Case report and review

Spinal infections are rare but potentially life-threate -ning disorders. A high level of clinical suspicion is neces sary for rapid diagnosis and treatment initiation. The treatment combines both antibiotics and surgical intervention in the vast majority of cases. The authors report the case of a 84-year old female patient with a three week history of persistent lumbar back pain radiating to both thighs following a lower respiratory tract infection. She had lumbar spine tenderness but no neurological compromise. Her inflammatory markers were elevated and lumbar spine magnetic resonance imaging revealed L4-L5 spondylodiscitis with spinal epidural abscess. Blood cultures isolated Klebsiella pneumoniae and, since she was neurologically stable, conservative treatment with two-week intravenous gentamicin and eight-week intravenous ceftriaxone was initiated with positive inpatient and outpatient evolution.publishersversionpublishe

Case series

B-cells play an important role not only in cellular but also in humoral immunity through differentiation into plasma cells and antibody production. B-cell depletion may, theoretically, change the course of systemic rheumatic diseases (SRD) in which self-reactive antibodies are part of the pathogenic pathway. In Rheumatology, anti-B-cell antibody Rituximab is currently licensed for the treatment of rheumatoid arthritis, however there is growing evidence of its potential use in other SRD. The authors present a case series of eight patients in which Rituximab was used off-label including overlap syndrome Rhupus, systemic lupus erythematosus and Wegener's granulomatosis. In the end, a brief literature review about this subject is performed.publishersversionpublishe

The Harvesting Memories Project: Historical ecology and landscape changes of the Sicani Mountains in Sicily

The Harvesting Memories project aims to investigate the historical landscape dynamics in an inner area of the Sicani Mountains district in Western Sicily (Contrada Castro, Corleone-Palermo). The interdisciplinary approach of the project allowed us to combine and integrate methods from different disciplines such as historical ecology, landscape archaeology, archaeobotany and GIS-based spatial analysis. In this paper some results have been summarized. The comparison between land mosaic change during the last 60 years, the relationship between site catchment area and land suitability and the correlation between archaeobotanical and phytosociological data. This approach underlined the relevance of the historical ecology for understanding landscape trajectories and planning strategy of suitable development of rural areas

Sources of geomaterials in the Sicani Mountains during the Early Middle Ages: A case study of Contrada Castro, central western Sicily

From 2017, an unknown rural settlement in Contrada Castro at Corleone (Palermo Province, western Sicily) was investigated as part of the ‘Harvesting Memories Project’. The stratigraphic sequence, supported by radiocarbon dating, has demonstrated a reoccupation of a pre-Roman site during the transition between the Byzantine and Islamic periods. In particular, the main occupation occurred in the late 8th–9th century when pottery kilns and a probable warehouse were constructed. During the 10th–11th century, a new structure with different orientations replaced the previous buildings that had already collapsed. Specifically focusing on a perspective of the household production and its relationship to the surrounding landscapes of this site, this paper presents the results of a geological survey and petrographic analysis of ceramic finds and lithic samples to identify the source area of the geomaterials used in the studied settlement. The ceramic finds were divided into different Paste Groups based on the characteristics of a polarizing microscope study. The use of some locally available raw materials was recorded both for ceramic and lithic samples. Such an approach enables us to better understand ceramic craft technology, clay and lithic procurement strategies and, more broadly, the consumption of household pottery in the Early Medieval site in Contrada Castro. Furthermore, this study verifies the close relationship that this rural settlement had with the surrounding resources in the area and reveals a connection with the city of Palermo during the Early Middle Ages

Patient-derived organoids and high grade serous ovarian cancer: from disease modeling to personalized medicine

Background: High grade serous ovarian cancer (HGSOC) is among the deadliest human cancers and its prognosis remains extremely poor. Tumor heterogeneity and rapid acquisition of resistance to conventional chemotherapeutic approaches strongly contribute to poor outcome of patients. The clinical landscape of HGSOC has been radically transformed since the advent of targeted therapies in the last decade. Nevertheless, the lack of predictive biomarkers informing on the differential clinical benefit in select subgroups, and allowing patient-centric approaches, currently limits the efficacy of these novel therapies. Thus, rational selection of the best possible treatment for each patient represents a clinical priority in order to improve outcome, while limiting undesirable effects. Main body: In this review, we describe the state of the art and the unmet needs in HGSOC management, illustrate the treatment options that are available and the biomarkers that are currently employed to orient clinical decisions. We also describe the ongoing clinical trials that are testing new therapeutic approaches for HGSOC. Next, we introduce the organoid technology as a promising, expanding strategy to study cancer and to develop personalized therapeutic approaches. In particular, we discuss recent studies that have characterized the translational potential of Patient's Derived Organoids (PDOs) to inform on drug sensitivity of HGSOC patients. Conclusions: PDOs can predict the response of patients to treatments and may therefore guide therapeutic decisions. Although preliminary results appear encouraging, organoids still need to be generated and expanded efficiently to enable drug screening in a clinically meaningful time window. A new generation of clinical trials based on the organoid technology should guarantee tailored approaches to ovarian cancer management, as it is now clear that the one-size-fits-all approach cannot lead to efficient and meaningful therapeutic advancements

Description of Methicillin-resistant Staphylococcus pseudintermedius from canine pyoderma in Minas Gerais state, Brazil

Methicillin-resistant Staphylococcus pseudintermedius (MRSP) is of worldwide concern in veterinary medicine. The identification of resistant strains is necessary for proper treatment and the prevention of its propagation among animals. This study aimed to identify S. pseudintermedius isolated from canine pyoderma and evaluate their resistance profiles. Lesions from 25 dogs with pyoderma were sampled. Bacterial isolates were subjected to phenotypic and genotypic analysis for identification of the causative agent. S. pseudintermedius isolates were subjected to SmaI macrorestriction analysis and PFGE for genetic grouping, and PCR to identify the presence of the mecA gene. Their resistance profiles against 12 antimicrobials were also assessed. According to the microbiological analysis, 70 of the 75 isolates obtained were S. pseudintermedius. The isolates presented PFGE patterns, with similarity varying between 84.6 and 100%, and were grouped into 19 clusters. Despite a high frequency of mecA-positive isolates (66 out 70), only 12 presented resistances to oxacillin. Multi-resistance was identified in 29 isolates. The high frequency of MRSP isolated in this study highlights the relevance of identifying resistant strains to lead proper clinical treatment

On The Possibility of Enrichment and Differentiation in Gas Giants During Birth by Disk Instability

We investigate the coupling between rock-size solids and gas during the formation of gas giant planets by disk fragmentation in the outer regions of massive disks. In this study, we use three-dimensional radiative hydrodynamics simulations and model solids as a spatial distribution of particles. We assume that half of the total solid fraction is in small grains and half in large solids. The former are perfectly entrained with the gas and set the opacity in the disk, while the latter are allowed to respond to gas drag forces, with the back reaction on the gas taken into account. To explore the maximum effects of gas-solid interactions, we first consider 10cm-size particles. We then compare these results to a simulation with 1 km-size particles, which explores the low-drag regime. We show that (1) disk instability planets have the potential to form large cores due to aerodynamic capturing of rock-size solids in spiral arms before fragmentation; (2) that temporary clumps can concentrate tens of $M_{\oplus}$ of solids in very localized regions before clump disruption; (3) that the formation of permanent clumps, even in the outer disk, is dependent on the grain-size distribution, i.e., the opacity; (4) that nonaxisymmetric structure in the disk can create disk regions that have a solids-to-gas ratio greater than unity; (5) that the solid distribution may affect the fragmentation process; (6) that proto-gas giants and proto-brown dwarfs can start as differentiated objects prior to the H$_2$ collapse phase; (7) that spiral arms in a gravitationally unstable disk are able to stop the inward drift of rock-size solids, even redistributing them to larger radii; and, (8) that large solids can form spiral arms that are offset from the gaseous spiral arms. We conclude that planet embryo formation can be strongly affected by the growth of solids during the earliest stages of disk accretion.Comment: Accepted by ApJ. 55 pages including 24 figures. In response to comments from the referee, we have included a new simulation with km-size objects and have revised some discussions and interpretations. Major conclusions remain unchanged, and new conclusions have been added in response to the new ru