Renal sympathetic nerve ablation for the treatment of difficult-to-control or refractory hypertension in a haemodialysis patient.

Haemodialysis patients show sympathetic hyperactivity. Hyperactivation of the sympathetic nervous system aggravates hypertension and it is related to left ventricular hypertrophy, heart failure, arrhythmias and atherogenesis. We report the first use of renal sympathetic nerve ablation for correction of uncontrolled hypertension in an end-stage renal disease patient on maintenance dialysis. We observed a progressive and sustained reduction of systemic blood pressure. Our case demonstrates the safety, the feasibility and the efficacy of this procedure. These findings suggest, however, that further clinical trials are needed into renal nerve radiofrequency ablation therapy for the treatment of hypertension and for the improvement of cardiovascular prognosis in this high-risk patient group

Topological conditions for discrete symmetry breaking and phase transitions

In the framework of a recently proposed topological approach to phase transitions, some sufficient conditions ensuring the presence of the spontaneous breaking of a Z_2 symmetry and of a symmetry-breaking phase transition are introduced and discussed. A very simple model, which we refer to as the hypercubic model, is introduced and solved. The main purpose of this model is that of illustrating the content of the sufficient conditions, but it is interesting also in itself due to its simplicity. Then some mean-field models already known in the literature are discussed in the light of the sufficient conditions introduced here

Candidate Genes and MiRNAs Linked to the Inverse Relationship Between Cancer and Alzheimer’s Disease: Insights From Data Mining and Enrichment Analysis

The incidence of cancer and Alzheimer\u2019s disease (AD) increases exponentially with age. A growing body of epidemiological evidence and molecular investigations inspired the hypothesis of an inverse relationship between these two pathologies. It has been proposed that the two diseases might utilize the same proteins and pathways that are, however, modulated differently and sometimes in opposite directions. Investigation of the common processes underlying these diseases may enhance the understanding of their pathogenesis and may also guide novel therapeutic strategies. Starting from a text-mining approach, our in silico study integrated the dispersed biological evidence by combining data mining, gene set enrichment, and protein-protein interaction (PPI) analyses while searching for common biological hallmarks linked to AD and cancer. We retrieved 138 genes (ALZCAN gene set), computed a significant number of enriched gene ontology clusters, and identified four PPI modules. The investigation confirmed the relevance of autophagy, ubiquitin proteasome system, and cell death as common biological hallmarks shared by cancer and AD. Then, from a closer investigation of the PPI modules and of the miRNAs enrichment data, several genes (SQSTM1, UCHL1, STUB1, BECN1, CDKN2A, TP53, EGFR, GSK3B, and HSPA9) and miRNAs (miR-146a-5p, MiR-34a-5p, miR-21-5p, miR-9-5p, and miR-16-5p) emerged as promising candidates. The integrative approach uncovered novel miRNA-gene networks (e.g., miR-146 and miR-34 regulating p62 and Beclin1 in autophagy) that might give new insights into the complex regulatory mechanisms of gene expression in AD and cancer

Patterns and localized structures in bistable semiconductor resonators

We report experiments on spatial switching dynamics and steady state structures of passive nonlinear semiconductor resonators of large Fresnel number. Extended patterns and switching front dynamics are observed and investigated. Evidence of localization of structures is given.Comment: 5 pages with 9 figure

Proposal of standardization of every step of angiographic procedure in bleeding patients from pelvic trauma

Trauma accounts for a third of the deaths in Western countries, exceeded only by cardiovascular disease and cancer. The high risk of massive bleeding, which depends not only on the type of fractures, but also on the severity of any associated parenchymal injuries, makes pelvic fractures one of the most life-threatening skeletal injuries, with a high mortality rate. Therefore, pelvic trauma represents an important condition to correctly and early recognize, manage, and treat. For this reason, a multidisciplinary approach involving trauma surgeons, orthopedic surgeons, emergency room physicians and interventional radiologists is needed to promptly manage the resuscitation of pelvic trauma patients and ensure the best outcomes, both in terms of time and costs. Over the years, the role of interventional radiology in the management of patient bleeding due to pelvic trauma has been increasing. However, the current guidelines on the management of these patients do not adequately reflect or address the varied nature of injuries faced by the interventional radiologist. In fact, in the therapeutic algorithm of these patients, after the word “ANGIO”, there are no reports on the different possibilities that an interventional radiologist has to face during the procedure. Furthermore, variations exist in the techniques and materials for performing angioembolization in bleeding patients with pelvic trauma. Due to these differences, the outcomes differ among different published series. This article has the aim to review the recent literature on optimal imaging assessment and management of pelvic trauma, defining the role of the interventional radiologist within the multidisciplinary team, suggesting the introduction of common and unequivocal terminology in every step of the angiographic procedure. Moreover, according to these suggestions, the present paper tries to expand the previously drafted algorithm exploring the role of the interventional radiologist in pelvic trauma, especially given the multidisciplinary setting

Cerebrovascular reactivity to carbon dioxide tension in newborns: Data from combined time-resolved near-infrared spectroscopy and diffuse correlation spectroscopy

Significance: Critically ill newborns are at risk of brain damage from cerebrovascular disturbances. A cerebral hemodynamic monitoring system would have the potential role to guide targeted intervention. Aim: To obtain, in a population of newborn infants, simultaneous near-infrared spectroscopy (NIRS)-based estimates of cerebral tissue oxygen saturation (StO2) and blood flow during variations of carbon dioxide tension (pCO2) levels within physiologic values up to moderate permissive hypercapnia, and to examine if the derived estimate of metabolic rate of oxygen would stay constant, during the same variations. Approach: We enrolled clinically stable mechanically ventilated newborns at postnatal age >24 h without brain abnormalities at ultrasound. StO2 and blood flow index were measured using a non-invasive device (BabyLux), which combine time-resolved NIRS and diffuse-correlation spectroscopy. The effect of changes in transcutaneous pCO2 on StO2, cerebral blood flow (CBF), and cerebral metabolic rate of oxygen index (tCMRO2i) were estimated. Results: Ten babies were enrolled and three were excluded. Median GA at enrollment was 39 weeks and median weight 2720 g. StO2 increased 0.58% (95% CI 0.55; 0.61, p < 0.001), CBF 2% (1.9; 2.3, p < 0.001), and tCMRO2 0.3% (0.05; 0.46, p 0.017) per mmHg increase in pCO2. Conclusions: BabyLux device detected pCO2-induced changes in cerebral StO2 and CBF, as expected. The small statistically significant positive relationship between pCO2 and tCMRO2i variation is not considered clinically relevant and we are inclined to consider it as an artifact

Can functional near-infrared spectroscopy (FNIRS) give us reliable insights on sheep brain activity?

Functional near-infrared spectroscopy (fNIRS) is a noninvasive optical technique for monitoring the concentration of oxygenated and deoxygenated haemoglobin in human cerebral cortex. Recently, fNIRS has been increasingly used in animal studies, but research is needed to improve measurement accuracy and result reliability (e.g. rejecting possible extracerebral contributions). A wearable continuous wave (CW) fNIRS system (Octamon, Artinis Medical Systems, The Netherlands) was used to measure the cerebral activity of ten freely moving ewes (Sarda breed, 8-month-old) undergoing a motor task (30s baseline, 30s walking; ten repetitions) and a startling test (after 30s baseline an umbrella was opened in front of the sheep for 3s, followed by 60s recovery; five repetitions). fNIRS sensors were applied on the depilated sheep forehead and held in place with a customized head cap. Two pairs of transmitter-receiver at short (10mm) and long (30mm) distance were used to record light intensity at two wavelengths (760nm, 850nm) from the left and right hemisphere. Data were fitted to a CW model for photon diffusion in a two-layer geometry to estimate absorption changes with respect to the baseline in the bottom layer (representing cerebral cortex) and in the upper layer (representing tissues above brain: scalp, skull, CSF). Upper layer thickness was derived from anatomical measurements, while baseline optical properties (absorption and reduced scattering coefficients) were derived from time-resolved reflectance measurements on the same sheep. Beer\u2019s law was then used to calculate oxygenated haemoglobin changes (\u394O2Hb) and deoxygenated haemoglobin changes (\u394HHb) in both layers. Results of the motor task showed no changes in the upper layer and a canonical response in the bottom layer (\u394O2Hb increase and \u394HHb decrease) in both hemispheres when sheep were walking (Fig 1a). For the startling test, we found no changes in the upper layer and, after the stimulus, a canonical response only in right bottom layer (\u394O2Hb increase and \u394HHb decrease) (Fig 1b). These results confirm that CW fNIRS allowed to non-invasively measure cerebral cortex activity in freely moving sheep and that the use of short and long distance pairs of transmitter-receiver, coupled to a two-layer model for photon diffusion, was useful to reject extracerebral contributions. Measuring cerebral areas activation has the potential to give us new insights in the study of animal emotion and welfare. This study was approved by the Italian National Ethical Commission (authorization n\ub0457/2016-PR) and supported by MIUR-PRIN2015 (Grant 2015Y5W9YP)

Prenatal tobacco smoke exposure increases hospitalizations for bronchiolitis in infants

BACKGROUND: Tobacco smoke exposure (TSE) is a worldwide health problem and it is considered a risk factor for pregnant women's and children's health, particularly for respiratory morbidity during the first year of life. Few significant birth cohort studies on the effect of prenatal TSE via passive and active maternal smoking on the development of severe bronchiolitis in early childhood have been carried out worldwide. METHODS: From November 2009 to December 2012, newborns born at ≥ 33 weeks of gestational age (wGA) were recruited in a longitudinal multi-center cohort study in Italy to investigate the effects of prenatal and postnatal TSE, among other risk factors, on bronchiolitis hospitalization and/or death during the first year of life. RESULTS: Two thousand two hundred ten newborns enrolled at birth were followed-up during their first year of life. Of these, 120 (5.4%) were hospitalized for bronchiolitis. No enrolled infants died during the study period. Prenatal passive TSE and maternal active smoking of more than 15 cigarettes/daily are associated to a significant increase of the risk of offspring children hospitalization for bronchiolitis, with an adjHR of 3.5 (CI 1.5-8.1) and of 1.7 (CI 1.1-2.6) respectively. CONCLUSIONS: These results confirm the detrimental effects of passive TSE and active heavy smoke during pregnancy for infants' respiratory health, since the exposure significantly increases the risk of hospitalization for bronchiolitis in the first year of lif

Circulating miR-184 is a potential predictive biomarker of cardiac damage in Anderson–Fabry disease

open21noFunding: This work was supported by the Italian Ministry of Health (PE-2013-02356818) to GCEnzyme replacement therapy (ERT) is a mainstay of treatment for Anderson–Fabry disease (AFD), a pathology with negative effects on the heart and kidneys. However, no reliable biomarkers are available to monitor its efficacy. Therefore, we tested a panel of four microRNAs linked with cardiac and renal damage in order to identify a novel biomarker associated with AFD and modulated by ERT. To this end, 60 patients with a definite diagnosis of AFD and on chronic ERT, and 29 age- and sex-matched healthy individuals, were enrolled by two Italian university hospitals. Only miR-184 met both conditions: its level discriminated untreated AFD patients from healthy individuals (c-statistic = 0.7522), and it was upregulated upon ERT (P < 0.001). On multivariable analysis, miR-184 was independently and inversely associated with a higher risk of cardiac damage (odds ratio = 0.86; 95% confidence interval [CI] = 0.76–0.98; P = 0.026). Adding miR-184 to a comprehensive clinical model improved the prediction of cardiac damage in terms of global model fit, calibration, discrimination, and classification accuracy (continuous net reclassification improvement = 0.917, P < 0.001; integrated discrimination improvement [IDI] = 0.105, P = 0.017; relative IDI = 0.221, 95% CI = 0.002–0.356). Thus, miR-184 is a circulating biomarker of AFD that changes after ERT. Assessment of its level in plasma could be clinically valuable in improving the prediction of cardiac damage in AFD patients.openSalamon I.; Biagini E.; Kunderfranco P.; Roncarati R.; Ferracin M.; Taglieri N.; Nardi E.; Laprovitera N.; Tomasi L.; Santostefano M.; Ditaranto R.; Vitale G.; Cavarretta E.; Pisani A.; Riccio E.; Aiello V.; Capelli I.; La Manna G.; Galie N.; Spinelli L.; Condorelli G.Salamon I.; Biagini E.; Kunderfranco P.; Roncarati R.; Ferracin M.; Taglieri N.; Nardi E.; Laprovitera N.; Tomasi L.; Santostefano M.; Ditaranto R.; Vitale G.; Cavarretta E.; Pisani A.; Riccio E.; Aiello V.; Capelli I.; La Manna G.; Galie N.; Spinelli L.; Condorelli G