Short-term one-lung ventilation does not influence local inflammatory cytokine response after lung resection

Background: One-lung ventilation (OLV) is a ventilation procedure used for pulmonary resection which may results in lung injury. The aim of this study was to evaluate the local inflammatory cytokine response from the dependent lung after OLV and its correlation to VT. The secondary aim was to evaluate the clinical outcome of each patient. Methods: Twenty-eight consecutive patients were enrolled. Ventilation was delivered in volume-controlled mode with a VT based on predicted body weight (PBW). 5 cmH2O positive end-expiratory pressure (PEEP) and FiO20.5 were applied. Bronchoalveolar lavage (BAL) was performed in the dependent lung before and after OLV. The levels of pro-inflammatory interleukins (IL-1α, IL-1β, IL-6, IL-8), tumor necrosis factor alpha (TNFα), vascular endothelial growth factor (VEGF), endothelial growth factor (EGF), monocyte chemoattractant protein-1 (MCP-1) and anti-inflammatory cytokines, such as interleukins (IL-2, IL-4, IL-10) and interferon (IFN-γ), were evaluated. Subgroup analysis: to analyze the VT setting during OLV, all patients were ventilated within a range of 5-10 mL/kg. Thirteen patients, classified as a conventional ventilation (CV) subgroup, received 8-10 mL/kg, while 15 patients, classified as a protective ventilation (PV) subgroup, received 5-7 mL/kg. Results: Cytokine BAL levels after surgery showed no significant increase after OLV, and no significant differences were recorded between the two subgroups. The mean duration of OLV was 64.44±21.68 minutes. No postoperative respiratory complications were recorded. The mean length of stay was for 4.00±1.41 days in the PV subgroup and 4.45±2.07 days in the CV group; no statistically significant differences were recorded between the two subgroups (P=0.511). Conclusions: Localized inflammatory cytokine response after OLV was not influenced by the use of different VT. Potentially, the application of PEEP in both ventilation strategies and the short duration of OLV could prevent postoperative complications

ANALISI DELLA VARIABILITÀ DELLA PORTATA E DELLA TEMPERATURA DELLE ACQUE REFLUE URBANE

I sistemi di recupero del calore dalle acque reflue dei sistemi fognari si stanno rapidamente diffondendo in molti Paesi e consentono di trasformare tali acque in una fonte energetica sostenibile. La quantità di energia che può essere ricavata dipende ovviamente dalla portata e dalla temperatura delle acque reflue. Risulta pertanto indispensabile una buona conoscenza della variabilità sia della portata sia della temperatura per poter progettare in modo ottimale un sistema di recupero e sfruttamento del calore posseduto dalle acque reflue. Nel presente studio sono state analizzate le variazioni di portata e temperatura, in condizioni di tempo secco, per cinque collettori, del medesimo sistema fognario, caratterizzati da un numero di abitanti variabile tra circa 12'000 a oltre 400'000. L'analisi ha consentito di individuare l’andamento “tipo” giornaliero sia della portata reflua, i cui coefficienti sono compresi tra 0,25 e 1,50, sia che della temperatura del refluo in cui i coefficienti riscontrati assumono valori variabili tra 0,90 e 1,05 circa

Microfabrication of {pH}-responsive 3D hydrogel structures via two-photon polymerization of high-molecular-weight poly(ethylene glycol) diacrylates

3D pH-responsive microstructures by two-photon lithography (2 PL) in poly(ethylene glycol) diacrylates (PEG-DAs) hydrogels are particularly suitable for biosensing as structural and functional components. So far, 2 PL patterning of hydrogels have been successfully achieved only for low molecular-weight (<= 700 Da MMw) PEG-DAs, which is unfortunately not mechanically compliant with single cell and tissues stiffness. We report an optimised protocol to setup a 2 PL fabrication of high MMw (10 kDa) PEG-DA-based formulations, suitable for pH sensing in soft biological tissues. Two different shapes (pyramids and domes) were obtained and tested for mechanical characterization and pH responsiveness at the microscale. Fast pH-induced swelling (< 15 min) in microstructures allows for envisioning high MMw PEG-DA-based micro and nanostructures via 2 PL as a tunable pH responsive tool for biosensing applications in cell and tissue

MRSA ST22-IVa (EMRSA-15 clone) in Palermo, Italy

Summary: Epidemic spread of methicillin-resistant Staphylococcus aureus (MRSA) strains carrying the Staphylococcal Chromosomal Cassettes (SCC) mec type IV is being increasingly reported in many geographical areas. A survey to determine the prevalence and characteristics of MRSA SCCmec IV isolates identified in four general hospitals in Palermo, Italy, was carried out. During the period February–June 2009, SCCmec type IVa has been found in 12 out of 94 isolates. Nine isolates from all hospitals and all strains from a NICU outbreak occurring in the same period were attributed with the ST22-IVa (EMRSA-15) clone. In our setting, due to the changing MRSA epidemiology, detection of SCCmec IV could be poorly predictive of CA-MRSA. Keywords: MRSA, ST22-IVA, EMRSA-15, Epidemiology, Molecular typin

Metabolic Profile of Patients with Smith-Magenis Syndrome: An Observational Study with Literature Review

Background: Smith-Magenis syndrome (SMS) is caused by either interstitial deletions in the 17p11.2 region or pathogenic variants in the RAI1 gene and is marked by a distinct set of physical, developmental, neurological, and behavioral features. Hypercholesterolemia has been described in SMS, and obesity is also commonly found. Aim: To describe and characterize the metabolic phenotype of a cohort of SMS patients with an age range of 2.9–32.4 years and to evaluate any correlations between their body mass index and serum lipids, glycated hemoglobin (HbA1c), and basal insulin levels. Results: Seven/thirty-five patients had high values of both total cholesterol and low-density lipoprotein cholesterol; 3/35 had high values of triglycerides; none of the patients with RAI1 variants presented dyslipidemia. No patients had abnormal fasting glucose levels. Three/thirty-five patients had HbA1c in the prediabetes range. Ten/twenty-two patients with 17p11.2 deletion and 2/3 with RAI1 variants had increased insulin basal levels. Three/twenty-three patients with the 17p11.2 deletion had prediabetes. Conclusion: Our investigation suggests that SMS ‘deleted’ patients may show a dyslipidemic pattern, while SMS ‘mutated’ patients are more likely to develop early-onset obesity along with hyperinsulinism

Off-label use of drugs and adverse drug reactions in pediatric units: A prospective, multicenter study

Background: Given the growing use of off-label in pediatric practice, there is a growing interest on pharmacovigilance programs monitoring the occurrence of adverse drug reactions related to off-label drug prescription in childhood. Patients and Methods: The results of a one-year program of pharmacovigilance issued in the Sicilian Region, Italy, are herein presented. The study involved 6 pediatric and neonatal centres and prospectively reviewed the prescriptions of 5,060 patients, who were stratified for age (newborn, infant, children, adolescents). Results: A total of 14,916 prescriptions were issued for 5,060 patients. Among them, 454 patients [8.97%] received at least one off-label drug. Among the off-label treated patients, 255 [56.2%] were newborns. Anti-infective drugs were the most frequent off-label used drugs, followed by drugs for alimentary tract and metabolism and drugs for blood or blood forming organs. Ninety adverse drug reactions were recorded [1.78% of the total patients]. They occurred after an off-label prescription in 33 out of 90 [36.7%], while those occurring after an on-label prescription were 57 [63.3%]. Patients treated with an off-label drug had a significantly higher risk of adverse drug reactions [7.3% vs. 1.2%; p <0.01]. Conclusion: The present study indicates that children admitted to neonatal intensive care units are likely to receive an off-label medication; children who receive an off-label medication are usually more likely to be treated with more medication than the others; adverse drug reactions occur in patients admitted in neonatal intensive care and pediatrics are units are more frequently with off-label than with on-label drugs