Cardiovascular Responses to Simultaneous Diving and Muscle Metaboreflex Activation

Background: The aim of study was to assess hemodynamic changes during the simultaneous activation of muscle metaboreflex (MM) and diving reflex (DR) in a laboratory setting. We hypothesized that as long as the exercise intensity is mild DR can overwhelm the MM. Methods: Ten trained divers underwent all four phases (randomly assigned) of the following protocol. (A) Postexercise muscle ischemia session (PEMI): 3 min of resting followed by 3 min of handgrip at 30% of maximum force, followed immediately by 3 min of PEMI on the same arm induced by inflating a sphygmomanometer. Three minutes of recovery was further allowed after the cuff was deflated for a total of 6 min of recovery. (B) Control exercise recovery session: the same rest-exercise protocol used for A followed by 6 min of recovery without inflation. (C) DR session: the same rest-exercise protocol used for A followed by 1 min of breath-hold (BH) with face immersion in cold water. (D) PEMI-DR session: the same protocol used for A with 60 s of BH with face immersion in cold water during the first minute of PEMI. Stroke volume (SV), heart rate (HR), and cardiac output (CO) were collected by means of an impedance method. Results: At the end of apnea, HR was decreased in condition C and D with respect to A (−40.8 and −40.3%, respectively vs. −9.1%; p < 0.05). Since SV increase was less pronounced at the same time point (C = +32.4 and D = +21.7% vs. A = +6.0; p < 0.05), CO significantly decreased during C and D with respect to A (−23 and −29.0 vs. −1.4%, respectively; p < 0.05). Conclusion: Results addressed the hypothesis that DR overcame the MM in our setting

Hyperglycemia in Streptozotocin-Induced Diabetes Leads to Persistent Inflammation and Tissue Damage Following Uveitis Due to Reduced Levels of Ciliary Body Heme Oxygenase-1

This study investigated the heme oxygenase-1 (HO-1) and the endotoxin-induced uveitis (EIU) in diabetic streptozotocin (STZ)-hyperglycemic rats. STZ-hyperglycemic rats had impaired levels of the enzyme HO-1 within the ciliary bodies if compared with the nondiabetic rats. STZ-hyperglycemic rats also predisposed the eye to produce high levels of both the cytokines IL-1β and CXCL8. Subsequent EIU further and significantly (P < .01) increased the cytokines production, an effect partly prevented by hemin treatment. Most importantly, hemin, an inducer of heme oxygenase expression and activity, recovered the huge number of infiltrated polymorphonuclear leukocytes PMN within the ciliary bodies associated with STZ-hyperglycemic state and EIU damage. Impairment of the stress-sensitive enzyme HO-1 in STZ-hyperglycemic rats increases and prolongs the inflammatory response to EIU

Intraperitoneal Oxygen/Ozone Treatment Decreases the Formation of Experimental Postsurgical Peritoneal Adhesions and the Levels/Activity of the Local Ubiquitin-Proteasome System

We have investigated whether an oxygen/ozone (95%O2/5%O3) mixture would have potential against the formation of experimental postsurgical peritoneal adhesions. In two groups of rats, one control intraperitoneally injected with 3 mL/rat of O2 and one intraperitoneally injected with oxygen/ozone mixture (3 mL/rat equivalent to 300 μg/kg ozone), we induced a midline laparotomy and an enterotomy at the level of the ileum to encourage the formation of peritoneal adhesions. Samples were taken from the parietal peritoneal tissue to assess the formation of adhesions 0 and 10 days after the surgical procedure and to assess the levels of ubiquitin and 20S proteasome. We found decreased formation of postsurgical peritoneal adhesions after treatment of the rats with 300 μg/kg ozone associated with a decreased levels of ubiquitin and 20S proteasome subunit within the adhered tissue. Oxygen/ozone mixture is potentially useful for approaching the post-surgical peritoneal adhesions, and the UPS system is involved in this

Carbon Black Functionalized with Naturally Occurring Compounds in Water Phase for Electrochemical Sensing of Antioxidant Compounds

A new sustainable route to nanodispersed and functionalized carbon black in water phase (W-CB) is proposed. The sonochemical strategy exploits ultrasounds to disaggregate the CB, while two selected functional naturally derived compounds, sodium cholate (SC) and rosmarinic acid (RA), act as stabilizing agents ensuring dispersibility in water adhering onto the CB nanoparticles' surface. Strategically, the CB-RA compound is used to drive the AuNPs self-assembling at room temperature, resulting in a CB surface that is nanodecorated; further, this is achieved without the need for additional reagents. Electrochemical sensors based on the proposed nanomaterials are realized and characterized both morphologically and electrochemically. The W-CBs' electroanalytical potential is proved in the anodic and cathodic window using caffeic acid (CF) and hydroquinone (HQ), two antioxidant compounds that are significant for food and the environment. For both antioxidants, repeatable (RSD &lt;= 3.3%; n = 10) and reproducible (RSD &lt;= 3.8%; n = 3) electroanalysis results were obtained, achieving nanomolar detection limits (CF: 29 nM; HQ: 44 nM). CF and HQ are successfully determined in food and environmental samples (recoveries 97-113%), and also in the presence of other phenolic classes and HQ structural isomers. The water dispersibility of the proposed materials can be an opportunity for (bio) sensor fabrication and sustainable device realization

Polypoid lesions of the gallbladder in a consecutive series of 2631 patients. A single-center experience

INTRODUZIONE: La diagnosi ultrasonografica (US) delle lesioni polipoidi della colecisti (PLG) è difficile per la bassa sensibilità (SE) della metodica. Non sono stati ancora completamenti definiti i criteri di selezione dei pazienti con PLG da indirizzare al trattamento chirurgico o al follow-up. L’indagine istopatologica (EI) rappresenta il gold standard per la diagnosi di polipi non-neoplastici (colesterolotici, infiammatori, fibroepiteliali, adenomiomatosici), di polipi neoplastici (carcinomi, carcinoidi), di lesioni precancerose non polipoidi (displasia dibasso ed alto grado, metaplasia intestinale di tipo muciparo, metaplasia gastrica di tipo pilorico) e di irregolarità nodulari parietali della colecistite xanto-granulomatosa. Gli scopi dello studio sono stati quelli di valutare in un campione di pazienti sottoposti a colecistectomia, la prevalenza dei polipi non neoplastici e neoplastici e la sensibilità dell’US tradizionale trans-addominale rispetto all’EI nell’identificazione delle PLG. MATERIALI E METODI: Studio osservazionale retrospettivo, condotto su un campione di 2631 pazienti, sottoposti a colecistectomia laparoscopica e open, in elezione e in urgenza, identificati mediante il codice ICD-9-CM 51.2, nel periodo Aprile 2005 - Marzo 2018, presso l’ospedale universitario “A. Fiorini” di Terracina - Polo Pontino, “Sapienza” Università di Roma. Tutti i pazienti erano stati sottoposti a US. RISULTATI: Il campione esaminato era costituito da 1175(44.6%) M, età media 56 anni, range 25-95 anni, 1456(55.4%) F, età media 46anni, range 17-90 anni. La diagnosi US di PLG veniva posta in 38/2631(1.4%) pazienti. All’esame istologico i polipi erano identificati in 68/2631(2.6%) pazienti, associati a litiasi biliare in 28/2631 (1.1%) casi. Dal confronto US e EI la diagnosi ecografica risultava gravata da falsi positivi (FP) (8/38; 21%) e falsi negativi (FN) (38/2631; 1.45%), con SE 44% (95% c.i.:32.2-55.7). L’incidenza istologica di PLG neoplastiche è stata dello 0.38% (10/2631), 3M e 7F, età media 64 anni, (range 49-80 anni). In 3 casi le neoplasie erano state identificate all’US (3/10; 30 % VP); nei restanti 7 casi costituivano reperto istologico incidentale (7/10; 70 % FN), di cui 5 con diametro &gt;1cm nel contesto di un quadro clinico di colecistite acuta litiasica e 2 con diametro &lt;1cm in un quadro di litiasi non complicata. DISCUSSIONE: L’US tradizionale trans-addominale sottostimava l’incidenza delle PLG rispetto all’EI (p=0.021) e i FP per PLG isolate sono stati causa di errata indicazione al trattamento chirurgico. Il confronto fra diagnosi US ed EI conferma la bassa SE della metodica ecografica nell’identificazione delle PLG, sia in presenza che in assenza di litiasi biliare. Il sesso femminile si è dimostrato specifico fattore di rischio per PLG benigne e maligne e lesioni mucosali non polipoidi (p=0.041). Nel nostro studio, probabilmente, le cause della mancata identificazione US delle irregolarità parietali maligne erano l’oscuramento della lesione dall’esordio clinico della neoplasia in colecistite acuta litiasica (in 5 pazienti) e le dimensioni &lt;1cm in presenza di litiasi non complicata (in 2 pazienti). La dimensione della lesione parietale &lt;0.5cm non escludeva la loro natura neoplastica. Attualmente la prevenzione e la diagnosi di GBC è basata sul precoce riscontro e trattamento delle lesioni polipoidi potenzialmente evolutive nell’arco di circa 15 anni. CONCLUSIONI: Probabilmente la colecistectomia precoce in tutti i pz con PLG di diametro &lt;1cm, isolate o associate a calcoli, sintomatici e asintomatici, può contribuire alla riduzione dell’incidenza del GBC.BACKGROUND: Challenges in the diagnosis of polypoid gallbladder lesion (PLG) is due to the low sensibility (SE) of ultrasound scan (US), and the selection criteria of patients with PLG to be addressed to surgical treatment or followup are not yet fully defined. MATERIALS AND METHODS: Retrospective observational study was conducted on 2631 patients, 1175(44.6%) M, mean age 56 years, 1456(55.4%) F, mean age 46 years, who underwent laparoscopic and open cholecystectomy. RESULTS: The US diagnosis for PLG was placed in 38/2631(1.4%) patients. On histological examination (HE) the polyps were identified in 68/2631(2.6%) patients and it was associated with biliary lithiasis in 28/2631 (1.1%) cases. From the US and HE comparison, the ultrasound diagnosis was burdened by false positives (8/38; 21%) and false negatives (38/2631;1.45%), with SE 44% (95% c.i.:32.2-55.7). The histological incidence of gall bladder cancer (GBC) was 0.38%(10/2631). DISCUSSION: US survey underestimated the incidence of PLG compared to the histological finding (p=0.021). Female gender has been shown to be a specific risk factor for benign and malignant PLG and non-polypoid mucosal lesions (p=0.041). The parietal lesion size &lt;0.5cm does not exclude the neoplastic nature. Currently the prevention and diagnosis of GBC is based on the early detection and treatment of potentially evolutionary polypoid lesions over a period of about 15 years. CONCLUSIONS: It is probably that early cholecystectomy in all the patients with PLG of diameter &lt;1cm, isolated or associated with lithiasis, symptomatic and asymptomatic, can contribute to the reduction of the incidence of GBC

On the Radiative Impact of Biomass-Burning Aerosols in the Arctic: The August 2017 Case Study

Boreal fires have increased during the last years and are projected to become more intense and frequent as a consequence of climate change. Wildfires produce a wide range of effects on the Arctic climate and ecosystem, and understanding these effects is crucial for predicting the future evolution of the Arctic region. This study focuses on the impact of the long-range transport of biomass-burning aerosol into the atmosphere and the corresponding radiative perturbation in the shortwave frequency range. As a case study, we investigate an intense biomass-burning (BB) event which took place in summer 2017 in Canada and subsequent northeastward transport of gases and particles in the plume leading to exceptionally high values (0.86) of Aerosol Optical Depth (AOD) at 500 nm measured in northwestern Greenland on 21 August 2017. This work characterizes the BB plume measured at the Thule High Arctic Atmospheric Observatory (THAAO; 76.53° N, °68.74° W) in August 2017 by assessing the associated shortwave aerosol direct radiative impact over the THAAO and extending this evaluation over the broader region (60° N-80° N, 110° W-0° E). The radiative transfer simulations with MODTRAN6.0 estimated an aerosol heating rate of up to 0.5 K/day in the upper aerosol layer (8-12 km). The direct aerosol radiative effect (ARE) vertical profile shows a maximum negative value of -45.4 Wm-2 for a 78° solar zenith angle above THAAO at 3 km altitude. A cumulative surface ARE of -127.5 TW is estimated to have occurred on 21 August 2017 over a portion (3.1 10^6 km2) of the considered domain (60° N-80° N, 110° W-0° E). ARE regional mean daily values over the same portion of the domain vary between -65 and -25 Wm-2. Although this is a limited temporal event, this effect can have significant influence on the Arctic radiative budget, especially in the anticipated scenario of increasing wildfires

Closure of cutaneous incision after thyroid surgery: A comparison between metal clips and cutaneous octyl-2-cyanoacrylate adhesive. A prospective randomized clinical trial

Octyl-2-cyanoacrylate (Dermabond, Ethicon Inc.) has been introduced in clinical practice as an ideal system of closure of wounds, but no studies have confirmed the advantages of wound closure performed with Dermabond compared to skin staples (Proximate, Ethicon Inc.) in thyroid surgery. The objective of this study is to evaluate the short- and long-term results of wound closure in thyroid surgery performed with Dermabond (DERM) versus Proximate (PROX). Seventy patients after thyroidectomy were randomly assigned into the two groups (DERM vs PROX). The postoperative and the long-term outcomes were clinically evaluated by physicians, and the Stony Brook scar evaluation scale has also been used. The patients' satisfaction with the early postoperative management and with the cosmetic outcomes has been assessed by a numerical scale ranging from 0 to 10. Results were compared using appropriate statistical tests. Thirty-two patients used DERM, while 38 patients used PROX. Immediate results showed difficult application in two cases DERM (6.2%) and hyperemia in one case DERM (3.1%). Early results showed edema in eight cases DERM (25%) vs two cases PROX (5.2%; p<0.05); patients' satisfaction: optimum judgement in 100% DERM vs 15.7% PROX (p< 0.001); patients' self aesthetic evaluation: PROX higher percentage of excellent results vs DERM (p<0.005). After one month, results showed edema in nine cases DERM (28.8%) vs two cases PROX (5.2%; p<0.01), while after 6 months, DERM had lesser symptoms than PROX (p< 0.01). Octyl-2-cyanoacrylate has proven to be effective and reliable in the skin closure of cervical incision similar to suture with staples and yields similar final cosmetic outcomes. Because Dermabond offers the advantage of better management in the early postoperative phase, the patients' satisfaction is clearly better. © Springer-Verlag 2010

Eleven Years of Health Monitoring in Wild Boars (Sus scrofa) in the Emilia-Romagna Region (Italy)

In recent years, the growth of wild ungulates has increased the focus on their health monitoring. In particular, the health status of wild boars is relevant for the economic impact on the pig industry. The Emilia-Romagna region activated a wildlife monitoring plan to better evaluate the health status of the wild boar population. Between 2011 and 2021, samples of found dead and hunted wild boar have been examined for trichinellosis, tuberculosis, brucellosis, african swine fever, classical swine fever, Aujeszky’s disease, swine vesicular disease, and swine influenza A. Trichinella britovi was identified in 0.001% of the examined wild boars; neither M. bovis nor M. tuberculosis were found in M. tuberculosis complex positive samples; 2.3% were positive for Brucella suis; 29.4% of the sera were positive for Aujeszky’s disease virus; and 0.9% of the samples were positive for swine influenza A virus. With an uncertain population estimate, the number of animals tested, the number of positives, and the sampling method do not allow us to make many inferences but suggest the need to implement and strengthen the existing surveillance activity, as it seems to be the only viable alternative for safeguarding animal and human health

Drain after elective laparoscopic cholecystectomy. A randomized multicentre controlled trial

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A rare case of primary gastric Burkitt's lymphoma associated with malignant pleural mesothelioma

Il linfoma di Burkitt (BL) e il mesotelioma pleurico maligno (MPM) sono tumori rari con prognosi infausta e nella maggior parte dei pazienti è indicato solo il trattamento palliativo. Il ruolo dell'infezione da HIV e da EBV nell'eziologia del BL sono stati confermati, mentre resta controversa l’associazione del BL a localizzazione gastrica con l’Helicobacter pylori. Il BL è endemico in Africa e sporadico nel resto del mondo, la localizzazione primitiva nello stomaco (PG BL) è estremamente rara, fino al 2017 erano stati descritti solo 53 casi, ed è altamente aggressiva con una frazione di crescita tra le più alte tra i tumori maligni. La sintomatologia di esordio è costituita da vomito, dolore post-prandiale, sanguinamento acuto o cronico. L'MPM è solitamente associato all'esposizione all'amianto e la dispnea dovuta a versamento pleurico è la manifestazione clinica tipica. Finora in Letteratura non sono stati descritti casi caratterizzati dall’associazione del mesotelioma pleurico maligno con il linfoma gastrico primitivo di Burkitt. Qui riportiamo il caso di un maschio caucasico di 80 anni, negativo per i comprovati fattori di rischio per LB e MPM, che si presentava alla nostra attenzione per un quadro di insufficienza respiratoria acuta da versamento pleurico massivo nell’emitorace sinistro, con sbandieramento mediastinico controlaterale. La tomografia computerizzata con mdc (CE-CT) mostrava una grossa massa causa di ispessimento circonferenziale del fondo gastrico, infiltrante la cupola diaframmatica sinistra e il pilatro omolaterale. All'esame endoscopico, il fondo gastrico appariva completamente occupato da una grossa massa ulcerata sporgente nel lume gastrico. L'esame istopatologico ed immunoistochimico dei campioni bioptici prelevati durante l'EGDS e la toracoscopia ha permesso di formulare la diagnosi di PG BL e MPM. Il paziente è stato sottoposto prima a posizionamento di drenaggio toracico per il versamento pleurico e poi a talcaggio pleurico toracoscopico nell'emitorace sinistro. Per la rapida crescita e l'elevato rischio di sanguinamento veniva programmato il trattamento chirurgico della lesione gastrica, ma il paziente è deceduto a causa di un'aritmia cardiaca fatale, prima di sottoporsi all’intervento chirurgico addominale. Questo case report mette in evidenza la vera sfida per i medici che è quella di identificare il MPM e il PG BL nella loro fase iniziale, specialmente nei pazienti senza i fattori di rischio comprovati. I sintomi di esordio ne fanno un caso molto singolare, caratterizzato da grave dispnea fino all'insufficienza respiratoria, per versamento pleurico massivo sinistro e sbanderiamento mediastinico controlaterale, senza sanguinamento attivo dalla massa gastrica, mentre i reperti CE-TC erano invece negativi per ispessimento pleurico e positivo per ispessimento circonferenziale del fondo gastrico.Background: Primary gastric Burkitt lymphoma (PG BL) and malignant pleural mesothelioma (MPM) are rare and aggressive tumors with poor prognosis. HIV and EBV infection have a link in the aetiology of PG BL, while MPM is usually associated with asbestos exposure. Endoluminal bleeding from massive solid tumor, and dyspnea usually due to pleural effusion, are the typical clinical manifestations respectively of PG BL and MPM. In most patients just palliative treatment is indicated. Case report: A caucasian elderly male, negative for the proven risk factors, presenting respiratory failure due to massive left pleural effusion with severe mediastinal shift. Contrast enhanced - Computed Tomography (CE-CT) showed a large mass causing circumferential thickening of the gastric fundus, infiltrating the left diaphragmatic dome and the ipsilateral crus. Macroscopically, on endoscopy the gastric fundus appeared completely occupied by an ulcerated large mass protunding in the gastric lumen. Histopathological examination from biopsy specimens taken during esophagogastroduodenoscopy and thoracoscopy allowed to make diagnosis of PG BL and MPM. The patient first underwent a placement of a chest tube drainage for the pleural effusion and then a thoracoscopic talc insufflation (TTI) in the left hemithorax. A surgical treatment of the gastric lesion was planned, due to the rapid growth and the high risk of bleeding. The patient died because of fatal cardiac arrhythmia, before undergoig abdominal surgery. Conclusions: This report presents an unique case of PG BL associated with MPM and highlights the real challenge for the physicians to identify them in early stage, especially in patients without the proved risk factors. The onset symptoms make it a very singular case, characterized by severe dyspnea up to respiratory failure, due to massive left pleural effusion and contralateral mediastinal fluttering, without an active bleeding from the gastric mass, while CE-CT findings were instead negative for pleural thickening and positive for circumferential thickening of the gastric fundus. Key words: Burkitt Lymphoma, Case Report, Gastric, Pleural Mesothelioma, Pleural Effusion, Respiratory Failure