VALUTAZIONE ECOGRAFICA INTEGRATA DELLA DISPNEA ACUTA: DIAGNOSI DIFFERENZIALE E STRATIFICAZIONE PROGNOSTICA.

Valutazione ecografica integrata della dispnea acuta: Diagnosi differenziale e stratificazione prognostica. La dispnea acuta costituisce uno dei principali motivi di accesso al Dipartimento di Emergenza. La diagnosi eziologica del quadro di insufficienza cardio-respiratoria che sottende la dispnea è fondamentale nella gestione del paziente e permette di assumere rapidamente un corretto atteggiamento terapeutico. Lo scopo del presente studio è stato di valutare il valore prognostico in termini di mortalità e ri-ospedalizzazione ad un mese e sei mesi di parametri derivati dalla valutazione ecografica integrata di cuore, polmone e vena cava inferiore in pazienti che afferivano al Dipartimento di Emergenza per dispnea acuta. Sono stati arruolati 118 pazienti che afferivano al Dipartimento di Emergenza per dispnea acuta. Sono stati sottoposti ad esame ecocardiografico transtoracico in cui è stata valutata la frazione di eiezione (FE) del vetriolo sinistro, la funzione diastolica del ventricolo sinistro (E/A) e la funzione sistolica del ventricolo destro (TAPSE). All’ecografia toracica sono stati identificati il pattern A e B e l’eventuale presenza di versamento pleurico. Infine sono stati valutati dimensioni ed indice di collassabilità della vena cava inferiore. Tutti i pazienti sono stati seguiti al follow-up per sei mesi dopo la dimissione. Ciascuna variabile è stata inserita in un modello di analisi di regressione logistica univariata usando come variabile dipendente gli endopoint ospedalizzazione ad un mese e sei mesi e mortalità a sei mesi; le variabili risultate significativamente associate all’end-point al test univariato sono state inserite, unitamente al sesso, in un modello di regressione logistica multivariata stepwise backward. I nostri dati mettono in evidenza nei pazienti che accedono per dispnea acuta in pronto soccorso una forte correlazione tra presenza di linee B e disfunzione diastolica ventricolare sinistra con ospedalizzazioni ad un mese. Per quanto riguarda le ospedalizzazioni a sei mesi vi è una forte correlazione con la ridotta frazione di eiezione del ventricolo sinistro (minore di 40%), la presenza di versamento pleurico e la variabile combinata cuore- polmone- vena cava inferiore. A medio termine pertanto, sembra evidente che la disfunzione globale rappresentata dalla variabile combinata cuore, polmone e vena cava inferiore insieme alla depressione della funzione sistolica globale del ventricolo sinistro giochi un ruolo importante nella stratificazione prognostica. Infine, la presenza di B profile ha un alto valore predittivo di mortalità a sei mesi rispetto agli altri indici ecografici presi in esame e può pertanto svolgere un ruolo nella stratificazione prognostica La valutazione integrata ecografica di cuore, polmone e vena cava inferiore può offrire un valore aggiunto in termini di stratificazione prognostica a breve e medio termine nel paziente con dispnea acuta. L’ausilio di una metodica semplice, riproducibile e di facile attuazione può rivelarsi fondamentale in scenari come quello della medicina d’urgenza dove si opera in condizioni difficili e con malati critici

Multiphoton Label-Free ex-vivo imaging using a custom-built dual-wavelength microscope with chromatic aberrations compensation

Label-Free Multiphoton Microscopy is a very powerful optical microscopy that can be applied to study samples with no need for exogenous fluorescent probes, keeping the main benefits of a Multiphoton approach, like longer penetration depths and intrinsic optical sectioning, while opening the possibility of serial examinations with different kinds of techniques. Among the many variations of Label-Free MPM, Higher Harmonic Generation (HHG) is one of the most intriguing due to its generally low photo-toxicity, which enables the examination of specimens particularly susceptible to photo-damages. HHG and common Two-Photon Microscopy (TPM) are well-established techniques, routinely used in several research fields. However, they require a significant amount of fine-tuning in order to be fully exploited and, usually, the optimized conditions greatly differ, making them quite difficult to perform in parallel without any compromise on the extractable information. Here we present our custom-built Multiphoton microscope capable of performing simultaneously TPM and HHG without any kind of compromise on the results thanks to two, separate, individually optimized laser sources with full chromatic aberration compensation. We also apply our setup to the examination of a plethora of ex vivo samples in order to prove the significant advantages of our approach

The light and shadow of senescence and inflammation in cardiovascular pathology and regenerative medicine

Recent epidemiologic studies evidence a dramatic increase of cardiovascular diseases, especially associated with the aging of the world population. During aging, the progressive impairment of the cardiovascular functions results from the compromised tissue abilities to protect the heart against stress. At the molecular level, in fact, a gradual weakening of the cellular processes regulating cardiovascular homeostasis occurs in aging cells. Atherosclerosis and heart failure are particularly correlated with aging-related cardiovascular senescence, that is, the inability of cells to progress in the mitotic program until completion of cytokinesis. In this review, we explore the intrinsic and extrinsic causes of cellular senescence and their role in the onset of these cardiovascular pathologies. Additionally, we dissect the effects of aging on the cardiac endogenous and exogenous reservoirs of stem cells. Finally, we offer an overview on the strategies of regenerative medicine that have been advanced in the quest for heart rejuvenation

SECONDARY METABOLITES: APPLICATIONS ON CULTURAL HERITAGE

Biological sciences and related bioͲtechnology play a very important role in research projects concerning protection and preservation of cultural heritage for future generations. In this work secondary metabolites of Burkholderia gladioli pv. agaricicola (Bga) ICMP 11096 strain and crude extract of glycoalkaloids from Solanaceae plants, were tested against a panel of microorganisms isolated from calcarenite stones of two historical bridges located in Potenza and in Campomaggiore (Southern Italy). The isolated bacteria belong to Bacillus cereus and Arthrobacter agilisspecies, while fungi belong to Aspergillus, Penicillium, Coprinellus, Fusarium, Rhizoctonia and Stemphylium genera. Bga broth (unfiltered) and glycoalkaloids extracts were able to inhibit the growth of all bacterial isolates. Bga culture was active against fungal colonies, while Solanaceae extract exerted bioͲactivity against Fusarium and Rhizoctonia gener

Dagli archivi di paesaggi a possibili musei virtuali

The title of the book coordinated by Laura Sasso “Archivi da mostrare, Paesaggi e architetture in rete per una rete di progetti” (“Archives, Landscapes and Architecture network for a network of projects”, NdT) wants to show the close relationships between the concept of archive considered as an open space, landscape as an archive of itself, the trinomial concept archive-museum-landscape. Graphics and tri-dimensional models have shown the possibility to plan a new archive and museum network in Turin’s metropolitan area, centered on the river Po and its affluents. Places and historic architectures were identified along this fluvial system apt to host polarities that can have the characteristics of a museum, an effective active preservation tool, truly original and innovative mediums to restore territories, rich with surprising potential. The study cases, analyzed and developed in their different aspects, illustrate the concept of the museum as a container of material that documents the museum that opens to the river, floods the river itself, and the landscape that is a museum of itself.

The Rapidly Evolving Concept of Whole Heart Engineering

Whole heart engineering represents an incredible journey with as final destination the challenging aim to solve end-stage cardiac failure with a biocompatible and living organ equivalent. Its evolution started in 2008 with rodent organs and is nowadays moving closer to clinical application thanks to scaling-up strategies to human hearts. This review will offer a comprehensive examination on the important stages to be reached for the bioengineering of the whole heart, by describing the approaches of organ decellularization, repopulation, and maturation so far applied and the novel technologies of potential interest. In addition, it will carefully address important demands that still need to be satisfied in order to move to a real clinical translation of the whole bioengineering heart concept

Natural Biocides to Prevent the Microbial Growth On Cultural Heritage

Many historic, cultural and artistic objects and buildings are made of stone. Like all materials, stone is subject to inexorable deterioration. Along with chemical and physical weathering factors, microbial growth plays an important role in this process. Stones type and local climatic differences have a great impact on the biodeterioration process and their outcomes. Microbial metabolism results in deteriorating agents such as organic and inorganic acid, chelating agents, enzymes and extracellular polymeric substances (EPS) causing e.g. biocorrosion and biomineralization; furthermore phototropic and heterotropic microorganism (ex. Firmicutes and fungi) are able to penetrate into stone mineral [1,2,3]. In addition to structural damage, rock biofilms cause aesthetic damage. In general the biocides used to prevent the growth of microbes are mostly based by using chemical methods, but they show a restricted efficiency and can cause discolorations and severe damages to the cultural heritage and ,also, they affect higher organisms including humans. Recently, the biotechnology and the applied microbiology (the use of antagonistic organisms or their metabolites products against the biodeteriorating agents) offers a wide range of new procedures for the cleaning and conservation of the artistic substrata [4-9]. The case of the study regards two historical bridges: the “San Vito Bridge” located in Potenza and “Della Vecchia Bridge” located in Campomaggiore, a little village near Potenza. The bacteria isolated belong to a wide variety of phylogenetic group being closely related to species of 10 genera within the Proteobacteria, the Firmicutes and the Actinobacteria; the number of fungi was slightly lower than those of bacteria. The fungi isolated on two bridges belong to Aspergillus, Penicillium and Stemphylium genera. In this work secondary metabolites of Burkholderia gladioli pv. agaricicola (Bga) ICMP 11096 strain and glycoalkaloids derived from Solanacee extracts, were used against bacteria and fungi isolated. Results show that all secondary metabolites inhibited in vitro and in vivo the growth of these colonising confirming that the application of biopesticides will be is a promising alternative to synthetic pesticides over traditional technologies. In fact, the use of these natural substances consents a more homogeneous removal of the surface deposits without compromising the substrata structure and the preservation of patina noble ; in addition, bio-cleaning has proven to be more selective than chemicals

Non-destructive testing of stone biodeterioration and biocleaning effectiveness

Microorganisms (bacteria, green algae and fungi) may lead to complex problems in the conservation of cultural heritage assets due to their biodeteriorative potential. The biodeterioration phenomena observed on materials of cultural heritage is determined by several factors, such as climatic conditions, chemical composition and nature of the material itself, as well as biological colonizers. The combination of several non-destructive techniques is compulsory in the field of cultural heritage in order to develop and design new and effective conservation strategies to prevent, control and minimize the causes of decay. For instance, Confocal Laser Scanning Microscopy (CLSM) permits to detect the presence, the penetration depth and the spatial organization of different phototrophic microorganisms established on stone surfaces, as well as Digital Image Analysis allows quantifying the surface area covered by microorganisms without destroying the sample. In this study, these non-destructive instrumental analyses, together with in vitro chlorophyll a quantification, were applied in order to evaluate a new procedure of stone cleaning consisting of the application of secondary metabolites with biocide properties. Three different natural biocides were tested on Hontoria limestone samples, a biosparitic limestone used in many Spanish monuments, previously inoculated with a multi-species phototrophic culture. After 1 month of biofilm growth on Hontoria limestone samples, the following biocides were applied: - culture filtrates of the fungus Trichoderma harzianum T-22 strain, - culture filtrates of the bacterium Burkholderia gladioli pv. agaricicola ICMP (Bga) 11096 strain, - glycoalkaloids (GLAs) extract from unripe berries of Solanum nigrum. After one month of incubation, CLSM revealed that none of the treatments was efficient against all inoculated phototrophic species, probably due to different biocide resistance. This was also corroborated by spectrophotometric determination of chlorophyll a and digital image analysis. Among all treatments, the culture filtrates of T.harzianum and the GLAs’ extract showed higher biocidal efficiency than the Bga culture filtrate. It seems evident that non-destructive analysis and ecological cleaning methods can represent a innovative strategy for the protection of our stone cultural heritage. Further work on the biocidal effectiveness and durability of secondary metabolites in the medium and long-term is needed for the design of effective and sustainable treatments for minimizing or eradicate stone biodeteriorationPeer Reviewe