Levothyroxine and lung cancer in females: the importance of oxidative stress

BACKGROUND: Levothyroxine (LT(4)) treatment can lead to iatrogenic hyperthyroidism and oxidative stress that can cause patient discomfort. Oxidative stress is also recognized as one of the causes of chronic diseases and cancer. METHODS: The prevalence of breast, colorectal, gastric and lung cancer in 18 Italian Regions during 2010 was correlated with the sales of LT(4) in 2009. The cancer prevalence was analyzed in women aged 30–84. This age range corresponds to more than 80% of the consumers of the drug and to about 99% of all malignant cancers. The correlation between sales of LT(4) and cancers was determined with the technique of Density Ellipses. The age and smoking contribution for lung cancer was determined with the Sequential test. RESULTS: No significant correlation was seen between LT(4) sales and breast, colorectal and gastric cancers. A significant correlation was instead found for lung cancer (p < 0.05) corrected for smoking and age. CONCLUSIONS: LT(4) consumption in Italy is about 0.7 boxes/women/year. There is a correlation between lung cancer and LT(4) treatment and oxidative stress caused by LT(4) supplementation can be one of the causes. Although we cannot exclude that dysthyroidism needing LT(4) supplementation might be the ground for lung cancer itself and measuring oxidative stress could be helpful in avoiding excessive use of the drug

Porous Optically Transparent Cellulose Acetate Scaffolds for Biomimetic Blood-Brain Barrier in vitro Models

In vitro blood-brain barrier (BBB) models represent an efficient platform to conduct high-throughput quantitative investigations on BBB crossing ability of different drugs. Such models provide a closed system where different fundamental variables can be efficaciously tuned and monitored, and issues related to scarce accessibility of animal brains and ethics can be addressed. In this work, we propose the fabrication of cellulose acetate (CA) porous bio-scaffolds by exploiting both vapor-induced phase separation (VIPS) and electrospinning methods. Parameters of fabrication have been tuned in order to obtain porous and transparent scaffolds suitable for optical/confocal microscopy, where endothelial cell monolayers are allowed to growth thus obtaining biomimetic BBB in vitro models. Concerning VIPS-based approach, CA membranes fabricated using 25% H2O + 75% EtOH as non-solvent showed submicrometer-scale porosity and an optical transmittance comparable to that one of commercially available poly(ethylene terephthalate) membranes. CA membranes fabricated via VIPS have been exploited for obtaining multicellular BBB models through the double seeding of endothelial cells and astrocytes on the two surfaces of the membrane. Electrospun CA substrates, instead, were characterized by micrometer-sized pores, and were unsuitable for double seeding approach and long term studies. However, the potential exploitation of the electrospun CA substrates for modeling blood-brain-tumor barrier and studying cell invasiveness has been speculated. The features of the obtained models have been critically compared and discussed for future applications

The ongoing impact of COVID-19 on adult cardiac surgery and suggestions for safe continuation throughout the pandemic:a review of expert opinions

OBJECTIVES: To establish the impact of the COVID-19 pandemic on adult cardiac surgery by reviewing current data and use this to establish methods for safely continuing to carry out surgery. METHODS: Conduction of a literature search via PubMed using the search terms: ‘(adult cardiac OR cardiothoracic OR surgery OR minimally invasive OR sternotomy OR hemi-sternotomy OR aortic valve OR mitral valve OR elective OR emergency) AND (COVID-19 or coronavirus OR SARS-CoV-2 OR 2019-nCoV OR 2019 novel coronavirus OR pandemic)’. Thirty-two articles were selected. RESULTS: Cardiac surgery patients have an increased risk of complications from COVID-19 and require vital finite resources such as intensive care beds, also required by COVID-19 patients. Thus reducing their admission and potential hospital-acquired infection with COVID-19 is paramount. During the peak, only emergencies such as acute aortic dissections were treated, triaging patients according to surgical priority and cancelling all elective procedures. Screening and 2-week quarantine prior to admission were essential changes, alongside additional levels of PPE. Focus was on reducing length of stay and switching to day-cases to reduce post-operative transmission risk, whilst several hospitals adopted ‘hot’ and ‘cold’ operating theatres for covid-confirmed and covid-negative patients. CONCLUSIONS: This paper suggests a ‘CARDIO’ approach for reintroducing elective procedures: ‘Care, Assess, Re-Evaluate, Develop, Implement, Overcome’; prioritising the mental and physical health of the workforce, learning from and sharing experiences and objectively prioritising patients to improve case load

Validity and reliability of a new instrument for the evaluation of dental collaboration in disabled people

Background: nowadays, oral health in people with disabilities is an important topic. The phsychological and behavioural problems of these people, their difficulties with environmental adaptations and the absence of any traditional communication determine the compliance needed for treatment The aim of this work was to test the validity and reliability of an original questionnaire that could become an instrument assessing the individual features in people with mental retardation and other developmental disabilities at the time of dental treatment. Methods: it was created a questionnaire with standardised answers regarding four specific areas: neuropsychology, emotional-affect, autonomy and environmental resources. The questionnaire was completed by 63 patients from three different institutes (two rehabilitation institutes and an Institute of Dentistry for patients with special needs). To analyse the answers, each item was transformed into a numeric value. A value of 1 was displayed as the minimum while 4 represented full possession of the considered skills. A total of 17 variables were analysed with descriptive statistics and multivariate analysis. Internal consistency reliability was measured using Cronbach’s alpha. Furthermore, an analysis on convergent/discriminant validity was provided. Results: all variables were positively correlated. The most significant were “guidance”, “communication”, “sociability”, “view”, “hearing” and “feeding”. Items like “self-control”, “equanimity”, “problematic behaviour”, “extroversion” and “autonomy” offered vague and less significant information in identifying the patient’s collaboration level. Variables like “evaluation by the compiler about the patient’s collaboration”, “previous dental experiences” and “attendant” were confirmed. Cronbach’s alpha was 0.77 (standardized result), which meet the a priori criterion of 0.90≥alpha≥0.70. Conclusions: the instrument was statistically tested and seems to be adequate to estimate the collaboration level of disabled patients. It is called CLEQ (Collaboration Level Evaluation Questionnaire). Further trials are warranted to confirm its validity and benefits.&nbsp