Switching on the deep brain stimulation: Effects on cardiovascular regulation and respiration.

BACKGROUND: Objective of this study was to evaluate the acute cardiovascular and respiratory effects of switching on the deep brain stimulation in the follow up of nine Parkinson's disease patients with subthalamic nucleus stimulation and six cluster headache patients with posterior hypothalamic area stimulation. METHODS: Systolic and diastolic blood pressure, heart rate, and respiratory rate were monitored continuously during supine rest in both groups. Each patient was assessed in two conditions: resting supine with stimulator off and with stimulator on. RESULTS: In supine resting condition switching on the DBS induced no significant changes (p>0.05) in systolic and diastolic blood pressure as well as in heart rate and respiratory rate, in both groups of patients, either taking 1 min or 10 heartbeats as a sample for analysis. CONCLUSIONS: Switching on the DBS does not modify heart rate, blood pressure nor respiratory rate in both Parkinson and cluster headache patients under resting conditions

Efficacy of ginger as antiemetic in children with acute gastroenteritis: a randomised controlled trial

Background: Ginger is a spice with a long history of use as a traditional remedy for nausea and vomiting. No data on the efficacy of ginger are presently available for children with vomiting associated with acute gastroenteritis (AGE). Aim: To test whether ginger can reduce vomiting in children with AGE. Methods: Double-blind, randomised placebo-controlled trial in outpatients aged 1 to 10 years with AGE-associated vomiting randomised to ginger or placebo. The primary outcome was the occurrence of ≥1 episode of vomiting after the first dose of treatment. Severity of vomiting and safety were also assessed. Results: Seventy-five children were randomised to the ginger arm and 75 to the placebo arm. Five children in the ginger arm and 4 in the placebo arm refused to participate in the study shortly after randomisation, leaving 70 children in the ginger arm and 71 in the placebo arm (N = 141). At intention-to-treat analysis (N = 150), assuming that all children lost to follow-up had reached the primary outcome, the incidence of the main outcome was 67% (95% CI 56 to 77) in the ginger group and 87% (95% CI 79 to 94) in the placebo group, corresponding to the absolute risk reduction for the ginger versus the placebo group of −20% (95% CI −33% to −7%, P = 0.003), with a number needed to treat of 5 (95% CI 3 to 15). Conclusion: Oral administration of ginger is effective and safe at improving vomiting in children with AGE. Trial registration: The trial was registered on https://clinicaltrials.gov/ with the identifier NCT02701491

L'arco cefalico: non tutte le stenosi delle fistole sono uguali

La stenosi dell'arco cefalico rappresenta un'entità unica nel capitolo delle stenosi delle FAV arterovenose in campo dialitico. L'arco cefalico, cioè l'ultimo tratto di vena cefalica prima della sua confluenza nella vena ascellare è sede frequente di stenosi, quasi sempre riscontrabile con fistole prossimali. La presenza di numerose valvole che rispondono con un processo di ipertrofia all'aumento del flusso ematico, la riduzione dello shear stress per l'alterata emodinamica legata alla geometria dell'arco e la rigidità delle strutture che circondano il vaso, rappresentano le principali cause favorenti lo sviluppo della stenosi. La diagnosi è relativamente agevole attraverso un attento esame obiettivo e l'ultrasonografia, ma il trattamento si rivela spesso impegnativo per l'elevata resistenza della lesione alla dilatazione e la tendenza della stenosi alla recidiva. Langioplastica rappresenta la prima opzione terapeutica, ma richiede un'attenta valutazione tecnica nella scelta e nell'utilizzo di palloni ad alta pressione. L'utilizzo di stent o stent-graft costituisce una ulteriore strategia nei casi di recidiva stenotica precoce. La chirurgia può essere considerata una soluzione alternativa ma più ragionevolmente costituisce un approccio successivo e si avvale di interventi di trasposizione della vena o di posizionamento di ponte protesico. La riduzione chirurgica del flusso della FAV può essere razionale nei casi di accesso vascolare ad alta portata. In tutti i casi l'elevata frequenza di recidive impone una stretta sorveglianza della FAV per garantirne la pervietà a distanza

Seismic activity in the Pollino region (Basilicata-Calabria border)

The Pollino region and the whole Calabria-Lucania border are known for the absence of destructive (M>6) historical earthquakes. This lack of historical seismicity is noticeable in the analysis of Southern Apennines and Calabria earthquake history (Rovida et al., 2011). At the same time, paleoseismological studies found evidence for significant active faulting (Cinti et al., 1997; Michetti et al., 1997) pointing to the Pollino area as a seismic gap. Instrumental seismicity in the region is characterized by the occurrence of seismic sequences, one of the most significant in the last decades is the Mercure seismic sequence, Mw 5.6 in September 1998 (Brozzetti et al., 2008). For this reason, the sequence started in 2010 raised a big concern in the population and local authorities. INGV is following the evolution of the sequence since its beginning, in March 2010, increasing the seismic monitoring and planning several activities and projects. The area was proposed by INGV to DPC (Dipartimento di Protezione Civile nazionale) for inclusion in the projects to be carried out in the present INGV-DPC agreement. This project has just started and will try to provide better constraints to the active tectonics and fault identification of the region. In this paper we describe what INGV is doing to understand better the tectonics of the region using microseismicity, and try to offer some cue to the discussion about the seismogenic faults in the area.Published5-92T. Tettonica attivaN/A or not JCRope

Preventive Effect of Cow's Milk Fermented with Lactobacillus paracasei CBA L74 on Common Infectious Diseases in Children: A Multicenter Randomized Controlled Trial

Background: Fermented foods have been proposed to prevent common infectious diseases (CIDs) in children attending day care or preschool

When should cardiovascular prevention begin? The importance of antenatal, perinatal and primordial prevention

Cardiovascular diseases represent a major health problem, being one of the leading causes of morbidity and mortality worldwide. Therefore, in this scenario, cardiovascular prevention plays an essential role although it is difficult to establish when promoting and implementing preventive strategies. However, there is growing evidence that prevention should start even before birth, during pregnancy, aiming to avoid the onset of cardiovascular risk factors, since events that occur early in life have a great impact on the cardiovascular risk profile of an adult. The two pillars of this early preventive strategy are nutrition and physical exercise, together with prevention of cardio-metabolic diseases during pregnancy. This review attempts to gather the growing evidence of the benefits of antenatal, perinatal and primordial prevention, discussing also the possibility to reverse or to mitigate the cardiovascular profile developed in the initial stages of life. This could pave the way for future research, investigating the optimal time and duration of these preventing measures, their duration and maintenance in adulthood, and the most effective interventions according to the different age and guiding in the next years, the best clinical practice and the political strategies to cope with cardiovascular disease

PARP inhibitors in endometrial cancer: current status and perspectives

Advanced, recurrent and metastatic endometrial cancer (EC) has a dismal prognosis due to poor response rates to conventional treatments. In the era of precision medicine, the improved understanding of cancer genetics and molecular biology has led to the development of targeted therapies, such as poly (ADP-ribose) polymerase (PARP) inhibitors. This class of drugs that inhibit PARP enzymes has been investigated in many different types of tumors and its use in the treatment of gynecological malignancies has rapidly increased over the past few years. Data from several clinical trials showed that PARP inhibitors have a beneficial role in cancers with a defect in the homologous DNA recombination system, regardless of the BRCA mutational status. Since EC frequently shows mutations in PTEN and TP53 genes, indirectly involved in the homologous DNA recombination pathway, several in vivo and in vitro studies investigated the efficacy of PARP inhibitors in EC, showing promising results. This review will discuss the use of PARP inhibitors in endome-trial cancer, summarizing data from preclinical studies and providing an overview of the ongoing trials, with a special focus on the development of combined treatment strategies with PARP inhibitors and immune checkpoint inhibitors

Combination of chemotherapy and PD-1 blockade induces T cell responses to tumor non-mutated neoantigens

Grimaldi and Cammarata et al. develop a proteomics-based, target discovery platform to identify immunogenic proteins specific to apoptotic tumor cells. This study highlights the importance of protein modifications in apoptotic tumor cells as a mechanism of generating immunogenic neoantigens that can be targeted for T cell-based immunotherapy.Here, we developed an unbiased, functional target-discovery platform to identify immunogenic proteins from primary non-small cell lung cancer (NSCLC) cells that had been induced to apoptosis by cisplatin (CDDP) treatment in vitro, as compared with their live counterparts. Among the multitude of proteins identified, some of them were represented as fragmented proteins in apoptotic tumor cells, and acted as non-mutated neoantigens (NM-neoAgs). Indeed, only the fragmented proteins elicited effective multi-specific CD4(+) and CD8(+) T cell responses, upon a chemotherapy protocol including CDDP. Importantly, these responses further increased upon anti-PD-1 therapy, and correlated with patients' survival and decreased PD-1 expression. Cross-presentation assays showed that NM-neoAgs were unveiled in apoptotic tumor cells as the result of caspase-dependent proteolytic activity of cellular proteins. Our study demonstrates that apoptotic tumor cells generate a repertoire of immunogenic NM-neoAgs that could be potentially used for developing effective T cell-based immunotherapy across multiple cancer patients

High prevalence of Trichomonas gallinae in wild columbids across western and southern Europe

Avian trichomonosis is known as a widespread disease in columbids and passerines, and recent findings have highlighted the pathogenic character of some lineages found in wild birds. Trichomonosis can affect wild bird populations including endangered species, as has been shown for Mauritian pink pigeons Nesoenas mayeri in Mauritius and suggested for European turtle doves Streptopelia turtur in the UK. However, the disease trichomonosis is caused only by pathogenic lineages of the parasite Trichomonas gallinae. Therefore, understanding the prevalence and distribution of both potentially pathogenic and non-pathogenic T. gallinae lineages in turtle doves and other columbids across Europe is relevant to estimate the potential impact of the disease on a continental scale