Silicone gauzes with α-tocopherol acetate oil in skin graft donor site dressing

Split-thickness skin graft is one of the most used procedures in plastic surgery. This procedure involves numerous painful dressings at the donor site. α-Tocopherol acetate has anti-oxidative and anti-inflammatory properties and it can reduce the local bacterial growth, thereby promoting wound healing. We designed a prospective study to evaluate the effects of two different kinds of dressings at skin graft donor sites. A total of 30 patients were subjected to daily dressings with α-tocopherol acetate oil and traditional moist gauzes (group 1). Another 30 patients were subjected to dressings every 4 days with α-tocopherol acetate oil and silicone–vitamin E gauzes (group 2). Healing time, infection rate, patient's pain perception and costs were evaluated in both the groups. No statistically significant difference was found in terms of healing time. The infection rate was slightly different in the two groups. Significant reduction of pain perception was detected in group 2. In the same group, significant reduction in the total cost of the treatment was also observed. α-Tocopherol acetate oil and silicone–vitamin E gauzes may represent a safe, simple, painless and inexpensive method for improving skin graft donor site healing

Search for the γ decay of the narrow near-threshold proton resonance in 11B

The γ decay of the elusive narrow, near-threshold proton resonance in 11B was investigated at Laboratori Nazionali di Legnaro (INFN) in a particle-γ coincidence experiment, using the 6Li(6Li,pγ) fusion-evaporation reaction and the GALILEO-GALTRACE setup. No clear signature was found for a possible E1 decay to the 1/2 , first-excited state of 11B, predicted by the Shell Model Embedded in the Continuum (SMEC) with a branching of with respect to the dominant particle-decaying modes. The statistical analysis of the γ-ray spectrum provided an average upper limit of for this γ-ray branching, with a global significance of 5σ. On the other hand, by imposing a global confidence level of 3σ, a significant excess of counts was observed for E keV, corresponding to a resonance energy of 11429(20) keV (namely 200(20) keV above the proton separation energy of 11B) and a γ-ray branching of . This result is compatible with the SMEC calculations, potentially supporting the existence of a near-threshold proton resonance in 11B.This work was supported by the Italian Istituto Nazionale di Fisica Nucleare, the Polish National Science Centre, Poland under research project No. 2020/39/D/ST2/03443 , the PRIN2017 call for funding, under the project 2017P8KMFT CTADIR from the Italian Ministry of Education, University and Research, the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, grant no. 2020R1A6A3A03039081 , the MCIN/AEI/10.13039/501100011033, Spain with grant PID2020-118265GB-C42 , by Generalitat Valenciana, Spain with grant CIAPOS/2021/114 and by the EU FEDER funds.Departamento de Física Aplicad

Clinicopathological predictive factors of melanoma lung metastases

Background: The lung is the second most common site for metastatic malignant melanoma, with a poor prognosis. In this regard, identify clinicopathological predictors for Melanoma Lung Metastases (MLM) plays a pivotal role in clinical practice. Methods: We computer-searched the clinical records of all our patients registered in our melanoma database to identify patients that presented MLM. Kaplan-Meier product was used to estimate time to MELANOMA LUNG METASTASES (TMLM) and Overall Survival (OS); while the log-rank test was used to evaluate differences between the survival curves. Cox proportional hazards regression was performed in the analysis between clinicopathological features of the primary tumor and MLM. Results: A total of 63 patients with MLM were included in our analysis. Median TMLM was 27.4 months, while median OS was 55.5 months, with a Median Lung Metastases Survival (MLMS) of 10 months. Melanoma patients with a primary axial tumor (p<0.001) and with an age ≤ 60 years (p=0.01) showed a better TMLM. While OS was statistically significant higher only in axial melanomas (p<0.001), multivariate analysis showed that peripheral site of the primary tumor remained the main predictor to develop MLM, with a significant influence in TMLM and also in the long-term (p<0.01 and p=0.04). Conclusions: Currently no standardized therapies exist for MLM. In this regard, the prevention of secondary recurrences plays a pivotal role in the management of melanoma patients. According to our results, peripheral melanoma is the main predictor for development of MLM

The dark atrophy with indocyanine green angiography

PURPOSE. To evaluate differences in fluorescein angiography (FA) and indocyanine green angiography (ICGA), findings between subjects affected by Stargardt disease (STGD) and atrophic AMD. METHODS. This was a consecutive, cross-sectional case series. A total of 24 eyes of 12 patients with STGD and 23 eyes of 14 patients with atrophic AMD were enrolled in the study. Patients underwent dynamic simultaneous FA and ICGA using a dual beam confocal scanning system. Images were recorded from the initial filling of choroidal and retinal vessels throughout all the phases of the angiogram. Spectral-domain optical coherence tomography (SD-OCT) and fundus autofluorescence were also executed. FA and ICGA findings in the two groups were evaluated. RESULTS. In 92% (22/24) of eyes affected by STGD, ICGA showed hypocyanescence from the areas of atrophy, more evident in the late phases. This finding, defined as ICGA-imaged ''dark atrophy,'' was present in only 13% (3/23) of the eyes affected by atrophic AMD. The remaining eyes in both groups showed iso-or mild hypercyanescence from the areas of atrophy. Eyes with ICGA-imaged dark atrophy, both in STGD and in atrophic AMD groups, did not show early obscuration of the choroidal vessels by FA. SD-OCT revealed morphologically intact choroid in STGD patients with ICGA-imaged dark atrophy. In atrophic AMD eyes with ICGA-imaged dark atrophy, SD-OCT revealed a severely thinned choroid. CONCLUSIONS. Hypocyanescence by ICGA from the areas of atrophy was more frequent in STGD compared with atrophic AMD. This finding, along with SD-OCT evidence of intact choroid, suggests a possible selective damage of the choriocapillaris in STGD. (Invest Ophthalmol Vis Sci. 2012;53:3999-4004) DOI:10.1167/iovs.11-9258 R ecessive Stargardt disease (STGD) and age-related macular degeneration (AMD) lead to progressive and severe visual acuity loss. STGD is one of the most common inherited retinal dystrophies, while AMD is the most important cause of central visual acuity loss in western countries. STGD typically appears before age 20. It exhibits simple Mendelian transmission and is caused by mutations in the ABCA4 gene. A reduction in ABCA4 activity in the photoreceptors results in the increased production and accumulation of A2E and related bisretinoids within RPE cells. 1,2 These compounds cannot be readily metabolized and have negative effects on RPE cell function and viability. 3,4 RPE cell loss might originate from several mechanisms, including photooxidative stress, 5 vascular alterations, 6,7 and deposition of toxic lipofuscin material under RPE. Fluorescein angiography (FA) and indocyanine green angiography (ICGA) are important tools for diagnostic and pathogenetic evaluation of the two diseases. In STGD, FA is helpful because it allows for the identification of the dark choroid. This finding is characterized by the absence of normal background fluorescence mainly due to the presence of RPE lipofuscin that absorbs the blue excitatory light. 8 Also, ICGA may provide useful information, in particular about the alterations of the choroid and the choriocapillaris. 10 In addition, partial absorption by retinal pigment epithelial melanin occurs. In contrast, indocyanine green absorbs and emits light in the near-infrared spectrum, and allows better penetration. Furthermore, indocyanine green is predominantly bound to plasma protein (98% compared with 60%-80% for fluorescein), and this limits its diffusion through the fenestrations of the choriocapillaris. 11 Moreover, AMD may be characterized by a presumed macular choroidal watershed filling. 12 ICGA showed diminished choroidal arterial perfusion of the macula and enlargement of choroidal veins in the pathogenesis of AMD. 13 The combination of FA and ICGA facilitates interpretation of the exam and provides more information than either FA or ICGA alone. 10 Therefore, in this study, simultaneous FA and ICGA were used to evaluate possible differences in the pathogenesis of the two clinical entities. METHODS Twenty-six consecutive patients affected by STGD and atrophic AMD

Treatment of macro-re-entrant atrial tachycardia based on electroanatomic mapping: identification and ablation of the mid-diastolic isthmus

Aims This multicentre prospective study evaluated the ability of electroanatomic mapping (EAM) using a specific parameter setting to identify clearly the mid-diastolically activated isthmus (MDAI) and guide ablation of macro-re-entrant atrial tachycardia (MAT). Methods and results Consecutive patients with MAT, different from typical isthmus-dependent atrial flutter, were enrolled. EAM was performed using a specific setting of the window of interest, calculated to identify the MDAI and guide ablation of this area. Sixty-five patients exhibiting 81 MATs (mean cycle length 308 + 68 ms) were considered. Thirty-two (49.2%) had previous heart surgery. In 79 of 81 morphologies (97.5%), EAM reconstructed 95.9 + 4.3% of the tachycardia circuit and identified the MDAI; 23 of the 79 morphologies (29.1%) were double-loop re-entry. Mapping of two morphologies was incomplete due to MAT termination after catheter bumping. In 73 of 79 mapped morphologies (92.4%), abolition of the MAT was obtained by 13.2 + 12.4 applications. During the 14 + 4 month follow-up, MAT recurred in 4 of the successfully treated patients (6.8%). Conclusion EAM using a specific parameter setting proved highly effective at identifying the MDAI in MAT, even in patients with previous surgery and multiple re-entrant loops. Ablation of the MDAI yielded acute arrhythmia suppression with low rate of recurrence during follow-up

Incidence and Predictors of Infections and All-Cause Death in Patients with Cardiac Implantable Electronic Devices: The Italian Nationwide RI-AIAC Registry

The incidence of infections associated with cardiac implantable electronic devices (CIEDs) and patient outcomes are not fully known. To provide a contemporary assessment of the risk of CIEDs infection and associated clinical outcomes. In Italy, 18 centres enrolled all consecutive patients undergoing a CIED procedure and entered a 12-months follow-up. CIED infections, as well as a composite clinical event of infection or all-cause death were recorded. A total of 2675 patients (64.3% male, age 78 (70-84)) were enrolled. During follow up 28 (1.1%) CIED infections and 132 (5%) deaths, with 152 (5.7%) composite clinical events were observed. At a multivariate analysis, the type of procedure (revision/upgrading/reimplantation) (OR: 4.08, 95% CI: 1.38-12.08) and diabetes (OR: 2.22, 95% CI: 1.02-4.84) were found as main clinical factors associated to CIED infection. Both the PADIT score and the RI-AIAC Infection score were significantly associated with CIED infections, with the RI-AIAC infection score showing the strongest association (OR: 2.38, 95% CI: 1.60-3.55 for each point), with a c-index = 0.64 (0.52-0.75), p = 0.015. Regarding the occurrence of composite clinical events, the Kolek score, the Shariff score and the RI-AIAC Event score all predicted the outcome, with an AUC for the RI-AIAC Event score equal to 0.67 (0.63-0.71) p < 0.001. In this Italian nationwide cohort of patients, while the incidence of CIED infections was substantially low, the rate of the composite clinical outcome of infection or all-cause death was quite high and associated with several clinical factors depicting a more impaired clinical status

Haem iron intake and risk of lung cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort

Background Epidemiological studies suggest that haem iron, which is found predominantly in red meat and increases endogenous formation of carcinogenic N-nitroso compounds, may be positively associated with lung cancer. The objective was to examine the relationship between haem iron intake and lung cancer risk using detailed smoking history data and serum cotinine to control for potential confounding. Methods In the European Prospective Investigation into Cancer and Nutrition (EPIC), 416,746 individuals from 10 countries completed demographic and dietary questionnaires at recruitment. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for incident lung cancer (n = 3731) risk relative to haem iron, non-haem iron, and total dietary iron intake. A corresponding analysis was conducted among a nested subset of 800 lung cancer cases and 1489 matched controls for whom serum cotinine was available. Results Haem iron was associated with lung cancer risk, including after adjustment for details of smoking history (time since quitting, number of cigarettes per day): as a continuous variable (HR per 0.3 mg/1000 kcal 1.03, 95% CI 1.00-1.07), and in the highest versus lowest quintile (HR 1.16, 95% CI 1.02-1.32; trend across quintiles: P = 0.035). In contrast, non-haem iron intake was related inversely with lung cancer risk; however, this association attenuated after adjustment for smoking history. Additional adjustment for serum cotinine did not considerably alter the associations detected in the nested case-control subset. Conclusions Greater haem iron intake may be modestly associated with lung cancer risk.Peer reviewe

MicroRNA profiles discriminate among colon cancer metastasis

MicroRNAs are being exploited for diagnosis, prognosis and monitoring of cancer and other diseases. Their high tissue specificity and critical role in oncogenesis provide new biomarkers for the diagnosis and classification of cancer as well as predicting patients' outcomes. MicroRNAs signatures have been identified for many human tumors, including colorectal cancer (CRC). In most cases, metastatic disease is difficult to predict and to prevent with adequate therapies. The aim of our study was to identify a microRNA signature for metastatic CRC that could predict and differentiate metastatic target organ localization. Normal and cancer tissues of three different groups of CRC patients were analyzed. RNA microarray and TaqMan Array analysis were performed on 66 Italian patients with or without lymph nodes and/or liver recurrences. Data obtained with the two assays were analyzed separately and then intersected to identify a primary CRC metastatic signature. Five differentially expressed microRNAs (hsa-miR-21, -103, -93, -31 and -566) were validated by qRT-PCR on a second group of 16 American metastatic patients. In situ hybridization was performed on the 16 American patients as well as on three distinct commercial tissues microarray (TMA) containing normal adjacent colon, the primary adenocarcinoma, normal and metastatic lymph nodes and liver. Hsa-miRNA-21, -93, and -103 upregulation together with hsa-miR-566 downregulation defined the CRC metastatic signature, while in situ hybridization data identified a lymphonodal invasion profile. We provided the first microRNAs signature that could discriminate between colorectal recurrences to lymph nodes and liver and between colorectal liver metastasis and primary hepatic tumor