Genome-scaled phylogeny of Saccharomyces cerevisiae from spontaneous must fermentations

Modern winemakers commonly inoculate selected S. cerevisiae strains in must to obtain controlled fermentations and reproducible products. However, wine has been produced for thousands of years using spontaneous fermentations from wild strains, a practice that is experiencing a revival among small wine producers. Despite the widespread usage of such strains in the past, there is much to know about their ecology, evolution and functional potential. For example, the reciprocal affinities of these strains within the S. cerevisiae phylogeny have yet to be discovered, as well as the degree of their biodiversity and their impact on wine terroir. To fill this knowledge gap, we aim at characterising at strain level the S. cerevisiae present in spontaneously fermented musts sampled across Italy. We set up a protocol based on polyphenols-removing prewashes, followed by whole-genome shotgun sequencing at a depth of 5Gb of DNA per sample. We performed both an assembly-free analysis to reconstruct the strain-level phylogeny of S. cerevisiae strains using the species-specific-marker based StrainPhlAn, and the reconstruction of Metagenome-Assembled Genomes of these strains for downstream functional analyses. To plan conservation acts in a scenario of continuous climate change, we aim at isolating and maintaining strains of interest. We will present preliminary results from the analysis of spontaneous musts sampled at different fermenting stages

Personalizing Cancer Pain Therapy: Insights from the Rational Use of Analgesics (RUA) Group

Introduction: A previous Delphi survey from the Rational Use of Analgesics (RUA) project involving Italian palliative care specialists revealed some discrepancies between current guidelines and clinical practice with a lack of consensus on items regarding the use of strong opioids in treating cancer pain. Those results represented the basis for a new Delphi study addressing a better approach to pain treatment in patients with cancer. Methods: The study consisted of a two-round multidisciplinary Delphi study. Specialists rated their agreement with a set of 17 statements using a 5-point Likert scale (0 = totally disagree and 4 = totally agree). Consensus on a statement was achieved if the median consensus score (MCS) (expressed as value at which at least 50% of participants agreed) was at least 4 and the interquartile range (IQR) was 3–4. Results: This survey included input from 186 palliative care specialists representing all Italian territory. Consensus was reached on seven statements. More than 70% of participants agreed with the use of low dose of strong opioids in moderate pain treatment and valued transdermal route as an effective option when the oral route is not available. There was strong consensus on the importance of knowing opioid pharmacokinetics for therapy personalization and on identifying immediate-release opioids as key for tailoring therapy to patients’ needs. Limited agreement was reached on items regarding breakthrough pain and the management of opioid-induced bowel dysfunction. Conclusion: These findings may assist clinicians in applying clinical evidence to routine care settings and call for a reappraisal of current pain treatment recommendations with the final aim of optimizing the clinical use of strong opioids in patients with cancer

Natural a-IFN in HCV recurrence after liver transplantation

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Anemia and ischemia: Myocardial injury in patients with gastrointestinal bleeding

Acute gastrointestinal bleeding can produce hypovolemia, hypotension, and diminished oxygen-carrying capacity, causing myocardial ischemia and necrosis. Activation of the sympathetic nervous system can further increase myocardial oxygen demand and worsen ischemia. These processes would be expected to be most important in patients with obstructive coronary artery disease, a group that is also at risk for gastrointestinal bleeding.1,2 Studies examining the relationship between gastrointestinal bleeding and myocardial ischemia suggest that the prevalence of acute myocardial infarction in patients with gastrointestinal hemorrhage ranges from 1 to 14%.1-3 Cardiac troponins are highly specific and sensitive markers of myocardial injury.6-8 However, there has been no systematic study using troponin to define myocardial injury in patients with acute gastrointestinal bleeding and anemia. Prior studies that included patients with acute anemia and myocardial injury, defined by troponin elevation, were designed to evaluate patients hospitalized with any critical illness.9,10 Furthermore, there is no general agreement about risk stratification of myocardial injury in patients with acute upper gastrointestinal bleeding. There is some suggestion that those with a greater number of coronary risk factors, a history of coronary artery disease, a lower blood pressure on admission, older age, severe illnesses, and/or lower hemoglobin are at greater risk of myocardial infarction.1-5 The aim of the present study is to examine the relationship between hemoglobin and the risk of myocardial injury, defined as an elevation of troponin I, in patients with anemia secondary to upper gastrointestinal bleeding and no other clinical signs or symptoms of coronary insufficiency on enrollment. These findings and other possible predictors of myocardial injury were examined during the hospitalization