Major postoperative complications and survival for colon cancer elderly patients

BACKGROUND: Increased life expectancy has led to elevating the mean age of the patients at the time of diagnosis of colon cancer and subsequent treatment. Differences in complication rates and outcome between elderly and younger patients have been investigated. METHODS: We retrospectively analysed a database containing the information of patients who underwent surgery for stage I-III colorectal cancer from January 2004 to January 2012 at our institution and compared demographic, cancer-related, and outcomes data of 235 elderly patients with 211 patients ≤65 years old. RESULTS: Intraoperative complications did not differ between young and old patients whereas some differences have been found in postoperative and late complications: elderly patients suffered more by ileus (P = 0.024), peritonitis or septic shock (P = 0.017), pelvic abscess (P = 0.028), wound infection (P = 0.031), and incisional/port herniation (P = 0.012) compared with younger patients. Moreover, elderly patients suffered by systemic complications such as cardiovascular (4.7% vs. 1.4%, P = 0.049), renal (4.7% vs. 0.5%, P = 0.006), and respiratory (10.6% vs. 5.2%, P = 0.036). The multivariate analysis assessing the odds of having a complication revealed that older age (Odd Ratio [OR] 2.75, 95% Confidential Interval [CI]: 1.67-4.52) and open surgery (OR 1.63, 95% CI: 1.01-2.62) are significantly and independently associated with having a complication. CONCLUSIONS: In our series, elderly patients have presented a slight higher incidence of comorbidities that may affect the incidence rates of postoperative complications. These results have implications in increasing the hospital stay as well as a higher rate of death

Analytical and experimental shear evaluation of GFRP-reinforced concrete beams

Reinforced Concrete (RC) technology is advancing towards new frontiers enhancing its sustainability and durability through innovative materials. In particular, the application of Glass Fiber Reinforced Polymer (GFRP) bars, in lieu of steel reinforcement, shows excellent performance, especially in aggressive environments. Nevertheless, current international design guidelines and standards tend to be rather conservative, especially concerning shear reinforcement. This element hinders the technology’s competitiveness, not only in terms of material consumption but also in construction efficiency. This research aims to conduct an analytical comparison and experimental validation of the formulations found in some international standards pertaining to shear capacity in a specific case. The focus is on scenarios involving reduced shear reinforcement and cases where the number of stirrups falls below the minimum recommended by these standards. In the sample beam tests, two distinct flexural GFRP reinforcement ratios were employed to evaluate their influence on shear capacity, leading to diverse failure mechanisms: rupture of longitudinal GFRP bars and concrete crushing. The experimental results were used to compare the North American ACI, French AFGC, and Italian CNR shear capacity design approaches in the case of reduced transversal reinforced ratio. Analytical capacity expressions of the standards above are discussed with some remarks aiming at structural optimization

Factors associated with metabolic syndrome in a Mediterranean population : role of caffeinated beverages

BACKGROUND: Intake of caffeinated beverages, such as coffee and tea, has been related to improvements in components of metabolic syndrome (MetS), but studies conducted in the Mediterranean region are scarce. The aim of this study was to evaluate whether or not consumption of a variety of beverages containing caffeine was associated with components of MetS in an Italian population. METHODS: From May 2009 to December 2010, a cross-sectional survey was conducted on 1889 inhabitants living in Sicily, southern Italy. Data regarding demographic characteristics, habitual beverage intake, and adherence to the Mediterranean diet were collected, and clinical information was retrieved from the general practitioners’ computer records. RESULTS: After adjusting for all covariates, coffee (odds ratio [OR] 0.43, 95% confidence interval [CI] 0.27–0.70) and tea (OR 0.51, 95% CI 0.34–0.78) were associated with MetS, whereas no association was observed between caffeine intake and MetS. Among other factors, age, body mass index, physical activity, current smoking, and adherence to Mediterranean diet were associated with having MetS. Triglycerides were inversely associated with consumption of both espresso coffee and tea. The healthy effects of such beverages were more evident in individuals with unhealthy dietary habits. CONCLUSIONS: Although no direct association between caffeine intake and MetS or its components was observed, coffee and tea consumption was significantly related to reduced odds of MetS

Association between polyphenol intake and adherence to the Mediterranean diet in Sicily, southern Italy

Abstract Background Mediterranean diet has been demonstrated to exert beneficial effects toward various health outcomes. Among the compounds that may be responsible for such benefits, polyphenols have been proposed as potential candidates. The aim of this study was to evaluate whether dietary polyphenols were associated with adherence to the Mediterranean diet in a Sicilian cohort. Methods A total of 1937 adults were recruited in the urban area of Catania, southern Italy. Background characteristics and dietary habits were collected through validated questionnaires. Adherence to the Mediterranean diet was evaluated through application of a validated score (MEDI-LITE score). Dietary intake of polyphenols was estimated through the Phenol-explorer database. Differences in mean intake between quartiles of the MEDI-LITE score and association between quartiles of polyphenol intake and high adherence to the Mediterranean diet (highest quartile of the score) were calculated though logistic regression analyses. Results Mean intake of most polyphenols was significantly different between quartiles of the MEDI-LITE score, being generally higher in individuals more adherent to the Mediterranean diet. Only few compounds, such as lignans, anthocyanins, and flavanones, showed a linear positive association with high adherence to the Mediterranean diet, while other polyphenol classes were associated in a non-linear manner. Among individual polyphenols, apigenin, hesperetin, naringenin, lariciresinol, matairesinol, pinoresinol, secoisolariciresinol, and ferulic acid were associated with high adherence to Mediterranean diet in a linear manner, while all the others (except for myricetin) were associated in a non-linear way. Conclusions Mean polyphenol intake was higher in individuals more adherent to the Mediterranean diet compared to less adherent. However, dietary sources of polyphenols not included in the traditional foods comprised in the Mediterranean diet may contribute to total and specific classes of polyphenols irrespectively of their inclusion within the context of the Mediterranean diet

Mechanical, thermomechanical and reprocessing behavior of green composites from biodegradable polymer and wood flour

The rising concerns in terms of environmental protection and the search for more versatile polymer-based materials have led to an increasing interest in the use of polymer composites filled with natural organic fillers (biodegradable and/or coming from renewable resources) as a replacement for traditional mineral inorganic fillers. At the same time, the recycling of polymers is still of fundamental importance in order to optimize the utilization of available resources, reducing the environmental impact related to the life cycle of polymer-based items. Green composites from biopolymer matrix and wood flour were prepared and the investigation focused on several issues, such as the effect of reprocessing on the matrix properties, wood flour loading effects on virgin and reprocessed biopolymer, and wood flour effects on material reprocessability. Tensile, Dynamic-mechanical thermal (DMTA), differential scanning calorimetry (DSC) and creep tests were performed, pointing out that wood flour leads to an improvement of rigidity and creep resistance in comparison to the pristine polymer, without compromising other properties such as the tensile strength. The biopolymer also showed a good resistance to multiple reprocessing; the latter even allowed for improving some properties of the obtained green composites

Health related quality of life in colorectal cancer patients: state of the art

Proceedings of the 26th National Congress of the Italian Society of Geriatric Surgery Silvestro Canonico, Bruno Amato and Alessandro Puzziello This supplement has not been sponsored. The source of funding used to cover open access publication charges is declared by the authors in each article. Articles have undergone the journal's standard review process for supplements. The supplement editors declare they have no competing interests. Conference 26th National Congress of the Italian Society of Geriatric Surgery 19-22 June 2013 Naples, ItalyBACKGROUND: Colorectal cancer (CRC) is the third most commonly diagnosed cancer in males and the second in females with a progressive increase in prevalence in industrialized countries. The loss of health due to the cancer and/or the consequence of the treatment may result in psychophysical, functional and social impairment; all of these affect health-related quality of life (QoL). DESCRIPTION: The most frequently CRC-specific QoL questionnaires is the FACT-C. QoL is not only important for the well-being of cancer patient but it also influences survival and response to therapy. Many studies investigated various determinants involved in the assessment of QoL in CRC, suggesting that symptoms, surgical procedures and the number of comorbidity significantly affected QoL. CONCLUSION: Despite that CRC patients have a relatively good QoL compared with the general population, a wide range of intervention could be undertaken to improve their QoL. The finding of this review may be useful for cancer clinicians in taking therapy and surveillance-related decisions. However, future research should be directed to large-scale prospective studies using well validated QoL instruments to facilitate comparison of results.Funding for this article has come from University funds.S

Primary headaches in children: clinical findings on the association with other conditions.

The aim of the present study is to report on the frequency of some comorbidities in primary headaches in childhood. Two hundred and eighty children (175 males and 105 females; ratio 1.7:1), aged 4 to 14 years, affected by primary headaches were consecutively enrolled in this study. In direct interviews, parents and children gave information about the association of their headaches with different conditions including asthma and allergic disorders, convulsive episodes, sleep disorders and increased body weight, affections some time associated in the literature to headache as comorbidities. In addition, anxiety and depression, attention deficit/hyperactivity disorder, tics, learning disabilities and obsessive-compulsive disorders, using psycho-diagnostic scales were evaluated. Two hundred and eighty children matched for age, sex, race and socio-economic status, were used as controls. No significant association of primary headaches was found with asthma and allergic disorders, convulsive episodes, sleep disorders and increased body weight. Overall behavioral disorders were more common in children who experienced headache than in controls. A significant association of primary headache was found with anxiety and depression (p value <0.001), but not with the other psychiatric disorders. Primary headaches in children are not associated with most of the psychiatric and systemic conditions herein investigated. On the contrary, there was a significant association with anxiety and depression, as frequently reported in adults

Mediterranean diet and metabolic status in post-menopausal women living in a mediterranean area

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Identification of miRNAs of Strongyloides stercoralis L1 and iL3 larvae isolated from human stool

Strongyloidiasis is a neglected tropical disease caused by the soil-transmitted nematode by Strongyloides stercoralis, that affects approximately 600 million people worldwide. In immunosuppressed individuals disseminated strongyloidiasis can rapidly lead to fatal outcomes. There is no gold standard for diagnosing strongyloidiasis, and infections are frequently misdiagnosed. A better understanding of the molecular biology of this parasite can be useful for example for the discovery of potential new biomarkers. Interestingly, recent evidence showed the presence of small RNAs in Strongyloididae, but no data was provided for S. stercoralis. In this study, we present the first identification of miRNAs of both L1 and iL3 larval stages of S. stercoralis. For our purpose, the aims were: (i) to analyse the miRNome of L1 and iL3 S. stercoralis and to identify potential miRNAs of this nematode, (ii) to obtain the mRNAs profiles in these two larval stages and (iii) to predict potential miRNA target sites in mRNA sequences. Total RNA was isolated from L1 and iL3 collected from the stool of 5 infected individuals. For the miRNAs analysis, we used miRDeep2 software and a pipeline of bio-informatic tools to construct a catalog of a total of 385 sequences. Among these, 53% were common to S. ratti, 19% to S. papillosus, 1% to Caenorhabditis elegans and 44% were novel. Using a differential analysis between the larval stages, we observed 6 suggestive modulated miRNAs (STR-MIR-34A-3P, STR-MIR-8397-3P, STR-MIR-34B-3P and STR-MIR-34C-3P expressed more in iL3, and STR-MIR-7880H-5P and STR-MIR-7880M-5P expressed more in L1). Along with this analysis, we obtained also the mRNAs profiles in the same samples of larvae. Multiple testing found 81 statistically significant mRNAs of the total 1553 obtained (FDR &lt; 0.05; 32 genes expressed more in L1 than iL3; 49 genes expressed more in L3 than iL1). Finally, we found 33 predicted mRNA targets of the modulated miRNAs, providing relevant data for a further validation to better understand the role of these small molecules in the larval stages and their valuein clinical diagnostics