Epidemiology of fragility fractures in Italy

OBJECTIVES: We aimed to calculate the incidence of major fragility fractures in Italy, including those which do not result systematically in hospital admissions, on the basis of hospitalization rates provided in our previous researches.METHODS: We analyzed Italian national hospital discharge data from year 2004 to 2006 in order to determine age- and sex-specific incidence rates of hip, vertebral, humeral, and forearm fractures occurred in people aged 40 to 100 years of age. Re-hospitalizations of the same patients have been excluded from the analysis. Hospital discharge data have been adjusted taking into account recently published information concerning fracture-specific hospitalization rates.RESULTS: We estimated a total of 88,647 hip fractures in year 2006 among people aged 40 to 100 years old, with a +5.9% increase across the three examined years. Women aged >75 years old (n=53,259) accounted for 60% of total fractures observed both in males and females from 40 to 100 years of age. Concerning males, the highest incidence was observed between 80 and 84 years old (about 5,000 hip fractures). Overall incidence rate per 100,000 inhabitants computed for hip fractures was 284.28, with marked age- and sex-specific differences. Clinical vertebral fractures were estimated to be almost 61,000 in 2006, with a +3.1% increase across the three examined years. Overall incidence rate per 100,000 inhabitants computed for clinical vertebral fractures was 195.23, but this value doubled between 75 and 95 years of age. In the same year 2006, a total of 56,129 humeral and 97038 forearm/wrist fractures, with a +5.5% and +3.9% increase across three years, respectively. Overall humeral fractures incidence per 100,000 was 180, with highest rates (up to 600 and over) observed in women between 75 and 95 years of age, while incidence per 100,000 computed for wrist fractures was 311, with top values observed in women between aged 55-85 years old - thus including early post-menopausal age group - and a peak in those between 75 and 79 years of age.CONCLUSIONS: The burden of major osteoporotic fractures in Italy is very high. Preventive strategies aimed to reduce fractures incidence should be carried out at regional level

Management of cutaneous discomfort in patients with scleroderma: a clinical trial.

Systemic sclerosis (scleroderma) is a disease of unknown cause, the hallmark of which is induration of the skin. This bad condition of the skin influences negatively the quality of life of patients with scleroderma. The aim of the study was to verify the efficacy of two formulations, specifically designed to wash, moisturize and soothe the scleroderma skin. An independent, randomized, double blind, controlled trial was conducted in the Department of Rheumatology of "A. Galateo" Hospital in San Cesario di Lecce. Forty-six women affected by scleroderma, and treated with Iloprost every month, were divided into two groups: group 1 followed a specific treatment with cleansing formulation only, group 2 followed a combined treatment with the cleansing solution and the moisturizing solution. In addition, a third group was evaluated: 14 women, who did not undergo intravenous Iloprost therapy, were treated simultaneously with the cleansing formulation and the moisturizing formulation. The three treatments lasted for 4 weeks. Reduction in trans epidermal water loss (TEWL), increase in moisturization of the stratum corneum, reduction in Skin Score and improvement in quality of life were assessed. Very significant improvement in quality of life occurred in each group. Group 2 obtained very significant improvement in hydration and reduction in skin score and TEWL. The study showed that the daily use of both formulations proved to be effective in washing, hydrating and soothing the skin of patients with scleroderma, especially in association with Iloprost therapy

Updated incidence rates of fragility fractures in Italy: extension study 2002-2008

OBJECTIVES: We aimed to update the incidence rates of major fragility fractures in Italy, including those which do not result systematically in hospital admissions, on the basis of hospitalization rates provided in our previous researches.METHODS: We analyzed italian national hospital discharge data from year 2002 to 2008 in order to determine age- and sex-specific incidence rates of hip, vertebral, humeral, and forearm fractures occurred in people aged 40 to 100 years of age. Re-hospitalizations of the same patients have been excluded from the analysis. Hospital discharge data have been adjusted taking into account recently published information concerning fracture-specific hospitalization rates.RESULTS: We estimated a total of 91,494 hip fractures in year 2008 among people aged 40 to 100 years old, with a +18.1% increase across the seven-year period. Women aged >75 years old (n=55,950) accounted for about 60% of total fractures observed both in males and females. Concerning males, the highest incidence was observed between 80 and 84 years old (about 5,000 hip fractures). Overall incidence rate per 100,000 inhabitants computed for hip fractures was 283.5, with marked age- and sex-specific differences. Clinical vertebral fractures were estimated to be almost 61,000 in 2008, with a +6.3% increase over seven years. Overall incidence rate per 100,000 inhabitants computed for clinical vertebral fractures was 189.0, but this value doubled between 75 and 95 years of age. For the same year 2008, we estimated a total of 57,400 humeral and 94,000 forearm/wrist fractures, with a +13.2% and +0.7% increase over the seven-year period, respectively. Overall humeral fractures incidence per 100,000 was estimated in 178.0, with highest rates (up to 600 and over) observed in women between 75 and 95 years of age, while incidence per 100,000 for wrist fractures was computed in 298.0, with top values observed in women between aged 55 years old and over.CONCLUSION: The burden of major osteoporotic fractures in Italy is still increasing. Preventive strategies aimed to reduce fractures incidence should be carried out at regional level

Prevalence of anti-CCP antibodies in systemic sclerosis

Joint involvement in systemic sclerosis (SSc) commonly occurs as arthralgias, while a true arthritis is less frequent. The most common arthritis developing in SSc is rheumatoid arthritis (RA) and its diagnosis may be misled by concomitant joint contracture or tendon sheath involvement due to SSc. Anti-citrullinated cyclic peptide (CCP) antibodies are an emerging tool to diagnose RA and have shown to be more specific than rheumatoid factor. We assessed the prevalence of anti-CCP antibodies in SSc patients and evaluated their sensitivity and specificity for associated RA. Searching for RF and anti-CCP antibodies and joint examination were carried out in sixty consecutive SSc patients. Hands and feet standard x-rays were performed in patients complaining with arthralgia and/or arthritis. Six out of sixty (10%) SSc patients had RA according to 1987 ARA revised criteria. Anti-CCP were detected in 5 patients (sensitivity 83%) and RF was present in all RA patients (sensitivity 100%). However, anti-CCP antibodies had a much higher specificity (94%) than RF (41%) for RA. Our study suggests that anti-CCP antibodies are a useful test to identify patients with SSc having also RA. This is crucial in the management of SSc because may allow an adequate therapy of RA and prevent further joint damage in patients who already have a poor quality of life

Massive transcriptome sequencing of human spinal cord tissues provides new insights into motor neuron degeneration in als

ALS is a devastating and debilitating human disease characterized by the progressive death of upper and lower motor neurons. Although much effort has been made to elucidate molecular determinants underlying the onset and progression of the disorder, the causes of ALS remain largely unknown. In the present work, we have deeply sequenced whole transcriptome from spinal cord ventral horns of post-mortem ALS human donors affected by the sporadic form of the disease (which comprises ∼90% of the cases but which is less investigated than the inherited form of the disease). We observe 1160 deregulated genes including 18 miRNAs and show that down regulated genes are mainly of neuronal derivation while up regulated genes have glial origin and tend to be involved in neuroinflammation or cell death. Remarkably, we find strong deregulation of SNAP25 and STX1B at both mRNA and protein levels suggesting impaired synaptic function through SNAP25 reduction as a possible cause of calcium elevation and glutamate excitotoxicity. We also note aberrant alternative splicing but not disrupted RNA editing

How the Commonwealth of the Northern Mariana Islands Stalled COVID-19 for 22 Months and Managed its First Significant Community Transmission

OBJECTIVE: The Commonwealth of the Northern Mariana Islands (CNMI) is a remote Pacific island territory with a population of 47 329 that successfully prevented the significant introduction of coronavirus disease (COVID-19) until late 2021. This study documents how the response to the introduction of COVID-19 in CNMI in 2021 was conducted with limited resources without overwhelming local clinical capacity or compromising health service delivery for the population. METHODS: Data from COVID-19 case investigations, contact tracing, the Commonwealth\u27s immunization registry and whole genome sequencing were collated and analysed as part of this study. RESULTS: Between 26 March 2020 and 31 December 2021, 3281 cases and 14 deaths due to COVID-19 were reported in CNMI (case fatality rate, 0.4%). While notification rates were highest among younger age groups, hospitalization and mortality rates were disproportionately greater among those aged \u3e 50 years and among the unvaccinated. The first widespread community transmission in CNMI was detected in October 2021, with genomic epidemiology and contact tracing data indicating a single introduction event involving the AY.25 lineage and subsequent rapid community spread. Vaccination coverage was high before widespread transmission occurred in October 2021 and increased further over the study period. DISCUSSION: Robust preparedness and strong leadership generated resilience within the public health sector such that COVID-19 did not overwhelm CNMI\u27s health system as it did in other jurisdictions and countries around the world. At no point was hospital capacity exceeded, and all patients received adequate care without the need for health-care rationing

Vitamin-V: Virtual Environment and Tool-boxing for Trustworthy Development of RISC-V based Cloud Services

Vitamin-V is a 2023-2025 Horizon Europe project that aims to develop a complete RISC-V open-source software stack for cloud services with comparable performance to the cloud-dominant x86 counterpart and a powerful virtual execution environment for software development, validation, verification, and test that considers the relevant RISC-V ISA extensions for cloud deployment

KRAS-regulated glutamine metabolism requires UCP2-mediated aspartate transport to support pancreatic cancer growth

The oncogenic KRAS mutation has a critical role in the initiation of human pancreatic ductal adenocarcinoma (PDAC) since it rewires glutamine metabolism to increase reduced nicotinamide adenine dinucleotide phosphate (NADPH) production, balancing cellular redox homeostasis with macromolecular synthesis1,2. Mitochondrial glutamine-derived aspartate must be transported into the cytosol to generate metabolic precursors for NADPH production2. The mitochondrial transporter responsible for this aspartate efflux has remained elusive. Here, we show that mitochondrial uncoupling protein 2 (UCP2) catalyses this transport and promotes tumour growth. UCP2-silenced KRASmut cell lines display decreased glutaminolysis, lower NADPH/NADP+ and glutathione/glutathione disulfide ratios and higher reactive oxygen species levels compared to wild-type counterparts. UCP2 silencing reduces glutaminolysis also in KRASWT PDAC cells but does not affect their redox homeostasis or proliferation rates. In vitro and in vivo, UCP2 silencing strongly suppresses KRASmut PDAC cell growth. Collectively, these results demonstrate that UCP2 plays a vital role in PDAC, since its aspartate transport activity connects the mitochondrial and cytosolic reactions necessary for KRASmut rewired glutamine metabolism2, and thus it should be considered a key metabolic target for the treatment of this refractory tumour