Showing papers by "University of Siena published in 2002"

Immunosuppressive therapy in lupus nephritis: the Euro-Lupus Nephritis Trial, a randomized trial of low-dose versus high-dose intravenous cyclophosphamide.

Abstract: OBJECTIVE: Glomerulonephritis is a severe manifestation of systemic lupus erythematosus (SLE) that is usually treated with an extended course of intravenous (IV) cyclophosphamide (CYC). Given the side effects of this regimen, we evaluated the efficacy and the toxicity of a course of low-dose IV CYC prescribed as a remission-inducing treatment, followed by azathioprine (AZA) as a remission-maintaining treatment. METHODS: In this multicenter, prospective clinical trial (the Euro-Lupus Nephritis Trial [ELNT]), we randomly assigned 90 SLE patients with proliferative glomerulonephritis to a high-dose IV CYC regimen (6 monthly pulses and 2 quarterly pulses; doses increased according to the white blood cell count nadir) or a low-dose IV CYC regimen (6 fortnightly pulses at a fixed dose of 500 mg), each of which was followed by AZA. Intent-to-treat analyses were performed. RESULTS: Followup continued for a median of 41.3 months in the low-dose group and 41 months in the high-dose group. Sixteen percent of those in the low-dose group and 20% of those in the high-dose group experienced treatment failure (not statistically significant by Kaplan-Meier analysis). Levels of serum creatinine, albumin, C3, 24-hour urinary protein, and the disease activity scores significantly improved in both groups during the first year of followup. Renal remission was achieved in 71% of the low-dose group and 54% of the high-dose group (not statistically significant). Renal flares were noted in 27% of the low-dose group and 29% of the high-dose group. Although episodes of severe infection were more than twice as frequent in the high-dose group, the difference was not statistically significant. CONCLUSION: The data from the ELNT indicate that in European SLE patients with proliferative lupus nephritis, a remission-inducing regimen of low-dose IV CYC (cumulative dose 3 gm) followed by AZA achieves clinical results comparable to those obtained with a high-dose regimen.

Model predictive control based on linear programming - the explicit solution

Abstract: We study model predictive control (MPC) schemes for discrete-time linear time-invariant systems with constraints on inputs and states, that can be formulated using a linear program (LP). In particular, we focus our attention on performance criteria based on a mixed 1 -norm, namely, 1-norm with respect to time and -norm with respect to space. First we provide a method to compute the terminal weight so that closed-loop stability is achieved. We then show that the optimal control profile is a piecewise affine and continuous function of the initial state and briefly describe the algorithm to compute it. The piecewise affine form allows to eliminate online LP, as the computation associated with MPC becomes a simple function evaluation. Besides practical advantages, the availability of the explicit structure of the MPC controller provides an insight into the type of control action in different regions of the state space, and highlights possible conditions of degeneracies of the LP, such as multiple optima.

Imipenem-EDTA Disk Method for Differentiation of Metallo-β-Lactamase-Producing Clinical Isolates of Pseudomonas spp. and Acinetobacter spp.

Abstract: Rapid detection of metallo-β-lactamase (MBL)-producing gram-negative bacilli is necessary to prevent their dissemination. The method using a disk with imipenem plus 750 μg of EDTA differentiated all MBL-producing pseudomonads, and the sensitivity and specificity for acinetobacters were 95.7 and 91.0%, respectively. The imipenem-EDTA disks were stable for 12 and 16 weeks at 4 and −20°C, respectively.

Efficacy of Raloxifene on Vertebral Fracture Risk Reduction in Postmenopausal Women with Osteoporosis: Four-Year Results from a Randomized Clinical Trial

Abstract: The Multiple Outcomes of Raloxifene Evaluation trial studied 7705 postmenopausal women with osteoporosis randomized to placebo, or raloxifene 60 or 120 mg/d [JAMA 282(1999): 637]. This report assesses the efficacy of raloxifene on the long-term cumulative incidence new vertebral fractures through 4 yr. New vertebral fractures was assessed from radiographs taken at baseline, yr 2-4. The primary analysis was the cumulative incidence of new vertebral fractures through 4 yr. A posthoc analysis compared the vertebral fracture risk in yr 4 alone with that observed in the first 3 yr. The 4-yr cumulative relative risks (RR) for one or more new vertebral fractures were 0.64 [95% confidence interval (CI) 0.53, 0.76] with raloxifene 60 mg/d and 0.57 (95% CI 0.48, 0.69) with raloxifene 120 mg/d. In yr 4 alone, raloxifene 60 mg/d reduced the new vertebral fracture risk by 39% [RR 0.61 (95% CI 0.43, 0.88)], which was not found to be significantly different from the RR observed in the first 3 yr in both raloxifene groups, irrespective of prevalent fracture status. The nonvertebral fracture risk was not significantly reduced [RR 0.93 (95% CI 0.81, 1.06)]. The safety profile after 4 yr was similar to that observed after 3 yr. Raloxifene 60 and 120 mg/d through 4 yr decreased the cumulative risk of new vertebral fractures in postmenopausal women with osteoporosis. The decreased vertebral fracture risk in yr 4 alone was not different from that observed in the first 3 yr.

Growth in Transition: What We Know, What We Don't and What We Should

Abstract: This essay surveys macroeconomic issues that marked the transition from centrally planned to market economy in Central and Eastern European and former Soviet Union countries. We first establish a set of stylized facts of the transition so far, namely: (1) output fell, (2) capital shrank, (3) labor moved, (4) trade reoriented, (5) the structure changed, (6) institutions collapsed, and (7) transition costs. We then critically survey the theoretical literature on transition, discussing various explanations for the initial output fall as well as medium term issues, such as optimal speed of transition, disorganization, institutions and sectoral reallocation as a source of output dynamics. Last, we review the empirical literature to assess how well it translates the theoretical models and explains the stylized facts. The essay concludes with a succinct list of suggestions for future research.

A Comparison of U.S. and European University-Industry Relations in the Life Sciences

Abstract: We draw on diverse data sets to compare the institutional organization of upstream life science research across the United States and Europe. Understanding cross-national differences in the organization of innovative labor in the life sciences requires attention to the structure and evolution of biomedical networks involving public research organizations (universities, government laboratories, nonprofit research institutes, and research hospitals), science-based biotechnology firms, and multinational pharmaceutical corporations. We use network visualization methods and correspondence analyses to demonstrate that innovative research in biomedicine has its origins in regional clusters in the United States and in European nations. But the scientific and organizational composition of these regions varies in consequential ways. In the United States, public research organizations and small firms conduct R&D across multiple therapeutic areas and stages of the development process. Ties within and across these regions link small firms and diverse public institutions, contributing to the development of a robust national network. In contrast, the European story is one of regional specialization with a less diverse group of public research organizations working in a smaller number of therapeutic areas. European institutes develop local connections to small firms working on similar scientific problems, while cross-national linkages of European regional clusters typically involve large pharmaceutical corporations. We show that the roles of large and small firms differ in the United States and Europe, arguing that the greater heterogeneity of the U.S. system is based on much closer integration of basic science and clinical development.

Growth in transition: what we know , what we don't, and what we should

Abstract: This essay surveys macroeconomic issues that marked the transition from planned to market economy in Central and Eastern European and former Soviet Union countries. We first establish stylized facts of the transition so far. We then critically survey the theoretical literature on transition, discussing explanations for the initial output fall, and mediumterm issues such as optimal speed of transition, disorganization, institutions and sectoral reallocation as source of output dynamics. We review the empirical literature to assess how well it translates the theoretical models and explains the stylized facts. We conclude with suggestions for future research.

Mutations of the Selenoprotein N Gene, Which Is Implicated in Rigid Spine Muscular Dystrophy, Cause the Classical Phenotype of Multiminicore Disease: Reassessing the Nosology of Early-Onset Myopathies

Abstract: Multiminicore disease (MmD) is an autosomal recessive congenital myopathy characterized by the presence of multiple, short core lesions (known as "minicores") in most muscle fibers. MmD is a clinically heterogeneous condition, in which four subgroups have been distinguished. Homozygous RYR1 mutations have been recently identified in the moderate form of MmD with hand involvement. The genes responsible for the three other forms (including the most prevalent phenotype, termed the "classical" phenotype) remained, so far, unknown. To further characterize the genetic basis of MmD, we analyzed a series of 62 patients through a combined positional/candidate-gene approach. On the basis of clinical and morphological data, we suspected a relationship between classical MmD and the selenoprotein N gene (SEPN1), which is located on chromosome 1p36 (RSMD1 locus) and is responsible for the congenital muscular dystrophy with rigid spine syndrome (RSMD). A genomewide screening, followed by the analysis of 1p36 microsatellite markers in 27 informative families with MmD, demonstrated linkage to RSMD1 in eight families. All showed an axial myopathy with scoliosis and respiratory failure, consistent with the most severe end of the classical MmD spectrum; spinal rigidity was evident in some, but not all, patients. We excluded linkage to RSMD1 in 19 families with MmD, including 9 with classical MmD. Screening of SEPN1 in the 8 families that showed linkage and in 14 patients with classical sporadic disease disclosed 9 mutations affecting 17 patients (12 families); 6 were novel mutations, and 3 had been described in patients with RSMD. Analysis of three deltoid biopsy specimens from patients with typical RSMD revealed a wide myopathological variability, ranging from a dystrophic to a congenital myopathy pattern. A variable proportion of minicores was found in all the samples. The present study represents the first identification of a gene responsible for classical MmD, demonstrates its genetic heterogeneity, and reassesses the nosological boundaries between MmD and RSMD.

Ultrafast Decay of Electronically Excited Singlet Cytosine via a π,π* to nO,π* State Switch

Abstract: Singlet fluorescence lifetimes of adenosine, cytidine, guanosine, and thymidine, determined by femtosecond pump−probe spectroscopy (Pecourt, J.-M. L.; Peon, J.; Kohler, B. J. Am. Chem. Soc. 2000, 122, 9348. Pecourt, J.-M. L.; Peon, J.; Kohler, B. J. Am. Chem. Soc. 2001, 123, 10370), show that the excited states produced by 263 nm light in these nucleosides decay in the subpicosecond range (290−720 fs). Ultrafast radiationless decay to the ground state greatly reduces the probability of photochemical damage. In this work we present a theoretical study of isolated cytosine, the chromophore of cytidine. The experimental lifetime of 720 fs indicates that there must be an ultrafast decay channel for this species. We have documented the possible decay channels and approximate energetics, using a valence-bond derived analysis to rationalize the structural details of the paths. The mechanism favored by our calculations and the experimental data involves (1) a two-mode decay coordinate composed of initial bond len...

Three-year clinical comparison of survival of endodontically treated teeth restored with either full cast coverage or with direct composite restoration.

Abstract: Statement of problem Little information exists regarding the outcome of crown build-ups on endodontically treated teeth restored with metal-ceramic crowns or with only a direct-placed composite. Purpose The aim of this study was to evaluate the clinical success rate of endodontically treated premolars restored with fiber posts and direct composite restorations and compare that treatment with a similar treatment of full-coverage with metal-ceramic crowns. Material and methods Subjects included in this study had one maxillary or mandibular premolar for which endodontic treatment and crown build up was indicated and met specific inclusion/exclusion criteria. Only premolars with Class II carious lesions and preserved cusp structure were included. Subjects were randomly assigned to 1 of the following 2 experimental groups: (1) teeth endodontically treated and restored with adhesive techniques and composite or (2) teeth endodontically treated, restored with adhesive techniques and composite, and then restored with full-coverage metal-ceramic crowns. Sixty teeth were included in the first group and 57 in the second. All restorations were performed by one operator. Causes of failure were categorized as root fracture, post fracture, post decementation, clinical and/or radiographic evidence of marginal gap between tooth and restoration, and clinical and/or radiographic evidence of secondary caries contiguous with restoration margins. Subjects were examined for the listed clinical and radiographic causes of failure by 2 calibrated examiners at intervals of 1, 2, and 3 years. Exact 95% confidence intervals for the difference between the 2 experimental groups were calculated. Results At the 1-year recall, no failures were reported. The only failure modes observed at 2 and 3 years were decementations of posts and clinical and/or radiographic evidence of marginal gap between tooth and restoration. There was no difference in the failure frequencies of the 2 groups (95% confidence interval, -17.5 to 12.6). There was no difference between the number of failures caused by post decementations and the presence of marginal gaps observed in the 2 groups (95% confidence intervals, -9.7 to 16.2 and -17.8 to 9.27). Conclusion Within the limitations of this study, the results upheld the research hypothesis that the clinical success rates of endodontically treated premolars restored with fiber posts and direct composite restorations after 3 years of service were equivalent to a similar treatment of full coverage with metal-ceramic crowns.

Blood Glutathione Disulfide: In Vivo Factor or in Vitro Artifact?

Abstract: Background: The reported mean concentration of glutathione disulfide (GSSG) in human blood/erythrocytes varies widely (1 to >500 μmol/L), as does that of reduced glutathione (GSH) to a lesser extent. We have identified and investigated possible pitfalls in measurement of both GSH and GSSG. Methods: We measured GSH and GSSG using a spectrophotometer with a modification of the GSH recycling method; the same samples were also measured by reversed-phase HPLC after derivatization of thiols (dithiothreitol was used to reduce disulfides) with monobromobimane. The thiol-bimane adduct was measured by a fluorescence detector. Results: Measured GSH/GSSG concentrations were affected by the following: ( a ) oxidation of thiols in acidified samples; ( b ) oxidation after restoring neutral-alkaline pH; ( c ) oxidation during acid deproteinization; ( d ) shift in the GSH/GSSG equilibrium because of irreversible blocking of free thiols; and ( e ) reaction of electrophiles with amino groups. In particular, oxidation during sample deproteinization with acid influenced and produced artifacts (30–150 μmol/L GSSG was produced by this procedure); this phenomenon was directly correlated with the presence of oxygenated hemoglobin, being minimized by both oxygen deprivation and incubation in an atmosphere of 5% carbon monoxide. Conclusions: GSSG is present in healthy human blood at low concentrations (2–6 μmol/L), and most published data on GSSG may be affected by artifacts.

Uterine and fetal cerebral Doppler predict the outcome of third‐trimester small‐for‐gestational age fetuses with normal umbilical artery Doppler

Abstract: Objective To assess the value of different admission tests in predicting the outcome of small-for-gestational age (SGA) fetuses with normal Doppler waveforms in the umbilical artery. Methods Criteria for admission into this retrospective study included: singleton pregnancy with a birth weight < 10th centile; absence of severe maternal complications; no evidence of fetal anomalies on the sonogram; normal umbilical artery Doppler; and availability of complete follow-up. At the first antenatal sonogram classifying the fetus as SGA, Doppler analysis of the uterine and middle cerebral arteries was performed and amniotic fluid volume was assessed. Outcome variables included adverse perinatal outcome (perinatal death, severe morbidity) and emergency Cesarean section for fetal distress. Results Two hundred and thirty-one pregnancies were included in the study. The mean ± standard deriation birth weight and gestational age at delivery were 2222 ± 502 g and 37.3 ± 2.9 weeks, respectively. In 37 cases (16%), an emergency Cesarean section was performed. There was one intrauterine death and three fetuses delivered by emergency Cesarean section developed severe morbidity. Logistic regression demonstrated that abnormal velocimetry of the uterine arteries and fetal middle cerebral artery were independently correlated with the occurrence of Cesarean section. Conclusions SGA fetuses with normal umbilical artery Doppler waveforms and abnormal uterine arteries and fetal middle cerebral artery waveforms have an increased risk of developing distress and being delivered by emergency Cesarean section. Particularly when both uterine and fetal cerebral waveforms are altered at the same time, the risk is exceedingly high (86%) and delivery as soon as fetal maturity is achieved seems advisable. On the other hand, when both vessels have normal waveforms, the chances of fetal distress are small (4%) and expectant management is the most reasonable choice.

A proof of standard completeness for Esteva and Godo's logic MTL

Abstract: In the present paper we show that any at most countable linearly-ordered commutative residuated lattice can be embedded into a commutative residuated lattice on the real unit interval [0, 1] We use this result to show that Esteva and Godo's logic MTL is complete with respect to interpretations into commutative residuated lattices on [0, 1] This solves an open problem raised in

Seizures after Spontaneous Supratentorial Intracerebral Hemorrhage

Abstract: Summary: Purpose: To characterize seizures after intracerebral hemorrhage (ICH), evaluating the risk of occurrence and relapse, predisposing factors, and prognostic significance, and to assess the utility of antiepileptic drug (AED) therapy as used in clinical practice. Methods: The study sample consisted of 761 patients with spontaneous, nonaneurysmal, supratentorial ICH. Seizures were classified as immediate (within 24 h of ICH) and early (within 30 days of ICH). Baseline variables and clinical events were compared in the seizure and nonseizure group by using a multivariate regression model of failure time data. Results: Fifty-seven patients had one or more seizures. The 30-day actuarial risk of a post-ICH seizure was 8.1%. Lobar location and small volume of ICH were independent predictors of immediate seizures. Early seizures were associated with lobar location and neurologic complications, mainly rebleeding. In patients with lobar ICH, the risk of early seizures was reduced by prophylactic AED therapy. Among seizure patients, history of alcohol abuse increased the risk of status epilepticus. Immediate and early seizures were not independent predictors of in-hospital mortality. Conclusions: Patients with ICH are exposed to a substantial risk of seizures; however, short-term mortality was not affected, and the risk of epilepsy was lower than previously thought. The likelihood of immediate seizures is influenced by factors that are inherent characteristics of ICH, whereas the chance of developing early seizures is influenced not only by certain characteristics of ICH, but also by unpredictable events. A brief period of therapy soon after ICH onset may reduce the risk of early seizures in patients with lobar hemorrhage. Key Words: Intracerebral hemorrhage—Stroke—Seizures—Status epilepticus—Epilepsy. Seizures as a clinical feature of intracerebral hemorrhage (ICH) have not been fully investigated. Little is known about the frequency, temporal distribution, and characteristics of seizures, and even less about factors predisposing to seizures and their prognostic significance for short-term mortality and risk of epilepsy. Major aspects have often been ignored, including the fact that delayed post-ICH seizures may have different predisposing factors from onset seizures, that the number of patients at risk for seizure varies in time, and that many predisposing factors may act synergistically in time to cause seizures. In this study the occurrence of seizures in patients with computed tomography (CT)-proven supratentorial nontraumatic nonaneurysmal ICH was analyzed by using multivariate analyses to determine the risk of developing initial and recurrent seizures, to identify predisposing factors for onset and delayed seizures, to evaluate the impact of seizures on outcome, and to assess the value of prophylactic antiepileptic drug (AED) therapy as used in clinical practice.

Incidence of limb fracture across Europe: Results from the European prospective osteoporosis study (EPOS)

Abstract: The aim of this population-based prospective study was to determine the incidence of limb fracture by site and gender in different regions of Europe. Men and women aged 50-79 years were recruited from population registers in 31 European centers. Subjects were invited to attend for an interviewer-administered questionnaire and lateral spinal radiographs. Subjects were subsequently followed up using an annual postal questionnaire which included questions concerning the occurrence of new fractures. Self-reported fractures were confirmed where possible by radiograph, attending physician or subject interview. There were 6451 men and 6936 women followed for a median of 3.0 years. During this time there were 140 incident limb fractures in men and 391 in women. The age-adjusted incidence of any limb fracture was 7.3/1000 person-years [pyrs] in men and 19 per 1000 pyrs in women, equivalent to a 2.5 times excess in women. Among women, the incidence of hip, humerus and distal forearm fracture, though not 'other' limb fracture, increased with age, while in men only the incidence of hip and humerus fracture increased with age. Among women, there was evidence of significant variation in the occurrence of hip, distal forearm and humerus fractures across Europe, with incidence rates higher in Scandinavia than in other European regions, though for distal forearm fracture the incidence in east Europe was similar to that observed in Scandinavia. Among men, there was no evidence of significant geographic variation in the occurrence of these fractures. This is the first large population-based study to characterize the incidence of limb fracture in men and women over 50 years of age across Europe. There are substantial differences in the descriptive epidemiology of limb fracture by region and gender.

Oxidative Stress in Preterm Neonates at Birth and on the Seventh Day of Life

Abstract: Previous studies have demonstrated increased oxidative damage to proteins and increased lipid peroxidation products in the plasma of hypoxic newborns at birth. We tested the hypothesis that hypoxic preterm newborns are at increased risk for oxidative stress in the first week of life. Heparinized blood samples of 34 hypoxic and 15 control preterm newborns were obtained at birth from the umbilical vein immediately after delivery and from a peripheral vein on postnatal d 7. Plasma levels of hypoxanthine, total hydroperoxide (TH), and advanced oxidation protein products (AOPP) were measured in cord blood and blood drawn on d 7. Hypoxanthine, TH, and AOPP levels were significantly higher in cord and d 7 blood samples of hypoxic newborn than control infants. Statistically significant correlations were observed between AOPP and hypoxanthine and between AOPP and TH plasma levels on d 7. AOPP and TH plasma levels significantly increased from cord to d 7 blood in neonates without hypoxia. These findings show that the oxidative stress observed in cord blood of hypoxic preterm newborns is still higher than control infants on d 7. The significant increase in TH and AOPP levels in nonhypoxic preterm newborns at the end of the first postnatal week indicates that damage caused by free radicals also occurs in nonhypoxic babies with normal clinical course. In summary, TH and AOPP production is prolonged for several days after birth in hypoxic preterm babies. The risk of free radical damage is lower but still exists in preterm neonates with normal clinical course.

Hodgkin's lymphoma: the pathologist's viewpoint

Abstract: Despite its well known histological and clinical features, Hodgkin's lymphoma (HL) has recently been the object of intense research activity, leading to a better understanding of its phenotype, molecular characteristics, histogenesis, and possible mechanisms of lymphomagenesis. There is complete consensus on the B cell derivation of the tumour in most cases, and on the relevance of Epstein-Barr virus infection and defective cytokinesis in at least a proportion of patients. The REAL/WHO classification recognises a basic distinction between lymphocyte predominance HL (LP-HL) and classic HL (CHL), reflecting the differences in clinical presentation and behaviour, morphology, phenotype, and molecular features. CHL has been classified into four subtypes: lymphocyte rich, nodular sclerosing, with mixed cellularity, and lymphocyte depleted. The borders between CHL and anaplastic large cell lymphoma have become sharper, whereas those between LP-HL and T cell rich B cell lymphoma remain ill defined. Treatments adjusted to the pathobiological characteristics of the tumour in at risk patients have been proposed and are on the way to being applied.

Association of Polymorphisms of the Estrogen Receptor α Gene With Bone Mineral Density and Fracture Risk in Women: A Meta‐Analysis

Abstract: The contribution of genetic polymorphisms to bone mineral density (BMD) and fracture risk in women is a controversial topic We evaluated the effect of the XbaI and PvuII polymorphisms of the estrogen receptor a to BMD and fracture risk in a meta-analysis, including published data and additional information from investigators Five thousand eight hundred thirty-four women from 30 study groups were analyzed with fixed and random effects models The PvuII polymorphism was not associated with BMD at any skeletal site examined and 95% CIs exclude effects over 0015 g/cm2 for both the femoral neck and the lumbar spine Conversely, XX homozygotes (women carrying two copies of the gene variant without an XbaI restriction site) consistently had higher BMD than other subjects The magnitude of the effect was similar in the femoral neck and lumbar spine (0014 g/cm2 [95% CI, 0003-0025] and 0015 g/cm2 [95% CI, 0000-0030], respectively; no between-study heterogeneity for either) Total body BMD was also significantly higher in XX homozygotes (by 0039 g/cm2 and 0029 g/cm2 compared with Xx and xx, respectively) Available data on fractures suggested a protective effect for XX (odds ratio [OR], 066 [95% CI, 047-093] among 1591 women), but not PP (OR, 093 [95% CI, 072-118] among 2,229 women) In summary, we have found that XX homozygotes may have higher BMD and also a decreased risk of fractures when compared with carriers of the x allele, whereas the PvuII polymorphism is not associated with either BMD or fracture risk

Effects of perinatal exposure to bisphenol A on sociosexual behavior of female and male rats.

Abstract: Perinatal action of estrogens or aromatizable steroids at the central nervous system level is responsible for brain sexual differentiation. Through early contact with the central nervous system, the estrogenic compound bisphenol A (BPA) could alter the processes affecting sociosexual behavior. To test this hypothesis, we studied agonistic and sexual behavior of adult female and male rats whose mothers were administered BPA (40 microg/kg/day) during pregnancy or lactation. An intruder test revealed in males but not in females an increase in defensive behavior due to BPA. We studied the effect of BPA on sexual behavior by testing sexual orientation and sexual activity. Male sexual orientation toward a stimulus female was not affected by BPA, whereas the sexual activity test revealed a slight impairment of sexual performance due to BPA in terms of latency and frequency of intromissions. In females, BPA produced a small increase in sexual motivation and receptive behavior. In conclusion, BPA administration, both during pregnancy and during lactation, does not masculinize female behavior or potentiate masculinization processes of males. On the contrary, we observed a potentiation of female behavior in females and a depotentiation of male behavior in males.

Stability measurements of osseointegrated implants using Osstell in partially edentulous jaws after 1 year of loading: a pilot study.

Abstract: Background: The introduction of resonance frequency analysis (RFA) as a commercially available technique has made it possible to measure implant stability in implant stability quotient (ISQ) units at any time during the course of implant treatment and loading. However, no information on normal ISQ levels can be found in the literature. Purpose: The aim of this pilot study was to measure the stability of clinically successful implants in partially edentulous patients after 1 year of loading and to study the influence of jaw, anterior/posterior position, implant length, and marginal bone level on implant stability. Materials and Methods: Fourteen partially edentulous patients previously treated with 45 implants were subjected to clinical and radiographie evaluations and RFA measurements using Osstell (Integration Diagnostics, Savedalen, Sweden) after 1 year of loading. Results: All 45 implants were stable, and implant stability levels were in the range of 57 to 82 ISQ units with a mean of 69 ± 6.5 ISQ after 1 year of loading. Mandibular implants were more stable than were maxillary ones. There were no differences between anterior and posterior implants. No correlation could be found between implant length and stability. Only minor marginal bone resorption was observed. Conclusions: The results from this limited material showed that successfully integrated implants have ISQ levels from 57 to 82 ISQ with a mean of 69 ISQ after 1 year of loading. Mandibular implants are more stable than are maxillary ones. High implant stability can be achieved with short implants and placement in posterior regions.

Automated diagnosis of pigmented skin lesions.

Abstract: Since advanced melanoma remains practically incurable, early detection is an important step toward a reduction in mortality. High expectations are entertained for a technique known as dermoscopy or epiluminescence light microscopy; however, evaluation of pigmented skin lesions by this method is often extremely complex and subjective. To obviate the problem of qualitative interpretation, methods based on mathematical analysis of pigmented skin lesions, such as digital dermoscopy analysis, have been developed. In the present study, we used a digital dermoscopy analyzer (DBDermo-Mips system) to evaluate a series of 588 excised, clinically atypical, flat pigmented skin lesions (371 benign, 217 malignant). The analyzer evaluated 48 parameters grouped into 4 categories (geometries, colors, textures and islands of color), which were used to train an artificial neural network. To evaluate the diagnostic performance of the neural network and to check it during the training process, we used the error area over the receiver operating characteristic curve. The discriminating power of the digital dermoscopy analyzer plus artificial neural network was compared with histologic diagnosis. A feature selection procedure indicated that as few as 13 of the variables were sufficient to discriminate the 2 groups of lesions, and this also ensured high generalization power. The artificial neural network designed with these variables enabled a diagnostic accuracy of about 94%. In conclusion, the good diagnostic performance and high speed in reading and analyzing lesions (real time) of our method constitute an important step in the direction of automated diagnosis of pigmented skin lesions.