Motorcycle-related trauma:effects of age and site of injuries on mortality. A single-center, retrospective study.

BACKGROUND: Motorcyclists are often victims of road traffic incidents. Though elderly patients seem to have worse survival outcomes and sustain more severe injuries than younger patients, concordance in the literature for this does not exist. The aim of the study is to evaluate the impact of age and injury severity on the mortality of patients undergoing motorcycle trauma. METHODS: Data of 1725 patients consecutively admitted to our Trauma Center were selected from 2002 to 2016 and retrospectively analyzed. The sample was divided into three age groups: ≤ 17 years, 18-54 years, and ≥ 55 years. Mortality rates were analyzed for the overall population and patients with Injury Severity Score (ISS) ≥ 25. Differences in survival among age groups were evaluated with log-rank test, and multivariate logistic regression models were created to identify independent predictors of mortality. RESULTS: A lower survival rate was detected in patients older than 55 years (83.6% vs 94.7%, p = 0.049) and in those sustaining critical injuries (ISS ≥ 25, 61% vs 83%, p = 0.021). Age (p = 0.027, OR 1.03), ISS (p < 0.001, OR 1.09), and Revised Trauma Score (RTS) (p < 0.001, OR 0.47) resulted as independent predictors of death. Multivariate analysis identified head (p < 0.001, OR 2.04), chest (p < 0.001, OR 1.54), abdominal (p < 0.001, OR 1.37), and pelvic (p = 0.014, OR 1.26) injuries as independent risk factors related to mortality as well. Compared to the theoretical probability of survival, patients of all age groups showed a survival advantage when managed at a level I trauma center. CONCLUSIONS: We detected anatomical injury distributions and mortality rates among three age groups. Patients aging more than 55 years had an increased risk of death, with a prevalence of severe chest injuries, while younger patients sustained more severe head trauma. Age represented an independent predictor of death. Management of these patients at a level I trauma center may lead to improved outcomes.

Epigenetic versus Genetic Deregulation of the KEAP1/NRF2 Axis in Solid Tumors: Focus on Methylation and Noncoding RNAs.

Oxidative and electrophilic changes in cells are mainly coordinated by the KEAP1/NRF2 (Kelch-like erythroid-derived cap-n-collar homology- (ECH-) associated protein-1/nuclear factor (erythroid-derived 2)-like 2) axis. The physical interaction between these two proteins promotes the expression of several antioxidant defense genes in response to exogenous and endogenous insults. Recent studies demonstrated that KEAP1/NRF2 axis dysfunction is also strongly related to tumor progression and chemo- and radiotherapy resistance of cancer cells. In solid tumors, the KEAP1/NRF2 system is constitutively activated by the loss of KEAP1 or gain of NFE2L2 functions that leads to its nuclear accumulation and enhances the transcription of many cytoprotective genes. In addition to point mutations, epigenetic abnormalities, as aberrant promoter methylation, and microRNA (miRNA) and long noncoding RNA (lncRNA) deregulation were reported as emerging mechanisms of KEAP1/NRF2 axis modulation. This review will summarize the current knowledge about the epigenetic mechanisms that deregulate the KEAP1/NRF2 cascade in solid tumors and their potential usefulness as prognostic and predictive molecular markers.

EZH2 and ZFX oncogenes in malignant behaviour of parathyroid neoplasms.

Several studies reported somatic mutations of many genes (MEN1, CTNNB1, CDKIs and others) in parathyroid adenoma, although with different prevalence. Recently, activating mutations of the EZH2 and ZFX oncogenes were identified in benign parathyroid adenoma by whole exome sequencing. The same mutations had been found in blood and ovary malignant tumours. On one hand, this result raised the hypothesis that these oncogenes may play a role in the onset of parathyroid tumour, but it would also suggest they may be involved in malignant, rather benign, parathyroid neoplasm. Our aim was to verify the occurrence of selected mutations of the EZH2 and ZFX genes in an Italian cohort of 23 sporadic parathyroid carcinomas, 12 atypical and 45 typical adenomas. DNA was extracted from paraffin-embedded tissues, PCR amplified and directly sequenced. No mutations were detected in the coding sequence and boundaries of both genes in any of the samples. Two polymorphisms of the EZH2 gene were identified with different prevalence: the rs2072407 variant was present in the 30 % of the samples, in keeping with the overall frequency in larger populations, while the rs78589034 variant, located close to the 5' end of the exon 16, was detected in only one proband with familial isolated hyperparathyroidism; we investigated the possible outcome on the splicing process. EZH2 and ZFX genes do not seem to have an impact on the onset of most parathyroid tumours, both benign and malignant, though further studies on larger cohorts of different ethnicity are needed.

Gene regulatory networks inference using a multi-GPU exhaustive search algorithm.

BACKGROUND: Gene regulatory networks (GRN) inference is an important bioinformatics problem in which the gene interactions need to be deduced from gene expression data, such as microarray data. Feature selection methods can be applied to this problem. A feature selection technique is composed by two parts: a search algorithm and a criterion function. Among the search algorithms already proposed, there is the exhaustive search where the best feature subset is returned, although its computational complexity is unfeasible in almost all situations. The objective of this work is the development of a low cost parallel solution based on GPU architectures for exhaustive search with a viable cost-benefit. We use CUDA™, a general purpose parallel programming platform that allows the usage of NVIDIA® GPUs to solve complex problems in an efficient way. RESULTS: We developed a parallel algorithm for GRN inference based on multiple GPU cards and obtained encouraging speedups (order of hundreds), when assuming that each target gene has two multivariate predictors. Also, experiments using single and multiple GPUs were performed, indicating that the speedup grows almost linearly with the number of GPUs. CONCLUSION: In this work, we present a proof of principle, showing that it is possible to parallelize the exhaustive search algorithm in GPUs with encouraging results. Although our focus in this paper is on the GRN inference problem, the exhaustive search technique based on GPU developed here can be applied (with minor adaptations) to other combinatorial problems.

Left basilar systolic murmur in retired racing greyhounds.

Nineteen of 28 (67%) Greyhounds enrolled in the Blood Donor Program at The Veterinary Teaching Hospital, The Ohio State University (Columbus, OH), had a left basilar systolic murmur. Ten Greyhounds with murmurs and 9 without murmurs were evaluated to gain knowledge about the pathogenesis of this murmur. Echocardiograms were performed without sedation by means of a GE Vivid 7 Echocardiographic System with a continuous ECG; systolic arterial blood pressure (SABP) was measured with an Ultrasonic Doppler Flow detector model 811-B. The mean peak aortic velocity in the Greyhounds with murmurs (2.15 m/s; range, 1.8-2.2 m/s) was significantly higher than in the Greyhounds without murmurs (1.89 m/s; range, 1.6-2.0 m/s) (P < .001); there were no significant differences between groups for aortic valve or annulus diameter, fractional shortening, pulmonic velocity, SABP, hematocrit, serum protein concentration, or red blood cell counts. In this study, Greyhounds with soft, left basilar systolic murmurs had mildly (but significantly) higher mean peak aortic velocities than similar dogs without murmurs. In the dogs with murmurs (and higher velocities), we could not identify structural abnormalities, such as valvular lesions or other congenital defects. There was no inverse correlation between the systolic murmur and the higher hematocrit and red blood cell counts observed in this breed. This 1-2/6 basilar systolic murmur is common in Greyhounds, and it does not appear to be of any clinical consequence.

[Follow-up of testicular tumors in the metastatic diffusion phase. Current orientation]. / Follow-up nei tumori del testicolo in fase di diffusione metastatica. Orientamenti attuali.

Lymphadenectomy in germinal tumors of the testis, in spite of the immediate morbility (postoperative complications) and of the permanent morbility (unejaculation), is still, as regards the group of non-seminoma neoplasms, the most suitable for survival. However, groups of oncologists are seeking the possibility of avoiding this technique at stage I and II of the lesions, with the help, of course, of careful observation by CT, NMR, markers. The use of combined therapies (chemotherapy and radius therapy) has increased survival and the patients' life, allowing a highly satisfying percentage of recovery also in the non-initial stages.

[Double-blind evaluation of mepartricin 150.000 U (40 mg) compared with placebo in benign prostatic hypertrophy]. / Valutazione in doppio cieco della mepartricina 150,000 U (40 mg) in confronto a placebo nella IPB.

The therapeutic efficacy and tolerance of a new 150,000 U (40 mg) formulation of mepartricin (to be administered once-a-day in the evening) were evaluated during a double-blind study against placebo in 2 groups of uncomplicated BPH patients treated for 60 days. The data obtained disclosed a positive pharmaco-therapeutic effect of this new formulation coupled with excellent local and systemic tolerance. At the end of trial the various objective and subjective parameters considered showed marked improvement in the group treated with mepartricin, with statistically significant differences from the placebo-treated group. The treatment efficacy was judged positive in 74-78% of cases by patients and physicians in the mepartricin group and in 36.4% of cases in the placebo group.

[Mepartricin in BPH. A new dosage approach]. / La mepartricina nella IPB. Nuovo approccio posologico.

The authors assessed the validity of a treatment with mepartricin in BPH at the dose of 150,000 U in a once-a-day evening administration for 6 months. The results from the controlled study were compared with those obtained in a homogeneous group of patients treated with placebo. The analysis of the data obtained would suggest a preferential opinion in favour of the group treated with mepartricin which was effective in improving the symptomatology. Some hypothesis are put forward to interpret the results.

Ketanserin plus prostaglandin E1 (PGE-1) as intracavernosal therapy for patients with erectile dysfunction unresponsive to PGE-1 alone.

OBJECTIVE: To evaluate the treatment of patients with erectile dysfunction and who were unresponsive to intracavernosal injections of prostaglandin E-1 (PGE-1) alone with a combination of PGE-1 and ketanserin, a peripheral vasodilator antagonizing 5-hydroxytryptamine receptors and with mild alpha-blocking effects. PATIENTS AND METHODS: The study comprised 98 men with erectile dysfunction all of whom received an intracavernosal injection of 5-40 micrograms of PGE-1. The 45 patients unresponsive to the maximum dose of 40 micrograms were selected for further treatment using a combined dose of 40 micrograms PGE-1 and 2-7 mg of ketanserin. Their erectile response was assessed both subjectively, by interviewing the patient and their partner, and objectively using the 'Rigiscan' monitor. RESULTS: The combined therapy was effective in producing an erection sufficient for sexual intercourse in 34 (76%) of the patients. The combined dose was tolerated well and there were no adverse effects. CONCLUSIONS: The results of this preliminary study suggest that the combination of PGE-1 and ketanserin may be a therapeutic alternative to the implantation of a prosthesis in patients unresponsive to PGE-1.

[Natural history of prostatic adenocarcinoma. Recent advances in prognostic parameters and biological behavior]. / Storia naturale dell'adenocarcinoma della prostata: attuali orientamenti nel comportamento biologico ed aspetti prognostici.

For many years diagnosis and management of prostatic adenocarcinoma were straightforward. However, with the advent of medical and less invasive therapies for the treatment of prostatic cancer, it has become necessary to know more about the etiology and pathophysiology of the disease. For example, hormonal factors, growth factors, stromal-epithelial interactions and aging have all been implicated in the etiology of the disease. The pathology of the disease demonstrates heterogeneity in the ratio of the stroma to the epithelium in any given patient, and the pathophysiology varies. Recognizing this heterogeneity in the disease, it is clear that no one form of medical or interventional therapy should be expected to result in a complete response.

[The disappearance of the circadian rhythm of the heart rate in heart transplantation in the presence of acute rejection]. / Scomparsa del ritmo circadiano della frequenza cardiaca nel trapianto di cuore in presenza di rigetto acuto.

The present study is aimed to investigate the circadian rhythm (CR) of heart rate (HR) in acute rejecting and non-rejecting heart transplanted patients (HTP). The purpose is to provide evidence that an impairment in the HR CR may have a role in predicting episodes of acute rejection in HTP. The study was carried out on 32 Holter monitorings of 13 patients: 9 Holter monitorings were carried out during an episode of acute rejection documented by endomyocardial biopsy. Time data series were analyzed by Cosinor method in order to validate the occurrence of HR CR. The Cosinor analysis found a highly statistically significant HR CR in non-rejecting HTP. The occurrence of the HR CR was not statistically validated in acute rejecting HTP. These findings suggest that the lack of a periodic variability in the 24-hour HR pattern may be useful to diagnose acute heart rejection.

GLC analysis of menthol, phenol, benzocaine, and pyrilamine maleate in aerosol spray lotion.

A GLC method is presented for the quantitative determination of menthol, phenol, benzocaine, and pyrilamine maleate. The propellent was exhausted from a pressurized can, and an aliquot of the alcoholic base was weighed. After the addition of the internal standard diluted with chloroform, 1 microliter of the mixture was injected in the chromatograph with a flame-ionization detector and a glass column packed with 2.5% OV-225. Average recoveries were 100.3 +/- 1.4, 100.0 +/- 1.4, 101.3 +/- 1.5, and 101.5 +/- 1.5% for menthol, phenol, benzocaine, and pyrilamine maleate, respectively.

Simultaneous GLC analysis of salicylamide, phenylpropanolamine hydrochloride, caffeine, chlorpheniramine maleate, phenylephrine hydrochloride, and pyrilamine maleate in capsule preparations.

A GLC method is described for the quantitative determination of salicylamide, phenylpropanolamine hydrochloride, caffeine, chlorpheniramine maleate, phenylephrine hydrochloride, and pyrilamine maleate. The sample was dissolved in ethanol, and an aliquot of the solution was brought to dryness and treated with 0.1 ml of 4-(dimethyl-amino)pyridine in pyridine-acetic anhydride (1:1). The components were isolated and measured by applying 1 microliter of the reaction mixture to a chromatograph equipped with a flame-ionization detector and fitted with 8% OV-101 glass columns. The accuracy was good. Dicyclohexylphthalate was used as the internal standard.

GLC analysis of theophylline, hydroxyethyltheophylline, and diphenylpyraline hydrochloride syrup.

A GLC method for determining theophylline, hydroxyethyltheophylline, and diphenylpyraline hydrochloride is presented. The method permits the separation and quantitative determination of the therapeutically active ingredients with a single injection in an overall time of approximately 2.5 hr.

Separation and spectrophotometric determination of theophylline and hydroxyethyltheophylline in a pharmaceutical syrup.

A simple chromatographic procedure was developed for the separation and determination of theophylline and hydroxyethyltheophylline. An aliquot of diluted syrup was pipetted into a chromatographic column containing a strong anion-exchange resin, which retains theophylline and allows the hydroxyethyl derivative to pass through it. Theophylline was subsequently eluted with 1 N HCl and determined by difference spectrophotometry at 284 nm; its derivative was determined at 272 nm.