Effects of add-on ultramicronized n-palmitol ethanol amide in patients suffering of migraine with aura. a pilot study

Background: Palmitoyl ethanol amide (PEA) is an endogenously produced substance showing anti-nociceptive effect through both receptor and non-receptor mediated effects at the level of different cellular and tissue sites. This study showed the results of a single blind study that was conducted to evaluate both the safety and the efficacy of ultramicronized PEA (umPEA; 1,200 mg/day) for up 90 days in patients suffering of Migraine with Aura (MA) treated with NSAIDs. Methods: A total of 20 patients, 8 male (33-56-years, average 41.4 ± 7.8) and 12 female (19-61-years, average 38.5 ± 11.9) with MA were admitted to our observation and diagnosed according to ICHD-3 criteria, they received umPEA (1,200 mg/day) in combination with NSAIDs for up to 90 days. They were revaluated at 30, 60, and 90 days after treatment. Results: umPEA administration induced a statistically significant and time dependent pain relief. In particular, these effects were evident at 60 days (male P = 0.01189; female P = < 0.01) and they lasted until the end of the study (male P = 0.0066; female P = 0.01473). Conclusion: Although further studies are needed, our findings indicate that in patients suffering of MA treatment with umPEA had good efficacy and safety which candidate this compound as a therapeutic tool in pain migraine management

An Expert Opinion on the Role of the Rosuvastatin/Amlodipine Single Pill Fixed Dose Combination in Cardiovascular Prevention

Current cardiovascular disease prevention strategies are based on the management of cardiovascular risk as a continuum, redefining the therapeutic goals for each individual based on the estimated global risk profile. Given the frequent clustering of the principal cardiovascular risk factors, such as hypertension, diabetes and dyslipidaemia, in the same individual, patients are required to take multiple drugs to achieve therapeutic targets. The adoption of single pill fixed dose combinations may contribute to achieve better control of blood pressure and cholesterol compared to the separate administration of the individual drugs, mostly due to better adherence related to therapeutic simplicities. This paper reports the outcomes of an Expert multidisciplinary Roundtable. In particular, the rational and potential clinical use of the single pill fixed dose combination "Rosuvastatin-Amlodipine" for the management of concomitant hypertension/hypercholesterolemia in different clinical fields are discussed. This Expert Opinion also illustrates the importance of an early and effective management of total cardiovascular risk, highlights the substantial benefits of combining blood pressure and lipid-lowering treatments in a single-pill fixed dose combination and attempts to identify and overcome the barriers to the implementation in clinical practice of the fixed dose combinations with dual targets. This Expert Panel identifies and proposes the categories of patients who may benefit the most from this fixed dose combination

Colchicine in managing skin conditions. a systematic review

(1) Background: Colchicine is a natural alkaloid with anti-inflammatory properties used to treat various disorders, including some skin diseases. This paper aims to incorporate all the available studies proposing colchicine as a treatment alternative in the management of cutaneous conditions. (2) Methods: In this systematic review, the available articles present in various databases (PubMed, Scopus-Embase, and Web of Science), proposing colchicine as a treatment for cutaneous pathological conditions, have been selected. Exclusion criteria included a non-English language and non-human studies. (3) Results: Ninety-six studies were included. Most of them were case reports and case series studies describing colchicine as single therapy, or in combination with other drugs. Hidradenitis suppurativa, pyoderma gangrenosum, erythema nodosum, erythema induratum, storage diseases, perforating dermatosis, bullous diseases, psoriasis, vasculitis, acne, urticaria, stomatitis, actinic keratosis, and pustular dermatosis were the main diseases discussed in literature. Although the therapeutic outcomes were variable, most of the studies reported, on average, good clinical results (4) Conclusions: Colchicine could be, as a single therapy or in combination with other drugs, a possible treatment to manage several skin diseases

Biomarkers in post-reperfusion syndrome after acute lower limb ischaemia

Ischaemia reperfusion (I/R) injury refers to tissue damage caused when blood supply returns to the tissue after a period of ischaemia. Matrix metalloproteinases (MMPs), neutrophil gelatinase-associated lipocalin (NGAL) and cytokines are biomarkers involved in several vascular complications. The aim of this study was to evaluate the role of MMPs, NGAL and inflammatory cytokines in I/R syndrome. We conducted an open label, multicentric, parallel group study, between January 2010 and December 2013. Patients with acute limb ischaemia were enrolled in this study and were divided into two groups: (i) those subjected to fasciotomy and (ii) those not subjected to fasciotomy, according to the onset of compartment syndrome. Plasma and tissue values of MMPs and NGAL as well as plasma cytokines were evaluated. MMPs, NGAL and cytokine levels were higher in patients with compartment syndrome. Biomarkers evaluated in this study may be used in the future as predictors of I/R injury severity and its possible evolution towards post-reperfusion syndrome

Omalizumab decreases exacerbation frequency, oral intake of corticosteroids and peripheral blood eosinophils in atopic patients with uncontrolled asthma.

Omalizumab is a humanized monoclonal anti-IgE antibody approved in 2005 by the European Medicine Agency (EMA) for the treatment of severe persistent allergic asthma, which remains inadequately controlled despite optimal therapy with high doses of inhaled corticosteroids and long-acting β2-adrenergic agonists. Within this context, the present observational study refers to 16 patients currently treated with omalizumab at the Respiratory Unit of "Magna Græcia" University Hospital located in Catanzaro, Italy, whose anti- IgE therapy was started in the period included between March 2007 and February 2010, thus lasting at least 10 months. After 40 weeks of add-on treatment with omalizumab, very relevant decreases were detected, in comparison with pre-treatment mean (± standard deviation) values, in monthly exacerbation numbers (from 1.1 ± 0.6 to 0.2 ± 0.4; p < 0.01) and oral corticosteroid consumption (from 22.6 ± 5.0 to 1.2 ± 2.9 mg/day of prednisone; p < 0.01). These changes were associated with stable improvements in lung function, expressed as increases of both FEV1 (from 53.6 ± 14.6% to 77.0 ± 14.9% of predicted values; p < 0.01) and FEV1/FVC ratio (from 56.3 ± 9.5% to 65.8 ± 9.2%; p < 0.01). Moreover, in 5 patients who persistently had increased numbers of eosinophils (mean ± SD: 15.9 ± 8.0% of total WBC count; absolute number: 1,588.0 ± 956.9/μl) despite a long-lasting therapy with inhaled and systemic corticosteroids, the peripheral counts of these cells decreased down to near normal levels (mean ± SD: 6.3 ± 2.3% of total WBC count; absolute number: 462.0 ± 262.3/μl) after 16 weeks of treatment with omalizumab. Therefore, this descriptive evaluation confirms the efficacy of add-on omalizumab therapy in selected patients with exacerbation-prone, chronic allergic uncontrolled asthma, requiring a continuous intake of oral corticosteroids

Artificial Intelligence Can Guide Antibiotic Choice in Recurrent UTIs and Become an Important Aid to Improve Antimicrobial Stewardship

Background: A correct approach to recurrent urinary tract infections (rUTIs) is an important pillar of antimicrobial stewardship. We aim to define an Artificial Neural Network (ANN) for predicting the clinical efficacy of the empiric antimicrobial treatment in women with rUTIs. Methods: We extracted clinical and microbiological data from 1043 women. We trained an ANN on 725 patients and validated it on 318. Results: The ANN showed a sensitivity of 87.8% and specificity of 97.3% in predicting the clinical efficacy of empirical therapy. The previous use of fluoroquinolones (HR = 4.23; p = 0.008) and cephalosporins (HR = 2.81; p = 0.003) as well as the presence of Escherichia coli with resistance against cotrimoxazole (HR = 3.54; p = 0.001) have been identified as the most important variables affecting the ANN output decision predicting the fluoroquinolones-based therapy failure. A previous isolation of Escherichia coli with resistance against fosfomycin (HR = 2.67; p = 0.001) and amoxicillin-clavulanic acid (HR = 1.94; p = 0.001) seems to be the most influential variable affecting the output decision predicting the cephalosporins- and cotrimoxazole-based therapy failure. The previously mentioned Escherichia coli with resistance against cotrimoxazole (HR = 2.35; p < 0.001) and amoxicillin-clavulanic acid (HR = 3.41; p = 0.007) seems to be the most influential variable affecting the output decision predicting the fosfomycin-based therapy failure. Conclusions: ANNs seem to be an interesting tool to guide the antimicrobial choice in the management of rUTIs at the point of care

Oltre l’era Covid-19: dall’emergenza alle prospettive di sviluppo professionale

The University was rapidly pushed into the era of distance teaching and learning (Dad) to cope with the imperative to ensure training for young people even in the lockdown period due to the Covid-19 pandemic. This necessity forced academics to a fast reconversion of traditional teaching into online learning environments for many still unknown and unusual. This has led to significant changes in the approaches and practices in use, favoring choices and solutions often not considered before. This research investigates the experience of distance teaching and learning (Dad), defining the concept, to investigate changes occurred in teaching practice, paying specific attention to the teaching mediation and to assessment, two areas considered foundational and emblematic in teaching-learning processes. 721 academics responded to an online questionnaire designed for this research; from the answers relevant changes in teaching and assessment methods emerged. Together with an increase of interest in the use of online practices, critical elements also emerged, such as the permanence of traditional models and innovation. Overall, the results seem to outline, although to different extents, the need to consider as central the professionalism of academics as a key factor to successfully reconvert the experience of Dad beyond the contingent moment.L’Università è entrata prepotentemente nell’era della didattica a distanza (DaD) per far fronte all’imperativo di garantire la formazione ai giovani anche nel periodo di lockdown imposto a seguito della pandemia del Covid-19. L’esperienza ha costretto la docenza ad una veloce riconversione della didattica tradizionale all’interno di modelli di azione on line per molti di loro sconosciuti e inusuali. Ciò ha determinato modificazioni significative negli approcci e nelle pratiche in uso, favorendo scelte e soluzioni spesso non considerate in precedenza. La ricerca indaga nello specifico l’esperienza della DaD, definendone il costrutto, per far emergere le modificazioni intervenute nella pratica didattica, ponendo un’attenzione particolare alla mediazione didattica e alla valutazione, due aree considerate fondative ed emblematiche nell’azione di insegnamento-apprendimento. Attraverso la somministrazione di un questionario on line a cui hanno risposto 721 docenti, si evidenziano le metamorfosi intervenute nell’azione di mediazione e di valutazione. Insieme ad un aumento di interesse verso l’utilizzo di pratiche on line compaiono elementi di criticità, connessi soprattutto al permanere di modelli tradizionali, e di innovazione, indotti dall’esigenza di offrire agli studenti un livello adeguato di qualità didattica per l’apprendimento. Nell’insieme gli esiti emersi sembrano profilare, sia pure con diverso grado di intensità, l’esigenza di considerare come centrale la professionalità del docente indicata quale fattore chiave per riconvertire positivamente l’esperienza della DaD oltre il portato contingente

Expresión del receptor de leptina en ovarios de llamas

El receptor a leptina (ObR) se expresa en células de la granulosa, teca interna y células luteales en distintas especies; incluida la alpaca, observándose que su expresión varía durante el ciclo estral. En llamas, la disminución en la secreción de leptina produce cuerpos lúteos más pequeños y menor secreción de progesterona, proponiéndose un rol regulador de la leptina sobre la función ovárica. Por lo tanto, el objetivo de este estudio fue evaluar en qué tipo celulares del ovario de llama se expresa el ObR. Se obtuvieron 6 ovarios de llama que fueron fijados en formol bufferado al 4%, realizándose la rutina histológica para confeccionar los tacos. Se realizaron cortes sagitales de 4 μm, y sobre los mismos se realizó la técnica de inmunohistoquímica para ObR con el anticuerpo monoclonal primario (sc-8391, Santa Cruz Biotechnology), según lo descripto por Gallelli et al. (2019). El análisis de imágenes subjetivo fue realizado por dos operadores independientes. Se analizaron 10 campos por CL y por cada tipo folicular (primario, secundario y terciario) a 1000x. La población de ObR se evaluó como el promedio del área total inmunopositiva; comparándose entre los distintos tipos foliculares mediante ANOVA (Gallelli et al., 2019). La expresión del ObR se observó en las células luteales y en las células de folículos primarios y secundarios y, en el caso de los folículos terciarios, se observó su presencia tanto en células de la granulosa como de la teca interna. Dicha expresión no prese ntó diferencias significativas entre los diferentes tipos de folículos. En conclusión, el ObR se expresa en los distintos tipos foliculares y en el CL de las llamas, evidenciando el sitio de acción para la leptina. Este conocimiento es de utilidad para avanzar en el estudio de la regulación de la función ovárica mediada por la leptina en esta especie

Electrocardiogram Monitoring Wearable Devices and Artificial-Intelligence-Enabled Diagnostic Capabilities: A Review

Worldwide, population aging and unhealthy lifestyles have increased the incidence of high-risk health conditions such as cardiovascular diseases, sleep apnea, and other conditions. Recently, to facilitate early identification and diagnosis, efforts have been made in the research and development of new wearable devices to make them smaller, more comfortable, more accurate, and increasingly compatible with artificial intelligence technologies. These efforts can pave the way to the longer and continuous health monitoring of different biosignals, including the real-time detection of diseases, thus providing more timely and accurate predictions of health events that can drastically improve the healthcare management of patients. Most recent reviews focus on a specific category of disease, the use of artificial intelligence in 12-lead electrocardiograms, or on wearable technology. However, we present recent advances in the use of electrocardiogram signals acquired with wearable devices or from publicly available databases and the analysis of such signals with artificial intelligence methods to detect and predict diseases. As expected, most of the available research focuses on heart diseases, sleep apnea, and other emerging areas, such as mental stress. From a methodological point of view, although traditional statistical methods and machine learning are still widely used, we observe an increasing use of more advanced deep learning methods, specifically architectures that can handle the complexity of biosignal data. These deep learning methods typically include convolutional and recurrent neural networks. Moreover, when proposing new artificial intelligence methods, we observe that the prevalent choice is to use publicly available databases rather than collecting new data