Archaeobotanical analysis from the long-term rural settlement of Contrada Castro (Corleone, Palermo): preliminary data

The project ¿Harvesting Memories: Ecology and Archaeology of Monti Sicani landscapes¿ aims to analyse the long-term relationship of landscape dynamics and settlement patterns in a Mediterranean inland of Central-Western Sicily. The project combined different interdisciplinary approaches of vegetation science, landscape ecology, history and archaeology in order to diachronically understand and reconstruct the human- society-environment interactions. From 2017 to 2019 a new rural settlement has been investigated in Contrada Castro (Corleone, Palermo). The excavation in Contrada Castro showed a clear case of long-term occupation of an hill-top site during Late Archaic/Classical age (6 th -5 th c. BC) and the Byzantine and Islamic period (7 th -11 th c. AD). Soils from the archaeological excavation were sampled to obtain evidences about paleo-vegetation and vegetal paleo-diet. Archaeobotanical data (seeds and charcoal remains) represent an informative source in human-environmental dynamics to collect specific data on a small scale in terms of chronology and topography (Hastorf, Popper 1988; Pearsall 2009). Furthermore, presence of edible plants as cereals, pulses and fruit characterize their use as economical resources. Unfortunately, archaeobotanical analyses from archaeological sites in Sicily are still not very common (see http://brainplants.successoterra.net/sites.html). For the reconstruction of the paleo-environment and the use of arboreal resources from the three chronological phases of the site, a total of 239 liters of soils were analysed. Taxonomical identification was made by optical microscopy through the comparison with the reference collection and specific atlases (fig.). More than 400 wood charcoals were observed, about 80% of them was identified. Thanks to comparisons with the current vegetation, so far 8 species have been identified - Quercus cfr. ilex (fig.), Pistacia cfr. terebinthus, Rhamnus alathernus, Fraxinus ornus, Ulmus canescens, Acer cfr. campestris, Ostrya carpinifolia, Populus cf. nigra; identification reached the detail of genus or subfamily in 6 cases - Quercus cf. robur / pubescens, Phillyrea sp., Sorbus sp., Rosacea cfr. Pirus sp. and maybe Moracea. The arboreal vegetation is therefore represented by evergreen oaks, semi- and deciduous oaks, maples, ash trees, associated with riparian species such as elm, poplar and hornbeam, and shrub species such as backthorn, terebinth, sorb, plum. Cultivated species are mostly not represented. Despite the widespread presence of the evergreen oaks in the whole record, differences between the three chronological phases were identified, highlighting a selective use of the wild species present in the area and a specific collection of wood for the hearths. 1) Hastorf C.A., Popper V.F.1988, Current Paleoethnobotany. Analytical Methods and Cultural Interpretations of Archaeological Plant Remains, Chicago. ISBN: 978022631893 2) Pearsall D. M. 2009, Paleoethnobotany: A Handbook of Procedures, Second Edition, Walnut Creek. ISBN-10: 1598744720 3) BRAIN Network, http://brainplants.successoterra.net/sites.htmlFinanciación: beca "Juan de la Cierva-incorporación, IJCI-2017-31494, MINECO), IJCI-2017-31494" y proyecto "Harvesting Memories" de la Universidad de Palermo (financiado por Bona Furtuna LLC)

Pancytopenia Secondary to Vitamin B12 Deficiency in Older Subjects

Background: Vitamin B12 (cobalamin CBL) is a water-soluble vitamin required to form hematopoietic cells (red blood cells, white blood cells, and platelets). It is involved in the process of synthesizing DNA and myelin sheath. Deficiencies of vitamin B12 and/or folate can cause megaloblastic anemia (macrocytic anemia with other features due to impaired cell division). Pancytopenia is a less frequent exordium of severe vitamin B12 deficiency. Vitamin B12 deficiency can also cause neuropsychiatric findings. In addition to correcting the deficiency, an essential aspect of management is determining the underlying cause because the need for additional testing, the duration of therapy, and the route of administration may differ depending on the underlying cause. Methods: Here, we present a series of four patients hospitalized for megaloblastic anemia (MA) in pancytopenia. All patients diagnosed with MA were studied for a clinic-hematological and etiological profile. Results: All the patients presented with pancytopenia and megaloblastic anemia. Vitamin B12 deficiency was documented in 100% of cases. There was no correlation between the severity of anemia and deficiency of the vitamin. Overt clinical neuropathy was present in none of the cases of MA, while subclinical neuropathy was seen in one case. The etiology of vitamin B12 deficiency was pernicious anemia in two cases and low food intake in the remaining cases. Conclusion: This case study emphasizes the role of vitamin B12 deficiency as a leading cause of pancytopenia among adults

The Influence of Two Different Breeding Systems on Quality and Clotting Properties of Milk from Dairy Buffaloes Reared in Sicily (Italy)

This study focuses on nine buffalo farms (a total of 692 buffaloes), five intensive herds (161 lactating buffalo cows) and four semiextensive herds (111 lactating buffalo cows), which are the most common in Sicily. The average milk and cheese yield, fat, protein and lactose contents were very similar between the two breeding systems. Milk casein was higher (P=0.04) in intensive herds than in semiextensive herds (4.07% vs 3.51%), whereas the urea content was higher in semi-extensive herds (40.68 mg/dL vs 37.50 mg/dL), yet within the normal range for buffalo milk. As regards milk pH and titration acidity (°SH), no difference was observed between the two breeding systems. Milk produced by the intensive herds scored the best clotting ability with shorter curd firming time (k20 3.08 min) and greater curd firmness (a30 32.69 mm). Milk produced by the semi-extensive herds, instead, was characterized by a longer curd firming time (k20 5.26 min) and lower curd firmness (a30 27.33 mm). This milk from buffaloes bred in Sicily (Italy) also showed a good chemical composition and clotting ability in particular when produced by the intensive herds

Bismuth-based quadruple therapy following H. Pylori eradication failures: A multicenter study in clinical practice

Background & Aims: Helicobacter pylori (H. pylori) eradication in patients who failed one or more therapeutic attempts remains challenging. This study aimed to assess the efficacy of three-in-one capsules bismuth-based quadruple therapy (Pylera®) in these patients managed in clinical practice. Methods: This was a prospective, open-label, multicenter study enrolling consecutive, adult patients with persistent H. pylori infection following at least one standard therapy. All patients received a rescue quadruple therapy with Pylera (3 capsules four times daily) and esomeprazole 20 mg (1 tablet twice daily) for 10 days. H. pylori eradication was assessed by using Urea Breath Test 4-6 weeks following therapy ending. H. pylori eradication rates, compliance, and side-effects were calculated. Results: A total of 208 patients in the 9 participating centres were enrolled. Overall, 180 patients were successfully cured from the infection, accounting for 86.5% (95% CI 81.9-91.2) and 92.3% (95% CI 88.6-96.1) eradication rates at intention-to-treat analysis and at per protocol analysis, respectively. Cure rates were similar across patients who failed one to three previous therapy attempts, but the success rate fell to 67% after 4 or more therapy failures. Compliance to therapy was good in 198 (95.2%) patients, whilst in 7 (5.3%) cases the therapy was interrupted within 5 days due to side effects. A total of 97 (46.6%) patients complained of at least one side effect; nausea, diarrhea and vomiting were the most frequently reported. Conclusions: Our study found that this bismuth-based quadruple therapy is highly effective as second-line and rescue therapy for H. pylori eradication in clinical practic

Immunohistochemical study of basement membrane collagen IV in uterine cervix carcinoma

CONTEXT: The integrity of basement membrane (BM) is damaged during the evolution of a benign or potentially malignant lesion into a malignant one, in which it may undergo several degrees of discontinuity as a necessary condition for the invasive process. Immunostaining for collagen IV, which is exclusively found in BM, has been used to evaluate its formation in neoplastic and benign lesions of several organs.OBJECTIVE: To investigate BM continuity pattern in squamous carcinoma in situ (CIS), microinvasive (MIC) and invasive (IC) squamous cell carcinoma of the uterine cervix, and to find out if BM expression could be useful in the diagnosis of early stromal invasion (MIC).DESIGN: Archival material between 1988 and 1993 was studied at the Pathological Anatomy Department - Unicamp.PROCEDURES: The selected cases, previously formalin fixed and paraffin embedded, were reviewed retrospectively by submitting them to immunohistochemical study via the avidin-biotin-peroxidase method using a monoclonal antibody anticollagen IV.RESULTS: In all, 17 cases of CIS, 16 of MIC and 21 of IC were evaluated. All IC cases showed evident BM discontinuity, either focal or diffuse. In the CIS group, a continuous BM pattern was predominant, being focally disrupted in only 2/17 cases (11.8%). The MIC group showed an intermediate pattern, but with a clear tendency to BM discontinuity in 10/16 cases (62.5%). Inflammatory infiltrate, a variable also studied, cannot be considered responsible for BM discontinuity, since there was no statistical correlation between them.CONCLUSION: We conclude that immunostaining for collagen IV may contribute to the diagnosis of stromal invasion by BM discontinuity.CONTEXTO: A integridade da membrana basal (MB) é destruída no processo de evolução de uma lesão benigna ou potencialmente maligna para uma lesão maligna, onde ela pode sofrer vários graus de descontinuidade, como condição necessária para o processo de invasão. A imunocoloração para colágeno IV, que é exclusivamente encontrado na MB, tem sido utilizada para avaliar sua formação em processos benignos e neoplásicos de vários órgãos. OBJETIVO: Investigar o padrão de continuidade da MB no carcinoma in situ (CIS), microinvasivo (CMI) e epidermóide (CE) do colo uterino. Além disso, pretendeu-se verificar em que medida estes padrões poderiam ser úteis no diagnóstico de invasão estromal inicial (CMI). TIPO DE ESTUDO: Foi estudado o material do arquivo de tecidos dos anos de 1988 a 1993 do Departamento de Anatomia Patológica da UNICAMP. PROCEDIMENTOS: Os tecidos eram fixados em formalina e incluídos em parafina e foram revistos retrospectivamente para serem submetidos à reação imuno-histoquímica pelo método da avidina-biotina-peroxidase, com o anticorpo monoclonal anti-colágeno IV. RESULTADOS: Ao todo, foram avaliados 17 casos de CIS, 16 de CMI e 21 de CE. Todos os casos de CE mostraram evidente descontinuidade da MB, quer focal ou difusa. No grupo dos CIS foi observado um padrão contínuo de MB, sendo focalmente lesado em apenas 2/17 casos (11,8%). O grupo dos CMI mostraram um padrão intermediário, com clara tendência à descontinuidade da MB em 10/16 casos (62,5%). O infiltrado inflamatório, variável também estudada, não pode ser responsabilizado pela descontinuidade da MB, já que não houve correlação estatística entre eles. CONCLUSÃO: A imunocoloração para colágeno IV pode contribuir no diagnóstico de invasão estromal, quando houver lesão da MB.1846185

Bismuth-based quadruple therapy following H. Pylori eradication failures: A multicenter study in clinical practice

Background & Aims: Helicobacter pylori (H. pylori) eradication in patients who failed one or more therapeutic attempts remains challenging. This study aimed to assess the efficacy of three-in-one capsules bismuth-based quadruple therapy (Pylera®) in these patients managed in clinical practice. Methods: This was a prospective, open-label, multicenter study enrolling consecutive, adult patients with persistent H. pylori infection following at least one standard therapy. All patients received a rescue quadruple therapy with Pylera (3 capsules four times daily) and esomeprazole 20 mg (1 tablet twice daily) for 10 days. H. pylori eradication was assessed by using Urea Breath Test 4-6 weeks following therapy ending. H. pylori eradication rates, compliance, and side-effects were calculated. Results: A total of 208 patients in the 9 participating centres were enrolled. Overall, 180 patients were successfully cured from the infection, accounting for 86.5% (95% CI 81.9-91.2) and 92.3% (95% CI 88.6-96.1) eradication rates at intention-to-treat analysis and at per protocol analysis, respectively. Cure rates were similar across patients who failed one to three previous therapy attempts, but the success rate fell to 67% after 4 or more therapy failures. Compliance to therapy was good in 198 (95.2%) patients, whilst in 7 (5.3%) cases the therapy was interrupted within 5 days due to side effects. A total of 97 (46.6%) patients complained of at least one side effect; nausea, diarrhea and vomiting were the most frequently reported. Conclusions: Our study found that this bismuth-based quadruple therapy is highly effective as second-line and rescue therapy for H. pylori eradication in clinical practic

Survival Of Women With Ovarian Carcinomas And Borderline Tumors Is Not Affected By Estrogen And Progesterone Receptor Status.

To examine the patterns of estrogen receptor (ER) and progesterone receptor (PR) expression in borderline ovarian tumors (BOTs) and ovarian carcinomas. We also assessed the disease-free survival (DFS) and overall survival (OS) in women with ovarian carcinoma, in relation to ER and/or PR expression. We examined ER/PR expression in 38 BOTs and 172 ovarian carcinomas removed from patients treated at the State University of Campinas-UNICAMP (Brazil), from 1993 to 2008 and followed for up to 60 months using tissue microarray-based immunohistochemistry. Twenty-eight (73.7%) mucinous and 10 (26.3%) serous BOTs were included. Ovarian carcinomas consisted mainly of 79 (46.0%) serous, 44 (25.5%) mucinous, 17 (9.8%) endometrioid, 10 (5.8%) clear-cell types. There was no significant difference of the ER/PR expression between BOT and ovarian carcinoma (p=0.55 for ER alone, 0.90 for PR alone, and 0.12 for combined expression). The level of ER/PR expression in BOTs was significantly higher in serous than in mucinous tumors (p<0.01). In carcinomas, ER/PR was higher in serous tumors than in mucinous (p<0.01) and clear cell tumors (p=0.02), and higher in endometrioid tumors than in mucinous tumors (p<0.01). DFS was affected neither by the clinical characteristics nor by combined steroid receptor status. OS was found to be significantly worse (p<0.01) only in women with stages II-IV tumors and those with residual disease after surgery (p<0.01). Overall, serous and endometrioid tumors were predominantly ER/PR positive, whereas mucinous and clear-cell tumors were preponderantly ER/PR negative. DFS and OS were not affected by ER/PR expression.24167-7

Hypovitaminosis D and COVID-19

As the main title 'COVID-19 revolution: a new challenge for the internist' states, the global coronavirus infection disease 2019 (COVID-19) pandemic represented a new challenge for the internists. This paper is part of a series of articles written during the difficult period of the ongoing global pandemic and published all together in this fourth issue of the Italian Journal of Medicine, with the aim of sharing the direct experiences of those who were the first to face this severe emergency, expressing each point of view in the management of COVID-19 in relation to other diseases. Each article is therefore the result of many efforts and a joint collaboration between many colleagues from the Departments of Internal Medicine or Emergency Medicine of several Italian hospitals, engaged in the front line during the pandemic. These preliminary studies therefore cover diagnostic tools available to health care personnel, epidemiological reflections, possible new therapeutic approaches, discharge and reintegration procedures to daily life, the involvement of the disease not only in the lung, aspects related to various comorbidities, such as: coagulopathies, vasculitis, vitamin D deficiency, gender differences, etc.. The goal is to offer a perspective, as broad as possible, of everything that has been done to initially face the pandemic in its first phase and provide the tools for an increasingly better approach, in the hope of not arriving unprepared to a possible second wave. This paper in particular deals with hypovitaminosis D and COVID-19

Sleep and Chronobiology as a Key to Understand Cluster Headache

: The cluster headache is a primary headache characterized by attacks of unilateral pain associated with ipsilateral cranial autonomic features. These attacks recur in clusters during the years alternating with periods of complete remission, and their onset is often during the night. This annual and nocturnal periodicity hides a strong and mysterious link among CH, sleep, chronobiology and circadian rhythm. Behind this relationship, there may be the influence of genetic components or of anatomical structures such as the hypothalamus, which are both involved in regulating the biological clock and contributing even to the periodicity of cluster headaches. The bidirectional relationship manifests itself also with the presence of sleep disturbances in patients affected by cluster headaches. What if the key to studying the physiopathology of such disease could rely on the mechanisms of chronobiology? The purpose of this review is to analyze this link in order to interpret the pathophysiology of cluster headaches and the possible therapeutic implications

Erenumab and Possible CGRP Effect on Chronotype in Chronic Migraine: A Real-Life Study of 12 Months Treatment

: The introduction of monoclonal antibodies (mAbs) directed against the calcitonin gene-related peptide (CGRP), or its receptor (CGRPr), revolutionized migraine management due to their high efficacy and few side effects. Data suggest that the CGRP may even be implicated in circadian rhythm, but studies about the effect of anti-CGRP treatments on sleep are still lacking. The aim of the present study was to assess the effect of erenumab (70 and 140 mg per month), a human mAb directed against CGRPr, on chronotype in chronic migraineurs; secondly, we assessed its efficacy, safety, and the effects on anxiety and depression. Sleep was evaluated using self-administrable questionnaires investigating chronotype, sleep quality, and daytime sleepiness. Migraine diaries and several self-administrable questionnaires regarding headache impact and psychological correlates were evaluated every 3 months during 12 months of treatment. Eighty-eight patients were included; most of them showed a significant reduction in headache frequency and an improvement in psychological symptoms. Moreover, an initial change in chronotype was observed at the three-month assessment from a morning chronotype to an intermediate one; a similar trend remained in the other evaluations, even if it did not reach a statistical significance. Lastly, patients who responded to the treatment showed a progressive sleep efficiency reduction. The present real-life study hypothesized the influence of erenumab on chronotype, representing a link between circadian rhythm, CGRP, and migraine