The Silkworm as a Source of Natural Antimicrobial Preparations: Efficacy on Various Bacterial Strains

The global spread of multi-resistant pathogens responsible for infections, which cannot be treated with existing drugs such as antibiotics, is of particular concern. Antibiotics are becoming increasingly ineffective and drug resistance is leading to more difficult-to-treat infections; therefore, new bioactive compounds with antimicrobial activity are needed and new alternative sources should be found. Antimicrobial peptides (AMPs) are synthesized by processes typical of the innate immune system and are present in almost all organisms. Insects are extremely resistant to bacterial infections as they can produce a wide range of AMPs, providing an effective first line of defense. The AMPs produced by insects therefore represent a possible source of natural antimicrobial molecules. In this paper, the possibility of using plasma preparations from silkworm (Bombyx mori) larvae as a source of antimicrobials was evaluated. After simple purification steps, insect plasma was analyzed and tested on different Gram-positive and Gram-negative bacterial strains. The results obtained are encouraging as the assays on Escherichia coli and Enterobacter cloacae showed significant decrease in the growth of these Gram-negative bacteria. Similar results were obtained on Gram-positive bacteria, such as Micrococcus luteus and Bacillus subtilis, which showed strong susceptibility to the silkworm AMPs pool. In contrast, Staphylococcus aureus displayed high resistance to Bombyx mori plasma. Finally, the tested plasma formulations were assessed for possible storage not only at 4 \ub0C, but also above room temperature. In conclusion, partially purified plasma from silkworm could be a promising source of AMPs which could be used in formulations for topical applications, without additional and expensive purification steps

Emergency radiology without the radiologist: the forensic perspective

Purpose. The aim of this paper is to describe two cases from the authors\u27 forensic archive database in which teleradiology was related to unfavourable outcomes. Material and methods. Two patients underwent autopsy after unexpected death following road accidents. In one case, death was caused by multiple cervical fractures following minor neck injury in the presence of diffuse idiopathic skeletal hyperostosis. In the other case, death was due to delayed isthmic aortic rupture occurring after thoracic blunt trauma in a young adult. Both conditions were diagnosed at autopsy only. Results. In both cases, the lethal outcome was due to the failure to obtain radiological reports of the X-rays performed in the emergency department. Radiological diagnoses could have been established by activating the teleradiology service which, according to the hospitals\u27 teleradiology protocols, is available on demand in cases of emergency only, as selected by the physician requesting the service. Conclusions. These cases suggest the high risk of excluding the radiologist from the management of patients whose images are transmitted via a teleradiology system.Obiettivo. Gli autori intendono descrivere due casi tratti dal proprio archivio autoptico medico-legale nei quali l\u27esito sfavorevole ? connesso all\u27uso della teleradiologia. Materiali e metodi. Sono descritte le risultanze dell\u27indagine autoptica eseguita su due soggetti deceduti in maniera inattesa dopo incidente della strada. In un caso la morte ? dipesa da fratture cervicali multiple determinatesi, in soggetto affetto da DISH (iperostosi scheletrica idiopatica diffusa), per un trauma minore del collo. Nel secondo caso un giovane adulto riportava una contusione del torace con "rottura in due tempi" dell\u27istmo aortico. Entrambe le patologie traumatiche sono state diagnosticate solo in sede di esame autoptico. Risultati. La mancata diagnosi in vita ha tratto origine, in entrambi i casi, dalla "non refertazione" degli esami radiologici eseguiti in urgenza; la diagnosi radiologica avrebbe potuto effettuarsi mediante attivazione del sistema di teleradiologia, utilizzabile, secondo il protocollo gestionale della struttura, solo in casi urgenti, selezionati dal medico richiedente la prestazione. Conclusioni. Questi due casi suggeriscono che l\u27esclusione del radiologo dalla gestione dei pazienti le cui immagini sono trasmesse in teleradiologia comporta un rischio molto elevato di prestazioni inadeguate

Atlas occipitalisation associated with other anomalies in a 16th century skeleton from Sardinia (Italy)

Archaeological excavations carried out in the plague cemetery of 16th century Alghero (Sardinia) brought to light the skeleton of a male aged 35–45 years, showing anomalies of the atlas. A macroscopic and radiological study has been carried out. The first cervical vertebra is fused with the skull base, resulting in an occipitalisation of the atlas. Absence of the costal element of the left foramen transversarium, resulting in an open anterior foramen transversarium, and posterior arch defect are also observed. The atlanto-occipital junction is a complex structure, susceptible to develop different patterns of congenital defects. These anatomical variations of atlas should be considered in modern clinical practice in order to formulate a correct diagnosis and to conceive an appropriate treatment. Osteoarchaeological cases are important as, beside to ascertain the presence of congenital defects in past populations, allow an in-depth study in dry bones, which can help modern medicine in interpreting anatomical variations. We present an association of congenital anomalies of the atlanto-occipital junction, a condition rarely documented in ancient and modern human skeletal remains

Noise reduction and spatial resolution in CT imaging with the ASIR iterative reconstruction algorithm at different doses and contrasts – a phantom study

Aims and objectives The aim of this study was to quantitatively assess noise reduction and spatial resolution in computed tomography (CT) imaging with the ASIR (Adaptive Statistical Iterative Reconstruction, GE Healthcare) reconstruction algorithm at different kVp, mAs and contrasts. Methods and materials Acquisitions of the Catphan-504 phantom were performed on a PET/CT scanner (Discovery-710, GE Healthcare). CT images were reconstructed using both filtered back projection (FBP) and ASIR with different percentages of reconstruction (20%, 40%, 60%, 80%, 100%). The image noise was estimated for different values of scanning parameters (i.e. tube-load, kilovoltage, pitch, slice thickness). Then, 3D/2D/1D noise power spectrum was estimated. Also, spatial resolution was assessed by obtaining the modulation transfer function (MTF) for a wide range of scanning parameters values and different contrast objects by the circular Edge Spread Function method (using CTP404 modulus) and the Point Spread Function method (using CTP528 modulus). . Results Image noise decreased (up to 50% as compared to FBP) with increasing the percentage of ASIR reconstruction (behaviour more relevant for higher spatial frequencies). Only for low tube load (<56 mAs) and low contrast objects (polistirene with respect to PMMA) acquisitions, MTF analysis showed that ASIR-reconstructed images were characterized by an appreciable reduction in spatial resolution, when compared to FBP-reconstructed images. Conclusion When compared to FBP, ASIR allows a relevant noise reduction without appreciably affecting image quality, except for very low dose and contrast acquisitions

A new physeteroid cetacean from the Lower Miocene of southern Italy: CT imaging, retrodeformation, systematics and palaeobiology of a sperm whale from the Pietra leccese

Herein we describe a new finding of a medium-sized sperm whale from the Burdigalian (Lower Miocene) of the Pietra leccese formation (southern Italy) on the basis of a partly prepared specimen that includes a partial cranium, seven detached teeth, the fragmentary right mandible and two partial vertebral bodies. Because of the overall compression of the specimen, we carried out a retro deformation of a 3D model of the cranium obtained via CT-scanning. The combined analysis of the original specimen and the retrodeformed model has allowed us to recognise that the studied specimen constitutes a new physeteroid taxon: Angelocetus cursiensis n. gen. n. sp., a longirostrine sperm whale characterised by a sideward projected supracranial basin, as evidenced by the overall displacement of its posteriormost margin. Based on a phylogenetic analysis, A. cursiensis n. gen. n. sp. is determined to be a crown physeteroid that does not belong to either the Physeteridae or the Kogiidae. The wide temporal fossa, elongated rostrum and slender teeth, as well as the skull dimensions (estimated bizygomatic width c. 550 mm) suggest a diet based on medium to large-sized bony fish that were likely captured by a raptorial pierce feeding strategy (as for most of the coeval Burdigalian physeteroids). Despite a seemingly low ecomorphological disparity, the high degree of taxonomic diversity of the Burdigalian physeteroids suggests that this time span represents a crucial phase for the evolutionary history of sperm whales

Ultra-High Frequency Ultrasound (Uhfus) Applications in Sjogren Syndrome: Narrative Review and Current Concepts

Primary Sjogren’s syndrome (SS) is a systemic autoimmune chronic inflammatory disease with predominant involvement of the exocrine glands, particularly the salivary glands (SGs). The role of salivary glands ultrasound (SGUS) in the work-up of patients with primary Sjogren syndrome (SS) is progressively increasing due to its useful support in diagnosis and follow-up as a widely available, repeatable, noninvasive and safe technique. Although SGUS is not yet included in the dominant primary SS classification, several studies supported its inclusion in the American College of Rheumatology/European League Against Rheumatism criteria. In this context, a novel imaging technique, ultra-high frequency ultrasound (UHFUS), is being explored. Compared to the frequencies used in conventional ultrasound (US) (up to 22 MHz), UHFUS operates with higher frequencies (30–100 MHz) allowing for outstanding image resolution, up to 30 μm. UHFUS permits the scn of both major and minor SGs, opening new avenues for the integration of tissue and imaging biomarkers. Although further studies are needed to confirm its role, this novel imaging technique might lead to several potential improvements, including earlier diagnosis, reduction of unnecessary and inadequate biopsies and better management and follow-up of patients with primary SS

Multislice computed tomography SYNTAX score for coronary artery disease evaluation prior to transcatheter aortic valve implantation

Background: Coronary computed tomography angiography (CCTA) is a useful tool for the evaluation of coronary anatomy prior to both surgical and transcatheter aortic valve implantation (TAVI). Multislice Computed Tomography (MSCT) SYNTAX score (SXscore) strongly correlates with the traditional angiographic SXscore, and the latter has proven to predict cardiovascular events in patients with coronary artery disease (CAD) referred to TAVI. Purpose: The aim of the study is to evaluate the feasibility and accuracy of the calculation of MSCT SXscore in TAVI patients, compared to the gold standard angiographic SXscore. Materials and methods: We evaluated 65 patients eligible for TAVI who underwent both CCTA and invasive coronary angiography (ICA) prior to valve replacement. CCTA was compared to ICA in terms of sensitivity, specificity, and positive and negative predictive values. CCTA performance was evaluated at 3 levels: patient level, vessellevel and segmentlevel. MSCT SXscore was calculated, when possible (i.e. only in fullyevaluable scans), and compared to the angiographic SXscore. Results: Overall CCTA diagnostic performance was good, with high sensitivity and negative predictive values (97.2% and 96.0%, respectively) and good agreement with ICA (k=0.81). As expected, specificity and positive predictive values were lower (82.8% and 87.5%, respectively). At vessellevel, the circumflex artery (CA) was more often misdiagnosed than the other arteries. We were able to calculate MSCT SXscore in 50/65 scans (76.9%). The correlation between MSCT and angiographic SXscore was excellent (Pearson's R=0.965, P&lt;0.001). Conclusions: MSCT SXscore emerges as an interesting tool with strong agreement with angiographic SXscore, providing a noninvasive ambulatory alternative to assess CAD severity in TAVI patients

A Case of Brachymetatarsia From Medieval Sardinia (Italy)

Archaeological excavations carried out in the Medieval village of Geridu (Sardinia) uncovered several burials dating to the late 13th or the first half of 14th century. Among these individuals, the skeleton of an adult female showing a bilateral abnormal shortness of the fourth metatarsal bone was identified. Bilaterality and absence of other skeletal anomalies allow to rule out an acquired aetiology of the disease and to support a diagnosis of congenital brachymetatarsia. Such a rare deformity has a clinical incidence of 0.02% to 0.05%, with strong predominance of the female gender. To our knowledge, no other cases of brachymetatarsia have been reported in paleopathology so far

Sclerosing bone dysplasia from 16th century Sardinia (Italy): a possible case of Camurati-Engelmann disease

The skeletal remains of a male aged 45–55 years displaying several bone anomalies were unearthed from the Alghero (Sardinia) plague cemetery ‘lo Quarter’, a burial site dating back to the 1582–1583 AD outbreak. The skeleton, whose stature is about 165 cm, presents a bilateral hyperostosis with increased diameter of the diaphyses of all the long bones of the upper and lower limbs; the metaphyses appear to be involved, while the epiphyses are spared. Marked thickening of the cranial vault is also evident. Radiological study showed irregular cortical thickening and massive endoperiosteal bone apposition; sclerotic changes are observed in the diaphysis of some metacarpals. Computed tomography (CT) cross sections of the long bones displayed a thickening of the cortical portion and endoperiosteal bone apposition. The individual was affected by a sclerosing bone dysplasia, a genetic disease characterized by increased bone density. In differential diagnosis, several sclerosing bone dysplasia, such as hyperostosis corticalis generalisata, craniodiaphyseal dysplasia, craniometadiaphyseal dysplasia, pachydermoperiostosis and Camurati–Engelmann disease, as well as other disorders characterized by sclerosing manifestations, such as Erdheim–Chester disease, mehloreostosis and skeletal fluorosis, need to be considered. The anomalies observed in skeleton 2179 fit with the features of Camurati–Engelmann disease, which is the most likely candidate for final diagnosis. It is highly challenging to evaluate how such a condition may have influenced the individual’s lifestyle in terms of development, mobility and quality of life. This individual was probably symptomatic and must have experienced common clinical symptoms, such as pain in the limbs and fatigability. However, the strong development of the muscular insertions and the degenerative changes in the upper limbs suggest that the mobility problems should not have prevented him from reaching a mature age and from performing essential daily activities. The presented case is the unique paleopathological evidence of Camurati–Engelmann disease so far diagnosed