Novel in vitro evidence on the beneficial effect of quercetin treatment in vascular calcification.

Vascular calcification is a pathological chronic condition characterized by calcium crystal deposition in the vessel wall and is a recurring event in atherosclerosis, chronic kidney disease, and diabetes. The lack of effective therapeutic treatments opened the research to natural products, which have shown promising potential in inhibiting the pathological process in different experimental models. This study investigated the anti-calcifying effects of Quercetin and Berberine extracts on vascular smooth muscle cells (VSMCs) treated with an inorganic phosphate solution for 7 days. Quercetin has shown the highest anti-calcifying activity, as revealed by the intracellular quantitative assay and morphological analysis. Confocal microscopy revealed downregulation of RUNX2, a key marker for calcified phenotype, which was otherwise upregulated in calcified VSMCs. To investigate the anti-inflammatory activity of Quercetin, culture media were subjected to immunometric assays to quantify the levels of IL-6 and TNF-α, and the caspase-1 activity. As expected, calcified VSMCs released a large quantity of inflammatory mediators, significantly decreasing in the presence of Quercetin. In summary, our findings suggest that Quercetin counteracted calcification by attenuating the VSMC pathological phenotypic switch and reducing the inflammatory response. In our opinion, these preliminary in vitro findings could be the starting point for further investigations into the beneficial effects of Quercetin dietary supplementation against vascular calcification.

[Observations on cancer metastasis from an unknown primary location]. / Considerazioni sulle metastasi da cancro a sede primitiva sconosciuta.

Following a short introduction in which the criteria used to classify patients suffering from cancer metastasis from an occult primary location are defined, the paper reports two cases of this type: an omental metastasis occluding the upper colon and an inguinal lymph node metastasis. Referring to the international literature, the Authors then analyse the reasons for the inability to recognise the neoplasm, its incidence, patients survival, the most appropriate diagnostic course and possible treatment of these cases. In conclusion, over and above the definition of a truly autonomous nosological status of metastasis of unknown origin, it is important to follow a correct diagnostic procedure in order to establish the most appropriate form of therapy.

[Leiomyosarcoma of the duodenum]. / Il leiomiosarcoma del duodeno.

The paper reports the case of a patient with leiomyosarcoma of the duodenum who underwent radical duodenocephalopancreatectomy and survived for 22 months after the operation. Following a review of the international literature on the topic, the diagnostic procedures and prognostic criteria of this uncommon tumour are discussed. In conclusion, leiomyosarcoma always presents considerable problems of diagnosis even with the aid of biopsy and only surgery can lead to recovery in a limited number of cases.

[Submucosal lipomas of the cecum. A case report]. / I lipomi sottomucosi del cieco. Descrizione di un caso.

The paper reports a case of submucous lipoma of the cecum. The difficulty of clinical diagnosis is underlined on account of aspecific symptoms, and in fact it is uncommon for diagnosis to be made on the basis of X-rays. Colonoscopy, in particular using bioptic techniques, allows the nature of the lipoma to be diagnosed, and in addition may act as an excellent therapeutic instrument.

[Spontaneous hematoma of the musculus rectus sheath]. / Ematoma spontaneo della guaina del muscolo retto.

Spontaneous haematoma of the musculus rectus is a rare event and can lead to a clinical picture comparable to what is seen in acute abdomen, thus posing a differential diagnosis problem. Three personally observed cases are reported, stress being laid on the fact that echography, in the light of clinical and laboratory data, made correct diagnosis possible. On the basis of clinical and echographic findings, one patient was subjected to surgical treatment and the others to conservative medical treatment because of the small dimensions of haematoma.

[Spleen autotransplant. Natural history and description of a case]. / L'autotrapianto di milza. Storia naturale e descrizione di un caso.

After considering the natural history of spleen auto-transplant, a clinical case followed up for seven months with instrumental (echography, scintigraphy) and humoral (Jolly bodies, Heinz bodies, reticulocytes, platelets, complement, immune globulin) examinations has been considered so as to verify "take" and function. One months after reimplantation the patient was again operated on for the onset of an intestinal occlusion due to adherences. On that occasion it was possible to control that the implant had taken. It is concluded that personally used parameters proved to be well correlated and that scintigraphy and echography are two complementary, effective techniques for monitoring auto-transplants.

[Tubercular enteral fistulas]. / Le fistole enteriche tubercolari.

Personal experience in the treatment of two cases of postoperative tubercular enterocutaneous fistula is reported. This complication of abdominal tuberculosis is rather rare and may be a consequence of tubercular enteritis or of an extraintestinal localisation.

[Echographic identification of symptomatic gastric carcinoma and its lymph node metastases]. / Identificazione ecografica del carcinoma gastrico sintomatico e delle sue metastasi linfonodali.

The diagnostic capability of ultrasound in symptomatic gastric cancer is stressed, on the basis of a prospective study of 64 neoplastic and 19 non-neoplastic patients. Aspecific signs are described which suggest the presence of five layers within the gastric wall as an index of absence of disease. The prospective importance of ultrasound investigation in 5 neoplastic patients with aspecific symptoms is emphasized.