Hypertension-induced posterior reversible encephalopathy syndrome as the presentation of progressive bilateral renal artery stenosis

SummaryPosterior reversible encephalopathy syndrome (PRES) is characterized clinically by headache, altered mental status, visual loss, and seizures. PRES is associated with neuroradiological findings characterized by white matter abnormalities, predominantly in the parieto-occipital regions of the brain. PRES is most often described in cases of hypertensive encephalopathy, eclampsia, renal failure, and immunosuppressive or anticancer therapy. We report a case of PRES associated with severe hypertension in the setting of a progressive renovascular hypertension from bilateral atherosclerotic renal artery stenosis. The pathogenesis of PRES is discussed and the importance of a prompt diagnosis and treatment is emphasized

Rutas de Resiliencia en Italia y España. Relanzamiento y reutilización de ferrocarriles en territorios frágiles

The processes of metropolization of the territory foster phenomena of spatial polarization that determine a growing state of economic and social fragility of the “inner peripheries” connected to the abandonment of the building and infrastructural heritage. In this context, between 2018 and 2020, the group of Italian and Spanish academics has developed the research entitled Resilience Paths. Reuse and relaunch of minor railways for the regeneration of fragile territories. Experiences in Italy and Spain. The research, based on the contextualization of the dynamics in Italy and Spain, such as the marginalization of the "aree interne" and the "España vacía", defines new methodological and operational references aimed at facing the processes of infrastructural dismantling, in line with European strategies. This research adopts three consolidated perspectives, within the framework of the urban planning debate, to analyse the fragilization phenomena. Moreover, the ongoing experiences and to propose guidelines for intervention: a "structural" perspective for the relaunch of the ordinary service, a "morphological and landscape" perspective for the enhancement of the cultural and tourist character of the railways and an "ecological" perspective for the construction of greenways. In this framework, based on an inductive methodology, the document represents a synthesis of the results and some insights into case studies that highlight the opportunity to experiment new integrated and multi-scalar categories for the planning of infrastructure networks, promoted by the national and European policies and programs.Los procesos de metropolización del territorio impulsan fenómenos de polarización espacial que determina un estado creciente de fragilidad económica y social de las “inner peripheries” conectada a fenómenos de abandono del patrimonio edificatorio y de infraestructuras. En este contexto, el grupo de académicos italianos y españoles ha desarrollado entre 2018 y 2020 la investigación intitulada Rutas de resiliencia. Reutilización y relanzamiento de ferrocarriles menores para la regeneración de los territorios frágiles. Experiencias en Italia y España. La investigación, a partir de la contextualización de las dinámicas en Italia y España, como la marginalización de las “aree interne” y de la “España vacía”, define nuevas referencias metodológicas y operativas orientadas a responder a los procesos de desmantelamiento infraestructural, en línea con las estrategias europeas. La investigación adopta tres perspectivas consolidadas en el marco del debate urbanístico para analizar los fenómenos de fragilización y las experiencias en curso y para proponer pautas de intervención: una perspectiva "estructural" para el relanzamiento del servicio ordinario, una perspectiva "morfológica y paisajística" de puesta en valor del carácter cultural y turístico de los ferrocarriles y una perspectiva “ecológica” para la construcción de vías verdes. En este marco, a partir de una metodología inductiva, el documento representa una síntesis de los resultados y algunas profundizaciones de casos de estudio que subrayan la oportunidad de experimentar nuevas categorías integradas y multiescalares para la planificación de redes de infraestructuras, promovidas por las políticas y los programas nacionales y europeo

Itaconic Acid Increases the Efficacy of Tobramycin against Pseudomonas aeruginosa Biofilms

The search for novel therapeutics against pulmonary infections, in particular Pseudomonas aeruginosa (PA) biofilm infections, has been intense to deal with the emergent rise of antimicrobial resistance. Despite the numerous achievements in drug discovery and delivery strategies, only a limited number of therapeutics reach the clinic. To allow a timely preclinical development, a formulation should be highly effective, safe, and most importantly facile to produce. Thus, a simple combination of known actives that enhances the therapeutic efficacy would be a preferential choice compared to advanced drug delivery systems. In this study, we propose a novel combination of an anti-inflammatory agent—itaconic acid (itaconate, IA)—and an approved antibiotic—tobramycin (Tob) or ciprofloxacin (Cipro). The combination of Tob and IA at a molar ratio of 1:5 increased the biofilm eradicating efficacy in the strain PA14 wild type (wt) by ~4-fold compared to Tob alone. In contrast, such effect was not observed for the combination of IA with Cipro. Subsequent studies on the influence of IA on bacterial growth, pyocyanin production, and Tob biofilm penetration indicated that complexation with IA enhanced the transport of Tob through the biofilm. We recommend the simple and effective combination of Tob:IA for further testing in advanced preclinical models of PA biofilm infections

A flexible sensor technology for the distributed measurement of interaction pressure

We present a sensor technology for the measure of the physical human-robot interaction pressure developed in the last years at Scuola Superiore Sant'Anna. The system is composed of flexible matrices of opto-electronic sensors covered by a soft silicone cover. This sensory system is completely modular and scalable, allowing one to cover areas of any sizes and shapes, and to measure different pressure ranges. In this work we present the main application areas for this technology. A first generation of the system was used to monitor human-robot interaction in upper- (NEUROExos; Scuola Superiore Sant'Anna) and lower-limb (LOPES; University of Twente) exoskeletons for rehabilitation. A second generation, with increased resolution and wireless connection, was used to develop a pressure-sensitive foot insole and an improved human-robot interaction measurement systems. The experimental characterization of the latter system along with its validation on three healthy subjects is presented here for the first time. A perspective on future uses and development of the technology is finally drafted

Femtosecond laser-assisted big-bubble deep anterior lamellar keratoplasty

Purpose: To determine whether type 1 big-bubble (BB) formation is influenced by the sequence of incisions created with the Victus femtosecond laser (FSL) enabled with software version 3.4 (SV 3.4) during deep anterior lamellar keratoplasty (DALK). Materials and Methods: Consecutive FSL-assisted DALK BB procedures were performed on 20 human donor corneas: 10 shaped by tunnel incision followed by lamellar incision (tunnel-lamellar group, TL) and 10 in the reverse order (lamellar-tunnel group, LT). The BB type was assessed by evaluating dynamic air movement during air inflation; bubble diameter and floor thickness were measured by anterior segment optical coherence tomography. Results: Overall, a type 1 BB formed in 85% of eyes: 100% in the TL group and 70% in the LT group. In the LT group, a type 2 BB formed in 2 corneas and one cornea was perforated during cannula insertion. Type 1 BB was achieved after one attempt in 90% of eyes in the TL group and in 57% in the LT group. Conclusion: Shaping the tunnel before rather than after lamellar incision may be more effective for obtaining a type 1 BB by air injection

Antiviral and antioxidant activity of a hydroalcoholic extract from Humulus lupulus L.

A hydroalcoholic extract from female inflorescences of Humulus lupulus L. (HOP extract) was evaluated for its anti-influenza activity. The ability of the extract to interfere with different phases of viral replication was assessed, as well as its effect on the intracellular redox state, being unbalanced versus the oxidative state in infected cells. The radical scavenging power, inhibition of lipoperoxidation, and ferric reducing activity were assayed as antioxidant mechanisms. A phytochemical characterization of the extract was also performed. We found that HOP extract significantly inhibited replication of various viral strains, at different time from infection. Viral replication was partly inhibited when virus was incubated with extract before infection, suggesting a direct effect on the virions. Since HOP extract was able to restore the reducing conditions of infected cells, by increasing glutathione content, its antiviral activity might be also due to an interference with redox-sensitive pathways required for viral replication. Accordingly, the extract exerted radical scavenging and reducing effects and inhibited lipoperoxidation and the tBOOH-induced cytotoxicity. At phytochemical analysis, different phenolics were identified, which altogether might contribute to HOP antiviral effect. In conclusion, our results highlighted anti-influenza and antioxidant properties of HOP extract, which encourage further in vivo studies to evaluate its possible application

Nosocomial outbreak of the pandemic Influenza A (H1N1) 2009 in critical hematologic patients during seasonal influenza 2010-2011: detection of oseltamivir resistant variant viruses

BACKGROUND: The pandemic influenza A (H1N1) 2009 (H1N1pdm09) virus infection caused illness and death among people worldwide, particularly in hematologic/oncologic patients because influenza infected individuals can shed virus for prolonged periods, thus increasing the chances for the development of drug-resistant strains such as oseltamivir-resistant (OST-r) variant. METHODS: The aim of our study was to retrospectively evaluate the clinical importance of OST-r variant in circulating strains of the pandemic H1N1pdm09 virus. By means of RT-PCR and Sanger sequencing we analysed the presence of OST-r variant in 76 H1N1pdm09 laboratory-confirmed cases, hospitalized at the hematologic/oncologic ward at Spedali Civili of Brescia –Italy. RESULTS: Out of 76 hospitalized hematologic/oncologic patients, 23 patients (30.2%) were infected by H1N1pdm09 virus. Further investigation revealed that 3 patients were positive for the OST-r variant carrying the H275Y mutation. All the 23 infected patients were immuno-compromised, and were under treatment or had been treated previously with oseltamivir. Three patients died (13%) after admission to intensive care unit and only one of them developed H275Y mutation. CONCLUSIONS: Our retrospective observational study shows that pandemic influenza A (H1N1) 2009 virus can cause significant morbidity and even mortality in hematologic/oncologic patients and confirms the high rate of nosocomial transmission of pandemic H1N1pdm09 virus in these critical subjects. Indeed, the reduction in host defences in these hospitalized patients favoured the prolonged use of antiviral therapy and permitted the development of OST-r strain. Strategies as diagnostic vigilance, early isolation of patients and seasonal influenza A(H1N1) vaccination may prevent transmission of influenza in high risk individuals

Exploitation of Tartary Buckwheat as Sustainable Ingredient for Healthy Foods Production

AbstractTartary buckwheat (Fagopyrum tataricum Gaertn) is a minor crop belonging to the Polygonaceae family that can be considered as sustainable crop thanks to its low input requirements. It is a pseudo-cereal known for its high healthy value related to antioxidant compounds present in its grains. For this reason it could be employed for the production of functional foods. This paper as well as reviewing about the agronomical and nutritional traits of buckwheat also provides the latest experimental results achieved by ENEA research activities