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.
COMBINATION OF AMPLATZER VASCULAR PLUG 4 IN OCCLUSION OF THE LEFT VERTEBRAL ARTERY, WITH MICROSPHERES PLUS COILS FOR EMBOLIZATION OF THE DEEP CERVICAL BRANCHES FOR PRESURGICAL TREATMENT OF A HYPERVASCULAR C-5 METASTASIS: CASE REPORT AND REVIEWWritten by Antonio Basile et al.
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.
CHILD ABUSE IN A MEDICAL SETTING: CASE ILLUSTRATIONS OF TWO VARIANTS OF MUNCHAUSEN SINDROME BY PROXY.Written by Antonietta Lanzarone et al.
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 ofMSbP, 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. Asrecently 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.
ACETYL-L-CARNITINE AFFECTS THE ELECTRICAL ACTIVITY OF MECHANOSENSORY NEURONS IN HIRUDO MEDICINALIS GANGLIAWritten by Giovanna Traina et al.
Was previously discovered that in the leech Hirudo medicinalis, acetyl-l-carnitine (ALC) affects forms of non-associative learning, such as sensitization and dishabituation, due to nociceptive stimulation of the dorsal skin in the swim induction behavioural paradigm, likely through modulating the activity of the mechanosensory tactile (T) neurons, which initiate swimming. Since was found that ALC impaired sensitization and dishabituation, both of which are mediated by the neurotransmitter serotonin, the present study analyzed how ALC may interfere with the sensitizing response. Was already found that ALC reduced the activity of nociceptive (N) neurons, which modulate T cell activity through serotonergic mediation.