Molecular analysis of appendiceal mucinous cystadenoma and rectal adenocarcinoma in a patient with urothelial carcinoma: a case report

Introduction: In this report, we present the case of a patient affected by appendiceal cystadenoma, a colorectal adenocarcinoma, and a concomitant bladder carcinoma, as well as the results of the molecular study of the most relevant mutational pathways involved in these tumors. Case presentation: A 68-year-old Italian man was admitted to our unit complaining of macrohematuria, rectorrhagia, and rectal tenesmus for about 2 months. A colonoscopy showed the presence of a rectal lesion at 11cm from the anal margin; multiple biopsies were performed and a diagnosis of moderately differentiated adenocarcinoma was made. Abdominal ultrasonography and total body computed tomography performed subsequently to stage the rectal cancer showed the presence of two round nodules, interpreted as swollen lymph nodes of neoplastic origin, at the anterior aspect of the iliopsoas muscle and a budding lesion affecting the bladder. The patient underwent transurethral biopsy of the lesion in the right retrotrigonal region; the diagnosis was grade II urothelial carcinoma. The patient underwent an open anterior rectal resection with loco-regional lymphadenectomy. An enlarged appendix and a voluminous whitish soft-tissue lesion requiring an appendicectomy were detected perioperatively. Transurethral resection of the bladder lesion was also performed. The histological examination revealed that the nodular lesions in the appendix were due to a cystadenoma. For mutation analysis, genomic deoxyribonucleic acid was isolated from tumor tissue samples; for PIK3CA mutations, screening revealed that all three samples analyzed carried mutations in exon 9. Conclusions: Appendiceal mucoceles are rare but require adequate surgical treatment, given their malignant potential and the possibility of causing peritoneal pseudomyxoma. It is essential to make a correct preoperative evaluation based on a colonoscopy rather than ultrasound and computed tomography to exclude synchronous neoplasias often associated with mucoceles and to plan the optimum surgical strategy. The association between appendiceal mucoceles and other neoplasias is relatively frequent, especially with colorectal cancer. Oncogenic activation in the PIK3CA-depending pathway may contribute substantially to the pathogenesis of the different solid tumors in the same patient

Primary dermal melanoma in a patient with a history of multiple malignancies: a case report with molecular characterization

Introduction: Primary dermal melanoma (PDM) is a recently described clinical entity accounting for less than 1% of all melanomas. Histologically, it is located in the dermis or subcutaneous tissue, and it shows no connections with the overlying epidermis. The differential diagnosis is principally made along with that of metastatic cutaneous melanoma. Case Report: A 72-year-old Caucasian woman with a history of multiple cancers (metachro-nous bilateral breast cancer, meningioma, clear cell renal cell carcinoma, uterine fibromatosis and intestinal adenomatous polyposis), came to our attention with a nodular lesion on her back. After removal of the lesion, the histology report indicated malignant PDM or metastatic malignant melanoma. The clinical and instrumental evaluation of the patient did not reveal any other primary tumour, suggesting the primitive nature of the lesion. The absence of an epithelial component argued for a histological diagnosis of PDM. Subsequently, the patient underwent a wide surgical excision with sentinel node biopsy, which was positive for metastatic melanoma. Finally, the mutational status was studied in the main genes that regulate proliferation, apoptosis and cellular senescence. No pathogenetic mutations in CDKN2A, BRAF, NRAS, KRAS, cKIT, TP53 and PTEN genes were observed. This suggests that alternative pathways and low-frequency alterations may be involved. Conclusions: The differential diagnosis between PDM and isolated metastatic melanoma depends on the negativity of imaging studies and clinical findings for other primary lesions. This distinction is important because 5-year survival rates in such cases are higher than in metastatic cases (80– 100 vs. 5–20%, respectively)

Gut health of horses: effects of high fibre vs high starch diet on histological and morphometrical parameters

BACKGROUND: The conventional feeding management of horses is still characterized by high starch and low fibre diets, which can negatively affect horse’s gastrointestinal health. Thus, the aim of this study was to compare the effects of a high-starch (HS) vs. a high-fibre (HF) diet on gut health in horses. A total of 19 Bardigiano horses destined for slaughter and aged 14.3 ± 0.7 months were randomly allotted to two dietary groups: HS (5 fillies and 4 colts,) and HF group (7 fillies and 3 colts). They received the same first-cut meadow hay but different complementary feeds for 72 days: HS group was fed 8 kg/animal/day of a starch-rich complementary feed while HF group was fed 3.5 kg/animal/day of a fibre‐rich complementary feed. At slaughter, stomachs were separated and washed for the evaluation of the glandular and squamous regions. Also, duodenum, jejunum, ileum, apex of the caecum, sternal flexure, pelvic flexure, right dorsal colon, rectum and liver were excised and submitted to histomorphometrical evaluation. RESULTS: The glandular region of HS group presented more severe gastric mucosa lesions compared to the HF group (P = 0.006). Moreover, a statistical tendency (P = 0.060) was found for the squamous region, presenting a higher score in HS than HF diet. Regarding morphometry, in jejunum villus height to crypt depth (Cd) ratio was influenced by sex, being greater in males than in females (P = 0.037) while in ileum Cd depended on interaction between sex and diet, being greater in males of HS group (P = 0.029). Moreover, in the duodenum and right dorsal colon the severity of the inflammation depended on sex (P = 0.024 and 0.050), being greater in females than in males. On the contrary, in the jejunum and in the pelvic flexure, inflammation was influenced by diet, being more severe in HS than in HF group (P = 0.024 and 0.052). CONCLUSIONS: These results suggested that HS diet provoked more severe mucosa lesions in the glandular region of the stomach and a higher inflammation both in the jejunum and pelvic flexure. The present study can represent a starting point for further investigations on gut health in horses

EFFETTI DELLA SOMMINISTRAZIONE DI LARVE VIVE DI HERMETIA ILLUCENS SULLE PERFORMANCES DI CRESCITA E SULLA SALUTE INTESTINALE DI POLLI A COLLO NUDO IN ALLEVAMENTO BIOLOGICO

L’obiettivo di questa tesi è stato valutare l’effetto di una dieta contenente larve vive di Hermetia illucens nel pollo a collo nudo. In particolare ci si è concentrati sull’effetto che la dieta ha avuto sulle performances di crescita, sulle caratteristiche della carcassa e sulla salute intestinale, valutando morfologia intestinale ed espressione delle mucine. Si sono inoltre valutati il grado di infiammazione e di degenerazione dei principali organi detossificanti e linfoidi per valutare la riposta sistemica dei polli alla dieta. La dieta sperimentale, contenente il 10% sul tasso di ingestione giornaliero di larve vive, non ha influenzato le performances di crescita, le caratteristiche della carcassa, la morfologia della parete intestinale e l’espressione delle mucine. Al contrario, ha avuto effetti significativi sugli indici di conversione alimentare e sul peso degli organi linfoidi. In, particolare ha causato l’aumento di peso di milza e borsa di Fabrizio, dimostrando che gli insetti possono avere un effetto immunostimolante benefico per la salute del pollo grazie al loro contenuto di chitina. Inoltre, la presenza delle larve nella dieta ha migliorato la conversione in energia del mangime fino ai 28 giorni di età, dimostrandosi un valido sostituto proteico dall’alto valore biologico, soprattutto nel primo mese di vita. Infine la dieta sperimentale ha mantenuto le differenze di performances, caratteristiche della carcassa e morfologia intestinale tra i due sessi così come ha preservato il gradiente prossimodistale degli indici morfometrici. Il mantenimento di queste ben note differenze fisiologiche, dimostra l’idoneità della dieta. In conclusione, questi risultati confermano la possibilità di utilizzare le larve vive di Hermetia illucens al 10% del tasso di ingestione giornaliera nell’allevamento biologico di polli a collo nudo, rappresentando un potenziale strumento a favore dell’economia circolare, dell’ecosostenibilità e del benessere animale. Tuttavia ulteriori studi sono necessari per valutare l’influenza della razza avicola e del substrato utilizzato per la crescita delle larve sulle performances di crescita e sulla salute intestinale nonché per identificare la dose di chitina più adeguata per massimizzarne gli effetti benefici evitando, però, effetti deleteri sulla digeribilità dell’alimento. Ulteriori studi sugli effetti della somministrazione di larve vive di altre specie d’insetto come Tenebrio molitor o Musca domestica, potrebbero anche fornire dati interessanti circa il loro utilizzo nell’allevamento avicolo

EFFETTI DELLA SOMMINISTRAZIONE DI LARVE VIVE DI HERMETIA ILLUCENS SULLE PERFORMANCES DI CRESCITA E SULLA SALUTE INTESTINALE DI POLLI A COLLO NUDO IN ALLEVAMENTO BIOLOGICO

L’obiettivo di questa tesi è stato valutare l’effetto di una dieta contenente larve vive di Hermetia illucens nel pollo a collo nudo. In particolare ci si è concentrati sull’effetto che la dieta ha avuto sulle performances di crescita, sulle caratteristiche della carcassa e sulla salute intestinale, valutando morfologia intestinale ed espressione delle mucine. Si sono inoltre valutati il grado di infiammazione e di degenerazione dei principali organi detossificanti e linfoidi per valutare la riposta sistemica dei polli alla dieta. La dieta sperimentale, contenente il 10% sul tasso di ingestione giornaliero di larve vive, non ha influenzato le performances di crescita, le caratteristiche della carcassa, la morfologia della parete intestinale e l’espressione delle mucine. Al contrario, ha avuto effetti significativi sugli indici di conversione alimentare e sul peso degli organi linfoidi. In, particolare ha causato l’aumento di peso di milza e borsa di Fabrizio, dimostrando che gli insetti possono avere un effetto immunostimolante benefico per la salute del pollo grazie al loro contenuto di chitina. Inoltre, la presenza delle larve nella dieta ha migliorato la conversione in energia del mangime fino ai 28 giorni di età, dimostrandosi un valido sostituto proteico dall’alto valore biologico, soprattutto nel primo mese di vita. Infine la dieta sperimentale ha mantenuto le differenze di performances, caratteristiche della carcassa e morfologia intestinale tra i due sessi così come ha preservato il gradiente prossimodistale degli indici morfometrici. Il mantenimento di queste ben note differenze fisiologiche, dimostra l’idoneità della dieta. In conclusione, questi risultati confermano la possibilità di utilizzare le larve vive di Hermetia illucens al 10% del tasso di ingestione giornaliera nell’allevamento biologico di polli a collo nudo, rappresentando un potenziale strumento a favore dell’economia circolare, dell’ecosostenibilità e del benessere animale. Tuttavia ulteriori studi sono necessari per valutare l’influenza della razza avicola e del substrato utilizzato per la crescita delle larve sulle performances di crescita e sulla salute intestinale nonché per identificare la dose di chitina più adeguata per massimizzarne gli effetti benefici evitando, però, effetti deleteri sulla digeribilità dell’alimento. Ulteriori studi sugli effetti della somministrazione di larve vive di altre specie d’insetto come Tenebrio molitor o Musca domestica, potrebbero anche fornire dati interessanti circa il loro utilizzo nell’allevamento avicolo

To What Extent do Fiscal Regimes Equalize Opportunities for Income Acquisition Among Citizens?

This project employs the theory of equality of opportunity, described in Roemer's book (Equality of Opportunity, Harvard University Press, 1998), to compute the extent to which tax-and-transfer regimes in ten countries equalize opportunities among citizens for income acquisition. Roughly speaking, equality of opportunity for incomes has been achieved in a country when it is the case that the distributions of post-fisc income are the same for different types of citizen, where a citizen's type is defined by the socioeconomic status of his parents. Intuitively, a country will have equalized opportunity if the chances of earning high (or low) income are equal for citizens from all family backgrounds. Of course, pre-fisc income distributions, by type, will not be identical, as long as the educational system does not entirely make up for the disadvantage that children, who come from poor families face, but the tax-and-transfer system can play a role in rectifying that inequality. We include, in our computation, two numbers that summarize the extent to which each country's current fiscal regime achieves equalization of opportunities for income, and the deadweight loss that would be incurred by moving to the regime that does.