Syncope and Epilepsy coexist in 'possible' and 'drug-resistant' epilepsy (Overlap between Epilepsy and Syncope Study - OESYS).

BACKGROUND AND AIM: Syncope and related falls are one of the main causes and the predominant cause of hospitalization in elderly patients with dementia. However, the diagnostic protocol for syncope is difficult to apply to patients with dementia. Thus, we developed a "simplified" protocol to be used in a prospective, observational, and multicenter study in elderly patients with dementia and transient loss of consciousness suspected for syncope or unexplained falls. Here, we describe the protocol, its feasibility and the characteristics of the patients enrolled in the study. METHODS: Patients aged ≥65 years with a diagnosis of dementia and one or more episodes of transient loss of consciousness during the previous 3 months, subsequently referred to a Geriatric Department in different regions of Italy, from February 2012 to May 2014, were enrolled. A simplified protocol was applied in all patients. Selected patients underwent a second-level evaluation. RESULTS: Three hundred and three patients were enrolled; 52.6% presented with episodes suspected to be syncope, 44.5% for unexplained fall and 2.9% both. Vascular dementia had been previously diagnosed in 53.6% of participants, Alzheimer's disease in 23.5% and mixed forms in 12.6%. Patients presented with high comorbidity (CIRS score = 3.6 ± 2), severe functional impairment, (BADL lost = 3 ± 2), and polypharmacy (6 ± 3 drugs). CONCLUSION: Elderly patients with dementia enrolled for suspected syncope and unexplained falls have high comorbidity and disability. The clinical presentation is often atypical and the presence of unexplained falls is particularly frequent

Adenocarcinoma del duodeno: case report e considerazioni cliniche

Background: Duodenal tumors are rare neoplasms with nonspecific symptoms mimicking benign patologies. There aren’t many large study to determine the prognostic factors and survival of these tumors. Case report: We report a case of a 71 years old man, who was admitted to our observation with a duodenal ulceration that reveled being a duodenal adenocarcinoma. Discussion: These lesions are characteried by a vague symptomatology like weight loss, abdominal pain, jaundice and anemia. The diagnosys is often delayed because of these nonspecific clinical signs. The most frequent location is the second portion of the duodenum. Curative surgery is the gold standard of treatment with an improving survival. Pancreaticoduodenectomy and its variants is the intervention of choice, reserving duodenal segmentectmy only for distal tumors. The role of lymph node metastases is debated and not cleared. There aren’t sure prognostic factors regarding respectability and out come. Global survival at 3 and 5 years showed be better than those of other peripapillary tumors. Conclusions: The absence of randomized clinical trials and the relative rarity of these lesions preclude the compilation of guide line for therapeutic procedure

Anti-nutrient components and metabolites with health implications in seeds of 10 common bean (Phaseolus vulgaris L. and Phaseolus lunatus L.) landraces cultivated in southern Italy

Common beans (Phaseolus vulgaris L.) provide an inexpensive food rich in macronutrients such as protein and starch, important micronutrients such as iron, and also a number of other stored bioactive compounds (phytates, polyphenols, tannins, raffinosaccharides, lectins, protease and α-amylase inhibitors, saponins, etc.) endowed with positive health implications through their antioxidant, anti-tumour or phyto-oestrogenic activity. They also produce negative dietary effects such as interference with micronutrient absorption, protein digestibility or glucose metabolism, or even direct toxic effects (lectins). Analysis of the levels of these compounds in seeds of local and underexploited common bean varieties and landraces may reveal traits of interest for promoting nutrition and preserving health, and in addition allow breeders to use them in genetic improvement programmes to modify the levels of specific compounds in new common bean varieties. In the present work, 10 bean populations belonging to 7 highly appreciated southern Italian landraces were analysed. The seeds of one of them, “Poverello di Rotonda AF”, was found to accumulate remarkable levels of 4 health-promoting components such as quercetin (24.2 μg/g), genistein (21.6 μg/g), soysapogenin B (433 μg/g) and oleanolic acid (11.9 μg/g), while “Tabacchino” contained very high amounts of iron (131 μg/g) and three health-promoting components: kaempferol (61.0 μg/g), oleanolic acid (12.3 μg/g) and condensed tannins (2.36 mg/g). A level of variation high enough to be exploited for breeding purposes was found for 7 out of 15 biochemical parameters studied

The contribution of cell phenotype to the behavior of gastric cancer.

none8noSeveral histochemical studies suggest a role of tumor cell phenotype and related differentiation markers in the prognostic assessment of gastric cancer. Unfortunately, most studies have dealt with single or a few markers and have paid limited attention to their interplay with tumor histological types, which are potentially informative of prognosis. In this study, 292 invasive (T1b to T4) gastric cancers with prolonged follow-up and carefully analyzed histotype, inclusive of histotype-based grade, were investigated histochemically with a panel of 14 phenotypic markers known to be expressed in normal gut tissues and gastric cancer. Three of seven intestinal type markers investigated showed a trend for improved prognosis, one of which, CDX2, was stage independent. Three among gastric and pancreatobiliary duct markers (MUC1, MUC6, and pepsinogen II), predicted more severe prognosis stage independently, as did a combination of eight potentially informative (p < 0.1 at univariable Cox analysis) markers. Cancers with predominantly intestinal phenotype had significantly better prognosis than those with predominantly gastric, mixed, or poorly defined phenotypes; among the latter, those with high lymphocyte response, with favorable outcome, were separated from anaplastic cancers, with ominous prognosis. At multivariable analysis, CDX2 and the eight marker combination proved to be stage- and grade-independent predictors. When individually considered, and with the exception of CDX2, the biomarkers investigated gave an appreciable, although moderate, contribution to the prognostic evaluation of gastric cancer. Combined analysis of all potentially informative markers gave more important information, highly additive to both stage and histotype-based grade.noneSolcia E;Klersy C;Vanoli A;Grillo F;Manca R;Tava F;Luinetti O;Fiocca RSolcia, E; Klersy, C; Vanoli, A; Grillo, Federica; Manca, R; Tava, F; Luinetti, O; Fiocca, Robert