Role of interventional radiology in pudendal neuralgia: A description of techniques and review of the literature [Ruolo della radiologia interventistica nella nevralgia del nervo pudendo: Descrizione della tecnica e revisione della letteratura]

Purpose: The authors sought to evaluate indications, technical feasibility and clinical efficacy of computed tomography (CT)-guided pudendal nerve infiltration in patients with chronic anoperineal pain by reviewing the role of the CT technique in their personal experience and in the recent interventional literature. Materials and methods: Twenty-eight women, mean age 50 years, and with a diagnosis of pudendal neuralgia on the basis of clinical and electromyographic criteria were enrolled in the study. CT-guided pudendal nerve injections were performed during three consecutive sessions held 2 weeks apart. In each session, patients received two percutaneous injections: one in the ischial spine, and the other in the pudendal (Alcock's) canal. Results: One patient dropped out of the study after the first session. At clinical assessment, 24h h after treatment, 21/27 patients reported significant pain relief. At follow-up at 3, 6, 9 and 12 months, 24/27 patients reported a ≥ 20% improvement in the Quality of Life (QOL) index. Conclusions. In pudendal nerve entrapment, CT-guided perineural injection in the anatomical sites of nerve impingement is a safe and reproducible treatment with a clinical efficacy of 92% at 12 months. © 2009 Springer-Verlag Italia

Multiparameter characterisation of vertebral osteoporosis with 3-T MR = Valutazione multiparametrica dell’osteoporosi vertebrale con RM a 3 Tesla

Purpose. This study was undertaken to evaluate the diagnostic capabilities of 3-Tesla (T) magnetic resonance (MR) in vertebral osteoporosis. Materials and methods. Thirty subjects (ten healthy controls, ten with osteoporosis but no fracture, ten with osteoporotic vertebral fractures) underwent MR of the lumbar spine. Turbo spin echo (TSE) T1-, T2- and T2- spectral selection attenuated inversion recovery (SPAIR) weighted imaging and spectroscopy for the selective evaluation of water and fat content were performed. The apparent diffusion coefficient (ADC) was calculated, and diffusion tensor imaging (DTI) was performed to create a map of the spatial arrangement of the tissue structures. Results. Morphological imaging detected recent vertebral fractures. In osteoporotic patients, spectroscopic imaging demonstrated an increase in the saturated fats and a decrease in the ADC, whereas the data provided by DTI demonstrated a bone structure with medium-degree anisotropy. Discussion. Osteoporosis is characterised by trabecular thinning, with an increase in the intertrabecular spaces, which are filled with fats. The anisotropic study and the subsequent assessment of colour and vector maps can provide a noninvasive tool for assessing the risk of fracture due to osteoporosis

The Magnetic Spin Ladder (C_{5}H_{12}N)_{2}CuBr_{4}: High Field Magnetization and Scaling Near Quantum Criticality

The magnetization, $M(H \leq 30$ T, 0.7 K $\leq T \leq 300$ K), from single crystals and powder samples of (C$_{5}$H$_{12}$N)$_{2}$CuBr$_{4}$ has been used to identify this system as an $S=1/2$ Heisenberg two-leg ladder in the strong coupling limit, $J_{\perp} = 13.3$ K and $J_{\parallel} = 3.8$ K, with $H_{c1} = 6.6$ T and $H_{c2} = 14.6$ T. An inflection point in $M(H, T = 0.7$ K) at half-saturation, $M_{s}/2$, is described by an effective \emph{XXZ} chain. The data exhibit universal scaling behavior in the vicinity of $H_{c1}$ and $H_{c2}$, indicating the system is near a quantum critical point.Comment: 4 pages, 4 figure

Enabling technologies for the in-house monitoring of vital signs in chronic patients

The in-house monitoring of vital signs represents a real opportunity to improve the effectiveness of the healthcare of chronic patients, integrating the traditional in-hospital healthcare model with a new out-of-hospital follow-up based on frequent monitoring of the clinical status. It allows clinicians and practitioners to realize and act promptly suspect aggravations, before they become irreversible and lead to hospitalization. This model relies on ICT, in particular biomedical sensors and concentrator devices (i.e. gateway) that enable to acquire vital signs at patient’s home and to transmit collected data in secure way, making them remotely available for medical personnel. This paper presents two gateway devices enabling the in-house monitoring of vital signs according to the kind and severity of the diseases, being the first conceived to be used by the patient while the second studied for professional caregivers. Moreover, it presents a novel sensor for the self-acquisition of the ECG signal

SHINe: Simulator for satellite on-board high-speed networks featuring SpaceFibre and SpaceWire protocols

The continuous innovation of satellite payloads is leading to an increasing demand of data-rate for on-board satellite networks. In particular, modern optical detectors generate and need to transfer data at more than 1 Gbps, a speed that cannot be satisfied with standardized technologies such as SpaceWire. To fill this gap, the European Space Agency (ESA) is supporting the development of a new high-speed link standard, SpaceFibre. SpaceFibre provides a data-rate higher than 6.25 Gbps, together with the possibility to use multiple Virtual Channels running over the same physical link, each one configurable with flexible Quality of Service parameters. These features make a SpaceFibre network very appealing but also complex to set up in order to achieve the desired end-to-end requirements. To help this process, a Simulator for HIgh-speed Network (SHINe) based on the open-source toolkit OMNeT++ has been developed and is presented in this paper. It supports the simulation of SpaceFibre and SpaceWire protocols in order to help both the final steps of the standardization process and the system engineers in the setup and test of new networks. SHINe allows to precisely simulate common network metrics, such as latency and bandwidth usage, and it can be connected to real hardware in a Hardware-in-the-Loop configuration

The association between retinal vascular geometry changes and diabetic retinopathy and their role in prediction of progression: an exploratory study

Background: The study describes the relationship of retinal vascular geometry (RVG) to severity of diabetic retinopathy (DR), and its predictive role for subsequent development of proliferative diabetic retinopathy (PDR). Methods. The research project comprises of two stages. Firstly, a comparative study of diabetic patients with different grades of DR. (No DR: Minimal non-proliferative DR: Severe non-proliferative DR: PDR) (10:10: 12: 19). Analysed RVG features including vascular widths and branching angles were compared between patient cohorts. A preliminary statistical model for determination of the retinopathy grade of patients, using these features, is presented. Secondly, in a longitudinal predictive study, RVG features were analysed for diabetic patients with progressive DR over 7 years. RVG at baseline was examined to determine risk for subsequent PDR development. Results: In the comparative study, increased DR severity was associated with gradual vascular dilatation (p = 0.000), and widening of the bifurcating angle (p = 0.000) with increase in smaller-child-vessel branching angle (p = 0.027). Type 2 diabetes and increased diabetes duration were associated with increased vascular width (p = <0.05 In the predictive study, at baseline, reduced small-child vascular width (OR = 0.73 (95 CI 0.58-0.92)), was predictive of future progression to PDR. Conclusions: The study findings suggest that RVG alterations can act as novel markers indicative of progression of DR severity and establishment of PDR. RVG may also have a potential predictive role in determining the risk of future retinopathy progression. © 2014 Habib et al.; licensee BioMed Central Ltd

Telemonitoring in the Covid-19 era: The tuscany region experience

Covid-19 has brought many difficulties in the management of infected and high-risk patients. Telemedicine platforms can really help in this situation, since they allow remotely monitoring Covid-19 patients, reducing the risk for the doctors, without decreasing the efficiency of the therapies and while alleviating patients’ mental issues. In this paper, we present the entire architecture and the experience of using the Tel.Te.Covid19 telemedicine platform. Projected for the treatment of chronic diseases, it has been technologically updated for the management of Covid-19 patients with the support of a group of doctors in the territory when the pandemic arrived, introducing new sensors and functionalities (e.g., the familiar use and video calls). In Tuscany (Central Italy), during the first wave of outbreak, a model for enrolling patients was created and tested. Because of the positive results, the latter has been then adopted in the second current wave. The Tel.Te.Covid19 platform has been used by 40 among general practitioners and doctors of continuity care and about 180 symptomatic patients since March 2020. Both patients and doctors have good opinion of the platform, and no hospitalisations or deaths occurred for the monitored patients, reducing also the impact on the National Healthcare System

Three-dimensional evaluation of masseter muscle in different vertical facial patterns: a cross-sectional study in growing children.

The aim of the present study was to analyze the anatomical three-dimensional (3D) characteristics of masseter muscle in growing subjects with different vertical patterns by using an ultrasound (US) method. The sample comprised 60 prepuberal subjects (33 males, 27 females) with a mean age of 11.5 ± 1.6 years with late mixed or permanent dentition and Class I molar and skeletal relationship. For each subject, a lateral cephalogram was required, and according to the mandibular plane angle (Frankfort horizontal plane/mandibular plane angle [FMA]), the subjects were divided into three groups of different underlying vertical facial patterns: brachyfacial: FMA &lt; 22°, mesofacial: 22° ≤ FMA ≤ 28°, and dolichofacial: FMA &gt; 28°. For each subject, an US scan was carried out to analyze the width, the thickness, the cross-sectional area, and the volume of the masseter muscle. Mean differences in measurements between vertical facial subgroups were contrasted by means of analysis of variance (ANOVA) with Tukey’s post hoc tests ( p &lt; 0.05). Measurements of the whole masseter in dolichofacial patients were significantly smaller when compared with brachyfacial and mesofacial individuals during relaxation and contraction. The volume of the masseter decreased significantly by 10% going from the brachyfacial group to the mesofacial group and from the mesofacial group to the dolichofacial group with no difference between the left and the right sides. A significant negative correlation was found between the US measurements and the divergency (FMA°). Ultrasound is a technique indicated in children for evaluating muscles of mastication in vivo. Growing patients with a dolichofacial vertical pattern present with a reduced dimension of the masseter when compared with brachyfacial and mesofacial subjects. </jats:p