Botulinum toxin A treatment for primary hemifacial spasm - A 10-year multicenter study

BACKGROUND: Botulinum toxin A (BTX) is the currently preferred symptomatic treatment for primary hemifacial spasm (HFS), but its long-term efficacy and safety are not known. OBJECTIVE: To assess the long-term effectiveness and safety of BTX in the treatment of primary HFS. DESIGN: Retrospective review of medical records of the 1st and 10th years of treatment. SETTING: Outpatient clinics of 4 Italian university centers in the Italian Movement Disorders Study Group. PARTICIPANTS: A series of 65 patients with primary HFS who had received BTX injections regularly for at least 10 years. MAIN OUTCOME MEASURES: Mean duration of improvement and quality of the effect induced by the preceding treatment (measured using a patient self-evaluation scale) and occurrence and duration of adverse effects in the 1st and 10th years of treatment. RESULTS: Using a mean BTX dose per treatment session similar to that used by others, we obtained a 95% response rate and an overall mean duration of improvement of 12.6 weeks during year 1. The effectiveness of BTX in relieving the symptoms of primary HFS, as measured by the response rate and average duration of improvement, remained unchanged in the 1st and 10th years. Patients needed statistically similar BTX doses in the 1st and 10th years. The rate of local adverse effects (including upper lid ptosis, facial weakness, and diplopia) diminished significantly in the 10th year of treatment. CONCLUSION: Treatment with BTX effectively induces sustained relief from symptoms of HFS in the long term, with only minimal and transient adverse reactions

A comprehensive characterization of Hermetia illucens derived chitosan produced through homogeneous deacetylation

The increasing demand for chitin and chitosan is driving research to explore alternative sources to crustaceans. Insects, particularly bioconverters as Hermetia illucens, are promising substitutes as they process food industry waste into valuable molecules, including chitin. Chitosan can be produced by chitin deacetylation: hot deacetylation to obtain a heterogeneous chitosan, the commonly produced, and cold deacetylation to obtain a homogeneous chitosan, not widely available. The two different treatments lead to a different arrangement of the amine and acetyl groups in the chitosan structure, affecting its molecular weight, deacetylation degree, and biological activity. This is the first report on the production and chemical-physical and biological characterization of homogenous chitosan derived from H. illucens larvae, pupal exuviae, and adults. This work, in addition to the report on heterogeneous chitosan by our research group, completes the overview of H. illucens chitosan. The yield values obtained for homogeneous chitosan from pupal exuviae (3 and 7 %) are in the range of insect (2–8 %) and crustaceans (4–15 %) chitosan. The evaluation of the antioxidant activity and antimicrobial properties against Gram-negative (Escherichia coli) and Gram-positive (Micrococcus flavus) bacteria confirmed the great versatility of H. illucens chitosan for biomedical and industrial applications and its suitability as an alternative source to crustaceans

Antimicrobial properties of chitosan from different developmental stages of the bioconverter insect Hermetia illucens

Growing antimicrobial resistance has prompted researchers to identify new natural molecules with antimicrobial potential. In this perspective, attention has been focused on biopolymers that could also be functional in the medical field. Chitin is the second most abundant biopolymer on Earth and with its deacetylated derivative, chitosan, has several applications in biomedical and pharmaceutical fields. Currently, the main source of chitin is the crustacean exoskeleton, but the growing demand for these polymers on the market has led to search for alternative sources. Among these, insects, and in particular the bioconverter Hermetia illucens, is one of the most bred. Chitin can be extracted from larvae, pupal exuviae and dead adults of H. illucens, by applying chemical methods, and converted into chitosan. Fourier-transformed infrared spectroscopy confirmed the identity of the chitosan produced from H. illucens and its structural similarity to commercial polymer. Recently, studies showed that chitosan has intrinsic antimicrobial activity. This is the first research that investigated the antibacterial activity of chitosan produced from the three developmental stages of H. illucens through qualitative and quantitative analysis, agar diffusion tests and microdilution assays, respectively. Our results showed the antimicrobial capacity of chitosan of H. illucens, opening new perspectives for its use in the biological area

Elevated 4R-tau in astrocytes from asymptomatic carriers of the MAPT 10+16 intronic mutation

The microtubule-associated protein tau gene (MAPT) 10+16 intronic mutation causes frontotemporal lobar degeneration (FTLD) by increasing expression of four-repeat (4R)-tau isoforms. We investigated the potential role for astrocytes in the pathogenesis of FTLD by studying the expression of 4R-tau. We derived astrocytes and neurons from induced pluripotent stem cells from two asymptomatic 10+16 carriers which, compared to controls, showed persistently increased 4R:3R-tau transcript and protein ratios in both cell types. However, beyond 300 days culture, 10+16 neurons showed less marked increase of this 4R:3R-tau transcript ratio compared to astrocytes. Interestingly, throughout maturation, both 10+16 carriers consistently displayed different 4R:3R-tau transcript and protein ratios. These elevated levels of 4R-tau in astrocytes implicate glial cells in the pathogenic process and also suggests a cell-type-specific regulation and may inform and help on treatment of pre-clinical tauopathies

Assessing the levels of awareness among european citizens about the direct and indirect impacts of plastics on human health

There is an urgent need to assess European citizens' perspective regarding their plastic consumption and to evaluate their awareness of the direct and indirect effect of plastics on human health in order to influence current behavior trends. In this study, the evaluation has been cross-related with scientific facts, with the final aim of detecting the most recommendable paths in increasing human awareness, reducing plastic consumption, and consequently impacting human health. A statistical analysis of quantitative data, gathered from 1000 European citizens via an online survey in the period from May to June 2020, showed that a general awareness about the direct impact of plastic consumption and contamination (waste) on human health is high in Europe. However, only a few participants (from a higher educational group) were aware of the indirect negative effects that oil extraction and industrial production of plastic can have on human health. This finding calls for improved availability of this information to general public. Despite the participants' positive attitude toward active plastic reduction (61%), plastic consumption on a daily basis is still very high (86%). The most common current actions toward plastic reduction are plastic bag usage, reusage, or replacement with sustainable alternatives (e.g., textile bags) and selecting products with less plastic packaging. The participants showed important criticism toward the information available to the general public about plastics and health. This awareness is important since significant relation has been found between the available information and the participants' decisions on the actions they might undertake to reduce plastic consumption. The study clearly showed the willingness of the participants to take action, but they also requested to be strongly supported with joint efforts from government, policies, and marketing, defining it as the most successful way toward implementing these changes

Characterization of chitin and chitosan derived from Hermetia illucens, a further step in a circular economy process

Due to their properties and applications, the growing demand for chitin and chitosan has stimulated the market to find more sustainable alternatives to the current commercial source (crustaceans). Bioconverter insects, such as Hermetia illucens, are the appropriate candidates, as chitin is a side stream of insect farms for feed applications. This is the first report on production and characterization of chitin and chitosan from different biomasses derived from H. illucens, valorizing the overproduced larvae in feed applications, the pupal exuviae and the dead adults. Pupal exuviae are the best biomass, both for chitin and chitosan yields and for their abundance and easy supply from insect farms. Fourier-transform infrared spectroscopy, X-ray diffraction and scanning electron microscope analysis revealed the similarity of insect-derived polymers to commercial ones in terms of purity and structural morphology, and therefore their suitability for industrial and biomedical applications. Its fibrillary nature makes H. illucens chitin suitable for producing fibrous manufacts after conversion to chitin nanofibrils, particularly adults-derived chitin, because of its high crystallinity. A great versatility emerged from the evaluation of the physicochemical properties of chitosan obtained from H. illucens, which presented a lower viscosity-average molecular weight and a high deacetylation degree, fostering its putative antimicrobial properties

Preliminary investigation on the effect of insect-based chitosan on preservation of coated fresh cherry tomatoes

: Chitosan was produced from Hermetia illucens pupal exuviae by heterogeneous and homogeneous deacetylation. Tomato fruits (Solanum lycopersicum), that are one of the most grown and consumed food throughout the world, were coated with 0.5 and 1% chitosan, applied by dipping or spraying, and stored at room temperature or 4 °C, for a storage period of 30 days. Statistical analysis give different results depending on the analysed parameters: heterogeneous chitosan, indeed, had a better effect than the homogenous one in maintaining more stable physico-chemical parameters, while the homogenous chitosan improved the total phenols, flavonoids and antioxidant activity. Chitosan coatings applied by spraying were more effective in all the analyses. Chitosan derived from H. illucens always performed similarly to the commercial chitosan. However, a general better performance of insect-derived chitosan on the concentration of phenolics and flavonoids, and the antioxidant activity was observed as compared to the commercial one. Chitosan coating has already been successfully used for preservation of fresh fruits, as alternative to synthetic polymers, but this is the first investigation of chitosan produced from an insect for this application. These preliminary results are encouraging regarding the validation of the insect H. illucens as a source of chitosan

Thyroid hormone inhibition in L6 myoblasts of IGF-I-mediated glucose uptake and proliferation: New roles for integrin αvβ3

Thyroid hormones L-thyroxine (T4) and 3,3′,5-triiodo-L-thyronine (Se

Serous cystic neoplasm of the pancreas: A multinational study of 2622 patients under the auspices of the International Association of Pancreatology and European Pancreatic Club (European Study Group on Cystic Tumors of the Pancreas)

OBJECTIVES: Serous cystic neoplasm (SCN) is a cystic neoplasm of the pancreas whose natural history is poorly known. The purpose of the study was to attempt to describe the natural history of SCN, including the specific mortality. DESIGN: Retrospective multinational study including SCN diagnosed between 1990 and 2014. RESULTS: 2622 patients were included. Seventy-four per cent were women, and median age at diagnosis was 58\u2005years (16-99). Patients presented with non-specific abdominal pain (27%), pancreaticobiliary symptoms (9%), diabetes mellitus (5%), other symptoms (4%) and/or were asymptomatic (61%). Fifty-two per cent of patients were operated on during the first year after diagnosis (median size: 40\u2005mm (2-200)), 9% had resection beyond 1\u2005year of follow-up (3\u2005years (1-20), size at diagnosis: 25\u2005mm (4-140)) and 39% had no surgery (3.6\u2005years (1-23), 25.5\u2005mm (1-200)). Surgical indications were (not exclusive) uncertain diagnosis (60%), symptoms (23%), size increase (12%), large size (6%) and adjacent organ compression (5%). In patients followed beyond 1\u2005year (n=1271), size increased in 37% (growth rate: 4\u2005mm/year), was stable in 57% and decreased in 6%. Three serous cystadenocarcinomas were recorded. Postoperative mortality was 0.6% (n=10), and SCN's related mortality was 0.1% (n=1). CONCLUSIONS: After a 3-year follow-up, clinical relevant symptoms occurred in a very small proportion of patients and size slowly increased in less than half. Surgical treatment should be proposed only for diagnosis remaining uncertain after complete workup, significant and related symptoms or exceptionally when exists concern with malignancy. This study supports an initial conservative management in the majority of patients with SCN