Genetic testing is a medical tool employed to screen changes in genes linked to cancer and other genetic diseases. Genetic tests are available for breast, ovarian, colon, thyroid, and some other cancers and they represent the main tool for early identification of the “risk” subjects. The choice to undergo genetic testing by a healthy or affected cancer patient with family history of the cancer has to be the fruit of a careful and prudent assessment of the advantages and disadvantages discussed during oncogenetic counselling. The latter, in turn, in the case of a patient's positive and informed choice, must constantly affiliate the genetic testing, in order to preserve the prediction and information role of the test as much as possible.
Allergic rhinitis is a common problem increasing greatly over the past three decades. Several studies have found a possible link between dyslipidemia and allergic disease but the relating causal mechanisms remain elusive. The aim of this study is to investigate the association between blood lipid levels and the presence of allergic rhinitis. A multicentre prospective study was carried out on 160 allergic rhinitis patients and 160 volunteers as a control according to age, gender, body mass index (BMI) values and full blood lipid profile. A possible correlation between abnormal dyslipidemia parameters and the severity of allergic rhinitis was studied too. Demographic characteristics didn’t differ between groups. While levels of LDL-C, total cholesterol, as well as TC/HDL ratio and LDL/HDL ratio, were significantly higher (p<0.001) in patients with allergic rhinitis, there was a positive correlation between abnormal dyslipidemia parameters and moderate/severe allergic rhinitis symptomatology ( p<0.001). We support the hypothesis that dyslipidemia might play a role in in the manifestation of allergic rhinitis.
The hyoid bone is the only "suspended bone" in our body, and its suspension system has an important role in posture maintenance. We studied postural modification in a group of patients affected by Obstructive Sleep Apnea Syndromewho had undergone surgical treatment including hyoid suspension. The surgical procedure performed was section of supra- and infrahyoid muscle and mobilization of the hyoid bone through its suspension to the thyroid cartilage. We studied the postural changes with stabilometric tests. In the early post-operative (one week) follow-up, we performed a posturography test with closed eyes and occlusal disjunction, and saw a worsening of the average parameter of the centre of pressure with antero-posterior oscillations. However, we would like to highlight that by the time of the one year follow up, a compensatory mechanism had been established which allowed for a return to normal hyoid bone kinematics.
The aim of the study was to evaluate individual inflammatory response after inguinal hernioplasty by measuring baseline and post-operative serum IL-6 response to surgery and quantifying the variability of the serum response in a homogeneous group of patients.Patients enrolled in the study underwent inguinal hernioplasty. Blood samples were used to analyze serum IL-6, TNF-alpha, LOOH and GSH levels. To identify high and low IL-6 responders, patients were divided into 2 groups according median values of the peak levels of IL-6. Mean levels of the cytokine were comparable at baseline but reached peak at 6 h and persisted elevated at following hours among high responders whereas remained significantly lower over time among low responders.Patients identified as low responders showed not significant changes in serum IL-6 levels over the post-operative period. In contrast, high responders demonstrated a significant response reaching the peak level of IL-6 after 6 hours post operation.
During the summer of 2016, a group of students from the University of Palermo attending the second year of medicine school took part in a four week course of Whole Cadaveric Dissection at the University of Malta. Within this project, we students worked on a male cadaver by using a surgical kit, taking care to record everything with pictures and videos. In this way, every structure was isolated and studied in comparison with the anatomic atlas’ pictures. The aim of this article is to show the dissection method of the brachial plexus that we used. We started removing cutis and subcutis, then we identified the muscles’ origin and insertion; after isolating vascular-nervous structures, we finally exposed nerves, cords, trunks and roots of brachial plexus by using blunt dissection method.
In recent years, the number of contrastographic exams has increased considerably, compared to an increase in the complications related to this type of interventional approach. A number of specialists (interventional radiologists, cardiologists, vascular surgeons, cardiac surgeons, etc.) have to deal with complications related to the procedure or contrast medium (CM) used. With regard to the latter, contrast induced nephropathy (CIN) is commonly defined as an increase in serum creatinine (sCr) concentration of 0.5 mg / dL or 25% above baseline within 48 h of CM administration. It is the third most common cause of hospital - acquired renal failure, with an incidence rate that varies from 1 to 25% depending on patient comorbidities. It carries with it a lifelong dialysis therapy risk of 0.5 - 2%. CIN is a condition that can affect anyone subjected to a contrastographic exam, although there are groups at increased risk. The purpose of this article is to describe and analyze the methods used for CIN management, and detail the risk factors associated, with particular emphasis on score systems created to categorise patients according to CIN risk after procedure. The aim is also to create an easy and quick tool to guide doctors presented with a patient facing an injection of CM for diagnostic or therapeutic purposes.
STRATEGY FOR IMPROVING ACCESS TO HIV CARE FOR ADOLESCENTS AND YOUTH: THE EXPERIENCE TOOK PLACE IN BEIRA, MOZAMBIQUE.Written by Tiziana Serena et al.
The objective of this paper is to respond to the urgent need for an increase in access to HIV care among adolescents and young people in Sub-Saharan Africa. Since 2014, doctors with Africa CUAMM in collaboration with UNICEF have been supporting specific ambulatories for the youth population (between the ages of 10- 24) aiming to improve health education, specifically in relation to HIV prevention. Mozambique has the eighth highest prevalence of HIV in the world. It represents one of the six countries in which half of the adolescents living with HIV reside. Beira is Mozambique’s second largest city, and in 2009 it had the most women and men between the ages of 15-49 were living with HIV. This study retrospectively analyzes data collected between 2013 and 2014, which described the impact of a new health service in a low resource setting with high HIV prevalence. The specificity of the service, only dedicated to young people, is the basis for this paper. We observed a significant increase in counseling in 2014 compared to 2013 (102,533 vs 63,959, p<0.01), confirming that strengthening specific youth services is an effective intervention for improving access to care of this target population. Youth ambulatories are great instruments to improve access to HIV care among young people.
IS THERE A RATIONALE IN THE USE OF THE BONE STRUT ALLOGRAFT FOR MANAGEMENT AND INTERNAL FIXATION IN PERIPROSTHETIC HUMERAL FRACTURES? A CASE REPORT.Written by Serafino Carta et al.
The gradual increase in shoulder implants has resulted in a parallel increase in periprosthetic fractures of the humerus. Currently, there are no definite certainties about the best methods of treatment and there are no adequate devices to ensure optimal healing. Undoubtedly, the multitude of experience in treating femoral periprosthetic fractures can be a guide used to improve the approach to periprosthetic fractures of the humerus. The use of metallic fixation devices, in combination with bone grafts, could represent a favourable mixed mechanical and biological solution in the treatment of periprosthetic fractures of the humerus. This article presents a case of periprosthetic humeral fracture in a 77-year-old woman with reverse shoulder prosthesis.
Despite the wide spread of many diseases, advancements in genetic engineering have led to considerable improvements in diagnosing these diseases. Therefore, pressure on prospective spouses to undergo premarital medical exams has increased significantly. Many Islamic countries have responded to this emerging need by making some premarital screening tests compulsory for a marriage. The adoption of these policies comes from the core message of Islam, which encourages counselling to protect future generations and to guarantee the continuity of worshipping God. However, some people reject the compulsory test, considering them against Islam rules. In this letter to the editor, the authors explore the view of Islam towards premarital medical tests.
EXPERIENCES THAT “REACH THE HEART”. TAKING PART IN A WHOLE BODY DISSECTION COURSE AT THE UNIVERSITY OF MALTAWritten by Pietro Pollara et al.
This article summarizes the activities of the four-week whole body dissection course the main authors participated in in August 2016 at the dissection hall of the University of Malta (UoM). Our team comprised 10 second-year medicine students from University of Palermo chosen among who had passed the Human Anatomy exam brilliantly. The need to move to the UoM to take part in such activity derives from the lack of practice approach in Italian schools of medicine, focused mostly on the theoretical studies, neglecting practical experience. The heart dissection reveal itself as a huge opportunity to finally apply our anatomical knowledge, improving it and enabling us to compare images took from books to the actual organ. We had the chance to handle a real heart, to appreciate its weight and consistence. We took part in coronary artery courses focusing on their functions within the heart machinery.
Glioblastoma (GBM) is the most common and malignant primary brain tumor in adults. The current treatment regimes for glioblastoma demonstrated a low efficiency and offer a poor prognosis. Advancements in conventional treatment strategies have only yielded modest improvements in overall survival. The heat shockproteins, heme oxygenase-1 (HO-1) and Hsp90, serve these pivotal roles in tumor cells and have been identified as effective targets for developing therapeutics. This topic review summarizes the current preclinical and clinical evidences and rationale to define the potential of HO-1 and Hsp90 in GBM progression and chemoresistance.
Cerebral cavernous malformations (CCMs) are benign tumours that affect brain capillaries. Although many cases remain asymptomatic, their incidence is steadily increasing. CCMs can arise sporadically or be inherited as autosomal dominant character. Inherited forms result from mutations at three different loci CCM1/KRIT1, CCM2/MGC4607 and CCM3/PDCD10. Etiology of sporadic forms is still unclear. Among the various molecular mechanisms proposed, presence of somatic mutations was sometimes proven. Here we report results obtained by a molecular screening of the three CCMs genes, performed on both germ-line and somatic DNA, isolated from CCM endothelial cells, in eight patients affected by sporadic lesions, who undergone surgery. Comparison of germ-line and somatic sequencing data, for each patient, showed no differences. Our results confirm that presence of somatic mutations is not sufficient to explain CCMs onset in patients affected by sporadic forms and with no CCM genes germ-line mutations. Other possible pathogenic mechanisms are also discussed.
TIGER NUT (CYPERUS ESCULENTUS): SOURCE OF NATURAL ANTICANCER DRUG? BRIEF REVIEW OF EXISTING LITERATURE.Written by Elom Achoribo et al.
In some parts of the world, Cyperus esculentus L. is widely used as a healthy food for both humans and animals due to their nutritional and functional properties. Current research and reviews on this plant have focused mainly on organoleptic properties, phytochemical compositions, oil content, biochemical activities, and nutritional values. The medicinal properties of Tiger nut are seldom discussed, although its medicinal use is well known in folklore activities. To explore the medicinal properties of Tiger nut, this review tries to investigate the potential anticancer properties of components issued from Tiger nut by reviewing the existing literature in the field. Based on the evidence from the review, it is recommended that there is a need for further investigation into the proposed anticancer properties of Tiger nut.
NATIONAL CONFERENCE OF PUBLIC HEALTH MEDICAL RESIDENTS OF THE ITALIAN SOCIETY OF HYGIENE, PREVENTIVE MEDICINE, AND PUBLIC HEALTH (S.IT.I.) - 4TH EDITIONWritten by Pietro Ferrara et al.
This Edition of the Italian National Conference of the Italian MRPHs (Giornate degli Specializzandi in Igiene e Medicina Preventiva S.It.I.) - the fourth - has been conceived with a new format. The aim of the conference is to represent a constructive opportunity for Public Health Medical Residents to improve their education and knowledge through oral and poster sessions, as well as through interactive discussions with Public Health experts, workshops, and opportunities dedicated to developing relationships and cooperation among Public Health Residents across Europe, thanks to the presence of members of the European Network of Medical Residents in Public Health (EuroNet MRPHs) and European Public Health Association (EUPHAnxt Project). The topics are linked by a central theme designed to acheive a highly valuable exchange of scientific knowledge in the MRPH community.