Dynamics of antibiotic resistance genes and presence of putative pathogens during ambient temperature anaerobic digestion.

AIMS: This study was focused on evaluating the persistency of antimicrobial resistance (AR) genes and putative pathogenic bacteria in an anaerobic digesters operating at mesophilic ambient temperature, in two different year seasons: summer and winter. METHODS AND RESULTS: Abundance and dynamic of AR genes encoding resistance to macrolides (ermB), aminoglycosides (aphA2) and beta-lactams (blaTEM -1 ) and persistency of potentially pathogenic bacteria in pilot-scale anaerobic digesters were investigated. AR genes were determined in the influent and effluent in both conditions. Overall, after 60 days, reduction was observed for all evaluated genes. However, during the summer, anaerobic digestion was more related to the gene reduction as compared to winter. Persistency of potentially pathogenic bacteria was also evaluated by metagenomic analyses compared to an in-house created database. Clostridium, Acinetobacter and Stenotrophomonas were the most identified. CONCLUSIONS: Overall, considering the mesophilic ambient temperature during anaerobic digestion (summer and winter), a decrease in pathogenic bacteria detection through metagenomic analysis and AR genes is reported. Although the mesophilic anaerobic digestion has been efficient, the results may suggest medically important bacteria and AR genes persistency during the process. SIGNIFICANCE AND IMPACT OF THE STUDY: This is the first report to show AR gene dynamics and persistency of potentially pathogenic bacteria through metagenomic approach in cattle manure ambient temperature anaerobic digestion.

Multiple oral and cerebral relapses of a Granular cell tumor (Abrikossoff Tumor) in a young girl affected by congenital dyserythropoietic anemia type II.

CASE REPORT: A 14-year-old girl presented with 1 cm large whitened lesion on the ventral surface of the tongue, appeared from 1 month. Past history showed congenital dyserythropoietic anemia type II. The lesion was excised and microscopic and immunohistochemical analyses were compatible with benign Abrikossoff tumor. Total body MRI was negative. After six months the patient presented a second tongue lesion and four months later another large painful lesion in the soft palate, with the same istological diagnosis. In addition, she had other multiple lesions: two apperead at pharyngeal level (not biopsied) that remain stable over time, and one at the pituitary gland. CONCLUSION: Granular cell tumors, with or without multiple lesions, are rare in children. About 50% of cases involve the head and neck region, with the tongue being the most affected site. Therapy is based on the surgical excision of the lesions; however some tumor forms, although their histological aspect of benignity, often have an important infiltrative power, making the therapeutic approach difficult, as in our case.

The Italian version of the Unité Rhumatologique des Affections de la Main (URAM) for Dupuytren's disease: The URAM-I(10).

Introduction: Several general hand functional assessment tools for Dupuytren's disease have been reported, but none of the patient-reported-outcome measures specific to Dupuytren's disease-associated disabilities are available in the Italian language. The purpose of this study was to culturally adapt the Unité Rhumatologique des Affections de la Main (URAM) into Italian (URAM-I) and determine its measurement properties. Methods: Cross-cultural adaptation was performed according to the current guidelines. Construct validity (convergent and divergent validity) was measured by comparing the URAM-I with the Pain-Rated Wrist/Hand Evaluation (PRWHE-I), Short-Form 36 (SF-36-I) scale and finger range of motion, respectively. Factor analysis was used to investigate the URAM-I's internal structure. Reliability was assessed by internal consistency (Cronbach's alpha) and test-retest reliability by Intra-Class Correlation Coefficient (ICC). Results: This study included 96 patients (males = 85%, age = 66.8 ± 9.3). Due to the cultural adaptation, we divided the original item #1 into two separate items, thus generating the URAM-I(10). Convergent validity analysis showed a strong positive (r = 0.67), significant (p < 0.01) Pearson's correlation with the PRWHE-I. Divergent validity analysis showed a weak, negative (r < 0.3) and not significant correlation with the SF-36-I subscales, except for the physical pain subscale (r = -0.21, p < 0.05). Factor analysis revealed a 2-factor, 4-item solution that explained 76% of the total variance. The URAM-I(10) demonstrated high internal consistency (α = 0.94) and high test-retest reliability (ICC = 0.97). Conclusion: The URAM-I(10) demonstrates moderate construct validity, high internal consistency and test-retest reliability, and showed a 2-factor internal structure. Its evaluative use can be suggested for the Italian Dupuytren's population.

Extramedullary hematopoiesis in the facial sinus in a patient homozygous for Hemoglobin Lepore: the first case in literature.

Extramedullary hematopoiesis (EMH) is a proliferation of hematopoietic tissue outside the bone marrow. The most affected areas are paravertebral ones. We report the case of a patient with homozygous Hb Lepore, not regularly transfused since the age of four years until the age of 29 years, when paravertebral heterotopic masses were first observed. After about 10 years she started reporting clinical signs suggestive of sinusitis. Computed tomography (CT) and Magnetic Resonance Imaging (MRI) showed heterotopic masses in the ethmoid and in the frontal sinuses. Involvement of the sinuses of the large facial area represents a rare localization of EMH. Various cases have been reported in patients with thalassemia intermedia, but no case has been reported with HbLepore. The diagnostic gold standard is MRI, which provides highly accurate and clear images. The treatment is based on hydroxyurea and/or an intensive transfusional regime and sometimes on surgery.

Transcripts with splicings of exons 15 and 16 of the hMLH1 gene in normal lymphocytes: implications in RNA-based mutation screening of hereditary non-polyposis colorectal cancer.

Germline mutations of the hMLH1 gene are estimated to account for a large fraction of kindreds affected by hereditary non-polyposis colorectal cancer (HNPCC). In a significant number of cases, hMLH1 mutations result in the expression of truncated proteins. We report here two novel alternatively spliced forms of hMLH1 mRNA in normal lymphocytes. One of these novel isoforms lacks the coding region of the gene between codons 557 and 578, corresponding to the entire exon 15. The deletion introduces a frameshift that results in a premature stop signal. The other isoform is characterised by an in-frame deletion spanning codons 578-632, corresponding to loss of the entire exon 16. Further studies are necessary to establish the biological significance of these alternative splicings. The presence of alternatively spliced hMLH1 transcripts that mimic pathogenic mutations should be taken into account in the mutational screening of the hMLH1 gene by reverse transcription-polymerase chain reaction methodologies.

Magnetic resonance imaging in the diagnosis of melanoma: in vivo preliminary studies with dynamic contrast-enhanced subtraction.

The aim of this study was to analyse the potential of fast dynamic subtraction magnetic resonance (MR) imaging in differentiating in vivo melanomas from benign melanocytic lesions. Dynamic MR imaging was performed after intravenous administration of gadopentetate dimeglumine (Gd-DTPA) in 18 patients with melanocytic skin lesions. Using a post-processing algorithm, time-signal intensity curves were obtained for the lesions and classified according to their shapes as type I (steady enhancement increase), type II (plateau of signal intensity) or type III (wash-out of signal intensity). Other parameters evaluated for their potential to differentiate melanomas from benign lesions were the enhancement rate (percentage of signal intensity increase) in the first minute after Gd-DTPA administration, the peak value of the enhancement rate, and the wash-out slope. The pigmented lesions were then surgically excised and the MR results compared with the histological assessment. In melanomas, the mean value of the enhancement rate in the first minute was 611%, whereas in benign lesions it was 131% (P = 0.001). The distribution of curve types was also different: seven of the nine naevi showed type I curves, while eight of the nine melanomas displayed a type III curve. In addition, distinctive wash-out dynamics were observed: the enhancement rate began to decrease between the first and third minutes for melanomas, but continued to increase until the sixth minute for naevi (P = 0.000). These findings, which are most likely related to the neoangiogenesis present in melanomas, indicate that dynamic MR imaging can be helpful in the differential diagnosis of pigmented skin lesions.

Mutational analysis of OB gene in obese and type 2 diabetes affected subjects.

Peripheral blood DNA from 12 subjects affected by familial obesity and from 35 subjects affected by type 2 diabetes were analysed for mutations in the coding sequence of the OB gene. Mutational analysis, conducted using the single strand conformation polymorphism (SSCP) technique, followed by direct sequencing did not reveal the presence of nucleotide variants in the coding region of the OB gene. The lack of mutations in the coding sequence is consistent with previous data suggesting that mutations in the coding sequence of the OB gene are not common in human familial obesity. In 2 samples displaying a non-informative pattern of SSCP and in 8 additional samples the nucleotide sequence of portion of the intron 2 bordering the coding sequence of exon 2 identified a G in the positions +14IVS and +18IVS, according to a sequence reported previously, but in contrast with some others. All samples were homozygous for these intron variants.

[Syndrome of catecholamine hypersecretion secondary to a jejuno-ileal bypass]. / Sindrome da iperincrezione catecolaminica secondaria a by-pass digiuno-ileale.

Hypersecretion of catecholamine primarily affecting adrenaline levels arose in a patient given a jejunoileal bypass for severe obesity. Apart from organic factors, including a hetero and/or orthotopic pheochromocytoma and the therapeutic effect of beta-blocking drugs, it is suggested that the pathogenesis of the patient's condition is based on a hypersecretion of VIP, as sometimes occurs in patients with short intestine/syndrome.

[Changes in some plasma parameters in the course of dextran 40]. / Sulle modificazioni di talune varianti plasmatiche in corso di terapia perfusionale con Dextran 40

Changes in certainplasma parameters (Hc, arterial and venous VP, creatinine clearance, potassium, PA and FC) induced by Dextran 40 perfusions (500 ml at 40 drops/min and 250 ml at 20 drops/min) were examined in 50 patients. The expander effect was more intense, though less protracted when the larger quantity was used. A rebound effect 24 hr after the test was also more frequent percentage-wise in this group. Significant changes in Hc were not observed for 24 hr and 96 hr respectively with the higher and the lower dose. The venous district was primarily concerned. There were also increases in blood potassium, FC and max PA, while min PA and blood proteins fell. No relation could be demonstrated between creatinine clearance and diuresis at the end of the test with respect to the amount of Dextran employed. None of these latter modifications was significant. There were no signs of intolerance.

[Relations between athero-arteriosclerosis and chronic liver diseases. Anatomopathological and statistical studies]. / Sui rapporti tra atero-arteriosclerosi ed epatopatie croniche. Indagine anatomopatologica e statistica.

Starting from well known anatomopathological premises and on the basis of relative physiopathological concepts, particularly lipid metabolism and the lipidaemic fractions in patients suffering from chronic hepatopathy and athero-arteriosclerosis, a statistical investigation was carried out into the relations between the two disease conditions on the basis of the anatomopathological material collected over a period of six years in the S. Giovanni and S. Giacomo Hospitals in Rome. The conclusion is that there is a smaller incidence of athero-arteriosclerotic pathology in patients suffering from chronic hepatopathy up to the sixth decade of life.

Digestibilidade da matéria seca de silagens de milho e de suplementos concentrados determinada por procedimentos in vitro / Dry matter digestibility of corn silages and concentrates determined by in vitro procedures

Compararam-se os valores de digestibilidade in vitro da matéria seca (DIVMS) de quatro silagens de milho e de seis concentrados (três proteicos e três energéticos), determinados pelo método de dois estádios realizados em tubos individuais ou em equipamento automatizado de fermentação, e avaliou-se a ocorrência de efeito associativo na digestão de alimentos destas três classes incubadas em um mesmo jarro de fermentação da incubadora in vitro, ou em jarros diferentes contendo a mesma classe de alimentos. Utilizou-se delineamento inteiramente ao acaso, em esquema fatorial 3 x 3 (procedimentos in vitro x classes de alimentos). Os valores de DIVMS determinados pelo método dos tubos foram mais próximos dos relatados na literatura e menores (P<0,02) que os obtidos pelos procedimentos automatizados. Não houve diferença (P>0,05) nos valores de DIVMS dos concentrados e das silagens de milho incubados no mesmo jarro de fermentação da incubadora ou, separadamente por alimento, em jarros diferentes.

The values of in vitro dry matter digestibility (IVDMD) of four corn silages and six concentrates (three proteic and three energetics) were determined by the two-stage technique that utilizes individual digestion tubes and by an automatic equipment of fermentation (filter bag technique). It was also evaluated the associative effect on digestion of these three food classes when incubated in the same fermentation jar of the "in vitro incubator" and when in different vessels containing the same class of foods. The experimental design was completely randomized in a 3 x 3 factorial arrangement (in vitro procedures x food classes). The IVDMD values determined in tubes were closer to those found in the literature and lower (P<0.02) than those obtained by the automatic procedure. No differences were found (P>0.05) in IVDMD of concentrates and silages when incubated together in the same fermentation jar or separated by food classes in separated jars.

Pattern sensitivity to boundary and initial conditions in reaction-diffusion models.

We consider Turing-type reaction-diffusion equations and study (via computer simulations) how the relationship between initial conditions and the asymptotic steady state solutions varies as a function of the boundary conditions. The results indicate that boundary conditions which are nonhomogeneous with respect to the kinetic steady state give rise to spatial patterns which are much less sensitive to variations in the initial conditions than those obtained with homogeneous boundary conditions, such as zero flux conditions. We also compare linear pattern predictions with the numerical solutions of the full nonlinear problem.