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Biomedical subjects

A Casagrande

Publications and source records attributed to A Casagrande.

At least 19 recordsLinked to original sources

Electroencephalographic staging of hepatic encephalopathy by an artificial neural network and an expert system.

AIM OF THE STUDY: To provide an objective EEG assessment of hepatic encephalopathy (HE), we set up and tested an entirely automatic procedure based on an artificial neural network-expert system software (ANNESS). PATIENTS AND METHODS: A training set sample of 50 EEG (group A) and a test sample of 50 EEG (group B) of 100 cirrhotic patients were considered. The EEGs had been visually classified by an expert electroencephalographer, using a modified five-degree Parsons-Simith classification of HE. The efficiency of the ANNESS, trained in group A, was tested in group B. RESULTS: Both the ANNESS and the visually-based classifications were found to be correlated to liver insufficiency, as assessed by the Child-Pugh score (Spearman's coefficient rho=0.485, P<0.0001; rho=0.489, P<0.0001, respectively) and by the biochemical indexes of hepatic function (bilirubin: rho=0.31 vs. 0.27; albumin: rho=-0.13 vs. -0.18; prothrombin time rho=-0.35 vs. -0.52). The classifications were found to be correlated to each other (rho=0.84 P<0.0001, Cohen's kappa=0.55). However, the ANNESS overestimated grade 2 EEG alterations. CONCLUSION: An ANNESS-based classification of EEG in HE provided data comparable with a visually-based classification, except for mild alterations (class 2) that tended to be overestimated. Further optimization of automatic EEG staging of HE is desirable, as well as a prospective clinical evaluation.

Aged↗

An artificial intelligence approach to classify and analyse EEG traces.

We present a fully automatic system for the classification and analysis of adult electroencephalograms (EEGs). The system is based on an artificial neural network which classifies the single epochs of trace, and on an Expert System (ES) which studies the time and space correlation among the outputs of the neural network; compiling a final report. On the last 2000 EEGs representing different kinds of alterations according to clinical occurrences, the system was able to produce 80% good or very good final comments and 18% sufficient comments, which represent the documents delivered to the patient. In the remaining 2% the automatic comment needed some modifications prior to be presented to the patient. No clinical false-negative classifications did arise, i.e. no altered traces were classified as 'normal' by the neural network. The analysis method we describe is based on the interpretation of objective measures performed on the trace. It can improve the quality and reliability of the EEG exam and appears useful for the EEG medical reports although it cannot totally substitute the medical doctor who should now read the automatic EEG analysis in light of the patient's history and age.

Adult↗

Impaired antifungal effector activity but not inflammatory cell recruitment in interleukin-6-deficient mice with invasive pulmonary aspergillosis.

A murine model of infection, in which immunocompetent or immunosuppressed interleukin-6-deficient (IL-6(-/-)) mice were infected intranasally with Aspergillus fumigatus conidia and were monitored for parameters of fungal colonization and innate and adaptive immunity, was used to assess the role of IL-6 in invasive pulmonary aspergillosis (IPA). The results indicate that IL-6(-/-) mice were more susceptible than wild-type mice to IPA. Susceptibility was associated with increased inflammatory pathology, decreased antifungal effector functions of phagocytes, and impaired development of protective type 1 responses. Exposure to exogenous IL-6 restored antifungal effector activity.

Animals↗

[Small bowel diverticula in adults: clinical and therapeutic features. Report of 2 cases and review of the literature].

The true diverticula of the small bowell are a very rare observation in clinical practice; they have a malformative origin and, occasionally, are acquired, contrary to what observed in the colon, where they are frequently an acquired pathology. They can involve the small bowel as a single lesion (Meckel's diverticulum), or as a segmentary disease (duodenal diverticula), or as a diffused diverticulosis. Generally they are asymptomatic and rarely they produce a true pathology. The symptomatic disease is primarily found in pediatric age and it requires a surgical procedure. This makes even more rare the diverticular pathology in the adult. The authors report 1 case of intestinal occlusion due to ileoileo-colic invagination arising from a Meckel's diverticulum and 1 case of intestinal occlusion in presence of a severe and acute diffuse diverticulosis of the small bowell, both in adult patients.

Adult↗

Interleukin 18 restores defective Th1 immunity to Candida albicans in caspase 1-deficient mice.

Caspase 1, formerly designated interleukin 1beta (IL-1beta)-converting enzyme, processes pro-IL-1beta and pro-IL-18 to yield active cytokines that play a pivotal role in inflammation and cell activation. We show here the effect of caspase 1 deficiency on the inflammatory and adaptive immune responses to the fungus Candida albicans. Caspase 1 deficiency did not affect susceptibility to primary systemic infection with the fungus, as revealed by survival and fungal growth. However, Th1-mediated resistance to reinfection was greatly impaired in caspase 1-deficient mice, and this correlated with low-level production of IL-12 and gamma interferon. Early in infection, production of these cytokines and that of tumor necrosis factor alpha, IL-6, and, interestingly, IL-1beta occurred normally in caspase 1-deficient mice, while that of IL-18 was severely impaired. Exogenous administration of IL-18, more than IL-12, restored the Th1-mediated resistance to the infection. We conclude that, while caspase 1 is not indispensable for release of mature IL-1beta in candidiasis, the caspase 1-dependent production of IL-18 may represent an important and novel pathway for the expression of sustained Th1 reactivity to the fungus.

Animals↗

On radiation-induced extraskeletal osteosarcoma: report of a case.

A case of extraskeletal osteogenic sarcoma arising in the soft tissues of the lower portion of the anterior abdominal wall (subumbelical region) is reported. The tumor developed in an area that had received telecobaltherapy 2 years 8 months previously (total skin dose of 9,000 rads delivered in 45 exposures over two separate periods of 106 and 141 days), after surgical treatment for a Stage I carcinoma of the uterine cervix. The clinical description and histopathology of this unusual neoplasm are presented, and the literature is reviewed.

Abdominal Neoplasms↗

[Late post-traumatic diaphragmatic hernia: unusual cause of colonic occlusion].

Traumatic diaphragmatic rupture is not an uncommon problem, particularly in the last few years because of the increasing number of road accidents, improved diagnostic techniques and resuscitation techniques after serious traumas. In a certain number of cases, post-traumatic diaphragmatic hernias may become clinically manifest only months or years after thoracic or abdominal trauma and are still a challenge to surgeons because of the vague clinical symptoms and the diagnostic difficulties involved. The Authors report a case of acute colon occlusion due to diaphragmatic hernia 24 months after thoraco-abdominal trauma. None of the radiological or endoscopic examinations demonstrated the presence of diaphragmatic hernia. Laparoscopy showed a diaphragmatic rupture with incarceration of the left colonic segment. The laparoscopic procedure was converted for technical reasons and the diaphragmatic defect was closed with a primary suture.

Adult↗