Valutazione della Correlazione tra i livelli plasmatici della Gamma Glutamil Transferasi e la qualita ossea

Lo studio clinico analizza la correlazione tra i valori di GGT frazionate e la qualità ossea. Abbiamo preso in esame 93 pazienti che fossero stati ricoverati presso l’Unità Operativa di Ortopedia e Traumatologia Universitaria I di Pisa per artrosi dell’anca o per frattura del femore prossimale. I pazienti sono stati divisi in due gruppi: il gruppo A comprendeva pazienti sottoposti ad intervento di sostituzione totale dell’anca per artrosi, il gruppo B pazienti sottoposti ad intervento di riduzione e sintesi di frattura del femore prossimale. Preoperatoriamente è stato prelevato ai pazienti un campione di sangue e sono stati analizzati i valori di GGT totali e delle frazioni di GGT. Intraoperatoriamente, per quanto riguarda i pazienti del gruppo A e i pazienti sottoposti ad intervento di sostituzione protesica del gruppo B, sono stati prelevati testa e collo di femore; la testa di femore è stata sottoposta ad analisi morfologica mentre il collo di femore ad analisi con microCT. Una volta ottenuti i risultati del campione di sangue e dei prelievi intraoperatori siamo andati a valutare la correlazione tra l’eventuale alterazione dei valori di GGT frazionate e la qualità dell’osso

WIMP physics with ensembles of direct-detection experiments

The search for weakly-interacting massive particle (WIMP) dark matter is multi-pronged. Ulti- mately, the WIMP-dark-matter picture will only be confirmed if different classes of experiments see consistent signals and infer the same WIMP properties. In this work, we review the ideas, meth- ods, and status of direct-detection searches. We focus in particular on extracting WIMP physics (WIMP interactions and phase-space distribution) from direct-detection data in the early discov- ery days when multiple experiments see of order dozens to hundreds of events. To demonstrate the essential complementarity of different direct-detection experiments in this context, we create mock data intended to represent the data from the near-future Generation 2 experiments. We consider both conventional supersymmetry-inspired benchmark points (with spin-independent and -dependent elastic cross sections just below current limits), as well as benchmark points for other classes of models (inelastic and effective-operator paradigms). We also investigate the effect on parameter estimation of loosening or dropping the assumptions about the local WIMP phase-space distribution. We arrive at two main conclusions. Firstly, teasing out WIMP physics with experi- ments depends critically on having a wide set of detector target materials, spanning a large range of target nuclear masses and spin-dependent sensitivity. It is also highly desirable to obtain data from low-threshold experiments. Secondly, a general reconstruction of the local WIMP velocity distribu- tion, which will only be achieved if there are multiple experiments using different target materials, is critical to obtaining a robust and unbiased estimate of the WIMP mass

Nodal upstaging robotic lobectomy for non-small cell lung cancer

Nodal upstaging takes place when unsuspected lymph node metastases are detected by pathological evaluation, after surgical treatment for non-small cell lung cancer. In early stages non-small cell lung cancer, nodal upstaging amounts to 4.8%-24.6%, depending on several factors, such as accuracy of preoperative staging, localisation and size of tumour and number of lymph nodes removed. Nodal upstaging is considered a surrogate of the completeness of thoracic oncologic surgery; for this reason, various studies focus on the evaluation of its rate in the different surgical approaches used to treat lung cancer. In this analysis, a high percentage of upstaging is observed in robotic surgery, having similar values to open surgery results, usually considered the gold standard in terms of oncologic radicality. In fact, thanks to its features, robotic surgery allows carrying out a thorough lymphadenectomy in the most comfortable manner, ensuring an excellent vision and manoeuvrability of the instruments even in the most remote areas of the thorax. According to these results, robotic surgery constitutes a safe and radical surgical option, showing encouraging results on the efficacy of lymphadenectomy and, consequently, on its the long-term outcomes

Correlation between gamma glutamyltransferase fractions and bone quality

Gamma-glutamyltransferase (GGT) has been recently identified as a bone-resorbing factor. Aim of the study was to investigate the association between plasma GGT fractions levels and bone quality. Plasma GGT fractions were analysed by gel-filtration chromatography. Bone quality was established by Micro-CT parameters: the BV/TV (mineralised bone volume/total volume), and the SMI (structure model index) that describes the rod-like (low-resistant) or plate-like (high-resistant) shape of bone trabeculae. We enrolled 93 patients hospitalised for elective total hip replacement (group Arthrosis, n=46) or for proximal femoral fracture (group Fracture, n=47). Patients within the first quartile of BV/TV (Q1, osteoporotic patients, n=6) showed higher levels of b-GGT fraction [median (min-max): 3.37 (1.42–6.81)] compared to patients with normal bone density (fourth quartile Q4, n=10; 1.40 (0.83–4.36); p=0.0393]. Also according to SMI, b-GGT value was higher in the subgroup with bone fragility [Q1, n=8: 1.36 (0.43–4.36); Q4, n=8: 5.10 (1.4 –7.60); p=0.0117]. In conclusion, patients characterised fragile bone structure showed specifically higher levels of plasma b-GGT activity thus suggesting fractional GGT analysis as a possible biomarker in the diagnosis of osteoporosi