Is there any survival advantage of obesity in Southern European haemodialysis patients?

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Organic Carbon Burial following the Middle Eocene Climatic Optimum (MECO) in the central - western Tethys

We present trace metal geochemistry and stable isotope records for the middle Eocene Alano di Piave section, NE Italy, deposited during magnetochron C18n in the marginal Tethys Ocean. We identify a $\sim$ 500 kyr long carbon isotope perturbation event we infer to be the middle Eocene Climatic Optimum (MECO) confirming the northern hemisphere expression and global occurrence of MECO. Interpreted peak climatic conditions are followed by the rapid deposition of two organic rich intervals ($\le$3\% TOC) and contemporaneous positive $\delta^{13}$C excursions. These two intervals are associated with increases in the concentration of sulphur and redox-sensitive trace metals, and low concentrations of Mn, as well as coupled with the occurrence of pyrite. Together these changes imply low, possibly dysoxic, bottom water O$_{2}$ conditions promoting increased organic carbon burial. We hypothesize that this rapid burial of organic carbon lowered global {\it p}CO$_{2}$ following the peak warming and returned the climate system to the general Eocene cooling trend

Criteria for the Evaluation of Italian Scientific Institutes for Research, Hospitalization and Healthcare (IRCCS): Comparison with European Standards and Certification Models

The definition of the title 'Istituto di Ricovero e Cura a Carattere Scientifico' (IRCCS) and how this title is given by the Italian Ministry of Health is presented. Specifically, the first assessment of a commission concerning the essential information for the accreditation process is introduced. Moreover, the two years review process that aims to collect last updated information of the IRCCS, to identify level of excellence and critical aspects, is also explained. The present Italian forms and international manuals like Joint Commission, OECI and HCERES were schematized using UML diagrams. The current IRCCS accreditation forms are presented with the suggested updates organized in some levels of structuring. We compared the Italian forms with the manuals required to obtain international certifications (Joint Commission and OECI) and we analyzed the criteria for the evaluation of research units in France (the HCERES standards). Although it is a preliminary study, the use of UML diagrams allows to schematize a new accreditation model, in line with European guidelines and the most important international certifications

Phylogenetic position of a copper age sheep (Ovis aries) mitochondrial DNA.

Background: Sheep (Ovis aries) were domesticated in the Fertile Crescent region about 9,000-8,000 years ago. Currently, few mitochondrial (mt) DNA studies are available on archaeological sheep. In particular, no data on archaeological European sheep are available. Methodology/Principal Findings: Here we describe the first portion of mtDNA sequence of a Copper Age European sheep. DNA was extracted from hair shafts which were part of the clothes of the so-called Tyrolean Iceman or O¨ tzi (5,350 - 5,100 years before present). Mitochondrial DNA (a total of 2,429 base pairs, encompassing a portion of the control region, tRNAPhe, a portion of the 12S rRNA gene, and the whole cytochrome B gene) was sequenced using a mixed sequencing procedure based on PCR amplification and 454 sequencing of pooled amplification products. We have compared the sequence with the corresponding sequence of 334 extant lineages. Conclusions/Significance: A phylogenetic network based on a new cladistic notation for the mitochondrial diversity of domestic sheep shows that the O¨ tzi’s sheep falls within haplogroup B, thus demonstrating that sheep belonging to this haplogroup were already present in the Alps more than 5,000 years ago. On the other hand, the lineage of the O¨ tzi’s sheep is defined by two transitions (16147, and 16440) which, assembled together, define a motif that has not yet been identified in modern sheep populations

Pollen extract in association with vitamins provides early pain relief in patients affected by chronic prostatitis/chronic pelvic pain syndrome

The therapeutic efficacy for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is currently unsatisfactory. The aim of the present study was to assess the safety and efficacy of pollen extract in association with vitamins (DEPROX 500®) in males with CP/CPPS. All patients with a diagnosis of CP/CPPS attending the same urologic centre between March and October 2012 were enrolled in this randomised controlled phase III study. Participants were randomised to receive oral capsules of DEPROX 500® (two capsules every 24 h) or ibuprofen (600 mg, one tablet three times a day) for four weeks. The National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), International Prostate Symptom Score and Quality of Well-Being (QoL) questionnaires were used. In the intention-to-treat analysis, 87 males (25 class IIIa and 62 class IIIb) with a mean age of 33.6±5.9 years were randomly allocated to the DEPROX 500® (n=41) or ibuprofen (n=46) treatment groups. At the follow-up examination (following one month of treatment), in the DEPROX 500® group, 31/41 patients (75.6%) reported an improvement in quality of life, defined as a reduction of the NIH-CPSI total score by ≥25%, compared with 19/46 (41.3%) in the control group (P=0.002). The greater improvement in the DEPROX 500® group compared with the ibuprofen group was statistically significant (treatment difference in the NIH-CPSI pain domain, -2.14±0.51, P<0.001; QoL scores, P=0.002). All patients were negative at the Meares-Stamey test evaluation. Adverse events were less frequent in the DEPROX 500® group than in the ibuprofen group. The DEPROX 500® treatment significantly improved total symptoms, pain and quality of life compared with ibuprofen in patients with CP/CPPS, without severe side-effects

Efficacy of pulsatile flow perfusion in adult cardiac surgery: Hemodynamic energy and vascular reactivity

Background: The role of pulsatile (PP) versus non-pulsatile (NP) flow during a cardiopulmonary bypass (CPB) is still debated. This study’s aim was to analyze hemodynamic effects, endothelial reactivity and erythrocytes response during a CPB with PP or NP. Methods: Fifty-two patients undergoing an aortic valve replacement were prospectively randomized for surgery with either PP or NP flow. Pulsatility was evaluated in terms of energy equivalent pressure (EEP) and surplus hemodynamic energy (SHE). Systemic (SVRi) and pulmonary (PVRi) vascular resistances, endothelial markers levels and erythrocyte nitric-oxide synthase (eNOS) activity were collected at different perioperative time-points. Results: In the PP group, the resultant EEP was 7.3% higher than the mean arterial pressure (MAP), which corresponded to 5150 ± 2291 ergs/cm3 of SHE. In the NP group, the EEP and MAP were equal; no SHE was produced. The PP group showed lower SVRi during clamp-time (p = 0.06) and lower PVRi after protamine administration and during first postoperative hours (p = 0.02). Lower SVRi required a higher dosage of norepinephrine in the PP group (p = 0.02). Erythrocyte eNOS activity results were higher in the PP patients (p = 0.04). Renal function was better preserved in the PP group (p = 0.001), whereas other perioperative variables were comparable between the groups. Conclusions: A PP flow during a CPB results in significantly lower SVRi, PVRi and increased eNOS production. The clinical impact of increased perioperative vasopressor requirements in the PP group deserves further evaluation

Recurrent COVID-19 pneumonia in the course of chemotherapy: consequence of a weakened immune system?

Letter to the Editor - We report a case of recurrent COVID‐19 pneumonia in a vulnerable patien

Indexed left atrial volume, C-reactive protein and erythrocyte sedimentation rate as predictors of recurrence of non-valvular atrial fibrillation after successful cardioversion

Indexed left atrial volume, C-reactive protein and erythrocyte sedimentation rate as predictors of recurrence of non-valvular atrial fibrillation after successful cardioversio

Posterior reconstruction during robotic-assisted radical cystectomy with intracorporeal orthotopic ileal neobladder: description and outcomes of a simple step

A posterior reconstruction (PR) might improve the fluidity and delicacy of the maneuvers related to the neovesico-urethral anastomosis during robotic-assisted radical cystectomy (RARC). Our objective is to describe in detail the surgical steps of PR and to assess its feasibility and functional outcomes. The data regarding patients undergoing a totally intracorporeal RARC with neobladder and PR for high-grade and/or muscle-invasive urothelial cancer of the bladder at Karolinska University Hospital between October 2015 and November 2016 by a single surgeon (PW) were reviewed. Prior to the anastomosis, a modified posterior Rocco’s repair involving the Denonvillier’s fascia, the rhabdosphincter, and the posterior side of the ileal neobladder neck was performed. The steps are shown in a video at https://doi.org/10.1089/vid.2019.0029. The primary outcome was urinary continence; the secondary outcomes were urinary leakage, intermittent catheterization, and complications related to the reconstructive steps. Eleven male patients with a median age and BMI of 67 years and 24, respectively, underwent RARC with PR associated to the neovesico-urethral anastomosis. Overall and posterior reconstruction time were 300′ (195–320) and 6′ (4–7), respectively. The daytime and nighttime continence rates were 100% and 44% at 12 months, respectively; the median pad weight was 3.5 g and 108 g at daytime and nighttime, respectively. One urinary leakage from the urethrovesical anastomosis was treated conservatively. Two patients perform intermittent catheterization. The posterior reconstruction during RARC is safe and feasible, providing good continence rates. It supported a careful suturing of the anastomosis as well as an uncomplicated catheter placement