Using the cytokinesis-block micronucleus cytome assay to evaluate Chromosomal DNA damage in chronic renal patients undergoing Bicarbonate Haemodialysis and Haemodiafiltration

Introduction. Chronic Renal Failure (CRF) patients are considered to show genomic instability and are associated with a high risk of both cardiovascular diseases and cancer. We explored DNA damage due to two dialysis treatments in 20 patients undergoing bicarbonate haemodialysis, 20 undergoing haemodiafiltration and 40 healthy subjects.Methods. The cytokinesis-block micronucleus (MN) assay was performed on peripheral blood lymphocytes to evaluate genetic damage.Results. A higher frequency of MN in the dialysis groups compared with controls was found. The results do not show a relationship between genetic instability and the type, frequency and duration of haemodialysis. The average BD and HDF treatment time was respectively 3.8±6.3 and 3.7±3.9 yrs. CAT and scintigraphy was independently correlated with high levels of MN.Discussion. Overall, the frequency of MN in CRF patients undergoing dialysis therapy was observed to be higher. Further studies need to be performed on a larger number of patients and for a longer period

Prevalence of SARS-CoV-2 infection and associated risk factors. A testing program and nested case-control study conducted at Sapienza University of Rome between March and June 2021

Background: To safely resume in-person activities during the COVID-19 pandemic, Sapienza University of Rome implemented rigorous infection prevention and control measures, a successful communication campaign and a free SARS-CoV-2 testing program. In this study, we describe the University's experience in carrying out such a program in the context of the COVID-19 response and identify risk factors for infection. Methods: Having identified resources, space, supplies and staff, from March to June 2021 Sapienza offered to all its enrollees a molecular test service (8.30 AM to 4 PM, Monday to Thursday). A test-negative case-control study was conducted within the program. Participants underwent structured interviews that investigated activity-related exposures in the 2 weeks before testing. Multivariable conditional logistic regression analyses were performed. Adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs) were calculated. Results: A total of 8,959 tests were administered, of which 56 were positive. The detection trend followed regional tendencies. Among 40 cases and 80 controls, multivariable analysis showed that a known exposure to a COVID-19 case increased the likelihood of infection (aOR: 8.39, 95% CI: 2.38–29.54), while having a job decreased it (aOR: 0.23, 95% CI: 0.06–0.88). Of factors that almost reached statistical significance, participation in activities in the university tended to reduce the risk (aOR: 0.32, 95% CI: 0.09–1.06), while attendance at private gatherings showed an increasing risk trend (aOR: 3.48, 95% CI: 0.95–12.79). Age, gender, activities in the community, visiting bars or restaurants, and use of public transportation were not relevant risk factors. When those students regularly attending the university campus were excluded from the analysis, the results were comparable, except that attending activities in the community came close to having a statistically significant effect (aOR: 8.13, 95% CI: 0.91–72.84). Conclusions: The testing program helped create a safe university environment. Furthermore, promoting preventive behavior and implementing rigorous measures in public places, as was the case in the university setting, contributed to limit the virus transmission

Chronic constipation diagnosis and treatment evaluation: The "CHRO.CO.DI.T.E." study

Background: According to Rome criteria, chronic constipation (CC) includes functional constipation (FC) and irritable bowel syndrome with constipation (IBS-C). Some patients do not meet these criteria (No Rome Constipation, NRC). The aim of the study was is to evaluate the various clinical presentation and management of FC, IBS-C and NRC in Italy. Methods: During a 2-month period, 52 Italian gastroenterologists recorded clinical data of FC, IBS-C and NRC patients, using Bristol scale, PAC-SYM and PAC-QoL questionnaires. In addition, gastroenterologists were also asked to record whether the patients were clinically assessed for CC for the first time or were in follow up. Diagnostic tests and prescribed therapies were also recorded. Results: Eight hundred seventy-eight consecutive CC patients (706 F) were enrolled (FC 62.5%, IBS-C 31.3%, NRC 6.2%). PAC-SYM and PAC-QoL scores were higher in IBS-C than in FC and NRC. 49.5% were at their first gastroenterological evaluation for CC. In 48.5% CC duration was longer than 10 years. A specialist consultation was requested in 31.6%, more frequently in IBS-C than in NRC. Digital rectal examination was performed in only 56.4%. Diagnostic tests were prescribed to 80.0%. Faecal calprotectin, thyroid tests, celiac serology, breath tests were more frequently suggested in IBS-C and anorectal manometry in FC. More than 90% had at least one treatment suggested on chronic constipation, most frequently dietary changes, macrogol and fibers. Antispasmodics and psychotherapy were more frequently prescribed in IBS-C, prucalopride and pelvic floor rehabilitation in FC. Conclusions: Patients with IBS-C reported more severe symptoms and worse quality of life than FC and NRC. Digital rectal examination was often not performed but at least one diagnostic test was prescribed to most patients. Colonoscopy and blood tests were the "first line" diagnostic tools. Macrogol was the most prescribed laxative, and prucalopride and pelvic floor rehabilitation represented a "second line" approach. Diagnostic tests and prescribed therapies increased by increasing CC severity

Using the cytokinesis-block micronucleus cytome assay to evaluate chromosomal DNA damage in chronic renal patients undergoing bicarbonate haemodialysis and haemodiafiltration

Introduction. Chronic Renal Failure (CRF) patients are considered to show genomic instability and are associated with a high risk of both cardiovascular diseases and cancer. We explored DNA damage due to two dialysis treatments in 20 patients undergoing bicarbonate haemodialysis, 20 undergoing haemodiafiltration and 40 healthy subjects.Methods. The cytokinesis-block micronucleus (MN) assay was performed on peripheral blood lymphocytes to evaluate genetic damage.Results. A higher frequency of MN in the dialysis groups compared with controls was found. The results do not show a relationship between genetic instability and the type, frequency and duration of haemodialysis. The average BD and HDF treatment time was respectively 3.8±6.3 and 3.7±3.9 yrs. CAT and scintigraphy was independently correlated with high levels of MN.Discussion. Overall, the frequency of MN in CRF patients undergoing dialysis therapy was observed to be higher. Further studies need to be performed on a larger number of patients and for a longer period

Conservative treatment of the central breast cancer with nipple-areolar resection: an alternative oncoplastic technique.

Conservative surgery with radiation therapy is the standard treatment for early-stage breast cancer. Nevertheless, the patients with subareolar breast cancer have been often excluded from breast-conserving surgery and treated with mastectomy because of the unacceptable cosmetic effect associated with the resection of the nipple-areola complex (NAC), as well as oncologic concerns about multicentricity or multifocality associated with these tumours. We show a conservative "oncoplastic technique" in which the resection of the central portion of the breast, including the NAC, can allow a wide excision of the tumour with uninvolved margins of resection and good cosmetic results

Progresses in the treatment of early breast cancer. A mini-review

Il trattamento chirurgico dei tumori della mammella ha subito continui e profondi cambiamenti negli ultimi 30 anni: - la chirurgia conservativa ha progressivamente e definitivamente sostituito la mastectomia nel trattamento dei tumori in stadio iniziale. Associata alla radioterapia, essa \ue8 in grado di garantire alle pazienti le stesse percentuali di sopravvivenza globale e migliori risultati estetici con un accettabile rischio di recidiva locale. - la diffusione dei programmi di screening ed il perfezionamento delle indagini diagnostiche hanno portato ad un incremento della diagnosi dei tumori infraclinici ed all elaborazione di sempre pi\uf9 accurate tecniche di localizzazione e trattamento dei tumori non palpabili. - la tecnica del linfonodo sentinella per i tumori in stadio iniziale ha permesso di evitare in casi selezionati la dissezione ascellare di principio senza rinunciare alle importanti informazioni prognostiche dei linfonodi loco-regionali. - l introduzione della chirurgia oncoplastica, coniugando tecniche di chirurgia generale con quelle proprie della chirurgia plastica, ha consentito di superare il conflitto tra estensione della resezione chirurgica e risultato estetico finale contribuendo in maniera importante a migliorare la qualit\ue0 di vita delle pazienti. L obiettivo di questa relazione \ue8 di riassumere le recenti evoluzioni nella terapia chirurgica conservativa dei tumori della mammella in stadio precoce con particolare riferimento alle problematiche dell exeresi mammaria