University of Siena

About: University of Siena is a education organization based out in Siena, Italy. It is known for research contribution in the topics: Population & Cancer. The organization has 12179 authors who have published 33334 publications receiving 1008287 citations. The organization is also known as: Università degli studi di Siena & Universita degli studi di Siena.

Traditional and innovative echocardiographic parameters for the analysis of right ventricular performance in comparison with cardiac magnetic resonance

Abstract: Aims Right ventricle fractional area change (RVFAC), tissue Doppler and M-mode measurements of tricuspid systolic motion [tricuspid Sm and tricuspid annular plane systolic excursion (TAPSE)], and 3D echocardiography are the current non-invasive methods for the quantification of RV systolic function; RV deformation analysis by speckle-tracking echocardiography (STE) has recently allowed the analysis of RV performance. Using cardiac magnetic resonance (CMR) as the reference standard, this study aimed at exploring the correlation between the traditional (fractional shortening, s′RV, TAPSE) and innovative (strain) echocardiographic parameters and RV ejection fraction (RVEF) measured by CMR. Methods and results CMR and transthoracic echo-Doppler were performed in 63 patients referred for clinical assessment. Twenty-one presented the suspicion of myocarditis, 8 presented idiopathic dilated cardiomyopathy, 10 hypertrophic cardiomyopathy, 10 arrhythmogenic right ventricular dysplasia (ARVD), 5 infiltrative cardiomyopathy, and 9 other reasons. RVEF was measured by magnetic resonance imaging (MRI). RVFAC, tricuspid S′, and TAPSE were calculated in all patients. RV longitudinal strain (RVLS) by STE was assessed by averaging RV free-wall segments (free-wall RVLS) and by averaging all segments (global RVLS). The ROC analysis was applied for the assessment of diagnostic accuracy. Good correlations were found for TAPSE, tricuspid S′, and global RVLS with RVEF ( r = 0.45, r = 0.52, and r = −0.71, respectively; P = 0.01 for all). Close correlations between free-wall RVLS and RVFAC with RVEF were found ( r = −0.86 and r = 0.77, respectively; P < 0.0001 for both). Furthermore, free-wall RVLS demonstrated the highest diagnostic accuracy [area under curve (AUC) 0.92] and good sensitivity and specificity of 96 and 93%, respectively, to predict reduced RVEF <45%, using a cut-off value of less than −17.0%. Conclusion In a heterogeneous group of patients referred to CMR evaluation, conventional (TAPSE, FAC, and tricuspid S′) and novice (2D speckle-tracking-derived longitudinal strain) parameters of RV systolic function were compared and correlated with RVEF measured by MRI. All tested parameters were found to be independent predictors of reduced RVEF (<45%), but the strongest correlation was seen for the RV free-wall longitudinal strain.

Measurements of the angular distributions in the decays B→K(*)μ(+)μ(-) at CDF.

Abstract: We reconstruct the decays B → K(*) µ+µ- and measure their angular distributions in pp collisions at √s = 1.96 TeV using a data sample corresponding to an integrated luminosity of 6.8 fb-1. The transverse polarization asymmetry AT(2) and the time-reversal-odd charge-and-parity asymmetry Aim are measured for the first time, together with the K* longitudinal polarization fraction FL and the µ on forward-backward asymmetry AFB, for the decays B0→K*0µ+µ- and B0→K*+µ+µ-. Our results are among the most accurate to date and consistent with those from other experiments.

Inhalation technique and variables associated with misuse of conventional metered-dose inhalers and newer dry powder inhalers in experienced adults

Abstract: Background Pressurized metered-dose inhalers (pMDIs) are often poorly used, but little information is available concerning use of the newer dry powder inhalers (DPIs). Objective To estimate the inhalation technique and variables associated with the misuse of pMDIs and newer DPIs in clinical practice. Methods A multicenter, observational survey was used to evaluate the inhalation technique in 1,404 experienced outpatients aged 15 to 88 years affected mostly by asthma (47%) and chronic obstructive pulmonary disease (39%). A total of 1,056 patients were using pMDIs, 190 in conjunction with a large volume spacer (LVS); regarding DPIs, 230 patients were using the Aerolizer Inhaler, 524 were using the Turbuhaler, and 475 were using the Diskus. In each center, a trained observer recorded patients' inhalation techniques for each inhaler used against a standardized step-by-step checklist. Results Twenty-four percent and 3% of patients used pMDIs poorly, alone or with an add-on LVS, respectively. Failure to correctly perform essential steps for reliable lung delivery with the Aerolizer Inhaler, Turbuhaler, and Diskus was found in 17%, 23%, and 24% of patients, respectively. There was no difference in most variables correlated with poor inhalation between patients using pMDIs and those using DPIs. Conclusions The use of DPIs is associated with a similar percentage of inadequate inhalation technique as the use of pMDIs in clinical practice. The addition of an LVS to a pMDI and education from health care personnel, rather than simply changing inhalers, represent the best strategies for minimizing poor inhalation technique.

Treatment of hypertrophy of the inferior turbinate: long-term results in 382 patients randomly assigned to therapy.

Abstract: A number of surgical techniques are commonly performed to control the symptoms of inferior turbinate hypertrophy unresponsive to medical treatment. We report long-term results in 382 patients randomly assigned to receive electrocautery (62), cryotherapy (58), laser cautery (54), submucosal resection without lateral displacement (69), submucosal resection with lateral displacement (94), and turbinectomy (45). Outcomes of objective test results from rhinomanometry, acoustic rhinometry, mucociliary transport time, and secretory immunoglobulin A levels were compared to the symptom scores before and yearly after surgical treatment. These data indicate that submucosal resection with lateral displacement of the inferior turbinate results in the greatest increases in airflow and nasal respiratory function with the lowest risk of long-term complications.

Hormonal effects of flutamide in young women with polycystic ovary syndrome

Abstract: Anovulation in women with polycystic ovary syndrome (PCOS) is the direct effect of high local androgen concentrations on the ovary. Antiandrogens are substances that prevent androgens from expressing their activity on target tissues. Flutamide is a nonsteroid antiandrogen that has been found effective in hirsute patients, although its mechanism of action is unclear. Eight girls, ranging in age from 16–19 yr, with moderate to severe hirsutism and menstrual irregularities were enrolled in this study. The basal hormonal pattern showed anovulatory cycles; increased concentrations of LH, androstenedione, and testosterone; and increased LH/FSH ratio. A baseline ultrasound scan revealed polycystic ovaries in all patients. All were given 250 mg flutamide twice a day for 6 months. LH, FSH, androstenedione, testosterone, estradiol, and progesterone were evaluated before treatment, every 4 days during the third month of treatment, and on day 24 of the sixth month of treatment. Hirsutism improved, androgen levels dro...