Academic literature on the topic 'Alta correlazione'

Invasive cervical resorption is a relatively un common form of external root resorption which has been a source of interest and academic debate by clinicians and researches for over a century. Tooth resorption is a condition associated with either a physiological or a pathological process resulting in loss of dentin, cementum or bone (1,2). This condition has been variously labeled, but because of its invasive nature of the term seems more appropriate to invasive cervical resorption. Although the etiology of this conditions remains obscure, knowledge of potential predisposing factors is important in assessing patients at risk. It is seen in most cases a late complication of traumatic injuries of teeth, but it may also occur after orthodontic movement, tooth bleaching, scaling, chronic inflammation of the pulp and periodontal tissue, root planing and a wide variety of traumatic conditions. The diagnosis of resorption into internal and external resorption is usually based on clinico-radiographic finding, internal resorption is comparatively more destructive and results in loss of tooth structure without the deposition of any hard tissue. It is most commonly found in the cervical region, and clinically presents asymptomatically. Usually, the coronal pulp is necrotic, the resorptive defect creates a clinically obvious pinkish color (“pink spot”) in the crown. The same resorptive process can occur in other tooth locations: in erupting teeth in may arise trough an enamel defect in the tooth crown and may be termed invasive coronal resorption, while a more apical source may be termed invasive radicular resorption. In root canal that leads to resorption of the aetiology is not known for which it was defined by the term idiopathic. Radiographically the lesion presents as a circumscribed in continuous expansion. Invasive cervical resorption has and continues to be misdiagnosed as a form of internal resorption, a misunderstanding that could possibly be attributed to the descriptions of internal resorption by Gaskill in 1984 and by Mummery in 1920 which included teeth showing “pink spot”. Currently, the etiology of invasive cervical resorption is poorly understood and this may explain some of the diversity in terminology. A basic question to be answered by researches is whether this process is purely inflammatory in nature, more probably activated by sulcural microorganisms, o alternatively a type of benign proliferative fibrovascular or fibro-osseus disorder in which microorganisms play a secondary role as an invading pathogen as demonstrated by studies of recently acquired. The classification in the diagram below shows the types of dental resorption in the regions.

Background: i disturbi temporomandibolari (TMD) rappresentano un gruppo di patologie che colpisce l’articolazione temporomandibolare (ATM) e le strutture associate.Il trattamento riabilitativo conservativo rappresenta il primo step per la gestione di questi disturbi, prima di considerare l'intervento chirurgico. Tuttavia, non sono presenti linee guida né consensi sulle strategie di intervento più efficaci. Obiettivo: Valutare lo stato dell’arte riguardo al trattamento riabilitativo dei TMD con un intervento sul rachide cervicale e la sua efficacia. A tal fine è stata condotta una ricerca che prendesse in considerazione questa tipologia di intervento, sia singolarmente sia in associazione ad altri interventi.
 Materiali e Metodi: la ricerca è stata effettuata nelle principali banche dati (PubMed, PEDro e The Cochrane Library). Sono stati inclusi gli studi clinici randomizzati (RCT) in cui fosse descritto il trattamento riabilitativo conservativo con intervento sul rachide cervicale e i risultati relativi, escludendo tutti gli studi in cui il trattamento descritto fosse unicamente di tipo farmacologico o chirurgico. Risultati:sono stati identificati ed analizzati 6 studi che rispettavano i criteri di inclusione riguardanti il quesito di ricerca. I risultati hanno mostrato diverse evidenze a supporto di questa tipologia di intervento, sia per l’ efficacia clinica sia la riduzione dei segni e sintomi dei disturbi TMD. Conclusioni: il trattamento riabilitativo conservativo risulta efficace nella maggior parte dei pazienti affetti da TMD. Gli articoli analizzati differiscono per quanto riguarda le strategie utilizzate, ma la mobilizzazione e la manipolazione della cervicale superiore sembrano essere l’intervento terapeutico più utilizzato ed affidabile.

To identify the regions of recurrent copy number abnormality in osteosarcoma and their effect on gene expression, we performed an integrated genome-wide high-resolution array CGH (aCGH) and gene expression profiling analysis on 40 human OS tissues and 12 OS cell lines. This analysis identified several recurrent chromosome regions that contain genes that show a gene dosage effect on gene expression. A further search, performed on those genes that were over-expressed and localized in the frequently amplified chromosomal regions, greatly reduced the number of candidate genes while their characterization using gene ontology (GO) analysis suggests the importance of the deregulation of the G1-to-S phase in the development of the disease. We also identified frequent deletions on 3q in the vicinity of LSAMP and performed a fine mapping analysis of the breakpoints. We precisely mapped the breakpoints in several instances and demonstrated that the majority do not involve the LSAMP gene itself, and that they appear to form by a process of non-homologous end joining. In addition, aCGH analysis revealed frequent gains of IGF1R that were highly correlated with its protein level. Blockade of IGF1R in OS cell lines with high copy number gain led to growth inhibition suggesting that IGF1R may be a viable drug target in OS, particularly in patients with copy number driven overexpression of this receptor.

To identify the regions of recurrent copy number abnormality in osteosarcoma and their effect on gene expression, we performed an integrated genome-wide high-resolution array CGH (aCGH) and gene expression profiling analysis on 40 human OS tissues and 12 OS cell lines. This analysis identified several recurrent chromosome regions that contain genes that show a gene dosage effect on gene expression. A further search, performed on those genes that were over-expressed and localized in the frequently amplified chromosomal regions, greatly reduced the number of candidate genes while their characterization using gene ontology (GO) analysis suggests the importance of the deregulation of the G1-to-S phase in the development of the disease. We also identified frequent deletions on 3q in the vicinity of LSAMP and performed a fine mapping analysis of the breakpoints. We precisely mapped the breakpoints in several instances and demonstrated that the majority do not involve the LSAMP gene itself, and that they appear to form by a process of non-homologous end joining. In addition, aCGH analysis revealed frequent gains of IGF1R that were highly correlated with its protein level. Blockade of IGF1R in OS cell lines with high copy number gain led to growth inhibition suggesting that IGF1R may be a viable drug target in OS, particularly in patients with copy number driven overexpression of this receptor.

Background: la Sindrome della Spinta è un quadro clinico conseguente a danno cerebrale destro o sinistro, a seguito del quale i soggetti spingono attivamente con il lato non paretico verso quello patologico, determinando la perdita dell’allineamento posturale sulla verticale mediana. Questi soggetti si oppongono a qualsiasi tentativo di correzione passiva della loro postura. La complessità dei sintomi che stanno alla base della Sindrome della Spinta comporta importanti ricadute sulla qualità della vita di questi soggetti e, di conseguenza, dei loro caregiver. Obiettivo: l’obiettivo di questa Scoping Review è quello di riassumere un corpus di conoscenze eterogeneo presente in Letteratura riguardo ai meccanismi neuropsicologici e agli aspetti neurofisiologici che stanno alla base della Sindrome della Spinta, al fine di fornire la conoscenza clinica necessaria per poter elaborare il programma di trattamento più efficace. Metodi: la ricerca è avvenuta consultando due banche dati online, PubMed e CINHAL, tramite una ricerca manuale bibliografica. Sono stati poi analizzati gli articoli pertinenti rispetto al quesito di partenza “Cosa ci dice la Letteratura in merito alle correlazioni tra la Sindrome della Spinta e gli aspetti clinici, neuropsicologici e neurofisiologici?”, prendendo in considerazione ogni tipologia di studio nella fascia temporale tra il 2010 e il 2021, senza imporre limiti di lingua Risultati: sono stati selezionati 12 articoli, di cui 4 revisioni narrative, 4 studi retrospettivi, 2 trial clinici, 1 studio prospettico e 1 case-report. Il processo di selezione degli articoli è stato riportato utilizzando un diagramma di flusso, mentre i contenuti dei singoli articoli sono stati schematizzati in una tabella sinottica. Conclusioni: dall’analisi attuale della Letteratura emerge come non sia una causa singola e specifica a determinare la Sindrome della Spinta, ma più fattori di tipo neurofisiologico, neuroanatomico e neuropsicologico.

La presente tesi si focalizza sullo studio della relazione tra la via di trasduzione del segnale dalla fosfolipasi C (PLC) β1 e la leucemogenesi, in una linea cellulare umana di Leucemia Mieloide Acuta (LAM) monocitica, identificando alcuni potenziali meccanismi epigenetici implicati nella proliferazione incontrollata dei blasti leucemici nella LAM MLL-AF9. Numerose evidenze sperimentali hanno ormai stabilito la presenza nel nucleo di fosfoinositidi (PIP) e degli enzimi che li regolano, che insieme partecipano a vie di segnalazione nucleari indipendenti rispetto a quelle citoplasmatiche. Fra questi enzimi nucleari, la PLCβ1 ricopre un ruolo importante nel controllare la proliferazione e il differenziamento cellulare. Recentemente, numerosi studi hanno inoltre dimostrato il potenziale ruolo dei PIP nucleari e dei loro enzimi regolatori nel controllo diretto dei fattori responsabili delle modificazioni dello stato della cromatina. Nel presente studio, abbiamo dimostrato che la PLCβ1 risulta essere coinvolta nella patogenesi della LAM, attraverso la sua interazione con l’enzima KDM4A, una demetilasi della lisina 9 dell’istone H3. La PLCβ1 regola positivamente l’espressione dei geni HOXA, responsabili della proliferazione neoplastica dei blasti leucemici, modulando l’attività di KDM4A. In particolare, la PLCβ1 favorisce la demetilazione dell’istone H3K9 sul promotore di questi geni, da parte di KDM4A e di conseguenza la trascrizione genica. Esperimenti di microarray hanno permesso di identificare un profilo di espressione genica comune tra i due enzimi, che sembrano partecipare a una via di segnalazione epigenetica comune. Complessivamente, i dati ottenuti mostrano l’esistenza di un meccanismo di controllo da parte dei fosfoinositidi innovativo all’interno della LAM, dimostrando una loro implicazione nella patogenesi di questa malattia. Lo scopo, in futuro, è poter associare un inibitore per la PLCβ1 con nuove combinazioni di inibitori di fattori epigenetici che possano agire in sinergia per invertire questa trascrizione genica disregolata e quindi combattere la progressione del fenotipo leucemico.<br>The current thesis focuses on the study of the relationship between phospholipase C (PLC) β1 signaling and leukemogenesis, in a human Acute Myeloid Leukemia (AML) monocytic cell line, identifying some new potential epigenetic mechanism involved in the leukemic blasts unregulated proliferation in MLL-AF9 driven AML. Many experimental findings have now established the existence of the phosphoinositides (PIs) and of the enzymes responsible for their metabolism in the nucleus that together participate to nuclear signalling pathways, different and independent from the cytoplasmic counterpart. Among the enzymes of the inositol lipid cycle, PLCβ1 is a key enzyme in nuclear signal transduction, and it controls a wide range of cellular processes including proliferation and differentiation. Lately, many studies have also established the potential role of the nuclear PI and of their regulatory enzymes in the direct control of factors responsible for chromatin remodeling. In this study, we discovered that PLCβ1 is involved in AML pathogenesis, through its interaction with KDM4A, a H3K9 histone demethylases. PLCβ1 positively regulates the expression of HOXA genes, that are responsible for the neoplastic proliferation of the leukemic blasts, by the modulation of KDM4A activity. In particular, PLCβ1 increases the H3K9 KDM4A mediated demethylation, on the promoter of HOXA genes, resulting in the activation of gene transcription. Gene-array studies allowed to identify a common expression pattern between the two enzymes, that seems to participate to a common epigenetic signalling pathway. Overall, this data shows the existence of an innovative control mechanism from phosphoinositides inside AML, which demonstrates their implication in the pathogenesis of this disease. The future aim is to associate a PLCβ1 specific inhibitor into a new combination of epigenetic factor inhibitor to act in synergy to fight the leukemic phenotype progression.

Contesto: l’efficacia dell’intervento fisioterapico dipende in parte dall’uso di scale di valutazione valide ed affidabili che possano documentare i cambiamenti e i risultati clinicamente rilevanti. Disegno di studio: studio prospettico longitudinale monocentrico. Obiettivo: valutazione della correlazione tra controllo del tronco (TLC e TCTSCI) e grado di autonomia (SCIM III). Soggetti dello studio: 39 soggetti di entrambi i sessi e diversa età con diagnosi di paraplegia completa motoria. Materiali e metodi: la classificazione neurologica della lesione spinale e del livello di completezza lesionale è avvenuta mediante la Classificazione ASIA e scala AIS. Per valutare il livello di autonomia raggiunta è stata utilizzata la parte sulla mobilità della scala SCIM, mentre per la valutazione funzionale del controllo del tronco sono state utilizzate la Thoracic-Lumbar Control Scale (TCL) e il Trunk Control Test for Spinal Cord Injury (TCTSCI). Le misurazioni sono avvenute dalla fase acuta (T0) al follow up di 18 mesi post dimissione (T3). Risultati: dall’analisi statistica risulta che i pazienti migliorano le proprie autonomie sia nel corso della degenza che dopo la dimissione; nella maggior parte dei casi però, a miglioramento della scala SCIM III non corrisponde un miglioramento nelle attività rappresentate dagli item delle scale di controllo del tronco. Conclusioni: le scale di valutazione del tronco utilizzate nella pratica clinica si sono dimostrate utili per la valutazione acuta ma non sono risultate sensibili ad alcun miglioramento nel controllo del tronco nel follow-up per le persone con paraplegia completa. Per questo si è cominciato a pensare alla possibilità di introdurre l’utilizzo di sensori inerziali indossabili come valida alternativa in grado di fornire risultati più validi ed oggettivi.

Introduzione: questa tesi è inserita all’interno di uno studio osservazionale che ha l’obiettivo di valutare il rischio di caduta in persone colpite da ictus tramite un sensore inerziale indossato durante l’esecuzione di 5 test funzionali. Sono state analizzate le correlazioni statisticamente significative fra i parametri strumentali del TUG e gli indici clinico-funzionali e si è realizzata un’analisi preliminare per individuare parametri predittivi e protettivi del rischio di caduta. Materiali e metodi: Il campione è costituito da 161 persone. I dati sono stati analizzati dal software Matlab e confrontati coi follow-up telefonici a 3, 6 e 12 mesi per valutare preliminarmente il rischio di caduta. Fra i parametri strumentali del TUG Test presi in esame ci sono 180° turn duration e turn-to-sit duration relativi al tempo impiegato per eseguire le svolte e Trunk mean pitch angle sit-to-walk e Trunk mean pitch angle walk relativi all’angolo di inclinazione anteriore del tronco durante la fase di alzata e di cammino. Risultati: Le correlazioni più forti e significative sono quelle fra alcuni parametri strumentali del TUG e le scale BIM e CIRS. Il cammino autonomo, la presenza di simmetria di forza fra i due arti inferiori e una patogenesi ischemica dell’ictus sono correlati con esecuzioni delle diverse fasi del test più performanti. I parametri 180° turn duration e turn-to-sit duration correlano con un maggior rischio di caduta mentre i parametri Trunk mean pitch angle sit-to-walk e Trunk mean pitch angle walk con un minor rischio di caduta. Conclusioni: I sensori inerziali rilevano parametri non visibili e compiono misurazioni dei movimenti più precise e oggettive di quanto si possa fare con la sola osservazione. Dalle analisi dei dati si potrebbe in futuro realizzare un’analisi precisa del rischio di caduta individuando i parametri predittivi e protettivi, definendo profili specifici per ogni soggetto e personalizzando le strategie di prevenzione e trattamento.

Bone disease in multiple myeloma (MM) patients is usually assessed by skeletal X-ray (XR) and magnetic resonance imaging (MRI) of the spine (MRIS). Diffusion-weighted MRI (DW-MRI) is an innovative whole-body MRI that detects malignant lesions studying water diffusion in tissues. This prospective study compared DW-MRI with XR and MRIS for the assessment of lytic bone lesions in MM patients. Patients had symptomatic MM at diagnosis (stage I-III Durie and Salmon [D&S]) requiring the first treatment, or MM at relapse before the start of the salvage treatment. An exploratory substudy enrolled asymptomatic patients with D&S stage I MM. The primary objective of the study was to assess whether DW-MRI could detect a higher number of lytic bone lesions than XR and MRIS. The secondary objectives were: to assess whether there was a correlation between the number of lesions and response to therapy; to assess whether the number of lesions could be correlated with progression; and, to assess whether the DW-MRI could detect more lesions than standard whole-body MRI (WB-MRI). The explorative objective of the substudy was to evaluate whether DW-MRI could detect more lytic bone lesions than standard imaging in asymptomatic MM patients. Along with clinical objectives, the study was aimed at correlating the data coming from the experimental imaging technique with the biologic characteristics of disease. Patients performed XR, MRIS, WB-MRI, and DW-MRI at diagnosis or at relapse, after the treatment and 6 months thereafter (symptomatic MM) or every 6 months for 1 year (asymptomatic MM). MRIS and DW-MRI were done in a single 45-minutes session by a standard 1.5 Tesla MRI scanner. DW-MRI consisted of multiple stacked axial EPI sequences at 4 b-values, evaluated by PET-like MIP and MPR reconstructions at the highest b-value (1000). Along with the radiology exams, patients performed at the same timepoints serological and histological evaluations of disease, including cytogenetics with FISH before starting treatment. The study enrolled 50 patients between 2008 and 2010, 36 of them in the main study, 14 in the substudy. Patients in the main study evaluable for the results were 35. Their median age was 65 years (range, 33-81), D&S stage was I for 48.6% of them, II for 5.7%, and III for 45.7%; ISS staging was I for 71.4% of patients. The 57.4% of patients had IgG, 25.7% had IgA MM, 8.6% had non-secerning and micromolecolar MM. 42.9% of patients were at diagnosis, 57.1% at relapse. Median bone marrow infiltration was 30%. FISH on selected CD138+ plasma cells was normal in 28.6% of patients; 42.9% of them had a del(13), 22.9% of them had t(11;14); 8.6% had t(4;14) and 5.7% del(17). Between the 1st and the 2nd exam, patients received a treatment including lenalidomide (35.3%), thalidomide (23.5%), or bortezomib (47.0%). 97% of patients received steroids (dexametasone or metilprednisone). 26.5% of patients received an autologous transplant, and 5.9% an allogeneic transplant. Response was as following: sCR 10.3%, VGPR 24.1%, PR 37.9%, SD 10.3%, PD 17.2%. At the 3rd radiology exam, the response status was: 8% sCR, 36% VGPR, 28% PR, 20% SD and 8% PD. At the first radiology exam, XR showed a median of 1 bones with focal lesions (range, 0-10). MRIS showed a median of 0 lesions (range, 0.0-4.0). The association of XR and MRIS (XR+MRIS) showed a median of 2 lesions (range, 0-10), WB-MRI a median of 2 lesions (range, 0-18, p=0.03), and DW-MRI a median of 5.8 lesions (range, 0-18, p<0.001). After the treatment, XR showed 1 lesion (range, 0-8), MRIS a median of 0 lesion (range, 0-5), and XR+MRIS a median of 1 lesion (range, 0-10). WB-MRI showed 0 lesions (range, 0-4, p=0.22), DW-MRI showed a median of 0 lesions (range, 0-14, p=0.29). At the 3rd exam, XR showed 0 lesions (range, 0-7), MRIS a median of 0 lesions (range, 0-3), and XR+MRIS a median of 1 lesions (range, 0-9). WB-MRI showed a median of 0 lesions (range, 0-11, p=0.40). DW-MRI showed a median of 1 lesions (range, 0-7, p=0.21). The average lesions observed by DW-MRI were more than WB-MRI in all the 3 exams performed (p=0.006, p=0.001, and p=0.002, respectively). The overall survival (OS) was 88.4% at 1 year, 79.3% at 2 years and 75.4% at 3 years (median not reached). Progression free survival (PFS) was 76.7% at 1 year, 61.9% at 2 years and 39.0% at 3 years (median, 30.1 months). Median time to progression was 16.7 months. Relapse free survival (RFS) was 81.8% at 1 year, 66.1% at 2 years and 44.4% at 3 years (median, 31.9 months). Cumulative indicence of relapse (RI) was 14.6% at 1 year, 32.2% at 2 years and 51.3% at 3 years. Non-relapse mortality was 2.8% at 6 months, 5.8% at 1 and 2 years, and 9.7% at 3 years of follow-up. Patients were compared according to the presence of <5 and >=5 lesions/patient detected by DW-MRI. OS was similar in these 2 groups (p=0.48), whereas patients with >=5 lesions had a worse PFS (p=0.018) and RFS (p=0.009), and a higher RI (p=0.002). After the treatment, patients is CR had a median of 0 lesions, those in VGPR 2 lesions, those in PR 3 lesions, and those in SD in PD 2 and 3 lesions, respectively. The average of lesions progressively rose from 0.7 (patients in CR) to 4.8 lesions (patients in PD). Standard methods showed a median of 0-2 lesions less than DW-MRI consistently with response. This association between response and DW-MRI was observed also in patients at the 3rd exam (0 lesions for patients in CR, 5 in patients in PD), with an increasing difference in detecting lesions according to disease status compared to the standard methods. The DW-MRI showed less lesions in the 2nd timepoint compared to the 1st timepoint (p=0.04), consistently with the fact that most patients responded to therapy, and remained stable between the 2nd and 3rd exam (p=0.21). The XR and XR+MRI remained the same during all the longitudinal 3 evaluations (p=1.0, p=0.12, and p=0.27, p=0.10, respectively). There was a trend for patients with IgA MM to have more lesions in DW-MRI (87.5% vs 50% of IgG MM, p=0.15). Patients with positive Bence-Jones had more lesions than those with negative BJ (60% vs 21.4%, p=0.06), and similarly those with positive urinary immunofixation (63.3% vs 30%, p=0.15). Freelite ratio was weakly correlated with the bone with lesions in DW-MRI (p=0.11, corr=0.29), but correlation increased considering the microscopic lesions detected by DW-MRI (corr=0.33, p=0.06). Patients at diagnosis had a 45.4% of lesions >=5 compared to 75.0% of those relapsed (p=0.21), and patients with D&S stage III had frequently >=5 lesions compared to lower stages (52.6% vs 37.5%). Patients with FISH at higher cytogetic risk (Mayo stratification) had more lesions compared to those at standard risk (73.6 vs 45.4%, p=0.24). There was a high correlation between the number of lesions showed by DW-MRI and LDH value before treatment (corr=0.44, p=0.008). Patients with high level of ICTP (>4.5) had >=5 lesions in DW-MRI. The substudy including asymptomatic patients showed a median of 0 lesions (range, 0-2) at XR, 0 at MRIS (range, 0-3), 1 lesion at XR+MRIS (range, 0-3), 0.5 lesions at WB-MRI (range, 0-6, p=0.81) and 2.5 lesions at DW-MRI (range, 0-8, p=0.04). After 6 and 12 months of follow-up the lesions were in median 0 for XR, MRIS and XR+MRIS, 0 for WB-MRI (p=0.67 and p=0.62), and 1.0 for DW-MRI at both timepoints (p=0.17 and p=0.22). In conclusion, DW-MRI was superior than standard radiological methods in detecting lytic bone lesions for symptomatic MM patients at diagnosis requiring treatment or at relapse. The number of lesions were correlated with PFS, RFS and RI. The lesions detected by the new technique correlated with response as categorized by IMWG criteria. The number of lesions were also correlated with LDH, and less strongly with Freelite ratio, Bence-Jones proteinuria or urinary immunofixation, high risk FISH, IgA isotype, relapsed disease. DW-MRI showed to be superior also in detecting lytic bone lesions in asymptomatic patients. The exams were feasible and well tolerated. DW-MRI is a new radiological method that is very promising in an highly specialized setting for the evaluation of bone lesions in MM.