Laparoscopic repair for perforated peptic ulcer: our experience, a comparison with the open approach and a review of the literature.

Backgrounds: The incidence of perforated peptic ulcers has decreased during the last decades but the optimal treatment for these patients remains controversial. At the same time, a laparoscopic approach to this condition has been adopted by an increased number of surgeons. Therefore, this study wants to evaluate the postoperative results of the laparoscopic treatment of perforated peptic ulcer performed in one Italian center with extensive experience in laparoscopic surgery. Methods: This retrospective study includes 94 patients who were operated for perforated peptic ulcer peritonitis at “St. Orsola Hospital - Emergency Surgery Unit - University of Bologna” from May 2014 to December 2019. The patients’ charts were reviewed for demographics, surgical procedure, complications, and short-term outcomes. Results: The diagnosis was made clinically and confirmed by the presence of gas under diaphragm on abdominal X-ray. All patients underwent primary suture repair with or without omentopexy. Boey score 0 or 1 was found in 66 (70%) patients, Boey 2 or 3 in 28 (30%) patients. The operative time was between 35 and 255 minutes, with a mean of 93 minutes. The overall median hospital stay was 9.5 (1-60) days. Post-operative complications occurred in 19 (20%) patients and 18 (19%) patients died. Conclusions: Perforated peptic ulcer is a severe condition that requires early hospital admission and immediate surgery. Laparoscopy in experienced centers and for selected patients is safe, associated with optimal outcomes and should be the preferred approach

Laparoscopic repair for perforated peptic ulcer: Our experience, a comparison with the open approach and a review of the literature.

Background: The incidence of perforated peptic ulcers has decreased during the last decades but the optimal treatment for these patients remains controversial. At the same time, a laparoscopic approach to this condition has been adopted by an increased number of surgeons. Therefore, this study wants to evaluate the postoperative results of the laparoscopic treatment of perforated peptic ulcer performed in one Italian center with extensive experience in laparoscopic surgery. Methods: This retrospective study includes 94 patients who were operated for perforated peptic ulcer peritonitis at “St. Orsola Hospital - Emergency Surgery Unit - University of Bologna” from May 2014 to December 2019. The patients’ charts were reviewed for demographics, surgical procedure, complications, and short-term outcomes. Results: The diagnosis was made clinically and confi rmed by the presence of gas under diaphragm on abdominal X-ray. All patients underwent primary suture repair with or without omentopexy. Boey score 0 or 1 was found in 66 (70%) patients, Boey 2 or 3 in 28 (30%) patients. The operative time was between 35 and 255 minutes, with a mean of 93 minutes. The overall median hospital stay was 9.5 (1-60) days. Post-operative complications occurred in 19 (20%) patients and 18 (19%) patients died. Conclusions: Perforated peptic ulcer is a severe condition that requires early hospital admission and immediate surgery. Laparoscopy in experienced centers and for selected patients is safe, associated with optimal outcomes and should be the preferred approach

Implementation of an Industry 4.0 system to optimally manage chemical plant operation

The evolution of the process industry in the direction of automation and digitalization is nowadays a consolidated phenomenon. In this direction, Industry 4.0 paradigms are leading many industrial companies to significantly update their facilities. This paper presents a scheduling algorithm that takes the role of a real-time optimization (RTO) element in a larger project framework where the various network components are aimed to be all highly interconnected. The proposed methodology is applied to an Italian chemical industrial site, in order to best manage the production rates of the various products and the sales plan for the different clients. Numerous plants and processes are considered into the model: batch and continuous production lines, saleable and non-storable products. Concepts of linear optimization and batch operation scheduling are used in the algorithm construction. This whole structure lays the foundation for a full integration between different elements of the facility, that is, the control systems and the selling department

Missense mutations in the PML/RAR alpha ligand binding domain in ATRA-resistant As2O3 sensitive relapsed acute promyelocytic leukemia

Background and Objectives. Acute promyelocytic leukemia is characterized by the chromosomal translocation t(15;17) which yields the fusion product PML/RAR alpha. Art-trans retinoic acid probably induces differentiation of atypical promyelocytes and clinical remission in APL patients by binding to the ligand binding domain (LBD) of the RAR alpha portion of the PML-RAR alpha chimeric protein. Structural alterations of the LED of the PML/RAR alpha have been revealed in ATRA-resistant APL cell lines and in a few APL patients with acquired clinical resistance to ATRA therapy. Two APL relapsed patients with clinical resistance to ATRA therapy were evaluated for the presence of nucleotide mutations in the LED of PML/RAR alpha gene and then treated with arsenic trioxide (As2O3). Design and Methods. DNA fragments from the LED of the PML/RAR alpha: chimeric transcript were obtained by reverse-transcribed polymerase chain reaction. Direct sequencing was performed by an unambiguous bidirectional automatic analysis. Samples representative of APL onset and relapse were analyzed from both patients. Results. In both patients, at the ATRA-resistant relapse, a missense point mutation in the LED of the PML/RAR alpha gene was found. The mutations, absent at APL onset, led to an Arg272Gln and to an Arg276Trp amino acid substitution, according to the sequence of the RAR alpha protein. Both patients had complete clinical and hematologic remission after treatment with As2O3. Interpretation and Conclusions. LED missense mutations appear to be a significant mechanism of acquired ATRA-resistance in vivo, closely related to clinical APL relapse. The two cases reported here provide the first in vivo evidence of Apt, relapsed patients, who have become ATRA-resistant for molecular reasons, being sensitive to arsenic trioxide

Halyomorpha halys in Emilia, prime risposte dal monitoraggio

OSSERVAZIONI IN CAMPO CONDOTTE NEL 2013-2014. Dopo la sua comparsa in Italia, accertata nel 2012, è stato attivato nella zona di ritrovamento un programma di monitoraggio teso a studiare l’insetto e il suo comportamento nell’ambiente. La specie desta maggiori preoccupazioni nel settore frutticolo, dove il danno rappresentato dalle tipiche deformazioni può giungere al 100

Halyomorpha halys in Italy: first results of field monitoring in fruit orchards

The invasive pest Brown Marmorated Stink Bug (BMSB) Halyomorpha halys (Heteroptera, Pentatomidae) was detected for the first time in Italy in September 2012 in Modena province (Northern Italy) during an insect collection for educational purposes. A survey performed in 2013 allowed to detect its presence in Emilia Romagna, Lombardy and Piedmont regions. In 2014, in the provinces of Modena, Reggio Emilia and Bologna a periodical active field monitoring was performed using tree beating, sweep-net and visual observations in selected orchards and vineyards, recording numbers of BMSB adults and nymphs, and of other Heteroptera. Besides, fruit injury and crop loss were recorded at harvest. Partial results from field data obtained between April and July 2014 are presented, indicating that BMSB is already becoming an important pest of fruit orchards and that special attention should be deserved to monitor its spread all over the region and the whole Italian country

Preoccupano le infestazioni della cimice asiatica

2015-Anno caldo delle cimici. Nel corso dell’estate le infestazioni di Halyomorpha halys hanno investito un territorio sempre più ampio, con gravi percentuali di danno su numerose colture. A esse si sono sovrapposti gli attacchi di altri pentatomidi, accomunati anch’essi dalla caratteristica di pungere e deprezzare i frutti. Il malessere degli agricoltori è crescente e la situazione in alcuni contesti ha assunto le dimensioni di un’autentica emergenza

The effects of biochar and its combination with compost on lettuce (Lactuca sativa L.) growth, soil properties, and soil microbial activity and abundance

Impacts of biochar application in combination with organic fertilizer, such as compost, are not fully understood. In this study, we tested the effects of biochar amendment, compost addition, and their combination on lettuce plants grown in a soil poor in nutrients; soil microbiological, chemical, and physical characteristics were analyzed, together with plant growth and physiology. An initial screening was also done to evaluate the effect of biochar and compost toxicity, using cress plants and earthworms. Results showed that compost amendment had clear and positive effects on plant growth and yield and on soil chemical characteristics. However, we demonstrated that also the biochar alone stimulated lettuce leaves number and total biomass, improving soil total nitrogen and phosphorus contents, as well as total carbon, and enhancing related microbial communities. Nevertheless, combining biochar and compost, no positive synergic and summative effects were observed. Our results thus demonstrate that in a soil poor in nutrients the biochar alone could be effectively used to enhance soil fertility and plant growth and biomass yield. However, we can speculate that the combination of compost and biochar may enhance and sustain soil biophysical and chemical characteristics and improve crop productivity over time

GENE EXPRESSION TIME-SERIES ANALYSIS OF CAMPTHOTECIN EFFECTS IN U-87-MG AND DBTRG-05 GLIOBLASTOMA CELL LINES

The clinical efficacy of camptothecin (CPT), a drug specifically targetingtopoisomerase I (TopoI), is under evaluation for the treatment of malignant gliomas. Due to thehigh unresponsiveness of these tumours to chemotherapy, it would be very important to study thesignalling network that drives camptothecin outcome in this type of cancer cells. To address thisissue, we had previously compared the expression profile of human U87-MG glioblastoma cellswith that of a CPT-resistant counterpart, giving evidence that the development of a robustinflammatory response was the main transcriptional effect associated with CPT resistance.Here we report time-related changes and cell line specific patterns of gene expression after CPTtreatment by using two p53 wild-type glioblastoma cell lines, U87-MG and DBTRG-05, withdifferent sensitivities to TopoI inhibition