Treatment of severe hyperbilirubinemia through coupled plasma filtration adsorption

The development of severe hyperbilirubinemia after cardiac surgery performed with cardiopulmonary bypass is a possible life-threatening challenging complication because its mechanism is still not completely clarified, and there are only a few specific therapies available for acute hepatobiliary injury. Here, we report the case of an 80-year-old male scheduled for elective aortic valve replacement, during the 1st post-operative day (POD 1), developed acute systo-diastolic cardiac failure, with a severe aortic paravalvular leak. The surgeon decided reoperation to correct prosthesis dehiscence. There was a continuous total serum bilirubin increase, with a peak value of 24.50 mg/dl on POD 16. It was diagnosed as a “cholestatic post-cardiac surgery syndrome,” and we performed seven cycles of coupled plasma filtration adsorption (CPFA), with definitive stable bilirubinemia reduction to 3.0 mg/dl at the discharge. CPFA was found to be a good hemodepurative technique to manage successfully severe hyperbilirubinemia of “cholestatic post-cardiac surgery syndrome.

Vascular flora evolution in the major Mediterranean islands

Characteristics of Mediterranean island floras are analyzed with stress on endemic units. On these bases the main relationships between the major Mediterranean areas and the inland territories with the strongest floristic affinities are analyzed. Finally the role of aliens in Mediterranean island floras and threats are discussed

Studio botanico finalizzato al recupero del paesaggio vegetale dell’Area archeologica di Lilibeo presso Marsala (Sicilia occidentale)

Viene presentato uno studio botanico volto al recupero del paesaggio vegetale dell’Area Archeologica di Capo Lilibeo (Marsala). Il progetto prevede l’eradicazione delle specie esotiche ad alto grado di invasività quali Ailanthus altissima e Vachellia karroo, il risanamento fitosanitario dei viali di Palme delle Canarie e la sostituzione degli individui malformati con specie ornamentali altamente decorative e a basso grado di invasività. E’ previsto l’impiego di specie afferenti agli stadi più evoluti dei sigmataxa Chamaeropo humilis- Querceto calliprini sigmetum ed al Pistacio lentisci- Chamaeropo humilis sigmetum al fine di assicurare i migliori risultati contro l’espansione della componente esotica ad alto grado di invasività.A plan based on a previous botanical investigation is presented here in order of recovering the plant landscape of the archaeological area o fthe Lilibeo Cape near Marsala. It includes the uprooting of highly invasive exotics such as Ailanthus altissima and Vachellia karroo, the recovery of the Canary date palms the replacement of disfigured tree specimens using less invasive ornamental trees. In addition, species belonging to the final stages of the sigmataxa Chamaeropo humilis- Querceto calliprini sigmetum and of the Pistacio lentisci- Chamaeropo humilis sigmetum in order to oppose successful barriers against the most invasive aliens

First results on the phenotypic analysis of wild and cultivated species of Pyrus in Sicily

Phenotypic analysis of Pyrus in Sicily using a set of 19 characters on 71 accessions belonging to 7 species is here reported. Results show a high level of morphological variation in this genus. Cluster analysis of the morphological characters allows to identify two groups: the first closely related to wild pears and the latter related to P. communis s. l. and P. sicanorum. It is likely to think that many Ethno-Varieties, usually attributed to P. communis, on the contrary are attributable to wild Sicilian pears and belong to indigenous germplasm

L’ATTIVITÀ DELL’ORTO BOTANICO DI PALERMO E DELLE STRUTTURE COLLEGATE PER LA CONSERVAZIONE DEGLI ANTICHI FRUTTIFERI DELLA SICILIA

B6 = L’ATTIVITÀ DELL’ORTO BOTANICO DI PALERMO E DELLE STRUTTURE COLLEGATE PER LA CONSERVAZIONE DEGLI ANTICHI FRUTTIFERI DELLA SICILIA P. MARINO1, M. GERACI2, D. CRISÀ2, F. M. RAIMONDO1, R. SCHICCHI1 1Dipartimento di Biologia ambientale e Biodiversità dell’Università, Via Archirafi, 38 - 90123 Palermo. [email protected] 2Ente Parco dei Nebrodi, Piazza Duomo – 98076 Sant’Agata di Militello, Messina L’attività di individuazione, valutazione e raccolta del germoplasma delle specie arboree da frutto di prevalente interesse negli agrosistemi tradizionali della Sicilia, iniziata nel 2005 (Schicchi et al., 2008a; Schicchi et al., 2008b) si protrae ancora oggi attraverso azioni volte alla conservazione ed alla diffusione delle risorse genetiche vegetali a rischio di erosione, tramite l’adesione ad iniziative a carattere pubblico previste dal PSR Sicilia 2007/2013 Reg. CE 1698/2005 Misura 214/2 - Azione A: Preservazione della biodiversità. Al riguardo, l’Orto botanico di Palermo ha promosso tre progetti attivando collaborazioni con Enti di ricerca, Enti locali e territoriali. L’attività, finalizzata alla costituzione di un network regionale per la conservazione e diffusione della biodiversità degli antichi fruttiferi, si articola in più fasi: a) individuazione, raccolta e caratterizzazione di ecotipi e varietà; b) realizzazione di centri, ex situ, per la conservazione, caratterizzazione, propagazione e utilizzazione del germoplasma agrario, in vivo e in vitro; c) allestimento dei campi collezione; d) realizzazione di centri per la produzione di piante madri; e) attività di diffusione sul territorio; f) predisposizione e implementazione di reti e azioni di accompagnamento. Per il raggiungimento dei suddetti obiettivi sono stati presentati e ammessi a finanziamento tre progetti. Il primo progetto (CenBioS), attivato dal Dipartimento di Biologia ambientale e Biodiversità dell’Università di Palermo, prende in considerazione il germoplasma del ciliegio (Prunus avium L.), melo (Malus domestica Bork.), pero (Pyrus communis L.) e fico (Ficus carica L.) a rischio di erosione genetica, di cui si propone la conservazione nell’ambito di due distinti campi collezione e la realizzazione di un campo di piante madri da realizzare rispettivamente a Montagnareale (Messina) e Cammarata (Agrigento). Il secondo progetto (MadBioS), di cui è soggetto proponente il Consorzio Universitario della Provincia di Palermo, prevede la realizzazione di tre distinti campi collezione. Il primo, nell’agro di Pollina (Palermo), ospiterà il germoplasma delle antiche cultivar di frassini da manna afferenti a Fraxinus angustifolia Vahl e Fraxinus ornus L.; il secondo, nel territorio di Isnello, ospiterà le cultivar locali di pero e melo; il terzo, da realizzare presso l’azienda dell’Istituto Professionale per l’Agricoltura e l’Ambiente di Castelbuono (Palermo), riguarda diverse cultivar di albicocco (Prunus armeniaca L.), pesco [Prunus persica (L.) Batsch] e susino (Prunus domestica L.) presenti nell’area delle Madonie. Il terzo progetto, di cui è capofila l’Ente Parco dei Nebrodi, prevede l’implementazione dell’attuale “Banca vivente del germoplasma vegetale dei Nebrodi” attraverso l’allestimento e il potenziamento di campi collezione e di piante madri nella sede di Ucria (Messina) e presso l’Istituto Professionale per l’Agricoltura e l’Ambiente di Caronia (Messina). Tali campi ospiteranno le cultivar tradizionali e antiche dell’area nebroidea di melo, albicocco, pesco, susino e pero. Nel complesso, oltre all’accertamento della corrispondenza varietale e delle condizioni fitosanitarie di oltre 150 etnovarietà, è prevista la caratterizzazione pomologica e genetica e la propagazione delle stesse nel territorio regionale, nell’ambito delle aziende agricole che aderiscono alla Misura 214/2 az. B del PSR. Schicchi R., Marino P. & Raimondo F.M., 2008. Individuazione, valutazione e raccolta del germoplasma delle specie arboree da frutto di prevalente interesse negli agrosistemi tradizionali della Sicilia. Collana Sicilia Foreste, Palermo. Schicchi R., Marino P., Saporito L., Di Noto G. & Raimondo F.M., 2008. Catalogo pomologico degli Antichi fruttiferi di Sicilia. Università di Palermo, Dip. Scienze Botaniche, Palermo

Acute abdomen as a consequence of an unusual suicide attempt: intra-abdominal injection of sulfuric acid

Caustic ingestion is a common cause of life-threatening upper gastrointestinal tract injuries. It mostly happens in children as accidental exposure, but may occur in adults as a result of suicide attempt. We present a case of an acute abdomen that occurred after a peculiar way of self-administration of sulfuric acid as a suicide attempt in an adult psychiatric male patient, already known for self-harm with caustic agents in the previous years. In a few hours, the patient developed diffuse peritonitis, pneumoperitoneum, and a rapid hemodynamic deterioration, as a consequence of ileum and sigmoid necrosis, requiring an emergency surgery with the application of a damage control strategy. The patient was then transferred to intensive care unit for hemodynamic stabilization, and definitive surgical correction of the abdominal lesions was performed after 3 days with Hartmann procedure. Thirty-nine days after hospital admission, the patient was discharged. In conclusion, to our knowledge, never has been reported in the literature a case of intra-abdominal self-administration of caustic substance causing a rapid evolution of clinical conditions and requiring the application of damage control strategy

Effects of ventilator settings, nebulizer and exhalation port position on albuterol delivery during non-invasive ventilation: an in-vitro study.

BACKGROUND:Few studies have investigated the factors affecting aerosol delivery during non-invasive ventilation (NIV). Our aim was to investigate, using a bench-top model, the effect of different ventilator settings and positions of the exhalation port and nebulizer on the amount of albuterol delivered to a lung simulator. METHODS: A lung model simulating spontaneous breathing was connected to a single-limb NIV ventilator, set in bi-level positive airway pressure (BIPAP) with inspiratory/expiratory pressures of 10/5, 15/10, 15/5, and 20/10 cmH2O, or continuous positive airway pressure (CPAP) of 5 and 10 cmH2O. Three delivery circuits were tested: a vented mask with the nebulizer directly connected to the mask, and an unvented mask with a leak port placed before and after the nebulizer. Albuterol was collected on a filter placed after the mask and then the delivered amount was measured with infrared spectrophotometry. RESULTS: Albuterol delivery during NIV varied between 6.7\u2009\ub1\u20090.4% to 37.0\u2009\ub1\u20094.3% of the nominal dose. The amount delivered in CPAP and BIPAP modes was similar (22.1\u2009\ub1\u200910.1 vs. 24.0\u2009\ub1\u200910.0%, p\u2009=\u20090.070). CPAP level did not affect delivery (p\u2009=\u20090.056); in BIPAP with 15/5 cmH2O pressure the delivery was higher compared to 10/5 cmH2O (p\u2009=\u20090.033) and 20/10 cmH2O (p\u2009=\u20090.014). Leak port position had a major effect on delivery in both CPAP and BIPAP, the best performances were obtained with the unvented mask, and the nebulizer placed between the leak port and the mask (p\u2009<\u20090.001). CONCLUSIONS: In this model, albuterol delivery was marginally affected by ventilatory settings in NIV, while position of the leak port had a major effect. Nebulizers should be placed between an unvented mask and the leak port in order to maximize aerosol delivery

Electrospun Membranes Designed for Burst Release of New Gold-Complexes Inducing Apoptosis of Melanoma Cells

Two non-commercial metallic Au-based complexes were tested against one of the most aggressive malignant melanomas of the skin (MeWo cells), through cell viability and time-lapse live-cell imaging system assays. The tests with the complexes were carried out both in the form of free metallic complexes, directly in contact with the MeWo cell line culture, and embedded in fibers of Polycaprolactone (PCL) membranes produced by the electrospinning technique. Membranes functionalized with complexes were prepared to evaluate the efficiency of the membranes against the melanoma cells and therefore their feasibility in the application as an antitumoral patch for topical use. Both series of tests highlighted a very effective antitumoral activity, manifesting a very relevant cell viability inhibition after both 24 h and 48 h. In the case of the AuM1 complex at the concentration of 20 mM, melanoma cells completely died in this short period of time. A mortality of around 70% was detected from the tests performed using the membranes functionalized with AuM1 complex at a very low concentration (3 wt.%), even after 24 h of the contact period. The synthesized complexes also manifest high selectivity with respect to the MeWo cells. The peculiar structural and morphological organization of the nanofibers constituting the membranes allows for a very effective antitumoral activity in the first 3 h of treatment. Experimental points of the release profiles were perfectly fitted with theoretical curves, which easily allow interpretation of the kinetic phenomena occurring in the release of the synthesized complexes in the chosen medium

Protective, Antioxidant and Antiproliferative Activity of Grapefruit IntegroPectin on SH-SY5Y Cells

Tested in vitro on SH-SY5Y neuroblastoma cells, grapefruit IntegroPectin is a powerful protective, antioxidant and antiproliferative agent. The strong antioxidant properties of this new citrus pectin, and its ability to preserve mitochondrial membrane potential and morphology, severely impaired in neurodegenerative disorders, make it an attractive therapeutic and preventive agent for the treatment of oxidative stress-associated brain disorders. Similarly, the ability of this pectic polymer rich in RG-I regions, as well as in naringin, linalool, linalool oxide and limonene adsorbed at the outer surface, to inhibit cell proliferation or even kill, at high doses, neoplastic cells may have opened up new therapeutic strategies in cancer research. In order to take full advantage of its vast therapeutic and preventive potential, detailed studies of the molecular mechanism involved in the antiproliferative and neuroprotective of this IntegroPectin are urgently needed

A simplified genomic profiling approach predicts outcome in metastatic colorectal cancer

The response of metastatic colorectal cancer (mCRC) to the first-line conventional combination therapy is highly variable, reflecting the elevated heterogeneity of the disease. The genetic alterations underlying this heterogeneity have been thoroughly characterized through omic approaches requiring elevated efforts and costs. In order to translate the knowledge of CRC molecular heterogeneity into a practical clinical approach, we utilized a simplified Next Generation Sequencing (NGS) based platform to screen a cohort of 77 patients treated with first-line conventional therapy. Samples were sequenced using a panel of hotspots and targeted regions of 22 genes commonly involved in CRC. This revealed 51 patients carrying actionable gene mutations, 22 of which carried druggable alterations. These mutations were frequently associated with additional genetic alterations. To take into account this molecular complexity and assisted by an unbiased bioinformatic analysis, we defined three subgroups of patients carrying distinct molecular patterns. We demonstrated these three molecular subgroups are associated with a different response to first-line conventional combination therapies. The best outcome was achieved in patients exclusively carrying mutations on TP53 and/or RAS genes. By contrast, in patients carrying mutations in any of the other genes, alone or associated with mutations of TP53/RAS, the expected response is much worse compared to patients with exclusive TP53/RAS mutations. Additionally, our data indicate that the standard approach has limited efficacy in patients without any mutations in the genes included in the panel. In conclusion, we identified a reliable and easy-to-use approach for a simplified molecular-based stratification of mCRC patients that predicts the efficacy of the first-line conventional combination therapy