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Background and purpose: Acquired neuromyotonia can occur in patients with thymoma, alone or in association with myasthenia gravis (MG), but the clinical prognostic significance of such comorbidity is largely unknown. The clinico‐pathological features were investigated along with the occurrence of neuromyotonia as predictors of tumour recurrence in patients with thymoma‐associated myasthenia. Methods: A total number of 268 patients with thymomatous MG were studied retrospectively. Patients with symptoms of spontaneous muscle overactivity were selected for autoantibody testing using immunohistology for neuronal cell‐surface proteins and cell‐based assays for contactin‐associated protein 2 (CASPR2), leucine‐rich glioma inactivated 1 (LGI1), glycine receptor and Netrin‐1 receptor antibodies. Neuromyotonia was diagnosed according to the presence of typical electromyography abnormalities and/or autoantibodies against LGI1/CASPR2. Results: Overall, 33/268 (12%) MG patients had a thymoma recurrence. Five/268 (2%) had neuromyotonia, four with typical autoantibodies, including LGI1 (n = 1), CASPR2 (n = 1) or both (n = 2). Three patients had Netrin‐1 receptor antibodies, two with neuromyotonia and concomitant CASPR2+LGI1 antibodies and one with spontaneous muscle overactivity without electromyography evidence of neuromyotonia. Thymoma recurrence was more frequent in those with (4/5, 80%) than in those without (28/263, 10%, P < 0.001) neuromyotonia. Neuromyotonia preceded the recurrence in 4/5 patients. In univariate analysis, predictors of thymoma recurrence were age at thymectomy [odds ratio (OR) 0.95, 95% confidence interval (CI) 0.93–0.97], Masaoka stage ≥IIb (OR 10.73, 95% CI 2.38–48.36) and neuromyotonia (OR 41.78, 95% CI 4.71–370.58). Conclusions: De novo occurrence of neuromyotonia in MG patients with previous thymomas is a rare event and may herald tumour recurrence. Neuronal autoantibodies can be helpful to assess the diagnosis. These observations provide pragmatic risk stratification for tumour vigilance in patients with thymomatous MG. [ABSTRACT FROM AUTHOR]

[15/19] Helicobacter pylori Eradication after the Standard 'Maastricht Triple Therapy': Which are the Predictors of Failure? Background: Short-term triple therapy with PPI, clarithromycin, and amoxycillin has been proposed by the [...]

[15/07] [*] Ranititine Bismuth Citrate (RBC) plus Amoxycillin and Tinidazole: A useful Second-Line Regimen After Failure of the Standard 'Triple Therapy' Background: Triple therapy with PPI, clarythromycin (CLA), and amoxycillin [...]

[10/11] HLA-DQA1 and -DQB1 Genes and Helicobacter pylori infection in Italian Patients with Gastric Adenocarcinoma Background: Both HLA-DQA1 and -DQB1 genes and Helicobacter pylori infection have been linked to gastric [...]

Background: The incidence of type 1 diabetes mellitus (T1DM) in Sardinia is among the highest in the world (44.8 cases/100,000 person-years). Recommendations of the Immunology of Diabetes Society advise evaluating autoantibody positivity in first-degree relatives (FDRs) of patients with T1DM, for their higher risk to develop the disease. The aim of this study was to determine the prevalence of beta-cell autoimmunity in FDRs of T1DM patients in Sardinia.Methods: A total of 188 Sardinian families were recruited in collaboration between diabetes and pediatric units of university and district hospitals in Sardinia. The recruitment involved 188 patients with diagnosed T1DM and all their available FDRs (n = 447). Autoantibodies (Aabs) against GAD, IA2, insulin, and ZnT8 were measured in all subjects. Human leukocyte antigen (HLA) risk genotypes (HLA-DR and DQ loci) were analyzed in 43 Aabs-positive FDR.Results: The prevalence of Aabs (any type of autoantibody, single or multiple) in FDR was 11.9% (53/447). Of those with autoantibodies, 62.3% (33/53) were positive to only 1 autoantibody, 22.6% (12/53) had 2 autoantibodies, 7.55% (4/53) had 3 autoantibodies, and 7.55% (4/53) had all 4 autoantibodies. Typing of HLA-DR and DQ loci showed that 89% of FDR carried moderate- to high-risk genotypes, with only 5 FDR with low-risk genotypes.Conclusions: The prevalence of T1DM autoantibodies in FDRs of T1DM patients was very high (11.9%) in the Sardinian population, higher than in other populations from the United States and Europe, and similar to that observed in Finland. Autoantibody positivity strongly associated with HLA risk. This study provides evidence of the high risk of T1DM in FDR of T1DM patients in Sardinia and warrants longitudinal follow-up to estimate the risk of progression to T1DM in high-risk populations. [ABSTRACT FROM AUTHOR]

In this work, we compared the photovoltaic performance of standard and inverted polymer solar cells with the aim to elucidate the origin of the different current output. We realized devices with both architectures using a blend film of poly[(4,8-bis-(2-ethylhexyloxy)-benzo[1,2-b:4,5-b′]dithiophene)-2,6-diyl-alt-(4-(2-ethylhexanoyl)-thieno[3,4-b]thiopene)-2,6-diyl] /[6,6]-phenyl C 71 butyric acid methyl ester (PBDTTT-C:[70]PCBM). The standard cell sequence is ITO/PEDOT:PSS/PBDTTT-C:[70]PCBM/Ca/Al and the inverted one is ITO/ZnO/PBDTTT-C:[70]PCBM/MoO 3 /Ag. The inverted architecture shows better performances compared to the standard one mainly in terms of current output. The optical modeling has revealed that this architecture allows more photons to be absorbed in the blend film, giving rise to an higher current output, although the observed improvement cannot be completely attributed to the calculated higher absorption of the incoming light. By using the impedance spectroscopy analysis, we found that the inverted device architecture has higher values for the interface trap time constant and the density of interface states. Both parameters contribute to retain the charge collection efficient, compared to the standard configuration, despite the increased charge carrier density and to further improve the current output. [ABSTRACT FROM AUTHOR]

In this work, highly conductive and transparent films based on poly(3,4 ethylenedioxythiophene):poly(styrene sulfonate) (PEDOT:PSS) doped with dimethyl sulfoxide (DMSO) were printed onto a flexible substrate, the polyethylene naphthalate (PEN), using the gravure printing method. Gravure-printed DMSO-PEDOT:PSS ink suitably modified with isopropanol was developed and used as anode in flexible solar cells replacing the commonly used anode, that is, Indium Tin Oxide (ITO). Several inks were prepared and characterized in terms of viscosity and surface energy and tested by gravure printing. The wettability of the PEN substrate was investigated through contact angle measurements. For comparison, the anodic conductive polymer was also spin coated on the PEN substrate using an ink suitable for this technique. The films produced with both the techniques, gravure printing and spin coating, each using a proper ink, were characterized in terms of structure and physical-chemical properties. The printed layers were employed as anodes into ITO free-polymer solar cells based on a bulk heterojunction of Poly({4,8-bis[(2-ethylhexyl)oxy]benzo[1,2- b:4,5-b′]dithiophene-2,6-diyl}{3-fluoro-2-[(2-ethylhexyl)carbonyl]thieno [3,4- b]thiophenediyl}) (PTB7) and [6,6]-phenyl C70-butyric acid methyl ester ([70]PCBM). The performances of the devices with printed and spin coated polymeric anode were compared. The cell with the spin-coated anode reached a power conversion efficiency of 3% while the corresponding device with the printed anode a value around 2%. POLYM. COMPOS., 36:1104-1109, 2015. © 2015 Society of Plastics Engineers [ABSTRACT FROM AUTHOR]

Poxvirus uracil DNA glycosylases are the most diverse members of the family I uracil DNA glycosylases (UNGs). The crystal structure of the uracil complex of Vaccinia virus uracil DNA glycosylase (D4) was determined at 2.03 Å resolution. One uracil molecule was located in the active-site pocket in each of the 12 noncrystallographic symmetry-related D4 subunits. Although the UNGs of the poxviruses (including D4) feature significant differences in the characteristic motifs designated for uracil recognition and in the base-excision mechanism, the architecture of the active-site pocket in D4 is very similar to that in UNGs of other organisms. Overall, the interactions of the bound uracil with the active-site residues are also similar to the interactions previously observed in the structures of human and Escherichia coli UNG. [ABSTRACT FROM AUTHOR]

Summary: Background: Substantial geographical clustering of Clostridium difficile infection (CDI) outbreaks in hospitals in the USA have previously been demonstrated. Aim: To test the hypothesis that hospital burden of CDI is associated with admission from and discharge to long-term care facilities (LTCFs). Methods: Hospital discharge data from 19 states in the USA were used to identify all patients discharged with a diagnosis of CDI from 1 January 2002 to 31 December 2004. For every hospital, the proportion of discharges with a diagnosis of CDI was calculated, and those above the 90th percentile were classified as ‘high CDI’ hospitals. We tested the association between this measure of hospital burden of CDI and the rates of admission from and discharges to LTCFs. We adjusted for other hospital level characteristics, case-complexity and local population characteristics. Findings: We identified 38,372,951 discharges during the three-year study period. Of all discharges, 274,311 (0.71%) had a primary or secondary diagnosis of CDI. Hospitals had a mean CDI burden of 7.8 cases per 1000 discharges. High CDI hospitals (N = 610; 10.0%) had a mean CDI burden of 34.8 cases per 1000 discharges. Compared to other hospitals, high CDI hospitals were more likely to have a high proportion of admissions from or discharges to LTCFs. This association persisted after adjustments for other hospital characteristics, case-complexity, and area population characteristics. Conclusion: A high rate of admission from or discharge to LTCFs is associated with an increased hospital burden of CDI. [Copyright &y& Elsevier]

Excessive body fat is associated with increased risk for coronary heart disease (CHD). Various anthropometric methods are currently used to quantify regional and total body fat. The objectives of this study were to provide more insight into differences in cutoff points between methods for measuring total body fat and those for measuring regional body fat, independently and in combination, and to determine how well anthropometric and bioelectrical impedance methods of estimating body composition predict cardiovascular risk in a sample of unfit National Guard soldiers. Unfit healthy men (n = 123) and women (n = 32) between 21 and 55 years old from the Army National Guard were assessed for total and regional body fat. After having their degree of total and regional body fat assessed, the participants were categorized by level of body fat and 10-year CHD risk. Comparisons and predictions were made between degree of total as well as regional body fat and 10-year CHD risk estimated from Framingham Heart Study equations. A significant positive relationship was observed between waist circumference and 10-year CHD risk in men. When controlling for age, waist circumference was predictive of 10-year CHD risk, contributing to 6.4% of the variance, whereas waist-to-hip ratio did not contribute to the model significantly. The results of this study show that waist circumference is the best measure for identifying unfit male individuals at risk for CHD. Copyright © 2009 by Elsevier Inc. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine physical work performance, energy cost, and physiological fatigue in military personnel during simulated operational conditions. Using a within-subject, repeated-measures design, 34 military personnel volunteered to undergo two experimental conditions: with body armor (BA+) and without BA (BA-). Subjects walked on a treadmill for 30 minutes and completed a physical performance battery during each of two sessions, which were separated by > or = 5 days. Subjects with BA+ as compared with BA- had significantly greater increases in: oxygen uptake (VO2) at slow (16.8 +/- 1.5 vs. 18.8 +/- 1.7 mL x kg(-1) x min(-1)) and moderate paces (34.8 +/- 3.9 vs. 40.8 +/- 5.0 mL x kg(-1) x min(-1)); blood lactate at a moderate pace (4.0 +/- 2.4 vs. 6.7 +/- 2.6 mmol/L); heart rate at slow (107 +/- 14 vs. 118 +/- 16 beats per minute) and moderate paces (164 +/- 16 vs. 180 +/- 13 beats per minute); and ratings of perceived physical exertion at slow (8.4 +/- 1.5 vs. 10.4 +/- 1.8) and moderate paces (14.3 +/- 2.3 vs. 16.7 +/- 2.1). Physical tasks were significantly affected by BA: under BA+, men performed 61% fewer pull-ups and women's hang time was reduced by 63%; stair stepping was reduced by 16% for both men and women. BA significantly impacted the physical work capacity of militarily relevant tasks. Specifically, wearing BA significantly increased VO2 when walking at both slow and moderate paces. The potential for physical exhaustion is high and performance of physical tasks is markedly impaired when wearing BA. [ABSTRACT FROM AUTHOR]

Scanning electron microscopy coupled with an energy dispersive X-ray detector (SEM-EDS) has been used to study samples of Sasanian glazed pottery. Analysis of ceramic bodies revealed a general homogeneity in composition among the studied samples and the use of calcareous clay for their manufacture. Glazes are typically alkaline in composition, with sodium and potassium oxide contents between 8 and 13%, and between 3 and 5%, respectively; calcium and magnesium oxide contents are between 7 and 10%, and between 3 and 5%, respectively. These data suggest the use of plant ash together with a silica source for glaze production. Coating thickness is highly variable among different samples, from some 400 up to 1200 µm, but it is generally uniform when a single sample is concerned. Glazes are mostly coloured blue or blue-green; copper and iron are the colouring agents detected; abundance of bubbles, silicate crystals and relics of unmelted material are responsible for their generally opaque appearance, together with the presence of weathering products. The characteristics of the body to glaze contact zone, together with the widespread presence of bubbles, would not rule out production by a single firing process. A few samples feature a peculiar gritty coating on one side of their surface; SEM images show that they are actually partially vitrified, and EDS data denote a rather heterogeneous composition. It seems possible that they result from mixing clay together with the frit used for glaze development. [ABSTRACT FROM AUTHOR]

Isolated fungal infections of the perianal skin are rare and their diagnosis is frequently overlooked. We report a case of a 78-year-old male patient who presented with a friable, violaceous, papulopustular lesion, with heaped-up edges along the anal verge. Biopsy revealed unicellular yeast consistent with blastomycosis. The patient was treated with itraconazole with resolution of this lesion. An extensive MEDLINE literature review from 1958 to the present indicates that this is an uncommon manifestation of cutaneous blastomycosis. A summary of the medical literature is presented with a review of the characteristics, diagnosis, and management of blastomycosis. [ABSTRACT FROM AUTHOR]

We sought to determine the impact of (1) grade of the colon injury, (2) the formation of an ostomy, and (3) associated injuries on outcomes such as morbidity and mortality after blunt colon injuries. We retrospectively reviewed 16,814 cases of blunt abdominal trauma. Patients with colonic injuries were selected and charts reviewed for demographic, clinical, and outcomes data. Injuries were grouped by the Colon Injury Scale (grades I-V). Independent risk factors of morbidity included spine and lung injuries, as well as increased age. A higher grade of colon injury trended toward a significant association with intra-abdominal complications. Independent risk factors of mortality included liver, heart, and lung injuries, as well as intracerebral blood and female gender. The grade of colon injury, the formation of an ostomy, and management of the colon trauma did not independently predict increased intra-abdominal complications, morbidity, or mortality. These results indicate that patients afflicted with blunt colon trauma experience a high rate of morbidity and mortality from associated injuries and or increased age. Treatment regimens directed at these factors will be most helpful in reducing the high morbidity and mortality after blunt colon trauma. Factors such as ostomy formation and management strategy are not associated with increased morbidity or mortality after blunt colon trauma. [ABSTRACT FROM AUTHOR]

Background: Urea breath test (UBT) is the most accurate non invasive test for either diagnosing (Dx) or confirming the successful eradication (Cx) of H. pylori infection. Aim: To evaluate the appropriateness of UBT referrals in one Italian Center. Methods: Patients consecutively referred for UBT (1-year period). Age, sex, symptoms, endoscopic findings, NSAIDs use, family history of gastric cancer or H. pylori infection, and concomitant diseases were recorded. Reasons for UBT referral were carefully examined and judged as appropriate or not according to the guidelines of the Maastricht 2-2000 Consensus Meeting. Patients were asked whether they had been referred by GP or gastroenterologist. Results: 1320 subjects (47±16 years) were referred for UBT to our Unit during 2001:578 (43.8%) for Dx and 742 (56.2%) for Cx of infection. The UBT was considered appropriate in 836 (63.3%) patients, inappropriate in 192 (14.5%), and still appropriate but avoidable in 292 (22.1%) patients who should have been tested with a biopsy-based method during prior endoscopy. In the subgroup of patients (n = 230) with uninvestigated dyspepsia, who underwent UBT according to the "test and treat" strategy proposed in Maastricht, 98 (42.6%) were > 45 years or presented at least one risk factor for organic disease. Overall, the appropriateness ratio of UBT referrals (appropriate UBT/inappropriate UBT) was 4.64 and 9.02 (p < 0.01) for GPs and gastroenterologists, respectively. Conclusion: In Italy, nearly 36% of UBT referrals are inappropriate or could be avoided if all dyspeptic patients with risk factors would be correctly referred to endoscopy or all dyspeptic patients undergoing endoscopy would be tested for H. pylori infection with a biopsy-based method. Although the European guidelines on the management strategies of H. pylori infection clearly indicate who to test and how to test, both GPs and, to a lesser extent, gastroenterologists still need educational programs to... [ABSTRACT FROM AUTHOR]

The effectiveness of intranasal neostigmine (9.3-13.8 mg) was tested in 20 subjects with myasthenia gravis, classified as Osserman grades 2A and 2B. In all cases the drug produced significant clinical and electromyographic improvement. No side effects were reported during the treatment. [ABSTRACT FROM AUTHOR]

In recent years, organisations have used multiple methods and approaches to design their strategic and action plans. In this context, resource-based view (RBV) and knowledge-based view (KBV) frameworks have received increased attention as being instrumental to strategy formulation. The synergy of these approaches with knowledge management initiatives is intuitive and their use in a common framework is discussed here to show the importance of methods and instruments to mapping and assessing the knowledge assets of an organisation. The application of such methods to the radiopharmaceutical centre of IPEN is described. [ABSTRACT FROM AUTHOR]