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The paradigm of mercy is the key of pope Francis’ pontificate which continues the magisterium of his predecessors. The Pope, however, calls the church to greater responsibility. This is not a new doctrine, but a pastoral practice that through languages and “gestures” may escort the man in this time in which hope is necessary. [ABSTRACT FROM AUTHOR]

The pattern of liver diseases has radically changed in our country over the last few decades. We prospectively collected data on the newly-diagnosed cases of chronic liver diseases in a region of southern Italy after about a decade from the last epidemiological study. We conducted a multicentric prospective study that enrolled 631 patients from 21 Liver Centers of the Campania region (Southern Italy) at their first hospital admission or at their first outpatient visit. In our cohort of 631 patients (367 males, 263 females), 397 (62.9%) were hepatitis C virus (HCV) positive, 75 (11.9%) were hepatitis B virus (HBV) positive, 8 (1.3%) were co-infected by HBV and HCV, 73 (11.6%) had an alcoholic liver disease and 64 (10.1%) had a nonalcoholic fatty liver disease. HBV infection was present in young people with a higher-than-expected prevalence, despite the vaccination program which should have involved this population. HCV chronic hepatitis still remains the most common cause of liver disease in our region. HBV infection still continues to represent a health problem in young people, despite the vaccination program. [ABSTRACT FROM AUTHOR]

The desire to increase their own physical performances in order to obtain better results in sports led athletes to seek alternative methods to train hard. In the time, the results obtained in genetics have been used in the field of sport, creating a new form of doping: "gene doping". The athletes may be able to use gene therapy to re-engineer their bodies for better performances. In the sport, leading authorities predict that the genetic engineering of athletes will be widespread by the 2004 Olympics. This new type of doping can be dangerous and detrimental to health as with it, gene transfer vectors may be produced in non-controlled laboratories. It is really difficult to identify athletes who have resorted to gene doping because many of the muscle based gene technologies are unlikely to be detected by urine or blood tests. Various options have been advanced to detect the use of genes for the purpose of doping but they turn out to be too invasive and not easily achievable. Athletes are not fully aware of the physical problems associated with the use of gene doping and they and their supporting staff will be educated on this subject in order to prevent the use. [ABSTRACT FROM AUTHOR]

Dialogical thought and Theology. Surveys and Perspectives. The primary nucleus of dialogical philosophy has its roots in religious reflection. Its contribution to the twentieth century culture is a new focus to being thought in the event of language of revelation. Interesting theological implicate ons can be found in the “philosophy of the Word” of Ebner and “creative Word” of Rosenzweig. But thanks to Ebner reflection acquires a predominantly Christological significance: The Father, in Christ Jesus, becomes the “You” of man, by awakening him from his solitude spiritual and by opening encounter with the other. [ABSTRACT FROM AUTHOR]

Anabolic steroids, technically known as anabolic-androgenic steroids (AAS), are synthetic derivatives of testosterone, modified to enhance its anabolic actions (promotion of protein synthesis and muscle growth). They are used by athletes (weightlifters, shot, hammer, discus or javelin throwers, rugby and American football players, swimmers and runners) to increase muscular mass and athletic performance and by bodybuilders to improve size and cosmetic appearance. AAS were the first identified doping agents that have ergogenic effects and are on the International Olympic Committee's list of banned substances. The most popular AS used as doping substances are: oximetolone, oxandrolone, testosterone undecanoate, nandrolone decanoate, nandrolone undercanoate, methandrostenolone. To reach high dosages and rapid effects, steroid users practice a method known as "staking" which consist in the intake of two or more steroids in high dosages. Another method, called "pyramiding" provides a progressive increase of steroids dosage. The pyramid protocol is alternated with drug-free, process defined as "cycle". AAS abuse causes significant side effect: infertility, azoospermia, testicular atrophy, and gynecomastia in men and in women may develop excessive body hair growth, menstrual irregularity, hypertrophy of sebaceous glands, acne. Other side effects are: premature cease of growth caused by premature epiphysis closure; Alteration of cardiovascular function; increase of platelet aggregation and plasmatic levels of low density lipoproteins (LDL); liver damage; euphoria, aggressiveness and psychosis. Their action in central neuron system involves the dopaminergic neurotransmission and produces amphetamine-like activity. Therefore, the use of AAS should be banned from the sport, making a work of supervision and accountability of the sports centers and authorities in this field. [ABSTRACT FROM AUTHOR]

Faith is a meeting between the personal You of God who reveals himself in history and the free choice of man. This act comes true starting from an authentic search of meaning that, ultimately, can only be found where God gives himself. The act of faith does’nt exclude the receptive ability of man (instinctus fidei) in dialogue with listening (auditus fidei).The person of Jesus Christ is the place of the encounter. This article emphasizes the aspect of the face/body of the Risen Christ in the mediation of this encounter. This new relationship with the Risen Lord is a call to witness. [ABSTRACT FROM AUTHOR]

Recently, in one of the homilies of Benedict XVI, he stressed the need of a new education; educating the sacred. This statement can be understood in the context of religious anthropology that sees the sacred as the search of sense and meaning that guides the divine. In developing the educational value of the sacred, it must properly emphasize its constant values, symbols, myths and rituals. [ABSTRACT FROM AUTHOR]

Hereditary haemochromatosis is an autosomal recessive disorder of iron regulation that results in abnormal intestinal iron absorption with progressive iron overloading of parenchymal cells.Two specific,single point mutations of the HFE gene (C282Y and H63D) have been described in haemochromatosis patients. Epidemiological studies have revealed a strict association between hereditary haemochromatosis and C282Y homozygosis or C282Y/H63D compound heterozygosis,suggesting that these mutations may provide a useful tool for diagnosis.However,recent investigations from southern Europe have reported lower allelic frequencies of the C282Y mutation among haemochromatosis patients,apparently depending on the geographical area of the population analysed.To assess the predictive value of the detection of the C282Y and H63D HFE mutations in our geographical area,we have evaluated their occurrence in 46 haemochromatosis patients from southern Italy. We found that only 19.6%of our patients were homozygous for the C282Y mutation and 21.7%were compound C282Y/H63D heterozygotes.Among the remaining 59%,approximately 40%did not display any of the known HFE mutations.We conclude that, in southern Italy,another genetic determinant/s must be responsible for many haemochromatosis cases and that a genetic screening for the C282Y and H63D HFE mutations is not sufficient for hereditary haemochromatosis diagnosis. [ABSTRACT FROM AUTHOR]

The thyroid gland is one of the largest endocrine glands in the body. Thyroid cancers are the most common endocrine tumors and are more prevalent in women and elderly individuals. In particular, papillary thyroid carcinoma is often non-enveloped and multifocal, i.e., it simultaneously affects different parts of the thyroid gland, and spreads mainly because of lymph nodes. Curcumin possesses a wide variety of biological functions, and thanks to its properties, it has gained considerable attention due to its profound medicinal value. We have undertaken the present work in order to define the possible role of curcumin in modulating the genetic expression of cell markers and to understand the effectiveness of this nutraceutical in modulating the regression of cancer phenotype. As a template we used the TPC-1 cells treated with the different extracts of turmeric, and examined the levels of expression of different markers (proliferative, inflammatory, antioxidant, apoptotic). Our data show for the first time that curcumin-enriched compounds are able to decrease TPC1 cell survival and this occurs through the induction of apoptosis mainly by significantly reducing the accumulation of Bcl2 and cyclin D1 and the levels of p21 and p53. Besides, ß-catenin, involved in cell growing, is also reduced by these curcumin-enriched compounds. It is also noteworthy that Nrf2, a downstream target of p21, is also affected. [ABSTRACT FROM AUTHOR]

Postural instability and resulting falls are major factors determining quality of life, morbidity, and mortality in individuals with Parkinson's disease (PD) (1); the ability to control balance is different in people with Parkinson's Disease (PD). The application of Whole Body Vibration (WBV) at low frequencies in a patient with PD influences physiological and psychological functions. The purpose of this preliminary study was to explore the acute effects of whole body vibration (WBV) on balance and stabilometric parameters, in a patient with PD, during the 20-min post-intervention. Postural sways of the participant was assessed with a stabilometric platform before and after WBV exposure to. Motor symptoms were assessed by the UPDRS (Unified Parkinson's Disease Rating Scale) motor score. The patient was subject to a whole body vibration session (5 set of 1 minute with 1 minute rest) at low frequencies on Double Vibe Bosco Platform. The vibration frequency used was 5 Hz. The assessment of the balance was performed at the baseline (T0), immediately after the exposure (T1), after 10 minutes (T10) and 20 minutes (T20), with Cyber Sabot Plate System. The stabilometric survey was carried out with open eyes. The postural parameters that were analyzed were the Area of the Pressure Center (AREA), Center of Pressure Total Distance (LENGTH) and Variance of Speed (S.VAR). Repeated Measures Analysis of Variance (RM-Anova) was performed to evaluate significant differences among the different variables (Area,Length and S.Var), no significant differences were found for the variables analyzed. Whole body vibration (WBV) training has emerged as an alternative and effective method which allows greater short term improvement in strength and balance with less time of application. No impairments in static balance were found after an acute bout of whole body vibration at low frequency in a patient with PD, consequently, whole body vibration may be considered as a safe application in individuals with PD. [ABSTRACT FROM AUTHOR]

After an acute liver damage, tissue regeneration repairs lesions with degradation of deposed fibrotic material, while mechanisms of tissue restoration are persistently activated following several repeated injuries, inducing deposition of extracellular matrix. (ECM). Factors responsible for ECM remodeling have been identified in a pathway involving a family of zinc-dependent enzyme matrix metalloproteinases (MMPs), together with tissue inhibitor of metalloproteinases (TIMPs). Recent experimental models suggested a role of CCR5 receptor in the genesis of liver fibrosis. Drawing from these background we decided to evaluate the effects of the treatment with the CCR5 inhibitor Maraviroc on LX-2, a human hepatic stellate cell line (HSC). Treatment with Maraviroc resulted in a block in S phase of LX-2 cells with increased expression levels of cyclin D1 and p21 while the expression of p53 was reduced. Treatment with Maraviroc was also able to block the accumulation of fibrillar collagens and extracellular matrix proteins (ECM), as demonstrated by the decrease of specific markers as Collagen type I, α-SMA and TGF-β1. In addition we observed a down regulation of both metalloproteins (MMP-2, MMP-9), used for the degradation of the extracellular matrix and their inhibitors (TIMP-1, TIMP-2). The identification of a compound that may modulate the dynamic of liver fibrosis could be crucial in all chronic liver diseases. Maraviroc could play an important role because, in addition to its own anti-HIV activity, it could reduce the release of pro-inflammatory citokynes implicated in liver fibrogenesis. [ABSTRACT FROM AUTHOR]

Background & Aims: Patients with liver cirrhosis (LC) often have malnutrition (MN), which can be associated with decompensation, infection, and death. The aims were to determine: the prevalence of MN in patients with LC and ascites, its impact on mortality, and the relationship between MN and spontaneous bacterial peritonitis (SBP). Methods: Nutritional status (NS) was analysed in cirrhotic patients, experiencing their first episode of ascites, who were consecutively admitted at two clinical liver centres between November 2014 and October 2016. The participants underwent diagnostic paracentesis and were followed up to assess their outcomes. Results: 110 participants underwent NS assessment in addition to routine clinical procedures. The prevalence of MN was 30.9% according to corrected body mass index, 67.3% according to upper mid-arm muscle area (UMA) and 40% according to upper mid-arm fat area (UFA). The percentages of the participants remaining alive were 68.1% at 3 months, 59.3% at 6 months, 45.1% at 12 months and 24.2% at the end of the study. Univariate analysis showed that SBP, model for end-stage liver disease (MELD), UFA, UMA and age were significantly associated with mortality. Multivariate analysis showed that only SBP, MELD and UFA (hazard ratio 2.2) were independently associated with mortality. There was a correlation between adipopenia, but not sarcopenia, and SBP. Conclusions: Adipopenia, as assessed by UFA, was present in 40% of the cirrhotic patients, and it was independently associated with mortality. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to evaluate the relationship between the liver stiffness measurement and the risk of developing hepatocellular carcinoma (HCC) in HCV cirrhotic patients undergoing new direct-acting antivirals. Methods: From April 2015 to April 2017, all consecutive HCV cirrhotic patients treated by direct-acting antivirals were enrolled. A liver stiffness measurement was computed at baseline, and an ultrasound evaluation was provided for all patients at baseline and every 6 months until 1 year after the stopping of the antiviral therapy. The diagnosis of HCC was performed according to international guidelines by imaging technique workup. Results: Two hundred and fifty-eight HCV patients with a diagnosis of cirrhosis were identified. The median liver stiffness was 25.5 kPa. Thirty-five patients developed HCC. Patients were divided into three groups, based on their liver stiffness: < 20 kPa (n = 72), between 20 and 30 kPa (n = 92) and > 30 kPa (n = 94). Compared to the < 20 kPa and 20–30 kPa groups, the > 30 kPa group showed a statistically significant increased risk of HCC (p = 0.019; HR 0.329; 95% CI 0.131–0.830). A ROC curve analysis to assess the overall predictive performance of liver stiffness measurement on the HCC risk was performed. The results allow us to identify a cutoff value of liver stiffness measurement equal to 27.8 kPa, which guarantees the highest sensitivity and specificity (respectively, 72% and 65%). Conclusions: The data underline that the baseline liver stiffness measurement and ultrasound surveillance is a valuable tool for assessing the risk of HCC in cirrhotic patients undergoing the direct-acting antivirals treatment. [ABSTRACT FROM AUTHOR]

Background/Aims: Liver biopsy represents the gold standard to establish a diagnosis in all liver patients, but its current position in chronic viral hepatitis is questioned. We aimed to create a consensus on best practice of use of liver biopsy in the management of chronic HCV infection. Methods: We applied the Delphi method to 12 clinical scenarios of chronic HCV infection, to assess the extent of agreement (consensus measurement) and to resolve disagreement (consensus development) on the appropriateness of liver biopsy. Results: Among 108 chosen hepatologists, 61 (56.5%) accepted to participate to the first-round survey. In four patients the majority of experts (from 61.4 to 86.2%) agreed not to perform liver biopsy; in two cases an equivalent opinion was found, and in the remaining six scenarios the majority of experts would have recommended a biopsy. No expert recommended liver biopsy in all cases, while most agreed for an histological evaluation of 4 to 8 cases. At the second round, 36 experts (59%) submitted ballots. Fifty-four out of 431 (12.6%) original judgments were changed with equal distribution among different scenarios. Conclusions: Our survey showed a great divergence of management of similar patients and should provide a stimulus for an evidence-based evaluation of liver histology in chronic HCV infection. [Copyright &y& Elsevier]