[Risk factors and screening for cardiac disease, carotid stenosis and aortic aneurysms in Sicily (Italy): a population-based cross sectional survey]. / Screening per malattie cardiache, stenosi carotidee e aneurismi aortici in Sicilia: uno studio trasversale di popolazione.

A cross-sectional survey was performed among 50 to 75 year-old residents in the town of Regalbuto in Sicily (Italy), to evaluate risk factors and prevalence of cardiovascular diseases (CVD) in this geographically- defined population. Subjects were invited to participate by letter and those accepting to participate were asked to complete a questionnaire collecting personal data and information regarding the presence of risk factors for CVD. All participating subjects aged >50 years and with a minimum of four risk factors for CVD (smoking, hypertension, diabetes, obesity) were screened for cardiac disease and carotid stenosis (> 50% stenosis). Screening for aortic aneurysms was performed only in male participants aged >65, regardless of the presence or absence of risk factors. Screening was performed by electrocardiography, bi-dimensional echography and ecodoppler. Overall 3,073 subjects were invited to participate, of whom 564 (18%) accepted to participate, 54% of whom female. Mean age of responders was 64 years. No differences were found in the prevalence of risk factors amongst men and women. Twenty-seven percent had one risk factor for CV disease, 35% had two risk factors, 19% had three and 6% had four or more risk factors. Hypertension was the most common risk factor detected (62%), followed by dyslipidemia (57%), obesity (26%), tobacco smoke (23%) and diabetes mellitus (17%). Overall, 134 responders (24%) underwent screening, of whom 38 were screened for cardiac diseases and carotid stenosis and 126 for aortic aneurysms. Screening identified 14 new cases of cardiovascular disease: three cases of carotid stenosis, eight of ischemic cardiopathy, and three aneurysms. In conclusion, screening in high risk subjects identified a high percentage of subects with CVD.

The bioartificial thyroid: a biotechnological perspective in endocrine organ engineering for transplantation replacement.

A new concept for ex situ endocrine organ bioengineering is presented, focused on the realization of a human bioartificial thyroid gland. It is based on the theoretical assumption and experimental evidence that symmetries in geometrical coordinates of the thyroid tissue remain invariant with respect to developmental, physiological or pathophysiological transformations occuring in the gland architecture. This topological arrangement is dependent upon physical connections established between cells, cell adhesion molecules and extracellular matrix, leading to the view that the thyroid parenchyma behaves like a deformable "putty", moulded onto an elastic stromal/vascular scaffold (SVS) dictating the final morphology of the gland. In particular, we have raised the idea that the geometry of the SVS per se provides pivotal epigenetic information to address the genetically-programmed, thyrocyte and endothelial/vascular proliferation and differentiation towards a functionally mature gland, making organ form a pre-requirementfor organ function. A number of experimental approaches are explored to obtain a reliable replica of a human thyroid SVS, and an informatic simulation is designed based on fractal growth of the thyroid intraparenchymal arterial tree. Various tissue-compatible and degradable synthetic or biomimetic polymers are discussed to act as a template of the thyroid SVS, onto which to co-seed autologous human thyrocyte (TPC) and endothelial/vascular (EVPC) progenitor cells. Harvest and expansion of both TPC and EVPC in primary culture are considered, with specific attention to the selection of normal thyrocytes growing at a satisfactory rate to colonize the synthetic matrix. In addition, both in vitro and in vivo techniques to authenticate TPC and EVPC lineage differentiation are reviewed, including immunocytochemistry, reverse trascriptase-polymerase chain reaction, flow cytomery and proteomics. Finally, analysis of viability of the thyroid construct following implantation in animal hosts is proposed, with the intent to obtain a bioartificial thyroid gland morphologically and functionally adequate for transplantation. We believe that the biotechnological scenario proposed herein may provide a template to construct other, more complex and clinically-relevant bioartificial endocrine organs ex situ, such as human pancreatic islets and the liver, and perhaps a new approach to brain bioengineering.