Prevalence and characteristics of diffuse idiopathic skeletal hyperostosis (DISH) in Italy

Purpose Diffuse idiopathic skeletal hyperostosis (DISH) is a benign condition characterized by ossification of the spine and prominent enthesopathies. Highly heterogeneous epidemiological figures have been reported in the literature, while in Italy the largest study has been conducted in 1992. The aim of our research is to contribute updated information about prevalence of DISH in Italy and to describe the clinical and radiographic characteristics associated with the disorder. Material and methods A retrospective review of lumbosacral spine, thoracic spine and pelvis radiographs was performed. Consecutive patients visiting the emergency department of our Institution over 3 years were enrolled. Presence of DISH was evaluated applying the Resnick and Niwayama criteria. Clinical and radiological features were also assessed. Results We included 1012 individuals (60.6% women), and DISH was present in 130 cases. The overall prevalence of DISH was 12.8% (95% CI 10.8-15.1), with higher figures in the male sample (16.8%) than in females (10.3%). In binary logistic regression adjusted for age, BMI (OR 1.50, p < 0.001) diabetes (OR 1.85, p = 0.003), hypertension (OR 2.04, p = 0.007) ischiopubic enthesopathy (OR 7.08, p < 0.001), iliac crest enthesopathy (OR 4.63, p < 0.001) and greater trochanter enthesopathy (OR 3.51, p < 0.001), were significantly associated with the condition. Conclusion The prevalence of DISH observed in our study is consistent with previous literature, and we confirm that the disorder is more frequently retrieved in men and that it is associated with the presence of metabolic disorders and pelvic enthesopathy. Knowledge about the epidemiology and characteristics of DISH is needed to properly identify the condition

RET mutation and increased angiogenesis in medullary thyroid carcinomas

Advanced medullary thyroid cancers (MTCs) are now being treated with drugs that inhibit receptor tyrosine kinases, many of which involved in angiogenesis. Response rates vary widely, and toxic effects are common, so treatment should be reserved for MTCs likely to be responsive to these drugs. RET mutations are common in MTCs, but it is unclear how they influence the microvascularization of these tumors. We examined 45 MTCs with germ-line or somatic RET mutations (RETmut group) and 34 with wild-type RET (RETwt). Taqman Low-Density Arrays were used to assess proangiogenic gene expression. Immunohistochemistry was used to assess intratumoral, peritumoral and nontumoral expression levels of VEGFR1, R2, R3, PDGFRa, PDGFB and NOTCH3. We also assessed microvessel density (MVD) and lymphatic vessel density (LVD) based on CD31-positive and podoplanin-positive vessel counts, respectively, and vascular pericyte density based on staining for a-smooth muscle actin (a-SMA), a pericyte marker. Compared with RETwt tumors, RETmut tumors exhibited upregulated expression of proangiogenic genes (mRNA and protein), especially VEGFR1, PDGFB and NOTCH3. MVDs and LVDs were similar in the two groups. However, microvessels in RETmut tumors were more likely to be a-SMA positive, indicating enhanced coverage by pericytes, which play key roles in vessel sprouting, maturation and stabilization. These data suggest that angiogenesis in RETmut MTCs may be more intense and complete than that found in RETwt tumors, a feature that might increase their susceptibility to antiangiogenic therapy. Given their increased vascular pericyte density, RETmut MTCs might also benefit from combined or preliminary treatment with PDGF inhibitors

Clinical characteristics and risk factors associated with COVID-19 severity in patients with haematological malignancies in Italy: a retrospective, multicentre, cohort study

Several small studies on patients with COVID-19 and haematological malignancies are available showing a high mortality in this population. The Italian Hematology Alliance on COVID-19 aimed to collect data from adult patients with haematological malignancies who required hospitalisation for COVID-19

Anthropometric and strength variables to predict freestyle performance times in elite master swimmers

The aims of this study were to determine in elite master swimmers of both genders whether, using anthropometric variables and the hand grip strength measure, it was possible to predict freestyle performance time, whether the considered predictors were related similarly to different events (50, 100, 200, 400, 800 m), and whether they were the same in male and female master swimmers. The relationships between performance times and age, body mass, height, arm length, forearm length, forearm muscle volume, and hand grip strength were examined in 135 elite master swimmers. Pearson's simple correlation coefficients were calculated and then prediction equations were developed. Age, height, and hand grip strength were the best predictors in short-distance events, whereas only age and height were predictors in middle- and long-distance events. The corresponding coefficient of determination (R2) of performance times were 0.84 in the 50-m event, 0.73 in the 100-m event, 0.75 in the 200-m event, 0.66 in the 400-m event, and 0.63 in the 800-m event. These regression equations were then cross-validated in a control group of 126 nonelite, age-matched swimmers, obtaining significant and good correlations for all distances (range, r = 0.67 and 0.83; p < 0.01), indicating that predictors are valid in an extended sample of master swimmers. Differences between sexes were not found in 50-m event, but were present in all other events. These models might be useful to determine individual performance times by contributing to improving the individual's training program and the selection of master swimmers. Coaches could have better accuracy in determining whether an athlete needs a strength training program in order to optimize performance time

Anthropometric and Strength Variables to Predict Freestyle Performance Times in Elite Master Swimmers

The aims of this study were to determine in elite master swimmers of both genders whether, using anthropometric variables and the hand grip strength measure, it was possible to predict freestyle performance time, whether the considered predictors were related similarly to different events (50, 1 00, 200, 400, BOO m), and whether they were the same in male and female master swimmers. The relationships between performance times and age, body mass, height, arm length, forearm length, forearm muscle volume, and hand grip strength were examined in 135 elite master swimmers. Pearson's simple correlation coefficients were calculated and then prediction equations were developed. Age, height, and hand grip strength were the best predictors in short-distance events, whereas only age and height were predictors in middle- and long-distance events

Tribological characterization of zirconia coatings deposited on Ti6Al4V components for orthopedic applications

One of the most important issues leading to the failure of total joint arthroplasty is related to thewear of the plastic components, which are generally made of ultra high molecular weight polyethylene (UHMWPE). Therefore, the reduction of jointwear represents one of themain challenges the research in orthopedics is called to address nowadays. Surface treatments and coatings have been recognized as innovativemethods to improve tribological properties, also in the orthopedic field. Thiswork investigated the possibility to realize hard ceramic coatings on themetal component of a prosthesis, by means of Pulsed Plasma Deposition, in order to reduce friction and wear in the standard coupling against UHMWPE. Ti6Al4V substrates were coated with a 2 μm thick yttria-stabilized zirconia (YSZ) layer. The mechanical properties of the YSZ coatings were assessed by nanoindentation tests performed on flat Ti6Al4V substrates. Tribological performance was evaluated using a ball-on-disk tribometer in dry and lubricated (i.e. with fetal bovine serum) highly-stressing conditions, up to an overall distance of 10km. Tribologywas characterized in terms of coefficient of friction (CoF) and wear rate of the UHMWPE disk. After testing, specimens were analyzed through optical microscopy and SEMimages, in order to check thewear degradationmechanisms. Progressive loading scratch tests were also performed in dry and wet conditions to determine the effects of the environment on the adhesion of the coating. Our results supported the beneficial effect of YSZ coating on metal components. In particular, the proposed solution significantly reduced UHMWPE wear rate and friction. At 10 kmof sliding distance, a wear rate reduction of about 18% in dry configuration and of 4% in presence of serum,was obtained by the coated group compared to the uncoated group. As far as friction in dry condition is concerned, the coating allowed to maintain low CoF values until the end of the tests, with an overall difference of about 40% compared to the uncoated balls. In wet conditions, the friction values were found to be comparable between coated and uncoated materials, mainly due to a premature delamination of the coating. Scratch tests inwet showed in fact a reduction of the critical load required to a complete delamination due to a formation of blister, although no change or damage occurred at the coating during the soaking period. Although conditions of high values of contact pressurewere considered, further analyses are however required to fully understand the behavior of YSZ coatings inwet environment and additional research on the deposition process will be mandatory in order to improve the coating tribological performance at long distances addressing orthopedic applications