NAFLD: Diagnostic Algorithms for Regulating Patient Fluxes

The global prevalence of NAFLD is estimated to be over 25% and it is already the leading cause of chronic liver disease in industrialized countries, as a consequence of the spread of obesity and metabolic syndrome. The prognosis of NAFLD is generally benign in the absence of fibrosis, but liver fibrosis rapidly progresses in 20% of the cases and can lead to cirrhosis and/or HCC. This review analysis focuses on non-invasive fibrosis testing strategies for patients with NAFLD in order to increase the efficiency and effectiveness of diagnosis and care, regulating secondary care referral fluxes. An integrated management plan between primary care and secondary care with a defined algorithm of non-invasive testing to stratify the risk of NAFLD fibrosis is indispensable to increase the early diagnosis of fibrosis but also decrease unnecessary referrals

Classification of professional values based on motivational content: An exploratory study on Italian Adolescents

This study applies a multidimensional scaling (MSD) technique to investigate the structural validity of the Work Values Inventory for Adolescents with a sample of Italian students. The MSD results indicated the presence of two underlying orthogonal dimensions: individuality versus sociality and conservation versus exploration. Implications for future research are also discussed. © 2011 The Author(s)

Removal of bunches or spikelets is not effective for the control of Aceria guerreronis.

Worldwide, there remains a reliance on repeated chemical applications as a control strategy for the coconut mite, but these are impractical, not economical, and environmentally hazardous. In this study, the damage severity of Aceria guerreronis on coconut fruits was studied under different conditions to investigate the effects of bunch management on the amount of damage to newly produced bunches. The damage was evaluated using a diagrammatic scale under four different conditions: 1) plants with bunches removed; 2) bunches with the distal portion of the spikelet removed; 3) bunches sprayed monthly with abamectin (9 g a.i./ha); and 4) control plants. For each treatment, two fruits from bunches 1 to 6 (counted from the last open inflorescence) from 10 plants were randomly collected every month for 4months. The removal of the distal portion of the spikelets had no effect on the damage level of new bunches but delayed the damage severity by 1 month. After the removal of all of the bunches, the damage severity was restored within 2 months to the newly produced bunches, whereas the chemical control with abamectin kept the A. guerreronis damage intensity at a low level. Thus, the removal of bunches or the distal portion of spikelets is not an effective practice for the control of A. guerreronis in areas with high levels of infestation

Health-related Quality of Life in Patients With Nonalcoholic Fatty Liver Disease: A Prospective Multi-center UK Study

BACKGROUND & AIMS: It is unclear whether health-related quality of life (HRQoL) is impaired in patients with nonalcoholic fatty liver disease (NAFLD) without advanced fibrosis and how this compares with the general population. We aimed to assess HRQoL in patients with NAFLD in comparison to the general population and any associations of fibrosis severity and metabolic comorbidities with impairments in HRQoL. METHODS: We prospectively enrolled 513 consecutive patients with NAFLD who completed the EuroQol 5-dimensional questionnaire (EQ-5D) and Chronic Liver Disease Questionnaires (CLDQ). Demographic and clinical information, liver biopsy results, and/or liver stiffness (LS) by transient elastography were recorded. A general population sub-cohort of the Health Survey for England 2018 was used as a comparator (n = 5483), and a 1:1 propensity-score (PS) matching was performed, according to age, sex, body mass index, and type 2 diabetes mellitus (T2DM). RESULTS: EQ-5D-5L utility was significantly lower in 466 PS-matched patients with NAFLD compared with PS-matched controls (0.77 ± 0.27 vs 0.84 ± 0.19; P < .001), even in those without advanced fibrosis (F ≤2 or LS <8kPa) (0.80 ± 0.24 vs 0.84 ± 0.19; P = .024). HRQoL measures (EQ-5D-5L, EQ-VAS, CLDQ) did not differ between patients with NAFLD with and without advanced fibrosis. LS was independently associated with lower EQ-5D-5L in all patients with NAFLD but not in those without advanced fibrosis. In the latter, lower EQ-5D-5L was associated with female sex, T2DM, and depression. CONCLUSIONS: Patients with NAFLD, even those without advanced fibrosis, have worse HRQoL compared with the general population. In patients with NAFLD without advanced fibrosis, HRQoL is independently associated with non-liver comorbidities but not LS. Multi-disciplinary management is therefore required in NAFLD, irrespective of fibrosis severity

Deregulated expression of the imprinted DLK1-DIO3 region in glioblastoma stemlike cells: Tumor suppressor role of lncRNA MEG3

Background: Glioblastoma (GBM) stemlike cells (GSCs) are thought to be responsible for the maintenance and aggressiveness of GBM, the most common primary brain tumor in adults. This study aims at elucidating the involvement of deregulations within the imprinted delta-like homolog 1 gene type III iodothyronine deiodinase gene (DLK-DIO3) region on chromosome 14q32 in GBM pathogenesis. Methods: Real-time PCR analyses were performed on GSCs and GBM tissues. Methylation analyses, gene expression, and reverse-phase protein array profiles were used to investigate the tumor suppressor function of the maternally expressed 3 gene (MEG3). Results: Loss of expression of genes and noncoding RNAs within the DLK1-DIO3 region was observed in GSCs and GBM tissues compared with normal brain. This downregulation is mainly mediated by epigenetic silencing. Kaplan-Meier analysis indicated that low expression of MEG3 and MEG8 long noncoding (lnc)RNAs significantly correlated with short survival in GBM patients. MEG3 restoration impairs tumorigenic abilities of GSCs in vitro by inhibiting cell growth, migration, and colony formation and decreases in vivo tumor growth, reducing infiltrative growth. These effects were associated with modulation of genes involved in cell adhesion and epithelial-to-mesenchymal transition (EMT). Conclusion: In GBM, MEG3 acts as a tumor suppressor mainly regulating cell adhesion, EMT, and cell proliferation, thus providing a potential candidate for novel GBM therapies

Ácaros associados ao cafeeiro em duas regiões do sul de Minas Gerais.

Existe uma grande complexidade nas populações de ácaros associados a cultura do café e o rompimento do equilíbrio dessas populações tem contribuído para o aparecimento de surtos de ácaros fitófagos, que vem sendo observados em varias regiões de cultivo. Para se verificar quais são os ácaros que compõem as populações de predadores e fitófagos, em equilíbrio natural na cultura, conduziu-se um estudo nos municípios de Lavras e Machado no período de marco de 1989 a marco 1990. Os cargos foram escolhidos em áreas que não recebiam nenhum tipo de tratamento fitossanitário. Em intervalos de 15 dias, 3 folhas por quadrante foram coletadas do terco superior interno de cada uma de dez plantas tomadas aleatoriamente em cada area de estudo. O material foi levado para o laboratório de Entomologia do Departamento de Fitossanidade-ESAL, onde todos os ácaros existentes em cada folha eram contados e coletados. As espécies coletadas nos dois campos estudados foram: Brevipalpus phoenicis (Geijskes), Iorrya formosa Cooreman, Tydeus (Tydeus) sp., Olegonychus ilicis (McGregor), Fungitarsonemus sp., Parapronematus sp., Paracheyletia aff. wellsi (Baker), Bdella sp., Zetzellia sp., Iphiseiodes zuluagai Denmark & Muma, Euseius citrifolius Denmark & Muma, E. concordis (Chant) E. alatus (DeLeon), Amblyseius herbicolus (Chant), Proprioseiopsis dominigos (El-Benhawy), Metaseiulus annectens (DeLeon)

Olfactory groove meningioma: report of 99 cases surgically treated at the Catholic University School of Medicine, Rome

OBJECTIVE: We reviewed our series of olfactory groove meningiomas (OGMs) with the aim to relate the surgical approach with outcome and to define clinical and pathologic predictors of prognosis. METHODS: Ninety-nine patients who underwent 113 craniotomies at our Institution between 1984 and 2010 were entered this study. The relationship between surgical approach (bifrontal, fronto-orbito-basal, and pterional) and either tumor diameter, extent of tumor resection, complication rate, need of reoperation, and Karnofsky Performance Status (KPS) was analyzed. The impact of age ( 64 70 vs. &gt; 70 years), sex, tumor diameter (&lt; 6 vs. 65 6 cm), pre- and postoperative KPS (&lt; 80 vs. 65 80), Simpson grade (I-II vs. III-IV), and World Health Organization (WHO) histologic grade (I vs. II-III) on survival was assessed. Kaplan-Meier survival curves were plotted and differences in survival between groups of patients were compared. A multivariate analysis adjusted for age, pre- and postoperative KPS, Simpson grade, tumor diameter, and WHO histologic grade also was performed. RESULTS: The fronto-orbito-basal approach (n = 22) allowed a significantly greater percentage of Simpson I-II removals than the bifrontal (n = 70) and pterional approach (n = 21) (P = 0.0354 and P = 0.0485, respectively). The risk of life-threatening complications trended to be lower in patients operated upon either via the fronto-orbito-basal and via the pterional approach than in those treated via the bifrontal approach. Retraction-related brain swelling did not occur in any case after the fronto-orbito-basal approach (P = 0.0384); however, this approach was associated with a greater rate of cerebrospinal fluid leak (P = 0.0011). Among prognostic factors, age 64 70 years (P = 0.0044), tumor diameter &lt;6 cm (P = 0.0455), pre- and postoperative KPS 65 80 (both P &lt; 0.0001), Simpson grade I-II (P = 0.0096), and WHO histologic grade I (P = 0.0112) were significantly associated with longer overall survival. Age (P = 0.0393) and WHO histologic grade (P = 0.0418) emerged as independent prognostic factors for overall survival on multivariate analysis. CONCLUSION: In the largest series of OGMs published to date, the bifrontal approach was associated with a greater risk of life-threatening complications compared with the lateral pterional and fronto-orbito-basal approaches. The fronto-orbito-basal approach provided greater chances of total tumor removal than the bifrontal and pterional approaches. Two independent factors for overall survival of patients with OGM were identified, namely age and WHO grade