26 research outputs found
Biological Monitoring of Metal Ions Released from Hip Prostheses
The aim of this study was to evaluate the levels of As, Be, Bi, Cd, Co, Cr, Cu, Hg, Mn, Ni, Pb, Se, Tl, V, and Zn, by inductively coupled plasma-mass spectrometry (ICP-MS) in the urine of two groups of patients with two different types of metal-on-metal (MoM) total hip prostheses (ASR DePuy\uae, group A, 25 patients; total Met-Met System Lima\uae, group B, 28 patients). The determination of metals reflected a steady-state release (group A: 9 years after surgery and group B: 6 years after surgery). The results obtained confirmed the increase of Co and Cr urinary levels in both group when compared with the reference values for the general population adopted by the Italian Society of Reference Values (SIVR). In particular, Co and Cr levels exceeded the threshold values in urine, respectively, of 30 \u3bcg and 21 \ub5g, adjusted to creatinine based on the threshold in whole blood of 7 \u3bcg/L proposed by the Medicines and Healthcare Products Regulatory Agency (MHRA). Regarding the other investigated metals, significantly higher values were found in Group A than in Group B. These differences could be due to the type of hip prosthesis implanted, the longer period of time since the implantation, as well as many other factors such as diet, age, drug consumption, physical activity, or presence of dental fillings. The continuous monitoring over the years of metal concentrations in patients carrying a prosthesis could be useful to better identify the sources of these metals
Semi-Automatic Method for Early Detection of Xylella fastidiosa in Olive Trees Using UAV Multispectral Imagery and Geostatistical-Discriminant Analysis
Xylella fastidiosa subsp. pauca (Xfp) is one of the most dangerous plant pathogens in the world. Identified in 2013 in olive trees in south–eastern Italy, it is spreading to the Mediterranean countries. The bacterium is transmitted by insects that feed on sap, and causes rapid wilting in olive trees. The paper explores the use of Unmanned Aerial Vehicle (UAV) in combination with a multispectral radiometer for early detection of infection. The study was carried out in three olive groves in the Apulia region (Italy) and involved four drone flights from 2017 to 2019. To classify Xfp severity level in olive trees at an early stage, a combined method of geostatistics and discriminant analysis was implemented. The results of cross-validation for the non-parametric classification method were of overall accuracy = 0.69, mean error rate = 0.31, and for the early detection class of accuracy 0.77 and misclassification probability 0.23. The results are promising and encourage the application of UAV technology for the early detection of Xfp infection
Cyclic Vomiting Syndrome in Children
Cyclic Vomiting Syndrome (CVS) is an underdiagnosed episodic syndrome characterized
by frequent hospitalizations, multiple comorbidities, and poor quality of life. It is often
misdiagnosed due to the unappreciated pattern of recurrence and lack of confirmatory
testing. CVS mainly occurs in pre-school or early school-age, but infants and elderly onset
have been also described. The etiopathogenesis is largely unknown, but it is likely to be
multifactorial. Recent evidence suggests that aberrant brain-gut pathways, mitochondrial
enzymopathies, gastrointestinal motility disorders, calcium channel abnormalities, and
hyperactivity of the hypothalamic-pituitary-adrenal axis in response to a triggering
environmental stimulus are involved. CVS is characterized by acute, stereotyped and
recurrent episodes of intense nausea and incoercible vomiting with predictable periodicity
and return to baseline health between episodes. A distinction with other differential
diagnoses is a challenge for clinicians. Although extensive and invasive investigations
should be avoided, baseline testing toward identifying organic causes is recommended
in all children with CVS. The management of CVS requires an individually tailored therapy
Management of acute phase is mainly based on supportive and symptomatic care. Early
intervention with abortive agents during the brief prodromal phase can be used to attempt
to terminate the attack. During the interictal period, non-pharmacologic measures as
lifestyle changes and the use of reassurance and anticipatory guidance seem to be
effective as a preventive treatment. The indication for prophylactic pharmacotherapy
depends on attack intensity and severity, the impairment of the QoL and if attack
treatments are ineffective or cause side effects. When children remain refractory to
acute or prophylactic treatment, or the episode differs from previous ones, the clinician
should consider the possibility of an underlying disease and further mono- or combination
therapy and psychotherapy can be guided by accompanying comorbidities and specific
sub-phenotype. This review was developed by a joint task force of the Italian Society
of Pediatric Gastroenterology Hepatology and Nutrition (SIGENP) and Italian Society
of Pediatric Neurology (SINP) to identify relevant current issues and to propose future
research directions on pediatric CV
Pathology reporting in neuroendocrine neoplasms of the digestive system: everything you always wanted to know but were too afraid to ask
During the 5th NIKE (Neuroendocrine tumors Innovation in Knowledge and Education) meeting, held in Naples, Italy, in May 2019, discussions centered on the understanding of pathology reports of gastroenetropancreactic neuroendocrine neoplasms. In particular, the main problem concerned the difficulty that clinicians experience in extrapolating relevant information from neuroendocrine tumor pathology reports. During the meeting, participants were asked to identify and rate issues which they have encountered, for which the input of an expert pathologist would have been appreciated. This article is a collection of the most rated questions and relative answers, focusing on three main topics: 1) morphology and classification; 2) Ki67 and grading; 3) immunohistochemistry. Patient management should be based on multidisciplinary decisions, taking into account clinical and pathology-related features with clear comprehension between all health care professionals. Indeed, pathologists require clinical details and laboratory findings when relevant, while clinicians require concise and standardized reports. In keeping with this last statement, the minimum requirements in pathology datasets are provided in this paper and should be a baseline for all neuroendocrine tumor professionals
Commentary: Case Report: Abdominal Lymph Node Metastases of Parathyroid Carcinoma: Diagnostic Workup, Molecular Diagnosis, and Clinical Management
In the issue of March 2021, Lenschow et al. reported the case of a 46-year-old woman with recurrent, programmed death-ligand-1 (PD-L1) negative, tumor mutational burden (TMB)-high parathyroid carcinoma (PC), who showed stable disease as her best response on imaging, and a three-fold drop in PTH after treatment with intravenous pembrolizumab. Given the remarkable results obtained by Lenschow et al. with the anti-PD-1 agent pembrolizumab in the above-mentioned case, we performed an extensive search for possible further relevant data sources, including a) full published articles in international online databases (PubMed, Web of Science, Scopus, and Embase); b) preliminary reports in selected international meeting abstract repositories (American Society of Clinical Oncology, ASCO; European Neuroendocrine Tumor Society, ENET; European Society for Medical Oncology, ESMO); c) registered clinical trials in the U.S. National Institutes of Health registry of clinical trials (http://clinicaltrials.gov) and in any primary register of the WHO International Clinical Trials Registry Platform (ICTRP)
In vitro and in vivo angiogenic activity of osteoarthritic and osteoporotic osteoblasts is modulated by VEGF and vitamin D3 treatment
Metabolically Unhealthy Phenotype: A Key Factor in Determining “Pediatric” Frailty
Frailty (FI) and metabolic syndrome (MS) are each associated with adverse health outcomes. A relationship between FI and MS has previously been described in adults. We considered the prevalence of a metabolically unhealthy phenotype (MUP) in malnourished children with neurological impairment and in subjects with obesity in comparison to a group of elderly individuals at risk of FI, and we did so in order to define the potential similarities that may underline the risk of FI in specific children. We considered 50 undernourished (defined as having a body mass index of BMI ≤ 2, standard deviation score, SDS, according to World Health Organization) disabled children; 50 children with obesity (BMI ≥ 2 SDS); 50 children who were a normal weight (−1 SDS ≤ BMI ≤ +1 SDS); 21 patients who were >75 years old. MUP was defined as the presence of at least one of the following risk factors: hypertension, hyperglycemia or diabetes, hypercholesterolemia, and hypertriglyceridemia. In children with a disability and obesity, a higher prevalence (p < 0.001) and risk (disability OR 54.88, obesity OR 13.37) of MUP was noted compared to children of a normal weight. Compared to elderly patients, the prevalence of MUP did not differ in disabled children. On the contrary, MUP was lower in children with obesity (p < 0.001) and in pediatric subjects of a normal weight (p < 0.01). MS might play a key role in “pediatric” frailty. The extremities of the aging process and malnutrition are likely key factors in the development of FI. A multidisciplinary approach to FI may represent an important milestone for pediatric care
Gender differences in vaccine therapy: where are we in COVID-19 pandemic?
Vaccination is one of the greatest achievements of public health. Vaccination programs have contributed to the decline in mortality and morbidity of various infectious diseases. This review aims to investigate the impact of sex/gender on the vaccine acceptance, responses, and outcomes. The studies were identified by using PubMed, until 30th June 2020. The search was performed by using the following keywords: SARS-CoV-2, COVID-19, gender, sex, vaccine, adverse reaction. Clinical trials, retrospective and prospective studies were included. Studies written in languages other than English were excluded. Studies were included if gender differences in response to vaccination trials were reported. All selected studies were qualitatively analyzed. Innate recognition and response to viruses, as well as, adaptive immune responses during viral infections, differ between females and males. Unfortunately, a majority of vaccine trials have focused on healthy people, with ages between 18 to 65 years, excluding the elderly, pregnant women, post-menopausal female and children. In conclusion, it is apparent that the design of vaccines and vaccine strategies should be sex-specific, to reduce adverse reactions in females and increase immunogenicity in males. It should be mandatory to examine sex-related variables in pre-clinical and clinical vaccine trials, such as their crucial role for successful prevention of pandemic COVID-19
Nutraceutical Preventative and Therapeutic Potential in Neuroblastoma: From Pregnancy to Early Childhood
Neuroblastoma (NB) is a highly malignant embryonic extracranial solid tumor that arises from sympathoadrenal neuroblasts of neural crest origin. In addition to genetic factors, NB has been linked to maternal exposure to a variety of substances during pregnancy. Recent interest in the potential of nutrients to prevent cancer and reduce malignancy has resulted in the identification of several nutraceuticals including resveratrol, curcumin, and molecular components of garlic, which together with certain vitamins may help to prevent NB development. As NBs arise during fetal development and progress during early childhood, specific NB inhibiting nutraceuticals and vitamins could enhance the preventative influence of maternal nutrition and breast feeding on the development and early progression of NB. In this article, we review NB inhibitory nutraceuticals and vitamins, their mechanisms of action and expound their potential as maternal nutritional supplements to reduce NB development and progression during fetal growth and early childhood, whilst at the same time enhancing maternal, fetal, and infant health