Limitations of blood pressure target in non-dialysis chronic kidney disease: a question of method?

International guidelines recommend to reduce blood pressure (BP) levels below 130/80 mmHg in non-dialysis chronic kidney disease (CKD) patients. However, this BP target has not been validated by randomized controlled trials and is mainly driven by data obtained in observational and post-hoc analyses suggesting that it improves the renal and, to some extent, cardiovascular prognosis. The inconclusive results on the prognostic role of the BP target in patients with CKD might also relate to the limited ability of office BP readings to adequately stratify the global risk of this population. In fact, alterations of the pressure profile (such as white-coat hypertension) and nighttime hypertension are common in CKD patients. Recent studies have demonstrated that ambulatory blood pressure monitoring (ABPM) is superior to clinic BP measurements in predicting renal death and cardiovascular events. Therefore, while waiting for the results from the ongoing randomized Systolic Blood Pressure Intervention Trial (SPRINT) comparing the effect on cardiorenal prognosis of two BP target levels, the more widespread use of ABPM is desirable in CKD patients.     

Locoregional recurrence in patients with HER2 positive breast cancer

Literature shows that HER2/neu positive breast cancer cells are more sensitive to radiation-induced apoptosis by targeting the epidermal growth factor receptor family tyrosine kinase. We selected 466 patients with pT1-2 HER2/neu positive tumors who received adjuvant trastuzumab for primary invasive breast cancer. Patients were divided into three groups [Quadrantectomy followed by conventional radiotherapy vs Quadrantectomy followed by Intra-operative radiotherapy with electrons vs Mastectomy without radiotherapy]. After a median follow-up of 52 months, the 5-year cumulative incidence of locoregional recurrence (LRR) was 1.9%, 11.5% and 5.0% respectively (p < 0.01). At the multivariate analysis, extensive perivascular invasion, Luminal B HER2/Progesterone Receptor (PgR) negative status and Quadrantectomy followed by Intra-operative radiotherapy with electrons have significantly increased the risk of LRR. Our results suggest that HER2/neu positive breast cancer might have better outcomes when treated simultaneously with external radiotherapy and trastuzumab. Moreover, we underline the importance of PgR and further new stratification of risk among luminal subtypes.     

Eating disorder inventory in the assessment of psychosocial status in the obese patients prior to and at long term following biliopancreatic diversion for obesity

Psychological traits of obese patients, assessed with the Eating Disorder Inventory (EDI), were compared to those of subjects in the long term following biliopancreatic diversion for obesity (BPD), when body weight has been steadily normal for over 1 year and any preoccupation with dieting and weight has been completely abandoned. The overall results suggest that the stable body weight normalization on a completely free diet does confer considerable psychological benefit on obese individuals. On the basis of the EDI results, post-BPD subjects were divided into weight-preoccupied and not-weight-preoccupied individuals. In the not-weight-preoccupied subjects, the psychosocial status and emotional rectivity were closely similar to those observed in lean control persons, whereas the few weight-preoccupied subjects, in spite of completely normal body weight, showed residual body dissatisfaction and personality traits very similar to those of eating-disordered patients. © 1994 by John Wiley & Sons, Inc.     

Schizotypal Personality Questionnaire: New sources of validity evidence in college students

Schizotypal traits represent the behavioral expression of vulnerability to psychosis in general population. Among the most widely used measurement instruments, we could find the Schizotypal Personality Questionnaire (SPQ) (Raine, 1991). However, some aspects of its psychometric quality have yet to be analyzed. The main goal of the present study was to gather new sources of validity evidence of the SPQ scores in non-clinical young adults. The final sample was made up of 1123 college students (M=20.3 years; S.D.=2.6). The study of the internal structure using exploratory factor analysis revealed that SPQ items were grouped in a theoretical structure of seven second-order factors. Confirmatory factor analyses showed that the four-factor model (Paranoid) displayed better goodness-of-fit indices than the other hypothetical dimensional models tested. More complex measurement models, such as those tested using second-order confirmatory factor analyses and Exploratory Structural Equation Modeling, also showed adequate goodness-of-fit indices. The reliability of the SPQ scores ranged from 0.80 to 0.91. A total of 11 items showed differential functioning by gender. Advances in psychosis phenotype measurement open up new horizons to understand the structure and content of schizotypy.     

Congenital Hepatoblastoma and Beckwith-Wiedemann Syndrome: A Case Study Including DNA Ploidy Profiles of Tumor and Adrenal Cytomegaly

A case of fatal congenital hepatoblastoma is described in which the autopsy provided the first evidence of Beckwith-Wiedemann syndrome. Aneuploid quantitative DNA patterns were found by image analysis of the tumor and the cytomegalic adrenal gland.     

Use of instenon in complex treatment of patients with optic nerve atrophy caused by craniocerebral trauma

Instenon, a combined nootropic agent, was used on the step-type basis within a complex treatment of optic nerve atrophy caused by craniocerebral trauma. Our study revealed that instenon, when used within a complex treatment of a partial optic nerve atrophy caused by craniocerebral trauma, improved the visual acuity in 85.7% of patients and it expanded the total visual field in 76.2% of patients, whereas the routine therapy ensured the related improvements in 58.9% and 61.5% of patients, respectively. Besides, the drug provided for a better retinal electric sensitivity and for a better optic nerve conduction in 73.8% of cases versus 64.1% of cases with basic therapy. Increased velocity parameters in the ocular-artery blood flow were registered in 77.1%, of patients who received instenon, by duplex scanning.     

Gastrointestinal stem cells in self-renewal and cancer

The gastrointestinal epithelium is a unique model for the study of mammalian stem cells. Not only does it have a highly stereotypical organization, its remarkable rate of self-renewal provides a daily readout of stem cell activity. The past decade has seen a major investment in developing technologies dedicated to revealing the identity of the long-elusive gastrointestinal stem cells. An array of purported stem cell biomarkers is now available for the mouse, including surface-expressed proteins that hold great promise as antibody targets for use in isolating human stem cells. Here we critically appraise the validity of these biomarkers and discuss their likely impact on our understanding of stem cell roles in self-renewal and cancer in the gastrointestinal tract.     

Evaluation of cryopreserved donor skin viability: the experience of the regional tissue bank of Verona

Background

Allogeneic human skin removed from cadaveric donors is the covering of choice for deep burns, since it accelerates the re-epithelialisation of autologous skin. In this study we evaluated the cellular viability of cryopreserved skin at the regional tissue bank of Verona (Italy).

Methods

From 1^st June 2007 to 30^th September 2007, tests of cutaneous cell viability were carried out on 21 consecutive skin donors using the MTT (tetrazolium salt) method on samples prior to freezing and on thawed samples after a period of cryopreservation.

Results

The mean percentage viability was 45.1% (±20.1%), which is similar to results obtained in other tissue banks. It was noted that viability decreased with increasing age of the donor.

Conclusions

The results of the evaluation of cutaneous cell viability document the validity of the skin cryopreservation procedure in use at the tissue bank in Verona.