Practice parameters for the treatment of colonic diverticular disease: Italian Society of Colon and Rectal Surgery (SICCR) guidelines

The mission of the Italian Society of Colorectal Surgery (SICCR) is to optimize patient care. Providing evidence-based practice guidelines is therefore of key importance. About the present report it concernes the SICCR practice guidelines for the diagnosis and treatment of diverticular disease of the colon. The guidelines are not intended to define the sole standard of care but to provide evidence-based recommendations regarding the available therapeutic options

Neurotensin localization in adenomatoid cystic malformation versus normal lung: Preliminary report of six consecutive cases

Neuropeptides are considered a new class of neurotransmitters, several of which interact with the immune system as well as the macrophagic activity. Among these, neurotensin (NT) enhances the phagocitic response of macrophages and is the only neuropeptide that can enhance the cytolytic effects of activated macrophages. In this way, it may play a role as an inflammatory mediator. In order to investigate the possible relationship between NT and the defence mechanisms of the lung, we started to localize the presence of NT in pulmonary adenomatoid cystic malformation (CCAM). This series consists of 6 children affected by CCAM. In every case, at operation, we obtained specimens of both normal and pathological lung. Tissue sections from the pathological lung showed a significant increase of NT-like immunoreactivity in respect to sections of normal lung. NT influences and activates the macrophages, thus suggesting that it could represent a defence mechanism in children's lung activated in some malformative conditions. Finally, the increasing evidence of NT immunoreactivity in CCAM could explicate an in utero infectious pathogenesis of this malformation

Effect of two gaps on the flux lattice internal field distribution: evidence of two length scales from muSR in Mg1-xAlxB2

We have measured the transverse field muon spin precession in the flux lattice (FL) state of the two gap superconductor MgB2 and of the electron doped compounds Mg1-xAlxB2 in magnetic fields up to 2.8T. We show the effect of the two gaps on the internal field distribution in the FL, from which we determine two coherence length parameters and the doping dependence of the London penetration depth. This is an independent determination of the complex vortex structure already suggested by the STM observation of large vortices in a MgB2 single crystal. Our data agrees quantitatively with STM and we thus validate a new phenomenological model for the internal fields.Comment: now in press Phys. Rev. Lett., small modifications required by the edito

Differential ABC transporter gene expression in adult Dirofilaria immitis males and females following in vitro treatment with ivermectin, doxycycline or a combination of both

BACKGROUND: Combination doxycycline/macrocyclic lactone (ML) protocols have been shown to provide a more rapid adulticidal and microfilaricidal effect than either MLs or doxycycline alone, although female worms were reported to have a higher tolerance to treatments compared to male worms. The present study aimed to evaluate how ABC transporters may be involved in the synergic effect of the combination treatment. Adult worms of D. immitis were treated in vitro for 24 hours with doxycycline (DOXY), ivermectin (IVM) and a combination of both, and changes in the modulation of ABC transporter genes were measured. Levels of doxycycline inside different treatment media, post-treatment, were determined through HPLC analysis. RESULTS: Quantitative RT-PCR analysis showed the presence of changes in the modulation of ABC transporter genes evaluated in this study. In particular, in female worms, the combination treatment induced a substantial increase in gene expressions, especially of Dim-pgp-10 and Dim-haf-4; whereas in male worms, the greatest increase in gene expression was observed for Dim-pgp-10 and Dim-pgp-11 when treated with DMSO\u2009+\u2009IVM and DMSO\u2009+\u2009DOXY/IVM. HPLC analysis of the DOXY concentrations in the media after in vitro treatments of male worms showed a slight difference between the DMSO\u2009+\u2009DOXY samples and the combination (DMSO\u2009+\u2009DOXY\u2009+\u2009IVM), while no difference was observed among females. CONCLUSIONS: Further studies are required to explain whether the modulation of cellular efflux plays a role, even partially, in the adulticide effect of doxycycline/macrocyclic lactone combinations in heartworm-infected dogs. To the authors' knowledge, this is the first study to evaluate P-gp expression in adult D. immitis

Management of perforated diverticulitis with generalized peritonitis. a multidisciplinary review and position paper

La diverticolite perforata è una condizione clinica emergente e la sua gestione è impegnativa e ancora dibattuta. Lo scopo di questo documento di posizione era di rivedere criticamente le prove disponibili sulla gestione della diverticolite perforata e della peritonite generalizzata al fine di fornire suggerimenti basati sull'evidenza per una strategia di gestione. Quattro società scientifiche italiane (SICCR, SICUT, SIRM, AIGO), esperti selezionati che hanno identificato 5 temi clinicamente rilevanti nella gestione della diverticolite perforata con peritonite generalizzata che trarrebbero beneficio da una revisione multidisciplinare. Sono state affrontate le seguenti 5 problematiche: 1) Criteri per decidere tra trattamento conservativo e chirurgico in caso di diverticolite perforata con peritonite; 2) Criteri o sistema di punteggio per scegliere l'opzione chirurgica più appropriata quando è confermata la peritonite diffusa 3); La procedura chirurgica appropriata in pazienti emodinamicamente stabili o stabilizzati con peritonite diffusa; 4) La procedura chirurgica appropriata per i pazienti con peritonite generalizzata e shock settico e 5) Terapia medica ottimale in pazienti con peritonite generalizzata da perforazione diverticolare prima e dopo l'intervento chirurgico. Nella diverticolite perforata la chirurgia è indicata in caso di peritonite diffusa o fallimento della gestione conservativa e la decisione di operare non è basata sulla presenza di aria extraluminale. Se la peritonite diffusa è confermata, la scelta della tecnica chirurgica si basa sui risultati intraoperatori e sulla presenza o il rischio di shock settico grave. Ulteriori fattori prognostici da considerare sono lo squilibrio fisiologico, l'età, le comorbidità e lo stato immunitario. Nei pazienti emodinamicamente stabili, la laparoscopia di emergenza presenta vantaggi rispetto alla chirurgia a cielo aperto. Le opzioni includono resezione e anastomosi, procedura di Hartmann o lavaggio laparoscopico. Nella peritonite generalizzata con shock settico, è preferibile un approccio chirurgico aperto. La resezione non restaurativa e / o la chirurgia per il controllo del danno sembrano essere le uniche opzioni praticabili, a seconda della gravità dell'instabilità emodinamica. La gestione medica multidisciplinare dovrebbe essere applicata con gli obiettivi principali di controllare l'infezione, alleviare il dolore postoperatorio e prevenire e / o trattare ileo postoperatorio. In conclusione, la complessità e la diversità dei pazienti con perforazione diverticolare e peritonite diffusa richiede una strategia personalizzata, che preveda un'accurata classificazione dello squilibrio fisiologico, la stadiazione dell'infezione intra-addominale e la scelta della procedura chirurgica più appropriata.Perforated diverticulitis is an emergent clinical condition and its management is challenging and still debated. The aim of this position paper was to critically review the available evidence on the management of perforated diverticulitis and generalized peritonitis in order to provide evidence-based suggestions for a management strategy. Four Italian scientific societies (SICCR, SICUT, SIRM, AIGO), selected experts who identified 5 clinically relevant topics in the management of perforated diverticulitis with generalized peritonitis that would benefit from a multidisciplinary review. The following 5 issues were tackled: 1) Criteria to decide between conservative and surgical treatment in case of perforated diverticulitis with peritonitis; 2) Criteria or scoring system to choose the most appropriate surgical option when diffuse peritonitis is confirmed 3); The appropriate surgical procedure in hemodynamically stable or stabilized patients with diffuse peritonitis; 4) The appropriate surgical procedure for patients with generalized peritonitis and septic shock and 5) Optimal medical therapy in patients with generalized peritonitis from diverticular perforation before and after surgery. In perforated diverticulitis surgery is indicated in case of diffuse peritonitis or failure of conservative management and the decision to operate is not based on the presence of extraluminal air. If diffuse peritonitis is confirmed the choice of surgical technique is based on intraoperative findings and the presence or risk of severe septic shock. Further prognostic factors to consider are physiological derangement, age, comorbidities, and immune status. In hemodynamically stable patients, emergency laparoscopy has benefits over open surgery. Options include resection and anastomosis, Hartmann’s procedure or laparoscopic lavage. In generalized peritonitis with septic shock, an open surgical approach is preferred. Non-restorative resection and/or damage control surgery appear to be the only viable options, depending on the severity of hemodynamic instability. Multidisciplinary medical management should be applied with the main aims of controlling infection, relieving postoperative pain and preventing and/or treating postoperative ileus. In conclusion, the complexity and diversity of patients with diverticular perforation and diffuse peritonitis requires a personalized strategy, involving a thorough classification of physiological derangement, staging of intra-abdominal infection and choice of the most appropriate surgical procedure

The Scoop on SCOBY (Symbiotic Culture of Bacteria and Yeast): Exploring consumer behaviours towards a novel ice cream

With the growing demand for sustainable practises, the food industry is increasingly adopting circular economy approaches. One example is recycling the symbiotic culture of bacteria and yeast (SCOBY) used in kombucha fermentation to create value-added products. However, consumer acceptance of such novel products remains unclear. To address this, the present study examined consumer attitudes towards ice cream made with SCOBY as an ingredient and how this affected their intention to consume it. Drawing on the theory of planned behaviour (TPB) and additional constructs such as emotions and food neophobia, an online survey was conducted with New Zealand consumers (N = 170). Results showed that the TPB constructs significantly predicted the intention to consume SCOBY ice cream. Moreover, by adding emotions to the constructs, the model’s explanatory power was enhanced. Attitudes, subjective norms, and emotions were the main predictors of intention, which in turn was found to be the main predictor of behaviour. Participants’ beliefs about the safety and taste of SCOBY ice cream were significantly correlated with their intention and behaviour, as were the opinions of nutritionists/dietitians, friends, and family. The model accounted for 21.7% of the variance in behaviour and 57.4% of the variance in intention. These findings can be used to plan marketing strategies related to waste-to-value-added products such as SCOBY ice cream

Advances in the preparations and applications of nanochitins

Chitin is a widely available polysaccharide, biodegradable, insoluble in most solvents and with low antigenic properties. Chitin nanoparticles such as nano whiskers and nanofiber (CHNF) can form a stable and uniform dispersion. The nanoparticle suspension shows the properties of crude chitin as well as the properties of high aspect ratio, high surface area, low density, and hydroxyl group, N-acetyl group and the residual amine group on its surface can also be chemically modified. This review describes nanochitin preparation technologies and food applications. Specifically, the role of nanochitin in modulating fat-soluble bioavailability and saltiness perception was investigated. Fat-soluble vitamins incorporated into CHNF are less available for digestion. Whereas hyaluronic acid and cancer-treatment drugs can be delivered through the skin to targeted locations via chitin nanogels. Interestingly, CHNF enhances saltiness perception via ionic binding with taste receptors. At pH < 7, the amino group chelates chloride, thus releasing sodium for interaction with salt receptors. This mechanism may allow salt reduction in food formulations. Furthermore, nanochitins express surfactant properties and strengthen composite food packaging (starch- or gelatin-based, gelatin nanocomposite, nanocellulose/nanochitin membranes coating F-SiO₂ suspensions). This paper can help build a better understanding of the opportunities of nanochitin as functional food ingredient

La pirámide de Mayo entre 1811 y 1856: significantes y significados.

Fil: Van Deurs, A. Universidad de Buenos Aires, Facultad de Filosofía y Letras, Instituto de Historia de las Artes "Julio E. Payró"; Argentina.Espantoso Rodríguez, T. Universidad de Buenos Aires, Facultad de Filosofía y Letras, Instituto de Historia de las Artes "Julio E. Payró"; Argentina.Fil: Galesi, M.F. Universidad de Buenos Aires, Facultad de Filosofía y Letras, Instituto de Historia de las Artes "Julio E. Payró"; Argentina.|Renard, M. Universidad de Buenos Aires, Facultad de Filosofía y Letras, Instituto de Historia de las Artes "Julio E. Payró"; Argentina.Serventi, M.C. Universidad de Buenos Aires, Facultad de Filosofía y Letras, Instituto de Historia de las Artes "Julio E. Payró"; Argentina.|Este trabajo analiza nuestro primer monumento, la Pirámide de Mayo, durante el período 1811-1856. Durante esos años, actuó como un significante permanente con un significado fluctuante, que se adaptó a las cambiantes circunstancias políticas. En 1856 ese significado se fijó definitivamente al colocarse en su coronamiento la imagen de la Libertad-República