An association of boswellia, betaine and myo-inositol (Eumastós) in the treatment of mammographic breast density. A randomized, double-blind study

Mammographic breast density is a recognized risk factor for breast cancer. The causes that lead to the proliferation of the glandular breast tissue and, therefore, to an increase of breast density are still unclear. However, a treatment strategy to reduce the mammary density may bring about very relevant clinical outcomes in breast cancer prevention. Myo-inositol is a six-fold alcohol of cyclohexane, has already been proved to modulate different pathways: inflammatory, metabolic, oxidative and endocrine processes, in a wide array of human diseases, including cancer and the genesis of mammary gland and breast diseases, like fibrosis, as well as metabolic and endocrine cues. Similarly, boswellic acid and betaine (three-methyl glycine) both inhibit inflammation and exert protective effects on breast physiology. Based on this scientific background, we hypothesized that a combination including, boswellic acid, betaine and myo-inositol would be able to reduce breast density working on different pathways.OBJECTIVE: Mammographic breast density is a recognized risk factor for breast cancer. The causes that lead to the proliferation of the glandular breast tissue and, therefore, to an increase of breast density are still unclear. However, a treatment strategy to reduce the mammary density may bring about very relevant clinical outcomes in breast cancer prevention. Myo-inositol is a six-fold alcohol of cyclohexane, has already been proved to modulate different pathways: inflammatory, metabolic, oxidative and endocrine processes, in a wide array of human diseases, including cancer and the genesis of mammary gland and breast diseases, like fibrosis, as well as metabolic and endocrine cues. Similarly, boswellic acid and betaine (threemethyl glycine) both inhibit inflammation and exert protective effects on breast physiology. Based on this scientific background, we hypothesized that a combinat ion including, boswellic acid, betaine and myo-inositol would be able to reduce breast density working on different pathways. PATIENTS AND METHODS: In this study, seventy-six premenopausal women were randomly assigned to the placebo and the experimental drug arms (Eumastós®) for six months. RESULTS: After 6 months of treatment, statistically significant difference between the two groups was recorded on the breast density reduction (60% vs. 9%), using mammographic as well as ultrasound examination. CONCLUSIONS: Preliminary data collected here with support the starting assumptions,that the association comprising boswellic acid, betaine and myo-inositol significantly reduces mammary density, providing the first evidence for a new and safe approach for the management of mammographic density treatment

In Vivo Study of HIV-1 Tat Arginine-rich Motif Unveils Its Transport Properties

Tat-derived peptides have attracted much interest as molecular carriers for intracellular delivery as they incorporate specific attributes required for efficient cargo delivery to sub-cellular domains. Little is known, however, about intracellular trafficking and interactions of Tat peptide–tagged cargoes, although some in vitro studies have suggested the relevance of active processes in Tat peptide–driven nuclear translocation. These issues are addressed by comparing Tat peptide–induced transport properties with well-established passive diffusion and active import benchmarks in living cells. Specifically, we examine several constructs of increasing molecular weight (MW) both below and above the threshold for passive diffusion through the nuclear pore. The resulting sub-cellular localization is analyzed by confocal imaging, and construct intracellular dynamics is investigated by fluorescence recovery after photobleaching (FRAP) real-time imaging. Our experiments yield the characteristic transport parameters of Tat peptide intra-cytoplasm dynamics and nucleus/cytoplasm shuttling. These results allow us to elucidate the mechanism of Tat peptide–driven nuclear permeation, demonstrating that it crosses the nuclear envelope (NE) by passive diffusion. Finally, we discuss the limitations of this route in terms of acceptable cargo size

Experimental multiparameter quantum metrology in adaptive regime

Relevant metrological scenarios involve the simultaneous estimation of multiple parameters. The fundamental ingredient to achieve quantum-enhanced performances is based on the use of appropriately tailored quantum probes. However, reaching the ultimate resolution allowed by physical laws requires non trivial estimation strategies both from a theoretical and a practical point of view. A crucial tool for this purpose is the application of adaptive learning techniques. Indeed, adaptive strategies provide a flexible approach to obtain optimal parameter-independent performances, and optimize convergence to the fundamental bounds with limited amount of resources. Here, we combine on the same platform quantum-enhanced multiparameter estimation attaining the corresponding quantum limit and adaptive techniques. We demonstrate the simultaneous estimation of three optical phases in a programmable integrated photonic circuit, in the limited resource regime. The obtained results show the possibility of successfully combining different fundamental methodologies towards transition to quantum sensors applications

Multiseptate gallbladder in a child

Multiseptate gallbladder (MSG) is a rare congenital anomaly. MSG may be accompanied with other abnormalities of the biliary tree. MSG can be asymptomatic and most cases are detected incidentally. Nevertheless, some patients present with biliary pain or colicky abdominal pain due to biliary stasis and calculi. We report a case of MSG in a girl who presented with recurrent abdominal pain and normal laboratory work-up recovered after laparoscopic cholecystectomy. A pediatric literature review of this rare anomaly is also performed

Propeller geometry optimization for pressure pulses reduction: an analysis of the influence of the rake distribution

The evaluation of pressure pulses is a current issue for any high-performance propeller design. It has been addressed experimentally, by means of model tests, and numerically but in most cases the analysis has been limited to the verification of a given geometry (or, at least of few configurations) identified at the end of a traditional design loop. A more direct inclusion of pressure pulses evaluation in the design procedure, for instance by very attractive multi-objective optimization approaches, could be beneficial, especially if more accurate codes may be exploited. Among the others, BEM represent an acceptable compromise between computational costs and accuracy with the further advantage, with respect to lower fidelity approaches, to account for effects of geometrical haracteristics (such as rake distribution) which are often defined only according to designer experience and special needs. However, if the ability of the BEM methods to predict propeller performance and cavitation extension is well documented, the direct computation of pressure pulses may be less reliable, especially in correspondence to heavy cavitating conditions, requiring further validations in particular when the influence of characteristics such as rake distribution, hardly addressed in literature also from the experimental point of view, are considered. Cavitation tunnel test, BEM and RANS calculations have been consequently carried out for two propellers, designed for the same functioning conditions with different rake distributions, in order to stress the capabilities and the limitations of the numerical approaches in dealing with cavitation, pressure pulses predictions and the capability to discriminate between slightly different geometries in the light of their possible application in a design by optimization procedure

Medication-related osteonecrosis of the jaw

In 2014, the nomenclature of bisphosphonate-related osteonecrosis of the jaw (BRONJ) was changed in medication-related osteonecrosis of the jaw (MRONJ) to include osteonecrosis of the jaw caused by non-bisphosphonates (BPs) drugs. MRONJs are a rare drug adverse reaction associated with BPs and other antiresorptive (denosumab) and antiangiogenetic therapies. MRONJ pathophysiology is not completely elucidated, and three risk factors should be considered: Local factors, underlying disease and kind of medication. MRONJ aff ects considerably patient’s quality of life, so it is important to know pathology and risk factor in order to prevent or treat immediately the disease. Various BRONJ staging systems are used by clinicians: In 2006 Ruggero at al. proposed a clinical staging system with three diff erent levels based on signs and symthoms; in 2009 American Association of Oral and Maxillofacial Surgeons implemented it with Stage 0. Marx in 2007 was the only one who divided the stages on the basis of the lesion’s size. Bedogni in 2012 proposed a clinical-radiological staging system. The aim of this review is to summarize the current diagnosis, prevention and treatment strategies

International expert consensus on the surgical anatomic classification of radical hysterectomies

Background: The anatomic descriptions and extents of radical hysterectomy often vary across the literature and operative reports worldwide. The same nomenclature is often used to describe varying procedures, and different nomenclature is often used to describe the same procedure despite the availability of guideline and classification systems. This makes it difficult to interpret retrospective surgical reports, analyze surgical databases, understand technique descriptions, and interpret the findings of surgical studies. Objective: In collaboration with international experts in gynecologic oncology, the purpose of this study was to establish a consensus in defining and interpreting the 2017 updated Querleu-Morrow classification of radical hysterectomies. Study design: The anatomic templates of type A, B, and C radical hysterectomy were documented through a set of 13 images taken at the time of cadaver dissection. An online survey related to radical hysterectomy nomenclature and definitions or descriptions of the associated procedures was circulated among international experts in radical hysterectomy. A 3-step modified Delphi method was used to establish consensus. Image legends were amended according to the experts' responses and then redistributed as part of a second round of the survey. Consensus was defined by a yes response to a question concerning a specific image. Anyone who responded no to a question was welcome to comment and provide justification. A final set of images and legends were compiled to anatomically illustrate and define or describe a lateral, ventral, and dorsal excision of the tissues surrounding the cervix. Results: In total, there were 13 questions to review, and 29 experts completed the whole process. Final consensus exceeded 90% for all questions except 1 (86%). Questions with relatively lower consensus rates concerned the definitions of types A and B2 radical hysterectomy, which were the main innovations of the 2017 updated version of the 2008 Querleu-Morrow classification. Questions with the highest consensus rates concerned the definitions of types B1 and C, which are the most frequently performed radical hysterectomies. Conclusion: The 2017 version of the Querleu-Morrow classification proved to be a robust tool for defining and describing the extent of radical hysterectomies with a high level of consensus among international experts in gynecologic oncology. Knowledge and implementation of the exact definitions of hysterectomy radicality are imperative in clinical practice and clinical research

the early pleistocene whale fall community of bargiano umbria central italy paleoecological insights from benthic foraminifera and brachyuran crabs

n/

Isolated auditory neuropathy at birth in congenital cytomegalovirus infection

BACKGROUND: Congenital cytomegalovirus (cCMV) infection is the most frequent non-genetic cause of sensorineural hearing-loss (SNHL) (i.e., hearing loss due to a cochlear and/or auditory nerve damage). It is widely accepted that SNHL at birth, when associated to cCMV symptomatic infection involving the central nervous system, benefits from antiviral therapy started in the neonatal period. Conversely, there is no consensus for antiviral treatment in congenitally infected infants diagnosed with isolated SNHL (i.e., SNHL in an otherwise asymptomatic infant) at birth. Our aim was to assess the frequency and the auditory outcome of isolated SNHL at birth due to auditory neuropathy (AN) (i.e., SNHL in a patient with normal cochlear function and auditory nerve dysfunction) in infants with cCMV infection. METHODS: We retrospectively reviewed the clinical history of 60 infants, born at term, with cCMV asymptomatic infection, without additional risk factors for SNHL, and exhibiting bilateral "pass" otoacustic emissions (OAE). None of them underwent antiviral therapy. Hearing thresholds were assessed by means of Auditory Brainstem Responses (ABR). AN affected children were followed up until possible normalization of the hearing thresholds or definitive diagnosis of AN. Each infant diagnosed with monolateral or bilateral AN was classified according to the worst ear threshold. RESULTS: In our population, the first ABR was performed at a mean age of 5.00 ± 2.79 (SD) months and AN was diagnosed in 16/60 (26.67%) infants; in 4 infants the AN was defined as mild (4/4 monolateral), moderate in 11 (5/11 bilateral), and severe in 1 (bilateral). The mean age at first ABR was 3.69 ± 2.80 (SD) months in the 16 babies with AN and 5.48 ± 2.66 (SD) months in the 44 infants with normal hearing (p = 0.007). All AN cases spontaneously recovered a normal auditory threshold over time. The mean length of the audiological follow-up was 32.44 ± 17.58 (SD) months (range 5-60 months). CONCLUSION: A delayed maturation of the auditory pathways should be considered when a mild/moderate isolated AN at birth is detected in cCMV infected infants. Prospective studies conducted on larger populations, and with a longer audiological follow-up, are needed to confirm our findings