Synchrotron-based XRD from rat bone of different age groups.

Synchrotron-based XRD spectra from rat bone of different age groups (w, 56 w and 78w), lumber vertebra at early stages of bone formation, Calcium hydroxyapatite (HAp) [Ca10(PO4)6(OH)2] bone fill with varying composition (60% and 70%) and bone cream (35-48%), has been acquired with 15keV synchrotron X-rays. Experiments were performed at Desy, Hamburg, Germany, utilizing the Resonant and Diffraction beamline (P9), with 15keV X-rays (λ=0.82666 A0). Diffraction data were quantitatively analyzed using the Rietveld refinement approach, which allowed us to characterize the structure of these samples in their early stages. Hydroxyapatite, received considerable attention in medical and materials sciences, since these materials are the hard tissues, such as bone and teeth. Higher bioactivity of these samples gained reasonable interest for biological application and for bone tissue repair in oral surgery and orthopedics. The results obtained from these samples, such as phase data, crystalline size of the phases, as well as the degree of crystallinity, confirm the apatite family crystallizing in a hexagonal system, space group P63/m with the lattice parameters of a=9.4328Å and c=6.8842Å (JCPDS card #09-0432). Synchrotron-based XRD patterns are relatively sharp and well resolved and can be attributed to the hexagonal crystal form of hydroxyapatite. All the samples were examined with scanning electron microscope at an accelerating voltage of 15kV. The presence of large globules of different sizes is observed, in small age groups of the rat bone (8w) and lumber vertebra (LV), as distinguished from, large age groups (56 and 78w) in all samples with different magnification, reflects an amorphous phase without significant traces of crystalline phases. Scanning electron microscopy (SEM) was used to characterize the morphology and crystalline properties of Hap, for all the samples, from 2 to 100µm resolution.

Short- and medium-term outcomes of laparoscopic sleeve gastrectomy: a single center experience.

There are different surgical techniques adopted to treat morbid obesity. The objective of this study is to report surgical results after 20 laparoscopic sleeve gastrectomy (LSG) cases treated for morbid obesity during a 2-year follow-up and verify the effectiveness of LSG in term of Excess Weight Loss (EWL) as compared to laparoscopic adjustable gastric banding (LAGB).

Methane intestinal production and poor metabolic control in type I diabetes complicated by autonomic neuropathy.

AIM: At the state of art it's unknown the correlation between diabetes and lower gastrointestinal disorders. Some studies show a significantly higher prevalence of small intestinal bacterial overgrowth in patients with type I diabetes in particular complicated by autonomic neuropathy. No data exists about gastrointestinal methane production in patients with diabetes and autonomic diabetic neuropathy. The aim of this paper was to evaluate the correlation of small intestinal bacterial overgrowth and gastrointestinal methane production with metabolic control and daily insulin requirements in patients with type 1 diabetes and. autonomic diabetic neuropathy. METHODS: Thirty subjects with type 1 diabetes and autonomic diabetic neuropathy were underwent hydrogen and methane lactulose breath test (LBT) to evaluate the presence of small intestinal bacterial overgrowth (double peak of hydrogen) and methane production. The metabolic control was evaluated through the glycated hemoglobin and the daily insulin requirement (calculated as ratio between total insulin units in a day and body weight). Methane producers were treated with metronidazole (500 mg bid for 10 days) and perform a LBT 8 weeks after the end of therapy RESULTS: Eight over thirty patients (26.6%) met the diagnostic criteria for small intestinal bacterial overgrowth. 11/30 patients (36%) were methane-producers (mean baseline value 16.37 ± 13.01 ppm; mean peak 26.62 ± 11.41 ppm); interestingly this subset of patients showed a worse glycemic control (mean HbA1c 8.16 ± 0.9% vs. 7.49 ± 0.8%, P<0.05). After metronidazole therapy 7/11 (63.3%) reduced CH4 production and they showed a mean HbA1c significantly lower than corresponding value before antibiotic therapy (7.63 ± 0.7% vs. 8.25 ± 0.8%). CONCLUSION: Our study showed for the first time a possible role of CH4 production in metabolic control. In particular, the most interesting data is that an increased values of HbA1c seems to be related to a gut CH4 production as confirmed by its significant improvement after eradication therapy. We are not yet able to determine whether poor glycemic control is the cause or the consequence of the selection of methanogenic flora.

Nickel free-diet enhances the Helicobacter pylori eradication rate: a pilot study.

BACKGROUND: The Helicobacter pylori eradication rate with standard triple therapy is very low. H. pylori is known to require the nickel-containing metalloenzymes urease and NiFe-hydrogenase to survive at the low pH environment in the stomach. AIM: To compare the H. pylori eradication rate of a nickel free-diet associated with standard triple therapy and standard triple therapy alone as the first-line regimen. METHODS: Fifty-two sex- and age-matched patients at the first diagnosis of H. pylori infection were randomized 1:1 into two different therapeutic schemes: (1) standard LCA (26 patients): lansoprazole 15 mg bid, clarithromycin 500 mg bid and amoxicillin 1,000 mg bid for 7 days with a common diet; (2) standard LCA plus a nickel free-diet (NFD-LCA) (26 patients). Patients followed 30 days of a nickel-free diet plus a week of lansoprazole 15 mg bid, clarithromycin 500 mg bid and amoxicillin 1,000 mg bid starting from day 15 of the diet. RESULTS: All patients completed the study. A significantly higher eradication rate was observed in the NFD-LCA group (22/26) versus LCA group (12/26) (p < 0.01). Only a few patients (9 of 52) reported the occurrence of mild therapy-related side effects, without any significant differences between the two groups. CONCLUSIONS: The addition of a nickel-free diet to standard triple therapy significantly increases the H. pylori eradication rate. The reduction of H. pylori urease activity due to the nickel-free diet could expose the bacterium to gastric acid and increase H. pylori's susceptibility to amoxicillin. Further studies are necessary to confirm this preliminary result.

Rifaximin treatment for small intestinal bacterial overgrowth in children with irritable bowel syndrome.

OBJECTIVES: Aims of the study were to assess the effects of rifaximin treatment on small intestinal bacterial overgrowth (SIBO) prevalence and gastrointestinal symptoms. STUDY DESIGN: Fifty (50) irritable bowel syndrome (IBS) children were consecutively enrolled. All subjects underwent lactulose hydrogen/methane breath test (LBT) to assess SIBO before and one month after the treatment with rifaximin 600 mg daily for one week. All IBS patients filled out a Visual Analogic Scale (VAS) to assess and score gastrointestinal symptoms (abdominal pain, constipation, diarrhoea, bloating, flatulence) at baseline and one month after treatment. RESULTS: The prevalence of abnormal LBT in patients with IBS was 66% (33/50). LBT normalization rate was 64% (21/33). Compliance was excellent, and no relevant side-effects were observed during treatment. VAS score was significantly higher in IBS patients with abnormal LBT than SIBO negatives, and strongly improved after successful treatment. CONCLUSIONS: Rifaximin was effective and safe in SIBO treatment and IBS symptoms improvement in childhood. Double blind placebo-controlled interventional studies are warranted to verify the real impact of SIBO on gastrointestinal symptoms in children with IBS.

The role of intestinal microbiota and the immune system.

BACKGROUND: The human gut is an ecosystem consisting of a great number of commensal bacteria living in symbiosis with the host. Several data confirm that gut microbiota is engaged in a dynamic interaction with the intestinal innate and adaptive immune system, affecting different aspects of its development and function. AIM: To review the immunological functions of gut microbiota and improve knowledge of its therapeutic implications for several intestinal and extra-intestinal diseases associated to dysregulation of the immune system. METHODS: Significant articles were identified by literature search and selected based on content, including atopic diseases, inflammatory bowel diseases and treatment of these conditions with probiotics. RESULTS: Accumulating evidence indicates that intestinal microflora has protective, metabolic, trophic and immunological functions and is able to establish a "cross-talk" with the immune component of mucosal immunity, comprising cellular and soluble elements. When one or more steps in this fine interaction fail, autoimmune or auto-inflammatory diseases may occur. Furthermore, it results from the data that probiotics, used for the treatment of the diseases caused by the dysregulation of the immune system, can have a beneficial effect by different mechanisms. CONCLUSIONS: Gut microbiota interacts with both innate and adaptive immune system, playing a pivotal role in maintenance and disruption of gut immune quiescence. A cross talk between the mucosal immune system and endogenous microflora favours a mutual growth, survival and inflammatory control of the intestinal ecosystem. Based on these evidences, probiotics can be used as an ecological therapy in the treatment of immune diseases.  

Comparison of the analgesic effects of robenacoxib, buprenorphine and their combination in cats after ovariohysterectomy.

The aim of this study was to compare the postoperative analgesic effects of robenacoxib and buprenorphine alone or in combination, in cats after ovariohysterectomy. Thirty healthy cats were randomly assigned to receive buprenorphine (0.02 mg/kg, n=10; GB), robenacoxib (2mg/kg, n=10; GR) or their combination at the same dosages (n=10; GBR) SC. After 30 min cats were sedated with an IM administration of medetomidine (0.02 mg/kg) and ketamine (5mg/kg). General anaesthesia was induced with propofol and after intubation was maintained with isoflurane. Before premedication and at 1, 2, 3, 4, 6, 8, 12 and 24h after extubation, pain and sedation were assessed using a simple descriptive pain scale, ranging from 0 (no pain/no sedation) to 4 (intense pain/ deep sedation). If the pain score was ≥ 3, rescue analgesia was provided using buprenorphine (0.02 mg/kg) administered IM. Pain score was higher in GB at 2, 3, 4, 6 and 8h compared to baseline and compared to GBR at the same study times. Moreover, the pain score was also higher in GB compared to GR at 2, 3, 4 and 6h. Pain score was similar at all study times between GR and GBR. Sedation at 1 and 2h was higher than baseline values in all groups. Cats in GB received rescue analgesia more often than cats assigned to GR or GBR. Robenacoxib was an effective analgesic drug in cats up to 24h after ovariohysterectomy. The addition of buprenorphine did not provide any additional analgesic effects compared to robenacoxib alone.

An extraordinary testimonial of thermal rehabilitation: Giuseppe Garibaldi - 2011: 150th Anniversary of the Italian Unification.

On the occasion of the 150th Anniversary of the Italian Unification, the discovery of some letters by Giuseppe Garibaldi - referring to a period of thermal treatments at the Baths in Civitavecchia (Rome) - gave us the opportunity for writing a commentary about a not well known experience in the Two World Hero's life: the numerous treatments carried out at many Italian spa centres for treating a rheumatic pathology (probably a rheumatoid polyarthritis) and the outcomes of various war wounds, especially the famous gunshot-wound in his right ankle during the Battle of Aspromonte, in 1862.

The effect of oral supplementation with Lactobacillus reuteri or tilactase in lactose intolerant patients: randomized trial.

BACKGROUND: Lactase enzyme supplements and probiotics with high beta-galactosidase activity may be valid treatment options for the lactose intolerance. Aim of this study was to assess whether supplementation with tilactase or Lactobacillus reuteri when compared to placebo affects hydrogen breath excretion and gastrointestinal symptoms in lactose intolerant patients during lactose breath test (H,-LBT). METHODS: Sixty lactose intolerant patients participated in the study and were randomized to three 20 patients-treatment groups: tilactase group (tilactase 15 minutes before control H2-LBT); placebo group (placebo 15 minutes before control H2-LBT); Lactobacillus reuteri group (LR) (LR b.i.d. during 10 days before control H2-LBT). The outcomes were LBT normalization rate, and influences of treatments on both mean maximum hydrogen concentration and clinical score. RESULTS: LBT normalization rate was significantly higher in tilactase and LR groups with respect to placebo. Tilactase was significantly more effective than LR in achieving LBT normalization (p <0.01). Both significant reduction of mean peak H2 excretion and improvement of the mean clinical score were observed in tilactase and LR groups after treatment with respect to placebo (p <0.0001). Tilactase was significantly more effective than LR in reducing both mean peak hydrogen excretion and mean clinical score. CONCLUSIONS: In lactose intolerants, tilactase strongly improves both LBT results and gastrointestinal symptoms after lactose ingestion with respect to placebo. Lactobacillus reuteri also is effective but lesser than tilactase. This probiotic may represent an interesting treatment option for lactose intolerance since its use is simple and its effect may last in the time after stopping administration.

[Experimental study on the influence of natural and artificial ventilation on indoor radon concentration]. / Studio sperimentale sull'influenza della ventilazione naturale e artificiale sulla concentrazione di radon indoor.

The study presents the results of a campaign of measurements on the daily radon concentration using a Genitron Alpha Guard spectrometer. All the measurements have been intended to highlight the radon concentration variability during the 24 hours of the day and trying to find correlations with other ambient parameters such as temperature and pressure or local conditions such as the presence or not of a forced ventilation system. The main part of the measurements have been carried in the area of the Nuclear Measurement Laboratory of the Department of Basic and Applied Sciences for Engineering of "Sapienza" University of Rome. Results show a rapid rise of radon concentration in the night, when the artificial ventilation system was off and with door and windows closed. In the morning, after the opening of door and windows, the concentration falls down abruptly. With artificial ventilation system in function concentration never reaches significant values.

Investigation of the distribution of elements in snail shell with the use of synchrotron-based, micro-beam X-ray fluorescence spectrometry.

In this study, synchrotron-based micro-beam was utilized for elemental mapping of a small animal shell. A thin X-ray spot of the order of approximately 10microm was focused on the sample. With this spatial resolution and high flux throughput, the X-ray fluorescent intensities for Ca, Mn, Fe, Ni, Zn, Cr and Cu were measured using a liquid-nitrogen-cooled 13-element energy-dispersive HpGe detector. The sample is scanned in a 'step-and-repeat' mode for fast elemental mapping and generated elemental maps at 8, 10 and 12keV. All images are of 10microm resolution and the measurement time was 1s per point. The accumulation of trace elements was investigated from the soft-tissue in small areas. Analysis of the small areas will be better suited to establish the physiology of metals in specific structures like small animal shell and the distribution of other trace elements.

Small bowel bacterial overgrowth and type 1 diabetes.

BACKGROUND: Gastrointestinal motility disorders are often present in diabetic patients (pts). Such motility dysfunctions have been attributed to autonomic neuropathy. Impaired intestinal motility is often associated with small-bowel bacterial overgrowth (SIBO) but only few studies evaluated the relationship between autonomic neuropathy and SIBO in diabetic pts. AIM: To compare the prevalence of SIBO between type 1 diabetic (T1D) pts with and without autonomic neuropathy. PATIENTS AND METHODS: 25 pts (13 males, 12 females; mean age 44.2+/-7) affected by type 1 diabetes with normal cardiovascular autonomic test (group A) and 25 type 1 diabetic pts with abnormal cardiovascular autonomic test (group B) were submitted to hydrogen lactulose breath test. RESULTS: 2 out of 25 (8%) showed SIBO among group A, while 11 out of 25 (44%) showed SIBO among group B (p<0.01). Interestingly, among group B, the daily insulin requirements was significantly higher in SIBO-positive pts compared to SIBO-negative: 0.66+/-0.3 vs. 0.59+/-0.1 UI/kg (p<0.05). CONCLUSIONS: Pts with autonomic neuropathy have a significantly higher prevalence of SIBO, that is also associated with a higher daily insulin requirements.

Use of oxycodone in polytrauma patients: the "Gemelli" experience.

INTRODUCTION: This is the first study investigating the effect of oxycodone in polytrauma patients. The management of pain in polytrauma patients has become a very relevant issue. Nonsteroidal anti-inflammatory drugs (NSAIDs) represent the most used drugs in polytrauma patients, even though their use is associated with an increased hemorrhagic risk. Previous studies have demonstrated the efficacy of oxycodone for the treatment of acute pain. The aim of this study was to assess the efficacy of oxycodone administration in polytrauma patients, with minor injuries. PATIENTS AND METHODS: 15 polytrauma patients (10 males, mean age 40 +/- 13 years; 5 females, mean age 49 +/- 26 years) were admitted to the Emergency Department of the Catholic University, A. Gemelli Hospital in Rome, Italy. All patients underwent physical examination, FAST ultrasound, total body CT scanning and blood tests. Three patients had multiple costal fractures, three had pelvic fracture, two had tibial fracture, five had vertebral fractures, one patient had clavicle fracture and ulnar fracture, one patient a severe trauma of the left leg, which required amputation. Five patients also reported minor head trauma, with a Glasgow Coma Score (GCS) 15. All patients reported abdominal trauma, while none of them had severe thoracic or kidney damage. Patients with head trauma also underwent a second CT head scanning 12 hours after admission, which excluded the occurrence of cerebral damage. All patients were then treated with oral administration of oxycodone 10 mg two times per day (bid) for 3 days. Pain intensity, before and after the administration of oxycodone, was evaluated using a scale ranging from 0 to 10. RESULTS: The mean pain score at admission was 8 +/- 0.7. All patients reported significant pain improvement after the administration of oxycodone (8 +/- 0.7 vs 1.8 +/- 0.9; p < 0.0001). A dosage increase of oxycodone from 20 to 40 mg bid was required in only one patient with a clavicle fracture. The main side effects were light-headache (5 patients), constipation (4 patients) and nausea (3 patients). CONCLUSIONS: These data indicate that oxycodone is a safe and effective drug for pain relief in polytrauma patients without severe thoracic, kidney or brain damage.

A comparative study for the development of a thermal odoscope for the wearable dynamic thermography monitoring.

BACKGROUND: The need of the reliable continuous monitoring of temperature is rising in many clinical applications. Today the use of thermography has become central for instance in the analysis of breast cancer, for the survey of inflammatory processes and certain skin areas during physical exercise. The core of the problem is the development of an ad hoc instrument, because traditional methodologies such as infrared and liquid crystals are no longer suitable. MATERIAL AND METHODS: We developed a dedicated simulation set-up using Matlab R12 procedures (The Mathworks, USA) and P-spice models (Interlink, USA). We simulated the realisation and use of three different equipment configurations for thermography, one based on PTC sensors, another on thermocouples, a third one on specific integrated silicon components. We also bench tested one prototype. RESULTS: The results showed the feasibility of the realisation of the instrument and the validity of the data obtained by means of the simulation.

A new kernel method for microcalcification detection: Spin Glass-Markov Random Fields.

Mammography associated with clinical breast examination is the only effective method for mass breast screening. Microcalcifications are one of the primary signs for early detection of breast cancer. In this paper we propose a new kernel method for classification of difficult-to-diagnose regions in mammographic images. It consists of a novel class of Markov Random Fields, using techniques developed within the context of statistical mechanics. This method is used for the classification of positive Region of Interest (ROI's) containing clustered microcalcifications and negative ROI's containing normal tissue. The obtained results show that the proposed approach can be successfully employed for detection of microcalcifications

Toward a quantitative analysis of skin lesion images.

Melanoma is the most dangerous form of skin cancer. Skin cancers, and particularly melanomas, can be easily cured if detected early. The regularity of the pigment network structure is a significant sign for early diagnosis of melanoma. We present here a quantitative analysis of the morphology of the pigment network structure. Our method is based on the extraction of the pigment network structure using digital image processing techniques. Once the network is extracted, it is possible to derive statistical indicators relative to its regularity or irregularity. We report experiments on a database of 14 images, showing the effectiveness of our method.

Comparison of different excitation methods for X-ray spectral analysis: the case of synchrotron radiation.

Different excitation means, protons, photons and electrons (PIXE, XRFA, and EPMA, respectively) have previously been compared with regard to the figures of merit, i.e. detection power, precision and accuracy. The aim in this article is to compare synchrotron radiation SR as another excitation method with the methods mentioned above. From this point of view the evaluation of (SR) was missing as an again independently optimized excitation method and was based as previously on practical problems of trace analysis, in this case on the determinations of traces in lead. The experiment has been performed with thick homogeneous samples of lead, the same samples already used in the former work, so that a direct comparison is possible. The calculation of the figures of merit is based on the measurements of the blank values and their relative standard deviation for the detection limit and on the random errors for the precision. Regarding the thick homogeneous target of lead XRFA still turns out to be the best method, whereas Synchrotron X-Ray Fluorescence SY-XRF compares favorably, at least for larger atomic numbers Z. Even PIXE is inferior to (SY-XRF) in the case of larger Z; when information on the lateral distribution of the elements is of interest, PIXE is indispensable.

Analysis of periapical lesion using statistical textural features.

In this work we present a quantitative study on different regions of periapical images with a series of textural features, extracted using cooccurrence matrices; those features are used for a pattern recognition analysis by means of an artificial neural network. The obtained results show that it is possible to recognize in an objective way changes in bone pattern.