The Role of Therapeutic Endoscopic Ultrasound in Management of Malignant Double Obstruction (Biliary and Gastric Outlet): A Comprehensive Review with Clinical Scenarios.

Endoscopic ultrasound (EUS)-guided interventions have revolutionized the management of malignant biliary obstruction (MBO) and gastric outlet obstruction (GOO), providing minimally invasive alternatives with improved outcomes. These procedures have significantly reduced the need for high-risk surgical interventions or percutaneous alternatives and have provided effective palliative care for patients with advanced gastrointestinal and bilio-pancreatic malignancies. EUS-guided biliary drainage (EUS-BD) techniques, including hepaticogastrostomy (EUS-HGS), choledochoduodenostomy (EUS-CDS), and antegrade stenting (EUS-AS), offer high technical and clinical success rates, with a good safety profile particularly when Endoscopic Retrograde Cholangiopancreatography (ERCP) is not feasible.

Clinical classification and long-term outcomes of seronegative coeliac disease: a 20-year multicentre follow-up study.

Background: Seronegative coeliac disease is poorly defined.

Aims: To study clinical phenotypes and long-term outcomes of seronegative coeliac disease in a multicentre cohort over 20 years.

Methods: Seronegative coeliac disease was diagnosed in HLA-DQ2/DQ8-positive patients with villous atrophy (VA), negative IgA endomysial (EmA), tissue transglutaminase (tTG) and deamidated-gliadin antibodies (DGP), clinical and histological response to a gluten-free diet (GFD), and no alternative causes for VA.

Behavior of Children during Dental Care with Rubber Dam Isolation: A Randomized Controlled Study.

Background: The establishment of the dental dam improves dentist working conditions and patient protection. The purpose of this study was to analyze the behavior of the child during dental care with or without a dam.

Methods: In this interventional randomized study, 51 patients are divided into two groups, one with a rubber dam and the other with cotton roll isolation.

Psychological and Brain Connectivity Changes Following Trauma-Focused CBT and EMDR Treatment in Single-Episode PTSD Patients.

Among the different therapeutic alternatives for post-traumatic stress disorder (PTSD), Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) and Eye Movement Desensitization and Reprocessing (EMDR) Therapy have shown promising results in helping patients cope with PTSD symptoms. However, given the different theoretical and methodological substrate of TF-CBT and EMDR, a potentially different impact on the brain for the two interventions could be hypothesized, as well as an interaction between trauma-specific PTSD symptomatology and response to a given psychotherapy. In this study, we monitored psychological and spontaneous functional connectivity fMRI patterns in two groups of PTSD patients who suffered by the same traumatic event (i.

Best practice in psychological activities in cardiovascular prevention and rehabilitation: Position Paper.

Recent guidelines on cardiovascular disease prevention suggest multimodal behavioral interventions for psychosocial risk factors and referral for psychotherapy in the case of clinically significant symptoms of depression and anxiety overall. Accordingly, psychologists of the Italian Association for Cardiovascular Prevention, Rehabilitation and Epidemiology (GICR-IACPR) have reviewed the key components of psychological activities in cardiovascular prevention and rehabilitation (CPR). The aim of this study was to elaborate a position paper on the best practice in routine psychological activities in CPR based on efficacy, effectiveness and sustainability.

Metabolic and Electrophysiological Changes Associated to Clinical Improvement in Two Severely Traumatized Subjects Treated With EMDR-A Pilot Study.

Neuroimaging represents a powerful tool to investigate the neurobiological correlates of Eye Movements Desensitization and Reprocessing (EMDR). The impact of EMDR on cortical and sub-cortical brain regions has been proven by several investigations demonstrating a clear association between symptoms disappearance and changes in cortical structure and functionality. The aim of this study was to assess by electroencephalography (EEG) and for the first time by positron emission tomography (PET) the changes occurring after EMDR therapy in two cases of psychological trauma following brain concussion and comatose state due to traffic accident.

Hydrodynamic gene delivery in human skin using a hollow microneedle device.

Microneedle devices have been proposed as a minimally invasive delivery system for the intradermal administration of nucleic acids, both plasmid DNA (pDNA) and siRNA, to treat localised disease or provide vaccination. Different microneedle types and application methods have been investigated in the laboratory, but limited and irreproducible levels of gene expression have proven to be significant challenges to pre-clinical to clinical progression. This study is the first to explore the potential of a hollow microneedle device for the delivery and subsequent expression of pDNA in human skin.

Neurobiological response to EMDR therapy in clients with different psychological traumas.

We assessed cortical activation differences in real-time upon exposure to traumatic memory between two distinct groups of psychologically traumatized clients also in comparison with healthy controls. We used electroencephalography (EEG) to compare neuronal activation throughout the bilateral stimulation phase of Eye Movement Desensitization and Reprocessing (EMDR) sessions. We compared activation between the first (T0) and the last (T1) session, the latter performed after processing the index trauma.

Hydrogen-hydrogen bonding: the current density perspective.

Current density plots of closed-shell intermolecular H-H interactions characterized by a bond critical point (BCP) show two vortices separated by a saddle, a pattern which allows for a clear definition of a pair current strength. This H-H current strength turns out to be roughly related to the potential energy density at the BCP and then to the dissociation energy. The same pattern is also recognizable, at least for an azimuthal orientation of a field perpendicular to the H-H line, for the intramolecular interactions previously investigated to propose the H-H bonding.

Topology of the magnetically induced current density and proton magnetic shielding in hydrogen bonded systems.

It is pointed out that a common feature of the current density induced in hydrogen bonded systems X-HY-Z by a magnetic field perpendicular to the H-bond is a continuous stagnation line made of (2,0) saddle points. The saddle line cuts the H-bond almost perpendicularly near the bond critical point (BCP). This implies the confinement of the current density within three basins of current delimited by two separatrices formed by all the asymptotic trajectories originating and terminating at the saddle points.

A prospective, randomized comparison of three different types of valved and non-valved peripherally inserted central catheters.

Purpose: Few randomized studies have investigated the impact of valved and non-valved power-injectable peripherally inserted central catheters (PICCs) in terms of incidence of occlusion, infection, malfunction and venous thrombosis.

Methods: We have prospectively compared three types of third-generation polyurethane PICCs. One hundred and eighty adult patients candidate to chemotherapy were randomized into three groups: power-injectable PICCs with Solo-2 proximal valve (Bard); power-injectable PICCs with PASV (Pressure Activated Safety Valve) proximal valve (Navilyst); and non-valved power-injectable PICCs (Medcomp).

Delocalized currents without a ring of bonded atoms: strong delocalized electron currents induced by magnetic fields in noncyclic molecules.

Some noncyclic small molecules, electrically neutral or charged, sustain interatomic electronic currents in the presence of a stationary, spatially uniform magnetic field. The existence of fairly large delocalized electron flow is demonstrated in H₂O, BH₃, NH₃, CH₄, CH₃-CH₃, H₃O⁺, CH₃⁺, and NH₄⁺, by plots of quantum mechanical current density. Convincing quantitative evidence is arrived at by current strengths, defined via a flux integral of the ab initio current density.

Development of a novel index to discriminate bulge from mass on small-bowel capsule endoscopy.

Background: Submucosal malignant masses (SMMs) and innocent bulges look similar on small-bowel capsule endoscopy (SBCE). In a previous observational study, 4 criteria associated with innocent bulges were recognized.

Objective: To devise and validate an index based on these criteria (smooth, protruding lesion index on capsule endoscopy [SPICE]) to discriminate SMMs from innocent bulges.

Small bowel capsule endoscopy performance in octogenarians: a case-control study.

Background And Study Aims: Capsule endoscopy is a high-sensitive tool for the investigation of suspected small bowel disorders, but its effectiveness in elderly patients is unknown. We sought to determine capsule endoscopy feasibility and diagnostic yield in octogenarians.

Patients And Methods: Records of patients ≥ 80 years old (Group A) were retrieved from a database of 827 consecutive capsule endoscopy performed on as many patients.

Plasmonic mediated interactions between waveguides and nanostructured metal surfaces.

We present the polarization resolved, angular dependent, optical reflectance properties for single TE mode optical waveguides in contact with a nanostructured gold surface. A substantial angle dependent resonant decrease in the TE polarized surface reflectivity is measured which cannot be explained by a simple waveguide coupling due to surface roughness. Rather we show that the resonance is due to the excitation of a coupled waveguide-plasmonic surface mode created by the interaction between the metal nanostructure and the waveguide.

Reproducibility of bowel ultrasonography in the evaluation of Crohn's disease.

Background: Bowel ultrasonography is increasingly used in the detection and follow-up of patients with Crohn's disease, but a limitation to its further diffusion is the lack of standardisation of ultrasonography parameters.

Aims: This study aimed to standardise the most common bowel ultrasonography parameters in order to develop an unequivocal imaging interpretation and to assess bowel ultrasonography reproducibility.

Patients: Twenty patients with Crohn's disease were examined.

Analysis of the fast recovery dynamics of a semiconductor laser with feedback in the low-frequency fluctuation regime.

We experimentally investigate the temporal evolution of the power of an external cavity semiconductor laser in the low-frequency fluctuation regime with subnanosecond resolution. We show, for the first time to our knowledge, that generally the laser power drops to a value significantly different from the solitary laser power. We demonstrate the analogy between the recovery of the laser intensity and the turn-on transient of a semiconductor laser.

Clinical outcome of patients examined by capsule endoscopy for suspected small bowel Crohn's disease.

Background: Capsule endoscopy has a greater diagnostic yield than radiology for detecting subtle inflammatory changes of the small bowel mucosa, but the clinical significance of these abnormalities is still uncertain because of the lack of long-term follow-ups.

Aim And Methods: To verify the accuracy of capsule endoscopy in a cohort of patients with suspected Crohn's disease of the small bowel, taking as 'gold standard' the final diagnosis made after a long follow-up. From April 2002 to March 2005, we enrolled and examined by capsule endoscopy 27 consecutive patients with abdominal pain and diarrhea lasting more than 3 months and at least one of the following: anaemia, weight loss, fever, extra-intestinal manifestation(s) of inflammatory bowel disease.

["Mini-rhinoplasty"].

Objectives: To define the interest of the so called "mini-rhinoplasty" in aesthetic nose surgery and to report the surgical technique.

Method: The experience of the authors, based on more than 500 mini-rhinoplasty surgical procedures is reported. The surgical procedure such as technical tips are reported.

Vertical-cavity semiconductor devices for fluorescence spectroscopy in biochips and microfluidic platforms.

This paper describes the properties of vertical-cavity semiconductor devices designed to emit light when driven in forward bias mode and detect optical radiation at wavelengths longer than that of emission when driven in reverse bias mode. The study of this type of devices is motivated by the miniaturization and integration into a single unit of the three functions that a microfluorimeter has to perform, optical pumping, optical detection, and optical filtering of weak light sources. The devices produced can generate fluorescence with a low output power since their emission wavelength can be tuned with that of maximum absorption of the fluorescent dye.