Misunderstanding Situations in Culture and Cultural Care

This article focuses on cultural misunderstanding in care relations, starting from the analysis of the effects misunderstanding causes in the relation between doctor and migrant patient. The Western medical model tends to be based on objective data, which can be diagnosed through more and more precise and detailed techniques, but it excludes human and cultural aspects of subjectivity and relation from care. This exclusion creates distance, which increases when doctor and patient do not share a cultural homogeneity but differ for their language and the way they conceive their body, health, and disease. By showing some clinical examples, this contribution points out how specialized competence can cause dark areas of obscurity, disagreement, and misunderstanding, although being successful in many distressing situations. The interpretation of misunderstanding in the field of healthcare delimits our observation to disease, treatment, and the relation between doctor and patient, but the identification and comprehension of misunderstanding are possible also, focusing our attention on the organizational and institutional environment where misunderstanding takes place

An integrated geodetic and InSAR technique for the monitoring and detection of active faulting in southwestern Sicily

We present the results of the analysis of GNSS (Global Navigation Satellite System) and InSAR (Interferometric synthetic-aperture radar) data collected in the frame of a project financed by the “Struttura Terremoti” of INGV (Istituto Nazionale di Geofisica e Vulcanologia). Combined investigations pointed out for potential seismogenic sources for destructive earthquakes recorded in southwestern Sicily, including the 1968 Belice earthquake sequence and that supposed to have destroyed the Greek city of Selinunte which, according to geoarcheological data experienced two earthquakes in historical times. Our approach is aimed to evaluate the current deformation rate in SW Sicily and to improve the knowledge about the seismic potential of this area. The geodetic data proposed in this paper show that the Campobello di Mazara–Castelvetrano alignment (CCA) is currently deforming with a vertical and horizontal displacements of 2 mm/yr and 0.5 mm/yr respectively, according to the tectonic setting of the are

Aurora Kinase A expression is associated with lung cancer histological-subtypes and with tumor de-differentiation

<p>Abstract</p> <p>Background</p> <p>Aurora kinase A (<it>AURKA</it>) is a member of serine/threonine kinase family. Several kinases belonging to this family are activated in the G2/M phase of the cell cycle being involved in mitotic chromosomal segregation. <it>AURKA </it>overexpression is significantly associated with neoplastic transformation in several tumors and deregulated <it>Aurora Kinases </it>expression leads to chromosome instability, thus contributing to cancer progression. The purpose of the present study was to investigate the expression of <it>AURKA </it>in non small cell lung cancer (NSCLC) specimens and to correlate its mRNA or protein expression with patients' clinico-pathological features.</p> <p>Materials and methods</p> <p>Quantitative real-time PCR and immunohistochemistry analysis on matched cancer and corresponding normal tissues from surgically resected non-small cell lung cancers (NSCLC) have been performed aiming to explore the expression levels of <it>AURKA </it>gene.</p> <p>Results</p> <p><it>AURKA </it>expression was significantly up-modulated in tumor samples compared to matched lung tissue (p < 0.01, mean log2(FC) = 1.5). Moreover, <it>AURKA </it>was principally up-modulated in moderately and poorly differentiated lung cancers (p < 0.01), as well as in squamous and adenocarcinomas compared to the non-invasive bronchioloalveolar histotype (p = 0.029). No correlation with survival was observed.</p> <p>Conclusion</p> <p>These results indicate that in NSCLC <it>AURKA </it>over-expression is restricted to specific subtypes and poorly differentiated tumors.</p

VARIABILITY OF DEPOSITIONAL SETTING ALONG THE NORTH-WESTERN SICILY CONTINENTAL SHELF (ITALY) DURING LATE QUATERNARY: EFFECTS OF SEA LEVEL CHANGES AND TECTONIC EVOLUTION

The geological, geomorphological and sedimentological features of the north-western Sicily continental shelf are here illustrated with the aim to propose a geological model able to explain the Neogene-Quaternary evolution of the Sicilian continental margin in the context of the central Mediterranean region. Above the continental shelf and upper slope the sedimentary succession, showing along the different sectors of the margin considerably variable internal geometry and stratigraphic relationships with the underlying units, is interpreted as a IV order depositional sequence (Late Quaternary Depositional Sequence, LQDS) deposited during the last eustatic change (last 125 ky). The lower boundary of the LQDS is represented by a subaerial erosional surface formed during the last eustatic sea level fall ended in the LGM (20-18 ka). This unconformity lies above a seaward dipping Pleistocene succession whose depositional architecture is in turn controlled by Quaternary eustatic sea-level fluctuations. A dense dataset of morphobathymetric and high resolution seismic data allowed to recognize along the continental shelf to bathyal plain system different types of continental shelf with different stratigraphic and morphostructural settings, associated to both large-scale processes and specific factors related to more local control: a) predominantly rocky shelves, both accompanied by a moderate frontal sedimentary prism and with a structural edge, in the structural highs of the Monti di Palermo offshore and around the main rocky headlands (Capo San Vito, Monte Catalfano); b), depositional shelves, in the Castellammare, Palermo and Termini Imerese gulfs, both with a regular seaward deepening of the substrate and with a substrate uplift at the shelf break. We confirm that depositional sequences in this margin are the result of the interaction between sea level changes and sedimentation, but demonstrate that the tectonic activity has played a key role, not only in the creation of different types of continental shelves, but also to determine the different characters of each sequence in different areas. The general tectonic uplift during the Pleistocene, together with the episodic alternation of extensional and compressional events, often with strike-slip component, is responsible for the thickness and facies variation both onland, where residual Pleistocene marine deposits today outcrops, and in the continental shelf, where most of the depositional sequences developed and are now recognized. As well tectonic activity exerted a control on the geomorphological features (e.g. pockmarks and mounds) of the present day coastal areas and shelf-slope system, as well as for the submarine canyons and the mass failure processes

Dasatinib modulates sensitivity to pemetrexed in malignant pleural mesothelioma cell lines

BACKGROUND: Thymidylate synthase (TS), one of the key enzymes for thymidine synthesis, is a target of pemetrexed (PEM), a key agent for the systemic therapy of malignant pleural mesothelioma (MPM) and its overexpression has been correlated to PEM-resistance. In MPM, experimental data report activation of the c-SRC tyrosine kinase suggesting it as a potential target to be further investigated. RESULTS: MPM cell lines showed different sensitivity, being MSTO the most and REN the least sensitive to PEM. REN cells showed high levels of both TS and SRC: dasatinib inhibited SRC activation and suppressed TS protein expression, starting from 100 nM dose, blocking the PEM-induced up regulation of TS protein levels. Dasatinib treatment impaired cells migration, and both sequential and co-administration with PEM significantly increased apoptosis. Dasatinib pretreatment improved sensitivity to PEM, downregulated TS promoter activity and, in association with PEM, modulated the downstream PI3K-Akt-mTOR signaling. CELL LINES AND METHODS: In three MPM cell lines (MPP89, REN and MSTO), the effects of c-SRC inhibition, in correlation with TS expression and PEM sensitivity, were evaluated. PEM and dasatinib, a SRC inhibitor, were administered as single agents, in combination or sequentially. Cell viability, apoptosis and migration, as well as TS expression and SRC activation have been assessed. CONCLUSIONS: These data indicate that dasatinib sensitizes mesothelioma cells to PEM through TS down-regulation

Retrospective study testing next generation sequencing of selected cancer-associated genes in resected prostate cancer

PURPOSE: Prostate cancer (PCa) has a highly heterogeneous outcome. Beyond Gleason Score, Prostate Serum Antigen and tumor stage, nowadays there are no biological prognostic factors to discriminate between indolent and aggressive tumors. The most common known genomic alterations are the TMPRSS-ETS translocation and mutations in the PI3K, MAPK pathways and in p53, RB and c-MYC genes. The aim of this retrospective study was to identify by next generation sequencing the most frequent genetic variations (GVs) in localized and locally advanced PCa underwent prostatectomy and to investigate their correlation with clinical-pathological variables and disease progression. RESULTS: Identified non-synonymous GVs included TP53 p.P72R (78% of tumors), two CSFR1 SNPs, rs2066934 and rs2066933 (70%), KDR p.Q472H (67%), KIT p.M541L (28%), PIK3CA p.I391M (19%), MET p.V378I (10%) and FGFR3 p.F384L/p.F386L (8%). TP53 p.P72R, MET p.V378I and CSFR1 SNPs were significantly associated with the HI risk group, TP53 and MET variations with T≥T2c. FGFR3 p.F384L/p.F386L was correlated with T≤T2b. MET p.V378I mutation, detected in 20% of HI risk patients, was associated with early biochemical recurrence. EXPERIMENTAL DESIGN: Nucleic acids were obtained from tissue samples of 30 high (HI) and 30 low-intermediate (LM) risk patients, according to D'Amico criteria. Genomic DNA was explored with the Ion_AmpliSeq_Cancer_Hotspot_Panel_v.2 including 50 cancer-associated genes. GVs with allelic frequency (AF) ≥10%, affecting protein function or previously associated with cancer, were correlated with clinical-pathological variables. CONCLUSION: Our results confirm a complex mutational profile in PCa, supporting the involvement of TP53, MET, FGFR3, CSF1R GVs in tumor progression and aggressiveness

Identification and Characterization of Cancer Stem Cells from Head and Neck Squamous Cell Carcinoma Cell Lines

Background/Aims: Head and neck squamous cell carcinoma (HNSCC) ranks sixth worldwide for tumor-related mortality. A subpopulation of tumor cells, termed cancer stem cells (CSCs), has the ability to support cancer growth. Therefore, profiling CSC-enriched populations could be a reliable tool to study cancer biology. Methods: We performed phenotypic characterization of 7 HNSCC cell lines and evaluated the presence of CSCs. CSCs from Hep-2 cell line and HNSCC primary cultures were enriched through sphere formation and sphere-forming cells have been characterized both in vitro and in vivo. In addition, we investigated the expression levels of Nicotinamide N-methyltransferase (NNMT), an enzyme overexpressed in several malignancies. Results: CSC markers were markedly expressed in Hep-2 cell line, which was found to be highly tumorigenic. CSC-enriched populations displayed increased expression of CSC markers and a strong capability to form tumors in vivo. We also found an overexpression of CSC markers in tumor formed by CSC-enriched populations. Interestingly, NNMT levels were significantly higher in CSC-enriched populations compared with parental cells. Conclusion: Our study provides an useful procedure for CSC identification and enrichment in HNSCC. Moreover, results obtained seem to suggest that CSCs may represent a promising target for an anticancer therapy

Successful surgical repair of left ventricular pseudoaneurysm in a patient with subacute ST-elevation myocardial infarction.

We report a successful surgical repair of left ventricular pseudoaneurysm in a patient with subacute ST-elevation myocardial infarction (STEMI). In the case of expansion of the infarct related ventricular wall, early (within 24 hours) or late (3-5 days after STEMI) cardiac rupture should be always borne in mind in order to proceed to life saving prompt surgical repair