Impact of Sarcopenia on Clinical Outcomes of Patients Undergoing Simultaneous Liver and Kidney Transplantation: A Cohort Study

International audience; Background: The impact of sarcopenia in patients undergoing simultaneous liver and kidney transplantation (SLKT) has not been fully delineated. The aim of this single-centre-cohort-study was to evaluate the impact of sarcopenia on the clinical outcomes. Methods: Between 2003 and 2018, 79 patients underwent SLKT. Sarcopenia was assessed via the total psoas muscle area (TPA) at the level of the 3rd. lumbar vertebra. Sarcopenia threshold was TPA < 1460 mm2 (women) and <1560 mm2 (men). We identified post-operative biliary, vascular and digestive complications. Survival analysis was performed by the Kaplan Meier method (log-rank test). Results: We included 43/79 SLK…

Confronto dei livelli di organoclorurati in esemplari di Thunnus thynnus allevati e selvatici

Food web reconstruction gives evidence of increased trophic levels in no-trawl areas: the red mullet, Mullus barbatus L. case in northern Sicily

This study was aimed at identifying the food web of the red mullet, Mullus barbatus in order to understand how it is affected by trawling disturbance. To achieve this objective: a) the main features of the red mullet habitat were investigated; b) the food web of this habitat was studied in two no-trawl areas and in two areas open to trawling. The working hypothesis is that trawling affects the biochemistry of the sediment and the trophic structure of the benthic assemblage. It was predicted: a) less biomass, smaller size and higher production rate in the benthic assemblages of protected gulfs; b) higher average trophic level for both the red mullet and its predators in protected gulfs; c) a…

Neuroimmaging in childhood central nervous system tuberculosis

Potential of the polychaete Sabella spallanzanii as bioindicator for PHAs

Every year 230.000 t of polycyclic aromatic hydrocarbons (PHAs) enter the marine environment, resulting ubiquitously distributed world‐wide. These compounds are aromatic molecules of special concern because of their toxic and carcinogenic properties. The two main sources of PHAs in the environment are fossil fuels, mainly crude oil, and the incomplete combustion of organic materials such as wood, coal and oil. They enter the sea by both atmospheric and aquatic routes. As a consequence of their hydrophobic nature, in aquatic environments PHAs rapidly tend to associate with particulate matter and sediments represent the most important reservoir. Animal and aquatic plants can accumulate PHAs f…

Multiple pulmonary and multivesicular interatrial septum hydatid cysts in a native italian patient

Multivesicular, pulmonary and cardiac hydatidosis are rarely observed and can give rise to serious complications. Cysts can remain asymptomatic for a long time, until they reveal themselves perforating into cardiac chambers and/or pulmonary arteries or the systemic circulation. A rare case of multivesicular interatrial septum hydatid cyst with multiple pulmonary involvement in a native Italian farm labourer is reported. Clinical, radiological, serological and histological findings are described. MR imaging showed the exact anatomic location and the multivesicular nature of the cardiac cyst and was useful in planning surgical treatment. A successful outcome was achieved with a combination of…

Agriculture:Monitoring the effects on humans and various agricultural plants of air pollution by particulate with trace metals.

Agriculture:Monitoring the effects on humans and various agricultural plants of air pollution by particulate with trace metals

Features in tubercular meningoencephalitis diagnosis: 18 childhood cases

The aim of this research is to illustrate clinical and instrumental features of central nervous system tuberculosis (CNS-TB) in childhood in order to allow prompt diagnosis and adequate patient management. TB remains one of the most important communicable diseases and represents a major global health problem. Although pulmonary TB tends to be the most common form of the disease, the highest mortality and morbidity occurs with TB of the central nervous system (CNS-TB), which develops in 4% of children with tuberculosis. It has a high fatality rate and causes serious sequelae, especially during childhood. CT and MR imaging studies of 18 patients (11 female, 7 male, mean age 45.72 months) were…

Biochemical genetic differentiation between Pomatoschistus marmoratus and P. tortonesei (Pisces, Gobiidae).

Several diagnostic genetic markers were identified in Pomatoschistus marmoratus and P. tortonesei using polyacrylamide gel electrophoresis (PAGE) of allozymes. Twenty-one loci were resolved, including the electrophoretic pattern of muscle proteins. The MDH*, PGM- 1,2*, EST-1,2*, FUM* and PGI-2* loci exhibited different alleles which were fixed for the two species being analysed. Genetic distance, as calculated by Nei’s index, showed a value of 0·413. Environmental hypersalinity, could have influenced the geographical distribution of P. tortonesei.

High liver RBP4 protein content is associated with histological features in patients with genotype 1 chronic hepatitis C and with nonalcoholic steatohepatitis.

Abstract Background and aim To investigate the hepatic expression of retinol-binding protein-4 (RBP4) in chronic hepatitis C (CHC) and nonalcoholic steatohepatitis (NASH) patients, and its association with biochemical and histological patterns of liver damage. Materials and methods Sixty-six genotype 1 CHC and 32 NASH patients were tested for hepatic RBP4 expression. Liver expression at immunostaining was scored as 0 (slight), 1 (mild), 2 (moderate), and 3 (intense). In addition, the mRNA and the quantitative protein expressions of RBP4 were tested by PCR and by western blot, respectively, in 12 NASH and 28 CHC patients. Twelve subjects undergoing elective cholecystectomy served as controls…

Tuberculosis of the central nervous system in children: 32 years survey.

Aim. In order to study the impact of clinical and diagnostic parameters on the clinical outcome of children with central nervous system tuberculosis (CNS-TB), we retrospectively reviewed all cases of CNS-TB diagnosed over a 32-year period at the Children's Hospital of Palermo, Italy. Methods. Data were collected with regard to the clinical, laboratory and demographic characteristics of patients, as well as the results of radiological investigations and data on clinical outcome. In relation to the date of introduction of new diagnostic methods (indirect as well direct) and to the change of treatment periods, the authors compared the clinical outcome of patients admitted prior and after 1984.…

Retinol-binding protein 4 (RBP4) : a new marker of G1 HCV-induced steatosis

The trophic structure of the pipefish community (Pisces: Syngnathidae) from a western Mediterranean seagrass meadow based on stable isotope analysis

Syngnathus abaster andSyngnathus typhle (Pisces: Syngnathidae) from a dense Cymodocea nodesa meadow in the western Mediterranean Stagnone di Marsala (Italy) were studied using δ13N and δ15N analysis. Because of the presence of these two species in the same habitat and the specialized parental care by the male, the effect of species and sex on the isotopic composition was also studied to investigate the different feeding strategies between and within species.S. abaster andS. typhle exhibited enriched13C and15N values throughout the sampling period (mean ±SE, δ13C =−10.5±1.8‰ and−10.8±2.0‰, δ15N=11.9±0.7‰ and 10.6±1.0%., respectively), suggesting that these species receive their energy mainly…

Picco plus monitoring haemodynamic parametres in critically ill patients

Survival of patients treated with sorafenib for hepatocellular carcinoma recurrence after liver transplantation: A systematic review and meta-analysis

Background: Data on survival and safety of sorafenib for hepatocellular carcinoma recurrence after liver transplant are still equivocal. Aim: We performed a meta-analysis of published studies, with the aim of estimating the 1-year rates of survival, analysing the variability in survival rates and, finally, identifying the factors associated with a longer survival. Methods: Data from 8 of the 17 selected studies were pooled, while the other 9 were excluded because survival rates were missing. All included studies were retrospective. Results: Overall, the 1-year survival ranged from 18% to 90%. Tumour progression was the main cause of death. The second cause was bleeding, reported only in pat…

Methylenetetrahydrofolate reductase homozygosis and low-density lipoproteins in patients with genotype 1 chronic hepatitis C

Summary.  Methylenetetrahydrofolate reductase status, homocysteine and lipoproteins levels have been associated with severity of disease and both rapid and sustained virological response (SVR) in patients with genotype 1 chronic hepatitis C (CHC). We aimed to assess the association of homocysteine and MTHFR status with serum cholesterol levels and their potential links to both histological findings and virological response, in patients with genotype 1 hepatitis C virus (HCV). A total of 119 consecutive patients were evaluated by biopsy and metabolic measurements. A total of 103 healthy blood donors were used as controls. Serum homocysteine and MTHFR C677T mutation were also evaluated. All p…

Retinol-binding protein 4: a new marker of virus-induced steatosis in patients infected with hepatitis C virus genotype 1.

Retinol-binding protein 4 (RBP4) is an adipocytokine associated with insulin resistance (IR). We tested serum levels of RBP4 to assess its link with steatosis in patients with genotype 1 chronic hepatitis C (CHC) or nonalcoholic fatty liver disease (NAFLD). Nondiabetic patients with CHC (n = 143) or NAFLD (n = 37) were evaluated by liver biopsy and anthropometric and metabolic measurements, including IR by the homeostasis model assessment. Biopsies were scored by Scheuer classification for CHC, and Kleiner for NAFLD. Steatosis was tested as a continuous variable and graded as absent-mild <30%, or moderate-severe > or =30%. Thirty nondiabetic, nonobese blood donors served as controls. …

Comparison of transient elastography and acoustic radiation force impulse for non-invasive staging of liver fibrosis in patients with chronic hepatitis C .

Transient elastography (TE) is adequate for a diagnosis of cirrhosis, but its accuracy for milder stages of fibrosis is much less satisfactory. The objective of this study was to compare the performance and the discordance rate of acoustic radiation force impulse (ARFI) and TE with liver biopsy in a cohort of chronic hepatitis C (CHC) patients.One hundred thirty-nine consecutive patients with CHC were enrolled in two tertiary centers, and evaluated for histological (Metavir score) and biochemical features. All patients underwent TE and ARFI.TE was unreliable in nine patients (6.5%), while in no cases (0%) were ARFI invalid measurements recorded (P=0.029). By area under receiver operating ch…

Influence of environmental and farm conditions on Dicentrarchus labrax L.reared in three different fish farms

IFNL3/4 genotype is associated with altered immune cell populations in peripheral blood in chronic hepatitis C infection

Single-nucleotide polymorphisms near the interferon lambda 3 (IFNL3) gene predict outcomes to infection and anti-viral treatment in hepatitis C virus (HCV) infection. To identify IFNL3 genotype effects on peripheral blood, we collected phenotype data on 400 patients with genotype 1 chronic hepatitis C (CHC). The IFNL3 responder genotype predicted significantly lower white blood cells (WBCs), as well as lower absolute numbers of monocytes, neutrophils and lymphocytes for both rs8099917 and rs12979860. We sought to define the WBC subsets driving this association using flow cytometry of 67 untreated CHC individuals. Genotype-associated differences were seen in the ratio of CD4CD45RO+ to CD4CD4…

Carotid atherosclerosis and chronic hepatitis C: A prospective study of risk associations

BACKGROUND AND AIMS: There are contrasting results in studies of cardiovascular risk in patients with genotype 1 chronic hepatitis C (G1 CHC). We evaluated the prevalence of carotid atherosclerosis compared with a control population in order to assess the potential association between atherosclerosis, host and viral factors, and liver histological features. MATERIALS AND METHODS: One hundred seventy-four consecutive biopsy-proven G1 CHC patients were evaluated by anthropometric and metabolic measurements. One hundred seventy-four patients attending an outpatient cardiology unit were used as controls. Intima-media thickness (IMT) and carotid plaques, defined as focal thickening of > 1.3 mm a…

Platelet Activity in Relation to Smoke and Exercise in Patients with Chronic Obstructive Lung Disease: Effects of Platelet Antiaggregating Drugs

Lung tissue is involved in the synthesis and/or metabolism of many vasoactive substances such as histamine, serotonin, dopamine, norepinephrine, bradikinin, angiotensin II and prostaglandins (1).

Retinol-binding protein 4 (RBP4): A new marker of G1 HCV-induced steatosis

The new Lessepsian entry Brachidontes pharaonis (Fischer P., 1870) (Bivalvia, Mytilidae) in the western Mediterranean: A physiological analysis under varying natural conditions

The feeding behavior of Brachidontes pharaonis (Mollusca, Bivalvia), a new Lessepsian entry in the western Mediterranean, living in a cooling vat of a saltworks system in western Sicily, was assessed by estimating its physiological rates throughout a 6 month-long study (May 1998 to March 1999). Clearance, filtration, ingestion, and food absorption rates were estimated using the biodeposition method and the results correlated to variations in temperature, salinity, and quality and quantity of available food. Measured seston concentrations were on average 81.5 ± 95.5 mg L-1, its labile fraction (estimated as the sum of particulate lipids, carbohydrates and proteins) was on average 0.55 ± 0.07…

Nosocomial colonization due to imipenem-resistant Pseudomonas aeruginosa epidemiologically linked to breast milk feeding in a neonatal intensive care unit.

Aim: We describe a one-year investigation of colonization by imipenemresistant, metallo-β-lactamase (MBL) producing Pseudomonas aeruginosa in a neonatal intensive care unit (NICU) of the University Hospital of Palermo, Italy. Methods: A prospective epidemiological investigation was conducted in the period 2003 January to 2004 January. Rectal swabs were collected twice a week from all neonates throughout their NICU stay. MBL production by imipenem-resistant strains of P aeruginosa was detected by phenotypic and molecular methods. Pulsed field gel electrophoresis (PFGE) was carried out on all isolates of P aeruginosa. The association between risk factors and colonization by imipenem-resistant…

Consequences of Extended Spectrum Beta-Lactamase-Producing Enterobacteriaceae and Methicillin-Resistant Staphylococcus aureus Carriage in Awaiting Liver Transplant Patients.

Infections in patients with cirrhosis are associated with liver-related complications (LRCs), especially in patients awaiting liver transplantation (LT). The aim of this study was to evaluate the impact of methicillin-resistant Staphylococcus aureus (MRSA) and extended spectrum beta-lactamase colonization on infections and LRCs for patients on the wait list and on infections after LT. We retrospectively included 250 of 483 patients with cirrhosis who were placed on the wait list for LT from December 2015 to January 2018. These patients were screened for MRSA or extended spectrum beta-lactamase–producing Enterobacteriaceae (ESBLE) at the time of wait-list placement and after LT. Of the patie…

Vitamin D levels and IL28B polymorphisms are related to rapid virological response to standard of care in genotype 1 chronic hepatitis C.

Background Genotype 1 (G1) chronic hepatitis C (CHC) patients achieving a rapid virological response (RVR) on pegylated interferon (PEG-IFN) plus ribavirin have a high chance of sustained virological response (SVR), influenced by IL28B status, viral load, fibrosis and insulin resistance. We assessed whether 25-hydroxyvitamin D (25[OH]D) serum levels are linked to RVR and can be used together with IL28B to construct a pretreatment model to predict RVR. Methods A total of 117 consecutive patients with G1 CHC were evaluated by biopsy and anthropometric and metabolic measurements. 25(OH)D serum levels were measured by HPLC. IL28B rs12979860 and rs8099917 polymorphisms were also evaluated. All p…

The trophic role of the macrophyte Cymodocea nodosa (Ucria) Asch. in a Mediterranean saltworks: Evidence from carbon and nitrogen stable isotope ratios

A multiple stable isotope analysis (δ13C and δ15N) was used to determine the trophic role of the seagrass Cymodocea nodosa (Ucria) Asch. for consumers in a Mediterranean saltworks. Stable carbon and nitrogen isotope ratios performed on primary producers and consumers in February and July 1999 showed that C. nodosa is not a direct dietary source via grazing. No animal presented carbon values as enriched as the seagrass (-7.8‰). The trophic role of Cymodocea occurs through the detritus route via SOM. Sedimentary organic matter (SOM) (δ13C = -16.5‰) seems to be a mixture of particulate organic matter (δ13C = -19.0‰), algae (δ13C = -18.6‰) and seagrass detritus (δ13C = -7.7‰). The results of a …

Acquatina Lagoon: a model ecosystem to study community patterns

Acquatina is a small lagoon ecosystem (0.45 km2) located on the Adriatic coast only 5 km north of Lecce (Italy). The lagoon has a freshwater input in the northern part and a connection with the sea at the south edge, being characterised by a latitudinal gradient of salinity and an internal patchiness of habitats. Here, we have used the lagoons as a model to study the influence of these sources of variation on the spatial distribution of macrobenthis and fish fauna, using both taxonomic and on taxonomic descriptors. Results showed a non random distribution of both species and functional traits of macroinvertebrate and fish fauna within the lagoon, despite the relatively small surface area. S…

751 RETINOL-BINDING PROTEIN 4 (RBP4): A NEW MARKER OF G1 HCV-INDUCED STEATOSIS

Fatal Pulmonary Hemorrhage Through Fiberoptic Broncoscopy in a Well Controlled Diabetic Female With Mucormycosis

A rare case of invasive pulmonary mucormycosis complicated by fatal massive haemoptysis through bronchoscopy in a patient with a well controlled diabetes is reported. Histological features of infection are reported and the characteristic aspects of the staining are discussed. Fiberoptic bronchoscopy revealed bilateral obstruction of the segmental bronchi and fatal massive bleeding occurring because of biopsy sampling. Caution is warranted in the use of bronchoscopy sampling in patients with radiological features of cavitated lesions of fungal origins. Better preventive and early therapeutic antifungal treatments are needed to avoid this serious complication.

A Biochemical Genetic Study of Isoenzyme Polymorphism within and between Two Populations of Atherina Boyeri Risso

Allozymic variation of 20 loci was investigated in two samples of Atherina boyeri collected in the Mediterranean Sea from the coast of Trappeto and Marsala Lagoon (Sicily, Italy). Five loci were polymorphic (PGM*, EST-1,2*, SOD-2*, PGI-2*) and appeared to be in Hardy-Weinberg equilibrium. A significant Fst mean value (0.02) (G = 23.77, P < 0.05, df = 5) showed that the samples can be considered as two distinct local populations and supports previous morphometric discrimination.

Diagnostic problems and postnatal follow-up in congenital toxoplasmosis

Aim. In order to assess the consequences of different clinica] approaches in the prenata] management of congenital toxoplasmosis, we retrospectively reviewed 58 pregnant women with Toxoplasma seroconversion and prospec­ tively enrolled their 59 infants, referred to us from 1999 to 2004. Metbods. Data on clinica!, laboratocy and de­ mographic characteristics of the pregnant women were collected. Their children were entered intoa 48-month follow-up progcamme in which clinica , instrumental, ophthalmo­ logic and serologic evaluations were carried out at birth, at 1, 3, 6, 9, 15, 18, 24, 36 and at 48 months of life. Paediatric treatment with Spiramycin alone or alternated with Pyrime­ thamine-S…

INVASIVE FUNGAL INFECTIONS IN INTENSIVE CARE UNIT

Invasive fungal infections (IFI) is associated with a high mortality rate, specially in patients with delayed beginning of antifungal treatment...

Multiclass HCV resistance to direct-acting antiviral failure in real-life patients advocates for tailored second-line therapies

Background & Aims: Despite the excellent efficacy of direct-acting antivirals (DAA) reported in clinical trials, virological failures can occur, often associated with the development of resistance-associated substitutions (RASs). This study aimed to characterize the presence of clinically relevant RASs to all classes in real-life DAA failures. Methods: Of the 200 virological failures that were analyzed in 197 DAA-treated patients, 89 with pegylated-interferon+ribavirin (PegIFN+RBV) and 111 without (HCV-1a/1b/1g/2/3/4=58/83/1/6/24/25; 56.8% treatment experienced; 65.5% cirrhotic) were observed. Sanger sequencing of NS3/NS5A/NS5B was performed by home-made protocols, at failure (N= 200) and w…

Clinical implications of the hyperdynamic syndrome in cirrhosis.

Abstract The hyperdynamic syndrome is a late consequence of portal hypertension in cirrhosis. The principal hemodynamic manifestations of the hyperdynamic syndrome are high cardiac output, and increased heart rate and total blood volume, accompanied by reduced total systemic vascular resistance. Pathophysiology involves a complex of humoral and neural mechanisms that can determine hemodynamic changes, and lead to hyperdynamic circulation. In this review we focus our attention on the manifestations of the hyperdynamic syndrome. Some of these are well described and directly related to portal hypertension (varices, ascites, hepatic encephalopathy, and hepatorenal syndrome), while others, such …

Stagnone di Marsala, Sicily – Italy.