Cerebrospinal Fluid Markers in Sporadic Creutzfeldt-Jakob Disease

Sporadic Creutzfeldt-Jakob disease (sCJD) is the commonest form of human prion diseases, accounting for about 85% of all cases. Current criteria for intra vitam diagnosis include a distinct phenotype, periodic sharp and slow-wave complexes at electroencephalography (EEG), and a positive 14-3-3-protein assay in the cerebrospinal fluid (CSF). In sCJD, the disease phenotype may vary, depending upon the genotype at codon 129 of the prion protein gene (PRNP), a site of a common methionine/valine polymorphism, and two distinct conformers of the pathological prion protein. Based on the combination of these molecular determinants, six different sCJD subtypes are recognized, each with distinctive clinical and pathologic phenotypes. We analyzed CSF samples from 127 subjects with definite sCJD to assess the diagnostic value of 14-3-3 protein, total tau protein, phosphorylated181 tau, and amyloid beta (Aβ) peptide 1-42, either alone or in combination. While the 14-3-3 assay and tau protein levels were the most sensitive indicators of sCJD, the highest sensitivity, specificity and positive predictive value were obtained when all the above markers were combined. The latter approach also allowed a reliable differential diagnosis with other neurodegenerative dementias

Sawmark Analysis of Three Cases of Amputation and a Craniotomy from the Seventeenth and Eighteenth Centuries Hospital Necropolis of Forlì Campus (Forlì, Italy)

The seventeenth-eighteenth century hospital necropolis of Forlì Campus (Forlì, Italy) was discovered during the Forlì Campus building work in 2014. Three cases of limb amputation and a craniotomy are examined using the forensic approach of sawmark analysis in order to understand features of the surgical instruments employed and to gain insight into the position of the surgeon during the cutting actions. With the aid of high definition photographs and moulds, we analyzed the cut surfaces of each sample, also using stereomicroscopy and SEM (Scanning Electron Microscopy). A qualitative and quantitative approach was used in the analysis of the kerf features (e.g. breakaway spur and notch, tooth scratches and hop, exit chipping), and empirical evidence was compared against comparisons coeval surgical essays. We hypothesize that a linear hand-powered push saw and an alternated push saw with a 2mm distance between the teeth were used for amputations. The craniotomy was executed presumably using a linear hand-powered saw with the set of the blade circa 1.3mm wide. Through the application of forensic methods on individuals from archaeological context we describe early cases of surgical practice in a more technical way

Risk for chronic kidney disease in the general population: Italian reports for World Kidney Days 2007-2009

The prevalence of chronic kidney disease (CKD) has rapidlyincreased in recent decades in many countries, leading toconsistent economic implications. Considering the fact thatpatients surviving to CKD often develop end-stage renal disease,the number of patients requiring replacement therapyreached 169/million population (pmp) in Italy in 2004 and342 pmp in the Unites States. Furthermore, CKD weighs onpatients survival with a considerably increased cardiovascular(CV) morbidity and mortality

Virgil: the future?

The poet Virgil remains the most significant and influential figure in Latin literature, and this expanded and updated Companion covers his life, work, and reception from antiquity to the present. The Aeneid, the Eclogues, the Georgics, and the Appendix Vergiliana are all discussed, as are art, history, politics, and philosophy; Virgil's literary style is carefully explored along with poetic traditions before and since, and chapters engage with his poems and their reception from perspectives including intertextuality, narratology, gender theory, philology and historicism. Leading authors cover topics from translations and commentaries to genre, authority, and characterisation, providing revised and updated recommendations for further reading. This volume is an accessible introduction to Virgil and his legacy for students and teachers, while also providing wide-ranging and in-depth investigations that will appeal to scholars of classical literature and other disciplines