRACT

BACKGROUND: Accurate measurements of limb volumes are important for clinical reasons. We aimed to assess the reliability and validity of two centimetric and two optoelectronic techniques for limb volume measurements against water volumetry, defined as the gold standard. METHODS: Five different measurement methods were executed on the same day for each participant, namely water displacement, fixed-height (circumferences measured every 5 (10) cm for the upper (lower limb) centimetric technique, segmental centimetric technique (circumferences measured according to proportional height), optoelectronic plethysmography (OEP, based on a motion analysis system), and IGOODI Gate body scanner technology (which creates an accurate 3D avatar). RESULTS: A population of 22 (15 lower limbs, 11 upper limbs, 8 unilateral upper limb lymphoedema, and 6 unilateral lower limb lymphoedema) participants was selected. Compared to water displacement, the fixed-height centimetric method, the segmental centimetric method, the OEP, and the IGOODI technique resulted in mean errors of 1.2, 0.86, -16.0, and 0.71%, respectively. The corresponding slopes (and regression coefficients) of the linear regression lines were 1.0002 (0.98), 1.0047 (0.99), 0.874 (0.94) and 0.9966 (0.99). CONCLUSION: The centimetric methods and the IGOODI system are accurate in measuring limb volume with an error of <2%. It is important to evaluate new objective and reliable techniques to improve diagnostic and follow-up possibilities.

4.
Multimed Tools Appl ; 82(7): 11079-11098, 2023.
Article in English | MEDLINE | ID: mdl-36118187

ABSTRACT

Recent developments in 3D graphic technologies enable the affordable and precise reconstruction of body scanned models that can be applied in a variety of verticals, such as fashion, fitness and wellness, and healthcare. The accuracy of body measurements is a crucial element for the successful application of avatars in the following use cases: Avatars that go beyond visual representation and offer intrinsic and precise anthropometric data defined as a smart body are discussed in this paper. In particular, this paper presents the Gate technology, an innovative, autonomous, sustainable body scanner, coupled with an automatic production pipeline and the concept of avatars as smart bodies. We present an accuracy study of scanning technology for scanning inanimate objects, as well as body parts versus the ground, by using an established accuracy scanning system. The results appear to be promising and confirm the hypothesis of applying the technology to the use cases discussed as well as broadening the research to other studies and future applications.

5.
Front Microbiol ; 14: 1301325, 2023.
Article in English | MEDLINE | ID: mdl-38179455

ABSTRACT

The selection of native yeast for alcoholic fermentation in wine focuses on ensuring the success of the process and promoting the quality of the final product. The purpose of this study was firstly to create a large collection of new yeast isolates and categorize them based on their oenological potential. Additionally, the geographical distribution of the most dominant species, Saccharomyces cerevisiae, was further explored. Towards this direction, fourteen spontaneously fermented wines from different regions of Greece were collected for yeast typing. The yeast isolates were subjected in molecular analyses and identification at species level. RAPD (Random Amplified Polymorphic DNA) genomic fingerprinting with the oligo-nucleotide primer M13 was used, combined with Matrix Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS) technique. All yeast isolates were scrutinized for their sensitivity to killer toxin, production of non-desirable metabolites such as acetic acid and H2S, ß-glucosidase production and resistance to the antimicrobial agent; SO2. In parallel, S. cerevisiae isolates were typed at strain level by interdelta - PCR genomic fingerprinting. S. cerevisiae strains were examined for their fermentative capacity in laboratory scale fermentation on pasteurized grape must. Glucose and fructose consumption was monitored daily and at the final point a free sorting task was conducted to categorize the samples according to their organoleptic profile. According to our results, among the 190 isolates, S. cerevisiae was the most dominant species while some less common non-Saccharomyces species such as Trigonopsis californica, Priceomyces carsonii, Zygosaccharomyces bailii, Brettanomyces bruxellensis and Pichia manshurica were identified in minor abundancies. According to phenotypic typing, most isolates were neutral to killer toxin test and exhibited low acetic acid production. Hierarchical Cluster Analysis revealed the presence of four yeast groups based on phenotypic fingerprinting. Strain level typing reported 20 different S. cerevisiae strains from which 65% indicated fermentative capacity and led to dry wines. Sensory evaluation results clearly discriminated the produced wines and consequently, the proposed yeast categorization was confirmed. A novel approach that employs biostatistical tools for a rapid screening and classification of indigenous wine yeasts with oenological potential, allowing a more efficient preliminary selection or rejection of isolates is proposed.

6.
World J Cardiol ; 13(9): 381-398, 2021 Sep 26.
Article in English | MEDLINE | ID: mdl-34621485

ABSTRACT

Peripheral artery disease (PAD) is a flow-limiting condition caused by narrowing of the peripheral arteries typically due to atherosclerosis. It affects almost 200 million people globally with patients either being asymptomatic or presenting with claudication or critical or acute limb ischemia. PAD-affected patients display increased mortality rates, rendering their management critical. Endovascular interventions have proven crucial in PAD treatment and decreasing mortality and have significantly increased over the past years. However, for the functional assessment of the outcomes of revascularization procedures for the treatment of PAD, the same tests that have been used over the past decades are still being employed. Those only allow an indirect evaluation, while an objective quantification of limb perfusion is not feasible. Standard intraarterial angiography only demonstrates post-intervention vessel patency, hence is unable to accurately estimate actual limb perfusion and is incapable of quantifying treatment outcome. Therefore, there is a significant necessity for real-time objectively measurable procedural outcomes of limb perfusion that will allow vascular experts to intraoperatively quantify and assess outcomes, thus optimizing treatment, obviating misinterpretation, and providing significantly improved clinical results. The purpose of this review is to familiarize readers with the currently available perfusion-assessment methods and to evaluate possible prospects.

7.
Sensors (Basel) ; 21(4)2021 Feb 13.
Article in English | MEDLINE | ID: mdl-33668520

ABSTRACT

One of the sectors that is expected to significantly benefit from 5G network deployment is eXtended Reality (XR). Besides the very high bandwidth, reliability, and Quality of Service (QoS) to be delivered to end users, XR also requires accurate environmental perception for safety reasons: this is fundamental when a user, wearing XR equipment, is immersed in a "virtual" world, but moves in a "real" environment. To overcome this limitation (especially when using low-cost XR equipments, such as cardboards worn by the end user), it is possible to exploit the potentialities offered by Internet of Things (IoT) nodes with sensing/actuating capabilities. In this paper, we rely on ultrasonic sensor-based IoT systems to perceive the surrounding environment and to provide "side information" to XR systems, then performing a preliminary experimental characterization campaign with different ultrasonic IoT system configurations worn by the end user. The combination of the information flows associated with XR and IoT components is enabled by 5G technology. An illustrative experimental scenario, relative to a "Tourism 4.0" IoT-aided VR application deployed by Vodafone in Milan, Italy, is presented.

8.
World J Diabetes ; 12(12): 2011-2026, 2021 Dec 15.
Article in English | MEDLINE | ID: mdl-35047116

ABSTRACT

As the global burden of diabetes is rapidly increasing, the incidence of diabetic foot ulcers is continuously increasing as the mean age of the world population increases and the obesity epidemic advances. A significant percentage of diabetic foot ulcers are caused by mixed micro and macro-vascular dysfunction leading to impaired perfusion of foot tissue. Left untreated, chronic limb-threatening ischemia has a poor prognosis and is correlated with limb loss and increased mortality; prompt treatment is required. In this review, the diagnostic challenges in diabetic foot disease are discussed and available data on minimally invasive treatment options such as endovascular revascularization, stem cells, and gene therapy are examined.

9.
CVIR Endovasc ; 3(1): 95, 2020 Dec 10.
Article in English | MEDLINE | ID: mdl-33301058

ABSTRACT

BACKGROUND: We retrospectively investigated outcomes of emergency TAE for the management of life-threatening haemorrhage in patients with uncorrected bleeding diathesis. MATERIALS AND METHODS: This multicenter, retrospective, study, was designed to investigate the safety and efficacy of percutaneous TAE for the management of life-threatening haemorrhage in patients with uncorrected bleeding disorder at the time of embolization. All consecutive patients with uncorrected coagulation who underwent TAE for the treatment of haemorrhage, between January 1st and December 31th 2019 in three European centers were included. Inclusion criteria were thrombocytopenia (platelet count < 50,000/mL) and/or International Normalized Ratio (INR) ≥2.0, and/or activated partial thromboplastin time (aPTT) > 45 s, and/or a pre-existing underlying blood-clotting disorder such as factor VIII, Von Willebrand disease, hepatic cirrhosis with abnormal liver function tests. Primary outcome measures were technical success, rebleeding rate and clinical success. Secondary outcome measures included patients' 30-day survival rate, and procedure-related complications. RESULTS: In total, 134 patients underwent TAE for bleeding control. A subgroup of 17 patients with 18 procedures [11 female, mean age 70.5 ± 15 years] which represent 12.7% of the total number of patients, presented with pathological coagulation parameters at the time of TAE (haemophilia n = 3, thrombocytopenia n = 1, cirrhosis n = 5, anticoagulants n = 7, secondary to bleeding n = 1) and were analyzed. Technical success was 100%, as in all procedures the bleeding site was detected and successfully embolised. Clinical success was 100%, as none of the patients died of bleeding during hospitalization, nor was surgically treated for bleeding relapse. Only one rebleeding case was noted (5.9%) that was successfully treated with a second TAE. No procedure-related complications were noted. According to Kaplan-Meier analysis the estimated 30-day survival rate was 84.2%. CONCLUSION: TAE in selected patients with uncorrected bleeding diathesis should be considered as a suitable individualized management approach. Emergency TAE for life threatening haemorrhage in patients with coagulation cascade disorders should be used as an aid in realistic clinical decision making.

11.
J Vasc Interv Radiol ; 31(2): 202-212, 2020 Feb.
Article in English | MEDLINE | ID: mdl-31954604

ABSTRACT

A formal systematic review and study-level meta-analysis of randomized controlled trials investigating treatment of the infrapopliteal arteries with paclitaxel-coated balloons compared with conventional balloon angioplasty for critical limb ischemia (CLI) was conducted. Medical databases and online content were last screened in September 2019. The primary safety and efficacy endpoint was amputation-free survival defined as freedom from all-cause death and major amputation. Target lesion revascularization (TLR) constituted a secondary efficacy endpoint. Summary effects were synthesized with a random-effects model. Some 8 randomized controlled trials with 1,420 patients (97% CLI) were analyzed up to 1 year follow-up. Amputation-free survival was significantly worse in case of paclitaxel (13.7% crude risk of death or limb loss compared to 9.4% in case of uncoated balloon angioplasty; hazard ratio 1.52; 95% confidence interval: 1.12-2.07, p = .008). TLR was significantly reduced in case of paclitaxel (11.8% crude risk of TLR versus 25.6% in control; risk ratio 0.53; 95% confidence interval: 0.35-0.81, p = .004). The harm signal was evident when examining the high-dose (3.0-3.5 µg/mm2) devices, but attenuated below significance in case of a low-dose (2.0 µg/mm2) device. Actual causes remain largely unknown, but non-target paclitaxel embolization is a plausible mechanism.


Subject(s)
Amputation, Surgical , Angioplasty, Balloon/instrumentation , Cardiovascular Agents/administration & dosage , Coated Materials, Biocompatible , Ischemia/therapy , Paclitaxel/administration & dosage , Peripheral Arterial Disease/therapy , Popliteal Artery , Aged , Aged, 80 and over , Amputation, Surgical/adverse effects , Amputation, Surgical/mortality , Angioplasty, Balloon/adverse effects , Angioplasty, Balloon/mortality , Cardiovascular Agents/adverse effects , Critical Illness , Equipment Design , Female , Humans , Ischemia/diagnosis , Ischemia/mortality , Ischemia/physiopathology , Limb Salvage , Male , Middle Aged , Paclitaxel/adverse effects , Peripheral Arterial Disease/diagnosis , Peripheral Arterial Disease/mortality , Peripheral Arterial Disease/physiopathology , Popliteal Artery/physiopathology , Progression-Free Survival , Randomized Controlled Trials as Topic , Risk Assessment , Risk Factors , Time Factors , Vascular Patency
12.
Insights Imaging ; 10(1): 91, 2019 Sep 23.
Article in English | MEDLINE | ID: mdl-31549250

ABSTRACT

The presence of endoleaks remains one of the main drawbacks of endovascular repair of abdominal aortic aneurysms leading to the increase of the size of the aneurysmal sac and in most of the cases to repeated interventions. A variety of devices and percutaneous techniques have been developed so far to prevent and treat this phenomenon, including sealing of the aneurysmal sac, endovascular embolisation, and direct sac puncture. The aim of this review is to analyse the indications, the effectiveness, and the future perspectives for the prevention and treatment of endoleaks after endovascular repair of abdominal aortic aneurysms.

13.
JACC Cardiovasc Interv ; 12(12): 1125-1136, 2019 06 24.
Article in English | MEDLINE | ID: mdl-31153838

ABSTRACT

OBJECTIVES: The aim of this study was to perform a comprehensive meta-analysis comparing all therapeutic modalities for intermittent claudication (IC), including best medical therapy (BMT) alone, percutaneous angioplasty (PTA), supervised exercise therapy (SET), and PTA combined with SET, to establish the optimal first-line treatment for IC. BACKGROUND: IC is a common health problem that limits physical activity, results in decreased quality of life (QoL) and is associated with poor cardiovascular outcomes. Previous meta-analyses have attempted to combine data from randomized trials; however, none have combined data from all possible treatment combinations or synthesized QoL outcomes. METHODS: Following a systematic review of the published research (conducted in December 2018) that identified 37 published randomized trials, a network meta-analysis was performed combining all possible IC treatment strategies. RESULTS: Overall, 2,983 patients with IC were included (mean weighted age 68 years, 54.5% men). Comparisons were performed between BMT (n = 688, 28 arms) versus SET (n = 1,189, 35 arms) versus PTA (n = 511, 12 arms) versus PTA plus SET (n = 395, 8 arms). Mean weighted follow-up was 12 months (95% confidence interval: 9 to 23 months). Compared with BMT alone, PTA plus SET outperformed other treatment strategies, with a maximum walking distance gain of 290 m (95% credible interval: 180 to 390 m; p < 0.001). A variety of QoL assessments using validated tools were reported in 15 trials; PTA plus SET was superior to other treatments (Cohen's D = 1.8; 95% credible interval: 0.21 to 3.4). CONCLUSIONS: In addition to BMT, PTA combined with SET seems to be the optimal first-line treatment strategy for IC in terms of maximum walking distance and QoL improvement.


Subject(s)
Angioplasty , Exercise Therapy , Intermittent Claudication/therapy , Peripheral Arterial Disease/therapy , Adult , Aged , Aged, 80 and over , Angioplasty/adverse effects , Cardiovascular Agents/therapeutic use , Combined Modality Therapy , Exercise Therapy/adverse effects , Exercise Tolerance , Female , Humans , Intermittent Claudication/diagnosis , Intermittent Claudication/physiopathology , Male , Middle Aged , Network Meta-Analysis , Peripheral Arterial Disease/diagnosis , Peripheral Arterial Disease/physiopathology , Quality of Life , Randomized Controlled Trials as Topic , Recovery of Function , Time Factors , Treatment Outcome , Walking
14.
SAGE Open Med Case Rep ; 7: 2050313X19844379, 2019.
Article in English | MEDLINE | ID: mdl-31065355

ABSTRACT

Tuberculosis used to be uncommon in the developed countries but seems to be still on rampant in developing countries. However, there seems to be an increasing occurrence in the developed countries too mainly due to low living conditions, increased migration, HIV immune-compromisation and inappropriate use of antitubercular drugs. Lymphatic tuberculosis is the second commonest extrapulmonary location of tuberculosis followed by genitourinary, bone and joint, miliary, meningeal and abdominal. Abdominal tuberculosis represents nearly 11%-16% of all extrapulmonary tuberculosis locations. Furthermore, abdominal tuberculosis co-exists with pulmonary tuberculosis in 10%-30% of patients. Abdominal tuberculosis remains difficult to diagnose due to non-specific symptoms, variable anatomical locations and lack of specific sensitive diagnostic tools. Diagnosis can be rarely suspected, especially in cases of isolated abdominal tuberculosis without clinical or radiological findings. We present a rare case of a patient with pulmonary tuberculosis combined with intra-abdominal lymphatic tuberculosis causing small intestine volvulus.

15.
Ann Vasc Surg ; 59: 285-292, 2019 Aug.
Article in English | MEDLINE | ID: mdl-31009734

ABSTRACT

Femoropopliteal atherosclerosis affects a significant percentage of the world population, leading to intermittent claudication and critical limb ischemia. The femoropopliteal segment has a unique set of biomechanical challenges that must be considered and overcome for treatment. The use of stents is a reality and a necessity in peripheral interventions. The success of first-generation femoropopliteal stents was limited by their rigidity and deformability. The standard nitinol stents overcame certain biomechanical challenges because of their superelasticity and thermal shape memory, although stent fracture is still an issue. Therefore, interwoven nitinol stents with helical structure have been developed, borrowing the concept from biliary stents, aiming to provide good flexibility while still maintaining a uniform cell size and significant radial strength. This unique interwoven structure gains it advantage in the femoropopliteal region. The purpose of this review article is to investigate the current published evidence of the use of self-expandable interwoven nitinol stents in femoropopliteal arterial disease and compare them with other endovascular treatment options.


Subject(s)
Alloys , Endovascular Procedures/instrumentation , Femoral Artery/surgery , Peripheral Arterial Disease/surgery , Popliteal Artery/surgery , Self Expandable Metallic Stents , Endovascular Procedures/adverse effects , Femoral Artery/physiopathology , Hemodynamics , Humans , Peripheral Arterial Disease/diagnosis , Peripheral Arterial Disease/physiopathology , Popliteal Artery/physiopathology , Prosthesis Design , Prosthesis Failure , Risk Assessment , Risk Factors , Stress, Mechanical , Treatment Outcome
16.
Disabil Rehabil ; 41(18): 2119-2134, 2019 09.
Article in English | MEDLINE | ID: mdl-29644897

ABSTRACT

Purpose: To establish feasibility, acceptability, and preliminary efficacy of an adapted version of a commercially available, virtual-reality gaming system (the Personalised Stroke Therapy system) for upper-limb rehabilitation with community dwelling stroke-survivors. Method: Twelve stroke-survivors (nine females, mean age 58 years, [standard deviation 7.1], median stroke chronicity 42 months [interquartile range 34.7], Motricity index 14-25 for shoulder and elbow) were asked to complete nine, 40-min intervention sessions using two activities on the system over 3 weeks. Feasibility and acceptability were assessed through a semi-structured interview, recording of adverse effects, adherence, enjoyment (using an 11-point Likert scale), and perceived exertion (using the BORG scale). Assessments of impairment (Fugl-Meyer Assessment Upper extremity), activity (ABILHAND, Action Research Arm Test, Motor Activity Log-28), and participation (Subjective Index of Physical and Social Outcome) were completed at baseline, following intervention, and at 4-week follow-up. Data were analysed using Thematic Analysis of interview and intervention field-notes and Wilcoxon Signed Ranks. Side-by-side displays were used to integrate findings. Results: Participants received between 175 and 336 min of intervention. Thirteen non-serious adverse effects were reported by five participants. Participants reported a high level of enjoyment (8.1 and 6.8 out of 10) and rated exertion between 11.6 and 12.9 out of 20. Themes of improvements in impairments and increased spontaneous use in functional activities were identified and supported by improvements in all outcome measures between baseline and post-intervention (p < 0.05 for all measures). Conclusions: Integrated findings suggested that the system is feasible and acceptable for use with a group of community-dwelling stroke-survivors including those with moderately-severe disability. Implications for rehabilitation To ensure feasibility of use and maintenance of an appropriate level of challenge, gaming technologies for use in upper-limb stroke rehabilitation should be personalised, dependent on individual need. Through the use of hands-free systems and personalisation, stroke survivors with moderate and moderately-severe levels of upper-limb impairment following stroke are able to use gaming technologies as a means of delivering upper-limb rehabilitation. Future studies should address issues of acceptability, feasibility, and efficacy of personalised gaming technologies for delivery of upper-limb stroke rehabilitation in the home environment. Findings from this study can be used to develop future games and activities suitable for use in stroke rehabilitation.


Subject(s)
Hemiplegia/rehabilitation , Stroke Rehabilitation/methods , Upper Extremity/physiopathology , Video Games , Virtual Reality , Aged , Feasibility Studies , Female , Hemiplegia/physiopathology , Humans , Male , Middle Aged , Stroke/physiopathology
17.
BMJ Case Rep ; 12(12)2019 Dec 29.
Article in English | MEDLINE | ID: mdl-31888920

ABSTRACT

A 63-year-old patient was admitted to intensive treatment unit with biliary sepsis due to a small distal common bile duct stone. Endoscopic retrograde cholangiopancreatography was initially attempted for insertion of a biliary stent but failed due to the presence of a periampullary diverticulum. Referral to interventional radiology for percutaneous drainage was considered the next alternative even though there was no dilatation of intrahepatic ducts. Due to complete absence of intrahepatic duct dilatation, the traditional percutaneous transhepatic route was considered rather challenging. An alternative percutaneous approach via the gallbladder and subsequent catheterisation of the duodenum via the distal common bile duct was successfully performed instead without complication. We would like to describe this technique as an alternative option for drainage of the non-dilated biliary system in patients with sepsis.


Subject(s)
Biliary Tract/microbiology , Catheterization/instrumentation , Common Bile Duct Diseases/pathology , Constriction, Pathologic/surgery , Gallbladder/surgery , Biliary Tract/pathology , Catheterization/methods , Cholangiopancreatography, Endoscopic Retrograde/methods , Common Bile Duct/pathology , Common Bile Duct/surgery , Drainage/standards , Drainage/statistics & numerical data , Duodenum/surgery , Gallbladder/diagnostic imaging , Humans , Male , Middle Aged , Sepsis/etiology , Treatment Outcome , Ultrasonography/methods
18.
Mycopathologia ; 184(1): 159-167, 2019 Feb.
Article in English | MEDLINE | ID: mdl-30062390

ABSTRACT

BACKGROUND: Saksenaea vasiformis is one of the numerous fungi of the Order Mucorales. Rapid progression and invasion of neighboring tissues are the most characteristic features of S. vasiformis mucormycosis. AIM: The objective of this review is the management of this type of infections. METHODS: Case report and literature review. RESULTS: A 62-year old woman, without a history of immunocompromisation, developed a localized cutaneous infection at her right thigh. No trauma, skin laceration or insect bite was reported at the side of infection. The initial treatment was surgical debridements and intravenous administration of amphotericin B/posaconazole. In order to avoid the further rapid progression of the infection and save her life, it was decided to proceed to amputation of the patient's right leg. This is the first case of S. vasiformis cutaneous infection in an immunocompetent patient, in Greece. CONCLUSION: Early diagnosis of S. vasiformis mucormycosis is of paramount importance. Clinical suspicion, based on the rapid progression of the infection and on the medical history of the patient, is sufficient to start antifungal treatment. Broad, aggressive, and repeated surgical debridement of the infection site together with systemic antifungal agents administration is the key point for successful treatment.


Subject(s)
Dermatomycoses/diagnosis , Dermatomycoses/pathology , Mucorales/isolation & purification , Mucormycosis/diagnosis , Mucormycosis/pathology , Thigh/pathology , Administration, Intravenous , Amphotericin B/administration & dosage , Amputation, Surgical , Antifungal Agents/administration & dosage , Debridement , Dermatomycoses/therapy , Female , Greece , Humans , Middle Aged , Mucormycosis/therapy , Triazoles/administration & dosage
19.
J Neuroeng Rehabil ; 15(1): 26, 2018 03 22.
Article in English | MEDLINE | ID: mdl-29566720

ABSTRACT

BACKGROUND: Published reports suggest a disparity between perceived and actual balance abilities, a trait associated with increased fall-risk in older adults. We investigate whether it is possible to 'recalibrate' these disparities using a novel gaming intervention. METHODS: We recruited 26 older adults for a 4-week intervention in which they participated in 8-sessions using a novel gaming intervention designed to provide explicit, augmented feedback related to postural control. Measures of perceived balance abilities (Falls Efficacy Scale-International) and actual postural control (limits of stability) were assessed pre- and post-intervention. We used focus groups to elicit the opinions of participants about how the game may have influenced balance abilities and confidence. RESULTS: A stronger alignment was observed between postural control and perceived balance capabilities post-intervention (i.e., significant correlations between Falls Efficacy Scale-International scores and limits of stability which were not present pre-intervention). Also, significant improvements in measures of postural control were observed, with these improvements confined to the aspects of postural control for which the exergame provided explicit, augmented feedback. Qualitative data revealed that the intervention made participants more "aware" of their balance abilities. CONCLUSIONS: Our results demonstrate that it is possible to recalibrate the perceptions of older adults relating to their balance abilities through a targeted, short-term intervention. We propose that the post-intervention improvements in postural control may have been, in part, the result of this recalibration; with altered perceptions leading to changes in balance performance. Findings support the application of novel interventions aimed at addressing the psychological factors associated with elderly falls.


Subject(s)
Accidental Falls/prevention & control , Exercise Therapy/methods , Perception , Postural Balance/physiology , Video Games , Aged , Aged, 80 and over , Female , Humans , Male , Self Concept
20.
J Neurol Sci ; 379: 157-162, 2017 Aug 15.
Article in English | MEDLINE | ID: mdl-28716231

ABSTRACT

BACKGROUND: Balance deficits in multiple sclerosis (MS) are often monitored by means of observer-rated tests. These may provide reliable data, but may also be time-consuming, subject to inter-rater variability, and potentially insensitive to mild fluctuations throughout the clinical course. On the other hand, laboratory assessments are often not available. The Nintendo Wii Balance Board (WBB) may represent a low-cost solution. The purpose of the current study was to examine the methodological quality of WBB data in MS (internal consistency, test-retest reliability), convergent validity with observer-rated tests (Berg Balance Scale, BBS; Timed-Up and Go Test, TUG), and discriminative validity concerning clinical status (Expanded Disability Status Scale, EDSS). METHODS: Standing balance was assessed with the WBB for 4min in 63 MS patients at two assessment points, four months apart. Additionally, patients were examined with the BBS, TUG and the EDSS. RESULTS: A period of 4min on the WBB provided data characterized by excellent internal consistency and test-retest reliability. Significant correlations between WBB data and results of the BBS and TUG were obtained after merely 2min on the board. An EDSS median-split revealed that higher EDSS values (>3) were associated with significantly increased postural sway on the WBB. CONCLUSIONS: WBB measures reflecting postural sway are methodologically robust in MS, involving excellent internal consistency and test-retest reliability. They are also characterized by convergent validity with other considerably lengthier observer-rated balance measures (BBS) and sensitive to broader clinical characteristics (EDSS). The WBB may hence represent an effective, easy-to-use monitoring tool for MS patients in clinical practice.


Subject(s)
Diagnostic Tests, Routine/methods , Multiple Sclerosis/diagnosis , Adult , Female , Humans , Male , Middle Aged , Postural Balance , Video Games , Young Adult
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