Occurrence and molecular prevalence of Anaplasmataceae , Rickettsiaceae and Coxiellaceae in African wildlife : a systematic review and meta-analysis

SUPPLEMENTARY MATERIAL : TABLE S1: PRISMA statement checklist; TABLE S2: PRISMA checklist for abstracts; TABLE S3: additional checklist for systematic reviews and meta-analyses retrieved from Migliavaca et al., 2020; TABLE S4: critical appraisal of included studies; TABLE S5: detailed summary of Anaplasmataceae, Rickettsiaceae and Coxiellaceae detected in African wildlife stratified by country and detection method; TABLE S6: results of the analysis of publication bias; TABLE S7: List of papers excluded during full-text examination and relevant exclusion criteriaINTRODUCTION : Tick-borne pathogens (TBPs) constitute an emerging threat to public and animal health especially in the African continent, where land-use change, and wildlife loss are creating new opportunities for disease transmission. A review of TBPs with a focus on ticks determined the epidemiology of Rhipicephalus ticks in heartwater and the affinity of each Rickettsia species for different tick genera. We conducted a systematic review and meta-analysis to collect, map and estimate the molecular prevalence of Anaplasmataceae, Rickettsiaceae and Coxiellaceae in African wildlife. MATERIALS AND METHODS : Relevant scientific articles were retrieved from five databases: PubMed, ScienceDirect, Scopus, Ovid and OAIster. Publications were selected according to pre-determined exclusion criteria and evaluated for risk of bias using the appraisal tool for cross-sectional studies (AXIS). We conducted an initial descriptive analysis followed by a meta-analysis to estimate the molecular prevalence of each pathogen. Subgroup analysis and meta-regression models were employed to unravel associations with disease determinants. Finally, the quality of evidence of every estimate was finally assessed. RESULTS : Out of 577 retrieved papers, a total of 41 papers were included in the qualitative analysis and 27 in the meta-analysis. We retrieved 21 Anaplasmataceae species, six Rickettsiaceae species and Coxiella burnetii. Meta-analysis was performed for a total of 11 target pathogens. Anaplasma marginale, Ehrlichia ruminantium and Anaplasma centrale were the most prevalent in African bovids (13.9 %, CI: 0–52.4 %; 20.9 %, CI: 4.1–46.2 %; 13.9 %, CI: 0–68.7 %, respectively). Estimated TBPs prevalences were further stratified per animal order, family, species and sampling country. DISCUSSION : We discussed the presence of a sylvatic cycle for A. marginale and E. ruminantium in wild African bovids, the need to investigate A. phagocytophilum in African rodents and non-human primates as well as E. canis in the tissues of wild carnivores, and a lack of data and characterization of Rickettsia species and C. burnetii. CONCLUSION : Given the lack of epidemiological data on wildlife diseases, the current work can serve as a starting point for future epidemiological and/or experimental studies.http://www.elsevier.com/locate/prevetmedhj2024Centre for Veterinary Wildlife StudiesProduction Animal StudiesVeterinary Tropical DiseasesSDG-03:Good heatlh and well-beingSDG-15:Life on lan

Robotic colectomy : is it necessary?

Sin dalla sua introduzione, ormai da oltre 20 anni, la chirurgia laparoscopica ha portato a un cambiamento paradigmatico nel trattamento chirurgico del tumore del colon retto. Pi\uf9 recentemente la chirurgia robotica \ue8 divenuta una valida alternativa alla chirurgia open e laparoscopica. I vantaggi pi\uf9 evidenti della chirurgia robotica rispetto alla laparoscopica sono principalmente riconducibili alla minore incidenza di conversione e alla pi\uf9 veloce curva di apprendimento. Tuttavia il ruolo della chirurgia robotica nella patologia colo-rettale non \ue8 ancora ben definito ed \ue8 diverso in relazione alla sua applicazione nella chirurgia colica rispetto a quella rettale. Per quanto riguarda il carcinoma del colon dai dati pi\uf9 recenti in letteratura emerge che la chirurgia robotica e quella laparoscopica hanno gli stessi vantaggi in termini di tempi di recupero funzionale del paziente, sebbene la chirurgia robotica presenti costi di cura pi\uf9 elevati a parit\ue0 di morbilit\ue0 e degenza postoperatoria. Per quanto riguarda i risultati a lungo termine un confronto fra chirurgia colica laparoscopica vs robotica ad oggi non \ue8 mai stato oggetto di studio. Tematiche interessanti per la didattica si associano alla chirurgia robotica laddove la doppia console pu\uf2 consentire al medico in formazione di partecipare attivamente alla procedura chirurgica sin dall\u2019inizio della sua esperienza in sala operatoria.More than 20 years ago the introduction of laparoscopic surgery represented a paradigm shift in the management of colorectal cancer. In most recent years robotic surgery is becoming a viable alternative to laparoscopic and traditional open surgery. The major clear advantages of robotic surgery in comparison with laparoscopy are the lower conversion to open surgery rates and the shorter learning curve. However, the role of robotics in colorectal surgery is still largely undefined and different with respect to its application in abdominal versus pelvic surgery. As for colon cancer there are emerging data that laparoscopic and robotic surgery have the same advantages in terms of faster recovery, although robotic-assisted colectomy is associated with costs increase of care without providing clear reduction in overall morbidity or length of stay. Long-term outcomes for laparoscopic versus robotic colonic resections remain still largely undetermined and randomized controlled clinical trials are required to establish a possible difference in outcomes. Interesting issues for the educational aspects are associated with robotic surgery, as the double console allows the resident to take part actively at the surgical procedure since the beginning of his surgical experience

Maternal-infant transmission of HCV infection

To determine the incidence of HCV infection among infants born to mother at risk, we tested for HCV antibody 28 anti-HIV positive and 6 anti-HIV negative IVDU mothers (all without clinical evidence of liver disease) and their children followed for at least 8 months and up to 24 months after birth. HCV antibody was detected in 10 of 28 infants born to anti-HIV positive and in 3 of 6 infants born to anti-HIV negative mothers. Maternal HCV antibodies were lost within 3-6 months of age; however, in 3 children HCV antibody levels raised since the sixth month, and they were infected also with HIV showing signs and symptoms of immunodeficiency. In one of this ALT elevations were seen since 21 days after birth (456 U/l) with peaks at 4 and 6 months. Our data could favour the view that the infection of mothers by HIV had the potential for enhancing the risk of transmission of HCV to their newborns

Role of robotic surgery in colorectal resections for cancer

Negli ultimi anni, la chirurgia robotica \ue8 divenuta una valida alternativa nel trattamento delle patologie colorettali rispetto alla tradizionale chirurgia a cielo aperto e alla chirurgia laparoscopica. I vantaggi tecnici pi\uf9 rilevanti della chirurgia robotica sono la visuale tridimensionale, la filtrazione del tremore, sette gradi di libert\ue0 di movimento e una posizione pi\uf9 elevata e confortevole per il chirurgo. Sia le serie di casi sia gli studi comparativi presenti nella letteratura riportano solo esiti a breve e medio termine. Per quanto concerne gli esiti perioperatori, tali studi sono in grado di dimostrare come la chirurgia robotica sia altrettanto sicura e fattibile della chirurgia laparoscopica. \uc8 necessario condurre studi con follow-up a lungo termine per stabilire la reale sicurezza ed efficacia della chirurgia robotica, soprattutto per quanto concerne le resezioni per cancro. La chirurgia robotica pu\uf2 essere considerata un settore chirurgico promettente. L\u2019elevato costo rappresenta tuttavia uno degli svantaggi principali.In recent years, robotic surgery is becoming a valid alternative in colorectal diseases treatment to laparoscopic and traditional open surgery. The most relevant reported technical advantages of the robotic surgery are 3D-view, tremor-filtering, seven degree-free motion and a higher comfortable setting for the surgeon. Both case series and comparative studies available in Literature report only short and mid-term outcomes. These studies are able to demonstrate that robotic surgery is as safe and feasible as laparoscopic surgery regarding perioperative outcomes. Trials with long term follow up are needed to establish the real safety and effectiveness of the robotic surgery especially concerning resections for cancer. The robotic surgery could be considered a promising surgical field. The high costs represent one of the most relevant drawback

Tuning adipogenic differentiation in adscs by metformin and vitamin d: Involvement of mirnas

Fat tissue represents an important source of adipose-derived stem cells (ADSCs), which can differentiate towards several phenotypes under certain stimuli. Definite molecules as vitamin D are able to influence stem cell fate, acting on the expression of specific genes. In addition, miRNAs are important modulating factors in obesity and numerous diseases. We previously identified specific conditioned media able to commit stem cells towards defined cellular phenotypes. In the present paper, we aimed at evaluating the role of metformin on ADSCs differentiation. In particular, ADSCs were cultured in a specific adipogenic conditioned medium (MD), in the presence of metformin, alone or in combination with vitamin D. Our results showed that the combination of the two compounds is able to counteract the appearance of an adipogenic phenotype, indicating a feedforward regulation on vitamin D metabolism by metformin, acting on CYP27B1 and CYP3A4. We then evaluated the role of specific epigenetic modulating genes and miRNAs in controlling stem cell adipogenesis. The combination of the two molecules was able to influence stem cell fate, by modulating the adipogenic phenotype, suggesting their possible application in clinical practice in counteracting uncontrolled lipogenesis and obesity-related diseases

Nonfunctional paraganglioma of the head of the pancreas: A rare case report

Background: Paragangliomas are rare neoplasms that originate from the neural crest. They are malignant in approximately 10% of cases, with a 50% survival rate at 5 years from diagnosis. In most cases, manifestations of malignancy (such as metastasis) are lacking, and paragangliomas are considered benign lesions. Pancreatic paragangliomas are extremely rare, with only 31 cases described in the scientific literature to date. Case summary: Here we describe a case of a 55-year-old Caucasian male patient referred to our institution in September 2013 for lumbar pain lasting five months. The ultrasound and the CT scan revealed a 2.5 cm solid nodule located in the uncinate process of the pancreas. On the basis of this evidence, the preoperative diagnosis was a pancreatic neuroendocrine tumor (NET), which was further confirmed by a subsequent In-Pentetreotide Scan examination. A pylorus-preserving duodenocephalopancreasectomy was performed. Pancreatic paraganglioma was the final pathological diagnosis. Rare localizations of paraganglioma are often discovered casually, during imaging examinations for other clinical reasons, as happened in the case of our patient. It appears evident that the preoperative diagnosis of pancreatic paragangliomas is extremely challenging. Surgery represents the cornerstone of the clinical management of these neoplasms, primarily for the need of a definitive diagnosis, which is difficult to assess preoperatively in most cases. Conclusions: Our strategy is the same as that adopted for the management of pancreatic NETs; the dimensional limit for a conservative resection is 2 cm, while major resections (Whipple’s approach or distal pancreatectomy) should be employed in larger tumors, which are generally associated with a worse prognosis

Factors predicting worse prognosis in patients affected by pT3 N0 colon cancer : long-term results of a monocentric series of 137 radically resected patients in a 5-year period

BACKGROUND AND PURPOSE: For patients with stage II colon cancer, the use of adjuvant chemotherapy remains controversial. The purpose of this study was to identify clinical and/or pathological findings related to a worse prognosis in this category of patients. PATIENTS AND METHODS: We retrospectively analyzed the data of consecutive patients, extracted by an institutional tumor registry, admitted to an affiliated university hospital in Milan (European Institute of Oncology) for adenocarcinoma of the colon (all sites), between 2000 and 2005, and having a final pT3 N0 pathology staging after curative surgery. Adjuvant chemotherapy was decided as a result of a medical decision within a multidisciplinary tumor board. RESULTS: Data of 137 patients were obtained, with a median follow-up of 77 months (range 6-131). Patients who received chemotherapy were younger than patients who did not. Nine patients out of 137 (6.5 %) died as a consequence of colon cancer recurrence; four of them had received adjuvant chemotherapy. Only histological grade III and mucinous histotype were found to impact on cumulative incidence of colon-related events (p\u2009=\u20090.03 and 0.02, respectively); no impact was found on cumulative incidence of colonic neoplasm recurrence-related deaths (p\u2009=\u20090.74 and 0.74, respectively). Number of analyzed lymph nodes (LNs) emerged as a factor possibly affecting the cumulative incidence of colon-related events (p\u2009=\u20090.09) as well as the cumulative incidence of colonic neoplasm recurrence-related deaths (p\u2009=\u20090.10). The risk of events was inversely proportional to the number of dissected LNs, even over 20 up to about 25 LNs. Never smokers exhibited a lower incidence of colon-related events, although the difference was not statistically significant (p\u2009=\u20090.09). All other analyzed variables did not show any impact on survival rate, including age, gender, ASA score, body mass index, site of colonic neoplasm, multifocality, perivascular invasion, and use of adjuvant chemotherapy. CONCLUSIONS: Histology grading G3 and mucinous histotype were predictors of worse outcome. Efforts to improve LN evaluation should result in clinically significant improvements in outcome and also the quality of care for patients with radically resected stage II colon cancer

Aggressive Surgical Approach for Treatment of Primary and Recurrent Retroperitoneal Soft Tissue Sarcoma

To analyze treatment and survival in a series of resected patients with primary or recurrent retroperitoneal sarcoma (RPS) treated and prospectively followed at a single institution. Between July 1994 and December 2015, 89 patients (36 M, 53 F; mean age 60\ua0years, range 25\u201379) were evaluated. For the purpose of analysis, complete resection was defined as removal of gross tumor with histologically confirmed clear resection margins. Eighty-three out of the 89 patients (93%), 46 of whom affected by primary RPS, and 37 by recurrent RPS, underwent surgical exploration. Sixty-two had a grossly and microscopically complete resection. Fifty-three out of 83 patients (64%) underwent removal of contiguous intra-abdominal organs. Preoperative mortality was nil and significant preoperative complications occurred in six cases only (7%). High-grade tumor pointed out to be a significant variable for a worse survival in all 83 patients amenable to undergo surgical resection (57% 5\ua0years survival for low grade vs 14% for high grade; P = 0.0004). Among completely resected patients, only histologic grade clearly affected disease-free survival (72% 5\ua0years survival for low grade vs 50% for high grade; P = 0.04), while the role of preoperative blood transfusions (67% 5\ua0years survival for non-transfused patients vs 29% for transfused patients; P = 0.05) has to be evaluated in connection to patient complexity. Histological grade and recurrence are the most valuable prognostic predictors; in this clinical subset, an aggressive surgical approach in both primary and recurrent RPS is associated with a best long-term survival and disease-free survival