A pilot study of lncRNAs expression profile in serum of progressive multiple sclerosis patients.

OBJECTIVE: Multiple Sclerosis (MS) is an inflammatory and neurodegenerative disease that affect both white and gray matter. The relapsing and the eventually progressive course of MS is heterogeneous; thus, a confident long-term prediction of individual prognosis is not possible yet. Recent studies have demonstrated the role of long non-coding RNA (lncRNAs) as potential biomarkers that could provide information to predict disease activity and progression. PATIENTS AND METHODS: By qRT-PCR, we analysed the lncRNAs expression in the serum of 16 secondary progressive MS (SP-MS), 12 primary progressive (PP-MS) patients and 8 healthy controls. RESULTS: We found that TUG1 was upregulated in SP-MS, while the comparison of PP-MS vs. controls showed a downregulation of non-protein coding RNA 188 (LRRC75A-AS1) and a significant upregulation of two lncRNAs: long intergenic non-protein coding RNA 293 (LINC00293) and RP11-29G8.3. Moreover, we performed an in-silico analysis using DIANA-LncBase v2 and HMDD v3.0 software, in order to predict the possible interaction of these four lncRNAs with miRNAs. We identified 21 miRNAs prediction targets possibly involved in MS. CONCLUSIONS: Our data indicate a regulatory function of these lncRNAs in autoimmune and inflammatory processes related to MS suggesting their potential role in progressive MS pathogenesis.

Arthrodesis of the ankle joint in septic osteoarthritis: six years long term outcomes in authors' personal experience.

OBJECTIVE: Our goal was to evaluate the long-term clinical outcome of ankle arthrodesis, obtained by an extramedullary internal fixation with or without bone-grafting in the treatment of ankle' septic arthritis. PATIENTS AND METHODS: All patients treated with arthrodesis by extramedullary internal fixation for septic arthritis of the ankle joint between January 2011 and December 2016 in the same hospital were included in our retrospective study. Patients were followed-up for a minimum of two years. To evaluate the quality of life, each patient filled in a short form of the physical and mental health summary scale and a visual analogue scale for pain. For the functional evaluation, the American Orthophaedic Foot and Ankle Society Score was used. Demographics and clinical data, including perioperative and postoperative complications, were evaluated. RESULTS: From January 2011 to December 2016, we performed 57 arthrodeses of the ankle joint with cannulated screws in 52 patients. Mean age was 52 years old. 48 patients (92%) had post-traumatic septic arthritis. The most frequently isolated pathogens were Staphylococcus aureus and Pseudomonas aeruginosa. 48% of patients reported a postoperative complication after three months; the most commonly reported complications were weight bearing ankle-foot pain (27%) and surgical wound dehiscence (12.25%). Nonunion was reported only in 8.75% of cases. CONCLUSIONS: Ankle arthrodesis could allow painless gait, improving patients life quality, even after long-term follow-up, and is, therefore, a solution to be considered in patients affected by septic arthritis.

Incidence of cancer in kidney transplantation waiting list patients: a single center experience.

INTRODUCTION: It is widely accepted that the risk of malignancies is significantly increased among patients with end-stage kidney disease (ESKD) and after kidney transplantation compared with the general population. Only a few data are available on kidney transplantation waiting list patients. The aim of this study was to investigate solid organ cancer incidence among subjects on the waiting list at a single center. MATERIALS AND METHODS: We retrospectively reviewed the records of all patients enrolled on our kidney transplantation waiting list between August 1, 2008 and July 31, 2010, seeking to evaluate the causes of withdrawal from the list, incidence of cancer, type of neoplasm, and its correlation with clinical features. We estimated the ratio of observed to expected numbers of cancers, the standardized incidence ratio (SIR). RESULTS: Among 1184 patients, we excluded 569 patients from the waiting list including 26 (4.56%) who displayed malignancies. The overall incidence of cancer was 0.11 events/person-months and the overall prevalence of cancer was 2.2%. In 97% of patients, the malignant disease was confined to the primitive organ of origin without secondary dissemination. We observed a prevalence of cancers related to ESKD (17; 65.38%). The SIR for all cancer types in our population compared with the general population was 2.22. The SIR for native kidney and thyroid cancers among our population compared with the general population was >10. CONCLUSION: The incidence of cancer was significantly increased among kidney transplantation waiting list patients compared with the general population. Our study highlighted the importance of a careful, targeted neoplastic screening. It could be particularly important for ESKD-related malignancies like native kidney tumors or thyroid cancers.

A very early and acute renal impairment due to polyomavirus allograft nephropathy.

Polyomavirus-associated nephropathy (PVAN) has become an important cause of graft loss in the last few years. The typical course of PVAN is characterized by an asymptomatic period of viruria followed, within weeks, by the development of viremia in the context of stable renal function. The persistence of viral replication characterized by high viremia, leads to parenchymal injuries and causes the development, within months, of PVAN that could lead to deterioration in graft function and graft loss. We reported, in a patient who received a renal transplant, an unusual presentation of PVAN characterized by the development of acute renal failurte earlier than would be expected after transplantation, where the histological presentation alone could be confused with an acute rejection. We underline the importance of the association of histological findings with the viral load in urine and blood and with ancillary techniques such as immunohistochemistry and polymerase chain reaction (PCR) in situ for virus detection. We also want to emphasize that decoy cells and PCR for BK virus DNA research could be considered among the diagnostic tools for possible acute renal failure in kidney transplant.