The nucleolar size is associated to the methylation status of ribosomal DNA in breast carcinomas.

BACKGROUND: There is a body of evidence that shows a link between tumorigenesis and ribosome biogenesis. The precursor of mature 18S, 28S and 5.8S ribosomal RNAs is transcribed from the ribosomal DNA gene (rDNA), which exists as 300-400 copies in the human diploid genome. Approximately one half of these copies are epigenetically silenced, but the exact role of epigenetic regulation on ribosome biogenesis is not completely understood. In this study we analyzed the methylation profiles of the rDNA promoter and of the 5' regions of 18S and 28S in breast cancer. METHODS: We analyzed rDNA methylation in 68 breast cancer tissues of which the normal counterpart was partially available (45/68 samples) using the MassARRAY EpiTYPER assay, a sensitive and quantitative method with single base resolution. RESULTS: We found that rDNA locus tended to be hypermethylated in tumor compared to matched normal breast tissues and that the DNA methylation level of several CpG units within the rDNA locus was associated to nuclear grade and to nucleolar size of tumor tissues. In addition we identified a subgroup of samples in which large nucleoli were associated with very limited or absent rDNA hypermethylation in tumor respect to matched normal tissue. CONCLUSIONS: In conclusion, we suggest that rDNA is an important target of epigenetic regulation in breast tumors and that rDNA methylation level is associated to nucleolar size

The acute phase management of spinal cord injury affecting polytrauma patients : the ASAP study

Publisher Copyright: © 2022, The Author(s).Background: Few data on the management of acute phase of traumatic spinal cord injury (tSCI) in patients suffering polytrauma are available. As the therapeutic choices in the first hours may have a deep impact on outcome of tSCI patients, we conducted an international survey investigating this topic. Methods: The survey was composed of 29 items. The main endpoints of the survey were to examine: (1) the hemodynamic and respiratory management, (2) the coagulation management, (3) the timing of magnetic resonance imaging (MRI) and spinal surgery, (4) the use of corticosteroid therapy, (5) the role of intraspinal pressure (ISP)/spinal cord perfusion pressure (SCPP) monitoring and (6) the utilization of therapeutic hypothermia. Results: There were 171 respondents from 139 centers worldwide. A target mean arterial pressure (MAP) target of 80–90 mmHg was chosen in almost half of the cases [n = 84 (49.1%)]. A temporary reduction in the target MAP, for the time strictly necessary to achieve bleeding control in polytrauma, was accepted by most respondents [n = 100 (58.5%)]. Sixty-one respondents (35.7%) considered acceptable a hemoglobin (Hb) level of 7 g/dl in tSCI polytraumatized patients. An arterial partial pressure of oxygen (PaO2) of 80–100 mmHg [n = 94 (55%)] and an arterial partial pressure of carbon dioxide (PaCO2) of 35–40 mmHg [n = 130 (76%)] were chosen in most cases. A little more than half of respondents considered safe a platelet (PLT) count > 100.000/mm3 [n = 99 (57.9%)] and prothrombin time (PT)/activated partial thromboplastin time (aPTT) < 1.5 times the normal control [n = 85 (49.7%)] in patients needing spinal surgery. MRI [n = 160 (93.6%)] and spinal surgery [n = 158 (92.4%)] should be performed after intracranial, hemodynamic, and respiratory stabilization by most respondents. Corticosteroids [n = 103 (60.2%)], ISP/SCPP monitoring [n = 148 (86.5%)], and therapeutic hypothermia [n = 137 (80%)] were not utilized by most respondents. Conclusions: Our survey has shown a great worldwide variability in clinical practices for acute phase management of tSCI patients with polytrauma. These findings can be helpful to define future research in order to optimize the care of patients suffering tSCI.Peer reviewe

The acute phase management of spinal cord injury affecting polytrauma patients: the ASAP study

Background: Few data on the management of acute phase of traumatic spinal cord injury (tSCI) in patients suffering polytrauma are available. As the therapeutic choices in the first hours may have a deep impact on outcome of tSCI patients, we conducted an international survey investigating this topic. Methods: The survey was composed of 29 items. The main endpoints of the survey were to examine: (1) the hemodynamic and respiratory management, (2) the coagulation management, (3) the timing of magnetic resonance imaging (MRI) and spinal surgery, (4) the use of corticosteroid therapy, (5) the role of intraspinal pressure (ISP)/spinal cord perfusion pressure (SCPP) monitoring and (6) the utilization of therapeutic hypothermia. Results: There were 171 respondents from 139 centers worldwide. A target mean arterial pressure (MAP) target of 80–90&nbsp;mmHg was chosen in almost half of the cases [n = 84 (49.1%)]. A temporary reduction in the target MAP, for the time strictly necessary to achieve bleeding control in polytrauma, was accepted by most respondents [n = 100 (58.5%)]. Sixty-one respondents (35.7%) considered acceptable a hemoglobin (Hb) level of 7&nbsp;g/dl in tSCI polytraumatized patients. An arterial partial pressure of oxygen (PaO2) of 80–100&nbsp;mmHg [n = 94 (55%)] and an arterial partial pressure of carbon dioxide (PaCO2) of 35–40&nbsp;mmHg [n = 130 (76%)] were chosen in most cases. A little more than half of respondents considered safe a platelet (PLT) count &gt; 100.000/mm3 [n = 99 (57.9%)] and prothrombin time (PT)/activated partial thromboplastin time (aPTT) &lt; 1.5 times the normal control [n = 85 (49.7%)] in patients needing spinal surgery. MRI [n = 160 (93.6%)] and spinal surgery [n = 158 (92.4%)] should be performed after intracranial, hemodynamic, and respiratory stabilization by most respondents. Corticosteroids [n = 103 (60.2%)], ISP/SCPP monitoring [n = 148 (86.5%)], and therapeutic hypothermia [n = 137 (80%)] were not utilized by most respondents. Conclusions: Our survey has shown a great worldwide variability in clinical practices for acute phase management of tSCI patients with polytrauma. These findings can be helpful to define future research in order to optimize the care of patients suffering tSCI

Selezione del paziente con ictus ischemico iperacuto da sottoporre al trattamento endovascolare

RIASSUNTO ANALITICO Lo stroke è una patologia cerebrovascolare conseguente ad uno squilibrio tra la richiesta metabolica e l’apporto sanguigno a carico del tessuto cerebrale e costituisce la seconda causa di morte dopo l’infarto, e la terza causa di disabilità (prima negli anziani), a causa delle sequele neurologiche che provoca I tassi di incidenza a livello mondiale oscillano tra 144 e 373/100.00/anno, con un tasso di mortalità intorno al 15%. Recentemente è stata dimostrata l’utilità terapeutica della trombectomia meccanica nei pazienti che non si sono o non possono giovarsi della fibrinolisi per via endovenosa purchè la rivascolarizzazione avvenga entro le 6 ore nel circolo anteriore e 12 nel territorio vertebrobasilare. La selezione del paziente da sottoporre a trattamento intrarterioso avviene tramite neuroimmagini, in particolare attraverso la dimostrazione della trombosi intrarteriosa con angioTC e la preservazione del parenchima cerebrale misurata con criteri radiologici nella TC basale. Obiettivo Validare le diverse metodiche TC e TC perfusionali nella selezione e nel potere predittivo dell’outcome nel paziente con ictus ischemico iperacuto da sottoporre al trattamento endovascolare . Pazienti e metodi Nel periodo compreso dal 1 gennaio 2017 al 31 luglio 2017 sono stati arruolati 44 pazienti sottoposti a trattamento endovascolare. Il campione è stato analizzato per distribuzione di età; clinica all’esordio(valutato mediante NIHSS e mRS); caratteristiche di neuroimaging (TC basale, AngioTC e TC perfusionale); sede dell’occlusione; tipo di trattamento endovascolare; outcome radiologico (valutato mediante tasso di ricanalizzazione) e outcome clinico (valutato mediante NIHSS e mRS). I dati di neuroimaging, in particolare la TC basale e la TC perfusionale, sono stati analizzati da due reader esperti e valutati secondo criteri di selezione differenti. Sono stati applicati due criteri di lettura distinti per la valutazione dell’ASPECTS-TC (Alberta Stroke Program Early CT Score), il primo secondo le linee guida AHA (ASPECTSaha), il secondo con criteri di inclusione più restrittivi (ASPECTSsg). Per quanto riguarda la valutazione della TC perfusionale è stato attribuito un punteggio ASPECTS al core ischemico sulle mappe di perfusione CBV, ed è stata valutata la presenza di mismatch confrontando le mappe di perfusione CBV ed MTT. I risultati ottenuti sono stati analizzati per tasso di riproducibilità intra e interosservatore e successivamente le variabili cliniche e radiologiche sono state testate come predittori di outcome clinico e radiologico post trattamento endovascolare. Risultati e discussione L’ASPECTSaha, risulta essere altamente riproducibile, ma non altrettanto sensibile nel predire l’outcome terapeutico ASPECTSsg, e ASPECTSp mostrano una capacità predittiva elevata di outcome, e la loro applicazione potrebbe affinare i criteri di selezione dei pazienti candidabili a trattamento endovascolare. In particolare, l’ASPECTSp si associa ad un elevato tasso di riproducibilità intra e interosservatore, per tale motivo risulta essere la metodica più affidabile nella selezione del paziente. Conclusione La selezione dei pazienti nel trattamento endovascolare dello stroke è uno step fondamentale. L’utilizzo dell’ASPECTSaha rimane il metodo più diffuso, sebbene la sua bassa riproducibilità induca a ricercare metodi più accurati, come sembra essere l’ASPECTSp

Dronedarone-associated acute renal failure: evidence coming from the Italian spontaneous ADR reporting database

AIM To describe cases of acute renal failure (ARF) and of renal failure (RF) from dronedarone retrieved in the general population during post-marketing surveillance through the Italian spontaneous ADR reporting database. METHODS A case by case analysis was performed. Reports codified with the System Organ Class (SOC) term \u2018urinary system disorders\u2019 of the ADR terminology of the World Health Organization associated with dronedarone treatment were selected. RESULTS Out of 124 069 ADR reports, in 55 of them dronedarone was listed as the suspected drug. Among these reports, we identified four cases of ARF, two of RF and three cases of increase of blood creatinine submitted by physicians between October 2010 and December 2011. The patient age was from 61 to 84 years and most cases occurred within the first 13 days of initiation of dronedarone therapy (range 6 days \u2013 2 months). Only one patient received a co-suspected drug labelled for causing ARF. In all reports but one, positive dechallenge was reported. CONCLUSIONS Clinicians should be made aware of the risk of ARF/RF associated with dronedarone and of the need to screen patients appropriately for ARF/RF risk factors before starting dronedarone therapy

«A preliminary assessment of green areas of the Matera city and their potential role in climate change»

Urban greening offers a series of services including the improvement of air quality, water cycle, through several functions (e.g., absorption of air pollutants, increasing water catchment operated by soil). There is an increasing attention to quantify urban green areas and the related benefits to the extent that the Italian National Statistics Institute (ISTAT) scores the “green value” of the main cities. There are still uncertainties on the classification of the green areas and their potential to provide services that collectively improve the urban life quality. This study analysed the green areas of the urban environment of the Matera city, focussing their category (private gardens, school gardens, green streets and urban parks) and size and their potential to serve as CO2 sink. The analyses were carried out on four representative areas and the size of the various categories was assessed through cadastral and other municipal data. The urbanization process had influences urban ecosystems including plant biodiversity, increasing the abundance of plant alien species. Knowledge on the spread of plant alien species might help to prevent the biodiversity loss. Therefore, a qualitative survey of the existing alien plant species in the urban environment was performed. Preliminary results show that the urban green area calculated in this study is 90 ha. In addition, private gardens share the higher surface of urban green areas, reflecting a good greening aptitude of citizens. Considering that the green areas within built environment is most beneficial for human well-being, a possible scenario related to the carbon (C) sequestration by these area in Matera city will be presented. A potential green corridor connecting some existing spot green areas to promote social aspects and improve well being of citizens and environmental sustainability will also discussed. This study might be supportive for urban planners and local policy makers, contributing to drive future decisions toward a greener built environment of the Matera city

Colonization and Infection of Indwelling Medical Devices by Staphylococcus aureus with an Emphasis on Orthopedic Implants

The use of indwelling medical devices has constantly increased in recent years and has revolutionized the quality of life of patients affected by different diseases. However, despite the improvement of hygiene conditions in hospitals, implant-associated infections remain a common and serious complication in prosthetic surgery, mainly in the orthopedic field, where infection often leads to implant failure. Staphylococcus aureus is the most common cause of biomaterial-centered infection. Upon binding to the medical devices, these bacteria proliferate and develop dense communities encased in a protective matrix called biofilm. Biofilm formation has been proposed as occurring in several stages—(1) attachment; (2) proliferation; (3) dispersal—and involves a variety of host and staphylococcal proteinaceous and non-proteinaceous factors. Moreover, biofilm formation is strictly regulated by several control systems. Biofilms enable staphylococci to avoid antimicrobial activity and host immune response and are a source of persistent bacteremia as well as of localized tissue destruction. While considerable information is available on staphylococcal biofilm formation on medical implants and important results have been achieved on the treatment of biofilms, preclinical and clinical applications need to be further investigated. Thus, the purpose of this review is to gather current studies about the mechanism of infection of indwelling medical devices by S. aureus with a special focus on the biochemical factors involved in biofilm formation and regulation. We also provide a summary of the current therapeutic strategies to combat biomaterial-associated infections and highlight the need to further explore biofilm physiology and conduct research for innovative anti-biofilm approaches