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Rheumatoid Retinitis pigmentosa (RP) is the most common inherited retinal dystrophy affecting peripheral visual field

and usually culminates in complete blindness. Among mutations in 73 genes implicated in RP pathogenesis, those in  

RP1 gene are inherited in autosomal recessive or dominant fashion. In RP Sicilian patients, we detected 3

polymorphisms in RP1 exon 4 hotspot region, not known to be associated with RP disease. Here, their frequency

in Sicilian populations was assayed in order to detect possible association with RP. Samples from 220 unrelated

healthy donors born and living in Sicily for at least two generations and 50 RP patients from Messina were

screened. Frequencies of all three polymorphisms in RP patients from Messina were about twice those observed

in the healthy controls from the same town and the overall Sicilian population. An association between 3

polymorphisms and RP was suggested, although their role in other related disorders cannot be excluded.

The demographic and epidemiological transitions resulted in a pressing need to reformulate the health workforce demand

and to revise pre- and post-graduate training to prepare the medical profiles to meet the new health needs focused on

chronic diseases. The Italian Junior Doctors Association and the Giotto Movement carried out a web survey to identify

the motivational aspects and the level of satisfaction of Italian junior doctors regarding knowledge and skills acquired

after attending the General Practitioners’ specific training (GP-ST). Three-hundred-forty-seven General Practitioners (GPs),

302 trainees and 45 newly qualified trainees answered a web questionnaire. Significant differences (p-value= 0.018)

were documented between the two groups regarding the level of satisfaction on the GP-ST. The analysis by geographic

macro-areas of the answers given by the 302 trainees showed a heterogeneous level of overall satisfaction

(p-value= 0.005). In conclusion, the evidence provided by this cross-sectional study support the proposal to evolve

the GP-ST regional courses into general practice and primary care specialization schools.

Human immunodeficiency virus (HIV) causes a sexually transmitted disease (STD) affecting the human immune system.

It is mainly transmitted through sexual intercourse, blood transfusions, hypodermic needles, and parenterally.

Multiple actions can be taken to prevent the spread of HIV/AIDS, such as condom and sterile needle use and

HIV testing for pregnant women. This study aims to assess freshmen students’ awareness, knowledge, attitudes,

and behavioral perceptions regarding HIV/AIDS at Oakland University (OU) in Michigan.

This study is a cross-sectional survey targeting freshman students at OU. The questionnaire is comprised of

seven sections including demographics, risk perception, protection measures, alcohol tendencies, health-seeking

behaviors, culturally sensitive issues, and methods of dissemination of information. The mean age of

respondents was 20. The majority of respondents knew that HIV is transmitted sexually (98%) and by

sharing needles (98%). Many misconceptions about transmission of HIV were expressed by 53%.

Data showed that while there was good knowledge regarding HIV transmission and prevention, some

misconceptions still prevailed. Our results indicate the need to develop educational programs with

specific interventions to raise awareness about preventive measures, clear misconceptions, and promote

healthy lifestyle in order to prevent new HIV infections among young college students.

Rheumatoid arthritis (RA) is an inflammatory joint disorder whose progression leads to destruction of cartilage and bone.

Chemokines, molecules able to induce chemotaxis in inflammation, are involved in RA pathogenesis. Aim of this study

was to determine whether -2150 A>G and delta32 (Δ32) polymorphisms in the chemokine receptor 5 (CCR5) confer

susceptibility to rheumatoid arthritis. Polymorphisms were assessed in 70 seropositive RA patients and 200 healthy

individuals of Messina and province.  About -2150 A>G polymorphism, a significant increase in AG genotype frequency

was observed in controls than in patients, despite a not significant difference in allelic frequencies. Conversely,

allelic and genotypic frequencies related to Δ32 polymorphism were significantly higher in controls group than

in patients. Furthermore, in the patient group no individuals with Δ32/Δ32 genotype were found. These results

suggest that CCR5 polymorphisms seem to play an important role in susceptibility to RA exerting a protective role

in the disease.

Crohn's disease (CD) is a type of inflammatory bowel disease (IBD) and its etiology is multifactorial and involves a

combination of genetic and environmental factors. The interaction of these factors causes an imbalance in the

microbiota, leading to the activation of several immunological and inflammatory mechanisms. From an

immunological point of view, there seems to be an involvement of the TIM-3/galectin-9 pathway and

of the autoregulation of LyTh1. The studies show that in patients with CD the autoregulation of LyTh1 is lost due

to a reduced concentration of galectin-9 and a reduced TIM-3 expression in LyTh1. This could be one of the

 reasons for the state of perpetual activation in LyTh1, resulting in the chronic inflammatory process.

Clinical use of Amplatzer Vascular Plug in central and peripheral vascular system has been extensively described in the

literature. We present a case of occlusion of  left vertebral artery (LVA) performed by deploying an Amplatzer Vascular

Plug, in addition to microspheres plus coils for embolization of the deep cervical branches that feed a cervical metastasis

involving the left VA. After the endovascular intervention, the patient underwent surgical resection of the lesion.

The application of the device, the use of multiple embolic materials, as well as the angiographic and clinical

results of the procedure, were evaluated because not previously reported in the literature. 

Hence, we provide an updated literature review about clinical use of Amplatzer Vascular Plug in supra-aortic vessels.

Positive airway pressure is the treatment of choice among obstructive sleep apnea syndrome patients.

Among surgical options, multilevel approach is a good option in patients with an involvement of all tract

of first airway. The aim of the present work is to establish the efficacy of anterior palatoplasty in the

treatment of selected patients with mild obstructive sleep apnea syndrome or simple snoring, within a

multilevel surgery. The group was composed of 16 mild obstructive sleep apnea syndrome adult patients

collected from January 2015 to June 2016 at University of Palermo, Ear, Nose and Throat Department. To

make diagnosis of obstructive sleep apnea syndrome, we employed polysomnography, the Epworth

Sleepiness Scale and an endoscopic study of aerodigestive tract in order to identify the sites of collapse.

All patients underwent to inferior turbinate reduction, anterior pharyngoplasty and hyoid suspension. After

treatment, 11 patients had Apnea Hypopnea Index ≤5 and 4 patients less than 50% compared to the

starting one. According to Epworth Sleepiness Scale, the daytime sleepiness enhanced from 12.6 to 8.6

post-operative average. Pre-operative mean value of Muller’s maneuver was N (nose):2.6, O (oropharinx):

3.4, H (hypopharinx):2.5 Before performing surgical procedure each patient was subjected to sleep

endoscopy to evaluate better the pattern of collapse. The post-operative mean outcomes of Mueller’s

Maneuver was: N 1.5, O 1.3, H 1.3. Barbed Anterior pharyngoplasty, combined with other surgical

procedures, can be considered a valid surgical option to relieve snoring, and mild apnoic events. Our

preliminary results, show that the anterior palatoplasty, combined with other surgical procedures, can be

considered a valid surgical option to relieve snoring and mild apnoic events.

Several lines of evidence showed that apoptosis rate of cumulus cells in oocytes derived by assisted

reproductive technologies could be used as an indicator of fertilizing gamete quality. Aim of the study

was to investigate the effects of three different ovarian stimulation protocols on the biological and clinical

outcome in hyporesponder patients. Collected data showed a higher significant rate of DNA fragmentation

index (DFI) in U group (patients treated with Highly Purified human Menopausal Gonadotrophin) than in

P group (treated with recombinant human Follicle Stimulating Hormone (r-hFSH) combined with

recombinant human Luteinizing Hormone (r-hLH)). Both groups R (treated with r-hFSH alone) and P

showed a significant increase in collected and fertilized oocytes number, embryo quality number. This

study showed that combined r-hFSH/r-hLH therapy could represent the best pharmacological strategy for

controlled ovarian stimulation and suggests to use DFI as a biomarker of ovarian function in

hyporesponder patients.

Munchausen syndrome is a complex type of abuse, which is often underdiagnosed or misdiagnosed in

clinical practice, and has harmful consequences for children. Its relationship with child abuse, of which it

is a variety, must be recognized in clinical and forensic practice. The authors report herein two observed

cases of different types of Münchausen syndrome by proxy (MSbP). The first, is the most severe form of

MSbP, with induced, true illness and related pathological symptoms into victim. The second case is a

moderate form, much more complex to detect, in which a perpetrator parent simulates and aggravates the

child‘s illness. Adequate training of health professionals and investigators is essential in revealing cases of

MSbP. Diagnosis must be based on the study of the different forms of "abuse" and the knowledge of

clinical protocols used to validate any suspected behaviour which could be potentially harmful to the

child. Moreover, a lack of training may lead to misleading interpretations of medical history interpretation

and fallacious conclusions. Our study aims to review the features that are to be considered in a suspected

case of MSbP, in accordance with a recently updated consensus statement by the Committee on Child

Abuse and Neglect from the American Academy of Pediatrics.

Gene expression in mammalians is a very finely controlled mechanism, and bidirectional promoters can be

considered one of the most compelling examples of the accuracy of genic expression coordination. As

recently reported, a bidirectional promoter regulates the expression of the PDCD10(whose mutations

cause familial Cerebral Cavernous Malformations (CCMs) and SERPINI1 gene pair, even though they are

non-homologous genes. The aim of this study was to identify any potential common roles of these two coregulated

genes. An in-silico approach was used to identify functional correlations, using the BioGraph,

IPA® and Cytoscape tools and the KEGG pathway database. The results obtained show that PDCD10 and

SERPINI1 may co-regulate some cellular processes, particularly those related to focal adhesion

maintenance. All common pathways identified for PDCD10 and SERPINI1 are closely associated with the

pathogenic characteristics of CCMs; we thus hypothesize that genes involved in these networks may

contribute to the development of CCMs.

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