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Background. Following high-dose chemotherapy/bone marrow transplantation, patients are routinely, prophylactically transfused with platelet concentrates (PC) if they have a platelet count ≤10×109/L or higher in the presence of risk factors for bleeding. However, whether such transfusions are necessary in clinically stable patients with no bleeding, or whether a therapeutic transfusion strategy could be sufficient and safe, is still debated. Materials and methods. The GIMEMA Haemostasis and Thrombosis Working Party sent a questionnaire to Italian haematology departments to survey several aspects of daily platelet transfusion practice, such as the cut-off platelet count for transfusion, the evaluation of refractoriness and the type of PC administered. Results. The questionnaire was answered by 18 out of 31 centres (58%). A total of 23,162 PC were transfused in 2,396 patients in 2013. The vast majority of centres (95%) transfused PC according to Italian and international guidelines; only a few transfused always at platelet counts ≤20×109/L. The broad agreement on platelet count cut-off for transfusion (≤10×109/L) was not confirmed when the World Health Organization (WHO) bleeding score was considered: only a third of centres (33%) used transfusions as recommended when the bleeding grade was ≥2. Platelet refractoriness was poorly monitored and most centres (89%) evaluated, mostly empirically (67%), response to transfusion only 24 hours later. Thirty percent of centres transfused platelets in asymptomatic refractory patients. Discussion. Although most Italian haematology departments transfuse PC according to Italian and international guidelines, our survey shows that in routine daily practice physicians do not comply closely with the WHO recommendations on platelet transfusions and monitoring platelet refractoriness. This causes excessive platelet transfusions, with a resulting increase of costs and waste of public health resources.

Since 2006 the University of Bologna has been conducted research in the Roman town of Ostra (Ancona, Marche region, central Italy), thanks to an agreement with the Soprintendenza per i Beni Archeologici delle Marche and in particular to the foresight of Giuliano de Marinis. The birth of the city is traditionally linked to the process of Romanization of the Ager Gallicus during the 3rd century BC, in particular after the issue of the Lex Flaminia de agro Gallico et Piceno viritim dividundo (232 BC). The aspect of the center of Ostra in these early stages of urban employment is not well-known, but the latest excavations are instead acquiring more elements about the organization of the north-eastern side of the forum between the 2nd and the 1st century BC. After the acquisition of the status of municipium, the realization of a building with a strong civil connotation linked to the activities of election of magistrates by the citizens is also attested. At last, some aerial surveys and targeted digs, allowing the discovering of several important buildings, monuments and evidence, which are largely contributing to propose a new hypothesis of the urban texture of the roman city and of the ancient roads system.

Since 2006 the University of Bologna has been conducted research in the Roman town of Ostra (Ancona, Marche region, central Italy), thanks to an agreement with the Soprintendenza per i Beni Archeologici delle Marche and in particular to the foresight of Giuliano de Marinis. The birth of the city is traditionally linked to the process of Romanization of the Ager Gallicus during the 3rd century BC, in particular after the issue of the Lex Flaminia de agro Gallico et Piceno viritim dividundo (232 BC). The aspect of the center of Ostra in these early stages of urban employment is not well-known, but the latest excavations are instead acquiring more elements about the organization of the north-eastern side of the forum between the 2nd and the 1st century BC. After the acquisition of the status of municipium, the realization of a building with a strong civil connotation linked to the activities of election of magistrates by the citizens is also attested. At last, some aerial surveys and targeted digs, allowing the discovering of several important buildings, monuments and evidence, which are largely contributing to propose a new hypothesis of the urban texture of the roman city and of the ancient roads system.

Il libro tratta dell'indagine archeologica e del restauro scientifico del Palazzo Agolanti-Pedrocca, edificio storico seicentesco situato nel centro della città di Rimini. La sua caratteristica saliente è l'inclusione di un tratto di mura urbiche romane del III secolo d.c.. Il contributo firmato dagli autori Alessandro Mori e Rossella Roversi, che hanno effettuato l'intervento in qualità di progettisti e direttori lavori, ricostruisce la storia del palazzo, ne analizza il degrado, descrive i criteri di intervento, le tecniche e le tecnologie adottate nel consolidamento e nel restauro scientifico dell'edificio e delle strutture rinvenute negli scavi archeologici. Si è curata anche la rassegna fotografica che chiude il volume.

The Ipanema alkaline-carbonatitic complex is part of the Meso-Cenozoic alkaline magmatism located within the southeastern part of the Brazilian Platform. Drill-core and field sampling have indicated the occurrence of glimmerites, with subordinate shonkinites (mela-syenites), clinopyroxene-bearing glimmerites, diorites and syenites. The glimmerites are cross-cut by lamprophyric dykes and calciocarbonatites. Fenitization has deeply affected the country rocks, originating dioritic and syenitic rocks. The Ipanema rocks show a distinct potassic affinity. The initial Sr-Nd- isotopic composition of the Ipanema rocks ( 87Sr/ 86Sr = 0.70661-0.70754 and 143Nd/ 144Nd = 0.51169-0.51181) is similar to that of tholeiitic and potassium-rich-alkaline rocks of the Eastern Paraguay. Stable isotope data for the Ipanema calciocarbonatite suggest interaction with fluids at temperatures typical of hydrothermal stages, as hypothesized for other carbonatite complexes from southeastern Brazil. The chemical differences between the lamprophyre, glimmerites, carbonatites, apatitites and magnetitites, and the absence of marked REE enrichment in the evolved lithologies, all indicate that fractional crystallization and accumulus of liquidus phases in a magma reservoir, likely coupled with liquid immiscibility processes, may have played an important role in the genesis of the Ipanema rocks.

Objective: To define the clinical spectrum and etiology of progressive myoclonic epilepsies (PMEs) in Italy using a database developed by the Genetics Commission of the Italian League against Epilepsy. Methods: We collected clinical and laboratory data from patients referred to 25 Italian epilepsy centers regardless of whether a positive causative factor was identified. PMEs of undetermined origins were grouped using 2-step cluster analysis. Results: We collected clinical data from 204 patients, including 77 with a diagnosis of Unverricht-Lundborg disease and 37 with a diagnosis of Lafora body disease; 31 patients had PMEs due to rarer genetic causes, mainly neuronal ceroid lipofuscinoses. Two more patients had celiac disease. Despite extensive investigation, we found no definitive etiology for 57 patients. Cluster analysis indicated that these patients could be grouped into 2 clusters defined by age at disease onset, age at myoclonus onset, previous psychomotor delay, seizure characteristics, photosensitivity, associated signs other than those included in the cardinal definition of PME, and pathologic MRI findings. Conclusions: Information concerning the distribution of different genetic causes of PMEs may provide a framework for an updated diagnostic workup. Phenotypes of the patients with PME of undetermined cause varied widely. The presence of separate clusters suggests that novel forms of PME are yet to be clinically and genetically characterized.

Recent data suggest that the newly discovered cytokine IL-15 cooperates with IL-2 in driving T cell-mediated immune responses. The aim of this study was to determine the role of IL-15 in the regulatory networks leading to the development of T cell alveolitis in the lung of patients with sarcoidosis. We demonstrated that alveolar macrophages (AMs) isolated from the bronchoalveolar lavage of patients with active sarcoidosis expressed IL-15 mRNA and membrane and cytoplasmic IL-15, while AMs from healthy subjects and patients with inactive sarcoidosis did not. Pulmonary CD4+ T cells from sarcoid patients were equipped with the IL-2R subunits, which are able to bind IL-15, i.e., the IL-2R beta/IL-2R gamma complex, and proliferated in response to IL-15. Interestingly, the T cell proliferation elicited by IL-15 was comparable with that determined by IL-2. Following the addition of graded amounts of IL-15, IL-2-pulsed T cells showed a significant increase in their stimulation. TNF-alpha up-regulated the IL-15-mediated proliferative response of bronchoalveolar lavage T lymphocytes. Following the block of the IL-2R beta- and gamma-chains with specific mAbs, the stimulatory activity of IL-15 was abolished. The evaluation of the IL-2R on sarcoid AMs demonstrated the constitutive expression of alpha- and gamma-chain mRNA and proteins. Taken together, these findings demonstrate that IL-15 triggers the growth of sarcoid T cells through the IL-2R beta/IL-2R-gamma complex and raise the possibility that AMs may deliver proliferative signals for the development of the T cell alveolitis. Modulation of IL-2R on AMs could represent a critical variable in regulating local inflammatory responses.

Background In 2011 the Latin America Asthma Insight and Management (LA AIM) survey explored the realities of living with asthma. We investigated perception, knowledge, and attitudes related to asthma among Latin American asthma patients.Methods Asthma patients aged ≥12 years from four Latin American countries (Argentina, Brazil, Mexico, Venezuela) and the Commonwealth of Puerto Rico responded to questions during face-to-face interviews. A sample size of 2,169 patients (approximately 400 patients/location) provided an accurate representation of asthma patients’ opinions. Questions probed respondents’ views on topics such as levels of asthma control, frequency and duration of exacerbations, and current and recent use of asthma medications.Results A total of 2,169 adults or parents of children with asthma participated in the LA AIM survey. At least 20% of respondents experienced symptoms every day or night or most days or nights. Although 60% reported their disease as well or completely controlled, only 8% met guideline criteria for well-controlled asthma. 47% of respondents reported episodes when their asthma symptoms were more frequent or severe than normal, and 44% reported seeking acute care for asthma in the past year. Asthma patients in Latin America overestimated their degree of asthma control.Conclusions The LA AIM survey demonstrated the discrepancy between patient perception of asthma control and guideline-mandated criteria. Additional education is required to teach patients that, by more closely following asthma management strategies outlined by current guidelines more patients can achieve adequate asthma control. Keywords: Asthma, Controlled, Guidelines, Exacerbation, Patient burden, Symptoms

Electroencephalography-functional magnetic resonance imaging (EEG-fMRI) coregistration has recently revealed that several brain structures are involved in generalized spike and wave discharges (GSWDs) in idiopathic generalized epilepsies (IGEs). In particular, deactivations and activations have been observed within the so-called brain default mode network (DMN) and thalamus, respectively. In the present study we analyzed the dynamic time course of blood oxygen level-dependent (BOLD) changes preceding and following 3 Hz GSWDs in a group of adolescent and adult patients with IGE who presented with absence seizures (AS). Our aim was to evaluate cortical BOLD changes before, during, and after GSWD onset.Twenty-one patients with IGE underwent EEG-fMRI coregistration. EEG-related analyses were run both at the single-subject and at group level (random effect). The time-course analysis was conducted for 3 s time windows before, during, and after GSWDs, and they were included until no further BOLD signal changes were observed.Fifteen patients (nine female, mean age 28 years) had GSWDs during EEG-fMRI coregistration (262 total events, mean duration 4 s). Time-course group analysis showed BOLD increments starting approximately 10 s before GSWD onset located in frontal and parietal cortical areas, and especially in the precuneus-posterior cingulate region. At GSWD onset, BOLD increments were located in thalamus, cerebellum, and anterior cingulate gyrus, whereas BOLD decrements were observed in the DMN regions persisting until 9 s after onset.Hemodynamic changes (BOLD increments) occurred in specific cortical areas, namely the precuneus/posterior cingulate, lateral parietal, and frontal cortices, several seconds before EEG onset of GSWD. A dysfunction of these brain regions, some of which belongs to the DMN, may be crucial in generating GSWDs in patients with IGE.

The São Fidelis - Santo António de Pádua sector of central Ribeira Fold Belt is mainly composed of migmatites, granulites and blastomylonites. Application of two contrasting methodologies to obtain petrological cooling rates based on Fe-Mg diffusion between garnet and respective biotite inclusions proved unfruitful. This was mainly due to: a) high dispersion of results caused by open-system behaviour; and b) narrow closure temperature variation caused by garnet reequilibration at high temperatures followed by very fast cooling. The obtained results are mainly qualitative but in broad agreement with previously obtained thermochronological results based on integration of multiple isotopic systems. O sector São Fidelis - Santo António de Pádua, pertencente à zona central da Faixa Ribeira, é fundamentalmente composto por migmatitos, granulitos e blastomilonitos. A aplicação de diferentes metodologias com o objectivo de obter taxas de arrefecimento baseadas na difusão Fe-Mg entre granada e respectivas inclusões de biotite revelou-se infrutífera. Tal deve-se fundamentalmente a: a) elevada dispersão dos resultados causada pela existência de um sistema aberto; b) estreita variação das temperaturas de fecho do sistema causada por re-homogeneização da granada a altas temperaturas seguida de arrefecimento muito rápido. Os resultados obtidos são fundamentalmente qualitativos, mas estão de acordo com resultados termocronológicos previamente obtidos baseados na integração de múltiplos sistemas isotópicos.

Geochemica et Cosmochimica Acta, Vol. 72, issue 12, Suppl. 1, A936

Publicado em: Geochemica et Cosmochimica Acta, Vol. 72, issue 12, Suppl. 1, A75

International audience; The pre-Mesozoic geodynamic evolution of SW Iberia has been investigated on the basis of detailed structural analysis, isotope dating, and petrologic study of high-pressure (HP) rocks, revealing the superposition of several tectonometamorphic events: (1) An HP event older than circa 358 Ma is recorded in basic rocks preserved inside marbles, which suggests subduction of a continental margin. The deformation associated with this stage is recorded by a refractory graphite fabric and noncoaxial mesoscopic structures found within the host metasediments. The sense of shear is top to south, revealing thrusting synthetic with subduction (underthrusting) to the north. (2) Recrystallization before circa 358 Ma is due to a regional-scale thermal episode and magmatism. (3) Noncoaxial deformation with top to north sense of shear in northward dipping large-scale shear zones is associated with pervasive hydration and metamorphic retrogression under mostly greenschist facies. This indicates exhumation by normal faulting in a detachment zone confined to the top to north and north dipping shear zones during postorogenic collapse soon after 358 Ma ago (inversion of earlier top to south thrusts). (4) Static recrystallization at circa 318 Ma is due to regional-scale granitic intrusions.