Leiomyoma of the testis

Testis leiomyoma is a very rare neoplasm. It is very difficult to perform an exact preoperative diagnosis; only histological examination can prove the presence of a leiomyoma. In our case radical orchidectomy was performed because of complete substitution of normal parenchyma, the extreme rarity at long-term follow-up of a reported benign intratesticular neoplasm, and the imperfect sensitivity of the extemporary histological examination.     

Thalassaemia major and infectious risk: High Mobility Group Box‐1 represents a novel diagnostic and prognostic biomarker

High mobility group box ‐1 (HMGB1) represents a common causal agent for various types of diseases, including infective pathologies. This study aimed to investigate the role of HMGB1 in β‐thalassemia major (TM) by evaluating its diagnostic and prognostic role. Fifty‐one TM patients and 30 healthy subjects (HS) were enrolled. Receiver operating characteristics (ROC) analysis was employed to calculate the area under the curve (AUC) for HMGB1 to determine the best cut‐off values capable of identifying infectious episodes. Adjusted risk estimates for infective events were calculated using univariate followed by multivariate Cox proportional hazard regression analysis. Serum HMGB1 levels were higher in TM patients than in HS (14·6 ± 8·7 vs. 2·08 ± 0·9 ng/ml, P < 0·0001). Patients who underwent splenectomy were characterized by lower levels of HMGB1, when compared with patients with an intact spleen (10·2 ± 8 vs. 19·1 ± 7 ng/ml, P = 0·004). ROC analyses revealed an AUC for serum HMGB1 of 0·801, with a sensitivity and specificity of 92·3% and 68·2% to detect an infectious episode. Low HMGB1 levels predicted high risk of infective events (HR: 0·81; P = 0·006). HMGB1 represents a prognostic marker for TM patients and a predictive factor for infectious events.     

Kinematic cues and recognition of self-generated actions

In the present study, we addressed the issue of whether healthy individuals can recognize a given gesture as their own, based on kinematic information. To this purpose, we required 36 volunteers to execute a series of hand movements of increasing complexity, while their kinematics was recorded by a motion-capture system. In a later session, we showed them a series of computer animations where a virtual hand, rendered as a simple stick-diagram, was animated by the kinematics recorded from the participants in the previous session. Their task was to recognize their own movements, choosing from three alternatives. To test the contribution of various potential cues to action recognition, the roles of (1) access to motor representation, (2) gesture complexity, and (3) familiarity effects were separately investigated. The results support the hypothesis that kinematic templates rather than single motor parameters contribute to self-recognition in the absence of morphological cues.     

Erythropoiesis and chronic kidney disease–related anemia: From physiology to new therapeutic advancements

Erythropoiesis is triggered by hypoxia and is strictly regulated by hormones, growth factors, cytokines, and vitamins to ensure an adequate oxygen delivery to all body cells. Abnormalities in one or more of these factors may induce different kinds of anemia requiring different treatments. A key player in red blood cell production is erythropoietin. It is a glycoprotein hormone, mainly produced by the kidneys, that promotes erythroid progenitor cell survival and differentiation in the bone marrow and regulates iron metabolism. A deficit in erythropoietin synthesis is the main cause of the normochromic normocytic anemia frequently observed in patients with progressive chronic kidney disease. The present review summarizes the most recent findings about each step of the erythropoietic process, going from the renal oxygen sensing system to the cascade of events induced by erythropoietin through its own receptor in the bone marrow. The paper also describes the new class of drugs designed to stabilize the hypoxia-inducible factor by inhibiting prolyl hydroxylase, with a discussion about their metabolism, disposition, efficacy, and safety. According to many trials, these drugs seem able to simulate tissue hypoxia and then stimulate erythropoiesis in patients affected by renal impairment. In conclusion, the in-depth investigation of all events involved in erythropoiesis is crucial to understand anemia pathophysiology and to identify new therapeutic strategies, in an attempt to overcome the potential side effects of the commonly used erythropoiesis-stimulating agents.     

Epidemiology and prevention of domestic injuries among children in the Verona area (north-east Italy)

In the developed world, domestic injuries (DI) are an important cause of morbidity, temporary or permanent disability, and death in early life, the social and economic costs of which are often underestimated. To assess the epidemiology of this phenomenon in an area of north-eastern Italy, a retrospective investigation was performed with an anonymous questionnaire administered to the parents of approximately 3000 children aged between 3 and 15 years. More than 45% of the sample had suffered at least one DI in their lifetime. The most common involved falling, wounding and scalding, and particularly affected children above 4 years old. The various types of injury were analyzed and correlated with the parents' personal parameters, the circumstances and the location of the accident. The type of aid required (medical advice was sought in more than 70% of cases) and the outcome of the DI (26% cases of temporary disability and 2% of permanent disability) were also assessed. The majority of DI could be prevented by a capillary campaign on the prevention of domestic hazards in childhood, preferably as part of a holistic approach to the problem that also considers their living conditions in architectural and interior design terms.     

Two-thirds power law in human locomotion: role of ground contact forces

Are there general rules for the generation of curvilinear motion of the end-effector? Form and kinematics of the arm trajectory are typically inter-related. A relationship between velocity and curvature of the endpoint path has been previously described and quantified as the two-thirds power law. Here we show that the two-thirds power law holds also for the foot trajectory (during the swing phase) in human locomotion for a wide range of walking speeds and gravitational loads, but air-stepping. In air-stepping, it was violated systematically. The results suggest that the power law represents a general constrain of biological motion, may be attributed to both mechanical and neural factors and can depend on natural interactions with external environment.     

An assessment of the existence of muscle synergies during load perturbations and intentional movements of the human arm

Summary A cross-correlation analysis was performed on EMG activities in elbow and shoulder flexors evoked by force perturbations acting in different directions on the forearm and during intentionally generated movements with the purpose of characterizing the temporal relationships between patterns of activation of different muscles. Qualitatively it was found that the shape of the crosscorrelation function differed from one experimental condition to the next. A principal component analysis permitted a quantitative assessment of this point. In general it was found that two principal components could account for the data. Furthermore when the cross-correlograms are represented in principal component space, there was no clustering of the data points. Several possible definitions of muscle synergies are discussed from the perspective of this finding. It is concluded that the most restrictive definition is incompatible with the data. Less restrictive definitions, while compatible with the data, do not lead to a simplification of the control problem.     

Cognitive, perceptual and action-oriented representations of falling objects

We interact daily with moving objects. How accurate are our predictions about objects' motions? What sources of information do we use? These questions have received wide attention from a variety of different viewpoints. On one end of the spectrum are the ecological approaches assuming that all the information about the visual environment is present in the optic array, with no need to postulate conscious or unconscious representations. On the other end of the spectrum are the constructivist approaches assuming that a more or less accurate representation of the external world is built in the brain using explicit or implicit knowledge or memory besides sensory inputs. Representations can be related to naive physics or to context cue-heuristics or to the construction of internal copies of environmental invariants. We address the issue of prediction of objects' fall at different levels. Cognitive understanding and perceptual judgment of simple Newtonian dynamics can be surprisingly inaccurate. By contrast, motor interactions with falling objects are often very accurate. We argue that the pragmatic action-oriented behaviour and the perception-oriented behaviour may use different modes of operation and different levels of representation.