May antitransglutaminase levels predict severity of duodenal lesions in adults with celiac disease?

Background and Objective: Pediatric guidelines on celiac disease (CD) state that children with anti‐transglutaminase antibodies (TGAs) >×10 upper limit of normal (ULN) may avoid endos-copy and biopsy. We aimed to evaluate whether these criteria may be suitable for villous atrophy diagnosis in CD adults. Materials and Methods: We retrospectively enrolled patients with CD aged >18 years. TGAs were expressed as xULN. Duodenal lesions were classified as atrophic or non-atrophic according to Marsh‐Oberhuber. Fisher’s exact and t‐test were used for variables compari-son. Receiver operating characteristics (ROC) curve analysis was performed with estimation of area under the curve (AUC), sensitivity, specificity, and positive and negative predictive value (PPV/NPV). Results: One hundred and twenty‐one patients were recruited. Sixty patients (49.6%) had TGA >×10 ULN, and 93 (76.8%) had villous atrophy. The cut‐off of >×10 ULN had sensitivity = 53.7%, specificity = 64.3%, PPV = 83.3%, and NPV = 29.5% to predict atrophy. Therefore, considering pediatric criteria, in 50 (41.3%) patients, biopsy could have been avoided. Patient subgroup with atrophy had higher TGA levels despite being not significant (37.2 ± 15.3 vs. 8.0 ± 1.3 ULN, p = 0.06). In adults, a slightly better diagnostic performance was obtained using a cut‐off of TGA >×6.2 ULN (sensitivity = 57.1%, specificity = 65.6%, and AUC = 0.62). Conclusions: Despite our confirmation that villous atrophy is linked to high TGA levels, CD and atrophy diagnosis based only on serology is not reliable in adults

HBsAg clearance by Peg-interferon addition to a long-term nucleos(t)ide analogue therapy.

The ideal endpoint of hepatitis B virus (HBV) antiviral therapy is HBsAg loss, a difficult goal to obtain, especially in HBeAg negative patients. Herein, we report the results obtained by the addition of peg-interferon α-2a to a long-lasting nucleos(t)ide analogue therapy in a HBeAg negative, genotype D patient with steadily HBV-DNA negative/HBsAg positive values. In 2002, our Caucasian 44-year-old male patient received lamivudine and, 4 years later, added adefovir because of a virological breakthrough. In 2011, considering his young age, liver stiffness (4.3 kPa) and HBsAg levels (3533 IU/mL), we added Peg-interferon α-2a for six months (3 in combination with nucleos(t)ide analogues followed by 3 mo of Peg-interferon α-2a monotherapy). A decrease of HBsAg levels was observed after 1 mo (1.21 log) of Peg-interferon and 3 mo (1.88 log) after the discontinuation of all drugs. Later, a complete clearance of HBsAg was obtained with steadily undetectable HBV-DNA serum levels (< 9 IU/mL). HBsAg clearance by the addition of a short course of Peg-interferon α-2a represents an important result with clinical and pharmaco-economic implications, considering that nucleos(t)ide analogues therapy in HBeAg negative chronic hepatitis B patients is considered a long-lasting/life-long treatment

A Finite Element Implementation of a Coupled Diffusion-Deformation Theory for Elastomeric Gels

The theory of Chester and Anand (2011) for fluid diffusion and large deformations of elastomeric gels is implemented as a user-defined element (UEL) subroutine in the commercial finite element software package ABAQUS. A specialized form of the constitutive equations and the governing partial differential equations of the theory are summarized, and the numerical implementation is described in detail. To demonstrate the robustness of the numerical implementation a few illustrative numerical simulation examples for axisymmetric, plane strain, and three-dimensional geometries are shown. For educational purposes, and also to facilitate the numerical implementation of other coupled multiphysics theories, the source code for the UEL is provided as an online supplement to this paper.National Science Foundation (U.S.) (NSF CMMI-1063626

Trace metal distributions in Posidonia oceanica and sediments from Taranto Gulf (Ionian Sea, Southern Italy)

Distribution of metals (Hg, Pb, Sn, Cu, Cd and Zn) was determined in sediments and in different tissues of Posidonia oceanica collected from San Pietro Island, Taranto Gulf (Ionian Sea, Southern Italy). In seagrass, results, compared with metal concentrations in sediments, showed that the highest concentrations of Hg, Pb, Sn and Cu were found in the roots, while in the green leaves were found the highest levels of Cd and Zn. Instead the lowest metal concentrations were found in the basal part of the leaf. Levels of  metals in the leaves were similar to those found by other authors in uncontaminated areas of the Mediterranean Sea. Mercury levels in roots were correlated to levels in sediments. This could demonstrate the plant memorizes sediments contamination . This study reinforces the usefulness and the relevance of Posidonia oceanica as an indicator of spatial metal contamination and an interesting tool for environmental quality evaluation

Therapeutic sequences in patients with grade 1−2 neuroendocrine tumors (NET): an observational multicenter study from the ELIOS group

Purpose: Many different treatments are suggested by guidelines to treat grade 1−2 (G1−G2) neuroendocrine tumors (NET). However, a precise therapeutic algorithm has not yet been established. This study aims at identifying and comparing the main therapeutic sequences in G1−G2 NET. Methods: A retrospective observational Italian multicenter study was designed to collect data on therapeutic sequences in NET. Median progression-free survival (PFS) was compared between therapeutic sequences, as well as the number and grade of side effects and the rate of dose reduction/treatment discontinuation. Results: Among 1182 patients with neuroendocrine neoplasia included in the ELIOS database, 131 G1–G2 gastroenteropancreatic, lung and unknown primary NET, unresectable or persistent/relapsing after surgery, treated with ≥2 systemic treatments, were included. Four main therapeutic sequences were identified in 99 patients: (A) somatostatin analogs (SSA) standard dose to SSA high dose (n = 36), (B) SSA to everolimus (n = 31), (C) SSA to chemotherapy (n = 17), (D) SSA to peptide receptor radionuclide therapy (PRRT) (n = 15). Median PFS of the second-line treatment was not reached in sequence A, 33 months in sequence B, 20 months in sequence C, 30 months in sequence D (p = 0.16). Both total number and severity of side effects were significantly higher in sequences B and C than A and D (p = 0.04), as well as the rate of dose reduction/discontinuation (p = 0.03). Conclusions: SSA followed by SSA high dose, everolimus, chemotherapy or PRRT represent the main therapeutic sequences in G1−G2 NET. Median PFS was not significantly different between sequences. However, the sequences with SSA high dose or PRRT seem to be better tolerated than sequences with everolimus or chemotherapy

Influence of Polyphenol Levels on the Perception of Aroma in Vitis vinifera cv. Malbec wine

The aim of this study was to explore the effect of two ranges of polyphenols naturally present in Malbec wine,high concentrations (4.5-7.2 g/L) and low (1.4-3.2 g/L), on the perception of aroma. Samples with a maximumethanol level of 13.5% were taken from the fermentation tanks before the clarification and filtration process. AQuantitative Descriptive Analysis of wines was assessed by ten trained assessors, and HS-SPME-GC-MS andphysicochemical analyses were performed. The intensities of fruity (P < 0.01), citrus (P < 0.01), strawberry (P< 0.05), cooked fruit (P < 0.01) and floral (P < 0.01) aromas decreased when the level of polyphenols increased.Neither volatile compounds nor physicochemical analyses were significant in the two groups of wines

Late recovery with cyclosporine-A of an auto-immune sudden sensorineural hearing loss

Sensorineural hearing loss of immune-mediated origin may be present as a symptom in systemic autoimmune diseases or may occur as a primary disorder without other organ involvement (auto-immune inner ear disease). The diagnosis of auto-immune inner ear disease is still predicated on clinical features and to date specific diagnostic tests are not available. We report a case of right-sided sudden hearing loss in a female patient in which the clinical manifestations, in addition to ANA positivity and hypocomplementaemia allowed us to hypothesize an auto-immune inner ear disease. The immunosuppressive treatment with cyclosporine-A was capable of a recovery of the hearing that, however, occurred progressively with normalization of the hearing function after 1 year of treatment. cyclosporine-A could be proposed as a therapeutic option in case of auto-immune inner ear disease allowing the suspension of corticosteroids that, at high dose, expose patients to potentially serious adverse events

Heavy metals monitoring in mussels Mytilus galloprovincialis from the Apulian coasts (Southern Italy)

Concentrations of six heavy metals (Cd, Cr, Cu, Hg, Pb and Zn) and one semi-metal (As) were determined in tissues of mussels Mytilus galloprovincialis collected along the Apulian coasts (Mediterranean sea). This project, performed in 2009, was targeted toward the assessment of levels and spatial distribution of metals in the environment in order to evaluate the coastal water quality using mussels as bioindicators and health risk for mussel consumers.The concentrations (mg/kg d.w.) of these metals ranged from 6.35 to 76.17 for arsenic (As), 0.38 to 2.54 for cadmium (Cd), 0.96 to 9.46 for chromium (Cr), 5.26 to 19.22 for copper (Cu), 0.10 to 0.81 for mercury (Hg), 25.00 to 110.51 for zinc (Zn) and from 0.37 to 3.25 for lead (Pb). These levels were lower than the permissible limits set by European Commission and FAO with the exception for Cr in three sampling stations. Evaluation of the risk associated to molluscs consumption for human health suggested that there is no evident risk for a moderate Mytilus g. consumer, however heavy metals concentrations must be monitored periodically and carefully with respect to the consumers health

Innovative teaching on photovoltaic generation

One of the most important technologies for the renewable energy production is the Photovoltaic (PV) one. In the last decades, the enormous growth in the world of Photovoltaic installation capacity, and future trends, makes the knowledge of this topic fundamental for engineers working in the energy field with this competence, and not only. Thus, for students enrolled in industrial engineering courses, appropriate and innovative teaching methods are necessary. This paper aims to describe the structure of the course 'Photovoltaic Power Generation' in which solar resource and the photovoltaic generators, including power electronics, are explained. The topics of traditional theoretical lectures are presented, with the links to practical exercises and laboratories