Application of clinical indexes in ulcerative colitis patients in regular follow-up visit. correlation with endoscopic 'mucosal healing' and implication for management

OBJECTIVE: Ulcerative Colitis (UC) is a chronic inflammatory disease of the colon of unknown etiology. Several clinical indexes have been proposed for UC disease activity evaluation, but none have been properly validated. Moreover, the reference parameter for the scores and their prognostic value is not clear. Mucosal healing has been recently proposed as an important end-point. Aim of the present study was to evaluate the correlation of four clinical indexes with objective diagnostic tools for UC evaluation, the discriminative ability in identifying patients with endoscopic mucosal healing, and to analyze the possible prognostic indication for disease course in 1 year of follow-up. PATIENTS AND METHODS: We analyzed data of 75 patients recorded in regular follow-up visit in IBD clinic at S. Andrea Hospital, Rome, between 2007-2011. We recorded clinical data and lab tests at the time of the visit, and endoscopic/ histological repor ts performed within 1 month. Clinical indexes (Seo' activity index, Simple Clinical Colitis Activity Index, partial Mayo score and Endoscopic-Clinical Correlation Index) were calculated and correlation to endoscopic and histologic activity, and to C-reactive protein increment, was assessed by mean of Spearman's rank correlation. Discriminative ability of the indexes for patients with and without endoscopic mucosal healing was tested by calculation of area under ROC curve (AUC). Patients with low and high clinical scores were compared for number of flares and increment of therapy during 1 year of follow-up. RESULTS: Clinical indexes had a good correlation with endoscopic activity (mean r = 0.73 ± 0.06), a fair correlation with CRP-increment (mean r = 0.55 ± 0.01) and a poor one with histologic activity (mean r = 0.35 ± 0.01). The discriminatory ability of the indexes for endoscopic mucosal healing was good for all the indexes (mean AUC = 0.87 ± 0.05). Patients with high clinical score had more flares and required more frequently increase of therapy at 1 year of follow up compared with patients with low score. CONCLUSIONS: Clinical indexes have a good correlation with endoscopic activity and can discriminate patients with and without mucosal healing. Patients with low and high score have different risk of disease flare and of need to increase therapy at 1 year. Clinical indexes may represent a useful tool for disease assessment in clinical practice in UC outpatients with mildmoderate disease

Impairment of the autophagic flux in astrocytes intoxicated by trimethyltin

Autophagy is a lysosomal catabolic route for protein aggregates and damaged organelles which in different stress conditions, such as starvation, generally improves cell survival. An impairment of this degradation pathway has been reported to occur in many neurodegenerative processes. Trimethyltin (TMT) is a potent neurotoxin present as an environmental contaminant causing tremors, seizures and learning impairment in intoxicated subjects. The present data show that in rat primary astrocytes autophagic vesicles (AVs) appeared after few hours of TMT treatment. The analysis of the autophagic flux in TMT-treated astrocytes was consistent with a block of the late stages of autophagy and was accompanied by a progressive accumulation of the microtubule associated protein light chain 3 (LC3) and of p62/SQSTM1. Interestingly, an increased immunoreactivity for p62/SQSTM1 was also observed in hippocampal astrocytes detected in brain slices of TMT-intoxicated rats. The time-lapse recordings of AVs in EGFP-mCherry-LC3B transfected astrocytes demonstrated a reduced mobility of autophagosomes after TMT exposure respect to control cells. The observed block of the autophagic flux cannot be overcome by known autophagy inducers such as rapamycin or 0.5mM lithium. Although ineffective when used at 0.5mM, lithium at higher concentrations (2mM) was able to protect astrocyte cultures from TMT toxicity. This effect correlated well with its ability to determine the phosphorylation/inactivation of glycogen kinase synthase-3β (GSK-3β)

Photoluminescence properties of C60 films deposited on silicon substrate

Photoluminescence (PL) spectra of C-60 films deposited on Si substrates have been measured from 10 to 300 K and as a function of laser excitation intensity. Recombination of self-trapped excitons and their phonon replicas, as well as X-trap-related emissions, are the main features of the PL spectra. The influence of the deposition parameters, namely deposition rate and substrate temperature, on the luminescence efficiency of the C-60 films have been investigated. Low substrate temperature produces a lowering of the PL efficiency, whereas an increase of the deposition rate causes an increase of the X-trap emission

Successful Coronary Stent Retrieval From a Pedal Artery

The purpose of this article is to report complications from a coronary drug-eluting stent lost in the peripheral circulation. We report the case of successful retrieval of a sirolimus coronary stent from a pedal artery in a young patient who underwent coronary angiography for previous anterior myocardial infarction. Recognition of stent embolization requires adequate removal of the device to avoid unwelcome clinical sequelae. Keywords Coronary stent Microsnare technique Peripheral embolization Stent retrieva

Bifid median nerve: report of two cases

The median nerve divides into its terminal branches at or proximal to the distal edge of the flexor retinaculum. An anatomy of the median nerve within the carpal tunnel is reported in two separate cases. Emphasis has been given to the value of direct vision when incising the flexor retinaculum in order to avoid injure of the median nerve

Modulations of glycerophosphorylcholine and phosphorylcholine in Friend erythroleukemia cells upon in vitro-induced erythroid differentiation: a 31P NMR study

AbstractA 31P NMR study has been carried out on Friend erythroleukemia cells (FLC) induced to undergo erythroid differentiation in vitro. Significant levels of glycerophosphorylcholine (GroPCho) and phosphorylcholine (P-Cho) were identified both in the untreated cells and in their PCA extracts. In FLC treated 4 days in vitro with either dimethylsulfoxide (DMSO) or hexamethylenebisacetamide (HMBA), the intracellular concentration of P-Cho was markedly increased, whereas that of GroPCho appeared to be significantly reduced. HMBA was more effective than DMSO in producing this effect. The concomitant modulations of GroPCho and P-Cho in differentiated FLC suggest the hypothesis that erythroid differentiation involves modifications of the regulatory mechanisms controlling biosynthesis and catabolism of phospholipids

Measles among healthcare workers in Italy. Is it time to act?

Vaccination of healthcare workers (HCWs) against measles is strongly recommended in Europe. In this study, we examined the impact of measles on Italian HCWs by systematically and quantitatively analyzing measles cases involving HCWs over time and by identifying the epidemiological characteristics of the respective measles outbreaks. We retrieved data on measles cases from the Italian national integrated measles and rubella surveillance system from January 2013 to May 2019. Additionally, we performed a systematic review of the literature and an analysis of the measles and rubella aggregate outbreaks reporting forms from 2014 to 2018. Our review suggests that preventing measles infection among HCWs in disease outbreaks may be crucial for the elimination of measles in Italy. National policies aiming to increase HCW immunization rates are fundamental to the protection of HCWs and patients, will limit the economic impact of outbreaks on the institutions affected and will help achieve the elimination goal

The primordial environment of supermassive black holes (II): deep Y and J band images around the z=6.3 quasar SDSS J1030+0524

Many cosmological studies predict that early supermassive black holes (SMBHs) can only form in the most massive dark matter halos embedded within large scale structures marked by galaxy over-densities that may extend up to 10 physical Mpc. This scenario, however, has not been confirmed observationally, as the search for galaxy over-densities around high-z quasars has returned conflicting results. The field around the z=6.28 quasar SDSSJ1030+0524 (J1030) is unique for multi-band coverage and represents an excellent data legacy for studying the environment around a primordial SMBH. In this paper we present wide-area (25x25 arcmin), Y- and J-band imaging of the J1030 field obtained with the near infrared camera WIRCam at the Canada-France-Hawaii Telescope (CFHT). We built source catalogues in the Y- and J-band, and matched those with our photometric catalogue in the r, z, i bands presented in Morselli et al. (2014). We used these new infrared data together with H and K and Spitzer/IRAC data to refine our selection of Lyman Break Galaxies (LBGs), extending our selection criteria to galaxies in the range 25.2<zAB<25.7. We selected 21 robust high-z candidates in the J1030 field with photometric redshift around 6 and colors i-z>=1.3. We found a significant asymmetry in the distribution of the high-z galaxies in J1030, supporting the existence of a coherent large-scale structure around the quasar. We compared our results with those of Bowler et al. (2015), who adopted similar LBGs selection criteria, and estimated an over-density of galaxies in the field of delta = 2.4, which is significant at >4 sigma. The over-density value and its significance are higher than those found in Morselli et al. (2014), and we interpret this as evidence of an improved LBG selection.Comment: 13 pages, 8 figures, accepted for publication in A&