Morphological and lipid metabolism alterations in macrophages exposed to model environmental nanoplastics traced by high-resolution synchrotron techniques

The release of nanoplastics (NPs) in the environment is a significant health concern for long-term exposed humans. Although their usage has certainly revolutionized several application fields, at nanometer size, NPs can easily interact at the cellular level, resulting in potential harmful effects. Micro/Nanoplastics (M/NPs) have a demonstrated impact on mammalian endocrine components, such as the thyroid, adrenal gland, testes, and ovaries, while more investigations on prenatal and postnatal exposure are urgently required. The number of literature studies on the NPs' presence in biological samples is increasing. However, only a few offer a close study on the model environmental NP-immune system interaction exploited by advanced microscopy techniques. The present study highlights substantial morphological and lipid metabolism alterations in human M1 macrophages exposed to labeled polypropylene and polyvinyl chloride nanoparticles (PP and PVC NPs) (20 μg/ml). The results are interpreted by advanced microscopy techniques combined with standard laboratory tests and fluorescence microscopy. We report the accurate detection of polymeric nanoparticles doped with cadmium selenide quantum dots (CdSe-QDs NPs) by following the Se (L line) X-ray fluorescence emission peak at higher sub-cellular resolution, compared to the supportive light fluorescence microscopy. In addition, scanning transmission X-ray microscopy (STXM) imaging successfully revealed morphological changes in NP-exposed macrophages, providing input for Fourier transform infrared (FTIR) spectroscopy analyses, which underlined the chemical modifications in macromolecular components, specifically in lipid response. The present evidence was confirmed by quantifying the lipid droplet (LD) contents in PP and PVC NPs-exposed macrophages (0-100 μg/ml) by Oil Red O staining. Hence, even at experimental NPs' concentrations and incubation time, they do not significantly affect cell viability; they cause an evident lipid metabolism impairment, a hallmark of phagocytosis and oxidative stress.

Investigating the Cellular Uptake of Model Nanoplastics by Single-Cell ICP-MS

A synthetic route to producing gold-doped environmentally relevant nanoplastics and a method for the rapid and high-throughput qualitative investigation of their cellular interactions have been developed. Polyethylene (PE) and polyvinyl chloride (PVC) nanoparticles, doped with ultrasmall gold nanoparticles, were synthesized via an oil-in-water emulsion technique as models for floating and sedimenting nanoplastics, respectively. Gold nanoparticles were chosen as a dopant as they are considered to be chemically stable, relatively easy to obtain, interference-free for elemental analysis, and suitable for bio-applications. The suitability of the doped particles for quick detection via inductively coupled plasma mass spectrometry (ICP-MS), operating in single-cell mode (scICP-MS), was demonstrated. Specifically, the method was applied to the analysis of nanoplastics in sizes ranging from 50 to 350 nm, taking advantage of the low limit of detection of single-cell ICP-MS for gold nanoparticles. As an initial proof of concept, gold-doped PVC and PE nanoplastics were employed to quantify the interaction and uptake of nanoplastics by the RAW 264.7 mouse macrophage cell line, using scICP-MS and electron microscopy. Macrophages were chosen because their natural biological functions would make them likely to internalize nanoplastics and, thus, would produce samples to verify the test methodology. Finally, the method was applied to assess the uptake by CaCo-2 human intestinal cells, this being a more relevant model for humanexposure to those nanoplastics that are potentially available in the food chain. For both case studies, two concentrations of nanoplastics were employed to simulate both standard environmental conditions and exceptional circumstances, such as pollution hotspot areas.

In Vitro High-Throughput Toxicological Assessment of Nanoplastics

Sub-micrometer particles derived from the fragmentation of plastics in the environment can enter the food chain and reach humans, posing significant health risks. To date, there is a lack of adequate toxicological assessment of the effects of nanoplastics (NPs) in mammalian systems, particularly in humans. In this work, we evaluated the potential toxic effects of three different NPs in vitro: two NPs obtained by laser ablation (polycarbonate (PC) and polyethylene terephthalate (PET1)) and one (PET2) produced by nanoprecipitation. The physicochemical characterization of the NPs showed a smaller size, a larger size distribution, and a higher degree of surface oxidation for the particles produced by laser ablation. Toxicological evaluation performed on human cell line models (HePG2 and Caco-2) showed a higher toxic effect for the particles synthesized by laser ablation, with PC more toxic than PET. Interestingly, on differentiated Caco-2 cells, a conventional intestinal barrier model, none of the NPs produced toxic effects. This work wants to contribute to increase knowledge on the potential risks posed by NPs.

Protein-corona formation on aluminum doped zinc oxide and gallium nitride nanoparticles

The interaction of semiconductor nanoparticles with bio-molecules attracts increasing interest of researchers, considering the reactivity of nanoparticles and the possibility to control their properties remotely giving mechanical, thermal, or electrical stimulus to the surrounding bio-environment. This work reports on a systematic comparative study of the protein-corona formation on aluminum doped zinc oxide and gallium nitride nanoparticles. Bovine serum albumin was chosen as a protein model. Dynamic light scattering, transmission electron microscopy and X-ray photoelectron spectroscopy techniques have been used to demonstrate the formation of protein-corona as well as the stability of the colloidal suspension given by BSA, which also works as a surfactant. The protein adsorption on the NPs surface studied by Bradford Assay showed the dependence on the quantity of proteins adsorbed to the available sites on the NPs surface, thus the saturation was observed at ratio higher than 5:1 (NPs:Proteins) in case of ZnO, these correlating with DLS results. Moreover, the kinetics of the proteins showed a relatively fast adsorption on the NPs surface with a saturation curve after about 25 min. GaN NPs, however, showed a very small amount of proteins adsorbed on the surface, a change in the hydrodynamic size being not observable with DLS technique or differential centrifugal sedimentation. The Circular Dichroism analysis suggests a drastic structural change in the secondary structure of the BSA after attaching on the NPs surface. The ZnO nanoparticles adsorb a protein-corona, which does not protect them against dissolution, and in consequence, the material proved to be highly toxic for Human keratinocyte cell line (HaCaT) at concentration above 25 µg/mL. In contrast, the GaN nanoparticles which do not adsorb a protein-corona, show no toxicity signs for HaCaT cells at concentration as high as 50 µg/mL, exhibiting much lower concentration of ions leakage in the culture medium as compared to ZnO nanoparticles.

Complementary Effect of Non-Persistent Silver Nano-Architectures and Chlorhexidine on Infected Wound Healing

Surgical site infection (SSI) substantially contributes each year to patients' morbidity and mortality, accounting for about 15% of all nosocomial infections. SSI drastically increases the rehab stint and expenses while jeopardizing health outcomes. Besides prevention, the treatment regime relies on an adequate antibiotic therapy. On the other hand, resistant bacterial strains have currently reached up to 34.3% of the total infections, and this percentage grows annually, reducing the efficacy of the common treatment schemes. Thus, new antibacterial strategies are urgently demanded. Here, we demonstrated in rats the effectiveness of non-persistent silver nano-architectures (AgNAs) in infected wound healing together with their synergistic action in combination with chlorhexidine. Besides the in vivo efficacy evaluation, we performed analysis of the bacteriological profile of purulent wound, histological evaluations, and macrophages polarization quantifications to further validate our findings and elucidate the possible mechanisms of AgNAs action on wound healing. These findings open the way for the composition of robust multifunctional nanoplatforms for the translation of safe and efficient topical treatments of SSI.

Doxorubicin-Loaded Gold Nanoarchitectures as a Therapeutic Strategy against Diffuse Intrinsic Pontine Glioma

Diffuse Intrinsic Pontine Gliomas (DIPGs) are highly aggressive paediatric brain tumours. Currently, irradiation is the only standard treatment, but is palliative in nature and most patients die within 12 months of diagnosis. Novel therapeutic approaches are urgently needed for the treatment of this devastating disease. We have developed non-persistent gold nano-architectures (NAs) functionalised with human serum albumin (HSA) for the delivery of doxorubicin. Doxorubicin has been previously reported to be cytotoxic in DIPG cells. In this study, we have preclinically evaluated the cytotoxic efficacy of doxorubicin delivered through gold nanoarchitectures (NAs-HSA-Dox). We found that DIPG neurospheres were equally sensitive to doxorubicin and doxorubicin-loaded NAs. Colony formation assays demonstrated greater potency of NAs-HSA-Dox on colony formation compared to doxorubicin. Western blot analysis indicated increased apoptotic markers cleaved Parp, cleaved caspase 3 and phosphorylated H2AX in NAs-HSA-Dox treated DIPG neurospheres. Live cell content and confocal imaging demonstrated significantly higher uptake of NAs-HSA-Dox into DIPG neurospheres compared to doxorubicin alone. Despite the potency of the NAs in vitro, treatment of an orthotopic model of DIPG showed no antitumour effect. This disparate outcome may be due to the integrity of the blood-brain barrier and highlights the need to develop therapies to enhance penetration of drugs into DIPG.

DDEL-12. NANOPARTICLE DELIVERY OF DOXORUBICIN FOR THE TREATMENT OF DIFFUSE INTRINSIC PONTINE GLIOMA (DIPG)

DIPGs are the most aggressive pediatric brain tumors. Currently, the only treatment is irradiation but due to its palliative nature patients die within 12 months. Effective delivery of chemotherapy across the blood-brain barrier (BBB) has been a key challenge for the eradication of this disease. We have developed a novel gold nanoparticle functionalised with human serum albumin (Au-NP, 98.8 ±19 nm) for the delivery of doxorubicin. In this study, we evaluated the cytotoxic efficacy of doxorubicin delivered through gold nanoparticles (Au-NP-Dox). We found that DIPG neurospheres were equally sensitive to doxorubicin and Au-NP-Dox (at equimolar concentration) by alamar blue assay. Colony formation assays demonstrated a significantly more potent effect of Au-NP-Dox compared to doxorubicin alone, while the Au-NP had no effect. Furthermore, western blot analysis indicated increased apoptotic markers cleaved Parp, caspase 3/7 and phosphorylated H2AX in Au-NP-Dox treated DIPG neurospheres. Live cell content and confocal imaging demonstrated significantly higher uptake of Au-NP-Dox compared to doxorubicin alone. Treatment of a DIPG orthotopic mouse model with Au-NP-Dox showed no signs of toxicity with stable weights being maintained during treatment. However, in contrast to the above in vitro findings the in vivo study showed no anti-tumor effect possibly due to poor penetration of Au-NP-Dox into the brain. We are currently evaluating whether efficacy can be improved using measures to open the BBB transiently. This study highlights the need for rigorous in vivo testing of new treatment strategies before clinical translation to reduce the risk of administration of ineffective treatments.

Biokinetics and clearance of inhaled gold ultrasmall-in-nano architectures

Among an organism's entry portals, the respiratory tract is one of the most promising routes for non-invasive administration of therapeutics for local and systemic delivery. On the other hand, it is the subtlest to protect from environmental pollution and microbial occurrences. Here, the biokinetics, distribution, and clearance trends of gold ultrasmall-in-nano architectures administered through a single intranasal application have been quantitatively evaluated. Apart from reaching the lung parenchyma, the (bio)degradable nano-architectures are able to translocate as well to secondary organs and be almost completely excreted within 10 days. These findings further support the clinical relevance of plasmonic nanomaterials for oncology and infectious disease treatment and management. Notably, this investigation also provides crucial information regarding the associated risks as a consequence of the pulmonary delivery of nanoparticles.

A Cost-Effective Approach for Non-Persistent Gold Nano-Architectures Production

The effective exploitation of the intriguing theranostic features of noble metal nanoparticles for therapeutic applications is far from being a routine practice due to the persistence issue. In this regard, passion fruit-like nano-architectures (NAs), biodegradable and excretable all-in-one, nature-inspired platforms which jointly combine these characteristics with the appealing optical behaviors of noble metal nanoparticles, can offer a new alternative for theranostic applications. Besides the need for efficacious and innovative systems, the reliable and cost-effective production of nanomaterials is a pivotal subject for their translation to the clinical setting. Here, we demonstrate the production of a new cheaper class of degradable, ultrasmall-in-nano-architectures (dragon fruit NAs, dNAs) using polyethyleneimine (PEI) as a cationic polymer without affecting either their compositions or their physiological behaviors, compared to the previous NAs. In particular, the standardized protocol characterized in this work ensures the preparation of high gold-loading capacity nanoparticles, a peculiar characteristic that, synergically with the interesting properties of PEI, may unlock new possible applications previously precluded to the first version of NAs while reducing the hand-made production cost by three orders of magnitude.

Endogenously-Activated Ultrasmall-in-Nano Therapeutics: Assessment on 3D Head and Neck Squamous Cell Carcinomas

Negative or positive HPV-associated Head and Neck Squamous Cell Carcinomas (HNSCCs) are high recurrence neoplasms usually resulting in a poor prognosis, mainly due to metastasis formation. Despite the low overall patient survival rate and the severe side effects, the treatment of choice is still cisplatin-based chemotherapy. Here, we report a straightforward protocol for the production of high throughput 3D models of negative or positive HPV-associated HNSCCs, together with their employment in the therapeutic evaluation of gold ultrasmall-in-nano architectures comprising an endogenously-activatable cisplatin prodrug. Beyond enhancing the biosafety of cisplatin, our approach paves the way for the establishment of synergistic co-therapies for HNSCCs based on excretable noble metals.

Silica-Based Nanoparticles for Protein Encapsulation and Delivery

Although conceptually obvious, the effective delivery of proteins in therapeutic applications is far from being a routine practice. The major limitation is the conservation of protein physicochemical identity during the transport to the target site. In this regard, nanoparticle-based systems offer new intriguing possibilities, provided that (i) the harsh and denaturating conditions typically used for nanoparticle synthesis are avoided or mitigated; and (ii) nanoparticle biocompatibility and degradation (for protein release) are optimized. Here, we tackle these issues by starting from a nanoparticle architecture already tested for small chemical compounds. In particular, silica-shielded liposomes are produced and loaded with a test protein (i.e., Green Fluorescent Protein) in an aqueous environment. We demonstrate promising results concerning protein encapsulation, protection during intracellular trafficking and final release triggered by nanoparticle degradations in acidic organelles. We believe this proof of principle may open new applications and developments for targeted and efficient protein delivery.

Endogenously Triggerable Ultrasmall-in-Nano Architectures: Targeting Assessment on 3D Pancreatic Carcinoma Spheroids

Several nanomaterials rely on the passive accumulation in the neoplasm target because of enhanced permeability and retention effect. On the other hand, directing nanomaterials to the target by employing the targeting agents may lead to a pivotal improvement in the efficacy of the treatment for a number of cancers. However, targeting moieties often lose their functionality upon injection in the bloodstream, leaving questions on their efficiency. Here, we assessed using a significant in vitro 3D model of pancreatic carcinoma the targeting efficiency of passion fruit-like nanoarchitectures (NAs) incorporated with a peptide that can recognize transferrin directly in the medium, thereby modulating protein solvation. NAs are biodegradable ultrasmall-in-nano platforms that combine the most appealing behaviors of noble metal nanomaterials with organism excretion of the building blocks by the renal pathway. Although the confocal images did not illustrate the significant differences in the targeting efficiency of the peptide-modified NAs, an improved internalization was quantitatively observed by inductively coupled plasma-mass spectrometry analysis. Our findings demonstrate that the peptide conjugation of NAs might be considered to enhance their theranostic potentials for this type of neoplasm.

Biodistribution and biocompatibility of passion fruit-like nano-architectures in zebrafish

Passion fruit-like nano-architectures (NAs) are all-in-one platforms of increasing interest for the translation of metal nanoparticles into clinics. NAs are nature-inspired disassembling inorganic theranostics, which jointly combine most of the appealing behaviors of noble metal nanoparticles with their potential organism excretion. Despite their unique and promising properties, NAs in vivo interactions and potential adverse effects have not yet been investigated. In this study, we employ zebrafish (Danio Rerio) to assess the development toxicity of NAs as well as their uptake and bioaccumulation at different stages of growth. The evaluation of multiple endpoints related to the toxicity clearly indicates that NAs do not induce mortality, developmental defects, or alterations on the hatching rate and behavior of zebrafish. Moreover, the analysis of nanostructures uptake and biodistribution demonstrates that NAs are successfully internalized and present a specific localization. Overall, our results demonstrate that NAs are able to pass through the embryos chorion and accumulate in specific tissues, exhibiting an impressive biocompatibility.

Ultrasmall-in-Nano Approach: Enabling the Translation of Metal Nanomaterials to Clinics

Currently, nanomaterials are of widespread use in daily commercial products. However, the most-promising and potentially impacting application is in the medical field. In particular, nanosized noble metals hold the promise of shifting the current medical paradigms for the detection and therapy of neoplasms thanks to the: (i) localized surface plasmon resonances (LSPRs), (ii) high electron density, and (iii) suitability for straightforward development of all-in-one nanoplatforms. Nonetheless, there is still no clinically approved noble metal nanomaterial for cancer therapy and diagnostics. The clinical translation of noble metal nanoparticles (NPs) is mainly prevented by the issue of persistence in organism after the medical action. Such persistence increases the likelihood of toxicity and the interference with common medical diagnoses. Size reduction to ultrasmall nanoparticles (USNPs) is a suitable approach to promoting metal excretion by the renal pathway. However, most of the functionalities of NPs are lost or severely altered in USNPs, jeopardizing clinical applications. A ground-breaking advance to jointly combine the appealing behaviors of NPs with metal excretion relies on the ultrasmall-in-nano approach for the design of all-in-one degradable nanoplatforms composed of USNPs. Such nanoarchitectures might lead to the delivery of a novel paradigm for nanotechnology, enabling the translation of noble metal nanomaterials to clinics to treat carcinomas in a less-invasive and more-efficient manner. This Review covers the recent progresses related to this exciting approach. The most-significant nanoarchitectures designed with the ultrasmall-in-nano approach are discussed, and perspectives on these nanoarchitectures are provided.

Biodegradable hollow silica nanospheres containing gold nanoparticle arrays

A protocol to synthesize novel inorganic nanosystems that could avoid the issue of persistence/accumulation in organisms is presented.

Landfill wall revegetation combined with leachate recirculation: a convenient procedure for management of closed landfills

There is a need for a reliable sustainable option to effectively manage the landfill leachate generation. This study presents a simple procedure for the revegetation of the walls of closed landfills, employing the leachate as a fertirrigant. The native plants Lepidium sativum, Lactuca sativa, and Atriplex halimus, which suit the local climate, were chosen for this study in Southern Italy. The methodology was structured into three phases (i) early stage toxicity assessment phase (apical root length and germination tests), (ii) adult plant resistance assessment phase, and (iii) soil properties verification phase. The rationale of the proposed approach was first to look at the distinctive qualities and the potential toxicity in landfill leachates for fertigation purposes. Afterwards, through specific tests, the plants used were ranked in terms of resistance to the aqueous solution that contained leachate. Finally, after long-term irrigation, any possible worsening of soil properties was evaluated. The results demonstrated the real possibility of using blended leachate as a fertigant for the revegetation of the walls of closed landfills. In particular, the plants maintained good health when leachate was blended at concentrations of lower than 25 and 5%, respectively for A. halimus and Lepidium sativum. Irrigation tests showed good resistance of the plants, even at dosages of 112 and 133.5 mm m(-2), at maximum concentrations of 25 and 5%, respectively, for A. halimus and Lepidium sativum. The analysis of the total chlorophyll content and of aerial parts dried weight confirmed the results reported above.

Removal of nalidixic acid and its degradation products by an integrated MBR-ozonation system

Chemical-biological degradation of a widely spread antibacterial (nalidixic acid) was successfully obtained by an integrated membrane bioreactor (MBR)-ozonation process. The composition of the treated solution simulated the wastewater from the production of the target pharmaceutical, featuring high salinity and a relevant concentration of sodium acetate. Aim of treatment integration was to exploit the synergistic effects of chemical oxidation and bioprocesses, by adopting the latter to remove most of the COD and the ozonation biodegradable products. Integration was achieved by placing ozonation in the recirculation stream of the bioreactor effluent. The recirculation flow rate was three-fold the MBR feed, and the performance of the integrated system was compared to the standard polishing configuration (single ozonation step after the MBR). Results showed that the introduction of the ozonation step did not cause relevant drawbacks to both biological and filtration processes. nalidixic acid passed undegraded through the MBR and was completely removed in the ozonation step. Complete degradation of most of the detected ozonation products was better achieved with the integrated MBR-ozonation process than using the sequential treatment configuration, i.e. ozone polishing after MBR, given the same ozone dosage.

Removal of organics and degradation products from industrial wastewater by a membrane bioreactor integrated with ozone or UV/H₂O₂ treatment

The treatment of a pharmaceutical wastewater resulting from the production of an antibacterial drug (nalidixic acid) was investigated employing a membrane bioreactor (MBR) integrated with either ozonation or UV/H(2)O(2) process. This was achieved by placing chemical oxidation in the recirculation stream of the MBR. A conventional configuration with chemical oxidation as polishing for the MBR effluent was also tested as a reference. The synergistic effect of MBR when integrated with chemical oxidation was assessed by monitoring (i) the main wastewater characteristics, (ii) the concentration of nalidixic acid, (iii) the 48 organics identified in the raw wastewater and (iv) the 55 degradation products identified during wastewater treatment. Results showed that MBR integration with ozonation or UV/H(2)O(2) did not cause relevant drawbacks to both biological and filtration processes, with COD removal rates in the range 85-95%. Nalidixic acid passed undegraded through the MBR and was completely removed in the chemical oxidation step. Although the polishing configuration appeared to give better performances than the integrated system in removing 15 out of 48 secondary organics while similar removals were obtained for 19 other compounds. The benefit of the integrated system was however evident for the removal of the degradation products. Indeed, the integrated system allowed higher removals for 34 out of 55 degradation products while for only 4 compounds the polishing configuration gave better performance. Overall, results showed the effectiveness of the integrated treatment with both ozone and UV/H(2)O(2).

Biodegradability of pharmaceutical industrial wastewater and formation of recalcitrant organic compounds during aerobic biological treatment

The biodegradability of different wastewater samples originated from the industrial production of three pharmaceuticals (naproxen, acyclovir, and nalidixic acid) was performed through the standard Zahn-Wellens test. Moreover, the wastewater composition before and during the test was evaluated in terms of parent compounds and main metabolites by LC/MS, and the biodegradability of the parent compounds was also assessed by performing extra Zahn-Wellens tests on synthetic solutions. The results, besides showing the relatively good biodegradability of acyclovir and naproxen, evidenced the masking role of the organic matrices, especially in the case of nalidixic acid. The latter compound showed to be recalcitrant and persistent, despite the apparently good performance of the Zahn-Wellens test. Deeper evaluation evidenced that the biodegradation of high concentrations of organic solvents and other biodegradable compound tended to "hide" the lack of removal of the target compound.

Effective organics degradation from pharmaceutical wastewater by an integrated process including membrane bioreactor and ozonation

The enhanced removal of organic compounds from a pharmaceutical wastewater resulting from the production of an anti-viral drug (acyclovir) was obtained by employing a membrane bioreactor (MBR) and an ozonation system. An integrated MBR-ozonation system was set-up by placing the ozonation reactor in the recirculation stream of the MBR effluent. A conventional treatment set-up (ozonation as polishing step after MBR) was also used as a reference. The biological treatment alone reached an average COD removal of 99%, which remained unvaried when the ozonation step was introduced. An acyclovir removal of 99% was also obtained with the MBR step and the ozonation allowed to further remove 99% of the residual concentration in the MBR effluent. For several of the 28 organics identified in the wastewater the efficiency of the MBR treatment improved from 20% to 60% as soon as the ozonation was placed in the recirculation stream. The benefit of the integrated system, with respect to the conventional treatment set-up was evident for the removal of a specific ozonation by-product. The latter was efficiently removed in the integrated system, being its abundance in the final effluent 20-fold lower than what obtained when ozonation was used as a polishing step. In addition, if the conventional treatment configuration is employed, the same performance of the integrated system in terms of by-product removal can only be obtained when the ozonation is operated for longer than 60 min. This demonstrates the effectiveness of the integrated system compared to the conventional polishing configuration.

Ischaemic stroke, factor V Leiden heterozygosity and left atrial thrombosis in sinus rhythm: a case report

We describe a 63-year-old man in sinus rhythm (SR) with an ischaemic stroke involving basal ganglia region on the right side. The patient was known to be heterozygous for factor V Leiden (FVL) mutation. On diagnostic work-up, no arterial sources of embolism were found. Transoesophageal echocardiography evidenced a left atrial (LA) thrombosis without relevant cardiopathies. LA thrombosis is generally associated to atrial fibrillation, atrial enlargement, mitral valve stenosis and left ventricular dysfunction, whereas mitral regurgitation is considered protective. To our knowledge, this is the first report of cardioembolic stroke related to a LA thrombosis in a patient in SR without risk factors for thrombus formation except for FVL heterozygosity.

Neurology and the soul: from the origins until 1500

The mind-brain dichotomy recalls the soul-body duality and the tendency to individualize in the nervous system a location for the soul. In this paper, the author analyses some of the principal theories which attribute the soul to a cerebral location, from the origins until the year 1500.

Motor evoked potentials in the post-surgical follow-up of cervical spondylotic myelopathy

Eighteen patients (6 female, 12 male; average age 51 years, range 37-79) with clinical and radiological evidence (MRI) of cervical spondylotic myelopathy (CSM) were examined. The subjects were divided into two groups depending on whether radiology indicated single level (9 patients) or multilevel (9 patients) compression of the cervical cord. All of the patients underwent surgical decompression. Seriate exam with trans-cranial magnetic stimulation was performed in double session before surgery, and 3 and 12 months after surgery. The follow-up study of these patients revealed a statistically significant neurophysiological improvement only in those patients with single-level compression. In these cases, the cervical cord pathology revealed by MRI signal hyperintensity in T2 may at least partially consist of an edematous component and/or an initial demyelinization that has still a chance of recovery. In patients with multilevel damage, the compression may cause irreversible lesions.

"The moon" and "the blood": two emblematic symbols in headache and epilepsy according to scientific traditions of the Salerno Medical school and popular medicine in southern Italy

Before describing the state of knowledge on headache and epilepsy at the Salerno Medical School (SMS), we will briefly summarize in the first part its history through the centuries until the "golden period" of the 12th century when it reached its peak by outshining all others in teaching, studies and research. In the second part we will refer to Saint Donato, healer of epileptics in the south of Italy, whose worship is still alive today. The finding of common symbols in conceptions of headache and epilepsy, both in the scientific tradition of the School and in popular medicine, represents a link which is explicable by the wide dissemination of the school's doctrines.