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Bertino G.,University of Pavia | Cacciola S.,University of Pavia | Fernandes W.B.,University of Pavia | Fernandes C.M.,University of Pavia | And 3 more authors.
Head and Neck | Year: 2015

Background. The purpose of this study was to assess the value of narrow band imaging (NBI) endoscopy in the diagnosis of phar-yngolaryngeal lesions and to demonstrate the validity of a new NBI-based classification of their vascular pattern. Methods. From 2009 to 2011, 248 patients with pharyngolaryngeal lesions underwent NBI-endoscopic evaluation. NBI findings were classified into 5 types according to the Ni classification and were compared with histopathological reports. Sensitivity, specificity, accuracy, and positive predictive value (PPV) and negative predictive value (NPV) were calculated. Results. Sensitivity, specificity, accuracy, PPV, and NPV were 97.4%, 84.6%, 92.7%, 91.6%, and 95.1%, respectively. Ninety-eight percent of histologically malignant lesions corresponded to type V endoscopic pattern, whereas 84.8% of the non-neoplastic lesions corresponded to a type I to IV pattern. Conclusion. The NBI ability to detect changes in the mucosal microvas-culature can be useful for distinguishing nonmalignant from malignant lesions. An internationally accepted NBI-endoscopic classification may contribute to the further definition of the diagnostic validity of this technique. © 2014 Wiley Periodicals, Inc.

Mazzucchelli I.,Neonatal Intensive Care Unit | Mazzucchelli I.,University of Pavia | Garofoli F.,Neonatal Intensive Care Unit | Ciardelli L.,Clinical Chemistry Laboratories | And 7 more authors.
Pediatric Critical Care Medicine | Year: 2013

OBJECTIVE:: CD64 index and triggering receptor expressed on myeloid cells-1 are biomarkers on neutrophil polymorphonuclear cells with crucial role in sepsis. The study aim is to assess diagnostic performance, individually and combined, of CD64 index and triggering receptor expressed on myeloid cells-1 (surface marker/soluble form), in late-onset sepsis of preterm infants. DESIGN:: Observational study. SETTING:: Neonatal ICU. PATIENTS:: Sixteen septic and 16 control preterm infants, gestational age younger than 32 weeks and/or birth weigh less than 1500 g. MEASUREMENT AND MAIN RESULTS:: Seventy preterm infants, free of sepsis were enrolled into the study. CD64 index and triggering receptor expressed on myeloid cells-1 were measured once between day 5 and 15 of life (T0) and once between day 16 and 25 (T1). At T1, 16 infants were assigned to septic group because of reported signs of sepsis and positive blood culture. From the remaining 54 infants, 16 of them who always remained free of sepsis had a blood sample at T1 and constituted the control group (n = 16). Comparing T1 vs T0, triggering receptor expressed on myeloid cells-1 polymorphonuclear cells percentage was significantly lower (p = 0.002) in septic group but not in control group; soluble triggering receptor expressed on myeloid cells-1 concentration did not show significant differences in both groups; CD64 index significantly increased (p = 0.0004) in septic group, while no difference was found in control group. Comparing septic with control group at T0, no differences were found in any markers. At T1, triggering receptor expressed on myeloid cells-1 polymorphonuclear cells percentage was significantly lower (p = 0.003) and CD64 index was higher (p = 0.00019) in septic infants. Triggering receptor expressed on myeloid cells-1 polymorphonuclear cells receiver operating characteristic curve indicated cutoff 62.12%, sensitivity 56.2%, specificity 93.5%, and area under the curve 0.8. CD64 index receiver operating characteristic curve indicated cutoff 2.85, sensitivity 87.5%, specificity 100%, and area under the curve 0.95. Combination of the two indexes was not useful in increasing individual diagnostic power. CONCLUSIONS:: Despite limited sample size, CD64 index demonstrated to be a promising biomarker, with high specificity, to diagnose late-onset sepsis. Further investigations are needed to substantiate these findings. Triggering receptor expressed on myeloid cells-1 showed less valuable diagnostic role. © 2013 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

Bertino G.,University of Pavia | Degiorgi G.,University of Pavia | Tinelli C.,Biometric Unit | Cacciola S.,University of Pavia | And 2 more authors.
European Archives of Oto-Rhino-Laryngology | Year: 2015

The purpose of this study was to assess the validity of CO2 laser cordectomy in the treatment of early glottic cancer and to determine the impact of margin status on disease-free survival and of the operation on voice quality. This is a retrospective review of 169 patients. Quantitative and qualitative variables were statistically compared. The impact on overall and disease-free survivals of different variables was calculated by univariate and multivariate analyses. Ten-year overall and disease free-survivals were 75 % and 60 %, respectively. Age and clinical stage showed a significant negative impact on overall survival, while margin status both on overall and disease-free survivals. The degree of dysphonia was directly related to the extension of the resection. This series confirms the good oncologic and functional outcomes of laser surgery for Tis, T1 and selected T2 glottic tumors. Patients with positive margins should undergo a further treatment or a very close follow-up. © 2015, Springer-Verlag Berlin Heidelberg.

Ospina S.,Center for Research in Sustainable Agricultural Production Systems | Rusch G.M.,Norwegian Institute for Nature Research | Pezo D.,Tropical Agriculture Research and Higher Education Center | Casanoves F.,Biometric Unit | And 2 more authors.
PLoS ONE | Year: 2012

In the Neotropics the predominant pathway to intensify productivity is generally thought to be to convert grasslands to sown pastures, mostly in monoculture. This article examines how above-ground net primary productivity (ANPP) in semi-natural grasslands and sown pastures in Central America respond to rainfall by: (i) assessing the relationships between ANPP and accumulated rainfall and indices of rainfall distribution, (ii) evaluating the variability of ANPP between and within seasons, and (iii) estimating the temporal stability of ANPP. We conducted sequential biomass harvests during 12 periods of 22 days and related those to rainfall. There were significant relationships between ANPP and cumulative rainfall in 22-day periods for both vegetation types and a model including a linear and quadratic term explained 74% of the variation in the data. There was also a significant correlation between ANPP and the number of rainfall events for both vegetation types. Sown pastures had higher ANPP increments per unit rainfall and higher ANPP at the peak of the rainy season than semi-natural grasslands. In contrast, semi-natural grasslands showed higher ANPP early in the dry season. The temporal stability of ANPP was higher in semi-natural grasslands than in the sown pastures in the dry season and over a whole annual cycle. Our results reveal that, contrary to conventional thinking amongst pasture scientists, there appears to be no increase in ANPP arising from replacing semi-natural grasslands with sown pastures under prevailing pasture management practices in seasonally dry climates, while the temporal distribution of ANPP is more even in semi-natural grasslands. Neither sown pastures nor semi-natural grasslands are productive towards the end of the dry season, indicating the potential importance of the widespread practice of retaining tree cover in pastures. © 2012 Ospina et al.

Perrotti P.,Chirurgia Gastroenterologica | Dominici P.,Bracco S.p.A | Grossi E.,Bracco S.p.A | Cerutti R.,Biometric Unit | Antropoli C.,Chirurgla Colonproctologica
Canadian Journal of Surgery | Year: 2010

Background: Spasm through die internal anal sphincter is one of die supposed causes for pain after hemorrhoidectomy, a common and distressing experience. We hypothesized that the addition of topical nifedipine to lidocaine would improve pain control by causing a relaxation of the smooth muscle of the internal anal sphincter. Methods: We conducted a multicentre randomized, double-blind trial to compare the efficacy of 0.3% nifedipine and 1.5% lidocaine ointment versus 1.5% lidocaine ointment alone in reducing pain after hemorrhoidectomy. A physician unaware of the treatment arm measured pain by use of the Analogue Chromatic Continuous Scale (ACCS) at baseline; soon after surgery; at 2, 4, 6, 8 and 24 hours after surgery; on day 7 after surgery; and at a final visit 14 days after surgery. The physician also noted die time to first analgesic administration within 24 hours after surgery. Results: In all, 135 patients per group participated (270 total). Evaluation of die delta ACCS score versus basal value, a covariate for rescue analgesic administration time, revealed better pain control in the group that received nifedipine with lidocaine at 6 hours after surgery and on day 7 (p < 0.011 and p < 0.054, respectively). We noticed no difference between groups for time of administration of rescue analgesic, blood pressure, heart rate or frequency of headache. Conclusion: Although there was no difference between groups for time of administration of rescue analgesic after open hemorrhoidectomy, the patients' assessment of pain using ACCS showed that the use of topical nifedipine with lidocaine may provide a slight significant difference in favour of the study group at 6 hours and at day 7 after surgery. Narcotic analgesics and nonsteroidal anti-inflammatory drug administration should continue to be recommended. Furdier research focusing on diese outcomes is warranted. © 2010 Canadian Medical Association.

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