Micro and Nanoparticles As Possible Causative-Prognostic Co-Factors Of Mixed Cryoglobulinemia Syndrome

Background/Purpose: We previously demonstrated that patients affected by membranoproliferative glomerulonephritis and mixed cryoglobulinemia syndrome (MCs) show the presence of circulating micro and nanoparticles (MPs and NPs) as possible causative/prognostic co-factors. This pilot study aimed to evaluate the possible role of occupational/environmental agents in the etiopathogenesis of MCs by investigating the patients’ exposure to both MPs and NPs. Methods: We investigated 20 consecutive HCV-positive MCs patients without renal involvement compared to 10 healthy, sex-/age-matched volunteers. All subjects completed a questionnaire concerning demographic data, dietary and smoking habits, prosthesis implants, air pollution, occupational and medical history. Environmental Scanning Electron Microscopy (ESEM) has been employed to detect inorganic MPs and NPs and to evaluate their presence in subjects with and without MCs. Energy Dispersive X-ray Spectroscopy (EDS) microanalysis was used to chemically characterize the elemental composition of the particles. Blood serum samples were spotted on metal free cover slips in a sterile environment. The complex of particles (MPs and NPs) was quantified using the number of spots (NS) containing inorganic particles in a fixed mapping area for each sample. Levels of NS were assessed statistically with Mann-Whitney U test. Results: Patients displayed higher serum levels of MPs/NPs particles (NS 36.6718.18, p0.0003), compared to controls (NS 5.626.25), independently of smoking habits. A direct correlation between the presence of particles and patients occupational exposure, environmental pollution and prosthesis implants was found. EDS microanalysis revealed that the particles have complex compositions, which includes several elements like Si, Fe, Al, Ti, Zn, Cu, Mn, and Ni. Conclusion: The ESEM analyses were a valuable tool to detect particulate matter in the serum samples. The complex of MPs/NPs particles was greater in MCs patients than in healthy subjects. These preliminary data suggest that, in addition to HCV infection, particulate complex might represent an environmental co-factor in the etiopathogenesis of MCs

Advanced oxidation protein products in serum of patients with systemic sclerosis: a possible indicator of clinical evolution

Background Systemic sclerosis (SSc) is a chronic, multisystem connective tissue disease characterised by by immune dys-regulation, obliterative microvasculopathy and fibrosis. Endothelial dysfunction, immune system imbalance and fibroblast activation constitute the three major factors of the pathogenetic process. In this context, oxidative stress could play a significant role through direct damage of endothelial cells and the persistent activation of the immune system.1,2 Objectives This study investigated the presence of advanced protein oxidation products (AOPP) in serum of patients with SSc and its correlation with disease’s features. Methods 50 patients with SSc (M:F 1:7, mean age 57.3±11.2 SD, mean duration of disease 10±9.1 SD years), were screened for AOPP in the serum, using the AOPP OxiSelect Kit of CELL BIOLABS (San Diego, Ca, USA). Among 50 SSc patients, 39 had limited cutaneous subset, while 11 had the diffuse one. Anamnestic and clinical data were collected for all SSc patients. As a control group 50 consecutive healthy subjects, sex and age matched, were recruited. Results We found serum levels of AOPP increased in the SSc group compared with the controls (p<0.0001) with mean values of 336.9±167.8 mmol/L and 167.5±59.2 mmol/L, respectively. In addition, higher levels of AOPP directly correlated with the diffuse cutaneous subset (p=0.0242), presence of digital ulcers (p=0.005), esophagopathy (p=0.006) and pulmonary fibrosis (p=0.0128). Conclusions Serum AOPP levels are significantly higher in patients with SSc than in controls. In addition, the correlations of AOPP with SSc diffuse cutaneous subset, digital ulcers, and pulmonary involvement (indicative of progressive disease and worse prognosis) suggest a possible role of this marker in the identification of the cases with worse clinical evolution. The data of this preliminary study should be confirmed on larger case series and analysed in prospective studies, in order to understand its eventual usefulness during the follow-up of SSc patients

One-Day Prostate Cancer Diagnosis: Biparametric Magnetic Resonance Imaging and Digital Pathology by Fluorescence Confocal Microscopy

In this prospective observational study, we tested the feasibility and efficacy of a novel one-day PCa diagnosis path based on biparametric magnetic resonance (bpMRI) and digital pathology by fluorescence confocal microscopy (FCM). Patients aged 55&ndash;70 years scheduled for PBx due to increased PSA levels (3&ndash;10 ng/mL) and/or abnormal digitorectal examination were enrolled. All patients underwent bpMRI and PBx with immediate FCM evaluation of biopsy cores. Patients were asked to fill out a dedicated Patient Satisfaction Questionnaire. Patients&rsquo; satisfaction rates and concordance between digital pathology and standard HE evaluation were the outcomes of interest. Twelve patients completed our one-day PCa diagnosis path. BpMRI showed suspicious lesions in 7 patients. Digital pathology by FCM identified PCa in 5 (41.7%) of the 12 patients. Standard pathology confirmed the diagnosis made through digital pathology in all the cases. At a per patient level, high concordance between the methods was achieved in Gleason Grading (4 out of 5 patients). The level of agreement in the number of positive cores was lower but did not affect the choice of treatment in any of the 5 PCa cases. At a per core level, the agreement was very high for the diagnosis of anyPCa (96.2%) and csPCa (97.3%), with a k coefficient of 0.90 and 0.92, respectively (near perfect agreement). In conclusion, one-day PCa diagnosis by FCM represents a feasible, reliable, and fast diagnostic method that provides significant advantages in optimizing time and resources, leading to patients having a higher quality standard of care perception

Urology in the time of coronavirus: reduced access to urgent and emergent urological care during the coronavirus disease 2019 outbreak in Italy

The coronavirus disease 2019 (COVID-19) pandemic has put a substantial burden on the Italian healthcare system, resulting in the restructuring of hospitals to care for COVID-19 patients. However, this has likely impacted access to care for patients experiencing other conditions. We aimed to quantify the impact of COVID-19 on access to care for patients with urgent/emergent urological conditions throughout Italy