Effects of Ultrasound and Green Synthesis ZnO Nanoparticles on Biogas Production from Olive Pomace

Abstract Agro-biomass residues can play a crucial role in promoting the fossil-fuel replacement in agro-food farms. Apulia, a region in Southern Italy, concentrates 22% of farms and 57% of total national olive and olive oil production, resulting the leader producer of the Country. So that, a high quantity of biomass (olive pomace) can be recovered from the milling process. This study investigates the biogas production that occurs during the anaerobic digestion of olive pomace by means of an ultrasound pre-treatment or by means of green synthesis of ZnO Nanoparticles mixed with olive pomace, in order to facilitate its digestion or co-digestion. Measurement of dry matter and biogas produced volume during the anaerobic process were investigated starting from 3-phase and 2-phase olive pomace by means of high specific energy and low frequency ultrasound values. The results highlight a promising influence of ultrasound pre-treatment useful at increasing the biogas yield of olive pomace

A rare case of pituitary melanoma metastasis: a dramatic and prolonged response to dabrafenib-trametinib therapy

Introduction: Pituitary metastases (PM) are rare events and to date only very few cases of melanoma PM have been described in literature up to now. Case Presentation: We describe the clinical history of a 33-year-old male patient who underwent surgical excision of an inter-scapular melanoma in 2008. The subsequent follow-up was negative for ~10 years. In September 2018, due to the onset of a severe headache, the patient underwent a brain magnetic resonance imaging, which showed an expansive mass in the saddle and suprasellar region with a maximum diameter of 17 mm. Pituitary function tests and visual field were normal. Worsening of the headache and the appearance of a left eye ptosis led the patient to surgical removal of the lesion in October 2018. The histological examination unexpectedly showed metastasis of the melanoma. Post-operative hormonal assessment showed secondary hypothyroidism and hypoadrenalism, which were both promptly treated, and a mild hypogonadism. Three months after surgery, a sellar MRI showed a persistent, increased pituitary mass (3 cm of diameter); fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) detected an increased radiopharmaceutical uptake in the sellar region. Due to the persistence of the disease and the evidence of a BRAF V600E mutation, in February 2019, the patient underwent a combined treatment with dabrafenib (a BRAF inhibitor) and trametinib (mitogen-activated extracellular signal-regulate kinase inhibitor). Sellar MRI performed 6 months later showed no evidence of mass in the sellar region. The patient was in a good clinical condition and did not complain of headaches or other symptoms; there were no significant side-effects from the anticancer therapy. After 13 months of treatment, the patient showed no recurrence of the disease on morphological imaging. Anticancer therapy was confirmed, replacement therapies with hydrocortisone and levothyroxine continued and the pituitary-gonadal axis was restored. Conclusion: This is a very interesting case, both for the rarity of the pituitary melanoma metastasis and for the singular therapeutic course carried out by the patient. This is the first case of a pituitary melanoma metastasis with BRAF mutation, successfully treated with the combination of dabrafenib and trametinib after incomplete surgical removal

Case Report: Ipilimumab-Induced Panhypophysitis: An Infrequent Occurrence and Literature Review

BackgroundImmune checkpoint inhibitors (ICIs), by unleashing the anticancer response of the immune system, can improve survival of patients affected by several malignancies, but may trigger a broad spectrum of adverse events, including autoimmune hypophysitis. ICI-related hypophysitis mainly manifests with anterior hypopituitarism, while the simultaneous involvement of both anterior and posterior pituitary (i.e., panhypophysitis) has rarely been described.Case PresentationIn June 2015, a 64-year-old man affected by liver metastases of a uveal melanoma was referred to us due to polyuria and polydipsia. Two months prior, he had started ipilimumab therapy (3 mg/kg iv every 21 days). The treatment was well-tolerated (only mild asthenia and diarrhea were reported). A few days before the fourth cycle, the patient complained of intense headaches, profound fatigue, nocturia, polyuria (up to 10 L urine/daily), and polydipsia. Laboratory tests were consistent with adrenal insufficiency, hypothyroidism, and transient central diabetes insipidus. The pituitary MRI showed an enlarged gland with microinfarcts, while the hypophyseal stalk was normal, and the neurohypophyseal 'bright signal' in T1 sequences was not detected. The treatment included dexamethasone (then cortisone acetate at replacement dose), desmopressin, and levothyroxine. Within the next five days, the symptoms resolved, and blood pressure, electrolytes, glucose, and urinalysis were stable within the normal ranges; desmopressin was discontinued while cortisone acetate and levothyroxine were maintained. The fourth ipilimumab dose was entirely administered in the absence of further side effects.ConclusionAs ICIs are increasingly used as anticancer agents, the damage to anterior and/or posterior pituitary can be progressively encountered by oncologists and endocrinologists in their clinical practice. Patients on ICIs and their caregivers should be informed about that risk and be empowered to alert the referring specialists early, at the onset of panhypopituitarism symptoms, including polyuria/polydipsia

Interview with Franco Mormando on Bernini: his life and his Rome, by Franco Mormando

As discussed in this interview, the sculptor, architect, painter, playwright, and scenographer, Gian Lorenzo Bernini (1598–1680) was the last of the great universal artistic geniuses of early modern Italy, placed by both contemporaries and posterity in the same exalted company as Leonardo, Raphael, and Michelangelo. And his artistic vision remains palpably present today, through the countless statues, fountains, and buildings that transformed Rome into the Baroque theater that continues to enthrall tourists. It is perhaps not surprising that this artist who defined the Baroque should have a personal life that itself was, well, baroque. As Franco Mormandos dazzling biography reveals, Bernini was a man driven by many passions, possessed of an explosive temper and a hearty sex drive, and he lived a life as dramatic as any of his creations. Drawing on archival sources, letters, diaries, and—with a suitable skepticism—a hagiographic account written by Bernini's son (who portrays his father as a paragon of virtue and piety), Mormando leads us through Bernini's many feuds and love affairs, scandals and sins. He sets Bernini's raucous life against a vivid backdrop of Baroque Rome, bustling and wealthy, and peopled by churchmen and bureaucrats, popes and politicians, schemes and secrets. The result is a seductively readable biography, stuffed with stories and teeming with life—as wild and unforgettable as Bernini's art. No one who has been bewitched by the Baroque should miss it.Title supplied by cataloger

Interview with Franco A. Mormando on The life of Gian Lorenzo Bernini by Domenico Bernini, by Franco Mormando

It would be nearly impossible to overstate the importance and influence of Gian Lorenzo Bernini (1598-1680). One of the creators of the Roman Baroque style, Bernini was a leading force in sculpture, architecture, painting and drama for most of the 17th century in Rome. The earliest biography of Bernini was long thought to be that published in Florence in 1682, written by Filippo Baldinucci and supposedly commissioned by Queen Christina of Sweden. Franco Mormando reveals that this biography was actually commissioned by Bernini's sons in the 1670s, and was largely based on a biography written by his youngest son, Domenico (1657-1723) which remained unpublished until 1713. Mormando has translated this invaluable primary source into English for the first time, and presents it here in a critical edition supported by unprecedented linguistic, historical, and cultural research on the artist, his works, his milieu, and his enduring influence.Title supplied by cataloger

Metabolic and endocrine toxicities of mitotane: a systematic review

Despite the pivotal role of mitotane in adrenocortical carcinoma (ACC) management, data on the endocrine toxicities of this treatment are lacking. The aim of this systematic review is to collect the available evidence on the side effects of mitotane on the endocrine and metabolic systems in both children and adults affected by adrenal carcinoma. Sixteen articles on 493 patients were included. Among the adrenal insufficiency, which is an expected side effect of mitotane, 24.5% of patients increased glucocorticoid replacement therapy. Mineralocorticoid insufficiency usually occurred late in treatment in 36.8% of patients. Thyroid dysfunction is characterized by a decrease in FT4, which occurs within 3–6 months of treatment in 45.4% of patients, while TSH seems to not be a reliable marker. Dyslipidemia is characterized by an increase in both LDL‐c and HDL‐c (54.2%). Few studies have found evidence of hypertriglyceridemia. In males, gynecomastia and hypogonadism can occur after 3–6 months of treatment (38.4% and 35.6%, respectively), while in pre‐menopausal women, mitotane can cause ovarian cysts and, less frequently, menstrual disorders. Most of these side effects appear to be reversible after mitotane discontinuation. We finally suggest an algorithm that could guide metabolic and endocrine safety assessments in patients treated with mitotane for ACC

GH receptor isoforms and skeletal fragility in acromegaly.

OBJECTIVE: Acromegaly is associated with an increased prevalence of vertebral fractures (VFs) in close relationship with GH hypersecretion. Two isoforms of the GH receptor (GHR) have been identified; the two isoforms differ or not by the expression of the protein fragment encoded by exon 3 of the GHR gene. Deletion of the exon 3 may influence the functional properties of the GHR and affect fracture risk in acromegalic patients. DESIGN: A cross-sectional study was designed to investigate the association between the d3-GHR isoform and the prevalence of VFs in patients with acromegaly. METHODS: In this study, 109 acromegalic patients were included (M/F, 48/61): 73 with controlled/cured acromegaly and 36 with active disease. GHR genotype was assessed in each patient. All patients were evaluated for VFs and bone mineral density at lumbar spine and hip. Serum IGF1 levels and bone metabolism markers were measured. A multivariate analysis was performed to establish risk factors for VFs in our population. RESULTS: d3-GHR carriers showed an increased prevalence of VFs when compared with patients expressing full-length GHR (35/55 vs 12/54; P<0.001). The association between GHR deletion and VFs was demonstrated both in patients with active disease and in those with controlled/cured disease. Out of 35 patients who were prospectively evaluated, 13 (37.1%) developed incident VFs. The incidence of VFs was significantly higher in patients for whom the GHR gene has been deleted when compared with those harboring the fl gene (P=0.04). In multivariate analysis, male sex (odds ratio (OR), 3.250; P=0.041), IGF1 levels (OR, 1.183; P=0.031), length of active diseases (OR, 1.038; P=0.001), and d3-GHR genotype (OR, 3.060; P=0.015) were all confirmed as risk factors of VFs in our population. CONCLUSIONS: This study suggests for the first time that exon 3 deletion of GHR may predispose patients with active and controlled acromegaly to a higher risk of VFs