Is arrhythmogenic right ventricular cardiomyopathy a paediatric problem too?

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a heart muscle disease that is often familial, characterized by arrhythmias of right ventricular origin, due to transmural fatty or fibrofatty replacement of atrophic myocardium. ARVC is usually diagnosed in the clinical setting between 20 and 40 years of age. The disease is seldom recognised in infancy or under the age of 10, probably because the clinical expression of the disease is normally postponed to youth and adulthood. This review focuses its attention to the pediatric age, defined as the period of life raging from birth to 18 years. During this span of life, ARVC is not so rare as previously supposed and can be identified by applying the same diagnostic criteria proposed for the adult. Ventricular arrhythmias range from isolated ventricular arrhythmias to sustained ventricular tachycardia and fibrillation. Children and adolescents with ARVC must be carefully evaluated and followed-up especially when a family positive history is present, taking into account the high probability during this life-period that asymptomatic affected patients become symptomatic or that arrhythmias worsen during follow-up. The recent identification of the first defective gene opens new avenues for the early identification of affected subjects even when asymptomatic.peer-reviewe

Parasite- and predator-induced maternal effects in the great tit (Parus major)

Organisms often face the simultaneous risk of predation and parasitism and a trade-off among the responses is predicted. Concurrent exposure of great tit mothers before reproduction to both of these stressors showed no interactive effect on growth and phenotype of offspring via maternal responses conveyed through eggs. Parasites, both via maternal effects and via direct exposure of nestlings, negatively influenced offspring phenotype, while risk of predation had no significant effec

Effect of Microwave Radiation on Enzymatic and Chemical Peptide Bond Synthesis on Solid Phase

Peptide bond synthesis was performed on PEGA beads under microwave radiations. Classical chemical coupling as well as thermolysin catalyzed synthesis was studied, and the effect of microwave radiations on reaction kinetics, beads' integrity, and enzyme activity was assessed. Results demonstrate that microwave radiations can be profitably exploited to improve reaction kinetics in solid phase peptide synthesis when both chemical and biocatalytic strategies are used

Models in economics

The paper reviews the philosophical literature on the epistemology of modelling in contemporary economics. In particular, it focuses on open questions concerning the epistemic role of models, the validity of inferences from the models to the world, and the legitimacy of their use for purposes of explanation, prediction and intervention.Peer reviewe

Kinetics of Circulating Plasma Cell-Free DNA in Paediatric Classical Hodgkin Lymphoma

Levels of plasma cell-free DNA (cfDNA) of a large series of children with classical Hodgkin lymphoma (cHL) were evaluated and analyzed at diagnosis and during chemotherapy treatment in relation with clinical characteristics. CfDNA levels in cHL patients were significantly higher compared with controls (p=0.002). CfDNA at diagnosis was correlated with presence of B symptoms (p=0.027) and high erythrocyte sedimentation rate (p=0.049). We found that the increasing of plasma cfDNA after first chemotherapy cycle seems to be associated with a worse prognosis (p=0.049). Levels of plasma cfDNA might constitute an interesting non-invasive tool in cHL patients' management

Complete Metabolic Response with Recanalization of Portal Vein Tumor Thrombosis after Sunitinib in a Patient with Advanced Hepatocellular Carcinoma

The prognosis of patients with advanced hepatocellular carcinoma (HCC) is very poor. The outcome of these patients is particularly bleak when the disease is complicated by portal vein tumor thrombosis (PVTT), since the increased portal pressure often causes serious gastrointestinal bleedings. Before the introduction of sorafenib (SOR), a tyrosine kinase inhibitor, no effective treatment was available for patients with advanced disease. SOR is now considered the standard treatment even for patients with tumor thrombosis, although the well-known interference between tyrosine kinase inhibitors and the coagulation pathway calls for caution against their use in this setting. Here, we report the case of a 74-year-old male patient with advanced HCC and PVTT treated with sunitinib (SUN), another multikinase inhibitor. During the third cycle, our patient experienced a life-threatening hematemesis with hemorrhagic shock that required intensive care treatment and SUN discontinuation. However, he completely recovered, and the PET/CT scan performed 1 year after the adverse effect demonstrated no evidence of the tumor together with portal vein recanalization. The short course of SUN causing both tumor response and gastrointestinal bleeding warrants further studies on the effectiveness of SUN in this setting as well as on the duration of treatment with multikinase inhibitors in patients with tumor thrombosis

QUATERNARY BUILD-UPS AND RHODALGAL CARBONATES ALONG THE ADRIATIC AND IONIAN COASTS OF THE ITALIAN PENINSULA: A REVIEW

In the Mediterranean, build-ups (created by coralline algae, Cladocora caespitosa, deep-water corals, vermetids, polychaetes and bacteria) and rhodolith beds are important hot-spots of biodiversity. Being severely threatened by anthropogenic impact and climate change, they have been included in international directives on environmental protection. This work wants to support the ongoing research on modern bioconstructions by providing further data on the long-term effects of environmental factors on these habitats. Our results are based on the analysis of the existing literature on the outcropping Quaternary successions of the Adriatic and Ionian coasts of peninsular Italy. The existing reports of build-ups and rhodalgal carbonates have been summarized in an homogeneous data-set and then studied to highlight distribution patterns in space and time. The analyses consistently outlined the importance of sedimentation rate in controlling the general distribution of build-ups and rhodalgal carbonates. The majority of the reports is concentrated south of the Gargano, where the sediment-load of the rivers is small. The majority of the reports is related to coralline algae, suggesting that they were the main carbonate producers during the period. C. caespitosa general distribution is mainly controlled by temperature, with most of the occurrences dating back to the warm periods of the late Ionian and of the Tarantian. Large build-ups of Cladocora are restricted to embayments and gulfs well-protected against storm waves. The distribution of the outcrops of deep-water corals is biased by the geological setting. A remarkable uplift is necessary to bring these corals from their original deep-water setting to elevated areas onshore. Consequently, most of the outcrops are in Southern Calabria which is characterized by a strong Quaternary uplift. Chemosynthetic build-ups, intertidal bioconstructions (made by vermetids, polychaetes or coralline algae), as well as stromatolites, are rare in the study area

Factors influencing choice of chemotherapy in metastatic colorectal cancer (mCRC)

Management of metastatic colorectal cancer requires a multimodal approach and must be performed by an experienced, multidisciplinary expert team. The optimal choice of the individual treatment modality, according to disease localization and extent, tumor biology, and patient clinical characteristics, will be one that can maintain quality of life and long-term survival, and even cure selected patients. This review is an overview of the different therapeutic approaches available in metastatic colorectal cancer, for the purpose of defining personalized therapeutic algorithms according to tumor biology and patient clinical features