Nocturnal non-dipping pattern in untreated hypertensives at different cardiovascular risk according to the 2003 ESH/ESC guidelines.

To evaluate in a large population of untreated, uncomplicated essential hypertensives the relationship between alterations in nocturnal blood pressure (BP) profile, i.e. non-dipping pattern, and total cardiovascular risk.A total of 580 consecutive patients with grade 1 or 2 hypertension, referred to our outpatient clinic, underwent the following procedures: (i) clinical and routine laboratory examinations; (ii) 24-h ambulatory BP monitoring; (iii) 24-h collection for microalbuminuria; (iv) echocardiography; and (v) carotid ultrasonography. Cardiovascular risk was assessed according to the stratification scheme suggested by the 2003 ESH/ESC guidelines.According to this classification, 16.2% of the 580 patients were considered at low added risk, 42.4% at medium added risk and 41.4% at high added risk; 38.5% of the overall population was classified in the high-risk stratum because of at least one manifestation of target organ damage (TOD) and 6.3% for the presence of three or more risk factors. The prevalence rates of a non-dipping pattern (decrease in BP at nightor = 10% compared with the average daytime values) were 28.5% in low-risk, 32.6% in medium-risk and 42.2% in high-risk patients, respectively. CONCLUSIONS. Our findings show that the prevalence of a non-dipping profile is significantly greater in patients stratified at high compared with those at low and medium added risk

Origin, duplication and reshuffling of plasmid genes: Insights from Burkholderia vietnamiensis G4 genome.

Using a computational pipeline based on similarity networks reconstruction we analysed the 1133 genes of the Burkholderia vietnamiensis ( Bv) G4 five plasmids, showing that gene and operon duplication played an important role in shaping the plasmid architecture. Several single/multiple duplications occurring at intra- and/or interplasmids level involving 253 paralogous genes (stand-alone, clustered or operons) were detected. An extensive gene/operon exchange between plasmids and chromosomes was also disclosed. The larger the plasmid, the higher the number and size of paralogous fragments. Many paralogs encoded mobile genetic elements and duplicated very recently, suggesting that the rearrangement of the Bv plastic genome is ongoing. Concerning the "molecular habitat" and the "taxonomical status" (the Preferential Organismal Sharing) of Bv plasmid genes, most of them have been exchanged with other plasmids of bacteria belonging (or phylogenetically very close) to Burkholderia, suggesting that taxonomical proximity of bacterial strains is a crucial issue in plasmid-mediated gene exchange. © 2014 Elsevier Inc

Bite and Sight: Is There a Correlation? Clinical Association between Dental Malocclusion and Visual Disturbances in Pediatric Patients

Aim: The aim of this study was to evaluate the correlation between malocclusions and visualdefects. Thisisacase-controlstudyevaluatingtheprevalenceofvisualdefectsinpatientswith di\ufb00erent types of malocclusions. Methods: One-hundred and sixty patients aged from 5 to 14 were evaluatedusingtheROMAindextodetectmalocclusion;theoneswiththelowestscoreswereusedas the control group. They were also submitted to visual-capacity inspection for motility and refractive disorders. Results: Our work showed an enhanced prevalence of refractive defects or fusional vergence defects and alteration of eye movements (especially the saccades) in almost all dental malocclusions. Statistics: TheKappatestvaluesforROMAindexwerebetween0.643and1.00forthe intraoperator agreement (0.00 < p < 0.002) and between 0.773 and 1.00 for the agreement between operators (p = 0 < 0.001). The statistically signi\ufb01cance level for the correlation malocclusion/visual defectswassetatp < 0.05. StatisticalanalyseswereperformedwiththeSTATAsoftware(version15.0, Stata Corp LP, College Station, TX, USA). Conclusion: Considering the high level of the statistical analysis and the accuracy of the methodology used, these data allows the establishment of a huge correlation between sagittal, transversal and vertical malocclusions with ocular disorders (myopia, hyperopia, astigmatism and ocular motility defects)

Metabolic syndrome and multiple organ damage in essential hypertension

Aim. We investigated the prevalence of the metabolic syndrome (MS) in hypertensive patients categorized according to the number of markers of organ damage (OD) in order to assess the value of a systematic search for cardiac and extra-cardiac OD in the MS setting. Methods. A total of 3119 untreated and treated essential hypertensives included in the Evaluation of Target Organ Damage in Hypertension (ETODH), an observational registry of hypertension-related OD, were considered for this analysis. All patients underwent extensive investigation for left ventricular hypertrophy (LVH) or LV concentric remodeling (cardiac OD), carotid plaques and/or intima-media thickening (vascular OD) and microalbuminuria (MA) and/or increased serum creatinine (renal OD). Subjects were classified as: positive for none (group 0), one (group I), two (group II) or three markers (group III) of OD. Results. MS prevalence rates progressively rose across the groups stratified according to the OD score, reaching a 2.3-fold increase in group III compared with their MS counterparts in group 0. The distribution of subjects with and without the MS across the groups was 15% vs 29% (group 0), 32% vs 38% (group I), 39% vs 26% (group II) and 14% vs 7% (group III), respectively. Thus, subjects having two or three markers of OD were 53% among those with MS and 33% (p<0.01) among those without it. Conclusion. Our findings indicate a strong association between the MS and OD by showing that a clustering of two or three markers of OD is the prevalent cardiovascular phenotype in MS hypertensives referred to a specialist center and call for a systematic evaluation of cardiac and extracardiac OD in this setting

Synthesis of functionalized iron N-heterocyclic carbene complexes and their potential application as flame behavior modifier in cross linked epoxy resins

The design of new flame retardants (FR) that avoid the use of halogen and phosphorus additives is challenging and urgent. Herein we report on the synthesis of bis-amino functionalized N-heterocyclic carbene cyclopentadienone iron complexes aimed at promoting the production of iron containing epoxy resins. Iron complexes are successfully employed to obtain high Tg thermosets with as low as 5% hardener content. Moreover the obtained resins display an impressive charring ability that paves the way to the application of such systems for material with improved flame behavior

Assessment of water vapor content from MIVIS TIR data

The main objective of land remotely sensed images is to derive biological, chemical and physical parameters by inverting sample sets of spectral data. For the above aim hyperspectral scanners on airborne platform are a powerful remote sensing instrument for both research and environmental applications because of their spectral resolution and the high operability of the platform. Fine spectral information by MIVIS (airborne hyperspec- tral scanner operating in 102 channels ranging from VIS to TIR) allows researchers to characterize atmospher- ic parameters and their effects on measured data which produce undesirable features on surface spectral signa- tures. These effects can be estimated (and remotely sensed radiances corrected) if atmospheric spectral trans- mittance is known at each image pixel. Usually ground-based punctual observations (atmospheric sounding bal- loons, sun photometers, etc.) are used to estimate the main physical parameters (like water vapor and tempera- ture profiles) which permit us to estimate atmospheric spectral transmittance by using suitable radiative trans- fer model and a specific (often too strong) assumption which enable atmospheric properties measured only in very few points to be extended to the whole image. Several atmospheric gases produce observable absorption features, but only water vapor strongly varies in time and space. In this work the authors customize a self-suf- ficient «split-window technique» to derive (at each image pixel) atmospheric total columnar water vapor con- tent (TWVC) using only MIVIS data collected by the fourth MIVIS spectrometer (Thermal Infrared band). MIVIS radiances have been simulated by means of MODTRAN4 radiative transfer code and the coefficients of linear regression to estimate TWVC from «split-windows» MIVIS radiances, based on 450 atmospheric water vapor profiles obtained by radiosonde data provided by NOAA\NESDIS. The method has been applied to pro- duce maps describing the spatial variability of the water vapor columnar content along a trial scene. The pro- cedure has been validated by means of the MIVIS data acquired over Venice and the contemporary radiosonde data. A discrepancy within 5% has been measured between the estimate of TWVC derived from the proposed self-sufficient split-window technique and the coincident radiosonde measurements. If confirmed by further analyses such a result will permit us to fully exploit MIVIS TIR capability to offer a more effective (at image pixel level) and self-sufficient (no ancillary observations required) way to obtain atmospherically corrected MIVIS radiances

The foot, Anatomy notes

The foot has 28 bones, 30 joints, and more than 100 muscles, ligaments, and tendons. These structures work together to carry out two main functions: weight-bearing and propulsion. Plus, the foot must be flexible to adapt to uneven surfaces and remain stable. In this article, we briefly illustrate the anatomy of the foot and its various structures

An IL-15 dependent CD8 T cell response to selected HIV epitopes is related to viral control in early-treated HIV-infected subjects.

In some early-treated HIV+ patients, Structured Treatment Interruption (STI) is associated to spontaneous control of viral rebound. Thus, in this clinical setting, we analyzed the immunological parameters associated to viral control. Two groups of early treated patients who underwent STI were retrospectively defined, according to the ability to spontaneously control HIV replication (Controller and Non-controller). Plasma cytokine levels were analyzed by multiplex analysis. CD8 T cell differentiation was determined by polychromatic flow cytometry. Antigen-specific IFN-Γ production was analyzed by ELISpot and intracellular staining after stimulation with HIV-peptides. Long-term Elispot assays were performed in the presence or absence of IL-15. Plasma IL-15 was found decreased over a period of time in Non-Controller patients, whereas a restricted response to Gag (aa.167–202 and 265–279) and Nef (aa.86–100 and 111–138) immunodominant epitopes was more frequently observed in Controller patients. Interestingly, in two Non-Controller patients the CD8-mediated T cells response to immunodominant epitopes could be restored in vitro by IL-15, suggesting a major role of cytokine homeostasis on the generation of protective immunity. In early-treated HIV+ patients undergoing STI, HIV replication control was associated to CD8 T cell maturation and sustained IL-15 levels, leading to HIV-specific CD8 T cell responses against selected Gag and Nef epitopes

Short-term reproducibility of nocturnal non-dipping pattern in recently diagnosed essential hypertensives.

Objective: To investigate in a selected population of patients with a recently diagnosed essential hypertension the short-term intrasubject variability of diurnal changes in blood pressure (BP). Methods: Two hundred and eight consecutive, recently diagnosed, never treated essential hypertensives (119 men, 89 women, 46 ± 12 years) underwent 24-h ambulatory BP monitoring (ABPM) twice within 3 weeks. Dipping pattern was defined as a reduction in average systolic and diastolic BP at night greater than 10% compared to average daytime values. Results: 177 subjects (85%) showed no change in their diurnal variations in BP. Of the 159 subjects who had a dipping pattern on first ABPM, 134 (90.6%) confirmed this type of profile on the second ABPM, while 15 (9.4%) showed a non-dipping pattern. Of the 59 subjects who had a non-dipping pattern on the first ABPM, 43 (72.2%) confirmed their initial profile on the second ABPM, while 16 (28.8%) did not. Conclusion: These findings indicate that short-term reproducibility of diurnal changes in BP in early phases of untreated essential hypertension, characterized by a large prevalence of dipping pattern, is overall satisfactory. However, our study underlines that also in this particularly selected population of hypertensives the definition of non-dipping status on the basis of a single ABPM remains unreliable in about one-third of patients

Spinal surgery complications: an unsolved problem—Is the World Health Organization Safety Surgical Checklist an useful tool to reduce them?

Abstract Purpose To investigate whether the World Health Organization Safety Surgical Checklist (SSC) is an effective tool to reduce complications in spinal surgery. Methods We retrospectively evaluated the clinical and radiological charts prospectively collected from patients who underwent a spinal surgery procedure from January 2010 to December 2012. The aim of this study was to compare the incidence of complications between two periods, from January to December 2010 (without checklist) and from January 2011 and December 2012 (with checklist), in order to assess the checklist's effectiveness. Results The sample size was 917 patients with an average of 30-month follow-up. The mean age was 52.88 years. The majority of procedures were performed for oncological diseases (54.4%) and degenerative diseases (39.8%). In total, 159 complications were detected (17.3%). The overall incidence of complications for trauma, infectious pathology, oncology, and degenerative disease was 22.2%, 19.2%, 18.4%, and 15.3%, respectively. No correlation was observed between the type of pathology and the complication incidence. We observed a reduction in the overall incidence of complications following the introduction of the SSC: In 2010 without checklist, the incidence of complications was 24.2%, while in 2011 and 2012, following the checklist introduction, the incidence of complications was 16.7% and 11.7%, respectively (mean 14.2%). Conclusions The SSC seems to be an effective tool to reduce complications in spinal surgery. We propose to extend the use of checklist system also to the preoperative and postoperative phases in order to further reduce the incidence of complications. Graphic abstract These slides can be retrieved under Electronic Supplementary Material