CT-based tumour response criteria compared after combined treatment for liver metastases of colorectal cancer

open6noPurpose: The aim of this analysis is to compare different tumour response criteria (TRC) after chemotherapy combined with bevacizumab in liver metastases from colorectal cancer (mCRC) to ascertain the best early prognostic indicator of response. Methods and Materials: 103 target liver metastases from 65 mCRC patients treated with chemoterapy plus bevacizumab were examined at the Istituto Oncologico Veneto IOV-IRCSS (March 2008-January 2013). All patients had baseline CT and at least one follow-up scan. Tumour response was retrospectively analyzed by two radiologists using RECIST1.1, modified Choi, and Chun morphologic criteria. Tumour response, classified as good (complete or partial response) or poor (stable or progressive disease), was compared with progression-free survival (PFS) at first follow-up (t1) and time of best response. Interobserver agreement and concordance between TRC were measured. Results: At t1, 32.31% showed a good response according to RECIST1.1 (median PFS 11.1), 84.62% according to Choi (median PFS 10.8). These percentages rose to 49.23% (median PFS 12.1) and 87.69% (median PFS 10.8), respectively, at the time of best response. According to Chun, 67.69% showed a good response at the time of best response (median PFS 10.8). The Choi criteria detected a higher proportion of good responders at t1, showing a better correlation with PFS; all methods correlated with PFS at the time of best response. Conclusion: The Choi criteria proved more consistent in the early detection of response in mCRC treated with chemotherapy plus bevacizumab, underscoring the importance of using these criteria in the early assessment of response to combined treatment.openopenVarotto, A.; Di Grazia, L.; Aliberti, C.; Bergamo, F.; Nardin, M.; Pomerri, F.Varotto, A.; Di Grazia, L.; Aliberti, C.; Bergamo, F.; Nardin, M.; Pomerri, Fabi

Enteral bleeding in a former preterm girl with short bowel syndrome: Do not miss the diagnosis

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Production of laccase by Botrytis cinerea and fermentation studies with strain F226

After induction, seven strains ofBotrytis cinerea released into the culture broth considerable amounts of laccase in a brief production time. The set-up of a suitable production process was studied with a selected strain in a 10-L fermenter. The optimum fermentation conditions were a 3% inoculum with a high degree of sporulation, a simple medium containing 20 g L−1 of glucose and 2 g L−1 of yeast extract at pH 3.5, 2 g L−1 gallic acid as inducer, added after 2 days of growth, an agitation speed of 300 rpm, an aeration rate of 1.2 vvm and a temperature of 24°C. By optimizing the culture conditions, the enzyme activity reached 28 U ml−1 in 5 days with a specific activity of 560 U mg−1 protein. The best procedure to obtain a suitable crude enzyme preparation was concentration of the supernatant medium to 10% of the initial volume by ultrafiltration, followed by a fractional precipitation with ethanol. The optimum pH and temperature for laccase activity were 5.5 and 40°C, respectively, with syringaldazine as the substrate

Composition of Arthropod Species Assemblages in Bt-expressing and Near Isogenic Eggplants in Experimental Fields

The environmental impact of genetically modified (GM) plants in experimental fields has been examined in several ways, in particular with respect to the dynamics of specific nontarget organisms. The approach of sampling for biodiversity in agroecosystems to compare complex patterns could also be useful in studying potential disruptions caused by GM crops. In this study, we set up replicated field plots of Bt-expressing eggplants and near isogenic untransformed eggplants as a control. We monitored the presence and abundance of herbivore and predator arthropods in weekly visual samplings of the plant canopy for three growing seasons (2001-2003). Insect species were pooled in organismal taxonomic units (OTUs); three multivariate methods were used to compare species assemblage as an estimate of insect biodiversity. This multistep statistical approach proved to be efficient in recognizing association patterns, as evidenced by the data for the target species Leptinotarsa decemlineata Say (Coleoptera: Chrysomelidae) clearly showing a significant association with the control plots. All the analyses indicate a comparable species assemblage between transgenic and near isogenic eggplant areas. Our results suggest that some taxa may warrant more specific study. For example, Alticinae beetles (Coleoptera: Chrysomelidae) were alternatively more abundant in either of the two treatments, and their overall abundance was significantly higher on transgenic eggplants. In light of these results and because of their taxonomic proximity to the target species, these herbivores may represent an important nontarget group to be further studied. Moreover, some sap feeders (e.g., Homoptera: Cicadellidae) were more abundant on Bt-expressing plants in some samples in all 3 y

Surveillance of enteric virus infections in a neonatal intensive care unit.

Objective. To investigate the epidemiology of neonatal viral gastroenteritis compared to the circulation of enteric viruses in children, 109 newborns in the NICU of Mother and Child Department and 214 children with enteritis admitted to the \u201cG. Di Cristina\u201d Children\u2019s Hospital in Palermo were monitored for Rotavirus, Adenovirus, Astrovirus and Norovirus infections. Methods. Stool samples were examined by EIA to detect viral antigens. Rotavirus strains were subjected to P- and G-typing. Results. A Norovirus strain was detected in one neonatal stool specimen whereas an astrovirus strain was dectected in two neonatal specimens. No Rotavirus or Adenovirus infection was identified among the newborn infants, while Rotavirus infections were detected in 24.8% of the symptomatic children. Type G4P[8] constituted 43.4% of the Rotavirus strains, followed by G2P[4] (18.9%), G3P[8] (17%), G1P[8] (13.2%) and G9P[8] (1.9%). Overall, Norovirus, Adenovirus and Astrovirus strains were responsible for 15.4% of infections in the paediatric population with diarrhoea. Conclusions. Viruses are diffuse agents of infection in children with enteritis. Virological tests have to be performed to diagnose enteric infections in the paediatric population. Maternal immunity to common Rotavirus strains combined with the limited circulation of the emerging G9 Rotavirus type among our population may account for the absence of Rotavirus infections in newborn infants

A protein kinase a-independent pathway controlling aquaporin 2 trafficking as a possible cause for the syndrome of inappropriate antidiuresis associated with polycystic kidney disease 1 haploinsufficiency.

Renal water reabsorption is controlled by vasopressin (AVP) which binds to V2 receptors resulting in PKA activation, phosphorylation of AQP2 at serine 256 (pS256) and translocation to the plasma membrane. Besides S256, AVP causes dephosphorylation of S261. Recent studies showed that cyclin-dependent kinases can phosphorylate S261 AQP2 peptides in vitro. In an attempt to investigate the possible role of cdks on AQP2 phosphorylation, we identified a new PKA-independent pathway regulating AQP2 trafficking. In ex-vivo kidney slices and MDCK-AQP2 cells, R-roscovitine, a specific cdks inhibitor, increased pS256 and decreased pS261. The changes in AQP2 phosphorylation were paralleled by an increase in cell surface AQP2 expression and osmotic water permeability in the absence of forskolin stimulation. Of note, R-roscovitine didn’t alter cAMP-dependent PKA activity. Because phosphorylation results from the balance between kinase and phosphatase activity, we evaluated the possible contribution of protein phosphatases PP1, PP2A and PP2B. Of these, R-roscovitine treatment specifically reduced PP2A protein expression and activity in MDCK cells. Interestingly, in PKD1+/- mice displaying a syndrome of inappropriate antidiuresis with high level of pS256 despite unchanged AVP and cAMP, we found a reduced PP2A expression and activity and reduced pS261. Similarly to what previously found in PKD1+/- mice, R-roscovitine treatment caused a significant decrease in intracellular calcium in MDCK cells. Our data indicate that a reduced activity of PP2A, secondary to reduced intracellular Ca2+ levels, promotes AQP2 trafficking independently of the AVP-PKA axis. This pathway may be relevant for explaining pathological states characterized by inappropriate AVP secretion and positive water balance

Serosurvey of schmallenberg virus infection in sheep in Abruzzo, Italy : short report

Infection with Schmallenberg virus (SBV) causes congenital musculoskeletal and vertebral malformations as well as neurological failures in fetuses of several ruminant species. In this study 1038 sheep samples from 10 flocks in the provinces of Chieti, Teramo and Pescara in Italy have been tested for antibodies against SBV by ELISA test. The purpose of the study was to ascertain the extent of SBV infections in sheep in Italy. The results of the ELISA test identified at least one positive animal in 9 of the 10 sheep flocks tested, and a mean within-flock prevalence of 8.57%. Furthermore, large variability of positive animals between flocks was observed (0 and 42.5%). These results demonstrate that SBV was endemic in this region and there could be is a risk of novel SBV infections in the following lambing season, raising serious concerns about its so rapid and pervasive spread

Early and late improvement of global and regional left ventricular function after transcatheter aortic valve implantation in patients with severe aortic stenosis: an echocardiographic study.

The recent development of transcatheter aortic valve implantation (TAVI) for severe aortic stenosis (AS) treatment offers a viable option for high-risk patient categories. Our aim is to evaluate whether 2D strain and strain rate can detect subtle improvement in global and regional LV systolic function immediately after TAVI. 2D conventional and 2D strain (speckle analysis) echocardiography was performed before, at discharge and after three months in thirty three patients with severe AS. After TAVI, we assessed by conventional echocardiography an immediate reduction of transaortic peak pressure gradient (p<0.0001), of mean pressure gradient (p<0.0001) and a concomitant increase in aortic valve area (AVA: 1.08±0.31 cm(2)/m(2); p<0.0001). 2D longitudinal systolic strain showed a significant improvement in all patients, both at septal and lateral level, as early as 72 h after procedure (septal: -14.2±5.1 vs -16.7±3.7%, p<0.001; lateral: -9.4±3.9 vs -13.1±4.5%, p<0.001; respectively) and continued at 3 months follow-up (septal: -18.1±4.6%, p<0.0001; lateral: -14.8±4.4%, p<0.0001; respectively). Conventional echocardiography after TAVI proved a significant reduction of LV end-systolic volume and of LV mass with a mild improvement of LV ejection fraction (EF) (51.2±11.8 vs 52.9±6.4%; p<0.02) only after three months. 2D strain seems to be able to detect subtle changes in LV systolic function occurring early and late after TAVI in severe AS, while all conventional echo parameters seem to be less effective for this purpose. Further investigations are needed to prove the real prognostic impact of these echocardiographic findings

The initial phases of the 2008-2009 Mt. Etna eruption: a multi-disciplinary approach for hazard assessment

Between 2007 and early 2008, the INGV monitoring networks on Etna volcano recorded a recharging phase that climaxed with a new effusive eruption on 13 May 2008, and lasted about 14 months. A dike-forming intrusion was accompanied by a violent seismic swarm, with more than 230 events recorded in the first six hours, the largest being ML = 3.9. In the meanwhile, marked ground deformation was recorded by the permanent tilt and GPS networks, and sudden changes in the summit area were detected by five continuously recording magnetic stations. Poor weather conditions did not allow direct observation of the eruptive events, but important information was provided by infrared satellite images that detected the start of lava fountains from the eruptive fissure, feeding a lava flow. This flow spread within the Valle del Bove depression, covering 6.4 km on the south-eastern flank of the volcano in a few hours. The seismicity and deformation pattern indicated that the dike-forming intrusion was propagating northwards. It produced a dry fracture field, which generated concern for the possibility that the eruptive fissures could expand downslope towards populated areas. Monitoring and modeling of the multi-disciplinary data, together with the simulations of ash dispersal and lava flows, allowed us both to infer the eruptive mechanisms and provide a correct interpretation of the ongoing phenomena, furnishing useful information for civil defense purposes. We describe how this approach of feedback between monitoring and research provides critical support to risk evaluation

Clostridium difficile infection in Italian urban hospitals: data from 2006 through 2011

BACKGROUND: In developed countries, Clostridium difficile infection (CDI) represents an emerging threat in terms of morbidity and mortality rates. In our country limited CDI epidemiological data can be found. We have conducted a 6-year retrospective study to evaluate the incidence of CDI in Italian urban hospitals. METHODS: Stool samples tested for C. difficile toxins from January 2006 to December 2011 in 5 large hospitals in Rome, Italy, were considered in the analysis. Repeated samples taken ≤ 2 months after a positive result were excluded. RESULTS: A total of 402 CDI episodes were identified. The incidence of CDI episodes progressively increased from 0.3 in 2006 to 2.3 per 10,000 patient-days in 2011. CDI episodes mostly occurred in patients > 60 years of age (77%). The >80 year-old age class reported the highest percentage of CDI episodes on tested samples (16%). Eighty percent (80%) of CDI episodes occurred in medical wards followed by surgery (10.2%) and intensive care units (9.8%). CONCLUSIONS: A significant increasing incidence of CDI episodes over the study period was observed during the years (p<.001), particularly in the older age groups. Medical wards experienced the highest number of CDI episodes as compared to intensive care and surgical wards. The increasing rate of CDI episodes over the last six years in our country, is alarming; urgent improvements in the surveillance systems and control programs are advisable