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.
ASSOCIATION OF THREE POLYMORPHISMS IN RP1 HOTSPOT REGION IN SICILIAN PATIENTS WITH RETINITIS PIGMENTOSA: PRELIMINARY DATAWritten by Elvira Velardi et al.
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.
MOTIVATIONAL ASPECTS AND LEVEL OF SATISFACTION OF ITALIAN JUNIOR DOCTORS WITH REGARD TO KNOWLEDGE AND SKILLS ACQUIRED ATTENDING SPECIFIC GENERAL PRACTICE TRAINING COURSES. A NATIONAL WEB SURVEYWritten by Walter Mazzucco et al.
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.
ROLE OF CCR5 -2150 A>G AND Δ32 POLYMORPHISMS IN RHEUMATOID ARTHRITIS: A CASE-CONTROL STUDY IN A SICILIAN POPULATIONWritten by Simona Alibrandi
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 an 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.