Clinical biomarkers in brain injury: a lesson from cardiac arrest.

Cardiac arrest (CA) is the primary cause of death in industrialized countries. Successful resuscitation rate is estimated of about 40%, but a good neurological outcome remains difficult to achieve. The majority of resuscitated victims suffers of a pathophysiological entity termed as "post resuscitation disease". Today's efforts are mainly pointed to the chain of survival, often devoting less attention to post-resuscitation care. Resuscitated patients are often victims of nihilistic therapeutic approach, with clinicians failing to promptly institute strategies that mitigate the ischemia-reperfusion injury to vital organs. Only after 72 hours prognostication can be realistically attempted. Neurological evaluation relies on a combination of clinical, instrumental and laboratoristic parameters, since no one alone holds a specificity of 100%. Biochemical markers, such as neuron specific enolase and S-100b, may contribute to predict prognosis after CA. To the contrary, when used individually the necessary precision remains poorly characterized. Biochemical studies suffer from substantial methodological differences hampering attempts to summarize their findings. We review the information available on biochemical markers of brain damage for neurological prognostication after CA

Formation of Penumbra in a Sample of Active Regions Observed by the SDO Satellite

Recently, high-resolution observations improved our understanding of the penumbra formation process around sunspots. In particular, two aspects have been carefully investigated: whether the settlement of the penumbra can occur between the main opposite magnetic polarities where new magnetic flux is still emerging, and the establishment of the Evershed flow. In this paper, we present the analysis of twelve active regions (ARs) where both the penumbra formation and the onset of the Evershed flow were observed. We used data acquired by the Helioseismic and Magnetic Imager (HMI) instrument on board the Solar Dynamic Observatory (SDO) satellite analyzing continuum images, magnetograms, and Dopplergrams of the selected ARs. The results obtained in our sample provided the following information about the stable settlement of the penumbra: eight spots formed the first stable penumbral sector in the region between the two opposite polarities, and nine spots formed on the opposite side. Moreover, eleven sunpots showed an inverse Evershed flow (i.e., a plasma motion directed toward the protospot border) before the penumbra formation, which changes within 1-6 hr into the classical Evershed flow as soon as the penumbra forms. Comparing our results with recent observations, we are able to discriminate between the different ways of penumbra formation. Moreover, we suggest that the change from inverse Evershed flow, visible before the penumbra appears, into the classical Evershed flow may be a signature of the formation of penumbral filaments

Antioxidant Properties of Propofol

Propofol is an intravenous sedative-hypnotic agent indicated for induction and maintenance of general anesthesia as well as for sedation of intubated, mechanically ventilated adults in intensive care units (ICU). Propofol is characterized by a phenolic structure similar to that of a-tocopherol, and presents antioxidant properties that have been demonstrated both in vitro and in vivo. The aim of the present review is to evaluate the antioxidant properties of propofol in various models and whether or not it may be considered an efficient therapeutic tool in counteracting oxidative stress during general anesthesia and sedation in ICU

IBIS 2.0 Science Description

The Interferometric BIdimensional Spectrometer 2.0 (IBIS 2.0) is a focal plane instrument which will be developed to acquire high cadence spectroscopic and spectropolarimetric images of the solar photosphere and chromosphere. Its previous version, named IBIS, was installed at the focal plane of the Dunn Solar Telescope of the National Solar Observatory in New Mexico (USA). It used two FPI in a classic mount and operated over the range 580 – 860 nm. IBIS 2.0 provides an important opportunity to investigate many open questions regarding the physics of the solar atmosphere, with particular attention to the phenomena visible in the photosphere and chromosphere. Moreover, IBIS 2.0 could represent a first step to develop a new instrument for the next generation telescopes. A brief overview of the project is available in [RD4]. A Science Working Group (SWG) has been charged by the project with the task of identifying the key science goals for the new version of the instrument and defining the corresponding science requirements that are needed to accomplish those goals. This document reports the outcome of such a Science Working Group

Spectrum of sepsis, mediators, source control and management of bundles.

Sepsis is a modern medicine icon and the onset of organ dysfunction is one of the worst scenario. More than 100 distinct molecules have been proposed as useful biological markers of sepsis. TNF-alpha, IL-6, chemokines and cytokines are considered the first line factors able to drive the dynamic process of sepsis. The PIRO scheme is a new classification of different aspects, used to stage sepsis. Resuscitation bundles must be started within 6 hours of presentation (serum lactate measured; blood cultures obtained before antibiotic therapy; broad-spectrum antibiotics within 3 hours from emergency admission and 1 hour from ICU admission; in case of hypotension and/or lactate higher than 4 mmol/L deliver an initial 20 ml/kg of crystalloid or colloid solution or apply vasopressors for hypotension not responding to initial fluid resuscitation to maintain mean arterial pressure above 65 mmHg). A management bundle should be implemented within 24 hour (low-dose steroids administered for septic shock; recombinant human activated protein C; glucose control maintained at less than 8.3 mmol/L; inspiratory plateau pressures maintained at less than 30 cm H2O)

Biological and clinical markers in colorectal cancer: state of the art.

Colorectal cancer (CRC) is the World's third most common cancer. Its prognosis is closely related to the disease stage at the time of diagnosis. Here we review the role of clinical biomarkers (tissue, serum, and faecal) in the management of CRC. Molecular studies have recently widened the opportunity for testing new possible markers, but actually, only few markers can be recommended for practical use in clinic. In the next future the hope is to have a complete panel of clinical biomarkers to use in every setting of CRC disease, and at the same time: 1) to receive information about prognostic significance by their expression and 2) to be oriented in the choice of the adequate treatment

Clinical and biological markers in gastric cancer: update and perspectives.

Gastric cancer is the second cause of death from cancer worldwide and the only chance to reach better outcomes lays on an early diagnosis. The need for non-invasive, low-cost tests is invoked also in countries in which imaging and endoscopic screening have already showed the ability to improve early diagnosis and overall survival. Genomic medicine could allow a better understanding of regulatory pathways driving the development and growth of gastric cancer and the characterization of specific molecular targets actually stimulate new drug developments. The knowledge of the role of Helicobacter pylori (HP) in gastric tumor pathogenesis has put new insides in the understanding of this peculiar disease and enriched the field of gastric biomarkers

Behavioral aspects in children's brothers affected by Autism Spectrum Disorders

Introduction: Autistic Spectrum Disorder (ASD) is a permanent and complex disability arising within the first three years of life characterized by a socio-communicative disorder and by fixed interests and repetitive behaviors. The present pilot study aims to evaluate behavioral aspects in a small population of siblings of ASD children. Material and methods: Population: 5 school-aged children (2 males, 3 females) (mean age 9.235 ± 2.041) were enrolled, as siblings of ASD children, and for comparison, 12 healthy (7 males, 5 females) children (average age 9,528 ± 3,351). All subjects underwent evaluation of the behavioral with Child Behavior Checklist (CBCL) scale. Results: The two groups were statistically comparable by age (p = 0.86) and gender distribution (p = 0.87). From the behavioral point of view evaluated with the CBCL scale, siblings of ASD have a higher degree of overall problem (Total problems) compared to control children (p=0.003), in addition they have significantly higher scores in the subscales of behavior examined (Anxious/Depressed, Withdrawn, Somatic Complaints, Social, Thought, Attention, Delinquent, Aggressive) as well as a greater share of disturbances both internalizing (p=0.004) and externalizing (p = 0.007) (Table 1). Conclusions: The present preliminary data confirm the need for a global management of the entire family structure for the correct management of Autistic Disorders