The impact of mpMRI-targeted vs systematic biopsy on the risk of prostate cancer downgrading at final pathology.

PURPOSE: Although targeted biopsies (TBx) are associated with improved disease assessment, concerns have been raised regarding the risk of prostate cancer (PCa) overgrading due to more accurate biopsy core deployment in the index lesion. METHODS: We identified 1672 patients treated with radical prostatectomy (RP) with a positive mpMRI and ISUP ≥ 2 PCa detected via systematic biopsy (SBx) plus TBx. We compared downgrading rates at RP (ISUP 4-5, 3, and 2 at biopsy, to a lower ISUP) for PCa detected via SBx only (group 1), via TBx only (group 2), and eventually for PCa detected with the same ISUP 2-5 at both SBx and TBx (group 3), using multivariable logistic regression models (MVA). RESULTS: Overall, 12 vs 14 vs 6% (n = 176 vs 227 vs 96) downgrading rates were recorded in group 1 vs group 2 vs group 3, respectively (p < 0.001). At MVA, group 2 was more likely to be downgraded (OR 1.26, p = 0.04), as compared to group 1. Conversely, group 3 was less likely to be downgraded at RP (OR 0.42, p < 0.001). CONCLUSIONS: Downgrading rates are highest when PCa is present in TBx only and, especially when the highest grade PCa is diagnosed by TBx cores only. Conversely, downgrading rates are lowest when PCa is identified with the same ISUP through both SBx and TBx. The presence of clinically significant disease at SBx + TBx may indicate a more reliable assessment of the disease at the time of biopsy potentially reducing the risk of downgrading at final pathology.

Propofol versus sodium thiopentone for the treatment of status epilepticus and refractory status epilepticus in dogs.

AIMS: To compare the effect on mortality and length of hospital stay of propofol with that of sodium thiopentone for the management of dogs with status epilepticus (SE) and refractory status epilepticus (RSE). METHODS: In this cohort study, medical records of a veterinary referral clinic in Argentina were retrospectively searched for dogs that were hospitalised and required induction of therapeutic coma (TC) with either propofol or sodium thiopentone for the management of SE or RSE of any cause. A logistic regression model was performed to evaluate the association between the type of anaesthetic used and in-hospital mortality adjusting for the type of epilepsy (idiopathic, structural, or reactive). Kaplan-Meier estimated survival curves for the length of hospital stay by the type of anaesthetic drug were compared using the log-rank test (deaths were considered censored events). Cox proportional hazards regression was used to estimate hazard ratios for time to hospital discharge, unadjusted and adjusted for type of epilepsy. RESULTS: A total of 24 dogs with SE were included in the study: eight treated with propofol and 16 treated with sodium thiopentone. Four dogs treated with propofol (proportion = 0.50; 95% CI = 0.15-0.84), and eight treated with sodium thiopentone (proportion = 0.50; 95% CI = 0.50-0.74) died during hospitalisation. The median hospitalisation time was 43 (IQR 24-56) hours for dogs that were treated with propofol and 72 (IQR 64-96) hours for dogs that were treated with sodium thiopentone. There was no evidence of a difference in the median duration of TC in dogs treated with propofol (12 (IQR 8-24) hours) or with sodium thiopentone (12 (IQR 7.5-20) hours; p = 0.946). In the logistic regression model, no evidence of association between the anaesthetic protocol for the management of RSE and in-hospital mortality, adjusted for the type of epilepsy, was found (OR 1.09 (95% CI = 0.17-6.87); p = 0.925). Cox regression analysis revealed a difference in the time to hospital discharge, adjusted by the type of epilepsy, between treatment groups (HR = 0.05 (95% CI = 0.01-0.54); p = 0.013). CONCLUSIONS AND CLINICAL RELEVANCE: The time spent in hospital before discharge was longer in dogs with RSE treated with sodium thiopentone compared to those treated with propofol. However, as the sample size was very small, the results obtained in the present study should be analysed with caution. Further studies including a greater number of dogs are required.

Porcine coronary arteries: immunohistochemical profile of TNF-alpha, IL-1beta, TGF-beta1 and ICAM-1.

BACKGROUND: In our study we used immunohistochemical technique to demonstrate the presence of the cytokines tumour necrosis factor alpha (TNF-α), interleukin 1beta (IL-1ß), transforming growth factor beta1 (TGF-ß1) and intercellular adhesion molecule-1 (ICAM-1) in porcine coronaries even in physiological conditions. MATERIALS AND METHODS: Inflammatory cytokines are polypeptide mediators which act as a communication signal between immune system cells and other types of cellsin different organs and tissues, both in human and pig coronary circulation. RESULTS: Our results show that pro-inflammatory cytokines TNF-α, IL-1ß, TGF-ß1 and ICAM-1 are also present in the medium tunica of the coronary arteries under physiological conditions. These results may be compared with those found in coronary atherosclerosis, where the increase in TNF-α has a dramatic effect on the function of the left ventricle, and the high value of IL-1 correlates directly with the extent of myocardial necrosis. In our study we observe the damage and activation of endothelial cells; this induces endothelial dysfunction by accumulation and oxidation of low density lipoproteins (LDL). The formation of oxidized LDL could play a central role in the amplification of the inflammatory response causing an increased expression of pro-inflammatory cytokines which promotes leukocyte recruitment in the intimal layer. These leukocytes, after the adhesion to the endothelium, penetrate the intimate tunic. CONCLUSIONS: Therefore inflammatory processes promote the onset and evolution of atheroma and the development of thrombotic complications.

Twinning as a risk factor for neonatal acute intestinal diseases: a case-control study.

Introduction: Acute intestinal diseases (AID), including necrotizing enterocolitis and spontaneous intestinal perforation, are a group of conditions that typically present in preterm infants, and are associated with an elevated mortality and morbidity rate. The risk factors for these diseases remain largely unknown. The aim of the study is to identify the correlation between twinning and the development of AID. Methods: A single-center retrospective case-control study was conducted. We recruited all infants with a diagnosis of AID, confirmed by anatomopathology, recovered in NICU between 2010 and 2020. Considering the rarity of the outcome, 4 matched controls for each subject were randomly chosen from the overall population of newborns. Odds Ratio (OR) and 95% Confidence Interval (CI) were calculated using a conditional logistic regression model and a multivariate model by the creation of a Directed Acyclic Graph (www.dagitty.net). Results: The study population resulted in 65 cases and 260 controls. The two groups present similar median gestational age and mean birthweight in grams. The cases have a higher frequency of neonatal pathology (defined as at least one of patent ductus arteriosus, early or late sepsis, severe respiratory distress) (84.6% vs. 51.9%), medically assisted procreation (33.8% vs. 18.8%) and periventricular leukomalacia (10.8% vs. 2.7%), and a lower frequency of steroids prophylaxis (67.7% vs. 86.9%). About 50% of cases needed surgery. The OR for the direct effect were difference from one using logistic regression booth without and with repeated measures statements: from 1.14 to 4.21 (p = .019) and from 1.16 to 4.29 (p = .016), respectively. Conclusions: Our study suggests that twinning may be a risk factor for the development of AID. Due to the small number of cases observed, further studies on larger populations are needed.

Controlled Periodic Illumination Enhances Hydrogen Production by over 50% on Pt/TiO2.

Efficient solar water photosplitting is plagued by large overpotentials of the HER and OER. Even with a noble metal catalyst, the hydrogen evolution reaction can be limited by the strong M-H bonding over some metals, such as Pt, Pd, and Rh, inhibiting hydrogen desorption. H absorption is regulated by the potential at the metal nanoparticles. Through controlled periodic illumination of a Pt/TiO2 suspension, we hypothesized a fast variation of the photopotential that induced catalytic surface resonance on the metal, resulting in more than a 50% increase of the efficiency at frequencies higher than 80 Hz.

Measuring Hall viscosity of graphene's electron fluid.

An electrical conductor subjected to a magnetic field exhibits the Hall effect in the presence of current flow. Here, we report a qualitative deviation from the standard behavior in electron systems with high viscosity. We found that the viscous electron fluid in graphene responds to nonquantizing magnetic fields by producing an electric field opposite to that generated by the ordinary Hall effect. The viscous contribution is substantial and identified by studying local voltages that arise in the vicinity of current-injecting contacts. We analyzed the anomaly over a wide range of temperatures and carrier densities and extracted the Hall viscosity, a dissipationless transport coefficient that was long identified theoretically but remained elusive in experiments.

Prospects for the Detection of Electronic Preturbulence in Graphene.

Based on extensive numerical simulations, accounting for electrostatic interactions and dissipative electron-phonon scattering, we propose experimentally realizable geometries capable of sustaining electronic preturbulence in graphene samples. In particular, preturbulence is predicted to occur at experimentally attainable values of the Reynolds number between 10 and 50, over a broad spectrum of frequencies between 10 and 100 GHz.

Caracterización morfológica del músculo bíceps femoral del perro / Morphological characterization of biceps femoris muscle in the dog

A partir de estudios previos realizados sobre la anatomía del musculo bíceps femoral en el perro y con el objetivo de avanzar en la caracterización inmunohistoquímica y nerviosa de este musculo, estudiamos la existencia de subvolúmenes musculares. Utilizamos la disección roma en piezas musculares aisladas fijadas y tratadas con ácido nítrico al 25%. Las divisiones de las ramas del nervio isquiático involucradas fueron utilizadas como guía en la disección. Se determinaron tres subvolúmenes, uno involucrando a la cabeza caudal y dos en el vientre correspondiente a la cabeza craneal que fueron denominados caudal, proximal y distal respectivamente. Realizamos mediciones del largo de las fibras musculares, dirección, dirección y densidad macroscópica de las mismas para caracterizar los compartimientos. Estos subvolúmenes deberán tenerse en cuanta al realizar estudios electromiográficos del musculo bíceps femoral y al evaluar las alteraciones en la locomoción producto de las alteraciones nerviosas y musculares en el nervio pelviano del canino.

From previous studies on the anatomy of the femoral biceps muscle in the dog and with the aim of advancing in immunohistochemical and nervous characterization of this muscle, we studied the existence of subvolumes in muscle structure. We used blunt dissection in isolated muscle pieces fixed and treated with 25% nitric acid. The divisions of the sciatic nerve branches involved were used to guide the dissection. Three subvolumes were identified; one, involving the caudal head, and two in the cranial head belly; they were called caudal, proximal and distal respectively. We measured muscle fiber length, orientation, and macroscopic density to characterize these compartments. These subvolumes must be considered when muscle electromyography research is carried out, and for locomotion changes evaluation due to lesions in nerve and muscle structure of the canine pelvic limb.

Simultaneous pyometra and viable puppies' gestation in a bitch.

Here we describe a case of pyometra coexisting with gestation in a 4.5 year-old miniature short-haired Dachshund. The dog exhibited depression, vaginal discharge, polydipsia and dehydration. Ultrasound examination revealed the presence of low to moderate anechoic fluid collection in the left uterine horn. Blood analysis revealed mild neutrophilia with a left shift. Based on these findings a presumptive diagnosis of pyometra was made and the bitch was treated using amoxicillin-clavulanate with dopaminergic agonist (cabergoline). A second ultrasound scan revealed the presence of two gestational vesicles in the right uterine horn that were successfully carried to term. Unusually, while pyometra persisted in the left uterine horn, two viable puppies were delivered by caesarean section from the right uterine horn.

Parasite assemblages in the Western whip snake Hierophis viridiflavus carbonarius (Colubridae) from southern Italy.

Parasite assemblages of the Western whip snake Hierophis viridiflavus carbonarius were investigated from the Calabria region in southern Italy. A total of 14 parasite taxa including 6 nematodes, 3 acanthocephalans, 2 cestodes, 2 digeneans and a single pentastomid was identified. Within the study area, H. v. carbonarius serves as the final host for seven species of helminths, of which only four (Hexametra quadricornis, Kalicephalus viperae, Paracapillaria sonsinoi and Renifer aniarum) can be considered as snake specialists, while one (Oswaldocruzia filiformis) is shared with other reptiles and amphibians, and two (Paradistomum mutabile and Rhabdias fuscovenosa) with lizards. A large proportion of larval forms of six helminth taxa (about 95% of all helminths collected) was found, for which H. v. carbonarius serves as an intermediate and/or paratenic host; however, adult stages of helminths were prevalent in snakes with snout-to-vent length greater than 70 cm. Our results suggest that ontogenetic and ecological factors should exert a strong influence upon the helminth assemblage of Western whip snakes. We concluded that H. v. carbonarius plays an important role in southern Italy as an intermediate/paratenic host for species of helminths infecting vertebrate groups which may include this snake species within their feeding chain. Eleven taxa, including three potential agents of zoonosis, were added to the poorly known parasite fauna of this host.

Social networks: a new source of psychological stress or a way to enhance self-esteem? Negative and positive implications in bronchial asthma.

The Internet and, in particular, social networks are an increasingly important part of daily life for both adolescents and adults who maintain a virtual relationship with others sharing interests and goals. Very often, they disclose more about themselves online than they do in person. However, cyberbullying and cyberostracism can be problematic for adolescents and sensitive individuals, who might be negatively affected by social networks. Some studies have shown an increased risk of depression, whereas others suggest beneficial effects through enhanced communication, social connection, and self-esteem. Bronchial asthma is an increasingly frequent disease in the industrialized world, and psychological implications play a role in increasing or in reducing its severity. One year after the case report of an asthma exacerbation that may have been triggered by Facebook, it seems reasonable to analyze the effects of social networks on bronchial asthma.

Cyclotron motion in the vicinity of a Lifshitz transition in graphite.

Graphite, a model (semi)metal with trigonally warped bands, is investigated with a magnetoabsorption experiment and viewed as an electronic system in the vicinity of the Lifshitz transition. A characteristic pattern of up to 20 cyclotron resonance harmonics has been observed. This large number of resonances, their relative strengths and characteristic shapes trace the universal properties of the electronic states near a separatrix in momentum space. Quantum-mechanical perturbative methods with respect to the trigonal warping term hardly describe the data which are, on the other hand, fairly well reproduced within a quasiclassical approach and conventional band structure model. Trigonal symmetry is preserved in graphite in contrast to a similar system, bilayer graphene.

Severe infection in a lung transplant recipient caused by donor-transmitted carbapenem-resistant Acinetobacter baumannii.

We describe a case of proven donor transmission of carbapenem-resistant Acinetobacter baumannii, which resulted in severe infectious complications after lung transplantation. A single bla(OXA-23) positive strain, belonging to a new multilocus sequence type (ST231), was isolated from donor and recipient, who died 65 days after transplantation. This report highlights the current challenges associated with the potential transmission of multidrug-resistant infections through organ transplantation.

[Management of workers with psychic disorder in the Salerno Medical Unit]. / La gestione del lavoratore con disagio psichico nell'ASL Salerno.

Within our Medical Unit of Competent Doctor, in the last years we have registered growing number of workers with psychic disorders, which affect, to various degrees, their normal working activity. This fact has required from us a thorough re-consideration of the psycho-social risks related to employment in general, but also of other issues such as the topic of third parties' healthcare assistance as well as the type of role that interested operators are supposed to play in managing people affected by this type of risks. The current work shows the outcome of the survey which was conducted, highlighting the main critical aspects which have emerged in managing workers with psychic disorders.

Helminth community structure of the Mediterranean gull (Ichthyaetus melanocephalus) in Southern Italy.

The helminth community of the Mediterranean gull (Ichthyaetus melanocephalus) from the Calabria region in southern Italy was examined. Ten species of helminths, including 2 cestodes (Alcataenia larina and Tetrabothrius cylindraceus), 4 digeneans ( Aporchis massiliensis , Brachylaima fuscatum, Cardiocephaloides longicollis, and Ornithobilharzia canaliculata), and 4 nematodes (Eucoleus contortus, Capillaria sp., Cosmocephalus obvelatus, and Paracuaria adunca), were found. The Mediterranean gull represents new host records for A. larina, A. massiliensis, B. fuscatum, and E. contortus; all species, except C. longicollis and O. canaliculata, constitute new locality records. The gastrointestinal helminth community of I. melanocephalus consisted of 9 species but, at the infracommunity level, species richness, diversity, and total helminth abundance are among the lowest reported from any gull species. Two cestode species accounted for 81% of all helminth specimens found.

Revisión anatómica del músculo bíceps femoral del canino / Anatomical review of canine biceps femoris muscle

El músculo bíceps femoral (BF) desempeña un rol fundamental en la biomecánica del miembro pelviano de los caninos, actuando en la flexoextensión de la articulación femorotibiorotuliana y la abducción del miembro. La evaluación correcta de su función es importante en la clínica veterinaria. Existen puntos controversiales entre los autores consultados acerca de la morfología de este músculo. El presente estudio tiene como objetivo discutir las distintas descripciones, reparando en las inserciones, la estructura e inervación del músculo. Se han realizado las disecciones bilaterales en 12 animales. La conservación de las piezas se realizó por inmersión en piletas, con una dilución de formol al 10 por ciento y ácido fenico al 4 por ciento en agua. Se utilizaron diferentes técnicas de abordaje al músculo en cuestión, para obtener distintas observaciones de las estructuras. Se halló que el músculo BF se origina por medio de dos cabezas, como queda implícito en su denominación, una cabeza craneal, más voluminosa y una cabeza caudal más pequeña. La primera originada en el ligamento sacrotuberal y en la superficie lateral de la tuberosidad isquiática. La cabeza caudal, se origina de la tuberosidad isquiática. Estas partes a pesar de hallarse estrechamente unidas se individualizan a nivel de los vientres musculares por medio de una delgada lámina de tejido conectivo que se extiende hasta el tercio distal del músculo. Respecto a la inervación, no se encontraron ramas del nervio glúteo caudal que inerven las partes al músculo.

The biceps femoris (BF) muscle plays a fundamental role in the biomechanics of the canine pelvic limb, acting in flexion ­ extension on knee articulation and abduction of the limb. Correct evaluation plays an important role in veterinary clinic. There are controversial issues among the authors consulted about the morphology of this muscle. The present study aims to discuss the various descriptions proposed for this muscle, considering insertions, structure and innervation. Bilateral dissections of 12 animals were carried out. Pieces conservation was done by immersion in pools with 10 percent formaldehyde and 4 percent carbolic acid in water. Different techniques were used in order to achieve various observations of muscle structures. It was found that BF muscle originates by two heads, as is implicit in its name, a craneal head, bulkier and a smaller caudal head. The first takes origin in the sacrotuberal ligament and the lateral surface of the ischial tuberosity. The caudal head, originates from the ischial tuberosity. These parts are closely linked but they can be identified at the level of the muscle bellies through a thin layer of connective tissue that extends to the distal part of the muscle. Regarding the innervation, we found that no caudal gluteal nerve branches reach this muscle.

Genotyping of methicillin-resistant Staphylococcus aureus isolates obtained in the Northeast region of Brazil

Methicillin-resistant Staphylococcus aureus (MRSA) is a major agent of hospital infections worldwide. In Brazil, a multiresistant MRSA lineage (ST239-SCCmecIIIA), the so-called Brazilian epidemic clone (BEC), has predominated in all regions. However, an increase in nosocomial infections caused by non-multiresistant MRSA clones has recently been observed. In the present study, 45 clinical isolates of MRSA obtained from a university hospital located in Natal city, Brazil, were identified by standard laboratory methods and molecularly characterized using staphylococcal chromosome cassette mec (SCCmec) typing and pulsed-field gel electrophoresis. Antimicrobial susceptibility testing was carried out using CLSI methods. The MRSA isolates studied displayed a total of 8 different pulsed-field gel electrophoresis patterns (types A to H) with predominance (73 percent) of pattern A (BEC-related). However, MRSA harboring SCCmec type IV were also identified, 3 (7 percent) of which were genetically related to the pediatric clone - USA800 (ST5-SCCmecIV). In addition, we found a considerable genetic diversity within BEC isolates. MRSA displaying SCCmecIV are frequently susceptible to the majority of non-β-lactam antibiotics. However, emergence of multiresistant variants of USA800 was detected.

Genotyping of methicillin-resistant Staphylococcus aureus isolates obtained in the Northeast region of Brazil.

Methicillin-resistant Staphylococcus aureus (MRSA) is a major agent of hospital infections worldwide. In Brazil, a multiresistant MRSA lineage (ST239-SCCmecIIIA), the so-called Brazilian epidemic clone (BEC), has predominated in all regions. However, an increase in nosocomial infections caused by non-multiresistant MRSA clones has recently been observed. In the present study, 45 clinical isolates of MRSA obtained from a university hospital located in Natal city, Brazil, were identified by standard laboratory methods and molecularly characterized using staphylococcal chromosome cassette mec (SCCmec) typing and pulsed-field gel electrophoresis. Antimicrobial susceptibility testing was carried out using CLSI methods. The MRSA isolates studied displayed a total of 8 different pulsed-field gel electrophoresis patterns (types A to H) with predominance (73%) of pattern A (BEC-related). However, MRSA harboring SCCmec type IV were also identified, 3 (7%) of which were genetically related to the pediatric clone--USA800 (ST5-SCCmecIV). In addition, we found a considerable genetic diversity within BEC isolates. MRSA displaying SCCmecIV are frequently susceptible to the majority of non-beta-lactam antibiotics. However, emergence of multiresistant variants of USA800 was detected.