Denosumab in patients with aneurysmal bone systs: A case series with preliminary results

Abstract PURPOSE:: Aneurysmal bone cyst (ABC) is a rare skeletal tumor usually treated with surgery/embolization. We hypothesized that owing to similarities with giant cell tumor of bone (GCTB), denosumab was active also in ABC. METHODS:: In this observational study, a retrospective analysis of ABC patients treated with denosumab was performed. Patients underwent radiologic disease assessment every 3 months. Symptoms and adverse events were noted. RESULTS:: Nine patients were identified (6 male, 3 female), with a median age of 17 years (range 14-42 years). Primary sites were 6 spine-pelvis, 1 ulna, 1 tibia, and 1 humerus. Patients were followed for a median time of 23 months (range 3-55 months). Patients received a median of 8 denosumab administrations (range 3-61). All symptomatic patients had pain relief and 1 had paresthesia improvement. Signs of denosumab activity were observed after 3 to 6 months of administration: bone formation by computed tomography scan was demonstrated in all patients and magnetic resonance imaging gadolinium contrast media decrease was observed in 7/9 patients. Adverse events were negligible. At last follow-up, all patients were progression-free: 5 still on denosumab treatment, 2 off denosumab were disease-free 11 and 17 months after surgery, and the last 2 patients reported no progression 12 and 24 months after denosumab interruption and no surgery. CONCLUSIONS:: Denosumab has substantial activity in ABCs, with favorable toxicity profile. We strongly support the use of surgery and/or embolization for the treatment of ABC, but denosumab could have a role as a therapeutic option in patients with uncontrollable, locally destructive, or recurrent disease

Assessment of hydropower potential in small karst catchments: the case of the Rocche Plateau, Central Italy

Estimation of flow duration characteristics is key in assessing hydropower potential in natural catchments. However, such analysis is not usually straightforward, especially in ungauged sites and/or in complex catchment areas. In this study we evaluate the feasibility of revamping of a small hydroelectric power plant, located in a karst plateau in central Italy, by assessing the hydropower potential of its feeding surface and subsurface stream network. A thorough analysis of runoff processes occurring in the examined area is carried out in order to corroborate regionalization studies based on measured specific flows in neighboring homogeneous basins. The results show an appreciable availability of water resources to be exploited for hydropower purposes

Assessment of hydropower potential in small karst catchments: the case of the Rocche Plateau, Central Italy

Estimation of flow duration characteristics is key in assessing hydropower potential in natural catchments. However, such analysis is not usually straightforward, especially in ungauged sites and/or in complex catchment areas. In this study we evaluate the feasibility of revamping of a small hydroelectric power plant, located in a karst plateau in central Italy, by assessing the hydropower potential of its feeding surface and subsurface stream network. A thorough analysis of runoff processes occurring in the examined area is carried out in order to corroborate regionalization studies based on measured specific flows in neighboring homogeneous basins. The results show an appreciable availability of water resources to be exploited for hydropower purposes

Malattia di Paget perianale: presentazione di 5 casi

Obiettivo. La malattia di Paget extramammaria (EMPD) è una neoplasia molto rara che frequentemente si associa a carcinomi cutanei o viscerali, sincroni o metacroni. Obiettivo dello studio è valutare retrospettivamente i risultati ottenuti in 5 casi di malattia di Paget perianale osservati e rivedere la letteratura sull’argomento. Pazienti e metodi. Cinque pazienti con EMPD perianale sono stati trattati presso la nostra Divisione da marzo 1996 a dicembre 2006. In 3 casi la malattia era confinata entro l’epidermide, in un caso plurirecidivo era presente un’infiltrazione del derma e un paziente presentava un adenocarcinoma del retto inferiore con diffusione pagetoide. I pazienti sono stati sottoposti ad ampie exeresi perianali e ricostruzioni con graft cutanei. L’asportazione dell’adenocarcinoma del retto è stata realizzata per via transanale. In due casi è stata eseguita una sigmoidostomia di protezione per favorire la guarigione della ferita. Risultati. Non si sono verificate complicanze postoperatorie, neanche a distanza. In due casi la malattia ha recidivato localmente, ma nessun paziente ha presentato metastasi a distanza. Quattro pazienti sono vivi e liberi da malattia, mentre un paziente con recidiva di malattia è deceduto per insufficienza cardiocircolatoria. Discussione. L’analisi della letteratura consente un’identificazione chiara della EMPD primitiva (intraepiteliale/intradermica) e della forma associata ad adenocarcinomi anorettali, interpretata come diffusione pagetoide. Poche informazioni sono invece ricavabili nei casi in cui la malattia si presenta come adenocarcinoma degli annessi. La malattia tende a recidivare anche dopo chirurgia exeretica radicale e ha capacità metastatizzanti, anche nella forma in situ. Conclusioni. La malattia di Paget perianale è una patologia complessa e difficile da diagnosticare. L’ associazione con carcinomi sincroni o metacroni impone follow-up lunghi con controlli clinici e strumentali frequenti

PRELIMINARY EVALUATION OF SPIROTOMEt DEVICE FOR LIVER BIOPSY IN GREEN IGUANAS (IGUANA IGUANA): A PILOT STUDY

The aim of this study was to evaluate a large-core manual biopsy device (Spirotomet, Medinvents, 3500 Hasselt, Belgium) for liver sampling and histologic diagnosis in green iguanas (Iguana iguana). The study included eight green iguanas, and two ultrasound-guided biopsies were collected for each lizard, for 16 biopsies in total. The procedure was carried out under general anesthesia induced by intravenous injection of propofol (10 mg/kg) maintained with a mixture of 2.0% isoflurane and 0.8\u20131.2 L/min oxygen after tracheal intubation. Fourteen (87.5%) of the 16 biopsies were considered diagnostic. Liver biopsy quality was assessed according to sample size and tissue preservation. In particular, mean length (16.2 6 4.5 mm), width (2.2 6 0.5 mm), area (34.8 6 6.9 mm2), and number of portal areas (9.4 6 3.9) of each biopsy were recorded for all green iguanas. The total available surface of the sections obtained from the biopsies and their grade of preservation enabled a satisfactory evaluation of the parenchymal architecture. One of the green iguanas in the study died the day after the procedure due to severe hemocoeloma. Risk assessment evaluation suggested that small green iguanas may not be suitable for this biopsy procedure

PRELIMINARY EVALUATION of SPIROTOME® DEVICE for LIVER BIOPSY in GREEN IGUANAS (IGUANA IGUANA): A PILOT STUDY

The aim of this study was to evaluate a large-core manual biopsy device (Spirotome®, Medinvents, 3500 Hasselt, Belgium) for liver sampling and histologic diagnosis in green iguanas (Iguana iguana). The study included eight green iguanas, and two ultrasound-guided biopsies were collected for each lizard, for 16 biopsies in total. The procedure was carried out under general anesthesia induced by intravenous injection of propofol (10 mg/kg) maintained with a mixture of 2.0% isoflurane and 0.8-1.2 L/min oxygen after tracheal intubation. Fourteen (87.5%) of the 16 biopsies were considered diagnostic. Liver biopsy quality was assessed according to sample size and tissue preservation. In particular, mean length (16.2 ± 4.5 mm), width (2.2 ± 0.5 mm), area (34.8 ± 6.9 mm2), and number of portal areas (9.4 ± 3.9) of each biopsy were recorded for all green iguanas. The total available surface of the sections obtained from the biopsies and their grade of preservation enabled a satisfactory evaluation of the parenchymal architecture. One of the green iguanas in the study died the day after the procedure due to severe hemocoeloma. Risk assessment evaluation suggested that small green iguanas may not be suitable for this biopsy procedure

Evaluation of liver parenchyma and perfusion using dynamic contrast-enhanced computed tomography and contrast-enhanced ultrasonography in captive green iguanas (Iguana iguana) under general anesthesia

Background: Contrast-enhanced diagnostic imaging techniques are considered useful in veterinary and human medicine to evaluate liver perfusion and focal hepatic lesions. Although hepatic diseases are a common occurrence in reptile medicine, there is no reference to the use of contrast-enhanced ultrasound (CEUS) and contrast-enhanced computed tomography (CECT) to evaluate the liver in lizards. Therefore, the aim of this study was to evaluate the pattern of change in echogenicity and attenuation of the liver in green iguanas (Iguana iguana) after administration of specific contrast media.Results: An increase in liver echogenicity and density was evident during CEUS and CECT, respectively. In CEUS, the mean ± SD (median; range) peak enhancement was 19.9% ± 7.5 (18.3; 11.7-34.6). Time to peak enhancement was 134.0 ± 125.1 (68.4; 59.6-364.5) seconds. During CECT, first visualization of the contrast medium was at 3.6 ± 0.5 (4; 3-4) seconds in the aorta, 10.7 ± 2.2 (10.5; 7-14) seconds in the hepatic arteries, and 15 ± 4.5 (14.5; 10-24) seconds in the liver parenchyma. Time to peak was 14.1 ± 3.4 (13; 11-21) and 31 ± 9.6 (29; 23-45) seconds in the aorta and the liver parenchyma, respectively.Conclusion: CEUS and dynamic CECT are practical means to determine liver hemodynamics in green iguanas. Distribution of contrast medium in iguana differed from mammals. Specific reference ranges of hepatic perfusion for diagnostic evaluation of the liver in iguanas are necessary since the use of mammalian references may lead the clinician to formulate incorrect diagnostic suspicions. © 2014 Nardini et al.; licensee BioMed Central Ltd

Update on pharmacokinetic profile of marbofloxacin in loggerhead sea turtles (Caretta caretta) after intravenous and intramuscular injection

Antibiotic therapy represents an essential aid in the treatment of sick or injured loggerhead sea turtle (Caretta caretta,). Marbofloxacin is commonly used in loggerhead sea turtles at 2 mgjkg similarly to other species. The aim of the study was to increase our understanding of marbofloxacin pharmacokinetic in Caretta caretta. Six healthy turtles were divided in two groups: the IV group (subjects A, B, D) and the IM group (subjects C, H, F). Each animal received a single dose of MarbocyP 2%, corresponding to 2 mg/ kg of marbofloxacin. The drug was administered via intravenous (IV) and intramuscular (IM) routes. After the administration, 13 blood samples were collected at different times:for IVgroup at 0, 10, 20, 30, 45 minutes, 1, 2, 4, 8, 12 hours and 1, 2, 2,5 days; for IM group at 0, 30 minutes, 1, 1.5, 2, 3, 4, 6, 8, 12 hours, and 1, 2, 2,5 days. A HPLC-UV (k 295 nm) analytical method was used to measure marbofloxacin concentrations in blood. The pharmacokinetic behavior of the drug was best described by a non-compartmental model The plasma concentration profiles of marbofloxacin were similar for the two administration routes and the residual concentrations at 1 day were almost identical. The molecule was detected up to 2,5 days. The apparent volume of distribution was > 1 L/kg. The IM route resulted in a rapid and complete marbofloxacin absorption (F = 131, 43 \ub112,06%)

Isolation of a novel Rhabdovirus from an insectivorous bat (Pipistrellus kuhlii) in Italy

Abstract Background Rhabdoviridae is one of the most ecologically diverse families of RNA viruses which can infect a wide range of vertebrates and invertebrates. Bats, among mammals, are pointed to harbor a significantly higher proportion of unknown or emerging viruses with zoonotic potential. Herein, we report the isolation of a novel rhabdovirus, detected in the framework of a virological survey on bats implemented in North Italy. Methods Virus isolation and identification were performed on samples of 635 bats by using cell cultures, negative staining electron microscopy and PCRs for different viruses. NGS was commonly performed on cell culture supernatants showing cytopathic effect or in case of samples resulted positive by at least one of the PCRs included in the diagnostic protocol. Results A rhabdovirus was isolated from different organs of a Pipistrellus kuhlii. Virus identification was obtained by electron microscopy and NGS sequencing. The complete genome size was 11,774 nt comprised 5 genes, encoding the canonical rhabdovirus structural proteins, and an additional transcriptional unit (U1) encoding a hypothetical small protein (157aa) (3’-N-P-M-G-U1-L-5′). The genome organization and phylogenetic analysis suggest that the new virus, named Vaprio virus (VAPV), belongs to the recently established genus Ledantevirus (subgroup B) and it is highly divergent to its closest known relative, Le Dantec virus (LDV) (human, 1965 Senegal). A specific RT-PCR amplifying a 350 bp fragment of the ORF 6 gene, encoding for L protein, was developed and used to test retrospectively a subset of 76 bats coming from the same area and period, revealing two more VAPV positive bats. Conclusions VAPV is a novel isolate of chiropteran rhabdovirus. Genome organization and phylogenetic analyses demonstrated that VAPV should be considered a novel species within the genus Ledantevirus for which viral ecology and disease associations should be investigated