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1. Best practice for forensic autopsy in suspected SARS-COV-2 infected bodies. An update from the task force of the Italian Group of Forensic Pathology

Author

Fais P, Gavelli S, Bolino G, Campobasso CP, Cecchetto G, Cecchi R, Demontis R, D'Ovidio C, Moretti M, Neri M, Oliva A, Pierucci G, Spagnolo Ventura E, Ventura F, Di Vella G, Fais, P, Gavelli, S, Bolino, G, Campobasso, Cp, Cecchetto, G, Cecchi, R, Demontis, R, D'Ovidio, C, Moretti, M, Neri, M, Oliva, A, Pierucci, G, Spagnolo Ventura, E, Ventura, F, and Di Vella, G

Subjects
forensic pathology, autopsy, SARS-CoV-2, corona virus disease 2019, reccomandations
Abstract

In light of the global spread of the new human coronavirus SARS-CoV-2, identified for the first time during an outbreak of pneumonia cases in Wuhan, China, a number of forensic autopsies will be performed on potentially infected corpses. The main aim of this document is to provide safety recommendations to perform forensic autopsies. Moreover, the forensic pathologist sometimes is the first physician facing to the death of a SARSCOV-2 infected subject. In this case, a comprehensive knowledge of SARS-COV-2 clinical and pathological features, may be of the utmost importance not only to timely pose the suspect of infection but also to timely provide safety measures and adequate post-mortem sampling. After summarizing clinical and pathological features of SARSCOV- 2 infection, information about the related health and safety issues will be provided. The autopsy facility must be Biosafety Level 3 and negative pressure with 6-12 air changes per hour should be provided in the autopsy room. Moreover, personal protective equipment for individual protection must guarantee protection both from direct contact and aerosol transmission. Furthermore, clinical information, relevant to pose the suspect of infection before and during the autopsy, will be focused in a dedicated section. Finally, the autopsy procedure will be illustrated together with the microbiological and histopathological sampling activity, recommended not only for diagnostic purposes but also for scientific studies. SARS-CoV-2 recommendations dedicated to the forensic setting seem of the utmost importance. Indeed, the forensic pathologist might be claimed not only to establish the cause of death, but also to solve a number of further issues, such as: the assessment of malpractice and medical liability, complicated by the rapid evolution of the state of the art; the potential contributory role of SARS-CoV-2 infection in the manner of death, for example, cases of suicide have been reported in infected patients; to reconstruct retrospectively the time and transmission modality of the infection in a specific subject, aimed for example to evaluate the liability to third parties especially for infections occurred in fragile patients living in nursing homes for elderly or disabled people.

Published
2020

3. Ultrastructural findings of lung injury due to Vaccine-induced Immune Thrombotic Thrombocytopenia (VITT) following COVID-19 vaccination: a scanning electron microscopic study.

Author

CONGIU, T., FANNI, D., PIRAS, M., GEROSA, C., CAU, F., BARCELLONA, D., D'ALOJA, E., DEMONTIS, R., CHIGHINE, F., NIOI, M., CONI, P., RAVARINO, A., CERRONE, G., AIMOLA, V., BOTTA, C., SCANO, A., ORRÙ, G., COGHE, F., VAN EYKEN, P., and LA NASA, G.

Abstract

Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare new syndrome occurring after the ChAdOx1 nCoV-19 vaccine immunization. Patients with VITT are characterized by a variable clinical presentation, likewise also the outcome of these patients is very variable. Here we report the lung ultrastructural findings in the course of VITT of a 58-year-old male patient. Alveoli were mainly dilated, irregular in shape, and occupied by a reticular network of fibrin, while interalveolar septa appeared thickened. The proliferation of small capillaries gave rise to plexiform structures and pulmonary capillary hemangiomatosis-like features. Near the alveoli occupied by a dense fibrin network, the medium-sized arteries showed a modi- fied wall and an intraluminal thrombus. This scenario looks quite similar to that found during COVID-19, where the lungs suffer from the attack of the antigen-antibodies complexes and the virus respectively. In both diseases, the final outcome is a severe inflammation, activation of the haemostatic system and fibrinolysis. [ABSTRACT FROM AUTHOR]

Published
2022

4. Scanning electron microscopy of lung disease due to COVID-19 - a case report and a review of the literature.

Author

CONGIU, T., DEMONTIS, R., CAU, F., PIRAS, M., FANNI, D., GEROSA, C., BOTTA, C., SCANO, A., CHIGHINE, A., FAEDDA, E., CAU, R., VAN EYKEN, P., MARONGIU, F., BARCELLONA, D., SABA, L., ORRÙ5, G., COGHE, F., SURI, J. S., FAA, G., and D'ALOJA, E.

Abstract

OBJECTIVE: The ongoing Coronavirus pandemic (COVID-19) showed similar characteristics with the severe acute respiratory syndrome (SARS). In the most compromised cases, COVID-19 infection leads to death due to severe respiratory complications. COVID-19-related acute respiratory distress syndrome (ARDS) is the primary cause of death in these patients. In the present study, we show an ultrastructural analysis on the lungs of a patient affected by COVID-19. PATIENTS AND METHODS: Lung specimens obtained at autopsy from a 63-years old patient affected by COVID-19 were fixed in 1% paraformaldehyde. Slices of 300 µm thickness were dehydrated and dried by Critical Point Drying in CO2. Slices were covered with a conductive gold film approximately 30 nm thick and observed at a Zeiss Sigma 300 SEM FEG in the secondary electron (SE) and backscattered electron (BSE) modes. As case control a lung biopsy from a 60-year-old man was considered. RESULTS: At low power in all COVID-19 lung specimens severe changes in the pulmonary architecture were found, due to the collapse of air spaces. Moreover, alveolar cavities were covered by large membranes. At high power, alveolar membranes showed a fibrillar structure, suggestive of a loose network of fibrin. It has been also found that intra-alveolar red blood cells were frequently present in the alveolar spaces, surrounded by a reticular fibrin network, suggestive for fibrin-hemorrhagic alveolitis. Alveolar changes were constantly associated with pathological features related to the pulmonary vessels. Vascular changes were prominent, including endothelial damage and thrombosis of large pulmonary vessels. Fibrinous microthrombi were frequently detected in the inter-alveolar septal capillaries. In addition, it has been frequently detected capillary proliferation in the alveolar septa with finding suggestive for intussusceptive neo-angiogenesis. CONCLUSIONS: In conclusion, our electron microscopy analysis showed that COVID-19-related lung disease is characterized by a substantial architectural distortion, with the interactions between alveolar and vascular changes. Intra-alveolar hyaline membranes are associated with macroand micro-thrombotic angiopathy, ending with capillary proliferation. The new blood vessel formation originates from the septa and extends into the surrounding parenchyma. Our findings confirm previous reports on the specificity of the multiple and complex morphological pattern typical, and apparently specific, of COVID-19-related lung disease. [ABSTRACT FROM AUTHOR]

Published
2021

5. Aortic vulnerability to COVID-19: is the microvasculature of vasa vasorum a key factor? A case report and a review of the literature.

Author

FAA, G., GEROSA, C., FANNI, D., BARCELLONA, D., CERRONE, G., ORRÙ, G., SCANO, A., MARONGIU, F., SURI, J., DEMONTIS, R., NIOI, M., D'ALOJA, E., LA NASA, G., and SABA, L.

Abstract

Arterial thromboembolic complications reported in patients with COVID-19 infection suggested that SARS-CoV-2 can trigger atherosclerotic plaque vulnerability. While endothelial cells in healthy subjects protect against thrombus formation, after injury they show prothrombotic activity. In addition, it has been hypothesized that "cytokine storm" might stimulate the production of neo-platelets triggering an abnormal "immunothrombosis" responsible for the hypercoagulable state induced in COVID-19 patients. The aim of this study is to report a case of severe COVID-19 infection characterized by the occurrence of microthrombosis in the vasa vasorum of the aorta. A 67-year-old male patient, in good health status and without comorbidities, who underwent a severe COVID-19 infection with fatal outcome, showed scattered aortic atherosclerotic plaques, characterized by multiple occlusive micro-thromboses in the vasa vasorum, spread out lymphocytic infiltrates and foci of endotheliitis and endothelial detachment. This case report confirms the previously described thrombotic involvement of vasa vasorum in COVID-19. The occurrence of the synchronous damage involving both the lumen surface (endothelial dysfunction, endotheliitis and endothelial detachment) and the adventitia (inflammation and occlusive thrombosis of vasa vasorum) could be the key points related to the fatal outcome of the SARS-CoV-2 patients. In our opinion, vasa vasorum thrombosis may thus initiate an atherogenic process that could be characterized by a much more rapid development. [ABSTRACT FROM AUTHOR]

Published
2021

6. Thrombotic sinusoiditis and local diffuse intrasinusoidal coagulation in the liver of subjects affected by COVID-19: the evidence from histology and scanning electron microscopy.

Author

FANNI, D., CERRONE, G., SABA, L., DEMONTIS, R., CONGIU, T., PIRAS, M., GEROSA, C., SURI, J., CONI, P., CADDORI, A., PIGA, M., MANCOSU, G., BARCELLONA, D., RAVARINO, A., CHIGHINE, A., CAU, F., SCANO, A., BALESTRIERI, A., COGHE, F., and ORRÙ, G.

Abstract

OBJECTIVE: Liver injury has been reported in patients with COVID-19. This condition is characterized by severe outcome and could be related with the ability of SARSCoV-2 to activate cytotoxic T cells. The purpose of this study is to show the histological and scanning electron microscopy features of liver involvement in COVID-19 to characterize the liver changes caused by the activation of multiple molecular pathways following this infection. PATIENTS AND METHODS: Liver biopsies from 4 patients (3 post-mortems and 1 in vivo) with COVID-19 were analyzed with histology and by scanning electron microscopy. RESULTS: The liver changes showed significant heterogeneity. The first case showed ground glass hepatocytes and scattered fibrin aggregates in the sinusoidal lumen. The second evidenced intra-sinusoidal thrombi. The third was characterized by sinusoidal dilatation, atrophy of hepatocytes, Disse's spaces dilatation and intra-sinusoidal aggregates of fibrin and red blood cells. The fourth case exhibited diffuse fibrin aggregates in the dilated Disse spaces and microthrombi in the sinusoidal lumen. CONCLUSIONS: In COVID-19-related liver injury, a large spectrum of pathological changes was observed. The most peculiar features were very mild inflammation, intra-sinusoidal changes, including sinusoidal dilatation, thrombotic sinusoiditis and diffuse intra-sinusoidal fibrin deposition. These findings suggested that a thrombotic sinusoiditis followed by a local diffuse intra-vascular (intra-sinusoidal) coagulation could be the typical features of the SARSCoV-2-related liver injury. [ABSTRACT FROM AUTHOR]

Published
2021

7. Vaccine-induced severe thrombotic thrombocytopenia following COVID-19 vaccination: a report of an autoptic case and review of the literature.

Author

FANNI, D., SABA, L., DEMONTIS, R., GEROSA, C., CHIGHINE, A., NIOI, M., SURI, J. S., RAVARINO, A., CAU, F., BARCELLONA, D., BOTTA, M. C., PORCU, M., SCANO, A., COGHE, F., ORRÙ, G., VAN EYKEN, P., GIBO, Y., LA NASA, G., D'ALOJA, E., and MARONGIU, F.

Abstract

OBJECTIVE: Vaccine-induced immune thrombocytopenia (VITT) is a new syndrome occurring primarily in healthy young adults, with a female predominance, after receiving the first dose of ChAdOx1 nCoV-19 vaccine. We describe VITT syndrome characterized by severe thrombosis and thrombocytopenia found in our patient, with fatal outcome. CASE REPORT: A 5 8-year-old m an, a fter 13 days from the first administration of ChAdOx1 nCoV-19 vaccine (AstraZeneca), presented with abdominal pain, diarrhea and vomitus. Laboratory tests revealed a severe thrombocytopenia, low fibrinogen serum levels and marked increase of D-dimer serum levels. The patient quickly developed a multiple organ failure, till death, three days after the hospital admission. RESULTS: At histology, in the lungs, interalveolar septa appeared thickened with microthrombi in the capillaries and veins. Interalveolar septa appeared thickened and showed vascular proliferation. Thrombi were detected in the capillaries of glomerular tufts. In the hearth, thrombi were observed in veins and capillaries. In the liver, voluminous fibrin thrombi were diffusely observed in the branches of the portal vein. Microthrombi were also found in the vasa vasorum of the wall of abdominal aorta. In the brain, microthrombi were observed in the capillaries of the choroid plexuses. Diffuse hemorrhagic necrosis was observed in the intestinal wall with marked congestion of the venous vessels. CONCLUSIONS: In our patient, the majority of data necessary for a VITT final diagnosis were present: thrombocytopenia and thrombosis in pulmonary, portal, hepatic, renal and mesenteric veins, associated with a marked increase of D-dimer serum levels. The finding of cerebral thrombosis in choroid plexuses, is a new finding in VITT. These features are suggestive for a very aggressive form of VITT. [ABSTRACT FROM AUTHOR]

Published
2021

8. Immunohistochemical findings in the lungs of COVID-19 subjects: evidence of surfactant dysregulation.

Author

GEROSA, C., FANNI, D., CAU, F., RAVARINO, A., SENES, G., DEMONTIS, R., CONI, P., PIRAS, M., ORRÙ, G., COGHE, F., CONGIU, T., LA NASA, G., D’ALOJA, E., SABA, L., and FAA, G.

Abstract

OBJECTIVE: Acute respiratory distress syndrome (ARDS) is characterized by quantitative and qualitative changes in surfactant composition, leading to surfactant dysregulation with alveolar collapse and acute respiratory hypoxic failure. Recently, surfactant has been hypothesized to play a relevant role in COVID-19, representing a strong defender against SARSCoV- 2 infection. The aim of our work was the study of immunohistochemical surfactant expression in the lungs of patients died following SARS-CoV-2 ARDS, in order to shed light on a possible therapeutic surfactant administration. PATIENTS AND METHODS: We investigated four patients who died due to ARDS following SARS-COV-2 infection and four patients submitted to lung biopsy, in the absence of SARSCoV- 2 infection. In all 8 cases, lung specimens were immunostained with anti-surfactant protein A (SP-A) and B (SP-B). RESULTS: In control subjects, reactivity for SP-B was restricted to type II alveolar cells. Immunostaining for SP-A was observed on the surface of alveolar spaces. In the COVID-19 positive lungs, immunoreactivity for SP-B was similar to that observed in control lungs; SP-A was strongly expressed along the alveolar wall. Moreover, dense aggregates of SP-A positive material were observed in the alveolar spaces. CONCLUSIONS: Our immunohistochemical data show the dysregulation of surfactant production in COVID-19 patients, particularly regarding SP-A expression. The increased presence of SP-A in condensed masses inside alveolar spaces could invalidate the therapeutic efficacy of the treatment with exogenous surfactant. [ABSTRACT FROM AUTHOR]

Published
2021

11. Le diagnostic de la maladie de Fabry : intérêt de l’enquête clinique

Author

Demontis R

Subjects
Pediatrics, medicine.medical_specialty, medicine.diagnostic_test, business.industry, Gastroenterology, Globotriaosylceramide, Cardiomyopathy, Disease, Enzyme replacement therapy, Delayed diagnosis, medicine.disease, Fabry disease, chemistry.chemical_compound, chemistry, Clinical investigation, Internal Medicine, medicine, business, Genetic testing
Abstract

Fabry disease, an X-linked lysosomal storage disorder due to alpha-galactosidase A deficiency, leads to an accumulation of globotriaosylceramide resulting in a multisystemic disorder. The initial manifestations of the disease are not specific, leading to a delayed diagnosis. We report a patient in whom the diagnosis was obtained by family screening and the confrontation of clinical signs. We also present a 4 year follow-up under enzyme replacement therapy (agalsidase β, 1 mg/kg/14 days).

Published
2010

15. A metabolomic approach to animal vitreous humor topographical composition: a pilot study.

Author

Locci, E, Scano, P, Rosa, Mf, Nioi, M, Noto, A, Atzori, L, Demontis, R, De Giorgio, Fabio, D'Aloja, Ernesto, De-Giorgio F (ORCID:0000-0002-9447-9707), d'Aloja E., Locci, E, Scano, P, Rosa, Mf, Nioi, M, Noto, A, Atzori, L, Demontis, R, De Giorgio, Fabio, D'Aloja, Ernesto, De-Giorgio F (ORCID:0000-0002-9447-9707), and d'Aloja E.

Abstract

The purpose of this study was to evaluate the feasibility of a (1)H-NMR-based metabolomic approach to explore the metabolomic signature of different topographical areas of vitreous humor (VH) in an animal model. Five ocular globes were enucleated from five goats and immediately frozen at -80 °C. Once frozen, three of them were sectioned, and four samples corresponding to four different VH areas were collected: the cortical, core, and basal, which was further divided into a superior and an inferior fraction. An additional two samples were collected that were representative of the whole vitreous body. (1)H-NMR spectra were acquired for twenty-three goat vitreous samples with the aim of characterizing the metabolomic signature of this biofluid and identifying whether any site-specific patterns were present. Multivariate statistical analysis (MVA) of the spectral data were carried out, including Principal Component Analysis (PCA), Hierarchical Cluster Analysis (HCA), and Partial Least Squares Discriminant Analysis (PLS-DA). A unique metabolomic signature belonging to each area was observed. The cortical area was characterized by lactate, glutamine, choline, and its derivatives, N-acetyl groups, creatine, and glycerol; the core area was characterized by glucose, acetate, and scyllo-inositol; and the basal area was characterized by branched-chain amino acids (BCAA), betaine, alanine, ascorbate, lysine, and myo-inositol. We propose a speculative approach on the topographic role of these molecules that are mainly responsible for metabolic differences among the as-identified areas. (1)H-NMR-based metabolomic analysis has shown to be an important tool for investigating the VH. In particular, this approach was able to assess in the samples here analyzed the presence of different functional areas on the basis of a different metabolite distribution.

Published
2014

19. A geo-data server for antarctic data

Author

Fortunati L., Salvetti O., Costa V., Demontis R., Galligani A., Carlesi C., and Biagioni S.

Subjects
Database applications, Meta-information, Standards, Geo data server, Geo-data server, Database applications. Spatial databases and GIS, Heterogeneous databases, spatial databases and GIS [Database applications], Database applications. Spatial database and GIS, Database applications: spatial databases and GIS
Abstract

This project is the natural evolution of the South Pole System for Antarctic Data Exchange [1] and has as main objectives the organisation, homogenisation, standardisation and diffusion of all the data acquired by the National Program for Research in Antarctica. A main activity is to design and implement a Geo-Data Server [2, 3, 4], constituted by a system storing consolidated data for remote consultation. Main features of Geo-Data Server are the definition of an Antarctic cartographic and image database, according to the international standards, a relational catalog, containing meta-information about the data archived in Geo-Data Server and a high-level interface to access the system. At present, a simulation prototype is under construction [5], composed of a UNIX workstation and three high-performance PCs networked, where the data managed are supplied by two Data Centres of South Pole System for Antarctic Data Exchange ('GEO' Centre, ENEA Casaccia, for remote sensing data, and 'TER' Centre, Dept. of Earth Science, University of Siena, for cartographic data). In this paper, the first results of the approach followed are shown.

Published
1999

20. Prototipo di geo-data server: il caso dell'autorità di bacino del Serchio

Author

Fortunati L., Cresci G., and Demontis r.

Subjects
Geodata server, H. Information Systems
Abstract

The work described in this document was developed as part of a research contract between the Experimental Basin Authority of Serchio river and CNUCE. The document contains a description of: · Geo-Data Server functionalities and project constraints; · data available on the server; · architectural choices and internal components; · transformations operated on data imported from the GIS.

Published
1998

21. Mapping dei dati delle campagne sperimentali di pesca

Author

Fortunati L., Garofalo G., and Demontis R.

Subjects
Data mapping, Database applications
Abstract

Trawl surveys generally produce a huge amount of data, for several reasons: o the time frequency of the surveys; o the geographical size of the study area; o the number of hauls carried out in the area; o the number of parameters collected during each haul; o the number of species identified; o the number of parameters collected for each species. This great abundance of data is generally processed by means of tools which do not consider the geographical position of the datum but produce synthetic and statistical information which is geographically not-correlated. The application developed is based on a GIS and is aimed at storing, managing and analysing the trawl survey data in their spatial context. It includes a set of functions which allow the user to work dynamically on the database by interactively selecting the surveys, the hauls, the various species and their parameters (length, sex, sexual maturity). For each selection performed by the user, it produces synthetic and high level information, both in a table and graphically. It can be considered as a tool for the preliminary analysis of data collected. Its results represent a consistent starting point for a study aimed at analysing the distribution, the abundance and the population dynamics of demersal species which are the target of commercial fisheries. The application (developed in the context of the activities within the FIGIS project of the European Community) uses data collected during the trawl surveys carried out in the Gulf of Castellammare (Sicily) in 1993-94, nevertheless it can be generalized so as to manage time series of trawl survey data relative to any geographical area.

Published
1998

22. Geo-data server: il caso dell'autorità di bacino del fiume Serchio

Author

Fortunati L., Cresci G., and Demontis R.

Subjects
Geo-data server
Abstract

Il lavoro descritto in quest'articolo è stato svolto nell'ambito della collaborazione che lega l'Autorità di Bacino Sperimentale del fiume Serchio al CNUCE - CNR che prevede, tra l'altro, la realizzazione di un sistema per la distribuzione di dati geografici ad utenti esterni. La disponibilità di dati in formato digitale è stata, per molto tempo, uno degli ostacoli alla diffusione e all'uso dei sistemi informativi territoriali (Geographical Information Systems: GIS). Oggi questi problemi sono superati, ma permangono difficoltà di accesso e fruizione dei dati geografici. La rete Internet offre l'opportunità di diffondere le informazioni in modo capillare e, basandosi su interfacce semplici e ben conosciute, ne consente la fruizione anche ad utenti "inesperti". La distribuzione di dati geografici via Internet richiede comunque valutazioni ed interventi, la cui natura ed entità dipendono dagli obiettivi e dai vincoli tecnici ed organizzativi di progetto. L'articolo descrive le specifiche del progetto, le funzionalità e i dati inseriti nel Geo-Data Server e discute le scelte progettuali e l'architettura adottata per il sistema.

Published
1998

24. La distribuzione via rete dell'informazione geografica

Author

Fortunati L., Cresci G, and Demontis R.

Subjects
Distributed databases, Distributed systems
Abstract

The present technology makes available tools for geographical data handling and archiving that were largely used by professionals, consequently large amounts of digital data are today available. The diffusion of the Internet, together with the continuous growth of transmission speed and the availability of powerful compression techniques, enable the diffusion of those data to an extremely large user population. These technological items give satisfying answers to the increasing request for geographical information, coming from many different sources, also from areas traditionally far from GIS technology. Complete environments to develop and manage applications for distribution via WWW of geographical data aren't yet available, so ad hoc programming is required as well as an accurate design taking into account data organization, interaction between GIS and WWW, software packages both on server and client side (to integrate the browser capabilities). This article contains a description of most common problems encountered in developing a system for geographical data distribution (Geo-Data Server) and describes the solution adopted for the Geo-Data Server of Serchio river Basin Authority.

Published
1998

40. TSDV: A GIS tool for inspecting trawl survey data

Author

Fortunati, L., Garofalo, G., and Demontis, R.

Subjects
FISHERIES, TRAWLING, MARINE geographic information systems
Abstract

The aim of this paper is to present a tool for the exploratory analysis of trawl survey data using a Geographical Information System (GIS). In particular, the architecture and the main functions of an interactive desktop mapping system, the Trawl Survey Data Viewer (TSDV), are described. The TSDV was developed to provide non-GIS specialists fishery researchers an intuitive visualization and query mechanism of the spatial data sets produced by trawl surveys. The system is able to readily produce distribution maps by species or groups of species. Moreover, it allows to visualize spatial distributions of abundance data, disaggregated by important population parameters such as length class, sex, and maturity. The rationale of this approach is the importance to investigate the spatial component of some relevant aspects of species biology (spatio-temporal distribution patterns, juvenile and/or nursery areas, spawning areas) and to formulate hypothesis for subsequent analysis. Further work must be conducted in order to develop analytical and statistical confirmatory procedures. [Copyright &y& Elsevier]

Published
2002
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42. Comparative Evaluation of Bone Aluminum Content and Bone Histology in Patients on Chronic Hemodialysis and Hemofiltration

Author

J. L. Sebert, Fohrer P, Demontis R, Michèle Garabédian, Cl. Galy, Leflon P, J. F. de Fremont, Albert Fournier, Lambrey G, A. Marie, Dkhissi H, B. Boudailliez, Ph. Morinière, and J. Guéris

Subjects
Adult, Male, medicine.medical_specialty, Resuscitation, Bone disease, medicine.medical_treatment, Urology, Ultrafiltration, Aluminum Hydroxide, Bone and Bones, Electrolytes, Osteogenesis, Renal Dialysis, Hemofiltration, medicine, Humans, In patient, Renal osteodystrophy, Chronic Kidney Disease-Mineral and Bone Disorder, Dose-Response Relationship, Drug, business.industry, Histology, Middle Aged, Alkaline Phosphatase, medicine.disease, Peptide Fragments, Surgery, Blood, Parathyroid Hormone, Kidney Failure, Chronic, Female, Hemodialysis, Complication, business, Aluminum
Abstract

In order to compare hemofiltration (HF) and hemodialysis (HD) in connection with the risk of aluminum overload and renal osteodystrophy, double bone biopsies after double tetracycline labeling and a desferrioxamine test were performed in 12 patients on HF and 15 patients on HD. The aluminum concentration was low (less than 0.6 mumol/l) both in the dialysate and the substitution fluid. The duration of treatment (about 2 years) and the cumulative doses of Al(OH)3 and CaCO3 were comparable in the two groups. None of the patients was taking 1 alpha-OH-D. The aluminum balance during an HF run ranged from -22 to +1.8 mumol/l, the balance being positive only when the plasma aluminum was less than 0.5 mumol/l. Basal plasma aluminum and its increase induced by desferrioxamine were comparable in the two groups. Bone aluminum content was also comparable, but was about 10 times higher than in 7 nonuremic controls. Bone aluminum content and plasma aluminum increase after desferrioxamine were correlated to the Al(OH)3 cumulative dose. None of the patients had florid osteomalacia with increased osteoid thickness, and only 1 in each group had traces of stainable aluminum. The mineralization front was decreased in 8 of 12 HF and in 9 of 14 HD patients, so that no difference was observed between the means of the two groups. The predominant histological bone picture of the patients was osteitis fibrosa which was present in 10 of 12 HF and in 13 of 15 HD patients. Mean osteoclast count and active resorption surface were comparable in the two groups, but was increased (5-10 times the mean of the controls).(ABSTRACT TRUNCATED AT 250 WORDS)

Published
1986

47. Moderate Exercise Improves Cognitive Function in Healthy Elderly People: Results of a Randomized Controlled Trial

Author

Gianmario Migliaccio, Stefano Lorrai, Goce Kalcev, Maria Pietronilla Penna, Mauro Giovanni Carta, Mirra Pintus, Dario Fortin, Giulia Cossu, Roberto Demontis, Eleonora Cocco, Elena Massa, Sofia Cosentino, Ferdinando Romano, Sergio Machado, Federico Cabras, Gioia Mura, Massimiliano Pau, Mario Musu, Alessandra Scano, Omar Callia, Franco Rongioletti, Antonio Preti, Antonio Crisafulli, Gabriele Finco, Valeria Ruggiero, Fernanda Velluzzi, Cesar Ivan Aviles Gonzalez, Luigi Minerba, Germano Orr, Rosanna Zaccheddu, Paolo Contu, Claudia Sardu, Andrea Loviselli, Maria Valeria Massidda, Giuliana Conti, Elisa Pintus, Enrico Cacace, Marco Monticone, Quirico Mela, Laura Atzori, Alberto Cauli, Carta, M. G., Cossu, G., Pintus, E., Zaccheddu, R., Callia, O., Conti, G., Pintus, M., Gonzalez, C. I. A., Massidda, M. V., Mura, G., Sardu, C., Contu, P., Minerba, L., Demontis, R., Pau, M., Finco, G., Cocco, E., Penna, M. P., Orr, G., Kalcev, G., Cabras, F., Lorrai, S., Loviselli, A., Velluzzi, F., Monticone, M., Cacace, E., Musu, M., Rongioletti, F., Cauli, A., Ruggiero, V., Scano, A., Crisafulli, A., Cosentino, S., Atzori, L., Massa, E., Mela, Q., Fortin, D., Migliaccio, G., Machado, S., Romano, F., and Preti, A.

Subjects
Quality of life, medicine.medical_specialty, Aging, Epidemiology, Cognition, Dementia, Physical activity, RCT, RCT [Invecchiamento, Article, law.invention, Demenza, Randomized controlled trial, law, Intervention (counseling), Medicine, Effects of sleep deprivation on cognitive performance, Cognitive decline, Cognizione, Attività fisica, Qualità della vita, RCT], business.industry, Psychiatry and Mental health, Physical therapy, Medical certificate, business, Anaerobic exercise
Abstract

Background: Physical activity in the elderly is recommended by international guidelines to protect against cognitive decline and functional impairment. Objective: This Randomized Controlled Trial (RCT) was set up to verify whether medium-intensity physical activity in elderly people living in the community is effective in improving cognitive performance. Design: RCT with parallel and balanced large groups. Setting: Academic university hospital and Olympic gyms. Subjects: People aged 65 years old and older of both genders living at home holding a medical certificate for suitability in non-competitive physical activity. Methods: Participants were randomized to a 12-week, 3 sessions per week moderate physical activity program or to a control condition focused on cultural and recreational activities in groups of the same size and timing as the active intervention group. The active phase integrated a mixture of aerobic and anaerobic exercises, including drills of “life movements”, strength and balance. The primary outcome was: any change in Addenbrooke's Cognitive Examination Revised (ACE-R) and its subscales. Results: At the end of the trial, 52 people completed the active intervention, and 53 people completed the control condition. People in the active intervention improved on the ACE-R (ANOVA: F(1;102)=4.32, p=0.040), and also showed better performances on the memory (F(1;102)=5.40 p=0.022) and visual-space skills subscales of the ACE-R (F(1;102)=4.09 p=0.046). Conclusion: A moderate-intensity exercise administered for a relatively short period of 12 weeks is capable of improving cognitive performance in a sample of elderly people who live independently in their homes. Clinical Trials Registration No: NCT03858114

Published
2021

48. Active elderly and health—can moderate exercise improve health and wellbeing in older adults? Protocol for a randomized controlled trial

Author

Paolo Contu, Roberto Demontis, Alessandra Scano, Giuliana Conti, Andrea Loviselli, Elena Massa, Maria Petronilla Penna, Maria Valeria Massidda, Gianmario Migliaccio, Marco Monticone, Gabriele Finco, Federico Cabras, Dario Fortin, Elisa Pintus, Valeria Ruggiero, Eleonora Cocco, Enrico Cacace, Quirico Mela, Laura Atzori, Omar Callia, Matthias C. Angermeyer, Sofia Cosentino, Claudia Sardu, Franco Rongioletti, Rosanna Zoccheddu, Mirra Pintus, Fernanda Velluzzi, Antonio Preti, Gioia Mura, Massimiliano Pau, Cesar Ivan Aviles Gonzalez, Giulia Cossu, Mario Musu, Antonio Egidio Nardi, Antonio Crisafulli, Germano Orrù, Mauro Giovanni Carta, Alberto Cauli, Stefano Lorrai, Goce Kalcev, Luigi Minerba, Carta, M. G., Cossu, G., Pintus, E., Zoccheddu, R., Callia, O., Conti, G., Pintus, M., Gonzalez, C. I. A., Massidda, M. V., Mura, G., Sardu, C., Contu, P., Minerba, L., Demontis, R., Pau, M., Finco, G., Cocco, E., Penna, M. P., Orru, G., Kalcev, G., Cabras, F., Lorrai, S., Loviselli, A., Velluzzi, F., Monticone, M., Cacace, E., Musu, M., Rongioletti, F., Cauli, A., Ruggiero, V., Scano, A., Crisafulli, A., Cosentino, S., Atzori, L., Massa, E., Mela, Q., Fortin, D., Migliaccio, G., Nardi, A. E., Angermeyer, M., and Preti, A.

Subjects
Gerontology, Quality of life, Male, Medicine (General), Aging, Cognition, Depression, Physical activity, RCT, Accidental Falls, Aged, Exercise Therapy, Female, Humans, Randomized Controlled Trials as Topic, Exercise, Quality of Life, Medicine (miscellaneous), Physical exercise, law.invention, Study Protocol, 03 medical and health sciences, R5-920, 0302 clinical medicine, Randomized controlled trial, law, Health care, Medicine, Pharmacology (medical), 030212 general & internal medicine, Cognitive skill, aging, physical activity, quality of life, cognition, depression, Depression (differential diagnoses), business.industry, Preferred walking speed, business, 030217 neurology & neurosurgery
Abstract

Background Aging is marked by a progressive rise in chronic diseases with an impact on social and healthcare costs. Physical activity (PA) may soothe the inconveniences related to chronic diseases, has positive effects on the quality of life and biological rhythms, and can prevent the decline in motor functions and the consequent falls, which are associated with early death and disability in older adults. Methods We randomized 120 over-65 males and females into groups of similar size and timing and will give each either moderate physical activity or cultural and recreational activities. Being younger than 65 years, inability to participate in physical activity for any medical reason, and involvement in a massive program of physical exercise are the exclusion criteria. The primary outcome measures are: quality of life, walking speed, and postural sway. Participants are tested at baseline, post-treatment, and 6-month (24 weeks) and 12-month (48 weeks) follow-ups. Discussion This study aims at improving the quality of life, wellness, and cognitive functioning in the elderly through a low-cost affordable program of moderate physical activity. Given the growing aging of the world population and the social and economic burden of disability in the elderly, our results might have a major impact on future practices. Trial registration ClinicalTrials.gov NCT03858114. Registered on 28 February 2019.

Published
2021

49. The human major sublingual gland and its neuropeptidergic and nitrergic innervations.

Author

Boi M, Demontis R, Isola M, Isola R, Loy F, Serra MP, Trucas M, Ekström J, and Quartu M

Subjects
Humans, Male, Female, Neuropeptide Y metabolism, Calcitonin Gene-Related Peptide metabolism, Vasoactive Intestinal Peptide metabolism, Immunohistochemistry, Middle Aged, Nitric Oxide Synthase Type I metabolism, Aged, Adult, Aged, 80 and over, Sublingual Gland innervation, Sublingual Gland metabolism, Neuropeptides metabolism, Substance P metabolism
Abstract

Background: What textbooks usually call the sublingual gland in humans is in reality a tissue mass of two types of salivary glands, the anteriorly located consisting of a cluster of minor sublingual glands and the posteriorly located major sublingual gland with its outlet via Bartholin's duct. Only recently, the adrenergic and cholinergic innervations of the major sublingual gland was reported, while information regarding the neuropeptidergic and nitrergic innervations is still lacking., Methods: Bioptic and autoptic specimens of the human major sublingual gland were examined by means of immunohistochemistry for the presence of vasoactive intestinal peptide (VIP)-, neuropeptide Y (NPY)-, substance P (SP)-, calcitonin gene related-peptide (CGRP)-, and neuronal nitric oxide synthase (nNOS)-labeled neuronal structures., Results: As to the neuropeptidergic innervation of secretory cells (here in the form of mucous tubular and seromucous cells), the findings showed many VIP-containing nerves, few NPY- and SP-containing nerves and a lack of CGRP-labeled nerves. As to the neuropeptidergic innervation of vessels, the number of VIP-containing nerves was modest, while, of the other neuropeptide-containing nerves under study, only few (SP and CGRP) to very few (NPY) nerves were observed. As to the nitrergic innervation, nNOS-containing nerves were very few close to secretory cells and even absent around vessels., Conclusion: The various innervation patterns may suggest potential transmission mechanisms involved in secretory and vascular responses of the major sublingual gland., Competing Interests: Declaration of Competing Interest None., (Copyright © 2024 The Authors. Published by Elsevier GmbH.. All rights reserved.)

Published
2024
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50. Volabolomic Fingerprinting for Post-Mortem Interval Estimation: A Novel Physiological Approach.

Author

Mazzatenta A, Pietrangelo T, Demontis R, and D'Ovidio C

Subjects
Humans, Autopsy, Postmortem Changes
Abstract

Death is a multifaceted process wherein each individual cell and tissue has a metabolic homeostasis and a time of functional cessation defined by the dying process as well as by intrinsic and extrinsic factors. Decomposition is physiologically associated with the release of different types of volatile organic compounds (VOCs), and these form volaboloma mortis. The main purpose of this study was to record the volabolomic fingerprint produced by volatile molecules during the physiological decomposition process of human tissue and muscle cells. The volatile chemical signature has important implications for an open issue in forensics and pathology, namely the estimation of the postmortem interval (PMI), which decreases in accuracy with the passage of time. Volatile metabolites emitted from human tissues and muscle cells at 0, 24, 48, and 72 h were recorded in real time with an electronic nose sensor device. The key findings were the continuous sampling of VOCs emitted from tissues and cells. These showed a common behavior as time progressed; particularly, after 48 h the distributions became dispersed, and after 72 h they became more variable. Volabolomic fingerprinting associated with time progression relevant to the study of PMIs was reconstructed. Additionally, there may be broader applications, such as in dog training procedures for detecting human remains, and perhaps even for studying scavenger and insect attractants.

Published
2024
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