Inventory of landslides triggered by an extreme rainfall event in Marche-Umbria, Italy, on 15 September 2022

Systematic and timely documentation of triggered (i.e. event) landslides is fundamental to build extensive datasets worldwide that may help define and/or validate trends in response to climate change. More in general, preparation of landslide inventories is a crucial activity since it provides the basic data for any subsequent analysis. In this work we present an event landslide inventory map (E-LIM) that was prepared through a systematic reconnaissance field survey in about 1 month after an extreme rainfall event hit an area of about 5000 km² in the Marche-Umbria regions (central Italy). The inventory reports evidence of 1687 triggered landslides in an area of ~550 km². All slope failures were classified according to type of movement and involved material, and documented with field pictures, wherever possible. The database of the inventory described in this paper as well as the collection of selected field pictures associated with each feature is publicly available at figshare.

Histological classification and expression of markers of canine mast cell tumors

Background and Aim:

Mast cell tumors (MCTs) are malignant neoplasms that are common in dogs. Their biological behavior is variable and unpredictable. The aim of the present study was to analyze the histological classification and expression of markers of canine MCTs.

Materials and Methods:

Thirty samples of canine MCTs were graded according to the histological classification methods of Patnaik and those of Kiupel. The expression of phosphoprotein 53 (p53) and c-kit proteins was quantified by immunohistochemistry using image processing software, ImageJ - a public domain computer program, developed at the National Institutes of Health.

Results:

It was possible to determine the grade of 100% of the samples. According to Patnaik’s classification, 20.00% of the samples were Grade 1, 43.30% were Grade 2, and 36.70% were Grade 3. According to Kiupel’s classification, 56.67% of the samples were of high intensity and 43.33% were of low intensity. Grade 1 tumors had the highest expression of p53 and c-kit, and Grade 2 had the lowest expression. The results showed that it is necessary to perform both histological grading methods. The classification into high and low intensity may provide more consistent results than the three-level grading system. However, a smaller number of categories, although it facilitates the classification, may not be sufficient for the prognosis.

Conclusion:

Quantitative evaluation of p-53 and c-kit expression is a useful tool to increase the accuracy of the analysis and to aid in choosing the treatment method for canine MCTs. Histological grading should be combined with other diagnostic methods.

Postpartum screening for type 2 diabetes mellitus in women with gestational diabetes: Is it really performed?

AIMS

This study evaluates the adherence to postpartum type 2 diabetes mellitus (T2DM) screening in women with previous gestational diabetes (GDM) and identifies elements associated with poor attendance.

METHODS

We retrospectively collected data from 650 consecutive women with GDM between 2016 and 2018, who should had 75 g-OGTT, 4-12 weeks after delivery. Impaired glucose regulation (IGR) was defined according with ADA criteria.

RESULTS

Only 41% of women had postpartum OGTT. Of these, 1.9% received T2DM diagnosis, with IGR prevalence of 18%. After introducing a recommendation letter, adherence to screening increased (47% in 2017 and 43% in 2018 vs. 32% in 2016). Screening procedure was less common in women with: no-family history of T2DM (38% vs. 46%; p < 0.05), age <35 (33% vs. 47%; p < 0.01), lower level of education (32% no-high-school-diploma vs. 35% high-school-diploma vs. 49% university-degree; p < 0.01) and unstable employment (35% vs. 44%; p < 0.05). At multivariate logistic regression analysis, age <35 years (OR 1.61; 95%CI: 1.14-2.28) and lowest educational level (OR 1.64; 95% CI: 1.13-2.37, compared to University degree) were independently associated with non-adherence.

CONCLUSION

Only 41% of women had postpartum T2DM screening. Women with lower attendance are those with age <35 years or low educational level. Further strategies are needed to implement postpartum test.

Synthesis of thermoelectric magnesium-silicide pastes for 3D printing, electrospinning and low-pressure spray

In this work, eco-friendly magnesium-silicide (Mg₂Si) semiconducting (n-type) thermoelectric pastes for building components concerning energy-harvesting devices through 3D printing, spray and electrospinning were synthetized and tested for the first time. The Mg₂Si fine powders were obtained through the combination of ball milling and thermal annealing under Ar atmosphere. While the latter process was crucial for obtaining the desired Mg₂Si phase, the ball milling was indispensable for homogenizing and reducing the grain size of the powders. The synthetized Mg₂Si powders exhibited a large Seebeck coefficient of ~ 487 µV/K and were blended with a polymeric solution in different mass ratios to adjust the paste viscosity to the different requirements of 3D printing, electrospinning and low-pressure spray. The materials produced in every single stage of the paste synthesis were characterized by a variety of techniques that unequivocally prove their viability for producing thermoelectric parts and components. These can certainly trigger further research and development in green thermoelectric generators (TEGs) capable of adopting any form or shape with enhanced thermoelectric properties. These green TEGs are meant to compete with common toxic materials such as Bi₂Te₃, PbTe and CoSb that have Seebeck coefficients in the range of ~ 290-700 μV/K, similar to that of the produced Mg₂Si powders and lower than that of 3D printed bulk Mg₂Si pieces, measured to be ~ 4866 μV/K. Also, their measured thermal conductivities proved to be significantly lower (~ 0.2 W/mK) than that reported for Mg₂Si (≥ 4 W/mK). However, it is herein demonstrated that such thermoelectric properties are not stable over time. Pressureless sintering proved to be indispensable, but difficultly achievable by long thermal annealing (even above 32 h) in inert atmosphere at 400 °C, at least for bulk Mg₂Si pieces constituted by a mean grain size of 2-3 μm. Hence, for overcoming this sintering challenge and become the silicide's extrusion viable in the production of bulk thermoelectric parts, alternative pressureless sintering methods will have to be further explored.

The role of adipokines in the pathogenesis of gestational diabetes mellitus

Gestational diabetes mellitus (GDM) is a complex condition whose physiopathology to date has not been completely clarified. Two major metabolic disorders, insulin resistance and β-cells dysfunction, play currently major role in pathogenesis of GDM. These elements are influenced by the amount of adipose tissue present before and/or during the pregnancy. Consequently, adipokines (adiponectin (APN), leptin (LPT), adipocyte fatty acid-binding protein, resistin, visfatin, omentin, vaspin, apelin, chemerin) secreted by adipose tissue, may contribute directly and/or indirectly, through the enhancement of chronic inflammation, aggravating insulin resistance and promoting GDM onset. This review aims to outline the potential physiopathological and prognostic role in GDM of adipokines, mainly APN and LPT.

Synchronization of time of development of ovarian follicular waves in South American Camelids

South American camelids (SAC) are induced ovulating animals. In unmated females, ovarian follicle development occurs in waves of growth and regression, while mating when there is the presence of a mature follicle leads to ovulation. The capacity to respond to an ovulatory stimulus depends on the stage of the follicular wave development. Treatments to control ovarian follicular development have been performed to synchronize timing of wave emergence and development of the dominant follicle at a predictable time. Thus, synchronization of the time of follicular wave development allows for performing fixed time mating or artificial insemination, and superestimulatory treatments for multiple follicule development. Protocols are based on removal of the suppressive effect of the dominant follicle, that can be achieved by physical ablation or by inducing ovulation (with LH or GnRH) or atresia (with progesterone or progestagens alone or combined with estradiol) of this follicle. Differences between treatments should be taken into consideration when choosing a protocol for fixed time mating or artificial insemination, especially when applying the use these technologies for SAC production by commercial enterprises. Furthermore, the objective of applying synchronization protocols should be considered, because not all of these are effective in inhibiting follicular growth before initiation of a superestimulatory treatment for multiple follicle development.

Early vs. standard screening and treatment of gestational diabetes in high-risk women - An attempt to determine relative advantages and disadvantages

BACKGROUND AND AIMS

Screening for Gestational Diabetes (GDM) is usually recommended between 24 and 28 weeks of pregnancy; however available evidence suggests that GDM may be already present before recommended time for screening, in particular among high-risk women as those with prior GDM or obesity. The purpose of this retrospective study was to evaluate whether early screening (16-18 weeks) and treatment of GDM may improve maternal and fetal outcomes.

METHODS AND RESULTS

In 290 women at high-risk for GDM, we analyzed maternal and fetal outcomes, according to early or standard screening and GDM diagnosis time. Early screening was performed by 50% of high-risk women. The prevalence of GDM was 62%. Among those who underwent early screened, GDM was diagnosed at the first evaluation in 42.7%. Women with early diagnosis were more frequently treated with insulin and had a slightly lower HbA1c than women with who were diagnosed late. No differences were observed in the prevalence of Cesarean section, operative delivery, gestational age at the delivery, macrosomia, neonatal weight, Ponderal Index and Large-for-Gestational-Age among women with early or late GDM diagnosis or NGT. However, compared to NGT women, GDM women, irrespective of the time of diagnosis, had a lower gestational weight gain, lower prevalence of macrosomia (3.9% vs. 11.4%), small (1.7% vs. 8.3%) as well as large for gestational age (3.3% vs. 16.7%), but higher prevalence of pre-term delivery (8.9% vs. 2.7%).

CONCLUSION

Early vs. standard screening and treatment of GDM in high-risk women is associated with similar short-term maternal-fetal outcomes, although women with an early diagnosis were treated to a greater extent with insulin therapy.

Highly transparent copper iodide thin film thermoelectric generator on a flexible substrate

Simultaneously transparent and flexible conductive materials are in demand to follow the current trend in flexible technology. The search for materials with compliant optoelectronic properties, while simultaneously retaining their electric conductivity at high strain deformation, comprises promising opportunities in modern nanotechnology. Copper iodide (CuI) is not only the most transparent and highly conductive p-type material, but its optimization has contributed to improved ZT values in planar thin-film thermoelectrics. In this work, the readiness of CuI thin films to transparent, flexible technology is evidenced. A maximum ZT value of 0.29 for single CuI thin films of ca. 300 nm in thickness is reported. Values of open-circuit voltage V_oc, short circuit current I_sc and power output of p–n thermoelectric modules of Gallium-doped zinc oxide (GZO) and CuI thin films deposited on a transparent flexible Kapton® (type CS) substrate are reported, and a prototype of a flexible transparent thermoelectric generator based on 17 p–n modules was constructed. Bending analysis of CuI thin films reveals interesting, distinct results when submitted to compression and tension analysis – a behaviour not seen in conventional semiconducting thin films under equivalent strain conditions. A plausible account for such diversity is also included.

Simultaneously transparent and flexible conductive materials are in demand to follow the current trend in flexible technology. A highly transparent and flexible thermoelectric generator of 17 p–n modules was constructed based on copper iodide thin films.

Estrogen and Progesterone Receptors in Human Colorectal Tumour Cells (Study of 70 Cases)

Estrogen and progesterone receptors were studied in 70 cases of human colorectal cancer by a cytochemical technique. 28.5% of the cases were estrogen-receptor positive and 42.8% progesterone-receptor positive.

There was no difference between the sexes for estrogen receptors but the women had more tumours with progesterone receptors than men.

The presence of receptors is unrelated to the differentiation of the tumour. More colon tumours were positive than those of the sigma and rectum. The concentration of cells with receptors in positive cancer cases tended to be low or medium-low.

Pulmonary Asbestosis Associated to Pleural Non-Hodgkin Lymphoma

We describe herein a case report of a patient affected by pulmonary asbestosis who developed a non-Hodgkin lymphoma originating in the pleura. The case is unusual for the uncommon site and because the chronic antigenic stimulation by asbestos bodies may have locally promoted an immunologic derangement.

Radioguided Surgery for Gastrinoma: A Case Report

Aims and Background

Gastrinomas are the most common neuroendocrine tumors of the duodenopancreatic region. Surgical resection is the primary type of radical treatment.

Methods and Study Design

At the Institute of General, Gastrointestinal and Breast Surgery we treated a patient with a duodenal gastrinoma that was diagnosed and localized by means of selective celiacmesenteric angiography and labeled octreotide scintigraphy. Surgery was performed using a radioguided technique; in this way we easily detected the small tumor and discovered another tracer-uptaking lesion that turned out to be a metastatic lymph node.

Results

Surgical resection is the ideal treatment for sporadic gastrinoma: it improves quality of life, prolongs survival, and reduces the incidence of metastases, with a modest percentage of complications and practically zero mortality. Meanwhile, medical treatment is being revaluated, particulary in the case of metastatic disease or polyendocrine MEN1 syndrome. A fundamental aspect in the management of gastrinomas is tumor localization. Endoscopic ultrasonography and labeled octreotide scintigraphy (Octreoscan) proved to be more effective than the usual imaging modalities. Intraoperative ultrasonography, gastroscopy for duodenal transillumination and repeated measurement of blood gastrin levels should be performed intraoperatively in the surgical treatment of gastrinomas.

Conclusions

The clinical application of radioguided surgery for tracer-uptaking endocrine tumors is still controversial. In our case the decision to use this method was influenced by the fear that the patient's obesity and the effects of previous surgery could hamper the identification of the small tumor.

Thrombocytosis in Malignant Pleural Mesothelioma

The prevalence of thrombocytosis (defined as a platelet count above 400,000/mm3 in at least two examinations) and the prevalence of thromboembolism were retrospectively investigated in a series of 41 patients with malignant pleural mesothelioma and in 40 subjects with non small cell lung carcinoma. All the patients were examined at necropsy. The mesothelioma patients showed a higher prevalence of thrombocytosis (56.8% vs 24.2%; p < 0.01). However, the prevalences of thromboembolism were similar in the two groups of patients (36.6% and 32.5% respectively). Among those with mesothelioma the prevalence of thrombocytosis varied widely from one histological type to another (76.9% in mixed type, 57.1% in the epithelial, and 30% in the sarcomatous type), the difference between mixed and sarcomatous being statistically significant (p < 0.01). Moreover, the mesothelioma patients of under 70 years had thrombocytosis more often than those over 70 (80% vs 29.4%; p < 0.01).

Asbestos Exposure in the Monfalcone Area. A Social and Pathological Study of 100 Autopsy Cases

Monfalcone is a coastal town with important shipyards. In the present investigation hyalin pleural plaques, lung asbestos bodies, and occupational history were studied in 100 consecutive autopsy cases, collected at the hospital of Monfalcone. Pleural plaques were observed in 72 % of males and in 33 % of females. Asbestos bodies were found after chemical digestion of pulmonary tissue in 94 cases, and an approximate estimation of their amount showed high or very high numbers in 39 cases. Occupational history, obtained from patients’ relatives, was suggestive of occupational asbestos exposure in 60 cases, with 37 subjects having worked in the shipyards. Thirteen other patients had had a probable domestic exposure to asbestos. The severity of asbestos exposure in the Monfalcone area is emphasized.

Diffuse Pleural Mesothelioma in Trieste. A Survey Based on Autopsy Cases

Records of necropsies performed at the Institute of Pathological Anatomy and Histology of the University of Trieste during the period December 1 1971-December 31 1977 have been reviewed. Cases with a necropsy diagnosis of pleural tumor or lung sarcoma were reexamined. Twenty-six cases were accepted as definite diffuse pleural mesothelioma. Occupational history was indicative of asbestos exposure in 22 cases, with 12 patients having worked in shipyards. The high incidence of diffuse pleural mesothelioma in the Province of Trieste is emphasized.

A Bayesian approach for the identification of patient-specific parameters in a dialysis kinetic model

Hemodialysis is the most common therapy to treat renal insufficiency. However, notwithstanding the recent improvements, hemodialysis is still associated with a non-negligible rate of comorbidities, which could be reduced by customizing the treatment. Many differential compartment models have been developed to describe the mass balance of blood electrolytes and catabolites during hemodialysis, with the goal of improving and controlling hemodialysis sessions. However, these models often refer to an average uremic patient, while on the contrary the clinical need for customization requires patient-specific models. In this work, we assume that the customization can be obtained by means of patient-specific model parameters. We propose and validate a Bayesian approach to estimate the patient-specific parameters of a multi-compartment model, and to predict the single patient's response to the treatment, in order to prevent intra-dialysis complications. The likelihood function is obtained by means of a discretized version of the multi-compartment model, where the discretization is in terms of a Runge-Kutta method to guarantee convergence, and the posterior densities of model parameters are obtained through Markov Chain Monte Carlo simulation. Results show fair estimations and the applicability in the clinical practice.

89 Comparative Quantification of Plasma Progesterone Through Radioimmumoassay and Enzyme-Linked Fluorescent Assay Techniques in Cattle

Progesterone (P4) is an important component of oestrous cyclicity and is critical to fertility. A concentration >1 ng mL−1 reflects the function of the corpus luteum (CL) and is considered indicative of a cyclic cow. Recent publications have shown that P4 at the onset of synchronization programs is critical to pregnancy outcomes in primiparous cows (Stevenson et al. 2015 J. Anim. Sci. 93, 2111-2123) and cows with P4 <5 ng mL−1 on Day 14 could predict pregnancy loss (Kenyon et al. 2013 Anim. Reprod. Sci. 136, 223-230). Currently, the gold standard technique to quantify P4 is radioimmunoassay (RIA). However, new techniques are emerging. The objective of this study was to evaluate a new commercial in vitro diagnostic assay to quantify P4 based on enzyme immunoassay by competition with detection of final fluorescence (enzyme-linked fluorescence assay, ELFA). A total of 30 cows were synchronized on Day 0 with an intravaginal device (IVD) containing 500 mg of P4 (Cronipres, Biogénesis Bagó, Argentina). On Day 7 and Day 8 all cows received 150 mg of prostaglandin F2α (Enzaprost, Biogénesis Bagó). All IVD were removed on Day 8. A total of 95 blood samples were taken at Days 0, 9, 9.5, and 10 using BD Vacutainer (Becton-Dickinson, Franklin Lakes, NJ, USA) with sodium heparin by jugular venipuncture and centrifuged at 3000 × g for 30 min for plasma separation, which was frozen at –20°C until analysis. Samples were measured in duplicate by IM1188-Progesterone-RIA (Beckman Coulter, Brea, CA, USA) and VIDAS-PRG-ELFA (Biomerieux, Marcy l’Étoile, France). Concentrations of P4 obtained by RIA were classified in 2 groups: (A) P4 <1 ng mL−1, and (B) P4 ≥1 ng mL−1 and matched with P4 concentrations obtained by ELFA. Kappa (κ) test was used to determine agreement between both techniques, intra-assay coefficients of variation was determined for RIA and ELFA; and sensitivity (SE), specificity (SP), positive predictive value (PPV), and negative predictive value (NPV) were determined for ELFA. There was very good agreement between the RIA and ELFA techniques, κ = 0.95, to determine P4 concentrations for group A (62 and 62 samples, respectively) and group B (33 and 33 samples, respectively). The intra-assay coefficients of variation were 5% (RIA) and 2.9% (ELFA). Values for SE = 0.97, SP = 0.98, PPV = 0.97, and NPV = 0.98 were obtained for ELFA. We were able to quantify P4 in bovine plasma in all samples using the ELFA technique with similar reliability to the RIA technique. Only 2 samples (2.1%) differed in their concentrations and clinical interpretation. There was a slight discrepancy between the results found for both techniques with an excellent SE and SP in ELFA compared with RIA. Based on the analytical results, we believe that this in vitro diagnostic assay developed for use with an autoanalyzer could be useful for routine bovine reproduction programs. Further studies should be carried out to strengthen these conclusions.

Italian national guidelines for the screening of gestational diabetes: Time for a critical appraisal?

BACKGROUND AND AIM

In 2011, the Italian National Health System guidelines introduced a selective screening for gestational diabetes (GDM) based on risk factors, recommending early evaluation in high risk women. The present study examined to which extent guidelines are applied, and analyzed the effectiveness of GDM diagnosis according to risk profile.

METHODS AND RESULTS

We analyzed 1338 pregnant women, consecutively screened for GDM with a 75 g OGTT between January 2013 and December 2015, according to national guidelines. Diagnosis of GDM was based on IADPSG/WHO 2013 criteria. As many as 14.4% of screened women was at high risk, 64% at medium, 21.6% did not have any risk factor. Only 50% of high-risk women were appropriately screened at 16th-18th gestational weeks; 28% of them repeated the OGTT due to NGT. The overall prevalence of GDM was 39.9%, higher in high risk women (67% vs. 40% medium risk vs. 22% low risk; p < 0.0001). An early GDM diagnosis was performed in 40.7% of high-risk women. In low risk women, gestational weight gain at the screening time was independently associated with GDM.

CONCLUSIONS

The recommendations for the screening of GDM are still insufficiently implemented, especially for early evaluation in high risk women. Considering the high proportion of early GDM diagnosis, the poor adherence to screening recommendation may result in late diagnosis of GDM. Finally, our finding of a 22% prevalence of GDM among low risk women suggests the need to consider additional risk factors, such as excessive weight gain during pregnancy.

Assessment of intradialysis calcium mass balance by a single pool variable-volume calcium kinetic model

INTRODUCTION

A reliable method of intradialysis calcium mass balance quantification is far from been established. We herein investigated the use of a single-pool variable-volume Calcium kinetic model to assess calcium mass balance in chronic and stable dialysis patients.

METHODS

Thirty-four patients on thrice-weekly HD were studied during 240 dialysis sessions. All patients were dialyzed with a nominal total calcium concentration of 1.50 mmol/L. The main assumption of the model is that the calcium distribution volume is equal to the extracellular volume during dialysis. This hypothesis is assumed valid if measured and predicted end dialysis plasma water ionized calcium concentrations are equal. A difference between predicted and measured end-dialysis ionized plasma water calcium concentration is a deviation on our main hypothesis, meaning that a substantial amount of calcium is exchanged between the extracellular volume and a nonmodeled compartment.

FINDINGS

The difference between predicted and measured values was 0.02 mmol/L (range -0.08:0.16 mmol/L). With a mean ionized dialysate calcium concentration of 1.25 mmol/L, calcium mass balance was on average negative (mean ± SD -0.84 ± 1.33 mmol, range -5.42:2.75). Predialysis ionized plasma water concentration and total ultrafiltrate were the most important predictors of calcium mass balance. A significant mobilization of calcium from the extracellular pool to a nonmodeled pool was calculated in a group of patients.

DISCUSSION

The proposed single pool variable-volume Calcium kinetic model is adequate for prediction and quantification of intradialysis calcium mass balance, it can evaluate the eventual calcium transfer outside the extracellular pool in clinical practice.

Prediction models for exacerbations in patients with COPD

Personalised medicine aims to tailor medical decisions to the individual patient. A possible approach is to stratify patients according to the risk of adverse outcomes such as exacerbations in chronic obstructive pulmonary disease (COPD). Risk-stratified approaches are particularly attractive for drugs like inhaled corticosteroids or phosphodiesterase-4 inhibitors that reduce exacerbations but are associated with harms. However, it is currently not clear which models are best to predict exacerbations in patients with COPD. Therefore, our aim was to identify and critically appraise studies on models that predict exacerbations in COPD patients. Out of 1382 studies, 25 studies with 27 prediction models were included. The prediction models showed great heterogeneity in terms of number and type of predictors, time horizon, statistical methods and measures of prediction model performance. Only two out of 25 studies validated the developed model, and only one out of 27 models provided estimates of individual exacerbation risk, only three out of 27 prediction models used high-quality statistical approaches for model development and evaluation. Overall, none of the existing models fulfilled the requirements for risk-stratified treatment to personalise COPD care. A more harmonised approach to develop and validate high- quality prediction models is needed to move personalised COPD medicine forward.

Joint position statement on "Nutraceuticals for the treatment of hypercholesterolemia" of the Italian Society of Diabetology (SID) and of the Italian Society for the Study of Arteriosclerosis (SISA)

AIM

Evidence showed that LDL-cholesterol lowering is associated with a significant cardiovascular risk reduction. The initial therapeutic approach to hypercholesterolemia includes dietary modifications but the compliance to recommendations is often inadequate. Some dietary components with potential cholesterol-lowering activity are present in small amounts in food. Therefore, in recent years the use of "nutraceuticals" (i.e., nutrients and/or bioactive compounds with potential beneficial effects on human health) has become widespread. Such substances may be added to foods and beverages, or taken as dietary supplements (liquid preparations, tablets, capsules). In the present manuscript, the cholesterol-lowering activity of some nutraceuticals (i.e. fiber, phytosterols, soy, policosanol, red yeast rice and berberine) will be discussed along with: 1) the level of evidence on the cholesterol-lowering efficacy emerging from clinical trial; 2) the possible side effects associated with their use; 3) the categories of patients who could benefit from their use.

DATA SYNTHESIS

Based on the current literature, the cholesterol-lowering effect of fiber, phytosterols and red yeast rice is consistent and supported by a good level of evidence. Over berberine, there is sufficient evidence showing significant cholesterol-lowering effects, although the results come from studies carried out almost exclusively in Asian populations. Data on the effects of soy are conflicting and, therefore, the strength of recommendation is quite low. The evidence on policosanol is inconclusive.

CONCLUSION

Although health benefits may arise from the use of nutraceuticals with cholesterol-lowering activity, their use might be also associated with possible risks and pitfalls, some of which are common to all nutraceuticals whereas others are related to specific nutraceuticals.

Matrix metalloproteinase (MMP)-9: A realiable marker for inflammation in early human trichinellosis

Matrix Metalloproteinases (MMPs) are involved in many physiological and pathological processes. As regards parasitic infections, the role of these proteins has been particularly studied in malaria, neurocysticercosis and angiostrongyloidosis. Recently, we evaluated serum levels of MMP-9 and -2 (gelatinases) in mice experimentally infected with Trichinella spiralis or Trichinella pseudospiralis, which cause different degrees of myositis and we found their significant increase in the former and, at a lesser extent, in the latter, thus suggesting the possibility that these gelatinases, particularly MMP-9, represent a marker of inflammation. Our aim was to evaluate the levels of MMP-9 and 2 in trichinellosis patients, to assess their possible clinical significance. Serum samples from 31 Trichinella britovi-infected individuals (20 males and 11 females), living in Tuscany, Central Italy, were analysed for MMP-9 and MMP-2 serum levels. Patients acquired infection with Trichinella after consuming raw or undercooked meat of wild boar. Their median age was 49±0.33years (range from 7 to 91). Sera was collected before starting anti-inflammatory treatment, aliquoted and stored at -20°C until use. Sera from healthy subjects was considered as controls. The gelatinolytic activity of MMPs was analysed by gelatin zymography on 8% polyacrylamide-SDS gels containing 0.1% porcine gelatin, under non-reducing conditions. Clear bands corresponding to the digested areas were evaluated with an appropriate software. MMP-9 levels were additionally determined in 15 patients using a commercial ELISA kit for human MMP-9. The zymographic analysis of the gels showed the presence in serum samples of gelatinase bands at approximately 125-kDa, 92-kDa and 72-kDa, corresponding to the MMP-9/Neutrophil gelatinase-associated lipocalin (NGAL) complex and proenzyme forms of MMP-9 and MMP-2, respectively. A significant (p<0.01) increase in gelatinolytic activity in patients compared to the control group was observed for pro-MMP-9 in 25 out of 31. The mean increase in activity was 39.25%±16.67%. No significant differences were observed for pro-MMP-2 activity. The MMP-9 levels detected by ELISA showed significant correlation with zymographic data (r²=0.62, p<0.003) and were higher in more affected patients (suffering diarrhea, facial edemas and myalgia). In conclusion, MMP-9 might be considered as a marker of inflammation in T. britovi patients. On the contrary, MMP-2 did not result significantly different in patients, compared to controls.

How to extract clinically useful information from large amount of dialysis related stored data

The basic storage infrastructure used to gather data from the technological evolution also in the healthcare field was leading to the storing into public or private repository of even higher quantities of data related to patients and their pathological evolution. Big data techniques are spreading also in medical research. By these techniques is possible extract information from complex heterogeneous sources, realizing longitudinal studies focused to correlate the patient status with biometric parameters. In our work we develop a common data infrastructure involving 4 clinical dialysis centers between Lombardy and Switzerland. The common platform has been build to store large amount of clinical data related to 716 dialysis session of 70 patient. The platform is made up by a combination of a MySQL(®) database (Dialysis Database) and a MATLAB-based mining library (Dialysis MATlib). A statistical analysis of these data has been performed on the data gathered. These analyses led to the development of two clinical indexes, representing an example of transformation of big data into clinical information.

[Asbestos at the time of the First World War]

Between the end of the 19th century and the beginning of the 20th numerous asbestos industries began operations in various parts of the world. At the time of the First World War there is ample evidence of the use of this mineral in shipbuilding, the aircraft industry and in the construction industry. In the years 1912-17 the writer Franz Kafka was co-proprietor of a small asbestos factory in Prague. Some of the writer's novels and journal pages were inspired by this experience. In this way asbestos entered into the history of 20th century European literature. In 1917 asbestos extraction was started at the quarry in Balangero, near Turin, Italy. Risks related to the use of asbestos were known at the beginning of the 20th century and legislation aimed at preventing the harmful effects of the mineral were approved in Italy.

III Italian Consensus Conference on Malignant Mesothelioma of the Pleura. Epidemiology, Public Health and Occupational Medicine related issues

The III Italian Consensus Conference on Pleural Mesothelioma (MM) convened on January 29th 2015. This report presents the conclusions of the 'Epidemiology, Public Health and Occupational Medicine' section. MM incidence in 2011 in Italy was 3.64 per 100,000 person/years in men and 1.32 in women. Incidence trends are starting to level off. Ten percent of cases are due to non-occupational exposure. Incidence among women is very high in Italy, because of both non-occupational and occupational exposure. The removal of asbestos in place is proceeding slowly, with remaining exposure. Recent literature confirms the causal role of chrysotile. Fibrous fluoro-edenite was classified as carcinogenic by IARC (Group 1) on the basis of MM data. A specific type (MWCNT-7) of Carbon Nanotubes was classified 2B. For pleural MM, after about 45 years since first exposure, the incidence trend slowed down; with more studies needed. Cumulative exposure is a proxy of the relevant exposure, but does not allow to distinguish if duration or intensity may possibly play a prominent role, neither to evaluate the temporal sequence of exposures. Studies showed that duration and intensity are independent determinants of MM. Blood related MM are less than 2.5%. The role of BAP1 germline mutations is limited to the BAP1 cancer syndrome, but negligible for sporadic cases. Correct MM diagnosis is baseline; guidelines agree on the importance of the tumor gross appearance and of the hematoxylin-eosin-based histology. Immunohistochemical markers contribute to diagnostic confirmation: the selection depends on morphology, location, and differential diagnosis. The WG suggested that 1) General Cancer Registries and ReNaM Regional Operational Centres (COR) interact and systematically compare MM cases; 2) ReNaM should report results presenting the diagnostic certainty codes and the diagnostic basis, separately; 3) General Cancer Registries and COR should interact with pathologists to assure the up-to-date methodology; 4) Necroscopy should be practiced for validation. Expert referral centres could contribute to the definition of uncertain cases. Health surveillance should aim to all asbestos effects. No diagnostic test is recommended for MM screening. Health surveillance should provide information on risks, medical perspective, and smoking cessation. The economic burden associated to MM was estimated in 250,000 Euro per case.