Dandy-Walker malformation: is the "tail sign" the key sign?

OBJECTIVE.To demonstrate the value of the "tail sign" in the assessment of Dandy-Walker Malformation (DWM). METHODS: A total of 31fetal MRI, performed before 24 weeks of gestation after second-line US examination between May 2013 and September 2014, were examined retrospectively. All MRI examinations were performed using a 1.5 Tesla magnet without maternal sedation. RESULTS: MRI diagnosed 15/31 cases of Dandy-Walker Malformation, 6/31 cases of vermian partial caudal agenesis, 2/31 of vermian hypoplasia, 4/31 of vermian malrotation, 2/31 of Walker-Warburg Syndrome, 1/31 of Blake pouch cyst, 1/31 of rhombencephalosynapsis. All data were compared with fetopsy results, Fetal MR after the 30th week or postnatal MRI; the follow up depended on the maternal decision to terminate or continue pregnancy. In our review study we found the presence of the "tail sign"; this sign was visible only in Dandy-Walker Malformation and Walker-Warburg Syndrome. CONCLUSION: The "tail sign" could be helpful in the difficult differential diagnosis between Dandy Walker, vermian malrotation, vermian hypoplasia and vermian partial agenesis

Non-invasive tool to assess heart rhythm in Zebrafish embryos

In the last years the zebrafish (Danio rerio) has emerged as model organism for cardiac research, in spite of the morphological differences with the human heart. In consequence of the similarity to humans in the early function, the zebrafish embryo has been suggested as an ideal model i) to study the molecular mechanism of cardiac development, and ii) to identify genes related to congenital cardiac defects in human [1]. The overall similarity of zebrafish embryos and human, in responses to human cardiotoxic drugs, was demonstrated, for example, in drug-induced cardiac arrhythmia [2]. For this reason, several methods have been developed to assess cardiac functions in zebrafish embryos [3,4]. Unfortunately, all these techniques suffer from drawbacks (time consuming, skillful operator are ended to perform the experiments) which limit their applications for large scale studies. The development in digital imaging has recently made analysis of cardiac functions in genetically modified transparent zebrafish embryos easier. This allowed to assess non-invasively heart rate variability in zebrafish embryos from videos of beating heart, but without measuring heartbeat rhythm, an important indicator of the cardiac function (heartbeat regularity is associated with cardiotoxicity in humans [1]), from power spectrum of heart signal. In the present study, we present a simple, non-invasive method that, by video-recording embryo images using confocal microscopy, and integrating image processing and power spectral analysis, allows to measure the heartbeat rhythm in zebrafish embryos heart chambers (atrium, ventricle, bulb) (Figure 1). The reliability of the herein proposed method was verified. Some embryos undergone treatment by tricaine, a cardiac anaesthetizing drug, in consequence of which a decrease of the heart rate is expected: the heartbeat regularity in tricaine- treated embryos determined from power spectral analysis decreased as compared to no-treated embryos. The results demonstrated that our method is able to assess the cardiac physiology, in term of heart rhythm, in zebrafish embryos

Parasitoids (Hymenoptera) of leaf-spinning moths (Lepidoptera) feeding on Vaccinium uliginosum L. along an ecological gradient in central European peat bogs

Parasitoids of leaf-spinning Lepidoptera associated with two isolated central European peat bogs were investigated. Five families of parasitoid Hymenoptera (Braconidae, Ichneumonidae, Eulophidae, Pteromalidae and Encyrtidae) were recorded. Three categories were recognised: (1) primary parasitoids, (2) facultative hyperparasitoids and (3) obligatory hyperparasitoids. Ten species of Braconidae, five species and seven marked morphospecies among Ichneumonidae, and three species of Chalcidoidea were identified. Despite of some niche-specific (but less host-specific) parasitoids, all these hymenopterans are likely to be generalists and none of them were confirmed to be habitat and/or host specialists. Unlike their eurytopic (opportunistic tyrphoneutral) parasitoids, the Lepidoptera hosts associated with peat bogs are partially highly stenotopic (tyrphobionts and tyrphophiles). The occurrence of parasitoids compared to their potential hosts was structured along an ecological (mesoclimatic) gradient, so most parasitoids were recorded from margins while stenotopic (narrow habitat adaptation) moths were mostly distributed near the centre of the bog habitat

Pemetrexed and Platinum Plus Pembrolizumab in Patients With Metastatic Nonsquamous NSCLC by Tumor Burden at Baseline: A Post Hoc Efficacy Analysis of KEYNOTE-189

INTRODUCTION: The aim of this study was to evaluate the efficacy of pemetrexed and platinum plus pembrolizumab by baseline tumor burden. METHODS: A total of 616 patients in the intention-to-treat population of the KEYNOTE-189 study were included in this analysis. Baseline tumor burden subgroups were identified on the basis of extent of distant metastasis (M1a versus M1b), median number (≤3 versus \u3e3) of organ systems with lesions, or symptom severity score of patient-reported lung cancer-associated symptoms (≤median versus \u3emedian). Overall survival (OS), progression-free survival (PFS), and PFS-2 were evaluated by Kaplan-Meier and univariate Cox methods. Objective response rate was analyzed using logistic regression models, and duration of response was analyzed descriptively. Efficacy outcomes were also analyzed according to the programmed death-ligand 1 expression levels. RESULTS: OS and PFS were significantly improved with pemetrexed and platinum plus pembrolizumab in all baseline tumor burden subgroups (M1a stage: OS hazard ratio [HR] = 0.54, p = 0.0037; PFS HR = 0.48, p = 0.0001; M1b stage: OS HR = 0.58, p ≤ 0.0001; PFS HR = 0.51, p ≤ 0.0001; number of organ systems with lesion ≤ 3: OS HR = 0.49, p ≤ 0.0001 PFS HR = 0.41, p ≤ 0.0001; \u3e3: OS HR = 0.67, p = 0.0068; PFS HR = 0.59, p = 0.0001; symptom severity score ≤ median: HR = 0.51, p ≤ 0.0001; PFS HR 0.49, p ≤ 0.0001; \u3e median: OS HR = 0.60, p = 0.0003; PFS HR = 0.48, p ≤ 0.0001). PFS2 and objective response rate were also improved with pemetrexed and platinum plus pembrolizumab in all baseline tumor burden subgroups. Efficacy outcomes were generally consistent regardless of programmed death-ligand 1 expression levels. CONCLUSIONS: Pemetrexed and platinum plus pembrolizumab were found to have relevant efficacy regardless of the extent of baseline tumor burden and the variables used to define it. These results further support pemetrexed and platinum plus pembrolizumab as the standard of care in the first-line treatment of metastatic nonsquamous NSCLC

Ecohealth interventions limit triatomine reinfestation following insecticide spraying in La Brea, Guatemala

In this study, we evaluate the effect of participatory Ecohealth interventions on domestic reinfestation of the Chagas disease vector Triatoma dimidiata after village-wide suppression of the vector population using a residual insecticide. The study was conducted in the rural community of La Brea, Guatemala between 2002 and 2009 where vector infestation was analyzed within a spatial data framework based on entomological and socio-economic surveys of homesteads within the village. Participatory interventions focused on community awareness and low-cost home improvements using local materials to limit areas of refuge and alternative blood meals for the vector within the home, and potential shelter for the vector outside the home. As a result, domestic infestation was maintained at ≤ 3% and peridomestic infestation at ≤ 2% for 5 years beyond the last insecticide spraying, in sharp contrast to the rapid reinfestation experienced in earlier insecticide only interventions. Copyright © 2013 by The American Society of Tropical Medicine and Hygiene

Age-Related Inflammation: the Contribution of Different Organs, Tissues and Systems. How to Face it for Therapeutic Approaches

A typical feature of ageing is a chronic, low-grade inflammation characterized by a general increase in the production of proinflammatory cytokines and inflammatory markers (“inflamm-ageing”). This status may slowly damage one or several organs, especially when unfavorable genetic polymorphisms and epigenetic alterations are concomitant, leading to an increased risk of frailty together with the onset of age-related chronic diseases. The contribution of different tissues (adipose tissue, muscle), organs (brain, liver), immune system and ecosystems (gut microbiota) to age-related inflammation (“inflamm-ageing”) will be discussed in this review in the context of its onset/progression leading to site-restricted and systemic effects. Moreover, some of the possible strategies and therapies to counteract the different sources of molecular mediators which lead to the age-related inflammatory phenotype will be presente