The vertical and horizontal distribution of Mesocriconema xenoplax (Raski, 1952) in Trentino vineyards (Northern Italy)

Spatial distribution of Mesocriconema xenoplax (Raski, 1952) was investigated in vineyards in the Trentino region (Northern Italy). Horizontal distribution showed characteristic aggregate pattern for nematodes, correlated to the symptomatology of the localized spots of infestations. The vertical distribution, in compact texture soils, revealed maximum population levels of the nematode in the top layers depending on the root occurrence that, in such conditions, is lower at the deeper levels. Higher nematode number was found at greater depths in loose soils, where roots easier penetrate. The knowledge gained from the spatial distribution of this species is fundamental to investigate the effectiveness of different sampling patterns in order to improve efficacy of control strategies

Withdrawal of mechanical ventilation in amyotrophic lateral sclerosis patients: a multicenter Italian survey

Background: Law 219/2017 was approved in Italy in December 2017, after a years-long debate on the autonomy of healthcare choices. This Law, for the first time in Italian legislation, guarantees the patient's right to request for withdrawal of life-sustaining treatments, including mechanical ventilation (MV). Objective: To investigate the current status of MV withdrawal in amyotrophic lateral sclerosis (ALS) patients in Italy and to assess the impact of Law 219/2017 on this practice. Methods: We conducted a Web-based survey, addressed to Italian neurologists with expertise in ALS care, and members of the Motor Neuron Disease Study Group of the Italian Society of Neurology. Results: Out of 40 ALS Italian centers, 34 (85.0%) responded to the survey. Law 219/2017 was followed by an increasing trend in MV withdrawals, and a significant increase of neurologists involved in this procedure (p 0.004). However, variations across Italian ALS centers were observed, regarding the inconsistent involvement of community health services and palliative care (PC) services, and the intervention and composition of the multidisciplinary team. Conclusions: Law 219/2017 has had a positive impact on the practice of MV withdrawal in ALS patients in Italy. The recent growing public attention on end-of-life care choices, along with the cultural and social changes in Italy, requires further regulatory frameworks that strengthen tools for self-determination, increased investment of resources in community and PC health services, and practical recommendations and guidelines for health workers involved

Association of Variants in the SPTLC1 Gene With Juvenile Amyotrophic Lateral Sclerosis

Importance: Juvenile amyotrophic lateral sclerosis (ALS) is a rare form of ALS characterized by age of symptom onset less than 25 years and a variable presentation.Objective: To identify the genetic variants associated with juvenile ALS.Design, Setting, and Participants: In this multicenter family-based genetic study, trio whole-exome sequencing was performed to identify the disease-associated gene in a case series of unrelated patients diagnosed with juvenile ALS and severe growth retardation. The patients and their family members were enrolled at academic hospitals and a government research facility between March 1, 2016, and March 13, 2020, and were observed until October 1, 2020. Whole-exome sequencing was also performed in a series of patients with juvenile ALS. A total of 66 patients with juvenile ALS and 6258 adult patients with ALS participated in the study. Patients were selected for the study based on their diagnosis, and all eligible participants were enrolled in the study. None of the participants had a family history of neurological disorders, suggesting de novo variants as the underlying genetic mechanism.Main Outcomes and Measures: De novo variants present only in the index case and not in unaffected family members.Results: Trio whole-exome sequencing was performed in 3 patients diagnosed with juvenile ALS and their parents. An additional 63 patients with juvenile ALS and 6258 adult patients with ALS were subsequently screened for variants in the SPTLC1 gene. De novo variants in SPTLC1 (p.Ala20Ser in 2 patients and p.Ser331Tyr in 1 patient) were identified in 3 unrelated patients diagnosed with juvenile ALS and failure to thrive. A fourth variant (p.Leu39del) was identified in a patient with juvenile ALS where parental DNA was unavailable. Variants in this gene have been previously shown to be associated with autosomal-dominant hereditary sensory autonomic neuropathy, type 1A, by disrupting an essential enzyme complex in the sphingolipid synthesis pathway.Conclusions and Relevance: These data broaden the phenotype associated with SPTLC1 and suggest that patients presenting with juvenile ALS should be screened for variants in this gene.</p

Management of Thyroid Nodules in Deceased Donors With Comparison Between Fine Needle Aspiration and Intraoperative Frozen Section in the Setting of Transplantation

Newly discovered thyroid nodules in deceased donors are investigated to rule out cancer that can be transmitted, but there are no established protocols. The aim of the study was to compare fine needle aspiration versus intraoperative frozen section in the donor management with limited time

Donor-Transmitted Cancers in Transplanted Livers: Analysis of Clinical Outcomes

The risk of transmission of malignancy from donor to recipient is low; however, this occurrence has dramatic consequences. Many reports of donor derived cancers in liver transplant recipients have been published, but they have not been a systematically summarized into a lucid and unified analysis. The present study is an attempt to provide clarity to this unusual, but clinically important problem. We systematically reviewed all case reports, case series, and registries published on cancer transmission events through the end of December 2019. We identified a total of 67 publications with 92 transmission events. The most frequently transmitted cancers were lymphomas (30 [32.6%]), melanomas (8 [8.7%]), and neuroendocrine tumors (8 [8.7%]). Most of the melanomas were metastasizing, while most of the lymphomas were localized to the graft. The median time to cancer diagnosis after transplantation was 7 months, with 78% of diagnoses established in the first year. Melanoma carried the worst prognosis, with no recipients alive at 1 year after cancer diagnosis. Lymphoma recipients had a better outcome, with more than 75% surviving at 2 years. Conclusion: A metastatic cancer carries a worse prognosis for recipients, also because recipients with localized cancer can benefit from the chance to undergo transplantation again. The findings confirm the need to pay attention to donors with a history of melanoma but also suggest the need for a more careful evaluation of groups of donors, such as those dying from cerebral hemorrhage. Finally, recipients of organs from donors with cancer should be carefully followed to detect potential transmission

Influence of steroids on HCV recurrence after liver transplantation: A prospective study

Background/Aims:To assess the effect of long-termmaintenance of steroids onHCV recurrence after liver transplantation (LT), that is still controversial, a prospective multicentre trial was conducted at the centres of Bologna and Padua, Italy. Methods:From September 2002, 47 eligible HCV positive LT recipients were randomized to receive 2 different steroid schedules in association with tacrolimus: group A: rapid tapering and withdrawal 91 days after LT group B: slow tapering and withdrawal 25 months after LT. Thirty-nine patients were assessable: 23 in group A and 16 in group B. Donor and recipient characteristics were similar in the two groups. Median follow-up was 841 days (130\u20131376). One hundred liver biopsies were performed, and every patient had a biopsy at month 12. Results: Twenty-two out of 23 (95, 65%) patients in group A and 15 out of 16 (93, 75%) in group B had histologicallyconfirmed HCV recurrence. Twelve-month histology showed advanced fibrosis (score 3 or 4) in 42.1% of the patients in group A versus 7.6% in group B (P = 0.03). One-and 2-year advanced fibrosis-free survival were 65.2 and 60.8 in group A and 93.7% in group B (P = 0.03 and = 0.02, respectively). Conclusions: Slow tapering of steroids reduced the progression of recurrent hepatitis C after LT

Cholecystectomy for acute cholecystitis in octogenarians: impact of advanced age on post-operative outcome

BaCKgrOuND: The number of surgical operations in elderly patients is increasing due to the aging demographics of western populations. The aim of the present study was to investigate the peri-operative outcome of octogenarian patients undergoing cholecystectomy for acute cholecystitis. MeThODS: We performed a retrospective analysis including all patients who underwent cholecystectomy for acute cholecystitis from January 2013 to December 2017. records were collected prospectively from two centers: 1) unit of emergency Surgery, St. Orsola university hospital, alma Mater Studiorum university, Bologna; 2) “advanced Surgical Technologies” Department of Surgical Sciences, umberto i university hospital, La Sapienza university, rome. Patients were divided by age (≥ or &lt;80 years) and peri-operative outcomes were compared. reSuLTS: During the study period, 464 patients were operated for acute cholecystitis in the two centers. Sixty-three (14%) patients were octogenarians (group 1) and median age was 84.8±3.9 years. Four hundred and one patients (86%) were younger than 80 years (group 2) with median age of 55.3±15.3 years. Forty-four per cent of group-1 patients under- went laparoscopic cholecystectomy versus 81% of the younger group (P&lt;0.01). elderly patients had a higher percentage of overall complications (25% vs. 9%; P=0.03) and a longer median postoperative length of stay (7.2±6.8 vs. 4.6±7.7; P=0.04). Overall mortality was 1%: two patients died in group-1 and one in group-2 (P=0.50). however, on multivariate analysis age older than 80 years was not found to be an independent risk factor for postoperative morbidity and mortality. CONCLuSiONS: The results of this study suggest that cholecystectomy for acute cholecystitis in octogenarians is a rela- tively safe procedure with an acceptable risk of complications and a postoperative hospital stay comparable to younger ones. (Cite this article as: Vaccari S, Lauro a, Cervellera M, Palazzini g, Casella g, Santoro a, et al. Cholecystectomy for acute cholecystitis in octogenarians: impact of advanced age on postoperative outcome. Minerva Chir 2019;74:000-000. DOi: 10.23736/S0026-4733.19.07891-X