Elevated serum levels of macrophage migration inhibitory factor and stem cell growth factor β in patients with idiopathic and systemic sclerosis associated pulmonary arterial hypertension.

Pulmonary arterial hypertension (PAH) can be idiopathic or secondary to autoimmune diseases, and it represents one of the most threatening complications of systemic sclerosis (SSc). Macrophage migration inhibitory factor (MIF) is a pleiotropic cytokine with proinflammatory functions that appears to be involved in the pathogenesis of hypoxia-induced PH. In SSc patients, high serum levels of MIF have been associated with the development of ulcers and PAH. Stem cell growth factor β (SCGF β) is a human growth factor that, together with MIF, is involved in the pathogenesis of chronic spinal cord injury. The aim of our study was to measure serum levels of MIF in patients with idiopathic and SSc-associated PAH. We enrolled 13 patients with idiopathic PAH and 15 with SSc-associated PAH. We also selected 14 SSc patients without PAH and 12 normal healthy controls, matched for sex and age. PAH was confirmed by right hearth catheterism (mPAP>25 mmHg). MIF and SCGF β levels were measured by ELISA. We found significantly higher circulating levels of MIF and of SCGF β in patients with idiopathic PAH (P=0.03 and P=0.004) and with PAH secondary to SSc (P=0.018 and P=0.023) compared to SSc patients without PAH. Higher levels of MIF were found in those patients with an higher New York Heart Association (NYHA) class (P=0.03). We can hypothesize that MIF and SCGF β are able to play a role in PAH, both idiopathic or secondary, and in the future they may be evaluated as useful biomarkers and prognostic factors for this serious vascular disease

Komponenta projekta ADRICOSM – sustav promatranja na velikoj skali – satelitski sustav

In the framework of the ADRICOSM project, the Satellite Oceanography Group (GOS) of Rome developed a Fast Delivery System (FDS) for providing the partner modeling centres with remotelysensed ocean colour and sea surface temperature (SST) data. Data are processed, mapped and binned on the Adriatic Sea area in order to be assimilated into both ecosystem models and circulation models for ocean forecasting. Further technological improvements permitted the building and optimization of a system suitable for meeting the increasing demand for near-real-time ocean colour and SST products for applications in operational oceanography. Real-Time Images of SeaWiFS chlorophyll concentration, clouds/case I/case II water flags and true colour images are obtained by processing the satellite passes using climatological ancillary data. These images are provided daily through an ad hoc automatic system that processes the raw satellite data and makes it available on the web within an hour of satellite overpass acquisition. All of the images are stored in a gallery web archive organized in a calendar chart. Accurate chlorophyll maps for assimilation are produced in near real time (typically after 4 days) as soon as daily meteorological ancillary data are made available on the NASA website. Each chlorophyll map is flagged for clouds or other contamination factors using the corresponding 24 quality flag maps. This implies that case-2 waters and spurious atmospheric effects have been removed from the pigment data set. This final product is binned on the Adriatic model grid and made available for the ADRICOSM project on the GOS web site. NOAA/AVHRR data are also acquired by the GOS ground station in Rome and managed by the FDS from their reception up to their distribution. Daily SST maps of the Adriatic Sea binned over the AREG model grid at 1/16° resolution are distributed weekly in Near-Real-Time along with the daily SST maps of the eastern Mediterranean Sea delivered at 1/8° resolution to the MFSTEP project. Real-Time SST maps of the Adriatic Sea at 1km resolution are posted daily in GIF format on the GOS website.U okviru projekta ADRISOSM, GOS (Grupa za satelitsku oceanografiju) iz Rima razvila je Sustav za brzu isporuku FDS, snabdijevanje partnerskih centara za modeliranje satelitskim snimcima boje mora i tem-peraturnim podacima površine mora (SST). Podaci za Jadran su obrađeni, pretvoreni u grafičke produkte i digitalizirani kako bi se mogli asimilirati u model strujanja i model ekosistema, te koristiti oceanografskoj prognozi. Daljnja tehnološka poboljšanja su omogućila izgradnju i optimalizaciju sustava, zbog rastućih potreba za produktima boje mora i površinske temperature za različite primjene u operativnoj oceanografiji. Slike koncentracije klorofila od senzora SeaWiFS, slike oblaka te Case1 i Case2 oznake, kao i slike prave boje dobivaju se procesiranjem satelitskih scena uz popratne klimatološke podatke. Slike se procesiraju dnevno kroz ad-hoc automatski sustav koji obrađuje sirove satelitske podatke i omogućuje njihovu isporuku na mrežu, sat vremena nakon prikupljanja satelitskih podataka tj. nakon prolaska satelita. Sve se slike spremaju u arihvu na mreži koja je organizirana prema datumima. Korigirane slike koncentracije klorofila za asimilaciju u model proizvode se u skoro realnom vremenu (tipično 4 dana kasnije) čim se dobiju popratni meteorološki podaci s mreže NASA-e. Na svakoj slici klorofila su označeni oblaci ili drugi kontaminirajući faktori, prema 24 kategorije kvalitete slika. To znači da su Case 2 slučajevi piksela uklonjeni iz snimaka kao i atmosferske sme-tnje. Konačni produkt se usklađuje s koordinatnom mrežom Jadrana i stavlja na raspolaganje na stranicama ADRICOSM-a preko GOS-ove Internet stranice. GOS zemaljska stanica u Rimu prikuplja i podatke NOAA/ AVHRR koji se procesiraju kroz FDS sustav, od prijema do konačne distribucije podataka. Dnevne se slike površinske temperature mora (SST), usklađene preko koordinatne mreže AREG-a pri prostornom razlučivanju od 1/16 stupnja, distribuiraju tjedno u skoro realnom vremenu, zajedno sa slikama istočnog Sredozemlja koje imaju razlučivanje od 1/8 stupnja prema MFSTEP projektu. Dnevno, u skoro realnom vremenu, isporučuju se slike SST za Jadran uz prostorno razlučivanje od 1 km u GIF formatu na Internet stranici GOS-a

Use of 3D T2-Weighted MR Sequences for the Assessment of Neurovascular Bundle Changes after Nerve-Sparing Radical Retropubic Prostatectomy (RRP): A Potential Diagnostic Tool for Optimal Management of Erectile Dysfunction after RRP

Erectile dysfunction (ED) is one of the complications after radical retropubic prostatectomy (RRP), and recovery of erectile function is quantitatively related to the preservation of the neurovascular bundles (NVBs). The aim of our study was to assess, in patients submitted to a nerve-sparing RRP, the capability of a dedicated 3D isotropic magnetic resonance imaging (MRI) T2-weighted sequence in the depiction of postsurgical changes of NVB formation. Fifty-three consecutive patients underwent a bilateral nerve-sparing RRP. Two postoperative magnetic resonance (MR) examinations and International Index of Erectile Function Five-Item (IIEF-5) questionnaire were carried out at 6 and 12 months. Morphological imaging of the postprostatectomy fossa was performed by first acquiring turbo spin echo T2-weighted sequences in the axial and coronal planes and then with 3D T2-weighted isotropic sequence on axial plane. Image findings were scored using a relative 5-point classification (0 = normal; I = mild; II = mild to moderate; III = moderate; IV = severe alterations) and correlated with postoperative IIEF-5 score questionnaire. The degree of association between the alteration score values obtained by postoperative MR morphologic evaluation for MR sequence and IIEF-5 score. Image interpretation was performed by two radiologists, that scoring MR alterations by the use of axial and multiplanar reconstruction 3D T2 isotropic sequence. The radiologists placed 43.30% of patients in class 0 (23/53 normal or quite normal), 32.00% in class I (17/53 mild), 11.40% in class II (6/53 mild to moderate), 7.50% in class III (4/53 moderate), and 5.70% in class IV (3/53 severe). In all cases, the correlation and regression analyses between the 3D T2 isotropic sequence and IIEF-5 score, resulted in higher coefficient values (rho = 0.45; P = 0.0010). The MRI protocol and NVB change classification score proposed in this study would represent an additional tool in the postoperative phase of those patients with ED. Sciarra A, Panebianco V, Salciccia S, Alfarone A, Gentilucci A, Lisi D, Passariello R, and Gentile V. Use of 3D T2-weighted MR sequences for the assessment of neurovascular bundle changes after nerve-sparing radical retropubic prostatectomy (RRP): A potential diagnostic tool for optimal management of erectile dysfunction after RRP. J Sex Med 2009;6:1430-1437

COMPLETE RESPONSE TO THE COMBINATION THERAPY WITH ANDROGEN BLOCKADE AND SOMATOSTATIN ANALOGUE IN A PATIENT WITH ADVANCED PROSTATE CANCER: MAGNETIC RESONANCE IMAGING WITH 1H-SPECTROSCOPY: Part 2

Serum prostate-specific antigen and chromogranin A levels steadily decreased over a 12-mo follow-up period, at which time the patient is alive without disease progression and with a complete objective and symptomatic response

Inflammatory response to cardiac bypass in ewe fetuses: effects of steroid administration or continuous hemodiafiltration

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Value of magnetic resonance spectroscopy imaging and dynamic contrast-enhanced imaging for detecting prostate cancer foci in men with prior negative biopsy

Purpose: This study aimed to prospectively analyze the role of magnetic resonance spectroscopy imaging (MRSI) and dynamic-contrast enhancement magnetic resonance (DCEMR) in the detection of prostate tumor foci in patients with persistently elevated prostate-specific antigen levels (in the range of >= 4 ng/mL to <10 ng/mL) and prior negative random trans-rectal ultrasound (TRUS)-guided biopsy. Experimental Design: This was a prospective randomized single-center study. One hundred and eighty eligible cases were included in the study. Patients in group A were submitted to a second random prostate biopsy, whereas patients in group B were submitted to a (1)H-MRSI-DCEMR examination and samples targeted on suspicious areas were associated to the random biopsy. Results: At the second biopsy, a prostate adenocarcinoma histologic diagnosis was found in 22 of 90 cases (24.4%) in group A and in 41 of 90 cases (45.5%) in group B (P = 0.01). On a patient-by-patient basis, MRSI had 92.3% sensitivity, 88.2% specificity, 85.7% positive predictive value (PPV), 93.7% negative predictive value (NPV), and 90% accuracy; DCEMR had 84.6% sensitivity, 82.3% specificity, 78.5% PPV, 87.5% NPV, and 83.3% accuracy; and the association MRSI plus DCEMR had 92.6% sensitivity, 88.8% specificity, 88.7% PPV, 92.7% NPV, and 90.7% accuracy, for predicting prostate cancer detection. Conclusions: The combination of MRSI and DCEMR showed the potential to guide biopsy to cancer foci in patients with previously negative TRUS biopsy. To avoid a potential bias, represented from having taken more samples in group B (mean of cores, 12.17) than in group A (10 cores), in the future a MRSI/DCEMR directed biopsy could be prospectively compared with a saturation biopsy procedure. Clin Cancer Res; 16(6); 1875-83. (C) 2010 AACR

Treatment of macro-re-entrant atrial tachycardia based on electroanatomic mapping: identification and ablation of the mid-diastolic isthmus

Aims This multicentre prospective study evaluated the ability of electroanatomic mapping (EAM) using a specific parameter setting to identify clearly the mid-diastolically activated isthmus (MDAI) and guide ablation of macro-re-entrant atrial tachycardia (MAT). Methods and results Consecutive patients with MAT, different from typical isthmus-dependent atrial flutter, were enrolled. EAM was performed using a specific setting of the window of interest, calculated to identify the MDAI and guide ablation of this area. Sixty-five patients exhibiting 81 MATs (mean cycle length 308 + 68 ms) were considered. Thirty-two (49.2%) had previous heart surgery. In 79 of 81 morphologies (97.5%), EAM reconstructed 95.9 + 4.3% of the tachycardia circuit and identified the MDAI; 23 of the 79 morphologies (29.1%) were double-loop re-entry. Mapping of two morphologies was incomplete due to MAT termination after catheter bumping. In 73 of 79 mapped morphologies (92.4%), abolition of the MAT was obtained by 13.2 + 12.4 applications. During the 14 + 4 month follow-up, MAT recurred in 4 of the successfully treated patients (6.8%). Conclusion EAM using a specific parameter setting proved highly effective at identifying the MDAI in MAT, even in patients with previous surgery and multiple re-entrant loops. Ablation of the MDAI yielded acute arrhythmia suppression with low rate of recurrence during follow-up

The clinical efficacy of nitrofurantoin for treating uncomplicated urinary tract infection in adults: a systematic review of randomized control trials

OBJECTIVE: To provide an updated systematic review of randomized control trials (RCTs) to investigate the clinical and microbiological efficacy of nitrofurantoin compared to other antibiotics or placebo for treatment of uncomplicated urinary tract infections (uUTI). A secondary aim is to assess whether nitrofurantoin use is associated with increased side effects compared to other treatment regimens.SUMMARY: The review was performed according to PRISMA guidelines. We searched 4 databases for articles published from database inception to May 6, 2020: (1) PubMed electronic database of the National Library of Medicine, (2) Web of Science, (3) Embase, and (4) Cochrane Library. Nine RCTs were selected for the review. RCTs were a mixture of double-blind, single-blind, and open-label trials. The most common comparators were trimethoprim-sulfamethoxazole and fosfomycin tromethamine. Overall study quality was poor with a high risk of bias. The clinical cure rates in nitrofurantoin ranged from 51 to 94% depending on the length of follow-up, and bacteriological cure rates ranged from 61 to 92%. Overall the evidence suggests that nitrofurantoin is at least comparable with other uUTI treatments in terms of efficacy. Patients taking nitrofurantoin reported fewer side effects than other drugs and the most commonly reported were gastrointestinal and central nervous system symptoms. Key Messages: Evidence on the clinical and bacteriological efficacy of nitrofurantoin is sparse, with a lack of new data, and hampered by high risk of bias. Although no firm conclusions can be made on the current base of evidence, the studies generally suggest that nitrofurantoin is at least comparable to other common uUTI treatments in terms of clinical and bacteriological cure. More robust research with well-designed double-blinded RCTs is needed