940-73 Predictive Value for Major Arrhythmic Events of Ventricular Arrhythmias Detected in the Subacute Phase of a Fibrinolysed Myocardial Infarction. An Analysis of the GISSI-2 Data Base

The relationship between ventricular arrhythmias (VA) in the subacute phase of a myocardial infarction and subsequent major arrhythmic events (MAE) was mainly defined in the prefibrinolytic era, We examined the large population of patients enrolled in the GISSI-2 study in order to evaluate the significance and predictive power for MAE (sustained ventricular tachycardia -SVT-and sudden death -SD-) of VA detected by Holter monitoring during the subacute phase of a fibrinolysed acute myocardial infarction (AMI). Of the 12,381 pts. enrolled in the GISSI-2 study, an Holter monitoring was available in 8,676 and a six month follow-up was completed in 7,713. During the follow-up 84 pts. died suddenly and 26 experienced one or more SVT. The relationship between VA and MAE was evaluated by odds ratio (OR) and their 95% confidence intervals. OR for MAE was 4.5 (2.7–7.5) if the Holter showed > 10 ventricular ectopic beats per hour; 2.3 (1.5–3.7) if couplets were present; 3.3 (1.5–7.0) if nonsustained ventricular tachycardias (NSVT) were noticed; 3.0 12.0–4.5) if any complex VA was detected. A multivariate analysis (Cox modell including the major prognostic determinants confirmed the independent prognostic value of VA in the Holter recording except for NSVT. Any arrhythmic parameter had a very low positive predictive power (from 2.4 to 3.0%). In conclusion, our data show that VA still have, in the fibrinolytic era, a prognostic significance for MAE, but the predictive power is very low and is therefore mandatory to add other variables to identify the pts. more at risk

Comparison of the action of different proteases on virulence properties related to the staphylococcal surface.

AIMS: The purpose of this study was to evaluate the antimicrobial efficacy of five different proteases belonging to two different families on Staphylococcus aureus and Staphylococcus epidermidis strains. METHODS AND RESULTS: We used three serine proteases and two metalloproteases in single species biofilm formation assays and in human cell invasion processes. Following each protease incubation with bacterial cells, surface protein patterns were analysed by SDS-PAGE and zymography. Some differently expressed proteins were identified by mass spectrometry. CONCLUSIONS: The effect of tested proteases on biofilm formation was not related to the protease category but was strain-dependent and was related to the biofilm formation capacity of each staphylococcal strain. Some proteases showed a nonspecific and indiscriminate effect on surface proteins, while others induced a discrete and reproducible action on protein profiles. SIGNIFICANCE AND IMPACT OF THE STUDY: The inhibition of the surface-related virulence factors is a promising avenue to overcome persistent infections caused by bacterial biofilms. To this end, we show here that proteases, in particular the metalloprotease serratiopeptidase, can interfere with adhesion and invasion of eukaryotic cells and biofilm formation in staphylococci and their use could represent a viable treatment for the development of novel combination therapie

A new anti-infective strategy to reduce the spreading of antibiotic resistance by the action on adhesion-mediated virulence factors in Staphylococcus aureus.

Staphylococcus aureus is a flexible microbial pathogen frequently isolated from community-acquired and nosocomial infections. S. aureus expresses a wide array of secreted and cell surface-associated virulence factors, including proteins that promote adhesion to damaged tissue and to the surface of host cells, and that bind proteins in blood to help evade immune responses. Furthermore, surface proteins have a fundamental role in virulence related properties of S. aureus, including biofilm formation. The present study evaluates the anti-infective capabilities of a secreted protein of Serratia marcescens (serratiopeptidase, SPEP), in impairing some staphylococcal virulence-related properties, such as attachment to inert surfaces and adhesion/invasion on eukaryotic cells. SPEP seems to exert its action by modulating specific proteins. It is not assessed if this action is due to the proteolytic activity of SPEP or to a specific mechanism which triggers an out/inside signal. Proteomic studies performed on surface proteins extracted from SPEP treated S. aureus cultures revealed that a number of proteins are affected by the treatment. Among these we found the adhesin/autolysin Atl, SdrD, Sbi, EF-Tu and EF-G. EF-Tu and EF-G are known to perform a variety of function, depending on their cytoplasmic or surface localization. All these factors can facilitate bacterial colonization, persistence and invasion of host tissues. Our results suggest that SPEP could be developed as a potential "anti-infective agent" capable to hinder the entry of S. aureus into human tissues, and also impairs the ability of this pathogen to adhere to prostheses, catheters and medical device

Singularly perturbed elliptic problems with nonautonomous asymptotically linear nonlinearities

We consider a class of singularly perturbed elliptic problems with nonautonomous asymptotically linear nonlinearities. The dependence on the spatial coordinates comes from the presence of a potential and of a function representing a saturation effect. We investigate the existence of nontrivial nonnegative solutions concentrating around local minima of both the potential and of the saturation function. Necessary conditions to locate the possible concentration points are also given

A simple and reliable methodology to detect egg white in art samples

A protocol for a simple and reliable dot-blot immunoassay was developed and optimized to test work of art samples for the presence of specific proteinaceus material (i.e. ovalbumin-based). The analytical protocol has been extensively set up with respect, among the other, to protein extraction conditions, to densitometric analysis and to the colorimetric reaction conditions. Feasibility evaluation demonstrated that a commercial scanner and a free image analysis software can be used for the data acquisition and elaboration, thus facilitating the application of the proposed protocol to commonly equipped laboratories and to laboratories of museums and conservation centres. The introduction of method of standard additions in the analysis of fresh and artificially aged laboratory-prepared samples, containing egg white and various pigments, allowed us to evaluate the matrix effect and the effect of sample aging and to generate threshold density values useful for the detection of ovalbumin in samples from ancient works of art. The efficacy of the developed dot-blot immunoassay was proved testing microsamples from 13th–16th century mural paintings of Saint Francesco Church in Lodi (Italy). Despite the aging, the altered conditions of conservation, the complex matrix, and the micro-size of samples, the presence of ovalbumin was detected in all those mural painting samples where mass-spectrometry-based proteomic analysis unambiguously detected ovalbumin peptides

Study protocol on advance care planning in multiple sclerosis (ConCure-SM): intervention construction and multicentre feasibility trial

Multiple sclerosis (MS) is the most common cause of progressive neurological disability in young adults. The use of advance care planning (ACP) for people with progressive MS (pwPMS) remains limited. The ConCure-SM project aims to assess the effectiveness of a structured ACP intervention for pwPMS. The intervention consists of a training programme on ACP for healthcare professionals caring for pwPMS, and a booklet to be used during the ACP conversation. Herein, we describe the first two project phases

The impact of the COVID-19 pandemic on people with neurological disorders: an urgent need to enhance the health care system's preparedness

The major ethical issue posed by the COVID 19 pandemic are discussed with special reference to the impact on acute and chronic neurological disorder