Il potere sanzionatorio della Consob e il caso Grande Stevens

Le conseguenze sul sistema del "doppio binario" determinate dalla sentenza della Corte Edu del 4 marzo 2014,relativa al caso Grande Stevens e altri c. Italia.Le problematiche derivanti dalla ravvisata violazione del principio del ne bis in idem e del principio del "giusto processo", risultanti dalla Cedu e dai relativi protocolli, nei procedimenti sanzionatori delle Autorita' Amministrative Indipendenti

Gestione della cefalea post puntura durale (PDPH): dai trattamenti conservativi all'esecuzione dell'epidural blood patch come trattamento definitivo.

Nonostante i progressi nelle apparecchiature e nelle tecniche di anestesia locoregionale, la cefalea post-puntura durale (PDPH) rimane un problema persistente. In molti casi la cefalea è di media intensità e di breve durata, senza sequele significative, comunque non è sempre così. PDPH è occasionalmente severa abbastanza da lasciare i pazienti coricati a letto e spesso ritarda la dimissione dall’ospedale. PDPH può prolungarsi nel tempo con sintomi riportati che durano mesi o anche anni. Inoltre c’è evidenza che la puntura non intenzionale della dura con ago di Tuohy può portare allo sviluppo di cefalea cronica. PDPH non trattato può portare allo sviluppo di persistente paralisi dei nervi craniali e anche ematoma subdurale. In letteratura è stato descritto un vasto range sia di trattamenti conservativi che invasivi per PDPH, qualche volta con scarso supporto scientifico. Oltre ai trattamenti conservativi come rimanere coricati, l’idratazione, l’utilizzo di caffeina (orale o parenterale) esistono trattamenti invasivi come l’epidural blood patch, come trattamento riservato ai casi in cui i trattamenti conservativi non hanno avuto successo e in quei casi in cui i sintomi sono severi. Oltre ai vari trattamenti possibili per PDPH con particolare attenzione all’EBP, si focalizza l’attenzione sulla controversia se proprio l’EBP dovesse essere proposto a tutti i pazienti con una cefalea post-puntura durale e l’efficacia di questo trattamento nella gestione di PDPH. Inoltre si segnalano le complicazioni legate all’EBP: ematoma subdurale e aracnoidite (causa iniziale o effetto finale?). Per finire viene studiato un caso di trombosi del seno venoso cerebrale dopo una tentata epidurale, eseguita per analgesia per travaglio di parto, complicata da una puntura accidentale della dura e la conseguente cefalea trattata con EBP. Oltre al case report riportato da Ghatge e coll. nel Regno Unito, abbiamo trattato un caso analogo anche nell’ospedale di Lucca, pertanto viene focalizzata l’attenzione sulla gestione di questo caso trattato con successo con l’epidural blood patch

Strategies for surviving down-regulation : effects on tumour cell growth potential and chemosensitivity profile

Survivin is a bifunctional protein that acts as a suppressor of apoptosis and plays a central role in cell division. The protein is strongly expressed in the most common human neoplasms, has prognostic relevance for some of them, and appears to be involved in tumour cell resistance to anticancer agents and ionizing radiation. On the basis of these findings, survivin has been proposed as an attractive target for new anticancer interventions. We generated a hammerhead ribozyme (Rz) targeting the CUA110 triplet in the survivin mRNA and transfected them into the JR8 human melanoma cell line. Cells endogenously expressing Rz were characterized by a lower survivin protein level than parental cells, and showed an increased caspase-9-dependent apoptotic response to treatment with the cytotoxic agents cisplatin and topotecan as well as with ɣ-irradiation. Moreover, an increased anti-tumour activity of oral topotecan was observed in Rz-expressing cells grown as xenograft tumours in athymic nude mice. In addition, we constructed a Moloney-based retroviral vector expressing Rz, encoded as a chimeric RNA within adenoviral VA1 RNA. Polyclonal cell populations, obtained by infection with the retroviral vector, of two androgen-independent human prostate cancer cell lines (DU145 and PC-3) were characterized by a significant reduction of survivin expression; the cells became polyploid and underwent caspase-9-dependent apoptosis. Survivin inhibition also enhanced their susceptibility to cisplatin-induced apoptosis and prevented tumour formation when cells were xenografted into athymic nude mice. Again we used RNAi to specifically repress survivin in DU145 and PC-3 cell lines. RNAi-mediated survivin knock-down was able to significantly reduce cell proliferation and to enhance the rate of caspase-9-dependent apoptosis. Moreover, sequential treatment with survivin-specific siRNA followed by the Hsp90 inhibitor 17-allylamino-17-demethoxy-geldanamycin produced supra-additive anti-proliferative effects in both cell lines. Finally, we investigated the effects of the novel cdk inhibitor NU6140, in term of ability to potentiate the response to paclitaxel in HeLa cells, in relation to its interference with survivin. Sequential administration of cdk inhibitors resulted in escape from the mitotic block imposed by paclitaxel and significantly increased the apoptotic rate, with inhibition of survivin expression/phosphorylation as the potential mechanism. Overall, such results suggest that strategies aimed at interfering with survivin expression/activity can be adopted to improve the chemo/radio-sensitivity profile of treatment-refractory human malignancies

PONV negli interventi di tiroidectomia

Analisi di 300 pazienti sottosti a tiroidectomia, si va a esaminare quanti hanno sofferto di PONV. E' risultato che si sono avuti 93 casi di PONV, 75 per gli OPEN e 18 per le VIDEO

Unusual aspects of the SARS-CoV-2 pandemic. From the development of a new protocol for reviving virions from faeces to the test of a new drug

Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) belongs to the Coronaviridae family, genus Betacoronavirus. Infection by SARS-CoV-2 can cause Coronavirus Disease (COVID-19). This is an infectious disease that can have a wide range of symptoms. Most people infected show mild to moderate respiratory illness and recover without special treatment. However, some patients can develop a serious illness and require medical attention. The virus can spread mainly from an infected person's mouth or nose in small liquid particles when they cough, sneeze, speak or breathe. These particles range from larger respiratory droplets to smaller aerosols and can stay suspended in the air in an indoor space for minutes or even hours. It has also been widely demonstrated that the virus can be found in the environment such as in waste-waters. It remains unclear and controversial if the faecal transmission has a crucial role in the human-to-human transmission of the virus. The experiments reported in this PhD thesis were conducted with the Virology Research Group and The Clinical Virology Research Group at the University of Oslo/Oslo University Hospital, Norway. They had two aims: first, to investigate the possibility of reviving SARS-CoV-2 virions from faeces of COVID-19-positive patients; and second, to study a new solution called Drug X as a new treatment for defeating SARS-CoV-2. Our preliminary results showed that for the 13,5% of faeces samples, it was possible to revive SARS-CoV-2 viable virions using the Vero-E6 cell line. This ideally indicated the possibility for positive patients to transmit the virus to naïve people. At the same time, it was possible to establish the highest concentration of Drug X can be used, so the highest concentration where the cells survive. It was compared with other acid solutions concluding that although our results showed that Drug X does not affect SARS-CoV-2 infection, this research lays the foundations to explore other similar solutions as a valuable treatment for COVID-19. A detailed exploration of the cellular and molecular functions of SARS-CoV-2 infection is still necessary to better understand virus-host cell interactions to provide novel ways to treat COVID-19 and limit virus circulation

Evaluation of the Wharton׳s jelly poroelastic parameters through compressive tests on placental and foetal ends of human umbilical cords

The umbilical cord is a conduit between the developing foetus and the placenta. In physiological conditions it contains two arteries and one vein immersed in a mucoid tissue called Wharton׳s jelly. Although the extreme importance of such a structure is fully recognized, the umbilical cord and its components have been scarcely studied. A deep investigation on the biomechanics of the umbilical cord could help to understand if the pregnancy outcome is influenced by umbilical cord mechanical properties, however, detailed biomechanical data are still lacking. In the present study, the mechanical properties during compression of the human Wharton׳s jelly have been evaluated using a poroelastic approach. Multi-ramp stress-relaxation tests in both confined and unconfined configurations were performed on Wharton׳s jelly samples extracted from foetal and placental sides of twenty human umbilical cords. The Young modulus and Aggregate modulus were calculated at three strain levels and the hydraulic permeability was found by fitting the confined stress-relaxation data to the analytical solution and minimizing the stress least square differences. The Wharton׳s jelly exhibits a highly non linear and viscoelastic behaviour showing a dependence on the applied strain values and a ~90% and ~85% relaxation in unconfined and confined configuration, respectively. Moreover, equilibrium Young and Aggregate moduli resulted significantly higher and the permeability significantly lower at the foetal than the placental site, showing a dependence of the three material parameters on the location (foetal or placental) and, consequently, a non-homogeneity in the Wharton׳s jelly mechanical properties

A cost-effective FE method for 2D Navier–Stokes equations

A cost-effective approach to the solution of 2D Navier–Stokes equations for incompressible fluid flow problems is presented. The aim is to reach a good compromise between numerical properties and computational efficiency. In order to achieve the set goal, the nonlinear convective terms are approximated by means of characteristics and spatial approximations of equal order are performed by polynomials of degree two. In this way, the computational kernels are reduced to elliptic ones for which solution very efficient techniques are available. The time-advancing is afforded by a fractional step method combined with a stabilization technique suitably simplified, so that the inf-sup condition is easily overcome. The algebraic systems generated by the new technique are solved by an iterative solver (Bi-CGSTAB), preconditioned by means of a suitable Schwarz additive scalable preconditioner. The properties of the new method have been confirmed from the comparison among the results obtained by it, and those obtained ..