Evaluating the expression of urokinase and tissue leukocyte being in benign and malignant breast disease

Introduction: Our objectives is to show that the expression of uPA leukocyte could be considered, in the future, as a marker of the expression of uPA in the malignant tissue and therefore a potential indicator of prognosis. Methods: We examined the expression of uPa in leukocytes and tissues of three groups of women: with breast cancer; with benign breast lesion and healthy women (control group). We used RT Real Time PCR assay. The expression of urokinase is significantly higher in malignant breast lumps compared to benign lesions. However, in women with carcinoma of the breast, malignant tissue expresses higher amounts of uPA than the healthy counterpart. There are no statistically significant differences in the expression of uPA, between tissues taken from women with benign lesions. The lymphocytes taken from healthy volunteers show a level of expression of uPA significantly lower than the other tested samples Lymphocytes extracted from cancer patients express higher amounts of uPA compared to lymphocytes belonging to women with benign breast lesions. The expression of uPA was compared with the clinical and biological parameters commonly used in clinical practice for the definition of the prognosis. The only exception found, concerns those tumors characterized by the simultaneous negativity for estrogen receptors, progesterone and HER2 (state of triple negative), in which the expression of uPA is very high. Results and conclusions: Our data show that uPA expressed by leukocytes of each individual patient is the mirror image of the one expressed by malignant nodular uPA.Introduction: Our objectives is to show that the expression of uPA leukocyte could be considered, in the future, as a marker of the expression of uPA in the malignant tissue and therefore a potential indicator of prognosis. Methods: We examined the expression of uPa in leukocytes and tissues of three groups of women: with breast cancer; with benign breast lesion and healthy women (control group). We used RT Real Time PCR assay. The expression of urokinase is significantly higher in malignant breast lumps compared to benign lesions. However, in women with carcinoma of the breast, malignant tissue expresses higher amounts of uPA than the healthy counterpart. There are no statistically significant differences in the expression of uPA, between tissues taken from women with benign lesions. The lymphocytes taken from healthy volunteers show a level of expression of uPA significantly lower than the other tested samples Lymphocytes extracted from cancer patients express higher amounts of uPA compared to lymphocytes belonging to women with benign breast lesions. The expression of uPA was compared with the clinical and biological parameters commonly used in clinical practice for the definition of the prognosis. The only exception found, concerns those tumors characterized by the simultaneous negativity for estrogen receptors, progesterone and HER2 (state of triple negative), in which the expression of uPA is very high. Results and conclusions: Our data show that uPA expressed by leukocytes of each individual patient is the mirror image of the one expressed by malignant nodular uPA

Different techniques of surgical left atrial appendage closure and their efficacy. a systematic review

Background: Atrial fibrillation has been identified as an independent risk factor for thromboembolic events. Since 1948 different surgical techniques have described the feasibility and the rationale of left atrial surgical appendage closure. The aim of this systematic review is to evaluate the reported patency rates of different surgical techniques. Methods: This systematic review was conducted according to preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Two independent investigators searched the PubMed, Scopus, Web of Science, Cochrane Central Register of Controlled Trials, and OVID & REG; (Wolters Kluwer, Alphen aan den Rijn, Netherlands) to identify relevant studies. Consecutively, a PICO (Population, Intervention, Comparison and Outcomes) strategy assessment of literature was performed to search eventual other relevant studies that may have been ignored. Results: A total of 42 studies were included in our analysis. The total number of patients who underwent surgical left atrial appendage closure was 5671, and in 61.2% an imaging follow up was performed, mostly with transesophageal echocardiographic evaluation. Success rate for the different techniques was: Clip deployment 98%; Lariat procedure 88%; Surgical amputation 91%; Endocardial suture 74.3%, Epicardial suture 65%; Left atrial appendage closure (LAAC) ligation 60.9%; Stapler technique with excision of left atrial appendage (LAA) 100%; Stapler without excision 70%. Conclusions: To date, data on surgical left atrial appendage closure are poor and not standardized, even if reported rates are acceptable and comparable to transcatheter procedures. If validated on large-scale non-retrospective and multicentric studies, these promising developments may offer a valuable alternative for patients with atrial fibrillation (AF) and ineligible for oral anticoagulation therapy

Cronotipo e cancro della mammella

Introduzione. In base al cronotipo, il nostro organismo è già “impostato” per essere più o meno attivo in determinati momenti della giornata. Il cronotipo può essere: • mattiniero, se vai a dormire presto e ti alzi presto; • serale, se vai a letto tardi e ti svegli tardi; • neutrale, se hai bioritmi regolati in maniera più equilibrata, come il 70% della popolazione mondiale! Nel 1976 i ricercatori Jim Horne e Olof Östberg hanno creato un questionario composto da 19 domande, in base alle quali è possibile identificare il proprio cronotipo. Lo scopo del nostro studio è quello di esaminare la possibilità di una correlazione tra cronotipo ed il cancro della mammella. Materiali e Metodi. Il centro per la prevenzione diagnosi e cura dei tumori della mammella di Palazzo Baleani accetta le pazienti senza appuntamento. Le donne vengono la mattina a prendere il numero e nella stessa mattina sono sottoposte a visita senologica, mammografia, ecografia ed eventuale agoaspirato. L’idea di questo studio è nata dall’osservazione che le pazienti con patologie mammarie maligne arrivavano agli esami diagnostici sempre al termine della mattinata, mai alle otto del mattino a differenza delle pazienti che non presentavano alcuna patologia. Nel periodo compreso tra il 2013 ed il 2016 abbiamo quindi proposto a 333 pazienti cui è stato diagnosticato un carcinoma il questionario di Jim Horne e Olof Ostberg composto da 19 domande per identificare il loro cronotipo. L’età delle pazienti era compresa tra 32 e 89, età media di 55 anni. Risultati. I risultati sono stati i seguenti: a. Definite morning type: 60 pazienti b. Moderate morning type: 130 c. Neither Type: 110 d. Moderate evening type: 30 e. Definite evening type: 0 Conclusioni. Come si evince dai dati sopra riportati la maggior parte delle pazienti appartenevano al cronotipo “ moderate morning type” e “neither type” in accordo con la maggior parte degli studi in letteratura i quali ribadiscono che il cronotipo non è associato con il rischio di cancro della mammell