Absence of beta-globin synthesis and excess of alpha-globin synthesis in homozygous beta-Thalassemia

Globin chain synthesis has been studied in β‐thalassemia by incubating red blood cells of 10 homozygous thalassemic patients with [3H] amino acids, and by measuring the incorporation of radioactivity into the globin chains, separated by column chromatography. Five of the ten patients were never transfused, five were polytransfused. The following results were obtained: (a) absence of β chain synthesis in both polytransfused and never trasfused patients; (b) excess of α chain synthesis in the ten cases examined (ratio α synthesis/(γ+δ) synthesis = 3.0). In three heterozygous subjects β globin synthesis and an excess of α chain synthesis was observed (ratio α/(β+γ+δ) = 1.6). The possible interpretations of these results are presented in the discussion. Copyright © 1967, Wiley Blackwell. All rights reserve

Value creation in the chain of "Parmigliano-Reggiano" cheese

The analysis of competitiveness should not focus exclusively on the efficiency of a single company, but on the effectiveness of the whole system. The capability of firms to compete in markets is increasingly linked to the development of relationships among firms operating at the different stages of the chain. The value created by an integrated production system arises from both the efficiency of the single firms and the development of co-operatives relationships. In the Parmigiano-Reggiano cheese production chain this kind of relationship is quite strong. For these reason, the analysis of competitiveness of the different players is crucial in order to define possible line of strategic action

STUDIO DEI DATI DEMOGRAFICI, CLINICI E DI INDICI DI OUTCOME DI PAZIENTI IN STATO VEGETATIVO CONSEGUENTE A GRAVE CEREBROLESIONE ACQUISITA IN ITALIA.

Introduzione. La riabilitazione delle Grave Cerebrolesioni Acquisite (GCA) rappresenta un complesso problema medico e sociale1,2. In particolare \ue8 segnalata la mancanza di dati epidemiologici e clinici nazionali riguardanti pazienti in stato vegetativo (SV) conseguente a GCA. Lo scopo di questo studio \ue8 di raccogliere ed analizzare dati epidemiologi, clinici e di outcome riguardanti pazienti in stato vegetativo conseguente a grave cerebrolesione acquisita in Italia, a nome dei centri aderenti al Registro on-line sulle GCA. Materiali e Metodi. Sono stati raccolti dati relativi a 492 pazienti affetti da Grave Cerebrolesione Acquisita e ricoverati in 29 riabilitazioni Italiane nel periodo tra Giugno 2008 e Dicembre 2011. Tutti i pazienti all\u2019ingresso erano in stato vegetativo (DRS-Disability Rating Scale > 21). I dati raccolti riguardavano parametri demografici (et\ue0, sesso), parametri clinici (eziologia della lesione, Glasgow Coma Scale, presenza di tracheostomia) e di outcome funzionale (DRS). Risultati. 183 (37%) pazienti in SV presentavano GCA di origine traumatica, 198 (40%) di origine vascolare e 111 (3%) conseguente ad insulto anossico. Il punteggio medio alla Glasgow Coma Scale (GCS) in ingresso era di 5. Alla dimissione il 43 % dei pazienti totali rimaneva in SV (di cui il 27% dei pazienti traumatici, il 41% dei vascolari e il 32% degli anossici), l\u20198% dei pazienti era deceduto durante la degenza (di cui il 21% dei traumatici, il 46% dei vascolari e il 33% degli anossici). Il restante 57% era uscito dallo stato vegetativo. L\u2019et\ue0 media della popolazione esaminata era 52 anni (43 anni per i pazienti con eziologia traumatica, 59 anni per i vascolari e 53 anni per gli anossici). Sul totale dei pazienti 331 (67%) erano di sesso maschile. Nei singoli gruppi eziologici il genere maschile rappresentava il 62% (69) degli anossici, il 54% (108) dei vascolari e l\u201984% (154) dei traumatici. 454 pazienti (92%) dei pazienti analizzati erano tracheostomizzati all\u2019ingresso in Riabilitazione (94% dei traumatici, 89% dei vascolari e 93% degli anossici). Dei pazienti con lesione traumatica che, alla dimissione dalla struttura riabilitativa, risultavano usciti e non dallo stato vegetativo l\u201988% e il 99% rispettivamente presentavano tracheostomia all\u2019ingresso. Cosi come nei pazienti con lesione vascolare la percentuale era pari all\u201985% ed al 94% e pari a 90% ed il 94% nei pazienti con danno anossico. Il 49% dei pazienti traumi, il 68% dei vascolari e il 77% degli anossici che uscivano dallo stato vegetativo presentavano una severa disabilit\ue0 alla dimissione (DRS 17-21). Conclusioni. Dall\u2019analisi emerge come una quota considerevole dei pazienti che entrano in degenza riabilitativa in stato vegetativo presenta alla dimissione un miglioramento dello stato di coscienza. Tuttavia la maggioranza di essi \ue8 affetto da un grado estremamente severo di disabilit\ue0 con conseguente necessit\ue0 di avvio di ben definiti percorsi sociali e/o assistenziali3. La ricerca di correlazioni e di fattori predittivi ha l\u2019obiettivo di contribuire alla creazione di progetti riabilitativi sempre pi\uf9 adeguati alle necessit\ue0 e agli obiettivi funzionali dei pazienti in stato vegetativ

First impact of COVID-19 on services and their preparation "instant paper from the field" on rehabilitation answers to the COVID-19 emergency

This paper reports the immediate impact of the epidemic on rehabilitation services in Italy, the first country in Europe hit by COVID-19. In a country with almost 5000 Physical and Rehabilitation Medicine physicians, the webinar had 230 live viewers (4.5%), and more than 8900 individual visualizations of the recorded version. The overall inadequate preparation of the rehabilitation system to face a sudden epidemic was clear, and similar to that of the acute services. The original idea of confining the COVID-19 cases to some areas of rehabilitation wards and/or hospitals, preserving others, proved not to be feasible. Continuous reorganization and adaptation were required due to the rapid changes. Overall, rehabilitation needs had to surrender to the more acute emergency, with total conversion of beds, wards and even hospitals. The quarantine needs heavily involved also outpatient services that were mostly closed. Rehabilitation professionals needed support, but also acted properly, again similarly to what happened in the acute wards. The typical needs of rehabilitation, such as human and physical contacts, but also social interactions including patient, team, family and caregivers, appeared clearly in the current unavoidable need of being suppressed. These notes could serve the preparation of other services worldwide

The tracheotomy tube weaning in patients with severe acquired brain injury: Comparison of two operative procedures in a postacute rehabilitation hospital

BACKGROUND: despite the high frequency of tracheotomy in severe acquired brain injury (sabi) patients, available literature about the weaning procedure is mainly represented by expert opinions with no standardized and evidence-based criteria. aiM: the institute of physical and rehabilitation Medicine \u201cGervasutta\u201d adopted a new decannulation procedure, recommended by the italian society of physical Medicine and rehabilitation (SIMFER). this study evaluates whether the new procedure helps to improve the decannulation process of sabi patients. DESIGN: a prospective observational with historical control was performed by dividing sabi patients into two groups depending on whether they were treated with or without the new procedure. sEttiNG: the department of Neurorehabilitation of the institute of physical and rehabilitation Medicine \u201cGervasutta\u201d in udine, Italy. populatioN: sabi patients with tracheal cannula admitted to the institute of physical and rehabilitation Medicine \u201cGervasutta\u201d from January 2015 to March 2019. MEthods: clinical data were collected as both process and outcome indicators before and after the adoption of the new procedure. data have been processed with simple interactive statistical analysis (sisa; irving, tX, usa) software. rEsults: a sample of 141 patients was analysed. among the 141 patients, 57 (40.4%) were treated with the new procedure. No differences were found between the two groups in terms of complications, functional independence measure (fiM), or level of cognitive functioning (lcf) at the admission. When the new procedure was applied, the decannulation rate was significantly higher (OR=1.8; 95% CI=1.2-9.8; P=0.01) and the time (days) between admission and oral feeding resumption was significantly lower (P<0.001; 95% CI=-10, -34 days). coNclusioNs: the introduction of the new protocol allowed the safe achievement of both oral feeding resumption and decannulation, which are two of the main early rehabilitation goals. CLINICAL REHABILITATION IMPACT: The standardization of the decannulation process has determined the achievement of a significantly faster oral feeding resumption and an increase in the decannulation rate during the rehabilitation of sabi patients

Internalization and recycling of ALCAM/CD166 detected by a fully human single-chain recombinant antibody.

Activated leukocyte cell adhesion molecule (ALCAM/CD166), a member of the immunoglobulin superfamily with five extracellular immunoglobulin-like domains, promotes heterophilic (ALCAM-CD6) and homophilic (ALCAM-ALCAM) cell-cell interactions. Here we describe a fully human single-chain antibody fragment (scFv) directed to ALCAM/CD166. We selected the I/F8 scFv from a phage display library of human V-gene segments by cell panning and phage internalization into IGROV-I human ovary carcinoma cells. The I/F8 specificity was identified as ALCAM/CD166 by matrix-assisted laser desorption/ionisation time-of-flight (MALDI-TOF) peptide mass fingerprinting of the I/F8-immunoprecipitated protein. The I/F8 scFv reacts with the human, monkey and murine ALCAM/CD166 molecule, indicating that the recognized epitope is highly conserved. The I/F8 scFv completely abolished binding of both ALCAM/Fc and CD6/Fc soluble ligands, whereas it did not compete with the anti-ALCAM/CD166 murine monoclonal antibodies J4-81 and 3A6 and therefore recognizes a different epitope. Engagement through I/F8 scFv, 3A6 monoclonal antibody or CD6/Fc ligand induced ALCAM/CD166 internalization, with a kinetics slower than that of transferrin in the same cells. Newly internalized I/F8-ALCAM complexes colocalized with clathrin but not with caveolin and we demonstrated, using surface biotinylation and recycling assays, that endocytosed ALCAM/CD166 recycles back to the cell surface. Such an endocytic pathway allows the efficient delivery of an I/F8 scFv-saporin immunotoxin into tumor cells, as the conjugates are able to selectively kill cell lines expressing ALCAM/CD166. Altogether these data provide evidence of the suitability of the I/F8 scFv for further functional analysis of ALCAM/CD166 and intracellular delivery of effector moieties