The emerging role of pectoral nerve block (PECS block) in breast surgery: A case-matched analysis

To evaluate the benefits of pectoral nerve block (PECS block) in breast cancer surgery, we compared outcomes of 100 patients receiving PECS vs 107 without PECS. Intraoperative use of fentanyl (P < .001) acetaminophen (P = .02), morphine (P < .01), and nonsteroidal anti-inflammatory drugs (NSAIDS) (P < .01) was lower in the PECS group. Occurrence of postoperative nausea and vomiting (PONV) was lower in the PECS group (P = .04). On postoperative day 1, the use of acetaminophen (P = .23), morphine (P = .83), and NSAIDS (P = .4) did not differ. Twenty-one patients received surgery with PECS block plus sedation alone. PECS block can reduce intraoperative use of opioids and analgesic drugs, and is associated with reduced occurrence of PONV. Selected patients can receive breast-conserving surgery with PECS plus sedation, avoiding general anesthesia

Castel di Sangro-Scontrone field camp – structural and applied geomorphology

The Geomorphological Field Camp 2014 in the Castel di Sangro-Scontrone area is the result of geological and geomorphological teaching field work activities carried out in Central Italy by a group of 23 students attending the Structural Geomorphology and Applied Geomorphology courses (Master's Degree in Geological Science and Technology of the Università degli Studi ‘G. d'Annunzio’ Chieti-Pescara, Italy, Department of Engineering and Geology). The Field Camp 2014 was organized in May 2014, following regular classes held during the fall term. General activities for the field camp were developed over four main stages: (1) preliminary analysis of the regional geological and geomorphological setting of the area; (2) preliminary activities for the analysis of the local area (orography, hydrography and photogeology investigations, and geographical information system processing); (3) field work, focused on the analysis of a specific issue concerning structural geomorphology or applied geomorphology (e.g. landscape evolution, river channel change, landslide distribution, and flood hazard); and (4) post-field work production of the map. Finally, the fundamental role of field work in the analysis of landscape and in land management was outlined: indeed, the overall field camp enhanced the crucial role of field-based learning for young geomorphologists in order to acquire a strong sensitivity to geomorphological processes and landscape evolution

Creating prodynorphin-expressing stem cells alerted for a high-throughput of cardiogenic commitment.

BACKGROUND: The development of cell therapy for the rescue of damaged heart muscle is a major area of inquiry. Within this context, the establishment of a cardiogenic cell line may remarkably facilitate the molecular dissection of cardiac fate specification, a low-efficiency and still poorly understood process, paving the way for novel approaches in the use of stem cells for cardiac repair. METHODS & RESULTS: We used GTR1 cells, a derivative of mouse R1 embryonic stem cells bearing the puromycin-resistance gene driven by the cardiomyocyte-specific alpha-myosin heavy chain promoter, affording a gene trapping selection of a virtually pure population of embryonic stem cell-derived cardiomyocytes. Third-generation lentiviral vectors were used to overexpress the prodynorphin gene, previously shown to orchestrate a dynorphinergic system acting as a major conductor of embryonic stem cell cardiogenesis. Lentiviral prodynorphin transduction remarkably enhanced the transcription of GATA-4 and Nkx-2.5, two cardiac lineage-promoting genes, resulting in a dramatic increase in the number of spontaneously beating cardiomyocytes. Transduced cells also exhibited a subcellular redistribution patterning of protein kinase C-beta, -delta and -epsilon, a major requirement in cardiac lineage commitment. This activation resulted from a sustained increase in the transcription of targeted protein kinase C genes. Prodynorphin transduction was selective in nature and failed to activate genes responsible for skeletal myogenesis or neuronal specification. CONCLUSIONS: The cell line developed in this study provides a powerful in vitro model of cardiomyogenesis that may help clarify the cascade of transcriptional activation and signaling networks that push multipotent cells to take on the identity of a cardiac myocyte

Antiangiogenic and immunomodulatory effects of rapamycin on islet endothelium: relevance for islet transplantation

Donor intra-islet endothelial cells contribute to neovascularization after transplantation. Several factors may interfere with this process and ultimately influence islet engraftment. Rapamycin, a central immunosuppressant in islet transplantation, is an mTOR inhibitor that has been shown to inhibit cancer angiogenesis. The aim of this study was to evaluate the effects of rapamycin on islet endothelium. Rapamycin inhibited the outgrowth of endothelial cells from freshly purified human islets and the formation of capillary-like structures in vitro and in vivo after subcutaneous injection within Matrigel plugs into SCID mice. Rapamycin decreased migration, proliferation and angiogenic properties of human and mouse islet-derived endothelial cell lines with appearance of apoptosis. The expression of angiogenesis-related factors VEGF, alphaVbeta3 integrin and thrombospondin-1 on islet endothelium was altered in the presence of rapamycin. On the other hand, rapamycin decreased the surface expression of molecules involved in immune processes such as ICAM-1 and CD40 and reduced the adhesion of T cells to islet endothelium. Our results suggest that rapamycin exerts dual effects on islet endothelium inducing a simultaneous inhibition of angiogenesis and a down-regulation of receptors involved in lymphocyte adhesion and activation