Minor mutations in HIV protease at baseline and appearance of primary mutation 90M in patients for whom their first protease-inhibitor ntiretroviral regimens failed

The association between minor mutations in human immunodeficiency virus (HIV) protease at baseline and development of common primary mutation 90M at virological failure (conferring some resistance to all protease inhibitors [PIs]) was evaluated in 93 previously drug-naive patients experiencing failure of their first PI-based antiretroviral regimens. In logistic regression analysis, the probability of accumulating a new 90M mutation at virological failure was associated with the presence at baseline of minor mutation 36I (naturally occurring in ∼25% of HIV clade B and in >80% of HIV non-clade-B viruses) (adjusted odds ratio, 13.5 [95% confidence interval, 1.89–95.6]; P=.009) and, possibly, of 10I/V. This suggests a potential role for the presence of 36I at baseline in predicting the appearance of 90M at virological failure

Effect of a heated humidifier during continuous positive airway pressure delivered by a helmet

INTRODUCTION: The helmet may be an effective interface for the delivery of noninvasive positive pressure ventilation. The high internal gas volume of the helmet can act as a 'mixing chamber', in which the humidity of the patient's expired alveolar gases increases the humidity of the dry medical gases, thus avoiding the need for active humidification. We evaluated the temperature and humidity of respiratory gases inside the helmet, with and without a heated humidifier, during continuous positive airway pressure (CPAP) delivered with a helmet. METHODS: Nine patients with acute respiratory failure (arterial oxygen tension/fractional inspired oxygen ratio 209 +/- 52 mmHg) and 10 healthy individuals were subjected to CPAP. The CPAP was delivered either through a mechanical ventilator or by continuous low (40 l/min) or high flow (80 l/min). Humidity was measured inside the helmet using a capacitive hygrometer. The level of patient comfort was evaluated using a continuous scale. RESULTS: In patients with acute respiratory failure, the heated humidifier significantly increased the absolute humidity from 18.4 +/- 5.5 mgH2O/l to 34.1 +/- 2.8 mgH2O/l during ventilator CPAP, from 11.4 +/- 4.8 mgH2O/l to 33.9 +/- 1.9 mgH2O/l during continuous low-flow CPAP, and from 6.4 +/- 1.8 mgH2O/l to 24.2 +/- 5.4 mgH2O/l during continuous high-flow CPAP. Without the heated humidifier, the absolute humidity was significantly higher with ventilator CPAP than with continuous low-flow and high-flow CPAP. The level of comfort was similar for all the three modes of ventilation and with or without the heated humidifier. The findings in healthy individuals were similar to those in the patients with acute respiratory failure. CONCLUSION: The fresh gas flowing through the helmet with continuous flow CPAP systems limited the possibility to increase the humidity. We suggest that a heated humidifier should be employed with continuous flow CPAP systems

The Outcome of Cholangitis After Percutaneous Biliary Drainage in Neoplastic Jaundice

The purpose of this paper is to evaluate factors affecting the outcome of cholangitis after PTBD in jaundiced cancer patients. Twenty nine patients with neoplastic jaundice (male/female ratio 13/16, median age 55 years) with full clinical data, were treated by PTBD and developed cholangitis at a median of 9 days later. Four patients (14%) died of biliary sepsis a median of one month after PTBD while the other 25 survived a median of 6 months, with one week median duration of cholangitis. The probability of the cholangitis resolving was analyzed by time to resolution and it was found that 50% and 100% of the recoveries occurred 5 and 9 months respectively from the onset of the complication

Lattice radiation therapy in clinical practice: a systematic review

Purpose: Lattice radiation therapy (LRT) is an innovative type of spatially fractionated radiation therapy. It aims to increase large tumors control probability by administering ablative doses without an increased toxicity. Considering the rising number of positive clinical experiences, the objective of this work is to evaluate LRT safety and efficacy. Method: Reports about LRT clinical experience were identified with a systematic review conducted on four different databases (namely, Medline, Embase, Scopus, and Cochrane Library) through the August 2022. Only LRT clinical reports published in English and with the access to the full manuscript text were considered as eligible. The 2020 update version PRISMA statement was followed. Results: Data extraction was performed from 12 eligible records encompassing 7 case reports, 1 case series, and 4 clinical studies. 81 patients (84 lesions) with a large lesion ranging from 63.2 cc to 3713.5 cc were subjected to exclusive, hybrid, and metabolism guided LRT. Excluding two very severe toxicity with a questionable relation with LRT, available clinical experience seem to confirm LRT safety. When a complete response was not achieved 3-6 months after LRT, a median lesion reduction approximately ≥50 % was registered. Conclusion: This systematic review appear to suggest LRT safety, especially for exclusive LRT. The very low level of evidence and the studies heterogeneity preclude drawing definitive conclusions on LRT efficacy, even though an interesting trend in terms of lesions reduction has been described

sulphur speciation of pm10 samples by xanes spectroscopy

AbstractSulphur K-edge X-ray absorption near edge structure (XANES) spectroscopy was used to identify sulphur compounds in PM10 samples collected simultaneously at two sites with different environmental situations in the province of Trieste (NE of Italy), during summer and winter seasons respectively. The first site is an industrial site located near a steel mill plant and the second is a coastal site. The sulphur speciation at the industrial site has shown the presence of the following sulphur compounds in both seasons: organic compounds (thiophenes or Polycyclic Aromatic Sulphur Heterocycles — PAHs) and sulphates while in the winter season sulphites were also present. In the coastal site organic compounds (thiophenes or PASHs) and sulphate were found during winter season, moreover bisulphates were found during summer season. Relative percentages of the different sulphur compounds have shown that sulphate is the most abundant form of sulphur in the industrial site samples during both seasons and in the coastal site sample collected during the winter season (> 98%); in the coastal site sample collected during the summer season the relative percentages of bisulphate and sulphate were around 40% and 60% respectively

Extended criteria donor lung reconditioning with the organ care system lung: a single institution experience

Lung transplantation is a life-saving procedure limited by donor's availability. Lung reconditioning by ex vivo lung perfusion represents a tool to expand the donor pool. In this study, we describe our experience with the OCS\u2122 Lung to assess and recondition extended criteria lungs. From January 2014 to October 2016, of 86 on-site donors evaluated, eight lungs have been identified as potentially treatable with OCS\u2122 Lung. We analyzed data from these donors and the recipient outcomes after transplantation. All donor lungs improved during OCS perfusion in particular regarding the PaO2/FiO2 ratio (from 340 mmHg in donor to 537 mmHg in OCS) leading to lung transplantation in all cases. Concerning postoperative results, primary graft dysfunction score 3 at 72 h was observed in one patient, while median mechanical ventilation time, ICU, and hospital stay were 60 h, 14 and 36 days respectively. One in-hospital death was recorded (12.5%), while other two patients died during follow-up leading to 1-year survival of 62.5%. The remaining five patients are alive and in good conditions. This case series demonstrates the feasibility and value of lung reconditioning with the OCS\u2122 Lung; a prospective trial is underway to validate its role to safely increase the number of donor lungs. \ua9 2018 Steunstichting ESO

La citt\ue0 metropolitana di Trieste

Verso la fine del 2012 la Regione Friuli Venezia Giulia ha conferito l\u2019incarico all\u2019Universit\ue0 degli Studi di Trieste di effettuare uno studio su un\u2019ipotesi di \u201cCitt\ue0 metropolitana di Trieste\u201d. Il primo passo \ue8 stata la ricognizione degli ambiti disciplinari e delle competenze utili per analizzare il tema. Sono stati individuati quattro ambiti che indicheremo come: \u2022 Ambito urbanistico-territoriale \u2022 Ambito economico-trasportistico \u2022 Ambito socio-politico \u2022 Ambito giuridico-legislativo Pur non essendo esaustivo, ciascuno di questi ambiti ha un sicuro rilievo nel definire e valutare l\u2019impatto che la costituzione della citt\ue0 metropolitana potrebbe avere rispetto all\u2019assetto territoriale, economico, sociale e amministrativo esistente. Si \ue8 quindi formato un ampio gruppo di ricerca proveniente da studiosi appartenenti a quattro diversi Dipartimenti: il Dipartimento di Ingegneria e Architettura, il Dipartimento di Scienze Economiche, Aziendali, Matematiche e Statistiche, il Dipartimento di Scienze Politiche e Sociali e il Dipartimento di Scienze Giuridiche, del Linguaggio, dell`Interpretazione e della Traduzione. Per il Dipartimento di Ingegneria e Architettura hanno partecipato Paola Di Biagi, Alessandra Marin, Claudia Marcon e Igor Ciuffarin; per il Dipartimento di Scienze Economiche, Aziendali, Matematiche e Statistiche Romeo Danielis, Lucia Rotaris; per il Dipartimento di Scienze Politiche e Sociali Giorgio Osti, Giovanni Carrosio e Marco Cesa; e per il Dipartimento di Scienze Giuridiche, del Linguaggio, dell`Interpretazione e della Traduzione Paolo Giangaspero, Alessia Ottavia Cozzi, Pietro Faraguna e Federico Gambini. La provenienza multidisciplinare del gruppo di ricerca ha permesso di evidenziare le specificit\ue0 di ciascuna disciplina nell\u2019affrontare il tema oggetto di studio e di metterle a confronto, facendole interagire, nel caso specifico dell\u2019ipotesi della Citt\ue0 Metropolitana di Trieste