Chronic hyperglycemia and intracranial meningiomas.

Meningiomas are among the most common primary tumors of the central nervous system. Previous research into the meningioma histological appearance, genetic markers, transcriptome and epigenetic landscape has revealed that benign meningiomas significantly differ in their glucose metabolism compared to aggressive lesions. However, a correlation between the systemic glucose metabolism and the metabolism of the tumor hasn't yet been found. We hypothesized that chronic levels of glycaemia (approximated with glycated hemoglobin (HbA1c)) are different in patients with aggressive and benign meningiomas. The study encompassed 71 patients with de novo intracranial meningiomas, operated on in three European hospitals, two in Croatia and one in Spain. Our results show that patients with WHO grade 2 meningiomas had significantly higher HbA1c values compared to patients with grade 1 lesions (P = 0.0290). We also found a significant number of patients (19/71; 26.7%) being hyperglycemic, harboring all the risks that such a condition entails. Finally, we found a significant correlation between our patients' age and their preoperative HbA1c levels (P = 0.0008, ρ(rho) = 0.388), suggesting that older meningioma patients are at a higher risk of having their glycaemia severely dysregulated. These findings are especially important considering the current routine and wide-spread use of corticosteroids as anti-edematous treatment. Further research in this area could lead to better understanding of meningiomas and have immediate clinical impact.

[THROMBOPROPHYLAXIS IN PATIENTS WITH NONVALVULAR ATRIAL FIBRILLATION ADMITTED IN UNIVERSITY HOSPITAL SPLIT, CROATIA, DUE TO THE ISCHAEMIC STROKE IN RELATION TO THROMBOEMBOLIC AND BLEEDING RISK].

Aim of the study was to assess the concordance of the thromboprophylactic treatment in patients with nonvalvular atrial fibrillation (nAF) at the time of admission due to ischemic stroke with clinical guidelines of the European Society of Cardiology. METHODS: In the cross-sectional study were included 327 patients [143 (44%) males] treated because of ischemic stroke associated with nAF. The index of the thromboembolic risk (TE) has been established by the CHA2DS2-VASc score, whereas the bleeding risk has been assessed by the HAS-BLED score. RESULTS: Before the ischemic stroke, 98.2% of patients belonged to the group of high TE risk. Among these patients only 179 (55%) were received thromboprophylaxis: 67.5% patients acetylsalicylic acid, 30.5% warfarin, and 4% clopidogrel. Previous ischemic stroke was independently correlated with warfarin administration (OR 2.5; 95% Cl 1.4-4.5; p=0.003), while poorly controlled arterial hypertension was independently correlated with warfarin non-administration (OR 0.47; 95% Cl 0.25-0.88; p=0.019). The 83.7% of 55 patients, who experienced ischemic stroke during anticoagulant treatment, had an INR values lower than therapeutic. CONCLUSION: Thromboprophylaxis among the patients with nAF admitted because of ischemic stroke did not correlate with their TE risk and contemporary guidelines of the European Society of Cardiology.

Glycemia and coagulation in patients with glioblastomas.

Glioblastomas are among the most malignant tumors which, despite aggressive treatment, currently have an abysmal prognosis. These lesions are known to cause local and systemic perturbations in the coagulation system, leading to neo-angiogenesis and a high risk of venous thromboembolism. Indeed, there have been multiple proposals of the coagulation system being a possible target for future treatment of these patients. However, non-selective anticoagulant therapy has proven suboptimal and leads to a significant increase of intracranial hemorrhage. Thus, recognizing factors which lead to hyper-coagulation is considered paramount. Hyperglycemia is a well-known pro-thrombotic factor, a fact which has received little attention in neuro-oncology so-far. We previously hypothesized that patients with brain tumors could be highly susceptible to iatrogenic glycemia dysregulation. Here, we analyzed the connection between glycated hemoglobin (HbA1c) and the routine coagulation markers (D-dimers, prothrombin time (PT) and activated partial thromboplastin time (aPTT)) in patients with de novo intracranial glioblastomas. Included in this study were 74 patients, operated on in three hospitals, Clinical Hospital Dubrava, Zagreb, Croatia; University Hospital Center Split, Split, Croatia and University Hospital de la Princesa, Madrid, Spain. We found a significant inverse correlation between HbA1c and aPTT (ρ=-0.379; P=0.0009). We also found a significant inverse correlation between Ki67 immunoreactivity and aPTT (ρ=-0.211; P=0.0082). No connection was found between HbA1c and D-dimers or PT. Our results suggest that hyperglycemic patients, with a more proliferative glioblastoma, could in fact have their coagulation profile significantly disrupted, primarily through the intrinsic coagulation pathway. Such findings could have great clinical importance. Further research in this area could help elucidate the vicious connection between glioblastomas and coagulation, and help combat the deadly disease.

Assessment of seabed litter in the Northern and Central Adriatic Sea (Mediterranean) over six years.

Seabed debris is much less investigated in respect to the sea surface and shores due to sampling difficulties and costs. However, detecting marine benthic litter is fundamental for developing policies aimed at achieving the Good Environmental Status in European Seas by 2020, as requested by the Marine Strategy Framework Directive. This study estimates seafloor litter abundance, composition, spatial distribution and main sources in the North-Central Adriatic Sea (FAO GSA 17) over a six-year period (2011-2016) with 67 stations sampled per year, representing the longest data set for the basin. Litter items collected using a "rapido" trawl were classified in six major categories. The average density of the litter collected over six years was 102.66 ±â€¯41.91 kg/km2. The highest concentration of litter was found in stations close to the coast within 30 m depth with a mean weight of 142.90 ±â€¯27.20 kg/km2, while the lowest value was recorded between 30 and 50 m of depth (41.12 ±â€¯9.62 kg/km2). Plastic was dominant followed by metal and other litter materials. Lost fishing nets and mussel culture debris accounted for 50% of the overall plastic litter collected. These data and the systematic monitoring of marine litter provide useful information to implement necessary measures to manage marine litter and minimize this type of anthropogenic pollution in the Adriatic region.

Non-indigenous macrozoobenthic species on hard substrata of selected harbours in the Adriatic Sea.

The intense shipping traffic characterising the Adriatic Sea favours the spread of marine organisms. Yet, a study of 12 Adriatic ports (4 on the western side and 8 on the eastern side of the basin) found that non-indigenous species (NIS) accounted for only 4% of the benthic communities settled on hard substrates. The cirripeds Amphibalanus amphitrite and Balanus trigonus, found in 8 harbours, were the most common invaders followed by Amphibalanus eburneus, the ascidian Styela plicata, and the bivalve Magallana gigas. The highest percentage of NIS was recorded in Venice and Ploce, the harbours with the least rich native communities; the lowest percentage was retrieved in Trieste, Koper, Pula, and Rijeka, the harbours hosting the highest species diversity. In contrast, the ports of Bari and Ancona showed both high NIS percentages and highly diversified communities.

First freshwater coralline alga and the role of local features in a major biome transition.

Coralline red algae are significant components of sea bottom and up to now considered as exclusively marine species. Here we present the first coralline alga from a freshwater environment, found in the Cetina River (Adriatic Sea watershed). The alga is fully adapted to freshwater, as attested by reproductive structures, sporelings, and an inability to survive brackish conditions. Morphological and molecular phylogenetic analyses reveal the species belongs to Pneophyllum and is described as P. cetinaensis sp. nov. The marine-freshwater transition most probably occurred during the last glaciation. The brackish-water ancestor was preadapted to osmotic stress and rapid changes in water salinity and temperature. The particular characteristics of the karst Cetina River, such as hard water enriched with dissolved calcium carbonate and a pH similar to the marine environment, favoured colonization of the river by a marine species. The upstream advance and dispersal is facilitated by exceptionally pronounced zoochory by freshwater gastropods. Pneophyllum cetinaensis defies the paradigm of Corallinales as an exclusively marine group.

Spatial pattern and weight of seabed marine litter in the northern and central Adriatic Sea.

The present study analyzes spatial distribution and typology of marine litter on the seabed in the FAO Geographical Sub-Area 17 (northern and central Adriatic Sea). Two surveys were conducted during fall 2011 and 2012 and 67 stations were sampled each year. Litter items were collected using the "rapido" trawl, a modified beam trawl commonly used by the Italian fishermen to catch flat fish and other benthic species. Marine litter in the catches was sorted and classified in 6 major categories (plastic, metal, glass, rubber, wood, other). Plastic litter was further subdivided in 3 sub-categories based on its source: fishing nets, aquaculture nets and other. Plastic was dominant in terms of weight followed by metal and other categories. The highest concentration of litter was found close to the coast likely as a consequence of high coastal urbanization, river inflow and extensive navigation associated with the morphological and hydrological features of the basin.