436 research outputs found

    Myoclonic super-refractory status epilepticus with favourable evolution in a teenager with FIRES: Is the association of vagus nerve stimulation and cannabidiol effective?

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    Background: Febrile infection-related epilepsy syndrome (FIRES) is a rare and catastrophic clinical syndrome occurring in previously healthy patients. Aetiology is still unknown and outcome usually poor. We describe a case of myoclonic prolonged super refractory status epilepticus (P-SRSE) in FIRES in a patient admitted to the paediatric intensive care unit of Padova, Italy. Case report: A previously healthy 14-year-old girl with onset of myoclonic status epilepticus after a mild febrile illness was admitted to our hospital with a diagnosis of FIRES. Extensive diagnostic work-up was inconclusive. Status epilepticus and electroclinical seizures recurred every time weaning from anaesthetic agents was attempted. Eventually, a vagal nerve stimulator (VNS) was implanted and cannabidiol (CBD) administered, 43 days and 70 days after P-SRSE onset, respectively. Two days after CBD introduction, status epilepticus weaned and the girl rapidly regained complete consciousness showing a brilliant and unexpected recovery. At last follow-up, 12 months later, she is 8-months seizure free on multiple antiseizure medications, has only mild neuropsychological impairment with no neurological and intellective deficit. Conclusions: To our knowledge, this represents a unique case with an extremely favourable evolution with a possible effect of the association of VNS and CBD to traditional antiseizure medications

    Serum MicroRNA-191-5p levels in vascular complications of type 1 diabetes: the EURODIAB prospective complications study

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    Context MicroRNA-191-5p regulates key cellular processes involved in the pathogenesis of diabetic complications such as angiogenesis, extracellular matrix deposition, and inflammation. However, no data on circulating microRNA-191-5p in the chronic complications of diabetes are currently available. Objective To assess whether serum levels of miR-191-5p were associated with micro- and macrovascular disease in a large cohort of subjects with type 1 diabetes (DM1) from the EURODIAB Prospective Complication Study (PCS). Design and Setting Levels of microRNA-191-5p were measured by quantitative PCR (qPCR) in 420 DM1 subjects recruited as part of the cross-sectional analysis of the EURODIAB PCS. Cases (n = 277) were subjects with nephropathy and/or retinopathy and/or cardiovascular disease (CVD). Controls (n = 143) were patients without complications. Logistic regression analysis was performed to evaluate the potential independent association of microRNA-191-5p levels with chronic complications of diabetes. Results Levels of microRNA-191-5p were significantly reduced (P < 0.001) in cases compared to controls even after adjustment for age, sex, and diabetes duration. Logistic regression analysis revealed that microRNA-191-5p was negatively associated with a 58% reduced odd ratio (OR) of chronic diabetes complications, specifically CVD, micro-macroalbuminuria, and retinopathy [OR: 0.42 95% CI (0.23-0.77)], independently of age, sex, physical activity, educational levels, diabetes duration, glycated haemoglobin (HbA1c), total insulin dose, hypertension, smoking, total cholesterol, albumin excretion rate (AER), estimated glomerular filtration rate (eGFR), serum Vascular Cell Adhesion Molecule-1 (sVCAM-1), and tumour necrosis factor-α (TNF-α). Analyses performed separately for each complication demonstrated a significant independent association with albuminuria [OR: 0.36 95% CI (0.18-0.75)], and CVD [OR: 0.34 95% CI (0.16-0.70)]. Conclusions In DM1 subjects, miR-191-5p is inversely associated with vascular chronic complications of diabetes

    Nuclear physics midterm plan at LNS

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    International audienceThe next years will see the completion of several new facilities at Istituto Nazionale di Fisica Nucleare – Laboratori Nazionali del Sud (LNS) opening up new possibilities in the fields of nuclear structure, nuclear dynamics, nuclear astrophysics and applications. These include a new line for high-intensity cyclotron beams, a new facility for in-flight production of radioactive ion beams, the PANDORA plasma trap for multidisciplinary studies and a high-power laser for basic science and applied physics. The nuclear physics community has organized a workshop to discuss the new physics opportunities that will be possible in the middle term (5–7 years) by employing state-of-the-art detection systems. A detailed discussion of the outcome from the workshop is presented in this report

    Enhanced recovery for liver transplantation: recommendations from the 2022 International Liver Transplantation Society consensus conference

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    Nuclear physics midterm plan at LNS

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    Association of serum MicroRNA-145-5p levels with microvascular complications of type 1 Diabetes: The EURODIAB prospective complications study

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    Aims To investigate whether serum miR-145-5p levels were associated with micro-macrovascular chronic complications in patients with type 1 diabetes (DM1). Methods A nested case-control study from the EURODIAB Prospective Complications Study was performed. Cases (n = 289) had one or more complications of diabetes, whereas controls (n = 153) did not have any complication. We measured miR-145-5p levels by qPCR and investigated the association with diabetes complications. Results Mean miR-145-5p levels were significantly lower in cases with microangiopathy [2.12 (0.86–4.94)] compared to controls [3.15 (1.21–7.36), P < 0.05] even after adjustment for age, gender, and diabetes duration. In logistic regression analysis, miR-145-5p levels in the lowest tertile were associated with an over three-fold increased odds ratio (OR) of albuminuria [3.22 (1.17–8.81)], independently of both demographic and diabetes-related factors. In addition, mir145-5p levels in the lowest tertile were independently and inversely associated with arterial hypertension [1.96 (1.08–3.56)] and hypertension was the mediator of the relationship between miR-145-5p and albuminuria. Conclusions In this large cohort of DM1 patients, we found an inverse association between miR-145-5p and albuminuria that was mediated by systemic hypertension

    Novel benchmark values for redo liver transplantation – does the outcome justify the effort?

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    To define benchmark cutoffs for redo liver transplantation (redo-LT). In the era of organ shortage, redo-LT is frequently discussed in terms of expected poor outcome and wasteful resources. However, there is a lack of benchmark data to reliably evaluate outcomes after redo-LT. We collected data on redo-LT between January 2010 and December 2018 from 22 high-volume transplant centers. Benchmark cases were defined as recipients with MELD score ≤25, absence of portal vein thrombosis, no mechanical ventilation at the time of surgery, receiving a graft from a donor after brain death. Also, high-urgent priority and early redo-LT including those for primary non-function (PNF) or hepatic artery thrombosis were excluded. Benchmark cutoffs were derived from the 75th percentile of the medians of all benchmark centers. Out of 1110 redo-LT, 373 (34%) cases qualified as benchmark cases. Among these cases, the rate of postoperative complications until discharge was 76%, and increased up to 87% at 1-year, respectively. One-year overall survival rate was excellent with 90%. Benchmark cutoffs included Comprehensive Complication Index (CCI®) at 1-year of ≤72, and in-hospital and 1-year mortality rates of ≤13% and ≤15%, respectively. In contrast, patients who received a redo-LT for PNF showed worse outcomes with some values dramatically outside the redo-LT benchmarks. This study shows that redo-LT achieves good outcome when looking at benchmark scenarios. However, this figure changes in high-risk redo-LT, as for example in PNF. This major analysis objectifies for the first-time results and efforts for redo-LT and can serve as a basis for discussion about the use of scarce resources

    Blood cell DNA methylation biomarkers in preclinical malignant pleural mesothelioma: the EPIC prospective cohort

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    Malignant pleural mesothelioma (MPM) is a rare and aggressive cancer mainly caused by asbestos exposure. Specific and sensitive non-invasive biomarkers may facilitate and enhance screening programs for the early detection of cancer. We investigated DNA methylation (DNAm) profiles in MPM pre-diagnostic blood samples in a case-control study nested in the European Prospective Investigation into Cancer and nutrition (EPIC) cohort, aiming to characterise DNAm biomarkers associated with MPM. From the EPIC cohort, we included samples from 135 participants who developed MPM during 20 years of follow up and from 135 matched, cancer-free, controls. For the discovery phase we selected EPIC participants who developed MPM within five years from enrolment (n=36) with matched controls. We identified nine differentially methylated CpGs, selected by 10-fold cross-validation and correlation analyses: cg25755428 (MRI1), cg20389709 (KLF11), cg23870316, cg13862711 (LHX6), cg06417478 (HOOK2), cg00667948, cg01879420 (AMD1), cg25317025 (RPL17) and cg06205333 (RAP1A). Receiver operating characteristic (ROC) analysis showed that the model including baseline characteristics (age, sex, PC1wbc) along with the nine MPM-related CpGs has a better predictive value for MPM occurrence than the baseline model alone, maintaining some performance also at more than five years before diagnosis [AUC (area under the curve) 10 years=0.75; baseline AUC range=0.63-0.67)]. DNAm changes as non-invasive biomarkers in pre-diagnostic blood samples of MPM cases were investigated for the first time. Their application can improve the identification of asbestos-exposed individuals at higher MPM risk in order to possibly adopt more intensive monitoring for early disease identification
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