Antithymocyte globulin for graft-versus-host disease prophylaxis in transplants from unrelated donors: 2 randomized studies from Gruppo Italiano Trapianti Midollo Osseo (GITMO)

Abstract One hundred nine patients with hematologic malignancies, undergoing bone marrow transplants (BMT) from unrelated donors, were randomized in 2 consecutive trials to receive or not to receive antithymocyte globulin (ATG) in the conditioning regimen, as follows: (A) 54 patients (median age, 28 years; 39% with advanced disease) were randomized to no ATG (n = 25) versus 7.5 mg/kg rabbit ATG (Thymoglobulin; Sangstat, Lyon, France) (n = 29) ; (B) 55 patients (median age, 31 years, 71% with advanced disease) were randomized to no ATG (n = 28) versus 15 mg/kg rabbit ATG (n = 27). Grade III-IV graft-versus-host disease (GVHD) was diagnosed in 36% versus 41% (P = .8) in the first and in 50% versus 11% (P = .001) in the second trial. Transplant-related mortality (TRM), relapse, and actuarial 3-year survival rates were comparable in both trials. In fact, despite the reduction of GVHD in the second trial, a higher risk for lethal infections (30% vs 7%; P = .02) was seen in the arm given 15 mg/kg ATG. Extensive chronic GVHD developed overall more frequently in patients given no ATG (62% vs 39%;P = .04), as confirmed by multivariate analysis (P = .03). Time to 50 × 109/L platelets was comparable in the first trial (21 vs 24 days; P = .3) and delayed in the ATG arm in the second trial (23 vs 38 days;P = .02). These trials suggest that (1) 15 mg/kg ATG before BMT significantly reduces the risk for grade III-IV acute GVHD, (2) this does not translate to a reduction in TRM because of the increased risk for infections, and (3) though survival is unchanged, extensive chronic GVHD is significantly reduced in patients receiving ATG

Effects of surface topography on growth and osteogenic differentiation of human mesenchymal stem cells

The clinical success of an endosseous artificial implant is related to the quality of its osseointegration with the surrounding living bone. To achieve a stable anchorage, mesenchymal cells, migrating to the implant surface from the surrounding tissue, must differentiate towards mature osteoblasts rather than connective tissue cell types. It is well known that the cell response is affected by the physicochemical parameters of the biomaterial surface, such as surface energy, surface charges or chemical composition. Topography seems to be one of the most crucial physical cues for cells (1). In particular, interactions between mesenchymal stem cells (MSCs) and surfaces with specific micro and nano patterns can stimulate MSCs to produce bone mineral in vitro (2). Herein, stamps reporting different micro and nano features were fabricated in order to obtain several corresponding replicas in a short time through microinjec- tion molding. Then, the effects of the substrate topography on human bone marrowderived MSC adhesion, proliferation, and osteogenic differentiation were investigated in the absence of inductive growth factors. Collectively, our data show that both micro- and nano-structured surfaces possess osteoinductive properties. A relationship between dimensional feature of surface topography and differentiative potential was noted. On the contrary, cell adhesion and proliferation seemed to be unaffected. Further in vivo studies will be carried out to confirm the osteoinductive properties of selected surface geometries

Operationalizing mild cognitive impairment criteria in small vessel disease: The VMCI-Tuscany Study

Introduction Mild cognitive impairment (MCI) prodromic of vascular dementia is expected to have a multidomain profile. Methods In a sample of cerebral small vessel disease (SVD) patients, we assessed MCI subtypes distributions according to different operationalization of Winblad criteria and compared the neuroimaging features of single versus multidomain MCI. We applied three MCI diagnostic scenarios in which the cutoffs for objective impairment and the number of considered neuropsychological tests varied. Results Passing from a liberal to more conservative diagnostic scenarios, of 153 patients, 5% were no longer classified as MCI, amnestic multidomain frequency decreased, and nonamnestic single domain increased. Considering neuroimaging features, severe medial temporal lobe atrophy was more frequent in multidomain compared with single domain. Discussion Operationalizing MCI criteria changes the relative frequency of MCI subtypes. Nonamnestic single domain MCI may be a previously nonrecognized type of MCI associated with SVD

Supplement: "Localization and broadband follow-up of the gravitational-wave transient GW150914" (2016, ApJL, 826, L13)

This Supplement provides supporting material for Abbott et al. (2016a). We briefly summarize past electromagnetic (EM) follow-up efforts as well as the organization and policy of the current EM follow-up program. We compare the four probability sky maps produced for the gravitational-wave transient GW150914, and provide additional details of the EM follow-up observations that were performed in the different bands

Effect of protein levels and sources on performance and nutrient utilization by lactating dairy cows

Foram utilizadas cinco vacas holandesas canuladas rúmen e duodeno, com produções de leite em torno de 30hga/d num delineamento do tipo Quadrado Latino 5 X 5. As dietas continham dieta silagem de milho, milho floculado, caroço de algodão e mistura mineral e vitamínica, e foram formuladas variando flores, e fontes de proteínas, constituindo-se em cinco tratamentos: controle, uréia, farelo de soja, soja tostada e farelo de glúten de milho. A dieta controle continha 3,4% de proteína bruta na matéria seca e as demais ao redor de 165%. O teor e a fonte de proteína não afetaram a ingestão de matéria seca a produção de leite, a porcentagem, e a produção de gordura do leite, e a eficiência alimentar. A suplementação de rosa tostada teve efeito negativo na porcentagem de proteína do leite. As digestibilidades da matéria seca, da matéria orgânica, do amido e da fibra, em detergente meiótico no trato total não foram afetados pelos tratamentos, mas o tratamento controle e soja tostada diminuíram a digestibilidade da proteína bruta. A suplementação de uréia aumentou a concentração de amônia no rúmen e de uréia no plasma, enquanto que, o pH rumenal, a produção de ácidos graxos voláteis e a concentração plasmática de glucose não foram afetadas por tratamentosFive rumen and duodenaly canulated dairy cows were utilized in a 5X5 L.S. design. Diets were based on com silage, steam-flaked com, whole cotton seed, protein supplement and mineral and vitamins. Different protein supplements were used, resulting in five treatments: control, urea, soybean meal, roasted soybeans and com gluten meal. The control diet was 13.49% crude protein and the other diets were around 16.5%. The dry matter intake, milk production, milk fat content and yield and feed efficiency were not affected by protein level and sources. The milk protein content was decreased by feeding roasted soybean. The treatments had no effect on the total tract digestibilities of dry matter, organic matter, starch and neutral detergent fiber, but crude protein digestibility was lower in the control and roasted soybeans diets. Feeding urea increased both, rumen ammonia N and plasma urea-N. The treatments had no effect on rumen pH, volatile fatty acids production and plasma glucose concentratio

Effect of protein levels and sources on performance and nutrient utilization by lactating dairy cows

Foram utilizadas cinco vacas holandesas canuladas rúmen e duodeno, com produções de leite em torno de 30hga/d num delineamento do tipo Quadrado Latino 5 X 5. As dietas continham dieta silagem de milho, milho floculado, caroço de algodão e mistura mineral e vitamínica, e foram formuladas variando flores, e fontes de proteínas, constituindo-se em cinco tratamentos: controle, uréia, farelo de soja, soja tostada e farelo de glúten de milho. A dieta controle continha 3,4% de proteína bruta na matéria seca e as demais ao redor de 165%. O teor e a fonte de proteína não afetaram a ingestão de matéria seca a produção de leite, a porcentagem, e a produção de gordura do leite, e a eficiência alimentar. A suplementação de rosa tostada teve efeito negativo na porcentagem de proteína do leite. As digestibilidades da matéria seca, da matéria orgânica, do amido e da fibra, em detergente meiótico no trato total não foram afetados pelos tratamentos, mas o tratamento controle e soja tostada diminuíram a digestibilidade da proteína bruta. A suplementação de uréia aumentou a concentração de amônia no rúmen e de uréia no plasma, enquanto que, o pH rumenal, a produção de ácidos graxos voláteis e a concentração plasmática de glucose não foram afetadas por tratamentosFive rumen and duodenaly canulated dairy cows were utilized in a 5X5 L.S. design. Diets were based on com silage, steam-flaked com, whole cotton seed, protein supplement and mineral and vitamins. Different protein supplements were used, resulting in five treatments: control, urea, soybean meal, roasted soybeans and com gluten meal. The control diet was 13.49% crude protein and the other diets were around 16.5%. The dry matter intake, milk production, milk fat content and yield and feed efficiency were not affected by protein level and sources. The milk protein content was decreased by feeding roasted soybean. The treatments had no effect on the total tract digestibilities of dry matter, organic matter, starch and neutral detergent fiber, but crude protein digestibility was lower in the control and roasted soybeans diets. Feeding urea increased both, rumen ammonia N and plasma urea-N. The treatments had no effect on rumen pH, volatile fatty acids production and plasma glucose concentratio

Alcune considerazioni su un caso di sepsi in gastroenterite acuta da Campylobacter jejuni.

Campylobacter jejuni is one the most common causes of human diarrea in the world. Complications are relatively rare, but infections have been associated with bacteremia, reactive arthritis and Guillain-Barrè syndrome.We report a 81-y-old patient with sepsis associated with CJ enteritis. Difficulties in CJ detection and identification due to its fastidious nature are also emphasized

Fluoroquinolone resistance: relation between drug use and evolution of resistance in some Units of the “San Bassiano” hospital from 2007 to 2008

There is substantial evidence that the overuse of antibiotics is a major cause for the emergence in antimicrobial resistance. This study analyzes the evolution of antimicrobial resistance to ciprofloxacin and levofloxacin from 2007 to 2008 in some Units of the “San Bassiano” hospital and compares this evolution among the consumption of the same antibiotics. The study involved the collection of all first isolates in blood, urine and transtracheal samples between 2007 and 2008; three microorganisms were chosen: Staphylococcus aureus, Escherichia coli and Pseudomonas aeruginosa. Microorganisms investigations concerned Geriatrics, Medicine, Surgery and Intensive Care Unit (ICU) with 48, 48, 44 and 10 beds respectively. Identification and antimicrobial susceptibility testing was performed using the Phoenix automated system (Becton Dickinson). If the ciprofloxacin susceptibility was (S) and levofloxacin susceptibility was (I/R) antimicrobial susceptibility was confirmed by the E-Test method (bioMérieux) on Muller Hilton agar and cell density of 0.5 MacFarland. Control strains were E. Coli ATCC 25922, P. aeruginosa ATCC 27853 and S. aureus ATCC 29213. The antibiotics consumed in the hospital between January 2007 and December 2008 were transformed into Defined Daily Dose (DDD), which corresponds to the quantity of antibiotics consumed by a patient in 24 h. Ciprofloxacin and levofloxacin demonstrated a similar pattern of increasing resistance in some units between 2007 and 2008. Fluoroquinolone resistance increase for E. coli, varies from 10% in Geriatrics to 15% in ICU, for S. aureus varies from 15% in Medicine Unit to 5% in ICU. P. aeruginosa maintained the same percentage of resistance from 2007 to 2008, but there was a significantly increase of strains with intermediate sensitivity (I) up to 30%. The consumption of Ciprofloxacin didn’t increase in any of the units and in some case decreased. The consumption of levofloxacin increased in every units and particularly in ICU it raised from 5100 ev doses in 2007 to 6480 in 2008 and from 0 to 300 doses os (DDD). The increased consumption of levofloxacin in 2008 in ICU could explain the increased of Pseudomonas aeruginosa strains with intermediate sensitivity (I)

Blood Vessel-Derived Acellular Matrix for Vascular Graft Application

To overcome the issues connected to the use of autologous vascular grafts and artificial materials for reconstruction of small diameter (<6 mm) blood vessels, this study aimed to develop acellular matrix- (AM-) based vascular grafts. Rat iliac arteries were decellularized by a detergent-enzymatic treatment, whereas endothelial cells (ECs) were obtained through enzymatic digestion of rat skin followed by immunomagnetic separation of CD31-positive cells. Sixteen female Lewis rats (8 weeks old) received only AM or previously in vitro reendothelialized AM as abdominal aorta interposition grafts (about 1 cm). The detergent-enzymatic treatment completely removed the cellular part of vessels and both MHC class I and class II antigens. One month after surgery, the luminal surface of implanted AMs was partially covered by ECs and several platelets adhered in the areas lacking cell coverage. Intimal hyperplasia, already detected after 1 month, increased at 3 months. On the contrary, all grafts composed by AM and ECs were completely covered at 1 month and their structure was similar to that of native vessels at 3 months. Taken together, our findings show that prostheses composed of AM preseeded with ECs could be a promising approach for the replacement of blood vessels