“Adenomatous Polyps Of The Gallbladder” Adenomas oF the Gallbladder

The finding of adenomatous polyps of the gallbladder is a rare occurrence and an unusual clinical problem

On the Use of Self-Organizing Map for Text Clustering in Engineering Change Process Analysis: A Case Study

In modern industry, the development of complex products involves engineering changes that frequently require redesigning or altering the products or their components. In an engineering change process, engineering change requests (ECRs) are documents (forms) with parts written in natural language describing a suggested enhancement or a problem with a product or a component. ECRs initiate the change process and promote discussions within an organization to help to determine the impact of a change and the best possible solution. Although ECRs can contain important details, that is, recurring problems or examples of good practice repeated across a number of projects, they are often stored but not consulted, missing important opportunities to learn from previous projects. This paper explores the use of Self-Organizing Map (SOM) to the problem of unsupervised clustering of ECR texts. A case study is presented in which ECRs collected during the engineering change process of a railways industry are analyzed. The results show that SOM text clustering has a good potential to improve overall knowledge reuse and exploitation

Regulatory T cells with multiple suppressive and potentially pro-tumor activities accumulate in human colorectal cancer

Tregs can contribute to tumor progression by suppressing antitumor immunity. Exceptionally, in human colorectal cancer (CRC), Tregs are thought to exert beneficial roles in controlling pro-tumor chronic inflammation. The goal of our study was to characterize CRC-infiltrating Tregs at multiple levels, by phenotypical, molecular and functional evaluation of Tregs from the tumor site, compared to non-tumoral mucosa and peripheral blood of CRC patients. The frequency of Tregs was higher in mucosa than in blood, and further significantly increased in tumor. Ex vivo, those Tregs suppressed the proliferation of tumor-infiltrating CD8+ and CD4+ T cells. A differential compartmentalization was detected between Helioshigh and Helioslow Treg subsets (thymus-derived versus peripherally induced): while Helioslow Tregs were enriched in both sites, only Helioshigh Tregs accumulated significantly and specifically in tumors, displayed a highly demethylated TSDR region and contained high proportions of cells expressing CD39 and OX40, markers of activation and suppression. Besides the suppression of T cells, Tregs may contribute to CRC progression also through releasing IL-17, or differentiating into Tfr cells that potentially antagonize a protective Tfh response, events that were both detected in tumor-associated Tregs. Overall, our data indicate that Treg accumulation may contribute through multiple mechanisms to CRC establishment and progression

Inflammation and Neurotransmission of the Vescico-Uterine Space in Cesarean Sections:

Collagen IV and laminin play a key role in regulating stiffness, elasticity and flexibility of the vescico-uterine space (VUS) tissue. The neurotensin (NT), the neuropeptide tyrosine (NPY) and the protein gene product 9.5 (PGP 9.5) possessing vasorelaxation and tissue vascularization activities, play key roles in cervical ripening, scar innervations and pain control. We propose that the integrity of these substances in VUS tissue is compromised after Cesarean section (CS), since wound healing disturbances and pelvic pain, as well as pregnancy and delivery complications, are related with lower uterine segment dysfunctions after CS. Therefore, the contents of collagen IV, laminin, NT, NPY and PGP 9.5 nerve fibres from the VUS tissue samples obtained during the first CS and the repeated CS were comparatively studied. VUS specimens were collected from 104 patients during CS and evaluated by immunohistochemistry. Collagen IV and laminin were mostly found in the vascular membrane bounds and their images were quantitatively evaluated by Quantimet Leica analyzer software. Differences of collagen IV, laminin, NT, NPY and PGP 9.5 values in VUS tissue between the first CS and the repeat CS samples were calculated by Student's Mest. Reduced laminin and increased collagen IV values were observed in the VUS scar tissue after the repeated CS in comparison with those of VUS intact tissue obtained during the first CS. Significantly higher values of nerve fibres, containing NT, NPY and PGP 9.5 were registered in intact VUS tissue samples, respectively 5±0.7, 7±0.6 and 5±0.9 CU, than those of VUS scar tissue samples obtained during the repeated CS, respectively 3±0.6,2±0.4 and 3±0.7 CU (p<0.05). The authors observed increased collagen IV and reduced laminin values after the repeated CS which might be the key signs of inflammatory damage of VUS scar tissue by CS. These findings were strengthened by the registration of decreased NT, NPY and PGP 9.5 values in the same samples, which are important neurotransmitters and are responsible for optimal wound healing, pain control and lower uterine segment functions

Predictive Response to Immunotherapy Score: A Useful Tool for Identifying Eligible Patients for Allergen Immunotherapy

A specific predictive tool of allergen immunotherapy (AIT) outcome has not been identified yet. This study aims to evaluate the efficacy of a disease score referred to as Predictive Response to Immunotherapy Score (PRIS) to predict the response to AIT and identify eligible patients. A total of 110 patients diagnosed with allergic rhinitis with or without concomitant asthma were enrolled in this study. Before beginning sublingual immunotherapy (SLIT), patients were evaluated by analyzing clinical and laboratory parameters. A specific rating was assigned to each parameter to be combined in a total score named PRIS. At baseline (T0) and follow-up [after 12 (T12) and 24 months (T24) of SLIT], a Visual Analogue Scale (VAS) was used to calculate a mean symptom score (MSS). Finally, the percentage variation between the MSS at T0 and at T12 [ΔMSS-12(%)] and T24 [ΔMSS-24 (%)] was measured. We observed a significant improvement of symptoms at T12 and T24 compared to T0 in all groups undergoing SLIT. PRIS was effective in predicting ΔMSS-24 (%) in patients treated with single-allergen SLIT. In addition, PRIS was effective in predicting ΔMSS-24 (%) in both patients with only rhinitis and with concomitant asthma. PRIS assessment can represent a useful tool to individuate potential responders before SLIT prescription

Lesson by SARS-CoV-2 disease (COVID-19): whole-body CT angiography detection of "relevant" and "other/incidental" systemic vascular findings

Objectives: Increasing evidence suggests that SARS-CoV-2 infection may lead to severe and multi-site vascular involvement. Our study aimed at assessing the frequency of vascular and extravascular events' distribution in a retrospective cohort of 42 COVID-19 patients. Methods: Patients were evaluated by whole-body CT angiography between March 16 and April 30, 2020. Twenty-three out of the 42 patients evaluated were admitted to the intensive care unit (ICU). Vascular and extravascular findings were categorized into "relevant" or "other/incidental," first referring to the need for immediate patient care and management. Student T-test, Mann-Whitney U test, or Fisher exact test was used to compare study groups, where appropriate. Results: Relevant vascular events were recorded in 71.4% of cases (n = 30). Pulmonary embolism was the most frequent in both ICU and non-ICU cases (56.5% vs. 10.5%, p = 0.002). Ischemic infarctions at several sites such as the gut, spleen, liver, brain, and kidney were detected (n = 20), with multi-site involvement in some cases. Systemic venous thrombosis occurred in 30.9% of cases compared to 7.1% of systemic arterial events, the first being significantly higher in ICU patients (p = 0.002). Among incidental findings, small-sized splanchnic arterial aneurysms were reported in 21.4% of the study population, with no significant differences in ICU and non-ICU patients. Conclusions: Vascular involvement is not negligible in COVID-19 and should be carefully investigated as it may significantly affect disease behavior and prognosis. Key points: • Relevant vascular events were recorded in 71.4% of the study population, with pulmonary embolism being the most frequent event in ICU and non-ICU cases. • Apart from the lung, other organs such as the gut, spleen, liver, brain, and kidneys were involved with episodes of ischemic infarction. Systemic venous and arterial thrombosis occurred in 30.9% and 7.1% of cases, respectively, with venous events being significantly higher in ICU patients (p = 0.002). • Among incidental findings, small-sized splanchnic arterial aneurysms were reported in 21.4% of the whole population

Environmental concentrations of fibers with fluoro-edenitic composition and population exposure in Biancavilla (Sicily, Italy)

Introduction. The town of Biancavilla (Sicily) was included in the National Priorities List of Contaminated Sites due to environmental dispersion of amphibole fibers owing to the extraction of materials from a local quarry. The present report summarizes results from several, hitherto unpublished, environmental surveys carried out in the area, as well as from published analyses of the chemistry and composition of fibers.Methods. Data included here comprises environmental fiber concentrations by scanning electron microscopy with energy dispersive spectroscopy (SEM-EDS) analysis in soil, indoor and outdoor air, personal monitoring, as well as a chemical characterization of the fibers.The full chemical structure and spectroscopic characterization of fibers were obtained through a multi-analytical approach: SEM-EDS, X-ray powder diffraction (XRPD), as well as Mössbauer (MS) and Fourier transform infrared (FT-IR) spectroscopies.Results. Data analyzed provided a spatial and temporal picture of fiber concentrations in Biancavilla, and a qualitative assessment of population exposure. Results suggest that until 2000, the population had been exposed to high levels of amphibole fibers. Mitigation measures adopted since 2001, gradually reduced exposure levels to about 0.1-0.4 ff/l. Previous studies on fibrous amphiboles from Biancavilla reported considerable chemical variability. Differences in composition, especially concerning the presence of Si, Ca, Fe, and Na, were found both within and between samples. Compared to the previously investigated prismatic fluoro-edenite, these fibrous fluorine amphiboles consistently showed higher average values of Si and Fe content, whereas Ca was significantly lower, which we consider a distinctive characteristic of the fluorine fibrous variety.Conclusions. The population of Biancavilla had been highly exposed to a suite of fibrous amphiboles for over 50 years. Dust mitigation measures have gradually reduced exposure, but continuous environmental follow-up is necessary in order to monitor exposurelevels and prevent adverse health effects for future generations

PET criteria by cancer type from imaging interpretation to treatment response assessment: beyond FDG PET score

Background: in recent years, the role of positron emission tomography (PET) and PET/computed tomography (PET/CT) has emerged as a reliable diagnostic tool in a wide variety of pathological conditions. This review aims to collect and review PET criteria developed for interpretation and treatment response assessment in cases of non-[18F]fluorodeoxyglucose ([18F]FDG) imaging in oncology. Methods: A wide literature search of the PubMed/MEDLINE, Scopus and Google Scholar databases was made to find relevant published articles about non-[18F]FDG PET response criteria. Results: The comprehensive computer literature search revealed 183 articles. On reviewing the titles and abstracts, 149 articles were excluded because the reported data were not within the field of interest. Finally, 34 articles were selected and retrieved in full-text versions. Conclusions: available criteria are a promising tool for the interpretation of non-FDG PET scans, but also to assess the response to therapy and therefore to predict the prognosis. However, oriented clinical trials are needed to clearly evaluate their impact on patient management

Infected pancreatic necrosis : outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study

Peer reviewe