Role of laparoscopy in the treatment of patients with endometrial cancer

Patients with endometrial cancer (EC) are conventionally staged by surgery. Depending on the tumor risk factors and the surgical findings, adjuvant treatment is indicated in the form of radiotherapy or chemotherapy. The FIGO guidelines on surgical staging are clear on the importance of assessing the presence of extra-uterine spread of disease, but are elusive on how extensive the surgical staging should be. Also, the role of lymphadenectomy and adjuvant radiotherapy in these patients is the object of controversy, as confirmed by recent results of clinical trials. With surgery remaining the cornerstone of treatment, the surgical approach associated with the least complications should be pursued, particularly since the association of surgery and radiotherapy can escalate the overall treatment morbidity. Therefore, in the last 15 years, laparoscopy has slowly been replacing the traditional midline laparotomy. The results of the few clinical trials and several retrospective studies are unanimous. The laparoscopic approach is feasible, safe and effective and has a lower complication rate as compared to laparotomy in all patients. The number of patients with endometrial cancer included in published studies so far is too low to achieve statistical significance with respect to survival outcomes. However, for some groups of patients, there are results from clinical trials showing that laparoscopy is the method of choice in view of the outstanding reduced surgical morbidity.     

Trace amines depress GABA B response in dopaminergic neurons by inhibiting G-betagamma-gated inwardly rectifying potassium channels

Trace amines (TAs) are present in the central nervous system in which they up-regulate catecholamine release and are implicated in the pathogenesis of addiction, attention-deficit/hyper-activity disorder, Parkinson's disease, and schizophrenia. By using intracellular and patch-clamp recordings from dopaminergic cells in the rat midbrain slices, we report a depressant postsynaptic action of two TAs, beta-phenylethylamine (beta-PEA) and tyramine (TYR) on the GABA(B)-mediated slow inhibitory postsynaptic potential and baclofen-activated outward currents. beta-PEA and TYR activated G-proteins, interfering with the coupling between GABA(B) receptors and G-betagamma-gated inwardly rectifying potassium channels. This is the first demonstration that beta-PEA and TYR depress inhibitory synaptic potentials in neurons of the central nervous system, supporting their emerging role as neuromodulators.     

Ketogenic Diet as a Preventive and Supportive Care for COVID-19 Patients

Severe obesity is associated with an increased risk of admission to intensive care units and need for invasive mechanical ventilation in patients with COVID-19. The association of obesity and COVID-19 prognosis may be related to many different factors, such as chronic systemic inflammation, the predisposition to severe respiratory conditions and viral infections. The ketogenic diet is an approach that can be extremely effective in reducing body weight and visceral fat in the short term, preserving the lean mass and reducing systemic inflammation. Therefore, it is a precious preventive measure for severely obese people and may be considered as an adjuvant therapy for patients with respiratory compromise.     

The genetics of bulimia nervosa

Although historically bulimia nervosa has been considered to be a disorder influenced primarily by sociocultural forces such as societal emphasis on thinness and attractiveness, over the past decade it has become increasingly clear that biology and genetics contribute substantially to its etiology. Currently, it is believed that combined study of genetic and environmental risk factors may ultimately hold the clue to the question of why when so many young individuals are exposed to societal risk factors, only a small number actually develop frank eating disorders. Genetic research on eating disorders is progressing in the direction of enhanced explication of the phenotype by focusing on behavioral, neurobiological and temperamental variables that may represent core features of the disorder. Such enhanced phenotyping may assist with identifying areas of the genome that may be implicated in susceptibility to these serious and debilitating conditions.     

Hepatitis B specific T cell immunity induced by primary vaccination persists independently of the protective serum antibody level

In 2005, in accordance with recommendations made by the European Medicines Agency, the Italian Drug Agency ordered withdrawal of the hexavalent Hexavac^® vaccine (Sanofi Pasteur MSD) from the market. Concerns had been raised about the low immunogenicity of the hepatitis B virus component of the vaccine, assessed by measurement of serum antibody levels, and its potential consequences on long-term protection against hepatitis B infection. We evaluated memory T cell response to establish whether there are differences in the protective mechanisms among children who had received either Hexavac^® or Infanrix-hexa^® (GlaxoSmithKline) as their primary vaccination. Immunological memory was determined by measuring the ability of T cells to proliferate and secrete IFNγ by ELISA and intracellular cytokines (IFNγ and IL-2) when cultured with hepatitis B surface antigen (HBsAg). The different memory subsets of T cells were also measured.     

Candidate gene studies in eating disorders

It has become increasingly clear that biological factors contribute to the etiology of eating disorders. Vulnerability to anorexia and bulimia nervosa is due, at least in part, to the effect of genes. The purpose of this paper is to review the extant literature on association studies of putative candidate genes for eating disorders.     

Immunization coverage and timeliness of vaccination in Italian children with chronic diseases

Since children with chronic diseases represent a primary target for immunization strategies, it is important that their immunization coverage and timeliness of vaccines is optimal. We performed a study to measure immunization coverage and timeliness of vaccines in children with type 1 diabetes, HIV infection, Down syndrome, cystic fibrosis, and neurological diseases. A total of 275 children aged 6 months-18 years were included in the study. Coverage for diphtheria-tetanus-pertussis (DTP), polio (Pol), and hepatitis B (HBV) vaccines approximated 85% at 24 months, while measles-mumps-rubella (MMR) coverage was 62%. Immunization coverage for seasonal influenza was 59%. The analysis of timeliness revealed that there was heterogeneity among children with different chronic diseases. A proportional hazard model showed that children with HIV infection had the longest time to complete three doses of DTP, Pol, and HBV, and those with neurological diseases received the first dose of MMR later than the other categories. Causes of missing or delayed vaccination mostly included a concurrent acute disease. Children with chronic diseases should be strictly monitored for routine and recommended vaccinations, and health care providers and families should be properly informed to avoid false contraindications.     

Waterborne outbreak of Norwalk-like virus gastroenteritis at a tourist resort,Italy

In July 2000, an outbreak of gastroenteritis occurred at a tourist resort in the Gulf of Taranto in southern Italy. Illness in 344 people, 69 of whom were staff members, met the case definition. Norwalk-like virus (NLV) was found in 22 of 28 stool specimens tested. The source of illness was likely contaminated drinking water, as environmental inspection identified a breakdown in the resort water system and tap water samples were contaminated with fecal bacteria. Attack rates were increased (51.4%) in staff members involved in water sports. Relative risks were significant only for exposure to beach showers and consuming drinks with ice. Although Italy has no surveillance system for nonbacterial gastroenteritis, no outbreak caused by NLV has been described previously in the country.     

A topological approach unveils system invariances and broken symmetries in the brain

Symmetries are widespread invariances underscoring countless systems, including the brain. A symmetry break occurs when the symmetry is present at one level of observation but is hidden at another level. In such a general framework, a concept from algebraic topology, namely, the Borsuk‐Ulam theorem (BUT), comes into play and sheds new light on the general mechanisms of nervous symmetries. The BUT tells us that we can find, on an n‐dimensional sphere, a pair of opposite points that have the same encoding on an n – 1 sphere. This mapping makes it possible to describe both antipodal points with a single real‐valued vector on a lower dimensional sphere. Here we argue that this topological approach is useful for the evaluation of hidden nervous symmetries. This means that symmetries can be found when evaluating the brain in a proper dimension, although they disappear (are hidden or broken) when we evaluate the same brain only one dimension lower. In conclusion, we provide a topological methodology for the evaluation of the most general features of brain activity, i.e., the symmetries, cast in a physical/biological fashion that has the potential to be operationalized. © 2016 Wiley Periodicals, Inc.