Reactivation of hepatitis B virus with immune-escape mutations after ocrelizumab treatment for multiple sclerosis

Ocrelizumab is an anti-CD20 monoclonal antibody for the treatment of multiple sclerosis (MS) that is closely related to rituximab. We describe a case of hepatitis B virus (HBV) reactivation in an MS patient with resolved HBV infection receiving ocrelizumab. HBV reactivation was monitored with HBV-DNA and HBV surface antigen periodic assessment. Anti-HBV treatment with entecavir was started after HBV-DNA detection. Ocrelizumab can reactivate viral replication in patients with resolved HBV infection. HBV reactivation monitoring seems an effective and safe option for the management of these patients. More studies are needed to assess the optimal management of HBV reactivation in MS patients on ocrelizumab treatment

Evaluating growth and intrinsic water-use efficiency in hardwood and conifer mixed plantations

Abstract Key message Juglans, Fraxinus, Quercus and Pinus species seem to better maximize the carbon–water ratio providing useful indications on species selection for forestry plantations in areas with increasing drought risk. Abstract Maximizing carbon sequestration for a given water budget is extremely important in the contest of climate change in the Mediterranean region, which is characterized by increasing temperatures and rising water stress. This issue is fundamental for plantation stands, where limited water availability during the growing season reduces CO2 assimilation and, consequently, tree growth. In this study, the main objective was to investigate the performances in terms of carbon–water balance of conifer (Pinus halepensis and Cupressus sempervirens) and hardwood (Quercus robur, Juglans regia, Fraxinus excelsior and Populus spp.) mixed plantations. To this aim, we used carbon isotope signatures to evaluate the intrinsic water-use efficiency (iWUE) and the species-specific relationship between basal area increments (BAI) and iWUE. At the species level, the highest iWUE values corresponded to the lowest carbon accumulation in terms of BAI, for water-saving species such as Cupressus. Conversely, Populus had the lowest iWUE and the highest BAI accumulation. Juglans, Fraxinus, and Pinus showed the most balanced ratio between BAI and iWUE. Overall, no clear correlation of iWUE and BAI was evident within all species, except for Populus and Cupressus. Considering projected aridification and increased temperatures that will negatively impact the growth, our data suggest that Pinus, for conifers, and Quercus, Juglans, Fraxinus for hardwood species should be preferred when choosing species for forestry plantation, as they performed better in terms of BAI and iWUE ratio

Paestum dietary habits during the Imperial period: archaeological records and stable isotope measurement

In historical contexts, analyses of carbon and nitrogen stable isotopes can be useful to answer different question on dietary behavior and to crosscheck information, drawn from texts and classical archaeological investigations. In this study the Isotope Ratio Mass Spectrometry (IRMS) facility installed at the IRMS-SUN Laboratory of the Second University of Naples is presented. Moreover, results coming from application of stable isotope analyses to bone collagen extracted from human remains of the necropolis of "Porta Sirena" in Paestum will be discussed. Finally, a combined analyses of archaeological and historical record and stable isotope measurements permits to expand our knowledge on diet in Roman Paestum.</p

Reactivation of hepatitis B virus with immune-escape mutations after ocrelizumab treatment for multiple sclerosis

Ocrelizumab is an anti-CD20 monoclonal antibody for the treatment of multiple sclerosis (MS) that is closely related to rituximab. We describe a case of hepatitis B virus (HBV) reactivation in an MS patient with resolved HBV infection receiving ocrelizumab. HBV reactivation was monitored with HBV-DNA and HBV surface antigen periodic assessment. Anti-HBV treatment with entecavir was started after HBV-DNA detection. Ocrelizumab can reactivate viral replication in patients with resolved HBV infection. HBV reactivation monitoring seems an effective and safe option for the management of these patients. More studies are needed to assess the optimal management of HBV reactivation in MS patients on ocrelizumab treatment

How future surgery will benefit from SARS-COV-2-related measures: a SPIGC survey conveying the perspective of Italian surgeons

COVID-19 negatively affected surgical activity, but the potential benefits resulting from adopted measures remain unclear. The aim of this study was to evaluate the change in surgical activity and potential benefit from COVID-19 measures in perspective of Italian surgeons on behalf of SPIGC. A nationwide online survey on surgical practice before, during, and after COVID-19 pandemic was conducted in March-April 2022 (NCT:05323851). Effects of COVID-19 hospital-related measures on surgical patients' management and personal professional development across surgical specialties were explored. Data on demographics, pre-operative/peri-operative/post-operative management, and professional development were collected. Outcomes were matched with the corresponding volume. Four hundred and seventy-three respondents were included in final analysis across 14 surgical specialties. Since SARS-CoV-2 pandemic, application of telematic consultations (4.1% vs. 21.6%; p &lt; 0.0001) and diagnostic evaluations (16.4% vs. 42.2%; p &lt; 0.0001) increased. Elective surgical activities significantly reduced and surgeons opted more frequently for conservative management with a possible indication for elective (26.3% vs. 35.7%; p &lt; 0.0001) or urgent (20.4% vs. 38.5%; p &lt; 0.0001) surgery. All new COVID-related measures are perceived to be maintained in the future. Surgeons' personal education online increased from 12.6% (pre-COVID) to 86.6% (post-COVID; p &lt; 0.0001). Online educational activities are considered a beneficial effect from COVID pandemic (56.4%). COVID-19 had a great impact on surgical specialties, with significant reduction of operation volume. However, some forced changes turned out to be benefits. Isolation measures pushed the use of telemedicine and telemetric devices for outpatient practice and favored communication for educational purposes and surgeon-patient/family communication. From the Italian surgeons' perspective, COVID-related measures will continue to influence future surgical clinical practice

Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy

IMPORTANCE Delays in screening programs and the reluctance of patients to seek medical attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced colorectal cancers at diagnosis. OBJECTIVE To evaluate whether the SARS-CoV-2 pandemic was associated with more advanced oncologic stage and change in clinical presentation for patients with colorectal cancer. DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study included all 17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December 31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period), in 81 participating centers in Italy, including tertiary centers and community hospitals. Follow-up was 30 days from surgery. EXPOSURES Any type of surgical procedure for colorectal cancer, including explorative surgery, palliative procedures, and atypical or segmental resections. MAIN OUTCOMES AND MEASURES The primary outcome was advanced stage of colorectal cancer at diagnosis. Secondary outcomes were distant metastasis, T4 stage, aggressive biology (defined as cancer with at least 1 of the following characteristics: signet ring cells, mucinous tumor, budding, lymphovascular invasion, perineural invasion, and lymphangitis), stenotic lesion, emergency surgery, and palliative surgery. The independent association between the pandemic period and the outcomes was assessed using multivariate random-effects logistic regression, with hospital as the cluster variable. RESULTS A total of 17 938 patients (10 007 men [55.8%]; mean [SD] age, 70.6 [12.2] years) underwent surgery for colorectal cancer: 7796 (43.5%) during the pandemic period and 10 142 (56.5%) during the prepandemic period. Logistic regression indicated that the pandemic period was significantly associated with an increased rate of advanced-stage colorectal cancer (odds ratio [OR], 1.07; 95%CI, 1.01-1.13; P = .03), aggressive biology (OR, 1.32; 95%CI, 1.15-1.53; P &lt; .001), and stenotic lesions (OR, 1.15; 95%CI, 1.01-1.31; P = .03). CONCLUSIONS AND RELEVANCE This cohort study suggests a significant association between the SARS-CoV-2 pandemic and the risk of a more advanced oncologic stage at diagnosis among patients undergoing surgery for colorectal cancer and might indicate a potential reduction of survival for these patients

Comparing Methods for the Analysis of &delta;13C in Falanghina Grape Must from Different Pedoclimatic Conditions

Agroforestry applications in viticulture are considered a promising strategy to improve vine water status by mitigating the threats of increasing drought due to climate change. The analysis of &delta;&sup1;&sup3;C is often used in viticulture to understand vine water use. In this study, the analysis of &delta;&sup1;&sup3;C was performed on the must of Falanghina grapevines growing in different pedoclimatic conditions. The aim was to compare the results obtained by the application of two different methodologies, using the whole must or extracted sugars as the matrix. The results showed that the &delta;&sup1;&sup3;C values obtained by applying the two methodologies were comparable in all analyzed vineyards independently from the pedoclimatic conditions. Indeed, the proposed method of extraction of the &delta;&sup1;&sup3;C on the must as a whole can be both cost- and time-saving for the analysis. This is valuable, considering that the &delta;&sup1;&sup3;C of must is becoming more and more used as indicator of vines&rsquo; water use. Therefore, the possibility to utilize a simplified method of extraction would enhance the application of the &delta;&sup1;&sup3;C at a larger scale to evaluate vine adaptation in the context of climate-change-driven increases in drought

Comparing Methods for the Analysis of δ¹³C in <i>Falanghina</i> Grape Must from Different Pedoclimatic Conditions

Agroforestry applications in viticulture are considered a promising strategy to improve vine water status by mitigating the threats of increasing drought due to climate change. The analysis of δ¹³C is often used in viticulture to understand vine water use. In this study, the analysis of δ¹³C was performed on the must of Falanghina grapevines growing in different pedoclimatic conditions. The aim was to compare the results obtained by the application of two different methodologies, using the whole must or extracted sugars as the matrix. The results showed that the δ¹³C values obtained by applying the two methodologies were comparable in all analyzed vineyards independently from the pedoclimatic conditions. Indeed, the proposed method of extraction of the δ¹³C on the must as a whole can be both cost- and time-saving for the analysis. This is valuable, considering that the δ¹³C of must is becoming more and more used as indicator of vines’ water use. Therefore, the possibility to utilize a simplified method of extraction would enhance the application of the δ¹³C at a larger scale to evaluate vine adaptation in the context of climate-change-driven increases in drought