ISSR markers show differentiation among Italian populations of Asparagus acutifolius L

BACKGROUND: Asparagus acutifolius L. is a dioecious and native plant species, widely distributed in the Mediterranean Basin. It is known for its fine flavour and could represent an important resource for cultivation programs in desert areas. Few molecular studies have been performed on this species. In the present paper, the ISSR technique was employed to study genetic diversity in Italian A. acutifolius. RESULTS: Twenty-three primers produced a total of 228 polymorphic fragments used to evaluate genetic variation. F(ST )(0.4561) and Theta B (0.4776) values indicate a wide genetic variation among the samples examined. The distance UPGMA tree grouped together the genotypes strictly according to their geographical origin, showing that each sample is genetically structured and can be considered a distinct population. AMOVA analysis further confirmed genetic structuring of the populations. Population-specific fragments were also detected. CONCLUSION: The results suggest that ISSR markers are useful in distinguishing the populations of A. acutifolius according to geographical origin, and confirm the importance of genetic studies for designing germplasm conservation strategies

Activated prothrombin complex concentrate (FEIBA\uae) for the treatment and prevention of bleeding in patients with acquired haemophilia: A sequential study

Despite anti-haemorrhagic therapy with proper doses of activated prothrombin complex concentrate (aPCC, Feiba\uae), patients with acquired haemophilia A (AHA) have a considerable risk of recurrent bleeding complications. Evidence in support of the benefit-to-risk ratio of prevention strategies with the use of lower doses of aPCC following the end of the initial treatment period is scarce and inconclusive. We report our experience in the management of 18 consecutive patients with AHA admitted to two Haemophilia centres in Italy. We managed the first 11 according to current guidelines (e.g., with conventional aPCC doses until bleeding resolution). Then, we decided to prolong the treatment beyond bleeding resolution with lower doses of the same concentrate (short-term prophylaxis) in the 7 additional patients. In these patients, the treatment was continued for as long as the titre of FVIII inhibitor was found to decrease by at least 50% when compared to the baseline one. We observed six relapses of bleeding in patients in whom aPCC was confined to the treatment of the qualifying bleeding episode, and none in patients to whom lower doses were administered until the pre-specified decrease in the titre of FVIII inhibitor was achieved. No patients experienced thrombotic complications during the study period. Prolonging the treatment with lower doses of aPCC beyond the initial phase in patients with AHA in whom the titre of FVIII inhibitor is still high is likely to safely prevent further bleeding complication

Cadaver kidney transplantation and vascular anomalies: A pediatric experience

IF 3.879 (ISI 2005

Outcome of biliary atresia after kasai portoenterostomy at a single italian center (university of Padova, 1990\u20132011).

Background: Biliary Atresia (BA) is worldwide the leading cause of end-stage liver disease in children and the most common indication for pediatric liver transplantation (LT). National studies from several European, Asiatic and North American countries report a 48% median success rate (range 30 1261%) of Kasai Portoenterostomy (KPE) and a median survival with native liver (SNL) of 37.9% (range 31 1253) at 10 years after KPE. Young age at diagnosis (<45 days) and center experience (>5 cases/year) are the main prognostic factors associated to KPE success. No published data are available concerning BA epidemiology and outcome in Italy. Objective: The aim of this study is to describe the outcome of children with BA treated at a single University Center of Pediatric Hepatology and LT in Italy. Methods: Health records of all cases of BA diagnosed at the Department of Pediatrics of the University of Padova between January 1990 and December 2011 were retrospectively reviewed. Results: A total of 52 children were diagnosed with BA during the study period (mean 2.5/year) of which 20 in the last 5 years (mean 4/year). 51 patients underwent KPE at a median age of 66 days (range 19\u2013115); a significant difference (p<0.001, unpaired t test) was observed concerning the mean age at KPE between children diagnosed during the 1990s (mean 49\ub15 days) and after 2000 (mean 72\ub13 days). Median age at last follow up was 5.6 years (0.7 1222 years). KPE success (i.e. total bilirubin <20 umol/L at 6 months after KPE) was 31%. Among patients with unsuccessful KPE (n = 34): 64% underwent LT at a median age of 1.8 years (main indications consisted in end-stage liver disease, hepato-pulmonary syndrome/HPS, hepatocellular carcinoma); 8% died on the waiting list for transplant at a median age of 10 months (all due to uncontrolled variceal bleeding); 14.7% have compensated cirrhosis and are still on follow up; one patient is on the waiting list for liver transplantation and one was lost at follow up. Among children with successful KPE (n = 15): 4 have no clinical or biochemical signs of liver disease; 4 have signs of portal hypertension; 4 show signs of compensated chronic liver disease; 1 was transplanted for HPS at 9.5 years of age; 1 died for reasons unrelated to BA; one was lost at follow up. Data of two patients were untraceable. Overall the rate of NLS at 10 years after KPE was 38%. Conclusions: Despite advanced age at KPE and relatively low numbers of new cases per year, both the success rate of KPE and the 10 years SNL after this intervention are comparable with current international standards. As demonstrated in other countries, centralization of surgical care and the launch of a screening program to anticipate age at referral have the potential to further improve the outcome of children after KPE. The time to begin an Italian National Program for the management of BA has definitely come

Autism and esophageal achalasia in childhood: a possible correlation? Report on three cases.

Chronic gastrointestinal symptoms are commonly reported in autistic patients. Dysphagia is often present, and it is generally related to behavioral eating disorders. The association between autism and esophageal achalasia has not been described in literature yet. We report our experience with three cases of autistic children we recently treated for esophageal achalasia. In the first case (a 14-year-old male), achalasia was diagnosed with barium swallow and esophageal manometry and was successfully treated with three pneumatic endoscopic dilatations (follow-up: 3 years). In the second case (a 12-year-old female), achalasia was diagnosed with barium swallow and esophageal manometry and was treated with Heller myotomy after two unsuccessful pneumatic endoscopic attempts (follow-up: 3 months). In the last case, a 15-year-old male underwent barium swallow and endoscopy that confirmed achalasia. He was treated with Heller myotomy, and he is asymptomatic at a 6-month follow-up. To our knowledge, this is the first report of a possible association between autism and esophageal achalasia. Because of the rarity of both diseases, their association in the same patient is unlikely to be casual even if speculation on their common etiology is impossible at present. This finding needs further confirmation, but it is sufficient, in our opinion, to indicate proper evaluation with barium swallow and/or manometry in any autistic children with eating difficulty

Clinical characteristics and predictors of mortality associated with COVID-19 in elderly patients from a long-term care facility

Since December 2019, coronavirus disease 2019 (COVID-19) pandemic has spread from China all over the world and many COVID-19 outbreaks have been reported in long-term care facilities (LCTF). However, data on clinical characteristics and prognostic factors in such settings are scarce. We conducted a retrospective, observational cohort study to assess clinical characteristics and baseline predictors of mortality of COVID-19 patients hospitalized after an outbreak of SARS-CoV-2 infection in a LTCF. A total of 50 patients were included. Mean age was 80 years (SD, 12 years), and 24/50 (57.1%) patients were males. The overall in-hospital mortality rate was 32%. At Cox regression analysis, significant predictors of in-hospital mortality were: hypernatremia (HR 9.12), lymphocyte count &lt; 1000 cells/µL (HR 7.45), cardiovascular diseases other than hypertension (HR 6.41), and higher levels of serum interleukin-6 (IL-6, pg/mL) (HR 1.005). Our study shows a high in-hospital mortality rate in a cohort of elderly patients with COVID-19 and hypernatremia, lymphopenia, CVD other than hypertension, and higher IL-6 serum levels were identified as independent predictors of in-hospital mortality. Given the small population size as major limitation of our study, further investigations are necessary to better understand and confirm our findings in elderly patients