The underestimated burden of aspiration event and pneumonia within hospitals: what happens after dysphagia.

Study design: Prospective observational study. Background: Despite dysphagia large prevalence and the growing ageing phenomenon occurring in European countries, aspiration events among inpatients are often underestimated, given their frequent spontaneous resolution or silent contribution to aspiration syndromes. Our main objective was to evaluate the incidence of aspiration events among medical inpatients and to identify risk factors influencing the outcome of the event. Methods: Data about aspiration events - day, hour, type and outcome of the event occurred - along with underlying patient clinical conditions at the admission were collected. Between May 2015 and September 2016, data about aspiration event occurred among medical inpatients were collected in three large Italian hospitals. Results: Patients affected by aspiration events were 135 on 102,619 cumulative days of hospitalization; they were mostly females (53%) with an average age of 82. The total incidence of aspiration events was of 1.4 every 1,000 days of hospitalization (C.I. 95%: 1.2-1.7) and the most frequent manifestation was cough (61.6%). The addition of drugs or an infection diagnosis during the 24 hours preceding the event acted as risk factors for those events that needed additional interventions during the hospitalization (OR 3.1 e OR 1.9 respectively), while the elimination of one or more prescribed drugs seemed to lead to aspiration events without impact on the hospitalization. Conclusions: Results showed a large incidence of aspiration events within medical wards, many of them influencing patient outcomes. Healthcare professionals' attention concerning aspiration events should be fostered during the first hours and days of hospitalization.

High-content drug screening for rare diseases.

Per definition, rare diseases affect only a small number of subjects within a given population. Taken together however, they represent a considerable medical burden, which remains poorly addressed in terms of treatment. Compared to other diseases, obstacles to the development of therapies for rare diseases include less extensive physiopathology knowledge, limited number of patients to test treatments, and poor commercial interest from the industry. Recently, advances in high-throughput and high-content screening (HTS and HCS) have been fostered by the development of specific routines that use robot- and computer-assisted technologies to automatize tasks, allowing screening of a large number of compounds in a short period of time, using experimental model of diseases. These approaches are particularly relevant for drug repositioning in rare disease, which restricts the search to compounds that have already been tested in humans, thereby reducing the need for extensive preclinical tests. In the future, these same tools, combined with computational modeling and artificial neural network analyses, may also be used to predict individual clinical responses to drugs in a personalized medicine approach.

Differential effects of all-trans retinoic acid on the growth of human keratinocytes and mouth carcinoma epidermoid cultures. Involvement of GRIM-19 and complex I of the respiratory chain.

Squamous cell carcinoma (SSC) is the most frequent malignant tumor of the oral cavity. A study on the effect of all-trans retinoic acid (RA) on cell growth, expression of GRIM-19 and content and activity of complex I of the mitochondrial respiratory chain in normal human keratinocytes (NHEK) and mouth carcinoma cells with low (HN) and high (KB) transformation grade was carried out. In NHEK cells, RA treatment resulted in growth suppression, significant overexpression of GRIM-19 protein, enhanced content of complex I but depressed activity of NADH-UQ oxidoreductase activity of the complex. In HN cells, RA treatment depressed cell growth, inhibited the enzymatic activity of complex I but had no significant effect on the levels of GRIM-19 and complex I. In KB cells RA had no effect on cell growth, GRIM-19 expression, content and activity of complex I.

Regulation by the cAMP cascade of oxygen free radical balance in mammalian cells.

A study is presented of the effect of the cAMP cascade on oxygen metabolism in mammalian cell cultures. Serum-starvation of the cell cultures resulted in depression of the forward NADH-ubiquinone oxidoreductase activity of complex I, decreased content of glutathione, and enhancement of the cellular level of H2O2. Depressed transcription of cytosolic Cu/Zn-SOD 1, mitochondrial glutathione peroxidase and catalase was also observed. Activation of the cAMP cascade reversed the depression of the activity of complex I and the accumulation of H2O2. The effect of cAMP involved the cAMP-dependent protein kinase.

Milking tests on Murgese mares and the design of adapted stalls.

The results of research into the milking of mares of the Murgese breed are described. A comparison was made between hand and mechanical milking with two pulsation rates (120 and 140 cycles/min) with the objective of defining mechanical and operational solutions for the design or standardisation of machine milking of mares with special reference to the Murgese breed. The study was performed on four multiparous mares, after a suitable adaptation period. The trial lasted 45 days, during which the animals were milked twice a day. Research showed considerable advantages, both from productive and technical manipulation viewpoints, of milking this species by mechanical means, rather than by hand. Moreover, mechanical milking at 140 cycles/min provided better results than other techniques examined, as it is possible to obtain the best milk production, the smallest specific power consumption and, in addition, the highest working capacity and labour productivity. The adaptation of the animals to mechanical milking and the resultant production can be considered adequate. Mechanical and operating solutions are proposed for new plants, together with adaptations to ensure security in existing plants.

MP-Link cementless distal fixation modular prosthesis for revision total hip arthroplasty.

The aseptic loosening of the femoral stem may require different treatments due to the complex problems related to the bone resorption (qualitatively and quantitatively): a minimum bone stock loss may result in a periprosthetic resorption that is so severe to make the fixation of the revision prosthesis extremely difficult. The revision surgery of a loosened hip prosthesis is often characterized by a complex reconstruction due to such severe loss of femoral bone tissue. We illustrate our experience with MP-Link modular stem (Waldemar Link, Hamburg, Germany) in cases of severe bone loss of the metaphyseal area and of the proximal third of the femoral shaft, assessing the technological developments (materials and design) over the years and examining the pros and cons of cementless distalfixation modular stems versus the traditional Wagner's stem.

Psychoacoustical performance in children.

In order to contribute to knowledge of the elementary auditory functions in infancy, a group of normally hearing children below the age of four years was examined using advanced tests for cochlear (remote masking, brief-tone audiometry, critical ratio) and central auditory functions (masking-level difference). The results showed that both cochlear and central auditory functions were almost the same in three-year-olds as they were in adults, if not better. This behavior is similar to that recorded with electrophysiological methods and leads to the conclusion that at age three years the auditory system has completed its neurofunctional maturation and it is therefore completely efficient in its elementary psychosensorial functions.

The use of collagenase-clostridiopeptidase combined with chloramphenicol in orthopaedics and traumatology.

The authors report a consecutive group of 95 patients suffering from chronic ulceration treated by a mixture of Collagenase Clostridiopeptidase A and 1% Chloramphenicol. Some cases involved skin only, some affected skin and muscle, and some also affected bone. The treatment was successful in all cases. The mixture acts by inducing debridement and cleansing of the necrotic areas and stimulating granulation tissue formation. This is followed by epithelialisation. At the same time the vitality of the deep tissues is maintained, even when it involves bone.