Comparison of post surgical results in medial and lateral lumbar spine herniated discs: Own case series experience

Abstract Lumbar disc herniation is a frequent condition. It causes radicular pain with irradiation along a lower limb or localized to the back. Disc herniation can be lateral or medial, with different clinical features. Medial disc herniation is more frequent, characterized by immediate good outcome after surgical treatment. Lateral disc herniation shows a greater delay in improvement on pain after surgical treatment, especially in the elderly. Some factors affect the surgical outcome, such as old age, alterations of the vertebral body, ligaments, intervertebral level. Our study is in line with these data, highlighting the better outcome, immediately after the surgical treatment in patients with medial disc herniation, while results has not been immediate in patients with lateral disc herniation, Finally, there was disappearance of the pain for both groups, as demonstrated in the long-term follow-up, after the surgical treatment

Validation of a questionnaire about knowledge and perception of biological risk among biomedical students of Sapienza University of Rome

Background and aim. Healthcare workers and Biomedical students are continuously exposed to biological risk in their clinical practice. The objective of this study was to evaluate the validity and reliability of an Italian questionnaire on the knowledge and perception of biological risk in Biomedical students at the beginning of their professional training. Material and methods.An electronic questionnaire was administered to students attending the second semester of the first year of Biomedical Courses at Sapienza University of Rome. The questionnaire consists of 40 questions divided into five sections collecting sociodemographic data, health status and level of knowledge and perception of biological risk. The statistical analysis was performed with Statistical Package for Social Sciences (SPSS) version 25. Results. A total of 309 individuals answered the online questionnaire, with a response rate of 83.5%. The analysis of internal consistency was performed by two dichotomous variables that measured the knowledge level on hygiene behaviour and gloves use. The analysis showed a standardized Cronbach’s alpha equal to 0.765, corresponding to a good reliability. A better reliability was found out among physiotherapy and medical students, with a Cronbach’s alpha equal to 0.944 and 0.881, respectively. Regarding vaccines, 97.7% of the sample was given a Hepatitis B vaccination and 98.7% of students consider vaccinations essential for healthcare workers. Conclusion. Results of Cronbach’s alpha showed a good reliability of the questionnaire. First-year Biomedical students may be exposed to occupational biological risk mainly because of their inexperience. A training educational path should be implemented in order to acquire competences, knowledge, attitudes and practical skills, correct behaviors and a personal and professional responsibility

A critical appraisal of epidemiological studies comes from basic knowledge: a reader's guide to assess potential for biases

Scientific literature may be biased because of the internal validity of studies being compromised by different forms of measurement error, and/or because of the selective reporting of positive and 'statistically significant' results. While the first source of bias might be prevented, and in some cases corrected to a degree, the second represents a pervasive problem afflicting the medical literature; a situation that can only be 'corrected' by a change in the mindset of authors, reviewers, and editors. This review focuses on the concepts of confounding, selection bias and information bias, utilising explanatory examples and simple rules to recognise and, when possible, to correct for them. Confounding is a mixing of effects resulting from an imbalance of some of the causes of disease across the compared groups. It can be prevented by randomization and restriction, and controlled by stratification, standardization or by using multivariable techniques. Selection bias stems from an absence of comparability among the groups being studied, while information bias arises from distorted information collection techniques. Publication bias of medical research results can invalidate evidence-based medicine, when a researcher attempting to collect all the published studies on a specific topic actually gathers only a proportion of them, usually the ones reporting 'positive' results. The selective publication of 'statistically significant' results represents a problem that researchers and readers have to be aware of in order to face the entire body of published medical evidence with a degree of scepticism

Knowledge and perception about climate change among healthcare professionals and students: A cross-sectional study

Aim: The aim of this study was to assess knowledge on Climate Change (CC) and related consequences among students and professionals of healthcare setting. Methods: A cross-sectional study involving 364 people was conducted. The survey was performed at Sapienza University (Rome) using questionnaire previously developed and validated by the same research group. Results: Findings indicate awareness about CC and its effects and correct identification of practices that could help to mitigate its repercussions. The majority of the participants believed that CC had an impact on the health of humans (96.7%), animals (99.5%) and on the environment (99.7%). Results from the multivariate analysis regarding overall knowledge, show an increased odd in professionals (OR=2.08; 95%CI=1.02-4.26), individuals from the North (OR=3.34; 95%CI=1.37-8.15) and from the Center (OR=2.07; 95%CI=1.17-3.66). Regarding factors able to modify Earth's climate, correct answer had higher odds of being chosen by professionals (OR=2.83; 95%CI=1.41–5.70), and from individuals from South/Islands than by the ones from the Center (OR=0.65; 95%CI=0.40-1.06). The main sources of information resulted to be TV and school/university. Conclusions: These new evidences could guide policymakers on increasing the awareness of the population about this fundamental subject. Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors

Knowledge and perception about climate change among healthcare professionals and students: A cross-sectional study

Aim: The aim of this study was to assess knowledge on Climate Change (CC) and related consequences among students and professionals of healthcare setting. Methods: A cross-sectional study involving 364 people was conducted. The survey was performed at Sapienza University (Rome) using questionnaire previously developed and validated by the same research group. Results: Findings indicate awareness about CC and its effects and correct identification of practices that could help to mitigate its repercussions. The majority of the participants believed that CC had an impact on the health of humans (96.7%), animals (99.5%) and on the environment (99.7%). Results from the multivariate analysis regarding overall knowledge, show an increased odd in professionals (OR=2.08; 95%CI=1.02-4.26), individuals from the North (OR=3.34; 95%CI=1.37-8.15) and from the Center (OR=2.07; 95%CI=1.17-3.66). Regarding factors able to modify Earth's climate, correct answer had higher odds of being chosen by professionals (OR=2.83; 95%CI=1.41–5.70), and from individuals from South/Islands than by the ones from the Center (OR=0.65; 95%CI=0.40-1.06). The main sources of information resulted to be TV and school/university. Conclusions: These new evidences could guide policymakers on increasing the awareness of the population about this fundamental subject. Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.   Author contributions: Conceptualization, G.L.T. and A.D.C..; Methodology, G.L.T. and A.M..; Formal Analysis, A.D.P.B., C.S., R.A.C., D.B.; Investigation, A.D.P.B., C.S., R.A.C., D.B.; Data Curation, A.D.P.B., C.S.; Writing – Original Draft Preparation, R.A.C., D.B.; Writing – Review & Editing, R.A.C., D.B., A.M..; Supervision, G.L.T..; Project Administration, G.L.T.   Conflicts of interest: None declare

3D-Printing of Arteriovenous Malformations for Radiosurgical Treatment: Pushing Anatomy Understanding to Real Boundaries

open9noRadiosurgery of arteriovenous malformations (AVMs) is a challenging procedure. Accuracy of target volume contouring is one major issue to achieve AVM obliteration while avoiding disastrous complications due to suboptimal treatment. We describe a technique to improve the understanding of the complex AVM angioarchitecture by 3D prototyping of individual lesions. Arteriovenous malformations of ten patients were prototyped by 3D printing using 3D rotational angiography (3DRA) as a template. A target volume was obtained using the 3DRA; a second volume was obtained, without awareness of the first volume, using 3DRA and the 3D-printed model. The two volumes were superimposed and the conjoint and disjoint volumes were measured. We also calculated the time needed to perform contouring and assessed the confidence of the surgeons in the definition of the target volumes using a six-point scale. The time required for the contouring of the target lesion was shorter when the surgeons used the 3D-printed model of the AVM (p=0.001). The average volume contoured without the 3D model was 5.6 ± 3 mL whereas it was 5.2 ± 2.9 mL with the 3D-printed model (p=0.003). The 3D prototypes proved to be spatially reliable. Surgeons were absolutely confident or very confident in all cases that the volume contoured using the 3D-printed model was plausible and corresponded to the real boundaries of the lesion. The total cost for each case was 50 euros whereas the cost of the 3D printer was 1600 euros. 3D prototyping of AVMs is a simple, affordable, and spatially reliable procedure that can be beneficial for radiosurgery treatment planning. According to our preliminary data, individual prototyping of the brain circulation provides an intuitive comprehension of the 3D anatomy of the lesion that can be rapidly and reliably translated into the target volume.openCONTI, Alfredo; PONTORIERO, ANTONIO; IATI', GIUSEPPE; MARINO, DANIELE; LA TORRE, Domenico; VINCI, Sergio Lucio; GERMANO', Antonino Francesco; PERGOLIZZI, Stefano; TOMASELLO, FrancescoCONTI, Alfredo; PONTORIERO, ANTONIO; IATI', GIUSEPPE; MARINO, DANIELE; LA TORRE, Domenico; VINCI, Sergio Lucio; GERMANO', Antonino Francesco; PERGOLIZZI, Stefano; TOMASELLO, Francesc

The telomeric protein AKTIP interacts with A- and B-type lamins and is involved in regulation of cellular senescence

AKTIP is a shelterin-interacting protein required for replication of telomeric DNA. Here, we show that AKTIP biochemically interacts with A- and B-type lamins and affects lamin A, but not lamin C or B, expression. In interphase cells, AKTIP localizes at the nuclear rim and in discrete regions of the nucleoplasm just like lamins. Double immunostaining revealed that AKTIP partially co-localizes with lamin B1 and lamin A/C in interphase cells, and that proper AKTIP localization requires functional lamin A. In mitotic cells, AKTIP is enriched at the spindle poles and at the midbody of late telophase cells similar to lamin B1. AKTIP-depleted cells show senescence-associated markers and recapitulate several aspects of the progeroid phenotype. Collectively, our results indicate that AKTIP is a new player in lamin-related processes, including those that govern nuclear architecture, telomere homeostasis and cellular senescence

AKTIP/Ft1, a new shelterin-interacting factor required for telomere maintenance

Telomeres are nucleoprotein complexes that protect the ends of linear chromosomes from incomplete replication, degradation and detection as DNA breaks. Mammalian telomeres are protected by shelterin, a multiprotein complex that binds the TTAGGG telomeric repeats and recruits a series of additional factors that are essential for telomere function. Although many shelterin-associated proteins have been so far identified, the inventory of shelterin-interacting factors required for telomere maintenance is still largely incomplete. Here, we characterize AKTIP/Ft1 (humanAKTIP and mouse Ft1 are orthologous), a novel mammalian shelterin-bound factoridentified on the basis of its homology with the Drosophila telomere protein Pendolino. AKTIP/Ft1 shares homology with the E2 variant ubiquitin-conjugating (UEV) enzymes and has been previously implicated in the control of apoptosis and in vesicle trafficking. RNAi-mediated depletion of AKTIP results in formation of telomere disfunction foci (TIFs). Consistent with these results, AKTIP interacts with telomeric DNA and binds the shelterin components TRF1 and TRF2 both in vivo and in vitro. Analysis of AKTIP- depleted human primary fibroblasts showed that they are defective in PCNA recruiting and arrest in the S phase due to the activation of the intra S checkpoint. Accordingly, AKTIP physically interacts with PCNA and the RPA70 DNA replication factor. Ft1-depleted p53-/- MEFs did not arrest in the S phase but displayed significant increases in multiple telomeric signals (MTS) and sister telomere associations (STAs), two hallmarks of defective telomere replication. In addition, we found an epistatic relation for MST formation between Ft1 and TRF1, which has been previously shown to be required for replication fork progression through telomeric DNA. Ch-IP experiments further suggested that in AKTIP-depleted cells undergoing the S phase, TRF1 is less tightly bound to telomeric DNA than in controls. Thus, our results collectively suggest that AKTIP/Ft1 works in concert with TRF1 to facilitate telomeric DNA replication

Anesthetic Techniques and Cancer Recurrence after Surgery

Many of the most common anesthetics are used in surgical oncology, yet effects on cancer cells are still not known. Anesthesia technique could differentially affect cancer recurrence in oncologic patients undergoing surgery, due to immunosuppression, stimulation of angiogenesis, and dissemination of residual cancer cells. Data support the use of intravenous anesthetics, such as propofol anesthesia, thanks to antitumoral protective effects inhibiting cyclooxygenase 2 and prostaglandins E2 in cancer cells, and stimulation of immunity response; a restriction in the use of volatile anesthetics; restriction in the use of opioids as they suppress humoral and cellular immunity, and their chronic use favors angiogenesis and development of metastases; use of locoregional anesthesia compared with general anesthesia, as locoregional appears to reduce cancer recurrence after surgery. However, these findings must be interpreted cautiously as there is no evidence that simple changes in the practice of anesthesia can have a positive impact on postsurgical survival of cancer patients