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1.
J Endovasc Ther ; : 15266028241245345, 2024 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-38654600

RESUMO

PURPOSE: To present a novel technique that enables safe and effective cannulation of target vessels with challenging anatomy during fenestrated/branched endovascular aortic repair (F/B-EVAR). TECHNIQUE: Following deployment of the F/B-EVAR endograft, the target vessels (TVs) are cannulated. The bundle wire technique provides a solution to challenging TVs and uses multiple fine atraumatic guidewires that together serve as a stiff guidewire. The technique can be executed in 2 ways using: (1) one 0.018 inch and one 0.014 inch guidewire or (2) three 0.014 inch guidewires. We demonstrate the technique in a case of a complex abdominal aortic aneurysm treated using branched EVAR in which the left renal artery with severe ostial stenosis was catheterized using the bundle wire technique. CONCLUSIONS: The bundle wire technique offers a technically feasible and economically viable solution for facilitating catheter and bridging stent delivery in anatomically challenging TVs during F/B-EVAR. It is a useful addition to the therapeutic armamentarium available to physicians for accessing demanding TVs.

3.
Vascular ; : 17085381231192687, 2023 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-37606562

RESUMO

INTRODUCTION: The aim of this study is to report the early and late outcomes of cryopreserved saphenous vein (CSV) in redo infrainguinal bypass and to investigate possible predictors of primary patency loss. METHODS: All patients who underwent a redo bypass for critical limb ischemia from January 2010 to December 2020 were reviewed. Early and late complications were analyzed and included. The endpoints of the study were all cause mortality, major limb amputation, and primary patency (PP). RESULTS: Data were collected from 95 patients. Among the entire cohort, 16 (16.8%) patients received a cryopreserved vessel bypass with anastomosis in the popliteal artery and 79 (83.2%) patients had cryopreserved vessel bypasses with distal anastomosis in tibial vessels. Median duration of follow-up was 73 months; during this, period estimated survival at 5 years was 80.5 ± 4% (95% CI, 78.0-91.2) and estimates of freedom from limb amputation was 90.3 ± 3.2% (95% CI, 87.3-98.1). Overall, the estimated primary patency of the bypass was 43.7 ± 6.7% (95% CI, 30.2-51.4). On multivariable analysis, intraprocedural tibial vessel angioplasty (HR = 2.3, p = 0.01), distal anastomosis in tibial vessels (HR = 3.6, p = 0.36), and the use of a composite graft (HR = 2.4, p = 0.01) were independently associated with loss of PP. CONCLUSIONS: The use of CSV in redo bypass is an effective strategy in salvaging threatened lower extremities and in preventing or delaying limb amputation. Our results confirm that further attempts at revascularization are generally appropriate, even in technically changing patients.

4.
Sensors (Basel) ; 23(13)2023 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-37447710

RESUMO

Repairing potholes is a task for municipalities to prevent serious road user injuries and vehicle damage. This study presents a low-cost, high-performance pothole monitoring system to maintain urban roads. The authors developed a methodology based on photogrammetry techniques to predict the pothole's shape and volume. A collection of overlapping 2D images shot by a Raspberry Pi Camera Module 3 connected to a Raspberry Pi 4 Model B has been used to create a pothole 3D model. The Raspberry-based configuration has been mounted on an autonomous and remote-controlled robot (developed in the InfraROB European project) to reduce workers' exposure to live traffic in survey activities and automate the process. The outputs of photogrammetry processing software have been validated through laboratory tests set as ground truth; the trial has been conducted on a tile made of asphalt mixture, reproducing a real pothole. Global Positioning System (GPS) and Geographical Information System (GIS) technologies allowed visualising potholes on a map with information about their centre, volume, backfill material, and an associated image. Ten on-site tests validated that the system works in an uncontrolled environment and not only in the laboratory. The results showed that the system is a valuable tool for monitoring road potholes taking into account construction workers' and road users' health and safety.


Assuntos
Imageamento Tridimensional , Software , Humanos , Imageamento Tridimensional/métodos , Cidades , Fotogrametria
5.
Sci Rep ; 13(1): 8214, 2023 05 22.
Artigo em Inglês | MEDLINE | ID: mdl-37217666

RESUMO

Pressures and responsibilities of medical school put a strain on medical student's personal wellbeing, leading among all to high rates of anxiety, emotional discomfort and stress. In this work we evaluated the effectiveness of a comprehensive Mindfulness-Based Intervention (MBI) in reducing this load. The intervention comprised 10 twice-a-week Integral Meditation classes, dietary advice, and brief yoga sessions. We performed a randomized trial on two cohort of medical students from Italian universities: 239 in cohort 1 (106 treated and 133 controls), and 123 in cohort 2 (68 treated and 55 control) for a total sample of 362 students. Nine questionnaires for evaluating the effectiveness of our intervention on stress (PSS), state anxiety (STAIX-1), well-being (WEMWBS), mind-wandering (MW-S), overall distress (PANAS), emotion regulation (DERS), resilience (RS-14), and attentional control (ACS-C and ACS-D) were collected both pre and post intervention. Linear mixed effect models were run on the whole sample showing that, after multiple testing correction, our intervention was effective in reducing perceived stress (ß = - 2.57 [- 4.02; - 1.12], p = 0.004), improving mental well-being (ß = 2.82 [1.02; 4.63], p = 0.008) and emotional regulation (ß = - 8.24 [- 12.98; - 3.51], p = 0.004), resilience (ß = 3.79 [1.32; 6.26], p = 0.008), reducing the tendency to wander with the mind (ß = - 0.70 [- 0.99; - 0.39], p = 0.0001), ameliorating the ability to maintain attention (AC-S (ß = - 0.23 [- 0.44; - 0.02], p = 0.04) and AC-D (ß = - 0.19 [- 0.36; - 0.01], p = 0.04)), and the overall distress (ß = 1.84 [0.45; 3.23], p = 0.02).


Assuntos
Atenção Plena , Estudantes de Medicina , Humanos , Estudantes de Medicina/psicologia , Estresse Psicológico/prevenção & controle , Estresse Psicológico/psicologia , Ansiedade/terapia , Emoções
6.
Urol Ann ; 15(1): 48-53, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37006224

RESUMO

Purpose: Prostate cryoablation has been proposed as an alternative to radical prostatectomy for men with localized prostate cancer (PCa); however, it is limited by the lack of data regarding oncological outcomes and the impossibility of performing a lymph node dissection. The aim of this study was to assess if whole-gland cryoablation is oncologically safe, especially for patients in whom pelvic lymph node dissection would be necessary. Materials and Methods: After institutional review board approval, we identified 102 patients who underwent whole-gland prostate cryoablation between 2013 and April 2019. Lymph node invasion (LNI) probability was computed using Briganti nomogram, and a 5% cutoff probability was used to stratify the population in two groups. Biochemical recurrence after procedure was assessed using Phoenix criteria. Multiparametric magnetic resonance imaging, (CT), and bone scan or choline positron-emission tomography/CT were performed for the detection of distant metastases. Results: Seventeen (17%) patients were treated for a low-risk PCa, 48 (47%) patients were at intermediate-risk PCa, and 37 (36%) patients were at high-risk PCa. Patients with a probability of LNI >5% (n = 46) exhibited higher prostate-specific antigen (PSA), PSA density, ISUP Grade Group, CT stage, and european association of urology (EAU) risk. Recurrence-free survival rates at 3 years' follow-up were 93%, 82%, and 72%, respectively for low-, intermediate-, and high-risk patients. At a median follow-up of 37 months (17-62), additional treatment and metastasis-free survival were 84% and 97%, respectively. No differences in oncological outcomes were found in patients with a probability of LNI above and below 5%. Conclusions: Prostate whole-gland cryoablation can be considered a safe procedure with acceptable outcomes in low- and intermediate-risk patients. A high preoperative risk of nodal involvement could not be considered an exclusion criterion to perform cryoablation. Further studies are required.

7.
J Clin Med ; 12(6)2023 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-36983324

RESUMO

Background: To define proximal neck dilation (PND) after standard endovascular aneurysm repair (EVAR) and fenestrated EVAR (FEVAR), determining: incidence and risk factors; evidence base that links PND to outcomes of patients; recurring themes or gaps in the literature. Methods: We performed a scoping review and included only full-text English articles with follow-up focusing on PND in patients undergoing EVAR or FEVAR, published between 2000 and 2022. The following PICO question was used to build the search equation: in patients with abdominal-aortic-aneurysm (AAA) (Population) undergoing endovascular repair (Intervention), what are the incidence, risk factors and prognosis of radiologically defined PND (Comparison) on short-term and long-term outcomes (Outcomes)? Results: 15 articles were included after review. Measurement protocols for proximal aortic neck (PAN) varied among individual studies and the definition of PND resulted as heterogeneous. Rate of patients with a PND ranged between 0% and 41%. Large proximal neck (>28 mm) and excessive graft sizing (30%) were predictors for PND. New endografts with low outward radial forces and FEVAR seemed to be protective. Surgical conversion was the definitive option in the case of patients unfit for other endovascular treatments. Conclusions: PND is a frequent finding after EVAR and FEVAR. Excessive graft oversizing and large baseline PAN were predictors of neck enlargement, independently by the type of standard endograft used. FEVAR may be considered protective against complications, together with endografts using low outward radial forces. Lifelong radiological follow-up is mandatory.

8.
Materials (Basel) ; 16(4)2023 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-36836965

RESUMO

Environmental safeguards promote innovative construction technologies for sustainable pavements. On these premises, this study investigated four hot mix asphalt (HMA) mixtures-i.e., A, B, C, and D-for the railway sub-ballast layer with 0%, 10%, 20%, and 30% reclaimed asphalt pavement (RAP) by total aggregate mass and a rejuvenator additive, varying the bitumen content between 3.5% and 5.0%. Both Marshall and gyratory compactor design methods have been performed, matching the stability, indirect tensile strength, and volumetric properties of each mixture. Dynamic stiffness and fatigue resistance tests provided mechanical performances. Laboratory results highlighted that the RAP and the rejuvenator additive increase the mechanical properties of the mixtures. In addition, the comparative analysis of production costs revealed up to 20% savings as the RAP content increased, and the life cycle impact analysis (LCIA) proved a reduction of the environmental impacts (up to 2% for resource use-fossils, up to 7% for climate change, and up to 13% for water use). The experimental results confirm that HMA containing RAP has mechanical performances higher than the reference mixture with only virgin raw materials. These findings could contribute to waste management and reduce the environmental and economic costs, since the use of RAP in the sub-ballast is not, so far, provided in the Italian specifications for railway construction.

9.
Artigo em Inglês | MEDLINE | ID: mdl-36768089

RESUMO

Sleep of inadequate quantity and quality is increasing in the present 24 h society, with a negative impact on physical and mental health. Mindfulness-based interventions (MBIs) generate a state of calm behavior that can reduce hyperactivity and improve sleep. We hypothesized that our specific MBI, administered online, may improve sleep quality and foster emotion regulation and mindfulness. The Pittsburgh Sleep Quality Index (PSQI), Sleep Condition Indicator (SCI), Arousal Predisposition Scale (APS), Ford Insomnia Response to Stress Test (FIRST), Sleep Hygiene Index (SHI) and Insomnia Severity Index (ISI) were used to measure sleep quality and stability. Emotion regulation and mindfulness were measured via the Emotion Regulation Questionnaire (ERQ) and Five Facet Mindfulness Questionnaire (FFMQ). Our MBI included 12 biweekly integral meditation (IM) classes, recorded IM training for individual practice, and dietary advice to promote sleep regulation. Fifty-six voluntary poor sleepers with a PSQI score of >5 were randomly allocated to treated (n = 28) and control (n = 28) groups. Linear mixed models were used to estimate the effectiveness of the intervention. Statistically significant results were observed in the FFMQ sub-domain non-reactivity to inner experience (ß = 0.29 [0.06; -0.52], p = 0.01), PSQI (ß = -1.93 [-3.43; -0.43], p = 0.01), SCI (ß = 3.39 [0.66; 6.13], p = 0.02) and ISI (ß = -3.50 [-5.86; -1.14], p = 0.004). These results confirm our hypothesis regarding the beneficial effects of our intervention on sleep quality.


Assuntos
COVID-19 , Atenção Plena , Distúrbios do Início e da Manutenção do Sono , Humanos , Distúrbios do Início e da Manutenção do Sono/terapia , Atenção Plena/métodos , Qualidade do Sono , Pandemias , Sono/fisiologia
10.
J Vasc Surg ; 77(3): 804-810.e3, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-36265668

RESUMO

OBJECTIVE: The aim of the present study was to develop and validate a risk prediction model for the prediction of long-term mortality for patients with severe asymptomatic de novo carotid stenosis undergoing carotid endarterectomy (PREMY2SE-CEA). METHODS: Data were collected retrospectively from a dedicated database of consecutive patients who had undergone elective CEA for severe (>70% using the NASCET [North American Symptomatic Carotid Endarterectomy Trial] criteria) asymptomatic carotid stenosis at two Italian University Hospitals from 2008 through 2016. Internal validation of the score was performed after random sampling in a 3:1 fashion. The primary end point of the PREMY2SE-CEA risk score was the 5-year mortality. RESULTS: Of the 1214 patients, 901 were included in the derivation cohort and 313 in the validation cohort. Using multivariable logistic regression with backward elimination, a parsimonious model was derived. A risk score incorporating eight risk factors was generated and found to be highly predictive of long-term mortality in the derivation (odds ratio [OR], 1.38; 95% confidence interval [CI], 1.28-1.41; P < .001) and validation (OR, 1.29; 95% CI, 1.21-1.37; P <.001) cohorts. The discrimination power in the receiver operating characteristic curve analysis was C = 0.775 (95% CI, 0.74-.80), and the optimism-corrected area under the curve in the bootstrapped samples was 0.761 (P < .001). A strong correlation was found between the predicted and actual mortality rates in the validation cohort (r = 0.71; P < .001). CONCLUSIONS: In the present study, we have described the development, evaluation, and validation of a risk prediction model (PREMY2SE-CEA) for long-term mortality after CEA in asymptomatic patients. Physicians could use the PREMY2SE-CEA risk scoring tool to complement their estimates of life expectancy and prompt selective consideration of prophylactic CEA to improve the long-term benefits of interventions.


Assuntos
Estenose das Carótidas , Endarterectomia das Carótidas , Acidente Vascular Cerebral , Humanos , Endarterectomia das Carótidas/efeitos adversos , Estudos Retrospectivos , Medição de Risco , Resultado do Tratamento , Fatores de Risco , Acidente Vascular Cerebral/etiologia
11.
Sensors (Basel) ; 22(23)2022 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-36501885

RESUMO

A comprehensive representation of the road pavement state of health is of great interest. In recent years, automated data collection and processing technology has been used for pavement inspection. In this paper, a new signal on graph (SoG) model of road pavement distresses is presented with the aim of improving automatic pavement distress detection systems. A novel nonlinear Bayesian estimator in recovering distress metrics is also derived. The performance of the methodology was evaluated on a large dataset of pavement distress values collected in field tests conducted in Kazakhstan. The application of the proposed methodology is effective in recovering acquisition errors, improving road failure detection. Moreover, the output of the Bayesian estimator can be used to identify sections where the measurement acquired by the 3D laser technology is unreliable. Therefore, the presented model could be used to schedule road section maintenance in a better way.


Assuntos
Benchmarking , Tecnologia , Teorema de Bayes , Coleta de Dados
12.
Sensors (Basel) ; 22(17)2022 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-36081019

RESUMO

Stone pavements are present in many cities and their historical and cultural importance is well recognized. However, there are no standard monitoring methods for this type of pavement that allow road managers to define appropriate maintenance strategies. In this study, a novel method is proposed in order to monitor the road surface conditions of stone pavements in a quick and easy way. Field tests were carried out in an Italian historic center using accelerometer sensors mounted on both a car and a bicycle. A post-processing phase of that data defined the comfort perception of the road users in terms of the awz index, as described in the ISO 2631 standard. The results derived from the dynamic surveys were also compared with the corresponding values of typical pavement indicators such as the International Roughness Index (IRI) and the Pavement Condition Index (PCI), measured only on a limited portion of the urban road network. The network's implementation in a Geographic Information System (GIS) represents the surveys' results in a graphical database. The specifications of the adopted method require that the network is divided into homogeneous sections, useful for measurement campaign planning, and adopted for the GIS' outputs representation. The comparisons between IRI-awz (R2 = 0.74) and PCI-awz (R2 = 0.96) confirmed that the proposed method can be used reliably to assess the stone pavement conditions on the whole urban road network.


Assuntos
Sistemas de Informação Geográfica , Cidades , Itália
13.
Front Psychol ; 13: 914183, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35859847

RESUMO

To limit the first spread of COVID-19 in March 2020, the Italian government imposed strict lockdown measures to the population. Despite necessary to reduce the virus transmission and the burden to the hospitals, social isolation has caused detrimental effects on psychological wellbeing and mental health. Moreover, during this period, it was also difficult to deliver psychological treatments and psychiatric assistance. A short (a weekly session for 9 weeks) mindfulness-based meditation program, named Integral Meditation (IM), was administered entirely online to healthy adults from Italy. This is a two-groups pre-post-quasi-experimental study in which the two groups, treated and control, were not randomized. Through matching procedures aimed at overcoming the absence of randomization, we analyzed a sample of 84 subjects (42 for each group). By applying linear mixed effect models, we tested the hypothesis of a beneficial effect of IM on wellbeing, perceived stress, and state anxiety, as measured by three self-reported questionnaires (WEMWBS, PSS, and STAI-X1, respectively), assuming that this effect could be different according to the level of baseline trait anxiety, as measured by STAI-X2. The results showed a statistically significant effect of STAI-X1 (ß = -8.24 [95%CI -15.39; -1.09], p = 0.02) and WEMWBS (ß = 4.61 [95%CI 0.94; 8.29], p = 0.01) in the higher trait anxiety subgroup only. No statistically significant effect of IM was observed for PSS. These results suggest that our IM, delivered online, may increase mental wellbeing and decrease anxiety specifically in subjects with higher trait anxiety.

14.
Diagnostics (Basel) ; 12(2)2022 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-35204368

RESUMO

In this prospective observational study, we tested the feasibility and efficacy of a novel one-day PCa diagnosis path based on biparametric magnetic resonance (bpMRI) and digital pathology by fluorescence confocal microscopy (FCM). Patients aged 55-70 years scheduled for PBx due to increased PSA levels (3-10 ng/mL) and/or abnormal digitorectal examination were enrolled. All patients underwent bpMRI and PBx with immediate FCM evaluation of biopsy cores. Patients were asked to fill out a dedicated Patient Satisfaction Questionnaire. Patients' satisfaction rates and concordance between digital pathology and standard HE evaluation were the outcomes of interest. Twelve patients completed our one-day PCa diagnosis path. BpMRI showed suspicious lesions in 7 patients. Digital pathology by FCM identified PCa in 5 (41.7%) of the 12 patients. Standard pathology confirmed the diagnosis made through digital pathology in all the cases. At a per patient level, high concordance between the methods was achieved in Gleason Grading (4 out of 5 patients). The level of agreement in the number of positive cores was lower but did not affect the choice of treatment in any of the 5 PCa cases. At a per core level, the agreement was very high for the diagnosis of anyPCa (96.2%) and csPCa (97.3%), with a k coefficient of 0.90 and 0.92, respectively (near perfect agreement). In conclusion, one-day PCa diagnosis by FCM represents a feasible, reliable, and fast diagnostic method that provides significant advantages in optimizing time and resources, leading to patients having a higher quality standard of care perception.

15.
Vascular ; 30(5): 891-901, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34416840

RESUMO

OBJECTIVE: The aim of the study was to evaluate the outcome of first line hybrid treatment in patients with chronic limb threatening ischemia (CLTI) and to evaluate possible predictors of primary patency (PP) loss and limb clinical improvement (LCI). METHODS: This was a retrospective non-randomized study. All patients underwent one-stage hybrid common femoral artery (CFA) endarterectomy combined with an inflow and/or outflow endovascular revascularization procedure. Demographic, clinical, and lesion characteristics for each patient were reported. Primary patency analysis was performed using Kaplan-Meier life tables, and univariate and multivariate analysis was used to assess possible predictors of PP loss and clinical improvement. RESULTS: Complete data were obtained from 132 patients. Patients were divided into two groups according to their Rutherford's category (RC), group 1 (Rutherford 4) and group 2 (Rutherford 5 and 6). Technical success was 98%. The overall surgical peri-operative complication rate was 8%. At a mean follow-up of 32 ± 23 months, the rate of major adverse limb events (MALE) was 30%; only the rate of major amputation between two groups was significant statistically different (p = .006). Group 1 had significantly lower amputation rate at 36 months (p = .01). The presence of high iliac peripheral artery calcium scoring system (PACCS) grade (HR 9.43, 95% CI 2.40-36.9, p = .001), the poor run-off of leg vessels (HR 0.15, 95% CI 0.02-0.92, p = .04), and undergoing CFA endarterectomy combined with outflow endovascular revascularization procedure (HR 4.25, 95% CI 1.07-16.89, p = .04) were independent predictors of PP loss, while severe iliac artery stenosis (OR 0.09, 95% CI 0.02-0.32, p = <.001) and the presence of pre-operative patent leg vessels (OR 8.03, 95% CI 2015-29.95, p = .002) were the significant independent predictors of LCI. CONCLUSION: The use of hybrid first line approach in patients with CLTI is a safe and feasible technique. From the analysis of the current study, it is clear that any effort should be made to achieve as many patency leg vessels as possible in order to obtain better and longer lasting clinical outcomes.


Assuntos
Procedimentos Endovasculares , Doença Arterial Periférica , Cálcio , Isquemia Crônica Crítica de Membro , Procedimentos Endovasculares/efeitos adversos , Humanos , Isquemia/diagnóstico por imagem , Isquemia/cirurgia , Salvamento de Membro , Doença Arterial Periférica/diagnóstico por imagem , Doença Arterial Periférica/cirurgia , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento , Grau de Desobstrução Vascular
16.
Ann Vasc Surg ; 79: 130-138, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34644647

RESUMO

BACKGROUND: At our institution, we adopted routinely ultrasound guided approach for all percutaneous procedures. The objective of this study was to describe the predictors of access site failures (ASFs) in patients undergoing percutaneous aorto iliac revascularization and to also evaluate whether other factors such as time period or different vascular devices may influence outcomes in terms of ASFs. METHODS: We reviewed all consecutive percutaneous revascularizations performed for aortoiliac occlusion or stenosis at our institution from 2011 to 2020. All procedure were performed using an ultrasound (US) guided common femoral access. The primary outcome was ASFs, defined as bleeding or groin hematomas that required transfusions; pseduoaneurysm (diagnosed by US); retroperitoneal hematoma; artery laceration or ruptured (diagnosed intraoperatively); and thrombosis. Multivariable logistic regression was used to determine predictors of ASFs. RESULTS: A total of 502 femoral arteries were accessed under DUS guidance with no failure in sheath placement. Technical success was achieved in 498 of 502 procedures (99.2%). ASFs occurred in 21 patients (7%); but year of procedure appear to be associated with an excess of ASFs as rates were different between the first and second period of the study (10.9% vs. 4.8%, P = 0.04). Results of multivariable logistic regression model indicated that independent predictors of ASFs were common femoral artery (CFA) calcification peripheral artery calcium scoring system (PACCS) grade (odds ratio [OR], 8.7; 95% confidence interval [CI], 5.5-13.7), and CFA diameter (OR, 0.46; 95% CI, 0.25-0.85). Compared to patients with successful percutaneous access, ASFs resulted in longer post-op lengths of stay (P = < 0.001). CONCLUSION: Percutaneous US guided access can be safely performed in patients undergoing endovascular procedures for aorto iliac revascularization with TASC C and D lesions. CFA calcification PACCS grade greater than 3 and smaller femoral vessel diameter are independent risk factors for ASFs.


Assuntos
Doenças da Aorta/terapia , Cateterismo Periférico/efeitos adversos , Procedimentos Endovasculares , Artéria Femoral , Artéria Ilíaca , Doença Arterial Periférica/terapia , Ultrassonografia de Intervenção , Idoso , Doenças da Aorta/diagnóstico por imagem , Procedimentos Endovasculares/efeitos adversos , Feminino , Humanos , Artéria Ilíaca/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Doença Arterial Periférica/diagnóstico por imagem , Punções , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores de Tempo , Falha de Tratamento , Ultrassonografia de Intervenção/efeitos adversos
17.
Cent European J Urol ; 74(3): 308-314, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34729218

RESUMO

INTRODUCTION: The aim of this article was to determine the impact of bioptic prostatic inflammation (PI) on the false positive rate of multiparametric magnetic resonance imaging (mp-MRI) in detecting clinically significant prostate ancer (csPCa). MATERIAL AND METHODS: Our prostate biopsy database was queried to identify patients who underwent mp-MRI before PB at our institution. A dedicated uropathologist prospectively assessed bioptic PI using the Irani scores. We evaluated the association between mp-MRI findings, bioptic Gleason grade (GG) and aggressiveness of PI, and PCa detection. RESULTS: In total, 366 men were included. In patients with Prostate Imaging Reporting and Data System (PIRADS) 4-5 lesions, the csPCa (GG ≥2) rate was significantly higher in those with low-grade than in those with high-grade PI (36% vs 29.7%; p = 0.002), and in those with low-aggressive than in those with high-aggressive PI (37.7% vs 30.1%; p = 0.0003). The false positive rates of PIRADS 4-5 lesions for any PCa were 34.2% and 57.8% for low- and high-grade PI, respectively (p = 0.002); similarly, they were 29.5% and 59.4% for mildly and highly-aggressive PI (p = 0.0003). Potential study limitations include its retrospective analysis and single-center study and lack of assessment of the type of PI. CONCLUSIONS: Bioptic PI directly correlates with false positive rates of mp-MRI in detecting csPCa. Clinicians should be aware that PI remains the most common pitfall of mp-MRI.

18.
Work ; 70(4): 1089-1099, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34842215

RESUMO

BACKGROUND: Mindfulness-based interventions (MBIs) are known for their beneficial effects on positive and negative psychological factors. When applied in an occupational context, MBIs might help workers to cope with stress, increase their professional outcomes and wellbeing. OBJECTIVE: In this two-groups pre-post experimental design we tested the effect of our MBI, called Integral Meditation (IM), among the employers of an Italian service company by measuring positive and negative aspects of psychological wellbeing related to mindfulness and workplace functioning through eight self-report questionnaires (CORE-OM, FFMQ, WEMWBS, MAIA, PSS, PANAS, STAI-X1, SCS). METHOD: Forty-two voluntary non-clinical employers of the company, randomly assigned to the experimental or the control group, were analyzed. The experimental group underwent our IM program, which consists of 12 weekly meditation classes given after the afternoon shift, while the control group did not receive any intervention. Data was analyzed via linear mixed models. RESULTS: Statistically significant results were obtained for FFMQ observing subscale (ß= 0.49, p = 0.014), WEMWBS (ß= 5.31, p = 0.02), PSS (ß= -3.31, p = 0.03), the whole scale of SCS (ß= 0.47, p = 0.01) and self-judgment (ß= 0.68, p = 0.003) and isolation (ß= -0.66, p = 0.01) SCS subscales. Statistically significant results were also found in four out of eight subscales of MAIA: emotional awareness (ß= 1.26, p < 0.001), self-regulation (ß= 1.28, p < 0.001), body listening (ß= 1.08, p < 0.001) and trusting (ß= 1.1, p < 0.001). CONCLUSION: Our intervention has demonstrated to bring beneficial effects in a mindfulness subdomain, in perceived stress, self-compassion, interoception and psychological wellbeing. Based on our results, we conclude that our intervention was effective in increasing the positive aspects of wellbeing and in reducing stress.


Assuntos
Meditação , Atenção Plena , Humanos , Autocompaixão , Inquéritos e Questionários , Local de Trabalho
19.
Sensors (Basel) ; 21(20)2021 Oct 13.
Artigo em Inglês | MEDLINE | ID: mdl-34696010

RESUMO

Airport pavements should ensure regular and safe movements during their service life; the management body has to monitor the functional and structural characteristics, and schedule maintenance work, balancing the often conflicting goals of safety, economic and technical issues. This paper presents a remote monitoring system to evaluate the structural performance of a runway composed of concrete thresholds and a flexible central runway. Thermometers, strain gauges, and pressure cells will be embedded at different depths to continuously monitor the pavement's response to traffic and environmental loads. An innovative system allows data acquisition and processing with specific calculation models, in order to inform the infrastructure manager, in real time, about the actual conditions of the pavement. In this way, the authors aim to develop a system that provides useful information for the correct implementation of an airport pavement management system (APMS) based on real-life data. Indeed, it permits comprehensive monitoring functions to be performed, based on the embedded sensing network.


Assuntos
Estresse Mecânico
20.
Cancers (Basel) ; 13(17)2021 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-34503192

RESUMO

Partial gland cryoablation (PGC) aims at destroying prostate cancer (PCa) foci while sparing the unaffected prostate tissue and the functionally relevant structures around the prostate. Magnetic Resonance Imaging (MRI) has boosted PGC, but available evidence suggests that ablation margins may be positive due to MRI-invisible lesions. This study aimed at determining the potential role of intraoperative digital analysis of ablation margins (DAAM) by fluoresce confocal microscopy (FCM) of biopsy cores taken during prostate PGC. Ten patients with low to intermediate risk PCa scheduled for PGC were enrolled. After cryo-needles placement, 76 biopsy cores were taken from the ablation margins and stained by the urologist for FCM analysis. Digital images were sent for "real-time" pathology review. DAAM, always completed within the frame of PGC treatment (median time 25 min), pointed out PCa in 1/10 cores taken from 1 patient, thus prompting placement of another cryo-needle to treat this area. Standard HE evaluation confirmed 75 cores to be cancer-free while displayed a GG 4 PCa in 7% of the core positive at FCM. Our data point out that IDAAM is feasible and reliable, thus representing a potentially useful tool to reduce the risk of missing areas of PCa during PGC.

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