Percutaneous blind needle biopsy versus combined laparoscopic excisional and guided needle biopsy in the diagnosis of liver disorders in pediatric patients

A special interest, both in scientific publications and in the mass media, is recently emerged about the use of hormone replacement therapy (HRT) in post-menopausal women. Beside, in fact, the specific indication for the relief of menopausal symptoms, hypotheses are debated about a possible role of HRT in the reduction of risk of osteoporosis and cardiovascular diseases, and in the increased risk of breast cancer. This situation emphasizes the need for assessing the benefit/risk profile for HRT in order to ensure that strategies of proven clinical effectiveness, based on large randomized clinical trials, will be adopted in the population.     

Università di Roma Tre, 1995-2005: Architecture and Mathematics

Andrea Pagano and Laura Tedeschini Lalli present a brief note on what has to be considered a teaching success story. They tell of ten years of teaching mathematics at the Faculty of Architecture of the Università di Roma Tre, describing some new course content that has been introduced, the methods used and, above all, the spirit that has driven the ideas about teaching mathematics to future architects. The experience covers the full curriculum of the student: from first year courses to individual projects.     

The Fight against the Influenza A Virus H1N1: Synthesis,Molecular Modeling,and Biological Evaluation of Benzofurazan Derivatives as Viral RNA Polymerase Inhibitors

The influenza RNA polymerase complex, which consists of the three subunits PA, PB1, and PB2, is a promising target for the development of new antiviral drugs. A large library of benzofurazan compounds was synthesized and assayed against influenza virus A/WSN/33 (H1N1). Most of the new derivatives were found to act by inhibiting the viral RNA polymerase complex through disruption of the complex formed between subunits PA and PB1. Docking studies were also performed to elucidate the binding mode of benzofurazans within the PB1 binding site in PA and to identify amino acids involved in their mechanism of action. The predicted binding pose is fully consistent with the biological data and lays the foundation for the rational development of more effective PA–PB1 inhibitors.     

Effect of hemodiafiltration with endogenous reinfusion on overt idiopathic chronic inflammation in maintenance hemodialysis patients: A multicenter longitudinal study

Chronic inflammation is widely diffuse in maintenance hemodialysis (MHD) patients and is associated with poor survival. Hemodiafiltration with endogenous reinfusion (HFR) is a dialysis technique, highly biocompatible, able to adsorb proinflammatory cytokines and to decrease amino acids and antioxidants loss. These features could be helpful in MHD patients affected by idiopathic chronic inflammation, but this issue remains to be elucidated. We performed a multicenter longitudinal study to assess the effect of the switching from bicarbonate HD to HFR in patients with serum C‐reactive Protein (CRP) > 5 mg/L coupled with albumin <4.0 g/dL in the last 6 months. We enrolled 24/176 (14%) patients, of which 20 patients were assessed at 4 months and 18 completed the study. We excluded 11 patients with evident causes of inflammation. At baseline, serum levels of CRP (18.7[7.0–39.4] mg/L) and albumin (3.5[3.3–3.7] g/dL) were significantly correlated (r = ?0.49; P = 0.028). The effect on CRP and albumin was almost evident in the first 4 months and remained stable until to eighth month. A strict correlation (R = ?0.49; 0.040) between percentage change of CRP (?35%) and albumin (+14%) after 8 months of HFR. These effects were associated with the reduction of IL‐6, IL‐1β, and TNF‐α and the increment of pre‐albumin and leptin, whereas the serum levels of Branched Chain Amino Acid (BCAA) remained unchanged. In MHD patients affected by idiopathic chronic inflammation the switching from BHD to HFR is associated with improvement of inflammation. Whether these favorable effects may modify the outcomes of these high‐risk patients needs to be confirmed by studies ad hoc.     

A closed-loop jacobian transpose scheme for solving the inverse kinematics of nonredundant and redundant wrists

The solution of the inverse kinematic problem is of the utmost importance in robotic manipulator control. This article proposes a closed-loop scheme for solving the inverse kinematic problem for nonredundant and redundant wrists based on the computation of the Jacobian transpose. The manipulability measure is suitably introduced as a constraint for redundant wrists, by taking advantage of the null space of the Jacobian matrix. The resulting algorithm provides a computational tool to solve a specified orientation trajectory into a joint trajectory. Numerical results with two spherical wrists show the excellent performance of the scheme.     

Bronchodilator response to salbutamol after spontaneous recovery from nonspecific bronchial provocation tests in asthma

Assessment of airway responsiveness by bronchoprovocation and bronchodilatation tests is important in the diagnostic work-up protocol of bronchial asthma and it would be convenient to undertake both tests on the same occasion. However, it is not known whether this can be done accurately. Therefore, this study evaluated the effect of a prior bronchial provocation test on the bronchodilator response to salbutamol after spontaneous recovery of the forced expiratory volume in one second (FEV1) in a group of asthmatic subjects. On two separate occasions at the same time of day, concentration-response studies with inhaled histamine or methacholine, or a sham challenge with normal saline were carried out in a blinded, randomized manner. Changes in airway calibre were followed as FEV1 and agonist responsiveness expressed as the provocative concentration causing a 20% fall in FEV1 (PC20). After either spontaneous recovery or a fixed-duration wait of 45 min (when appropriate), the subjects received 2x100 microg of salbutamol from a metered dose inhaler with a spacer. The bronchodilator response to salbutamol was expressed as a percentage of initial FEV1 (deltaFEV1% init). Bronchial challenge with both agonists failed to alter significantly the airway response to salbutamol, with the deltaFEV1% init mean value (range) being 16.9% (9.0-31.9) and 17.5% (11.6-31.2) on the sham and histamine/methacholine challenge day respectively. It was shown that the degree of bronchodilatation achieved after salbutamol 200 microg is not affected by prior bronchoprovocation testing when enough time is allowed for the airways to recover spontaneously to baseline forced expiratory volume in one second. Thus evaluation of airway responsiveness by both bronchial provocation tests and bronchodilator testing can be assessed reliably within a few hours in asthmatic patients.     

Impact of double Rayleigh scattering noise in distributed higher order Raman pumping schemes

We analyze the equivalent optical noise figure (NF) performances and double Rayleigh-scattering-induced noise characteristics of distributed Raman amplifiers based on higher order pumping schemes. We confirm that higher order counterpumping configurations improve the amplifier equivalent NF but also increase multipath interference noise, inducing system penalties at high ON-OFF Raman gain. A Q-factor analysis allows a quantitative evaluation of the real benefits provided by higher order pumping schemes.     

Secondary haematological neoplasm after treatment of adult acute lymphoblastic leukemia: analysis of 1170 adult ALL patients enrolled in the GIMEMA trials. Gruppo Italiano Malattie Ematologiche Maligne dell'Adulto

Between 1983 and 1994 the incidence of secondary haematological neoplasms (SHM) was evaluated in 1170 new cases of ALL enrolled in the GIMEMA trials. Of the 942 patients who achieved complete remission (CR); seven developed a SHM: four AMLs and three NHLs. The median latency from onset of ALL and of secondary haematological neoplasm was 69 months for AML and 61 months for NHL. Three out of four patients with secondary AML were unresponsive to the new chemotherapy and died, whereas the fourth patient achieved a new CR. Among the three NHL cases, two patients are presently alive in CR, whereas the third patient was refractory to chemotherapy and died. The relative risk of haematological malignancy among the GIMEMA trials population, as compared to that of the Italian Cancer Registries, was 15.25-fold higher, and the actuarial estimated cumulative proportion of ALL patients with a secondary haematological neoplasm at 5 and 10 years were 0.59% and 3.63% respectively. The incidence of adult ALL who developed a SHM, although apparently lower than in the paediatric ALL series, was higher when compared to the normal population. The difference between paediatric and adult ALL is probably due to the lack of craniospinal radiotherapy and to the lower doses of epipodoxiphyllotoxins used in adult trials. The higher percentage of childhood ALL with a prolonged event-free survival could result in an increase of secondary neoplasms in these cases, which suggests that secondary haematological neoplasms in adult ALL patients are real, although rare, events.     

Enriching the egg yolk in n − 3 fatty acids by feeding hens with diets containing horse fat produced in Uruguay

The present study was conducted to evaluate the ability of horse fat produced in Uruguay, compared with other lipid sources supplemented in the diet of laying hens, to modify the lipid composition and the n − 6/n − 3 fatty acid ratio of the produced eggs. For this purpose, 60 laying hens (Gallus domesticus) were fed for 30 days with five experimental diets (12 hens/diet) containing 3% sunflower oil (SO), rice oil (RO), beef tallow (BT), pressed-fat (PF), obtained by pressing fat from bovine viscera, and horse fat (HF) obtained from horse bone medulla. Throughout the trial, feeding rate, shell index, weight and total lipid contents of eggs, were not affected by the different diets. Feeding on the SO and RO diets significantly increased the amount of linoleic acid of the egg, although it was lower in the RO than in the SO eggs. Diet BT did not affect the saturated fatty acid content of the yolks. The diets with animal fats containing 18:3n − 3 (diets PF and HF), resulted in a significant increase in the n − 3 fatty acid contents of the eggs, through an increase of linolenic (18:3n − 3) and docosahexaenoic acid (DHA, 22:6n − 3) contents. Eggs from hens fed the HF diet showed increased linolenic acid (46 mg/yolk) and DHA (71 mg/yolk, 1.7% of total fatty acids) contents. These levels were obtained after two weeks of feeding. Moreover, the fatty acid profiles of eggs from treatment HF were not significantly affected by thermal treatment of the yolks. In conclusion, the fat from horse bone medulla, as produced in Uruguay, can be considered as a suitable lipid source for diets of laying hens, to modify the nutritional composition of the eggs in n − 3 PUFA content, especially DHA, and consequently, the n − 6/n − 3 fatty acid ratio.