Gastrointestinal Involvement in Extra-Digestive Disease: Which Is the Role of Fecal Calprotectin?

Fecal calprotectin (FC) is a very sensitive marker of inflammation of the gastrointestinal tract. Its clinical utility can be appreciated in both intestinal and extraintestinal diseases. Recent evidence suggests a link between intestinal inflammation and dermatological, rheumatic and neurological diseases. This review focuses on the role of FC in non-gastrointestinal disease, such as rheumatic, dermatologic, neurologic and last but not least SARS-CoV-2 infection

Mutant human β4 subunit identified in amyotrophic lateral sclerosis patients impairs nicotinic receptor function.

Recently identified mutations in the genes encoding the neuronal nicotinic ACh receptor (nAChR) subunits in patients affected by sporadic amyotrophic lateral sclerosis (sALS) may represent a factor which enhances disease susceptibility, in particular in association with ambient causes such as cigarette smoking. In this work, we characterize the functional properties of nAChRs containing the β4R349C subunit, the mutation most frequently encountered in sALS patients. The mutation was coexpressed with wild-type α3 or α4 subunits or with mutant α4R487Q subunit, which has been detected in one patient together with β4R349C mutation. None of the functional parameters examined showed differences between α4β4 and α4R487Qβ4 nAChRs. By contrast, β4R349C mutation, independent of the companion α subunit, caused the reduction in potency of both ACh and nicotine, decreased the density of whole-cell current evoked by maximal transmitter concentrations, and altered the kinetics of ACh-evoked whole-cell currents. These data confirm that sALS-associated mutations in nicotinic subunits may markedly perturb cholinergic transmission in individuals bearing the mutations

Lack of dystrophin functionally affects alpha 3 beta 2/beta 4-nicotinic acethylcholine receptors in sympathetic neurons of dystrophic mdx mice

In the sympathetic superior cervical ganglion (SCG), nicotinic acetylcholine receptors (nAChRs) mediate fast synaptic transmission. We previously demonstrated that in SCG neurons of mdx mice, an animal model for Duchenne muscular dystrophy, lack of dystrophin causes a decrease, compared to the wild-type, in postsynaptic nAChRs containing the alpha 3 subunit associated with beta 2 and/or beta 4 (alpha 3 beta 2/beta 4-nAChRs), but not in those containing the alpha 7 subunit. Here we show, by whole cell patch-clamp recordings from cultured SCG neurons, that both nicotine and acetylcholine-evoked currents through alpha 3 beta 2/beta 4-nAChRs are significantly reduced in mdx mice compared to the wild-type, while those through ea-nAChR are unaffected. This reduction associates with that of protein levels of alpha 3, beta 2 and beta 4 subunits. Therefore, we suggest that, in mdx mouse SCG neurons, lack of dystrophin, by specifically affecting membrane stabilization of alpha 3 beta 2/beta 4-nAChRs, could determine an increase in receptor internalization and degradation, with consequent reduction in the fast intraganglionic cholinergic transmission. (c) 2010 Elsevier Inc. All rights reserved

Bedside cardiac pocus in emergency setting: a practice review

Background: in the last years, ultrasound technology has entered in clinical practice as a tank and today, it has also allowed to no-cardiologists to extend and to deep their medical examination without the needing to call the consultant and having a good profile of diagnostic accuracy. The ultrasound bedside does not replace the consultant but it allows not to perform inappropriate consultations with more savings for hospitals. Objective: The aim was to review recently published literature to inform the clinician about the most up to date management of use bedside echography in emergency setting. In this short review we focused on two types of syndromes, no traumatichypotension and dyspnea, common to the three holistic disciplines of medicine, showing the main and basic questions and answers that ultrasound can give us for rapid identification of the problem. Methods: We conducted a systematic review using Pubmed/Medline, Ovid/Willey and Cochrane Library, combining key terms such as "cardiac ultrasound, "cardiac diseases","emergency medicine","pocus", "dyspnea"," hypotension". We selected the most relevant clinical trials and review articles (excluding case reports) published in the last 19 years and in our opinion 59 publications appeared the best choice according to the PRISMA statement. In additional papers identified from individual article reference lists were also included. Conclusion: Recent studies have shown promise in establishing best practices for evaluation of heart, lung abdomen and deep vessels At the moment bedside US is widely used in an integrated ultrasound vision just like the holistic view have internal medicine, intensive care and emergency medicine and many medical schools in Europe and the USA are inserting ultrasonography into the core curriculum but we still have to find a standard method for the training program for minimum competence acquisition

Use of the PEPTESTTM tool for the diagnosis of GERD in the Emergency Department

Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal disorders in the general population, with a prevalence of 8.8%\u201325.9% in Europe [1]. Many patients affected by GERD refer to the Emergency Department (ED) reporting an angina-like retrosternal chest pain [2-5]. For an optimal initial management of chest pain [6] in ED, the Italian Society of Emergency Medicine recommend to perform a 12 lead ECG, serial blood troponin levels, chest X-ray and eventually a cardiac stress test to exclude acute coronary syndrome (ACS) [7]. However, only a minority [8] of these patients (15%) does have an ACS [9], while 85% has a non-cardiac chest pain (NCCP) [9,10], in which GERD ranks first [9]. A recently developed tool, the PEPTESTTM (RD BIOHIT Health- Care, Milan, Italy), turns out to be useful, safe and cheap for the diagnosi