Case report of a familial triple: a syndrome and review of the literature

n/

Preoperative Fibrinogen-to-Albumin Ratio as Potential Predictor of Bladder Cancer: A Monocentric Retrospective Study

: Background and objective: Fibrinogen and albumin are two proteins widely used, singularly and in combination, in cancer patients as biomarkers of nutritional status, inflammation and disease prognosis. The aim of our study was to investigate the preoperative fibrinogen-to-albumin ratio (FAR) as a preoperative predictor of malignancy as well as advanced grade in patients with bladder cancer. Materials and Methods: A retrospective analysis of patients who underwent TURBT at our institution between 2017 and 2021 was conducted. FAR was obtained from preoperative venous blood samples performed within 30 days from scheduled surgery and was analyzed in relation to histopathological reports, as was the presence of malignancy. Statistical analysis was performed using a Kruskal−Wallis Test, and univariate and multivariate logistic regression analysis, assuming p < 0.05 to be statistically significant. Results: A total of 510 patients were included in the study (81% male, 19% female), with a mean age of 71.66 ± 11.64 years. The mean FAR was significantly higher in patients with low-grade and high-grade bladder cancer, with values of 80.71 ± 23.15 and 84.93 ± 29.96, respectively, compared to patients without cancer (75.50 ± 24.81) (p = 0.006). Univariate regression analysis reported FAR to be irrelevant when considered as a continuous variable (OR = 1.013, 95% CI = 1.004−1.022; p = 0.004), while when considered as a categorical variable, utilizing a cut-off set at 76, OR was 2.062 (95% CI = 1.378−3.084; p < 0.0001). Nevertheless, the data were not confirmed in the multivariate analysis. Conclusions: Elevated preoperative FAR is a potential predictor of malignancy as well as advanced grade in patients with bladder cancer. Further data are required to suggest a promising role of the fibrinogen-to-albumin ratio as a diagnostic biomarker for bladder tumors

Debito e dono

The analysis of the concept of the gift implies the analysis of the concept of debt. In the context of our post-global age, an age in which the grands récits which Jean François Lyotard spoke about in the ‘70’s are anything but extinct and now simply hidden or inscribed in the language and order of our society, they work intensely to reify social relations, and it is debt that has taken on a primary role in the construction of the world

Mobile health applications in kidney stone disease management: A reliable support for patients?

Introduction: Mobile health applications (MHAs) represent an interesting issue to assist and improve the quality of life of patients affected by Kidney Stone Disease (KSD). Despite this, their scientific quality and adherence to guidelines are not yet addressed.Material and methods: On 2 November 2022, we conducted an observational cross-sectional descriptive study of all MHAs on KSD. A search in the Apple App Store and Google Play Store was performed. We reviewed all mobile apps from Apple App Store and Google Play Store for KSD and evaluated their usage in screening, prevention, management, and adherence to EAU guidelines.Results: In total 13 MHA were included in the final analysis. All MHAs, 4 (30.8%) from the Apple App Store and 9 (69.2%) from the Google Play Store are geared towards the patient. Engagement ranged from 1.73 to 4.06; Functionality ranged from 3.17 to 4.75; Aesthetics ranged from 1.9 to 4.12; Information ranged from 2.25 to 4.27, and Subjective quality ranged from 1.58 to 3.23. MHAs reported low and medium adherence to EAU guidelines.Conclusions: MHAs provide a very useful assistance in several medical fields, including KSD. Despite MHAs development is constantly increasing, the scientific validation, content, and quality are not yet solved. Future research is necessary to improve the quality of the apps and promote new user designed, and high-quality apps

Clinical anatomic, immunomorphologic and molecular anatomic data suggest interplay of thyroidal molecules, autoantibodies and Hsp60 in Hashimoto’s disease

Hsp60 is, typically, a mitochondrial protein, but it also occurs in the cytosol, vesicles, and plasma membrane, and in the intercellular space and biological fluids, e.g., blood. Changes in the levels and distribution of Hsp60 are linked to several pathologies, including cancer and chronic inflammatory and autoimmune disorders. What is the histopathological pattern of Hsp60 in the thyroid of Hashimoto’s patients? Are there indications of a pathogenic role of Hsp60 that may make Hashimoto’s thyroiditis a chaperonopathy? Experiments reported here provide information regarding those questions. We found by various immunomorphological techniques increased levels of Hsp60 in the thyroid from HT patients, localized to thyrocytes of small and degenerated follicles and to oncocytes (Hurtle cells). Immunofluorescence showed the chaperonin both inside the cells and also in the plasma membrane, especially in oncocytes. We also found that Hsp60 levels in the blood of HT patients were increased compared to controls and correlated with those of autoantibodies against two distinctive thyroidal proteins, thyroglobulin (TG) and thyroid peroxidase (TPO) (r=0.379, p=0.0103; r=0.484, p=0.0008; respectively). Molecular analysis of these two proteins in comparison with Hsp60 demonstrated various regions of high structural similarity shared by them, which could very well be immunologically crossreactive epitopes. Thus, it is likely that the three proteins potentiate each other as immunogens to elicit autoantibodies and, as antigens, to cause antigen-antibody reactions at those sites in which Hsp60 is exposed, for example the surface of oncocytes. This would lead to inflammation and oncocyte lysis with destruction of thyroidal tissue. The cytometric bead assay revealed that recombinant Hsp60 did not induce increment of cytokine production by peripheral blood mononuclear cells from HT patients. Consequently, we propose that Hsp60 is implicated in the pathogenesis of Hashimoto’s thyroiditis as autoantigen, via a participation of autoantibodies that also recognize TG and TPO, whereas participation of inflammatory cytokines induced by the chaperonin is unlikely. Supported by IEMEST (FC and AJLM)

Chronic constipation diagnosis and treatment evaluation: The "CHRO.CO.DI.T.E." study

Background: According to Rome criteria, chronic constipation (CC) includes functional constipation (FC) and irritable bowel syndrome with constipation (IBS-C). Some patients do not meet these criteria (No Rome Constipation, NRC). The aim of the study was is to evaluate the various clinical presentation and management of FC, IBS-C and NRC in Italy. Methods: During a 2-month period, 52 Italian gastroenterologists recorded clinical data of FC, IBS-C and NRC patients, using Bristol scale, PAC-SYM and PAC-QoL questionnaires. In addition, gastroenterologists were also asked to record whether the patients were clinically assessed for CC for the first time or were in follow up. Diagnostic tests and prescribed therapies were also recorded. Results: Eight hundred seventy-eight consecutive CC patients (706 F) were enrolled (FC 62.5%, IBS-C 31.3%, NRC 6.2%). PAC-SYM and PAC-QoL scores were higher in IBS-C than in FC and NRC. 49.5% were at their first gastroenterological evaluation for CC. In 48.5% CC duration was longer than 10 years. A specialist consultation was requested in 31.6%, more frequently in IBS-C than in NRC. Digital rectal examination was performed in only 56.4%. Diagnostic tests were prescribed to 80.0%. Faecal calprotectin, thyroid tests, celiac serology, breath tests were more frequently suggested in IBS-C and anorectal manometry in FC. More than 90% had at least one treatment suggested on chronic constipation, most frequently dietary changes, macrogol and fibers. Antispasmodics and psychotherapy were more frequently prescribed in IBS-C, prucalopride and pelvic floor rehabilitation in FC. Conclusions: Patients with IBS-C reported more severe symptoms and worse quality of life than FC and NRC. Digital rectal examination was often not performed but at least one diagnostic test was prescribed to most patients. Colonoscopy and blood tests were the "first line" diagnostic tools. Macrogol was the most prescribed laxative, and prucalopride and pelvic floor rehabilitation represented a "second line" approach. Diagnostic tests and prescribed therapies increased by increasing CC severity

Luigi Settembrini. Periodico letterario educativo mensile. A. 2, n.1(1892)-A. 3, n.10(1894)

A.2, n.1(nov.1892): G. Olivieri, Ad Antonio Bartolini, P. 1-2 ; G. Olivieri, Prospero Viani, P. 2-11; R. Sabbatini, Ancora Quom o Quum?, P. 11-2 ; Pensieri del Settembrini, P. 12-3 ; E. Perito, Ad nubem, P. 13; F. Lagrance, Dell’educazione fisica, p. 14-15 ; Cronaca dell’Istituto L. Settembrini, P. 15-6.A. 2, n. 2(dic. 1892): G. Lanzalone, La morale nell’arte, P. 17-23 ; B. ( dal Bibliografo), Per i libri di testo nelle scuole elementari, P. 23-5 ; V. Notari, In Gutembergium artis typograficae inventorem, P. 25; Progressi della navigazione aerea, P. 26-8 ; Pensieri del Settembrini, P. 28-9 ; Il nostro concorso, P. 29 ; G. Lanzalone, La prima pioggia d’autunno, P. 30-1A. 2, n.3(gen. 1893): Bonghi, Una lettera del Bonghi, P. 33-4 ; G. Lanzalone, Ancora della morale nell’arte, P. 34-8 ; Pensieri del Settembrini, P. 38-9 ; C. Arlìa, Buon dì e tre anguille, P. 39-41 ; G. Lanzalone , All’amico G. Olivieri , P. 42-3 ; P. Lioy, Bagni e villeggiature, P. 43-5.A. 2, n. 4(feb. 1893): C. A. Alemagna, Per la morale nell’arte, P. 49-55.A. 2, n. 5(mar. 1893): R. Sabbatini, L’epistola di Saffo a Faone, P. 65-6 ; G. Lanzalone, Il drammaturgo(caricatura), P. 66-7 ; G. Lanzalone, Ancora per la morale dell’arte, P. 67-70 ; F. De Falco, Un’altra lettera!, P. 71-2 ; Il Settembrini, Per una petizione al Parlamento, P. 72; E. Perito, A mia sorella morta, P. 73-4.A. 2, n.6(apr. 1893): Il Settembrini, Petizione al Parlamento, P. 81-3 ; C. Arlia, Noterelle filologiche, P. 84-5 ; G. Bigoni, Ricordi Picentini (2 sonetti), P. 85 ; C. A. Alemagna, Lettera con annotazioni, P. 86-90 ; V. Caputo, Il giuramento, P. 90-1 ; A. Buscaino Campo, Il piè fermo di Dante, P. 92-3.A.2, n.7(apr. 1893): G. Lanzalone, Professori e maestri, P. 97-9 ; il Settembrini, Petizione al Parlamento, P. 100-2 ; Lista delle adesioni, P. 102-4 ; Guido Bigoni, Domenica Rusticana, P. 105 ; Pensieri del Settembrini, P. 105-7 ; Dal Gazzettino d’oro, Utili varietà, P. 107-8 ; G. Lanzalone, Al maggiore Vincenzo Notari, P. 108 ; V. Notarius, Risposta, P. 109 ; F. Accinelli, La poesia della vita, P. 109-10.A. 2, n.8(giu. 1893): C. Arlìa, Noterelle filologiche, P. 113-16 ; Guido Bigoni, La quercia del Tasso, P. 116 ; G. Lanzalone, La ginnastica con la neve, P. 116-17 ; Luigi Settembrini, Una lettera inedita di L. Settembrini, P. 118-19 ; V. Notaro, In Ariostum, P. 119 ; L’arte di respirare, P. 120-21 ; F. De Falco, Il suicidio e la religione, P. 122-24.A.2, n.9/10(lug.-ago. 1893): R. Mariano, Ad un banchetto nunziale, P. 129-132 ; G. Lanzalone, A Cristoforo Colombo, P. 132-34 ; C. Arlìa, Note filologiche, P. 135-36 ; G. Olivieri, Il terzo libro della vita di G. Cristo, P. 136-39 ; F. Persico, La pace, P. 140-41 ; L. A. Villari, Cesare Dalbono, P. 141-45.A.2, n.11/12(sett.-ott. 1893): Luigi Settembrini, Una lettera inedita di L. Settembrini, P. 153-54 ; A. De Leo, Vite di illustri salernitani, P. 154-62 ; G. Franciosi, I sogni, P. 162-63 ; A. Frabasile, Bozzetti ellenici, P. 164-70 ; L. A. Villari , Errori Giudiziari, P. 171-75 ; G. Lanzalone, Verismo, P. 175-76.A.3,n.1/2 (nov.-dic. 1893): M. Giordano, La pubblica educazione e l’ateismo, P. 1-4 ; il Settembrini, Concorso, P. 4 ; Per una forca conservata in un museo, P. 5 ; G. Lanzalone, L’Ora presente, P. 5 ; C. Mariano Pilar, Silvio Spaventa, P. 6-19 ; C. Arlìa, Note filologiche, P. 20-1 ; G. Grammatica, Ideale, P. 22 ; G. Olivieri, Funesta rimembranza, P. 31-2 ; G. Olivieri, La notte della vigilia del Natale, P. 32.A.3, n.3/4(gen.-feb. 1894): G. Lanzalone, E la nostra petizione?, P. 33-5 ; Dall’albo di Luigi Antonio Villari, P. 36 ; G. Olivieri, Una visita inaspettata, P. 37-46 ; A. Frabasile, Alla signora G. P., P. 47 ; M. Giordano, Il Governo, i Municipi e l’istruzione religiosa, P. 48-53 ; G. Lanzalone, Esercizi militari, P. 53 ; C. Arlìa, Note filologiche, P. 54 ; G. Lanzalone, Un dubbio proposto al prof. Sabbadini, P. 54-5 ; G. L., Risultato del passato concorso e concorso nuovo, P. 55-6 ; R. Galdi, Epistola di Catullo ad Ortalo, P. 57.A.3, n.5/6(mar-apr 1894): G. Lanzalone, Dell’educazione nelle scuole classiche, P. 65-70 ; G. L., Un epigramma di Leone XIII, P. 70-1 ; V. Caputo, Vita di borso, P. 72-6 ; C. Arlìa, Note filologiche, P. 76-7 ; G. Lanzalone, Amore, P. 78 ; Aniello Gaeta, Dulcissime Rerum, P. 79-81 ; Francesco De Falco, La duchessa Ravaschieri e il dormitorio, P. 81-2 ; Carmine Zottoli, Risultato del passato concorso e concorso nuovo, P. 82-6.A.3, n. 7/8(mag. – giu 1894): C. Arlìa, Note filologiche, P. 97-8 ; G. Lanzalone, Per il 1°Maggio, P. 98-101 ; M. Giordano, La libertà d’insegnamento e di coscienza, P. 101-10 ; L. A. Villari, Il capitano Tim- Tim, P. 111- 15 ; C. A. Alemagna, L’opera recente di Herbert Spencer, P. 115-16 ; Nicc. Castagna, Sospiro, P. 116 ; G. Cuomo, Sovra un passo del carme “I Sepolcri”, P. 117-20.A.3, n.9(lug. 1894): Concorso nuovo, P. 125 ; C. Arlìa, Note filologiche, P. 126-27 ; Il manicomio dei genii, P. 127 ; G. Lanzalone, Elena, P. 128 ; Giovanni Cuomo, Nunzio del giorno, P. 128-29 ; Giovanni Manfredi, Ofelia, P. 129 ; G. Lanzalone, Da Anacreonte, P. 139.A.3, n.10(ago. 1894): R. Sabbadini, L’anno della nascita di Gasparino Barziza, P. 141-42 ; G. Lanzalone, Il Discredito dei versi, P. 142-46 ; C. Arlìa, Note filologiche, P. 147-48 ; E. Perito, L’ultima rosa d’estate, P. 148 ; D’Aloja, L’arte e la critica, P. 149-51 ; Epigrammi, P. 151-52

An integrated assessment of the Good Environmental Status of Mediterranean Marine Protected Areas

Este artículo contiene 11 páginas, 2 figuras, 2 tablas.Local, regional and global targets have been set to halt marine biodiversity loss. Europe has set its own policy targets to achieve Good Environmental Status (GES) of marine ecosystems by implementing the Marine Strategy Framework Directive (MSFD) across member states. We combined an extensive dataset across five Mediterranean ecoregions including 26 Marine Protected Areas (MPAs), their reference unprotected areas, and a no-trawl case study. Our aim was to assess if MPAs reach GES, if their effects are local or can be detected at ecoregion level or up to a Mediterranean scale, and which are the ecosystem components driving GES achievement. This was undertaken by using the analytical tool NEAT (Nested Environmental status Assessment Tool), which allows an integrated assessment of the status of marine systems. We adopted an ecosystem approach by integrating data from several ecosystem components: the seagrass Posidonia oceanica, macroalgae, sea urchins and fish. Thresholds to define the GES were set by dedicated workshops and literature review. In the Western Mediterranean, most MPAs are in good/high status, with P. oceanica and fish driving this result within MPAs. However, GES is achieved only at a local level, and the Mediterranean Sea, as a whole, results in a moderate environmental status. Macroalgal forests are overall in bad condition, confirming their status at risk. The results are significantly affected by the assumption that discrete observations over small spatial scales are representative of the total extension investigated. This calls for large-scale, dedicated assessments to realistically detect environmental status changes under different conditions. Understanding MPAs effectiveness in reaching GES is crucial to assess their role as sentinel observatories of marine systems. MPAs and trawling bans can locally contribute to the attainment of GES and to the fulfillment of the MSFD objectives. Building confidence in setting thresholds between GES and non-GES, investing in long-term monitoring, increasing the spatial extent of sampling areas, rethinking and broadening the scope of complementary tools of protection (e.g., Natura 2000 Sites), are indicated as solutions to ameliorate the status of the basin.This article was undertaken within the COST Action 15121 MarCons (http://www.marcons-cost.eu, European Cooperation in Science and Technology), the Interreg MED AMAre Plus (Ref: 8022) and the project PO FEAMP 2014-2020 Innovazione, sviluppo e sostenibilita ` nel settore della pesca e dell’acquacoltura per la Regione Campania (ISSPA 2.51). M.C.U., A.B. have been funded by the project MEDREGION (European Commission DG ENV/MSFD, 2018 call, Grant Agreement 110661/ 2018/794286/SUB/ENV.C2). Aegean Sea data were retrieved from the project PROTOMEDEA (www.protomedea.eu), funded by DG for Marine Affairs and Fisheries of the EC, under Grant Agreement SI2.721917. JB acknowledges support from the Spanish Ministry of Science and Innovation (Juan de la Cierva fellowship FJC 2018-035566-I).With the institutional support of the ‘Severo Ochoa Centre of Excellence’ accreditation (CEX2019-000928-S).Peer reviewe

Influence of Antisynthetase Antibodies Specificities on Antisynthetase Syndrome Clinical Spectrum TimeCourse

Introduction: Increased cardiovascular (CV) morbidity and mortality is observed in inflammatory joint diseases (IJDs) such as rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis. However, the management of CV disease in these conditions is far from being well established.Areas covered: This review summarizes the main epidemiologic, pathophysiological, and clinical risk factors of CV disease associated with IJDs. Less common aspects on early diagnosis and risk stratification of the CV disease in these conditions are also discussed. In Europe, the most commonly used risk algorithm in patients with IJDs is the modified SCORE index based on the revised recommendations proposed by the EULAR task force in 2017.Expert opinion: Early identification of IJD patients at high risk of CV disease is essential. It should include the use of complementary noninvasive imaging techniques. A multidisciplinary approach aimed to improve heart-healthy habits, including strict control of classic CV risk factors is crucial. Adequate management of the underlying IJD is also of main importance since the reduction of disease activity decreases the risk of CV events. Non-steroidal anti-inflammatory drugs may have a lesser harmful effect in IJD than in the general population, due to their anti-inflammatory effects along with other potential beneficial effects.This research was partially funded by FOREUM—Foundation for Research in Rheumatolog

Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements