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Graziani M.S.,Azienda Ospedaliera Universitaria Integrata di Verona | Merlini G.,University of Pavia
Expert Review of Molecular Diagnostics | Year: 2014

The serum free light chain (FLC) assay is an important tool in the management of patients with monoclonal gammopathies. MEDLINE®, the Cochrane Central Register of Controlled Trials and the Cochrane Database of Systematic Reviews from January 2000 through July 2013, were used as data sources. The available evidence is rather weak. For screening of multiple myeloma and related conditions, the association of the FLC assay with the traditional serum tests avoids urine study. Screening for immunoglobulin light-chain (AL) amyloidosis or other rare syndromes requires the urine examination. FLC measurement is used in the assessment of the risk of progression of precursor diseases to overt myeloma, and for risk stratification in solitary plasmacytoma, multiple myeloma and AL amyloidosis. In patients with oligosecretory myeloma and AL amyloidosis, the quantification of FLC is essential for monitoring and categorization of response to therapy. Further studies with improved design are warranted to strengthen the available evidence. © 2014 Informa UK, Ltd.

An update of the 2002 guidelines for the evaluation and management of chronic kidney disease (CKD) has recently been published by the Kidney Disease Improving Global Outcomes (KDIGO) initiative. This report intends to summarize and comment the topics of interest for the clinical laboratory, emphasizing differences with the previous guideline. Clinical biochemists are explicitly mentioned among the target audience of new guidelines, because of the fundamental role that laboratory tests have in the detection and follow up of CKD; this is certainly something new in the history of clinical guidelines. The most important differences between 2002 and new guidelines are: a new risk prediction model including cause, glomerular filtration rate (GFR) and urine albumin results; a higher role assigned to urine albumin considered both as a component of risk prediction and as the primary test to detect proteinuria; the suggestion to use the Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) equation (considered more accurate than the Modification of Diet in Renal Disease (MDRD) formula) to calculate GFR; the utility of using cystatin C and the GFR formulas based on this protein to confirm the renal impairment in certain categories of patients. Laboratorians can find in the guidelines a number of detailed indications on how to report and interpret laboratory tests for CKD, ranging from the type of sample to be used for urine albumin measurement (i.e., the first morning void) to the way of estimated GFR reporting (rounded to the nearest whole number) and to creatinine and cystatin C calibration approaches that should be traceable to the international reference materials.

Faggiano E.,Polytechnic of Milan | Antiga L.,Orobix srl | Puppini G.,Azienda Ospedaliera Universitaria Integrata di Verona | Quarteroni A.,Polytechnic of Milan | And 3 more authors.
Biomechanics and Modeling in Mechanobiology | Year: 2013

Bicuspid aortic valve (BAV) is associated with aortic dilatation and aneurysm. Several studies evidenced an eccentric systolic flow in ascending aorta associated with increased wall shear stresses (WSS) and the occurrence of an helical systolic flow. This study seeks to elucidate the connections between jet asymmetry and helical flow in patients with normally functioning BAV and dilated ascending aorta. We performed a computational parametric study by varying, for a patient-specific geometry, the valve area and the flow rate entering the aorta and drawing also a tricuspid valve (TAV). We considered also phase-contrast magnetic resonance imaging of four BAV and TAV patients. Measurement of normalized flow asymmetry index, systolic WSS and of a new index (positive helix fraction, PHF) quantifying the presence of a single a single helical flow were performed. In our computation, BAV cases featured higher values of all indices with respect to TAV in both numerical and imaged-based results. Moreover, all indices increased with decreasing valve area and/or with increasing flow rate. This allowed to separate the BAV and TAV cases with respect to the jet asymmetry, WSS localization and helical flow. Interestingly, these results were obtained without modeling the leaflets. © 2012 Springer-Verlag Berlin Heidelberg.

Azienda Ospedaliera Universitaria Integrata Di Verona, Rare Partners S.R.L., University of Bari and University of Ferrara | Date: 2012-06-13

The invention relates to the use of 4,6,4-trimethylangelicin (TMA) and structural analogues thereof to prepare a medicament for the treatment of cystic fibrosis with the primary objective of correcting the defective CFTR in a sub-group of cystic fibrosis patients consisting of patients carrying the F508de1-CFTR mutation.

Dieterich S.,Stanford University | Cavedon C.,Azienda Ospedaliera Universitaria Integrata di Verona | Chuang C.F.,University of California at San Francisco | Cohen A.B.,Accuray | And 7 more authors.
Medical Physics | Year: 2011

The task group (TG) for quality assurance for robotic radiosurgery was formed by the American Association of Physicists in Medicine's Science Council under the direction of the Radiation Therapy Committee and the Quality Assurance (QA) Subcommittee. The task group (TG-135) had three main charges: (1) To make recommendations on a code of practice for Robotic Radiosurgery QA; (2) To make recommendations on quality assurance and dosimetric verification techniques, especially in regard to real-time respiratory motion tracking software; (3) To make recommendations on issues which require further research and development. This report provides a general functional overview of the only clinically implemented robotic radiosurgery device, the CyberKnife®. This report includes sections on device components and their individual component QA recommendations, followed by a section on the QA requirements for integrated systems. Examples of checklists for daily, monthly, annual, and upgrade QA are given as guidance for medical physicists. Areas in which QA procedures are still under development are discussed. © 2011 American Association of Physicists in Medicine.

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