Superhydrophobic lab-on-chip measures secretome protonation state and provides a personalized risk assessment of sporadic tumour.

Secretome of primary cultures is an accessible source of biological markers compared to more complex and less decipherable mixtures such as serum or plasma. The protonation state (PS) of secretome reflects the metabolism of cells and can be used for cancer early detection. Here, we demonstrate a superhydrophobic organic electrochemical device that measures PS in a drop of secretome derived from liquid biopsies. Using data from the sensor and principal component analysis (PCA), we developed algorithms able to efficiently discriminate tumour patients from non-tumour patients. We then validated the results using mass spectrometry and biochemical analysis of samples. For the 36 patients across three independent cohorts, the method identified tumour patients with high sensitivity and identification as high as 100% (no false positives) with declared subjects at-risk, for sporadic cancer onset, by intermediate values of PS. This assay could impact on cancer risk management, individual's diagnosis and/or help clarify risk in healthy populations.

[Patient satisfaction in hemodialysis: a pilot cross-sectional analysis and a review]. / Valutazione del grado di soddisfazione da trattamento nel paziente in emodialisi: metologia di ricerca, strumenti, limiti e studio pilota trasversale.

BACKGROUND: Assessment of patient satisfaction is not performed routinely in many healthcare institutions. In this review, we discuss methodological aspects of assessment of patient satisfaction in hemodialysis. We also present a pilot study conducted in the Gambro Healthcare Italy dialysis clinics network. METHODS: Patient satisfaction was assessed in a network of hemodialysis units by using an internally validated Italian translation of the Choices for Healthy Outcomes in Caring for ESRD (CHOICE) questionnaire. A cross-sectional analytic study design was used and data analysed with univariate and multivariate hierarchical logistic regression to explore correlates of the risk of being unsatisfied with dialysis treatment. Covariates which were considered include a series of over 20 clinical, demographic, organizational and structural aspects. In addition, unexplained inter-centre residual variability due to 'case-mix' was explored and plotted. RESULTS: Seventeen dialysis units participated in this cross-sectional analysis and 758/1001 (75.7%) provided answers to the questionnaires. There was a statistically significant association on multivariate hierarchical analysis between the risk of being unsatisfied with dialysis treatment and interdialysis body weight gain (unit of increase: 1 kg, p=0.004). On the contrary, the risk of unsatisfaction with dialysis treatment was significantly lower in patients with higher dry weight (unit of increase: 1 kg, p=0.002). Our multivariate hierarchical analysis identified some residual variability between dialysis units (n=6 outliers) which may not be explained by any of over 20 potential confounding covariates which were explored. CONCLUSIONS: Assessment of ''customer satisfaction'' is standard practice in private for profit product companies in general but needs to be increasingly recognized as a standard in both public and private providers of healthcare services. Social research methods, which are used for this type of analysis, need to be fine tuned and actively implemented in order to better understand how we may influence the quality of service we provide to our patients and the level at which they rate it.

Contribution of mono and polysaccharides to heterotrophic N2 fixation at the eastern Mediterranean coastline.

N2 fixation should be a critical process in the nitrogen-poor surface water of the eastern Mediterranean Sea. Despite favorable conditions, diazotroph abundance and N2 fixation rates remains low for reasons yet explained. The main goal of this study was to investigate the limiting nutrients for diazotrophy in this oligotrophic environment. Hence, we conducted dedicated bottle-microcosms with eastern Mediterranean Sea water that were supplemented with mono and polysaccharides as well as inorganic nitrogen and phosphorous. Our results indicate that the diazotrophic community expressing nifH was primarily represented by heterotrophic Proteobacteria. N2 fixation and heterotrophic bacterial activity increased up-to tenfold following two days of dark incubations, once seawater was supplemented with organic carbon substrate in the form of glucose (monosaccharides) or gum-xanthan (polysaccharide surrogate). Furthermore, our results point that carbon-rich polysaccharides, such as transparent exopolymer particles, enhance heterotrophic N2 fixation, by forming microenvironments of intense metabolic activity, high carbon: nitrogen ratio, and possibly low O2 levels. The conclusions of this study indicate that diazotrophs in the eastern Mediterranean coast are primarily limited by organic carbon substrates, as possibly in many other marine regions.

Development of latent fingerprints on metallic surfaces using electropolymerization processes.

We propose a new process for developing latent fingerprints on metal items, applicable to unfired weapons made of Ergal in particular. The method is based on the presence of fatty acids that are contained in fingerprints and act as an insulator on the surface where fingerprints are to be developed. The process of polymerization occurs on the metal portions left untouched by finger contact. Hence, the developing process results as a negative pattern of the original fingerprint. The reaction consists in the electropolymerization of pyrrole and substituted porphyrins, i.e., tetra (o-aminophenyl) porphyrine: radical-cations are generated on superficial nucleation sites by oxidation of monomer, close to the electrode surface; subsequently, the radical species react with the neutral monomer, which begins to diffuse to the electrode. We have also studied the polymer's morphology by means of SEM and AFM, in order to find a correlation between the reagent to be used and the quality of the enhancement process. These are only preliminary results; however, they show that the suggested method is a new way to increase the rate of success in developing latent fingerprints on metal surfaces. In this regard, it may be considered complementary to other conventional procedures, due to the low costs of the instruments and reagents, and the rapidity and simplicity of the treatment.

[Diagnosis of intrathoracic goiter]. / Sulla diagnostica dei gozzi intratoracici

The various aspects of the diagnosis of intrathoracic goitre are examined. Clinical, blood chemistry and radiological and radioisotope data are required before a firm decision can be made. Detailed recognition of goitre type and assessment of the site and extent of the intramediastinal portion, together with determination of the existence of intra- and extraparenchymal inflammation or degeneration or other signs of disease, are an essential differential overture to the choice of a surgical approach route (cervical, cervical-mediastinal with median sternotomy, transthoracic) and the appraisal of prognosis. In the absence of malignant degeneration, prognosis is good in all cases, since this type of goitre can be completely and finally eradicated.

Ibutilide for cardioversion of atrial flutter: efficacy of a single dose in recent-onset arrhythmias.

AIM: Ibutilide is particularly effective in rapid termination of atrial flutter (AFL) with few adverse effects. Despite the recommendation of 2 infusions, cardioversion may occur up to 70 minutes after a single dose. We investigated the feasibility, efficacy and safety of a single dose ibutilide treatment of AFL in a single-center, observational study. METHODS: Fifty-nine consecutive patients (44 males, mean age 70 +/- 12), referred to our CCU for paroxysmal AFL (mean arrhythmia duration 10 +/- 18 days), were treated with 1 mg ibutilide. In case of inefficacy, a 2nd dose could be administered 10 to 60 minutes later on the basis of the ECG examination for QTc prolongation and AFL cycle variations. Successful cardioversion was defined as sinus rhythm (SR) restoration within 2 hours. RESULTS: Forty-four patients (75%) converted to SR after ibutilide, 31 with single dose (53%, Group 1), and 13 with double dose (22%, Group 2). AFL duration was shorter in Group 1 (4 +/- 5 vs 16 +/- 29 days). The mean time to the 2nd dose administration was 34 +/- 11 minutes in responders, 51 +/- 23 minutes in non-responders. Only 3 (5%) significant adverse events, all observed after a single dose, occurred. CONCLUSION: Ibutilide is highly effective and safe, in a monitored environment, for rapid termination of AFL. Recent onset AFL may be terminated with a single infusion in many cases; yet, cardioversion should be waited for no more than 30 minutes after the end of the 1st dose, before administering the 2nd one, in order not to reduce the possibility of SR restoration.

[The frequency of early coronary reperfusion assessed by electrocardiographic criteria in relation to the timing of thrombolytic therapy in acute myocardial infarct]. / Frequenza della riperfusione coronarica precoce valutata con criteri elettrocardiografici in rapporto al tempo del trattamento trombolitico nell'infarto miocardico acuto.

This study was aimed at assessing coronary reperfusion in patients with acute myocardial infarction (AMI) undergoing systemic thrombolysis with SK and rtPA. The occurrence of reperfusion was related to the time of treatment. The evaluation of reperfusion was performed by monitoring ST segment changes. 56 patients with AMI were studied. 22 out of these (39.2%) showed a significant decrease (greater than 50%) in ST segment sum (sigma ST) at 100 minutes from the beginning of the treatment. Analysis of the relationship between reperfusion and elapsed time between the onset of symptoms and the treatment, reveals that the reperfusion is less frequent (p less than 0.05) in patients treated at 180 minutes or later. The standard electrocardiogram appears as the most useful method to evaluate indirectly coronary reperfusion in acute myocardial infarction. A further refinement of this method is desirable to recommend its widespread clinical use. The assessment of reperfusion by means of ECG in large series of patients will permit the evaluation of the benefits of reperfusion, in terms of survival, complications and incidence of ventricular dysfunction.

[Erythrocyte filtration in acute myocardial infarction]. / Studio della filtrazione eritrocitaria nell'infarto miocardico acuto.

In 12 patients with acute myocardial infarction we have studied the behavior of the red blood cell filterability using polycarbonate membranes of 13 mm diameter with pores of 5 mu diameter according to the Reid's method. The samples were drawn soon afterwards the admission and successively every 48 h for a period of about 12 days. In the meantime, erythrocyte sedimentation rate (ESR), fibrinogen, leukocyte, platelet and alpha 2-macroglobulin changes have been determined. The average initial filterability values in patients with infarction were 0.84 +/- 0.20, while in control subjects were 0.58 +/- 0.15. During the observation period, a statistically significant increase of filterability after 48 h (1.06 +/- 0.24) and after 96 h (0.88 +/- 0.21) was observed. Using the statistical analysis we have noticed a strong correlation among filterability and leukocytes and ESR. The effect of leukocytes is due to the reduction of membrane pores through which red blood cells filter. The correlation with the ESR shows the presence of a plasma factor different from fibrinogen and capable of transforming the red blood cell aggregation by reducing their filterability.

[Effects of propafenone on arrhythmias induced by exertion in patients with ischemic cardiopathy]. / Effetti del propafenone sulle aritmie indotte dallo sforzo in pazienti con cardiopatia ischemica.

The efficacy of Propafenone to prevent exercise-induced ventricular arrhythmias (EIVA) has been studied in eleven patients affected by ischemic heart disease. None of the patients manifested any arrhythmia at rest, but ventricular arrhythmias occurred in every case during a treadmill test. EIVA disappeared after Propafenone in nine patients, while a reduction by 90% was achieved in the remaining two patients. A further treadmill test carried out five days after withdrawal of the drug induced again the same ventricular arrhythmias in all the patients. Thus, Propafenone appears effective to prevent EIVA in patients with ischemic heart disease.

Parasystolic ventricular tachycardia with variable exit block.

This case is an example of ventricular parasystolic tachycardia associated with variable expressions of ectopic-ventricular (E-V) exit block. The exit block manifested with 2:1, 3:2, 4:3 and higher ratios of E-V conductions, interspaced with periods of 1:1 conduction. Concealed E-V conduction of the ectopic impulse could also be deduced.

Discrimination between Butylammonium Isomers by Calix[5]arene-Based ISEs.

Penta-O-alkylated p-tert-butylcalix[5]arenes 1-5 (R = benzyl, isohexyl, isopropoxyethyl, isopropoxycarbonylmethyl, and tert-butoxycarbonylmethyl, respectively) in a fixed C(5)(v) cone conformation have been studied as ionophores in liquid membrane ion-selective electrodes (ISEs) for n-butylammonium against the other branched butylammonium isomers, alkali metals, and ammonium ions, in terms of detection limits, sensitivity, and selectivity. The highest levels of potentiometric selectivity and detection limits up to 3 × 10(-)(6) M are observed with ISEs based on ionophore 2, where selectivity follows the order n-BuNH(3)(+) ≫ i-BuNH(3)(+) > s-BuNH(3)(+) > t-BuNH(3)(+). The lower potentiometric selectivity displayed by ISEs based on ionophores 3-5 is ascribed to their affinity for the Na(+) ion of the lipophilic salt present in the membrane, as evidenced by appropriate (1)H NMR competition experiments with Na(+) and n-BuNH(3)(+) ions. Further investigation on the selectivity mechanism of ionophore 2 by means of frequency response analysis shows that the interaction of the linear butylammonium ion with membranes containing 2 involves a lower resistance process than that occurring with the other branched isomers, thus suggesting the presence of a favorable kinetic-controlled mechanism.

Calixarene--poly(dithiophene)-based chemically modified electrodes.

The stepwise synthesis of cone and partial cone 1,3-bridged n-propoxy-calix[4]crown ethers ("monomers" 2 and 3) with an electropolymerizable 2,2'-dithiophene-3-yl-hexylene functionality at the lower rim, is described. The potential of 2 and 3 as sensing agents for alkali metal ions was investigated by 1H NMR titration experiments with NaSCN and KSCN. The results obtained have confirmed that the presence of the heterocyclic subunit does not affect the well-known size-selectivity observed with calix[4]crowns. Monomers 2 and 3 were electropolymerized (Pt as a working electrode, CH2Cl2/CH3CN, Bu4NPF6) to produce the title chemically modified electrodes (CMEs). After coating with a PVC membrane containing a lipophylic cation exchanger, CMEs based on calix[4]-crown-5 2b (cone) and 3b (partial cone) were tested for the potentiometric recognition of alkali metal ions in aqueous solution. In agreement with NMR titration studies, a satisfactory potentiometric response in terms of K+/Na+ selectivity was obtained only with CME 2b (pK(K/Na) 1.51). The amperometric responses of PVC-uncoated CMEs were studied by cyclic voltammetry (CV) experiments in CH3CN solution. High Na- selectivity was found with the CME based on partial cone calix[4]crown-4 3a, and frequency response analysis (FRA) measurements support this finding.