[A case of massive pulmonary embolism treated with angiojet thrombectomy system]

Pulmonary embolism is a common disease process associated with a high mortality rate. In patients with massive pulmonary embolism, systemic thrombolysis is considered to be the treatment of choice, but surgical or catheter thrombectomy may be alternative emergency treatments. A 36-year-old woman with massive pulmonary embolism and contraindications to thrombolytic therapy was treated with catheter thrombectomy using the Angiojet thrombectomy system. The procedure was successfully performed with an excellent immediate angiographic result at the site of the rheolytic thrombectomy. The clinical improvement was maintained while in-hospital and during a 4-month follow-up period, with a decrease to a normal level of the peak systolic pulmonary pressure. Our case report indicates that in patients with contraindications to systemic thrombolysis, catheter thrombectomy for massive pulmonary embolism may constitute a life-saving intervention

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Consiglio Nazionale delle Ricerche - Biblioteca Centrale - P.le Aldo Moro, 7 Rome / CNR - Consiglio Nazionale delle RichercheSIGLEITItal

Evaluation of antioxidant, antinflammatory and antityrosinase potential of extracts from different aerial parts of Rhanterium suaveolens from Tunisia

AbstractThe genus Rhanterium (Asteraceae) is a widely distributed medicinal plant throughout western North Africa and some Rhanterium species are used in folk medicine. The aim of research was to investigate methanolic extracts from different parts (flowers, leaves, and stems) of Tunisian Rhanterium suaveolens as potential sources of bioactive products useful for healthy purposes. In particular, were analyzed the phenolic composition of these extracts and their antioxidant, anti‐inflammatory, and anti‐tyrosinase properties.The phytochemical analyses were performed using standard colorimetric procedures, HPLC‐DAD and HPLC‐DAD‐ESI‐MS. Then, several in vitro cell‐free assays have been used to estimate the antioxidant/free radical scavenging capability of the extracts. Moreover, in vitro, and in vivo anti‐melanogenesis activities of these extracts were tested, respectively, with the tyrosinase inhibition assay and the Zebrafish embryo model. Finally, the anti‐inflammatory potential of these extracts in an in vitro model of acute intestinal inflammation in differentiated Caco‐2 cells was evaluated.The R. suaveolens extracts under study appeared particularly rich in flavonols and hydroxycinnamic acids and all extracts appeared endowed with good antioxidant/free radical scavenging properties, being the flower extracts slightly more active than the others. Moreover, R. suaveolens flowers extract was able to inhibit in vitro tyrosinase activity and exhibited bleaching effects on the pigmentation of zebrafish embryos. Furthermore, all extracts showed good anti‐inflammatory activity in intestinal epithelial cells as demonstrated by the inhibition of TNF‐α‐induced gene expression of IL‐6 and IL‐8.R. suaveolens aerial parts may be considered as a potential source of whitening agents, as well as of agents for the treatment of disorders related to oxidative stress and inflammation

Potential Role of miRNAs in the Acquisition of Chemoresistance in Neuroblastoma

Neuroblastoma (NB) accounts for about 8–10% of pediatric cancers, and the main causes of death are the presence of metastases and the acquisition of chemoresistance. Metastatic NB is characterized by MYCN amplification that correlates with changes in the expression of miRNAs, which are small non-coding RNA sequences, playing a crucial role in NB development and chemoresistance. In the present study, miRNA expression was analyzed in two human MYCN-amplified NB cell lines, one sensitive (HTLA-230) and one resistant to Etoposide (ER-HTLA), by microarray and RT-qPCR techniques. These analyses showed that miRNA-15a, -16-1, -19b, -218, and -338 were down-regulated in ER-HTLA cells. In order to validate the presence of this down-regulation in vivo, the expression of these miRNAs was analyzed in primary tumors, metastases, and bone marrow of therapy responder and non-responder pediatric patients. Principal component analysis data showed that the expression of miRNA-19b, -218, and -338 influenced metastases, and that the expression levels of all miRNAs analyzed were higher in therapy responders in respect to non-responders. Collectively, these findings suggest that these miRNAs might be involved in the regulation of the drug response, and could be employed for therapeutic purposes

Management of acute pharyngitis in children: summary of the Italian National Institute of Health guidelines

Background: Discrepancies in the management of pharyngitis in children have been reported in Europe and the United States, and recommendations concerning the use of clinical scores, rapid antigen diagnostic tests (RADTs) or throat cultures, and the indications for antibiotic treatment largely differ. Objective: This article summarizes the Italian guidelines on the management of pharyngitis in children issued by the National Institute of Health. Methods: A multidisciplinary panel of experts (the Guidelines Development Group) developed and used a set of key questions to conduct a systematic review of the literature. Relevant publications in English were identified through a systematic review of MEDLINE and the Cochrane Database of Systematic Reviews from their inception through April 30, 2011. Final recommendations were scaled according to the Italian National Guidelines Program grading. Results: Eighteen clinical questions were defined, and 44 recommendations were issued. None of the available scoring systems is sufficiently accurate to identify group A β-hemolytic streptococci (GABHS) pharyngitis in settings with low prevalence for rheumatic disease. RADT should be performed by trained personnel in every child with a history and signs/symptoms suggestive of GABHS pharyngitis. RADT is not recommended in children with a McIsaac score of 0 or 1 with ≥2 signs/symptoms suggestive of viral infection. Backup culture in children with negative RADT result is not recommended. Culture test with antibiotic susceptibility assay should be performed exclusively for epidemiologic purposes. Streptococcal antibody titers are of no value in diagnosing acute pharyngitis. Antibiotic therapy is recommended in microbiologically documented GABHS pharyngitis. Because penicillin V is not available in Italy, amoxicillin (50 mg/kg/d in 2-3 doses orally) for 10 days is the first choice of treatment. In noncompliant cases, benzathine penicillin may be administered. Although not routinely recommended due to the high cost and wide spectrum of activity, a 5-day course with a second-generation cephalosporin may be used in noncompliant cases. Macrolides should be limited to children with demonstrated type I hypersensitivity to penicillin. Ibuprofen or paracetamol is recommended for relief of pain or fever associated with discomfort. Because the carrier state is not associated with increased risk of suppurative complications and risk of GABHS transmission to contacts is minimal, the carrier state should never be investigated and treated. Recommendations for the management of suppurative complications are given. Conclusions: This guideline provides a comprehensive, evidence based, tool for the diagnosis and therapy of acute pharyngitis in children. (Clin Ther. 2012;34: 1442-1458

Proposals for rural landscape and archaeological site flora management: the contribution of archaeobotany through the BRAIN network research

Archaeobotanical data suggest that models of a multiple land use have always contributed to the fruitful management of environmental resources, and this is among the most interesting results obtained from the reconstructions of past landscapes in the Mediterranean. The development of Historical Ecology, an historical approach that promotes interdisciplinary studies involving several research fields (like botany, archaeobotany, history, archaeology, geography, cartography, forestry, geology, climatology, landscape genetics), is carrying out proposals for applications in agricultural management and environmental conservation based on rigorous land use reconstructions. Several members of the BRAIN community are involved in these topics thanks to the interdisciplinary plant-based studies carried out on archaeological sites and other human-influenced contexts (Environmental Archaeology)

Pain assessment and management in haemophilia: A survey among Italian patients and specialist physicians

Introduction: Persons with haemophilia (PWH) experience recurrent joint bleeding which leads from early synovitis to irreversible joint damage. Pain strongly affects patients’ quality of life, as PWH suffer from acute pain associated with haemarthroses and chronic pain due to arthritic and degenerative complications. Aim: To investigate pain issues among PWH and their treaters in Italy. Methods: Persons with haemophilia and specialist physicians responded to a survey focused on pain characteristics, assessment, and management by phone call and online, respectively. Results: One hundred and nineteen patients (76% severe haemophilia, 61% ≥18 years) and 44 physicians were involved. Pain was reported by 61% of PWH; among those who did not experience pain, 70% were children on prophylaxis. Patients described pain as chronic (71%), acute (69%) or postoperative (8%), and rated it as severe in 65% of cases. Clinicians reported lower percentages of patients with pain (46%), classified as chronic (58%), acute (33%) or postoperative (21%), half using specific scales. Pain was systematically investigated by treaters according to 36% of patients. Paracetamol was largely the most prescribed first-line pain therapy (89%), as well the most employed analgesic by PWH (51%), who also used non-steroidal anti-inflammatory drugs (24%), cyclo-oxygenase-2 inhibitors (21%) or opioids (26%). To manage pain, 61% of clinicians stated to collaborate with other specialists. Physiotherapy was often suggested but less frequently used by PWH. Conclusions: Pain is under-recognized and unsatisfactorily addressed by haemophilia treatment centre (HTC) clinicians, with discrepant management compared to PWH responses. Education in systematic pain assessment and multidisciplinary treatment and development of management guidelines are highly needed