Delayed Duodenal Hematoma and Pancreatitis from a Seatbelt Injury

Traumatic duodenal hematoma is a rare condition that is encountered in the paediatric age group following blunt abdominal trauma. It poses both a diagnostic and therapeutic challenge. The main concern is increased morbidity secondary to delayed diagnosis and associated occult injuries to the adjacent structures. Most of these hematomas resolve spontaneously with conservative management, and the prognosis is good. We present a case of a 15-year-old boy who had a delayed presentation of duodenal hematoma and acute pancreatitis, which was treated conservatively with complete resolution

Effect of Mo content on the microstructure and mechanical properties of CoCrFeNiMox HEA coatings deposited by high power impulse magnetron sputtering

In this work, CoCrFeNiMox high entropy alloy (HEA) films were deposited by High Power Impulse Magnetron Sputtering (HiPIMS) using pure Mo and equiatomic CoCrFeNi targets. The effect of Mo content on the microstructure, residual stress state, and mechanical properties of the films was investigated in the range of 0–20 at.%. All films exhibited a columnar growth morphology and a high density of planar defects. Increasing the Mo content promoted the formation of a fine-grained structure and induced the transformation from a single face-centered cubic (FCC) phase to a mixture of FCC and body-centered cubic (BCC) phases. All produced films displayed a compressive residual stress state regardless of the Mo concentration. In terms of mechanical properties, the hardness of the films increased with increasing Mo content due to solid solution and grain boundary strengthening, along with the formation of a hard BCC phase. On the other hand, the elastic modulus decreased, likely due to the formation of an amorphous phase at higher Mo concentrations

Syndecan-1 promotes the angiogenic phenotype of multiple myeloma endothelial cells

Angiogenesis is considered a hallmark of multiple myeloma (MM) progression. In the present study, we evaluated the morphological and functional features of endothelial cells (ECs) derived from bone marrow (BM) of patients affected by MM (MMECs). We found that MMECs compared with normal BM ECs (BMECs) showed increased expression of syndecan-1. Silencing of syndecan-1 expression by RNA interference technique decreased in vitro EC survival, proliferation and organization in capillary-like structures. In vivo, in severe combined immunodeficient mice, syndecan-1 silencing inhibited MMEC organization into patent vessels. When overexpressed in human umbilical vein ECs and BMECs, syndecan-1 induced in vitro and in vivo angiogenic effects. Flow-cytometric analysis of MMECs silenced for syndecan-1 expression indicated a decreased membrane expression of vascular endothelial growth factor (VEGF) receptor-2 (VEGFR-2). Immunoprecipitation and confocal analysis showed colocalization of VEGFR-2 with syndecan-1. Absence of nuclear translocation of VEGFR-2 in syndecan-1-knockdown cells together with the shift from perinuclear localization to recycling compartments suggest a role of syndecan-1 in modulation of VEGFR-2 localization. This correlated with an in vitro decreased VEGF-induced invasion and motility. These results suggest that syndecan-1 may contribute to the highly angiogenic phenotype of MMECs by promoting EC proliferation, survival and modulating VEGF–VEGFR-2 signalling

B-cell depletion abrogates immune mediated cytopenia and rejection of cord blood transplantation in Hurler syndrome

Umbilical cord blood is the preferred donor cell source for children with Inherited Metabolic disorders undergoing Hematopoietic Cell Transplant (HCT), and its use has been associated with improved “engrafted survival” and higher donor chimerism compared to other cell sources. However, as in other pediatric cord blood transplants for non-malignant disease, immune-mediated cytopenia and primary graft failure limit its use, and the latter remains the commonest cause of death following cord blood transplant for non-malignant disease. We have previously shown an association between immune-mediated cytopenia and graft failure in inherited metabolic diseases suggesting that both immune-mediated cytopenia and graft failure could be mediated by antibodies from the residual recipient B cells. Since rituximab is effective in depletion of B cells and management of refractory immune-mediated cytopenia following HCT, we have added rituximab to the conditioning regimen. We studied 57 patients in 2 centers who received myeloablative conditioning for cord blood transplant in Hurler syndrome, and report a significant improvement in event-free survival with reduced incidence of graft failure and without any evidence of immune-mediated cytopenia in those patients that had received rituximab

Application of an updated methodology to estimate the burden of healthcare-associated infections in Italy, 2022

Background: Accurate burden estimates are necessary to inform priority setting and rational resource allocation. Weighting prevalence inversely proportional to time-at-risk has been proposed as a solution for length-biased sampling, an important limitation affecting prevalence to incidence conversion for healthcare-associated infections (HAIs). Aim: This study aimed to update Italian burden estimates by calculating HAI incidence, attributable mortality and disability-adjusted life years (DALYs). Further, we describe an adapted methodology for burden estimations. Methods: We used data from the latest European Centre for Disease Prevention and Control (ECDC) point prevalence survey (PPS) of HAIs, conducted in Italy in November 2022, to calculate the burden of five major HAIs at national level. We adapted the Burden of Communicable Diseases in Europe (BCoDE) methodology to include inverse probability weighting and compared results of na & iuml;ve and weighted calculations. Results: The national sample included 18,397 patients. Overall, 564.8 DALYs per 100,000 general population resulted from weighted calculations (95% uncertainty interval (UI): 450.04-694.38), with an annual incidence of 685.42 cases per 100,000 general population (95% UI: 611.09-760.86) and 33.23 deaths per 100,000 general population per year (95% UI: 28.62-38.33). Concerning na & iuml;ve estimates, overall 1,017.81 DALYs per 100,000 general population were calculated (95% UI: 855.16-1,190.59). In both calculations, healthcare-acquired bloodstream infections had the highest burden in terms of DALYs per 100,000 hospitalised and general population. Conclusion: Our study confirmed the substantial burden of HAIs in Italy and renews the need to prioritise resources for infection prevention and control interventions