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The elastic stability of a plane metamaterial made up of a mesh of orthogonal rods coupled with diagonal cables is studied. The stability domain and the optimal values of the stiffness of the cables are determined.

Background and purpose: Glioblastoma (GBM) is the most aggressive and frequent subtype of all malignant gliomas. At the time of recurrence, therapeutic options are lacking. Ortataxel, a second-generation taxane was reported to be effective in pre-clinical and phase I clinical studies. The aim of this study was to evaluate a potential therapeutic activity of ortataxel in patients with GBM recurring after surgery and first line treatment. Methods: In this phase II study, according to a two stage design, adult patients with histologically confirmed GBM in recurrence after surgery or biopsy, standard radiotherapy and chemotherapy with temozolomide were considered eligible. Patients included were treated with ortataxel 75mg/m2 i.v. every 3weeks until disease progression. The primary objective of the study was to evaluate the activity of ortataxel in terms of progression free survival (PFS) at 6months after the enrollment. PFS, overall survival at 9months after the enrollment, objective response rate, compliance and safety were evaluated as secondary endpoints. Results: Between Nov 26, 2013 and Dec 12, 2015, 40 patients were recruited across six centres. The number of patients alive and free from progression at 6months after the enrollment, observed in the first stage was four (11.4%), out of 35 patients included in the analysis, below the minimum number of events (7 out of 33) required to continue the study with the second stage The most important toxicities were neutropenia and hepatotoxicity that occurred in 13.2% of patients and leukopenia that occurred in 15.8% of patients. Conclusion: Overall ortataxel treatment fail to demonstrate a significant activity in recurrent GBM patients. However in a limited number of patients the drug produced a benefit that lasted for a long time. Trial registration: This study is registered with ClinicalTrials.gov, number NCT01989884.

Our clinical and experimental experience with chemotherapy of bladder tumours is reviewed. The routes of drug administrations, drug dosages and combinations, are presented. Adjuvant radiotherapy and chemoprophylaxis of certain tumours are discussed.S. Afr. Med. J., 48, 631 (1974)

Lo squalene un triterpene noto come un intermedio nella biosintesi degli steroli nel mondo vegetale ed animale. In particolare, nell’olio extravergine di oliva rappresenta il componente più abbondante nella frazione minoritaria rispetto a quella trigliceridica, la sua quantità oscilla tra 1 e 20 g per kg di olio in funzione della varietà e dell’area di produzione del frutto dell’oliva. Lo squalene è presente anche, per circa il 12%, nel secreto delle ghiandole sebacee dove svolge una funzione antiossidante protettiva del derma sul quale stende un velo che trattiene la naturale umidità della pelle contro le radiazioni solari, alla stregua di un filtro biologico. Inoltre grazie alla sua idrofobicità ricopre un ruolo di primo piano nella protezione dello strato corneo della pelle contro la penetrazione di agenti esogeni quali prodotti chimici, detergenti, traumi ecc.

Anche se non tutto il colesterolo è nocivo in quanto la frazione veicolata dalle lipoproteine di alta densità (HDL) ne attiva l’eliminazione per le vie biliari, è da tempo noto che aumenti considerevoli di colesterolo nell’organismo umano, dovute ad alterazioni dei delicati equilibri tra assunzione, biosintesi endogena ed eliminazione con la bile e le feci, sono responsabili di lesioni vascolari, ischemie, trombosi o infarti nei vari parenchimi ed in particolare a livello cardiaco. Per cercare di prevenire tali condizioni patologiche, la modifica dello stile di vita e delle abitudini alimentari, sono alla base di qualsiasi intervento volto alla riduzione del colesterolo ematico. In tale ambito i fitosteroli, composti vegetali lipofili della famiglia dei triterpeni ampiamente distribuiti nel regno vegetale, con struttura analoga a quella del colesterolo ma con proprietà ipocolesterolemizzanti già note dai primi anni 1950, hanno suscitato recentemente un crescente interesse sia da parte della comunità scientifica che dei consumatori.

Tra tutti i componenti quelli peculiari ed esclusivi dell’olio extravergine di oliva sono i composti a struttura fenolica che appartengono a diverse classi quali acidi ed alcoli fenolici, flavonoidi, lignani e secoiridoidi. Infatti, i composti fenolici non sono presenti negli altri oli vegetali perché sono estratti da semi e non da un frutto come quello dell’olivo, inoltre nel caso di oli di oliva non commestibili tali composti vengono perduti durante i processi di raffinazione necessari a renderli adatti al consumo umano. L’attività antiossidante esplicata dai singoli composti fenolici è diversa e dipenda dalle caratteristiche di ciascuna molecola ed è di estrema importanza sui metabolismi di molteplici distretti. Ai composti fenolici è riconosciuta, inoltre, la capacità di conferire le caratteristiche gustative amare e piccanti tipiche esclusivamente degli oli extravergini di oliva.

Il tessuto grasso, in particolare il grasso bianco, considerato fino a pochi anni fa solo un accumulo di lipidi negli adipociti, è invece un organo endocrino, costituito da adipociti, fibroblasti, cellule endoteliali e macrofagi, con importanti ruoli nei meccanismi infiammatori e metabolici. Infatti gli adipociti producono almeno 50 adipochine, liberano proteine chemotattiche e del complemento (adipsina), coinvolte nel controllo della pressione, dell’angionenesi, del metabolismo del glucosio e dei lipidi quali adiponectina, resistina, visfatina, apelina, vaspina, hepcidina, chemerina, omentina. Liberano anche proteine con attività pro-coagulante come l’inibitore dell' attivatore del plasminogeno (PAI-1), il fattore VII e la forma inducibile dell’enzima ossido nitrico sintetasi (iNOS), fattori che spiegano almeno in parte il maggior rischio di malattie cardiovascolari negli obesi, citochine con attività pro-infiammatoria quali la leptina, la proteina-1 chemoattrattiva dei monociti (MCP-1), il TNF-alfa e IL-6, favorendo la flogosi cronica accentuata dal grande numero di macrofagi messi in circolo, e infine acidi grassi e glicerolo favorendo la resistenza all’insulina, il diabete tipo 2 e la sindrome metabolica.

The objective of this prospective, multicentre trial, carried out at 18 third level hospitals in Italy, was to evaluate efficacy of modified porcine surfactant (Curosurf), administered at birth to prevent the development of respiratory distress syndrome (RDS) in premature infants. 287 babies with a gestational age of 24-30 weeks were randomized to prophylactic treatment with Curosurf (80 mg/ml; dose 20 mg/kg) or to a control group receiving no surfactant treatment in the delivery-room. Babies in both groups were eligible for rescue treatment with surfactant (200 mg/kg) if they developed clinical symptoms of RDS and required mechanical ventilation. The main end-point was to obtain, in the prophylaxis group, a 30% reduction in the incidence of grade 3-4 RDS. Median gestational age was 28 weeks in both groups and mean birth weight 1010 and 1002 g, respectively for prophylaxis and control babies. There was a 32% reduction in the incidence of grade 3-4 RDS in the prophylaxis group (p < 0.05). This was associated with a significant reduction in mean maximum fraction of inspired oxygen (0.57 vs 0.66%; p < 0.01), a decreased incidence of pulmonary interstitial emphysema (7 vs 14%; p < 0.05) and a lowered mortality (21 vs 35%; p < 0.01). Combined unfavourable outcome (mortality + bronchopulmonary dysplasia and/or grade 3-4 intraventricular hemorrhage and/or grade 2-4 retinopathy of prematurity) was significantly lower in the prophylaxis than in the second group (41 vs 58%; p < 0.01). The favourable effects of prophylactic treatment were equally recorded in all the age groups, including the babies with the lowest gestational age (24-25 weeks). Multiple and logistic regression analysis confirmed that high gestational age and surfactant prophylaxis were, independently, associated with a lower degree of RDS (p = 0.0001 and p = 0.0008, respectively) and a lower mortality (p = 0.0001 and p = 0.0045, respectively). We conclude that prophylaxis with modified natural surfactant effectively prevents RDS in newborn babies between 24 and 30 weeks' gestation.

The effectiveness of carbocysteine lysine salt monohydrate (SCMC-Lys) and ambroxol hydrochloride (ABX) in the management of respiratory impairment was compared in a single-blind, randomized study of 26 cystic fibrosis patients with similar baseline characteristics. Adults received either SCMC-Lys 900 mg or ABX 33 mg three times a day and children under 14 years of age either SCMC-Lys 270 mg three times a day or ABX 10 mg four times a day. All treatments were given orally for 80 days and at the end of this control period both groups showed significant improvement in chest sound score but improvement in cough score was observed only in those receiving SCMC-Lys. Expectorate viscosity and elasticity decreased significantly in both groups. In SCMC-Lys-treated patients paCO2 decreased and paO2 and Hb O2 saturation increased while only paO2 increased significantly in those treated with ABX. An increase in tidal volume, peak expiratory flow values and forced expiratory volume were evident in those receiving SCMC-Lys while significant increases in forced expiratory flow were recorded in those receiving ABX. SCMC-Lys patients' Shwachmann index improved significantly and conversely to the ABX patients. No adverse events were recorded in either treatment group. The study concluded that SCMC-Lys is at least as effective as ABX in improving respiratory function in patients with cystic fibrosis.

In ancient Greece, the chronological boundaries of the stages of life hinged upon Solon’s theory of human life as divided into ten seven year stages. At the peak of Latin civilization, the chronological limits of the infant, pueritia and adulescentia were respectively 0-8 years, 8-16 years and 16-17 years, when in a ceremony the adolescent (a term derived from adolescente(m) present participle of the Latin verb adolescere = to grow) wearing the “toga of manhood” is declared an adult (teenager adult) and up to 30 years later iuventus. Throughout the following centuries, the chronological boundaries of the various ages came to acquire only a theoretical worth, since the child, once introduced to the world of work, used to suddenly become an adult. Only in the wave of Humanism in the XVI – XVII century, people started to rediscover the Greek ‘paideia’ (education), the Latin Humanitas’ (recognition and respect towards manhood in every man), and, through the Christian ‘caritas’ (to recognize and to love the son of God in every man) begins a moral vision of childhood, of his weakness and innocence, a reflection of the ‘divine purity’. In this evolution, the twentieth century identifies itself with adolescence, so that history moves from an era devoiced of adolescence to an age in which adolescence appears to be the privileged age: the adolescent is the hero of the twentieth century. Several and many important institutions have proceeded to recognize the essential rights of adolescent care in pediatric departments, but many are still admitted to adult wards with suboptimal therapeutic results, particularly for blood-cancer. The pediatrician, both the family one and the one in the hospital, must be the referees for the health of the adolescent, especially in cases of chronic diseases or in those of psychosocial relevance, following her in the path of the disease especially if other specialists are involved with a view to further investigation, and establishing, since early childhood, communication, dialogue and compliance with her and the whole family. One of the greatest philosophers and sophists of Magna Graecia, Gorgia of Lentini, used to state that the word has tremendous power: it can instill the joy, eliminate pain, enhance compassion, put an end to fear: then be medicine for the suffering. The doctor is in fact, in certain situations of life, a drug for his patient. He is the most widely used drug because drugs are not the only thing that matters: the soul of medicine lies in the relationship, in the communication between the healer and the healed.

The aim of this study is to evaluate the impact of Botrytis cinerea, a noble rot, on the aroma components of Amarone, a dry red wine produced from withered grapes. A comparative analysis of wines obtained from manually selected healthy and botrytized grapes was done. Aroma analysis revealed that most compounds varied significantly according to the percentage of botrytized berries utilized. Botrytized wines contained less fatty acids and more fruity acetates than healthy wines. A positive correlation between the content of N-(3-methylbutyl)acetamide, sherry lactone and an unidentified compound and the level of fungal infection was also observed. The results indicate that noble rot can significantly modify important aroma components of Amarone wine.

OBJECTIVES: To assess risk factors for nasopharyngeal carriage of Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis in a large sample of healthy children. METHODS: In this point prevalence survey nasopharyngeal specimens were obtained from 1723 healthy children, ages 1 to 7 years, attending day-care centers or schools in 18 Italian cities. Written questionnaires for obtaining information about the demographics and medical history of the children were completed by the parents in the presence of a pediatrician. RESULTS: The overall carrier rate of respiratory pathogens was 17.9% (S. pneumoniae, 3.5%; H. influenzae, 11.9%; M. catarrhalis, 4.1%). Only 5% of S. pneumoniae strains were penicillin-resistant whereas approximately 40% were erythromycin-resistant. Beta-lactamase production was found in 5.8% of H. influenzae and 88.7% of M. catarrhalis isolates. By multivariate analysis age (< or = 3 years), having older siblings, a history of prolonged full-time day-care attendance and living in a rural area significantly influenced the odds of carrying nasopharyngeal respiratory pathogens, particularly in children ages 1 to 5 years. Sex, breastfeeding, passive smoking and recent upper respiratory tract infections were not significant variables. Antibiotic treatment in the previous 3 months did not affect nasopharyngeal carriage, whereas repeated treatments with a macrolide were associated with carriage of S. pneumoniae. CONCLUSIONS: Our results suggest that there is a strong and long term relationship between exposure to large numbers of children in the first years of life and nasopharyngeal carriage of all respiratory pathogens. In addition antimicrobial restrictive guidelines should be tailored to local microbiologic sceneries.

Earlier analysis of the Italian population showed patterns of genetic differentiation that were interpreted as being the result of population settlements going back to pre-Roman times. DNA disease mutations may be a powerful tool in further testing this hypothesis since the analysis of diseased individuals can detect variants too rare to be resolved in normal individuals. We present data on the relative frequencies of 60 cystic fibrosis (CF) mutations in Italy and the geographical distribution of the 12 most frequent CF mutations screened in 3492 CF chromosomes originating in 13 Italian regions. The 12 most frequent mutations characterize about 73% of the Italian CF chromosomes. The most common mutation, delta F508, has an average frequency of 51%, followed by N1303K and G542X, both with average frequencies around 5%. Multivariate analyses show that the relative frequencies of CF mutations are heterogeneous among Italian regions, and that this heterogeneity is weakly correlated with the geographical pattern of non-DNA 'classical' genetic markers. The northern regions are well differentiated from the central-southern regions and within the former group the western and eastern regions are remarkably distinct. Moreover, Sardinia shows the presence of mutation T338I, which seems absent in any other European CF chromosome. The north-western regions of Italy, characterized by the mutation 1717-1G--A, were under Celtic influence, while the north-east regions, characterized by the mutations R1162X, 2183AA--G and 711 + 5G--A, were under the influence of the Venetic culture.

In order to evaluate the role of Mycoplasma pneumoniae and Chlamydia pneumoniae, we studied 613 children aged 2-14 years who were hospitalized for community-acquired lower respiratory tract infections (LRTIs). The patients were enrolled in the study by 21 centers in different regions of Italy from May 1998 through April 1999. Paired serum samples were obtained on admission and after 4-6 weeks to assay the titers of M. pneumoniae and C. pneumoniae antibodies. Nasopharyngeal aspirates for the detection of M. pneumoniae and C. pneumoniae were obtained on admission. Acute M. pneumoniae infections in 210 patients (34.3%) and acute C. pneumoniae infections in 87 (14.1%) were diagnosed. Fifteen of the 18 children with M. pneumoniae and/or C. pneumoniae infections whose treatments were considered clinical failures 4-6 weeks after enrollment had not been treated with macrolides. Our study confirms that M. pneumoniae and/or C. pneumoniae plays a significant role in community-acquired LRTIs in children of all ages and that such infections have a more complicated course when not treated with adequate antimicrobial agents.