Not in their Minds

Mary Ann Smart, Waiting for Verdi: Opera and Political Opinion in Nineteenth-Century Italy, 1815–1848. California: University of California Press, 2018. 266 pp. ISBN 9780520276253 (hard cover)

Serum digoxin concentrations : a retrospective analysis

The use of digoxin is limited by its narrow therapeutic index. American and European guidelines for the management of heart failure and atrial fibrillation recommend targeting a serum digoxin concentration (SDC) between 0.5 and 0.9ng/ml. The aim of the study was to retrospectively analyse SDCs and to assess compliance to the SDC target range recommended in the guidelines. SDCs recorded at the hospital Pathology laboratory between January 2008 and December 2017 were analysed according to gender, age, origin of request, specialty of referring physician and reason for request, and were compared to the SDC target range. Serum potassium (K+) levels and estimated glomerular filtration rate (eGFR) were analysed for SDCs recorded in 2017. A total of 19,065 SDCs from 6,107 patients (65% female, mean age 78 ± 11 years) were analysed. Mean SDC was 1.31 ± 1.01ng/ml (range 0.9ng/ml (66.76 ± 36.43) and ≥ 2.0ng/ml (64.39 ± 34.23) compared to patients with SDC ≤ 0.9ng/ml (73.84 ± 35.21mL/min/1.73m²). The mean SDC observed was higher than the upper limit of the recommended target SDC range. Further investigation to establish the clinical significance of the observed SDC findings on patient outcomes is warranted.peer-reviewe

How the Heart Was Involved in COVID-19 during the First Pandemic Phase: A Review

Coronavirus disease (COVID-19) was first observed in Wuhan, Hubei Province (China) in December 2019, resulting in an acute respiratory syndrome. Only later was COVID-19 considered a public health emergency of international concern and, on 11 March 2020, the WHO classified it as pandemic. Despite being a respiratory virus, the clinical manifestations are also characterized by cardiological involvement, especially in patients suffering from previous comorbidities such as hypertension and diabetes mellitus, its complications being potentially serious or fatal. Despite the efforts made by the scientific community to identify pathophysiological mechanisms, they still remain unclear. A fundamental role is played by the angiotensin 2 converting enzyme, known for its effects at the cardiovascular level and for its involvement in COVID-19 pathogenesis. The goal of this paper was to highlight the mechanisms and knowledge related to cardiovascular involvement during the first pandemic phase, as well as to emphasize the main cardiological complications in infected patients

Evaluation of a quality system developed for pharmacy teaching laboratories

Background: The implementation of a quality system improves the educational quality of activities undertaken in a laboratory. Aim: To evaluate the perception of undergraduate pharmacy students and laboratory demonstrators on the quality system implemented in the laboratories of the Department of Pharmacy at the University of Malta. Method: A self-administered questionnaire was developed, psychometrically evaluated and distributed to second, third and fourth year undergraduate pharmacy students and laboratory demonstrators (N=110). Results: Out of a total of 94 questionnaires collected, 91 participants agreed that the implemented quality system is important to carry out procedures correctly and safely in the laboratory and is a helpful educational tool for students to appreciate quality processes in pharmacy (n=84). Ninety two participants agreed that standard operating procedures are an essential aspect of a quality system and are important educational tools for laboratory work (n=73). Conclusion: The implemented laboratory quality system is a valuable educational tool for pharmacy students.peer-reviewe

Global profiling of viral and cellular non-coding RNAs in Epstein-Barr virus-induced lymphoblastoid cell lines and released exosome cargos.

Abstract The human EBV-transformed lymphoblastoid cell line (LCL), obtained by infecting peripheral blood monocular cells with Epstein–Barr Virus, has been extensively used for human genetic, pharmacogenomic, and immunologic studies. Recently, the role of exosomes has also been indicated as crucial in the crosstalk between EBV and the host microenvironment. Because the role that the LCL and LCL exosomal cargo might play in maintaining persistent infection, and since little is known regarding the non-coding RNAs of LCL, the aim of our work was the comprehensive characterization of this class of RNA, cellular and viral miRNAs, and cellular lncRNAs, in LCL compared with PBMC derived from the same donors. In this study, we have demonstrated, for the first time, that all the viral miRNAs expressed by LCL are also packaged in the exosomes, and we found that two miRNAs, ebv-miR-BART3 and ebv-miR-BHRF1-1, are more abundant in the exosomes, suggesting a microvescicular viral microRNA transfer. In addition, lncRNA profiling revealed that LCLs were enriched in lncRNA H19 and H19 antisense, and released these through exosomes, suggesting a leading role in the regulation of the tumor microenvironment

An exploration of hydration practices in Maltese residential care homes for older people

Background: The integral relationship between adequate hydration and good health is widely recognised. Older people with complex needs and frailty can struggle to maintain adequate hydration, with residents in care home settings being at an increased risk of dehydration. Aims: To explore current hydration practices in residential care homes in Malta. Methods: An exploratory qualitative approach was adopted to explore staff’s views and approaches in supporting resident’s hydration. Data was collected via semi-structured, individual and small group interviews with 2 care homes from the central and southern region of Malta. A process of open coding, followed by axial coding were used to analyse the data. Peer debriefing was performed throughout, until agreement was reached amongst the research team about the final themes and sub-themes. Findings: Three themes emerged from the data: culture of promoting fluid intake; challenges in supporting older people to achieve optimum hydration; hydration practices and approaches. Conclusion: A hydration promotion culture was demonstrated through various practices adopted in the care homes. The strong focus on water intake, in response to concerns about consuming sugary beverages, has implications on the promotion of a person-centred approach to hydration care. Inconsistencies in monitoring of fluids and daily recommended targets, highlights the importance of policies or guidelines to guide hydration practice. Challenges related to refusal of fluids and language barriers amongst non-native staff were evident and justifies further research is this area

Oral Manifestations in Children and Young Adults with Down Syndrome: A Systematic Review of the Literature

Down syndrome (DS) is an autosomal disorder associated with mental and physical involvement. The typical craniofacial phenotype and the dental anomalies in DS subjects have been widely described, but a systematic report on the manifestations affecting the oral mucosae in children with DS is still lacking. This systematic review aimed to establish the prevalence of oral mucosal manifestations in children/young adults with DS. Pubmed, Web of Science, and Scopus were investigated in September 2020. Documents in English on DS children/young adults (up to 25 years) reporting oral mucosal findings were considered. Study quality was assessed with ROBIN-I. Of the 150 references retrieved, 14 studies were considered eligible. The risk of bias ranged from low to unclear. Fissured tongue appeared to increase with age and was more prevalent in DS children than in the general population. Lip fissures and cheilitis were heterogeneously reported. Candida spp. carriage with and without active candidiasis was more frequent in DS children/young adults than in controls. C. albicans was the most prevalent species. Few other oral mucosal conditions have been reported sporadically. The heterogeneity of the works revealed the need for more appropriate oral examination to intercept the oral manifestations of oral mucosa and prevent recurrent candidiasis

Activation of the S100A7/RAGE Pathway by IGF-1 Contributes to Angiogenesis in Breast Cancer

Background: Breast cancer (BC) mortality is increased among obese and diabetic patients. Both obesity and diabetes are associated with dysregulation of both the IGF-1R and the RAGE (Receptor for Advanced Glycation End Products) pathways, which contribute to complications of these disorders. The alarmin S100A7, signaling through the receptor RAGE, prompts angiogenesis, inflammation, and BC progression. Methods: We performed bioinformatic analysis of BC gene expression datasets from published studies. We then used Estrogen Receptor (ER)-positive BC cells, CRISPR-mediated IGF-1R KO BC cells, and isogenic S100A7-transduced BC cells to investigate the role of IGF-1/IGF-1R in the regulation of S100A7 expression and tumor angiogenesis. To this aim, we also used gene silencing and pharmacological inhibitors, and we performed gene expression and promoter studies, western blotting analysis, ChIP and ELISA assays, endothelial cell proliferation and tube formation assay. Results: S100A7 expression correlates with worse prognostic outcomes in human BCs. In BC cells, the IGF-1/IGF-1R signaling engages STAT3 activation and its recruitment to the S100A7 promoter toward S100A7 increase. In human vascular endothelial cells, S100A7 activates RAGE signaling and prompts angiogenic effects. Conclusions: In ER-positive BCs the IGF-1 dependent activation of the S100A7/RAGE signaling in adjacent endothelial cells may serve as a previously unidentified angiocrine effector. Targeting S100A7 may pave the way for a better control of BC, particularly in conditions of unopposed activation of the IGF-1/IGF-1R axis

The Reverse Transcription Inhibitor Abacavir Shows Anticancer Activity in Prostate Cancer Cell Lines

Background: Transposable Elements (TEs) comprise nearly 45% of the entire genome and are part of sophisticated regulatory network systems that control developmental processes in normal and pathological conditions. The retroviral/ retrotransposon gene machinery consists mainly of Long Interspersed Nuclear Elements (LINEs-1) and Human Endogenous Retroviruses (HERVs) that code for their own endogenous reverse transcriptase (RT). Interestingly, RT is typically expressed at high levels in cancer cells. Recent studies report that RT inhibition by non-nucleoside reverse transcriptase inhibitors (NNRTIs) induces growth arrest and cell differentiation in vitro and antagonizes growth of human tumors in animal model. In the present study we analyze the anticancer activity of Abacavir (ABC), a nucleoside reverse transcription inhibitor (NRTI), on PC3 and LNCaP prostate cancer cell lines. Principal Findings: ABC significantly reduces cell growth, migration and invasion processes, considerably slows S phase progression, induces senescence and cell death in prostate cancer cells. Consistent with these observations, microarray analysis on PC3 cells shows that ABC induces specific and dose-dependent changes in gene expression, involving multiple cellular pathways. Notably, by quantitative Real-Time PCR we found that LINE-1 ORF1 and ORF2 mRNA levels were significantly up-regulated by ABC treatment. Conclusions: Our results demonstrate the potential of ABC as anticancer agent able to induce antiproliferative activity and trigger senescence in prostate cancer cells. Noteworthy, we show that ABC elicits up-regulation of LINE-1 expression, suggesting the involvement of these elements in the observed cellular modifications