Search

Clostridioides (previously Clostridium) difficile infection (CDI) is a common cause of antibiotic-associated diarrhea, whose symptoms range from mild diarrhea to life-threatening pseudomembranous colitis. CDI is characterized by significant recurrence rate following initial resolution and recurrent C. difficile infection (rCDI) represents an onerous burden for the healthcare systems. Conventional antibiotic-based approaches are generally used for the treatment of rCDI but the effective therapy remains elusive. Recently, the faecal microbiota transplantation (FMT) has emerged as an alternative therapeutic strategy against rCDI, with high treatment success rate. In 2018, the Italian National FMT Program was launched, with the aim to provide high quality standards in FMT application to adults with rCDI not responding to antibiotic therapy. Here, we sketch out the key characteristics and the progress of the Italian National FMT Program during the CO-VID-19 pandemic.

Pro-nerve growth factor (proNGF) is the predominant form of NGF in the brain and its levels increase in neurodegenerative diseases. The balance between NGF receptors may explain the contradictory biological activities of proNGF. However, the specific role of the two main proNGF variants is mostly unexplored. proNGF-A is prevalently expressed in healthy brain, while proNGF-B content increases in the neuro-degenerating brain. Recently we have investigated in vitro the biological action of native mouse proNGF variants. To gain further insights into the specific functions of the two proNGFs, here we intranasally delivered mouse-derived proNGF-A and proNGF-B to the brain parenchyma of healthy and diabetic rats, the latter characterized by dysfunction in spatial learning and memory, in the septo-hippocampal circuitry and by relative increase in proNGF-B hippocampal levels. Exogenous proNGF-B induces depression of hippocampal DG-LTP and impairment of hippocampal neurogenesis in healthy animals, with concomitant decrease in basal forebrain cholinergic neurons and cholinergic fibers projecting to the hippocampus. proNGF-A, while ineffective in healthy animals, rescues the diabetes-induced impairment in DG-LTP and hippocampal neurogenesis, promoting the concomitant recovery of the basal forebrain cholinergic phenotype. Our experimental evidences suggest that the balance between different proNGFs may influence the development and progression of neurodegenerative diseases.

AIM: Enhanced Recovery After Surgery (ERAS) guidelines represent one of the most important steps forward in colorectal surgery in the last ten years. Despite the well-known and demonstrated positive impact on the clinical outcomes that this pathway provides, a cultural revolution in patient management is needed. This is not easy to obtain, especially in small and peripheral centers. In Italy, the diffusion of minimally invasive surgery and "fast-track" perioperative management of the patient is rapidly spreading, even in the central and southern regions. However, in these regions, the percentage of laparoscopic colorectal procedures is dramatically less than in the north of Italy. In this context, the idea of a research group based in Rome focused on the development and spreading of ERAS protocols in the Lazio Region was developed.METHODS: A research group, based in Rome, was founded in December 2016 to evaluate the diffusion of the ERAS program over the main colorectal centers of the region. This "Lazio Network" began with a group of surgeons and anesthesiologists from 5 hospitals. After one and half years, the project now includes 17 hospitals in the region. A multicenter database was created, including consecutive patients who underwent laparoscopic colorectal resection following the ERAS program in the participating centers between January 2016 and December 2017.RESULTS: Data for more than 1200 patients were collected over the observed period. The rate of minimally invasive surgery was higher compared to the regional rate (90% vs. 30%), adherence to the ERAS pathway was around 60% of the items per patient. A clinical study will result from this database. The objective is to evaluate the mean number of ERAS items applied, the most common and uncommon items applied and the influence of this application on the clinical outcomes.CONCLUSIONS: The adoption of the ERAS program is rapidly increasing even in central Italian regions, even though the total rate of minimall

It is well known that the axial load plays an important role in the evaluation of the structural capacity of RC columns. In existing buildings this problem can be even more significant than in new ones, since the material can easily present poor mechanical properties. The paper is aimed at the investigation of the role of the axial load variation on the seismic performance of RC columns of a case-study, i.e. a doubly symmetric 4-storey RC building. The effects of the axial load variation have been checked on the first storey columns, by comparing the seismic response, measured in terms of chord rotation and shear force, with the corresponding capacity. The sensitivity of the seismic performance to the axial load is evaluated with special attention on the type of analysis adopted to determine the seismic response and on considering a wide range of values for the concrete strength. The study points out a non-negligible effect of the axial load variation on the seismic response of the case-study building, especially when combined to concrete strength variability., Applied Mechanics