Search

Introduction Diffuse malignant peritoneal mesothelioma (DMPM) is a rare malignant neoplasm with poor survival that shares some similarities with the best-known pleural variant, pleural mesothelioma. The recent European Reference Network on Rare Adult Cancers (EURACAN)/International Association for the Study of Lung Cancer (IASLC) proposals attempted to improve the histological diagnosis and patient risk stratification. Herein, we investigated whether the pathology recommendations and suggestions of the pleural proposals were applicable to diffuse malignant peritoneal mesothelioma. Methods Fifty multiple laparoscopic biopsies of DMPM were consecutively collected at the Pathology Unit of the University of Bari. A two-tier system, i.e., low, and high grade, was used to categorize 34 epithelioid DMPMs. Architectural patterns, cytological features and stromal changes were also reported. Immunohistochemistry was performed for BRCA1-associated protein 1 (BAP1), programmed death-ligand 1 (PD-L1), and Ki67, while fluorescence in situ hybridization (FISH) was performed for p16/cyclin-dependent kinase inhibitor 2A (CDKN2A). Results High-grade epithelioid mesothelioma, high Ki67, and p16/CDKN2A deletion were significantly associated with short survival (p = 0.004, p p = 0.002, respectively). BAP1 loss and PD-L1 negativity were the most common findings. Multivariate analysis revealed that the nuclear grading system and p16 deletion significantly correlated with survival (p = 0.003 each). Conclusions The present study examined the prognostic significance of several factors proposed for pleural mesothelioma in an extra pleural site. Notably, the introduction of a grading system may provide better risk stratification in epithelioid DMPM. Ki67, BAP1 and p16/CDKN2A should also be measured whenever possible. A detailed report with all supportive data would allow us to collect sufficient information for use in further studies on larger case series.

Atypical fibroxanthoma-like amelanotic melanoma is a very rare variant of melanoma that can, if not correctly recognized and framed, lead to diagnostic errors that can potentially cause problems of extreme relevance to patients. Correct knowledge of this entity and the execution of adequate immunohistochemical investigations are the basic conditions for the correct management of this lesion. We report on a case of atypical fibroxanthoma-like amelanotic melanoma, which clinically simulated a fibrohistiocytic lesion, and which created differential diagnostic problems, and finally, we conduct a short review of the literature.

The association between environmental conditions and pregnancy outcome has been under investigation for a long time, but results appear to be inconclusive regarding damage to either the newborn or the mother. The aim of this study was to evaluate the distribution of hospitalization of newborns with low birthweight (

There is evidence that asbestos could play a role in the carcinogenesis of digestive cancers. The presence of asbestos fibres in histological samples from gastric, biliary, colon cancers has been reported, but the mechanism is still controversial. It has been hypothesised that asbestos reaches these sites, especially through contaminated water; however, some experimental studies have shown that the inhaled fibres are mobile, so they can migrate to many organs, directly or via blood and lymph flow. We report four unusual cases of colorectal cancers in patients with a long history of asbestos exposure who also developed synchronous or metachronous mesothelioma. We evaluated the roles of BRCA associated protein-1 (BAP1) and cyclin-dependent kinase inhibitor 2A (CDKN2A) in colon cancer and mesothelioma to support the hypothesis that BAP-1 and CDKN2A are tumour suppressor genes involved in disease progression, recurrence, or death in both digestive cancers and mesothelioma. Potentially, these markers may be used as predictors of worse prognosis, but we also stress the importance of clinical surveillance of exposed patients because asbestos could induce cancer in any organ.

Lung neuroendocrine neoplasms (lung NENs) are categorised by morphology, defining a classification sometimes unable to reflect ultimate clinical outcome. Subjectivity and poor reproducibility characterise diagnosis and prognosis assessment of all NENs. Here, we propose a machine learning framework for tumour prognosis assessment based on a quantitative, automated and repeatable evaluation of the spatial distribution of cells immunohistochemically positive for the proliferation marker Ki-67, performed on the entire extent of high-resolution whole slide images. Combining features from the fields of graph theory, fractality analysis, stochastic geometry and information theory, we describe the topology of replicating cells and predict prognosis in a histology-independent way. We demonstrate how our approach outperforms the well-recognised prognostic role of Ki-67 Labelling Index on a multi-centre dataset comprising the most controversial lung NENs. Moreover, we show that our system identifies arrangement patterns in the cells positive for Ki-67 that appear independently of tumour subtyping. Strikingly, the subset of these features whose presence is also independent of the value of the Labelling Index and the density of Ki-67-positive cells prove to be especially relevant in discerning prognostic classes. These findings disclose a possible path for the future of grading and classification of NENs., SCOPUS: ar.j, info:eu-repo/semantics/published

Objective Asbestos was widely used in construction in both a friable and a compact form until the 1990s, before its use was banned. Today, many of these materials are still in situ and represent a source of risk for construction workers. The objective of the study was to analyse the cases of mesothelioma arising among construction workers registered in the Apulia regional register of mesothelioma. Results For the period 1993–2018, there were 178 male cases, and 10.2% of the cases were present in the regional register. The average age at diagnosis was 64.7 years. The site was pleural in 96.06% of cases, with a diagnosis of certainty in 86.5% of the total cases and 61.8% of cases with epithelial histology. The average latency is 43.9 years. In 75.2% of cases, the exposure began between 1941 and 1970, with an average duration of 24.3 years. The age at the start of exposure in 68.5% of cases is between 8 and 20 years. The ORs were 2.5 (C.I. 95% 1.01–6.17) for the epithelioid histotype and the high duration of exposure. The data underline the need for prevention and information on all activities involving construction workers in which asbestos-containing materials are still used.

The primary cilium (PC) is a sensory organelle present on the cell surface, modulating the activity of many pathways. Dysfunctions in the PC lead to different pathologic conditions including cancer. Hedgehog signaling (Hh) is regulated by PC and the loss of its control has been observed in many cancers, including mesothelioma. Malignant pleural mesothelioma (MPM) is a fatal cancer of the pleural membranes with poor therapeutic options. Recently, overexpression of the Hh transcriptional activator GL1 has been demonstrated to be associated with poor overall survival (OS) in MPM. However, unlike other cancers, the response to G-protein-coupled receptor smoothened (SMO)/Hh inhibitors is poor, mainly attributable to the lack of markers for patient stratification. For all these reasons, and in particular for the role of PC in the regulation of Hh, we investigated for the first time the status of PC in MPM tissues, demonstrating intra- and inter-heterogeneity in its expression. We also correlated the presence of PC with the activation of the Hh pathway, providing uncovered evidence of a PC-independent regulation of the Hh signaling in MPM. Our study contributes to the understanding MPM heterogeneity, thus helping to identify patients who might benefit from Hh inhibitors.

Simple Summary Primary ovarian mesothelioma is a rare and aggressive neoplastic disease with a poor prognosis. The rarity of this entity and the challenging differential diagnosis with other ovarian and peritoneal neoplasms may lead to frequent misdiagnosis and some concerns about its histogenesis. This case series describes four histologically and ultrastructurally documented primary ovarian mesotheliomas in exposed patients, as reported in the medical history. Because of the few cases described, we reviewed the English literature on ovarian mesothelioma and on its possible risk factors, already known and recognized for pleural, pericardial, peritoneal, tunica vaginalis mesothelioma. Describing such rare cases and summarizing the knowledge so far is fundamental to gain greater awareness of this neoplasm and try to answer unsolved questions on its origin. Abstract Primary ovarian mesothelioma is a rare, aggressive neoplastic disease with a poor prognosis. At onset, the tumor is only rarely limited to the ovaries and usually already widespread in the peritoneum. The rarity of this entity and the difficulties differentiating it from either ovarian carcinoma or peritoneal mesothelioma may lead to frequent misdiagnoses and may raise some concerns about its histogenesis. Thus, reporting such rare cases is fundamental to gain greater awareness of this neoplasm and try to answer unsolved questions. Herein, we described four cases of histological diagnoses of ovarian mesothelioma extrapolated by the regional mesothelioma register of Apulia (southern Italy). In all cases, a detailed medical history was collected according to national mesothelioma register guidelines. A broad panel of antibodies was used for immunohistochemistry to confirm the diagnoses. Moreover, ovarian tissue samples were also examined by transmission and scanning electron microscopy, detecting asbestos fibers and talc crystals in two cases. Because of the few cases described, we reviewed the English literature in the Medline database, focusing on articles about ovarian mesothelioma “misclassification”, “misdiagnosis”, “diagnostic challenge” or “diagnostic pitfall” and on unsolved questions about its histogenesis and possible risk factors.

Mesonephric adenocarcinomas are rare tumors of the female genital tract, thought to arise from embryonic mesonephric remnants, primarily in the cervix and vagina. Conversely, endometrial and ovarian mesonephric adenocarcinomas may have a different pathogenesis, probably originating from transdifferentiated Müllerian carcinomas, as demonstrated by the association of these neoplasms with endometriosis and ovarian serous tumors. For this reason, in the endometrium and in the ovary, they are defined as “mesonephric-like adenocarcinomas”. Some cases of mesonephric carcinomas of the female genital tract have been reported to show a sarcomatous component and have been defined as “mesonephric carcinosarcomas”, characterized by poor prognosis and high metastatic behavior, but this entity has never been described in the ovary. The case herein presented is of a 74-year-old female with abdominal discomfort and a complex ovarian mass. Histological and immunohistochemical analysis showed features of ovarian mesonephric-like carcinoma combined with a low-grade serous component, in support of the theory of a Müllerian origin of these neoplasms. The tumor also revealed foci of chondrosarcomatous differentiation, never before reported in the ovary, showing a similar immunohistochemical profile to the mesonephric-like elements. This work thus describes the first reported case of ovarian mesonephric-like carcinosarcoma.

To estimate the size of the novel coronavirus (COVID-19) outbreak in the early stage in Italy, this paper introduces the cumulated and weighted average daily growth rate (WR) to evaluate an epidemic curve. On the basis of an exponential decay model (EDM), we provide estimations of the WR in four-time intervals from February 27 to April 07, 2020. By calibrating the parameters of the EDM to the reported data in Hubei Province of China, we also attempt to forecast the evolution of the outbreak. We compare the EDM applied to WR and the Gompertz model, which is based on exponential decay and is often used to estimate cumulative events. Specifically, we assess the performance of each model to short-term forecast of the epidemic, and to predict the final epidemic size. Based on the official counts for confirmed cases, the model applied to data from February 27 until the 17th of March estimate that the cumulative number of infected in Italy could reach 131,280 (with a credibility interval 71,415-263,501) by April 25 (credibility interval April 12 to May 3). With the data available until the 24st of March the peak date should be reached on May 3 (April 23 to May 23) with 197,179 cumulative infections expected (130,033-315,269); with data available until the 31st of March the peak should be reached on May 4 (April 25 to May 18) with 202,210 cumulative infections expected (155.235-270,737); with data available until the 07st of April the peak should be reached on May 3 (April 26 to May 11) with 191,586 (160,861-232,023) cumulative infections expected. Based on the average mean absolute percentage error (MAPE), cumulated infections forecasts provided by the EDM applied to WR performed better across all scenarios than the Gompertz model. An exponential decay model applied to the cumulated and weighted average daily growth rate appears to be useful in estimating the number of cases and peak of the COVID-19 outbreak in Italy and the model was more reliable in the exponential growth phase.

Virtually any malignancy can metastasize to the liver. Large solitary metastases are rare and can be difficult to distinguish from primary tumors. Malignant mesothelioma is often considered as a locally invasive cancer but tumor dissemination to extra-thoracic sites is possible, and the liver can be involved. Herein, we present a rare case of pleural mesothelioma with a solitary large liver metastasis diagnosed postmortem in a ninety-two-year-old man with 35 years of exposure to asbestos. Results of immunohistochemical staining of the pleural and liver tumor were similar, both positive for low-molecular weight keratins, calretinin, vimentin, and podoplanin, and negative for Claudin-4, TTF1, CEA, BerEP4, CK7, CK19, CK20, BAP1, Hep Par1, p40, and WT1. Fluorescent in-situ hybridization (FISH) for p16/CDKN2A was also performed and a homozygous deletion was detected in both tumors, supporting the diagnosis of mesothelioma. Reporting this case, we would like to point out that extra-thoracic dissemination from pleural mesothelioma, even if exceptional, can occur. In cases where differential diagnoses are challenging, the value of ancillary techniques and a practical approach to diagnostic work-up is of primary importance.

Diffuse malignant peritoneal mesothelioma (DMPM) is a rare malignant neoplasm with a poor survival. Although some advances in knowledge have been obtained for the pleural form, much less is known about DMPM. Advantages in terms of prognosis are still limited and strong efforts need to be made. The aim of our study was to correlate several histological and molecular factors with survival in a large cohort of 45 DMPMs. We evaluated histotype, nuclear grade, mitotic count, necrosis, inflammation, desmoplastic reaction, Ki67 percentage, WT-1 expression, p16 protein by immunohistochemistry and CDKN2A deletion by FISH. Our results showed that epithelioid histotype, nuclear grade 2, mitotic count &le, 5 x mm2, absence of desmoplasia and p16/CDKN2A deletion, low Ki67 value, and high WT-1 expression were correlated with the most prolonged survival (p = 0.0001). Moreover, p16 loss in immunohistochemistry reflected CDKN2A deletion detected with FISH, and both were correlated with the worst survival (p = 0.0001). At multivariate analysis, Ki67 value, WT-1 expression and p16/CDKN2A deletion emerged as independent prognostic factors (p = 0.01, p = 0.0001 and p = 0.01, respectively). These parameters are easy to analyse at the time of DMPM diagnosis and may support better patient stratification, prediction of treatment effectiveness and therapeutic optimization.

Background Legionella bacteria is a common cause of pneumonia, but the infection may affect several organs in the most serious cases. A systemic involvement ab initio could be non-specific, leading to a diagnostic misinterpretation. Case presentation A 33-year-old woman had been complaining of mental confusion, restlessness, aggressiveness, and, subsequently, hirsutism. After 3 weeks, the patient developed pneumonia and died during the hospitalization. The autopsy examination revealed a multi-organ necrotizing exudative disease involving the lung, the heart and the brain. The microbiological tests of tracheal aspirate were positive for Legionella pneumophila serotype 1. Conclusion The Legionella infection may show a proteiform clinical course and an extra-pulmonary manifestation may be the first sign of the disease. Herein, we report a case of Legionella infection in a young female, presenting with non-specific neurological symptoms and hirsutism at onset, misdiagnosed as a metabolic disease.

To estimate the size of the novel coronavirus (COVID-19) outbreak in Italy, this paper introduces the cumulated and weighted average daily growth rate (WR) to evaluate an epidemic curve, On the basis of an exponential decay model (EDM), we provide estimations of the WR in four-time intervals from February 27 to April 07, 2020. By calibrating the parameters of the EDM to the reported data in Hubei Province of China, we also attempt to forecast the evolution of the outbreak. We compare the EDM applied to WR and the Gompertz model, which is based on exponential decay and is often used to estimate cumulative events. Specifically, we assess the performance of each model to short-term forecast of the epidemic, and to predict the final epidemic size. Based on the official counts for confirmed cases, the model applied to data from February 27 until the 17st of March estimate that the cumulative number of infected could reach 131,280 (with a credibility interval 71,415-263,501) by April 25 (credibility interval April 12 to May 3). With the data available until the 24st of March the peak date should be reached on May 3 (April 23 to May 23) with 197,179 cumulative infections expected (130033-315,269); with data available until the 31st of March the peak should be reached on May 4 (April 25 to May 18) with 202,210 cumulative infections expected (155.235-270,737); with data available until the 07st of April the peak should be reached on May 3 (April 26 to May 11) with 191,586 (160,861-232,023) cumulative infections expected. Based on the average mean absolute percentage error (MAPE), cumulated infections forecasts provided by the EDM applied to WR performed better across all scenarios than the Gompertz model. An exponential decay model applied to the cumulated and weighted average daily growth rate appears to be useful in estimating the number of cases and peak of the COVID-19 outbreak in Italy and the model was more reliable in the exponential growth phase.

The &ldquo, Love Food, Not Waste&rdquo, project was conducted to train students on good food choices and evaluate food waste in school canteens. Teachers, parents and students were surveyed before and after training. Weights of both the served and wasted food were recorded for one week both before the educational intervention in February 2019 and after the educational intervention in March 2019, using the same menu. Students completed a food satisfaction questionnaire on the days the data were collected. For the first dish, the mean wastes per school were 1199 g before training and 1054 g after training. For the second dish, the mean wastes per school were 246 g before training and 220 g after training. For the side course, the means wastes per school were 663 g before training and 747 g after training. The results did not significantly differ among weeks or schools. Less food was wasted when boys judged the food&rsquo, s general aspects like smell, taste and appearance as positive, more food was wasted when girls judged these factors as negative. Food waste monitoring is mandatory but does not always occur. Analyzing food waste relative to students&rsquo, food perceptions can help determine whether educational interventions can help reduce waste. Students&rsquo, satisfaction must also be considered.

The study describes a cluster of 71 malignant mesothelioma cases among Bari residents without asbestos exposure other than residential exposure. This small cohort, as expected, was composed of a majority of females (56.34%) with a M/F ratio of 0.8, ages &le, 65 years old (52.11%) and the epithelioid morphological type (78.87%). Sixty-four subjects (90.14%) lived between 10 m and 1000 m from the asbestos cement factory (Fibronit), and the latency length was longer than 55 years for 25 subjects (35.21%). The adjusted risk (adjusted OR) of observing the epithelial form of mesothelioma among subjects living at small distances from Fibronit was high (OR = 1.870 (0.353&ndash, 9.905)) for people living 550&ndash, 1000 m from the site and for those living less than 550 m from the site (OR = 1.470 (0.262&ndash, 8.248)). Additionally, the subjects with a high length of exposure showed a relevant risk of epithelioid mesothelioma both for 21&ndash, 40 years of exposure (OR = 2.027 (0.521&ndash, 7.890)) and more than 40 years of exposure (OR = 2.879 (0.651&ndash, 12.736)). All of the estimates were high but not significant because this transitional study has a typically low power. The adjustment for latency showed the same trend. Using detailed information collected by the regional mesothelioma registry, this study provided evidence of a continuing health impact of the Fibronit asbestos cement factory in Bari on the resident population.

It is known that heat stress affects dairy cow performance in multiple ways: physiological, behavioral, reproductive, and productive. The aim of the present study was to determine if a threshold of temperature-humidity index (THI) exists for multiple milk production traits (milk yield, fat-corrected milk, protein and fat yield and percentage, energy-corrected milk, cheese production, and cheese yield) in Italian Brown Swiss dairy cows from the period 15 d before the day of the Italian Breeders Association test-day sampling. A 10-yr data set (2009-2018) containing 202,776 test-day records of 23,296 Brown Swiss cows was matched with the maximum THI. In all parities considered, no THI thresholds were observed for milk yield in Brown Swiss. In contrast, a THI threshold of 75 was identified for fat-corrected milk. No THI threshold was found for fat percentage, but fat yield showed the highest THI thresholds in cows of first and second parity. Protein yield and cheese production were affected by heat stress with average THI threshold of 74. The THI thresholds identified indicate that the Brown Swiss breed has higher thermal tolerance versus literature values reported for Holstein cows. As THI rises, Brown Swiss cows tend to produce the same volume of milk, but with a decreasing quality with regard to components. Further study is necessary to estimate the genetic component of heat tolerance, in Brown Swiss cattle, considering that the correct estimation of THI thresholds represents the first step to identify components that could be included in selection procedures.

Determination of Legionella concentrations in water networks is useful for predicting legionellosis risks. The standard culture technique using concentration with membranes filters is the most commonly used method for environmental surveillance of Legionella. The aim of this study was to verify whether filtration with different filter pore sizes (0.2 and 0.45 &micro, m) according to (ISO) 11731:2017, followed by directly placing them on culture media, can influence Legionella detection. Three laboratories participated in an experimental study that tested a known suspension of Legionella pneumophila (Lpn) serogroup 1 (ATCC 33152) (approximate final cell density of 15 CFU/mL). E. coli (ATCC 11775) and Pseudomonas aeruginosa (ATCC 25668) were included as control tests. The average (95% CI) percentage of recovery of Lpn was 65% using 0.45-&micro, m filters and 15% using 0.2-&micro, m filters (p &lt, 0.0001). For control tests, the average (95% CI) percentage of recovery was higher with 0.45 vs. 0.2 &micro, m filters: 97% vs. 64% for Escherichia coli (p &lt, 0.00001) and 105% vs. 97% (p = 0.0244) for P. aeruginosa. Our results showed that the 0.45-&micro, m filters provided the greatest detection of Legionella. Because the current national guidelines leave the choice of membrane porosity to the operator, experimental studies are important for directing operators towards a conscious choice to standardize Legionella environmental surveillance methods.

Asbestos is an environmental carcinogen, and asbestos-related diseases are a global-scale public health issue. We report three cases (one male and two females) of pleural malignant mesothelioma (PMM) caused by environmental asbestos exposure reported by the Apulia Regional Operating Centre (COR) to the National Mesothelioma Registry (ReNaM). The patients revealed no history of asbestos exposure even after detailed assessment. The environmental (neighborhood) asbestos exposure for each of the three cases was due to both the residential history of the subjects and their workplace, close to a military barracks, at a distance of between 45 and 100 m. Moreover, in addition to this new source of pollution, an asbestos cement factory was located in the urban area of Bari municipality, in the Apulia region, southern Italy. Environmental-residential/neighborhood asbestos exposure in the city of Bari, a contaminated area classified as a site of national concern for land reclamation, is discussed also with reference to the military barracks.

Simple Summary Mucosal melanoma accounts for only about 1% of all melanoma cases worldwide, but achieving the correct recognition, diagnosis and prognosis is of extreme importance for the patient. Moreover, primary melanoma of the urinary tract is a rarity among rarities, accounting for less than 4% of all the mucosal melanomas. The urethra is the most common location for this type of melanoma, followed by the bladder and ureter with decreasing incidences. Patients with this form of melanoma are usually elderly (over 60 years) and asymptomatic or have hematuria symptoms. Compared to other mucosal melanomas, there is not much knowledge of the risk factors, etiology, and molecular characteristics of urological melanoma. In addition, there are no uniform staging systems or treatment protocols available for this disease. A thorough knowledge of the existence and management of this disease entity is essential to allow research advances in this area and, in particular, to devise innovative therapies. In this paper, we focus in detail on melanoma originating from the uropoietic apparatus, discuss the cases reported in literature of this very rare and still partially enigmatic melanoma subclass, and consider the scenario leading to metastasization to neighboring organs. Abstract Melanoma is reported as the 19th most common cancer worldwide, with estimated age-standardized incidence rates of 2.8–3.1 per 100,000. Although the origin is most frequently cutaneous, mucosal melanoma has been described several times in literature, and despite its rarity (only 1% of all melanomas), increasing attention is being paid to this disease form. Within this subgroup, melanomas of the uropoetic apparatus are a rarity among rarities. Indeed, less than 50 cases of primary melanoma originating from the urinary bladder have been described, and even less originating from the kidney, renal pelvis and urethra. In this work, we present a detailed review of the literature related to this subclass of mucosal melanoma, delve into the biological landscape of this neoplasm and discuss current approaches, future perspectives and potential therapeutic approaches.

The breast phyllodes tumor is a biphasic tumor that accounts for less than of 1% of all breast neoplasms. It is classified as benign, borderline, or malignant, and can mimic benign masses. Some recurrent alterations have been identified. However, a precise molecular classification of these tumors has not yet been established. Herein, we describe a case of a 43-year-old woman that was admitted to the emergency room for a significant bleeding from the breast skin. A voluminous ulcerative mass of the left breast and multiple nodules with micro-calcifications on the right side were detected at a physical examination. A left total mastectomy and a nodulectomy of the right breast was performed. The histological diagnosis of the surgical specimens reported a bilateral giant phyllodes tumor, showing malignant features on the left and borderline characteristics associated with a fibroadenoma on the right. A further molecular analysis was carried out by an array-Comparative Genomic Hybridization (CGH) to characterize copy-number alterations. Many losses were detected in the malignant mass, involving several tumor suppressor genes. These findings could explain the malignant growth and the metastatic risk. In our study, genomic profiling by an array-CGH revealed a greater chromosomal instability in the borderline mass (40 total defects) than in the malignant (19 total defects) giant phyllodes tumor, reflecting the tumor heterogeneity. Should our results be confirmed with more sensitive and specific molecular tests (DNA sequencing and FISH analysis), they could allow a better selection of patients with adverse pathological features, thus optimizing and improving patient’s management.

Nosocomial infections cause significant morbidity and mortality worldwide, and the pathogenic organisms responsible for such infections can develop resistance to antimicrobial agents. Understanding the activity of disinfectants against clinical and environmental bacterial isolates is therefore crucial. We analysed the in vitro activity of five antimicrobial products (phenolic compounds, didecyldimethylammonium chloride (DDAC), sodium hypochlorite, isopropanol + ammonium compounds (IACs), hydrogen peroxide) against 187 bacterial strains comprising clinical isolates, as well as 30 environmental isolates of Pseudomonas aeruginosa from hospital water samples. Disk diffusion assays were employed to assess antimicrobial activity. Hydrogen peroxide was significantly more active (p &lt, 0.0001) than the other disinfectants against all P. aeruginosa, Klebsiella pneumoniae, Enterococcus faecalis and Staphylococcus aureus strains. It was also the only disinfectant with activity against both clinical and environmental strains of P. aeruginosa. DDAC and IAC-based disinfectants were ineffective against Gram-negative strains, but showed significant activity (particularly IACs, p &lt, 0.0001) against the Gram-positive strains. Compared with IACs, DDAC was significantly more active on E. faecalis and less active on S. aureus (p &lt, 0.0001). Sodium hypochlorite and phenol compounds, by contrast, were inactive against all bacterial strains. The development of disinfection procedures that are effective against all microorganisms is essential for limiting the spread of nosocomial infections.

Introduction Malignant mesothelioma is an aggressive malignancy of the thoracic cavity caused by prior asbestos exposure. In the peritoneum the mesothelioma is an extremely rare condition. In the present preliminary study, high-resolution array-comparative genomic hybridization (a-CGH) was performed to identify genetic imbalances in a series of malignant peritoneal mesothelioma cases. Materials and methods Between 1990 and 2008, among the cases recorded in the Apulia Mesothelioma Register, we found 22 peritoneal mesothelioma cases. CGH-array was performed on samples from all patients. Results The CGH-array analysis revealed multiple chromosomal imbalances. Interestingly, deletion at 8p23.1 was observed in 12 cases. Furthermore, another novel deletion at 1q21 was present in 11. Often, 1q21 and 8p23.1 losses were present in the same patient (7 cases). Losses of BAP1 and CDKN2A loci were not detected. Discussion The region at 8p23.1 contains the beta-defensin gene cluster (DEF) and 1q21 contains ubiquitin conjugating enzyme E2 (UBE2Q1). We hypotesized that the loss of function of ubiquitination, as well as of the defensins, could play an important role in the initial development and subsequent progression of mesothelioma.

We read with interest the results of the retrospective study by Hadjinicolaou et al . (1) which described a case of primary small bowel malignant melanoma (SBM) in a 60-year-old man with review of the literature. The authors conclude that primary SBM is a rare entity, affect more frequently the men, with debatable pathophysiology.

Introduction Bari municipality (Apulia region, Southern Italy) has been defined as a contaminated site of national priority for remediation because of diffuse environmental contamination caused by an asbestos cement factory. Up to date, the regional mesothelioma registry listed 66 environmental mesothelioma cases among residents. We report two peculiar cases of malignant mesothelioma, one peritoneal and one pleural, due to residential asbestos exposure close to a military barracks, located inside the urban area and reclaimed only in 2006. Methods The records of the two cases with environmental exposure were listed in the Apulia regional mesothelioma registry. The registry ensures complete, quality information on exposure and diagnosis thanks to the adoption of operative guidelines agreed at national level. Molecular analysis with CGH-array was performed on paraffin-embedded tissue. Results The peritoneal case in a 36-year-old man shows a peculiar characteristics long survival (more than 17 years). The patient was treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Molecular analysis detected multiple chromosomal imbalances. The gains were prevalent. DNA copy number alterations (CNAs) observed loss at 1q21, 8 p23.1 and gains at 3 p22.2→3 p22.1, 3 p25.3→p25.1, 4q13.1 and Xq22.2. These are novel CNAs here identified and uncommon in malignant peritoneal mesothelioma. The pleural case, a 74-year-old man, suffering from a familial Becker type muscular dystrophy, opted for chemotherapy (alimta +cisplatinum) with external hyperthermia. At follow-up in April 2017, about 2 years from diagnosis and 21 months from the beginning of chemotherapy treatments, he has left shoulder pain, general weakness but good respiratory expansion. Both cases lived in apartments overlooking military barracks from 1963 to 1999. Discussion Past intensive use of asbestos has implied severe public health consequences among Bari inhabitants. Our study showed that the presence of the asbestos cement factory, as well as the military barracks, have been related with the onset of malignant mesothelioma among the neighbouring resident population.

Neurofibromatosis type 1 (NF1) is one of the most common autosomal dominant genetic diseases. It is caused by mutations in the NF1 gene encoding for the large protein, neurofibromin. Genetic testing of NF1 is cumbersome because 50% of cases are sporadic, and there are no mutation hot spots. In addition, the most recognizable NF1 clinical features—café-au-lait (CALs) spots and axillary and/or inguinal freckling—appear early in childhood but are rather non-specific. Thus, the identification of causative variants is extremely important for early diagnosis, especially in paediatric patients. Here, we aimed to identify the underlying genetic defects in 72 index patients referred to our centre for NF1. Causative mutations were identified in 58 subjects, with 29 being novel changes. We evaluated missense and non-canonical splicing mutations with both protein and splicing prediction algorithms. The ratio of splicing mutations detected was higher than that reported in recent patients’ series and in the Human Gene Mutation Database (HGMD). After applying in silico predictive tools to 41 previously reported missense variants, we demonstrated that 46.3% of these putatively missense mutations were forecasted to alter splicing instead. Our data suggest that mutations affecting splicing can be frequently underscored if not analysed in depth. We confirm that hamartomas can be useful for diagnosing NF1 in children. Lisch nodules and cutaneous neurofibromas were more frequent in patients with frameshifting mutations. In conclusion, we demonstrated that comprehensive in silico analysis can be a highly specific method for predicting the nature of NF1 mutations and may help in assuring proper patient care.

Role of BRCA1 and PARP1 has been studied by immunohistochemistry in a cohort of ovarian cancers. Their expression has been related to overall survival and disease free disease. Objective: To investigate the clinical outcome of an heterogeneous population of ovarian cancers as respect to immunohistochemical expression of BRCA1 and PARP1 in order to identify a histological threshold for positivity and negativity and to predict possible candidates to anti-PARP therapy Material and methods: 97 cases of ovarian cancers were collected in a multicentre study and immunohistochemically tested for BRCA1 and PARP1. The immunohistochemical expression of BRCA1 and PARP1 was studied on formalin-fixed and paraffin-embedded samples. Overall survival and disease free survival were evaluated. Statistical analysis was performed including cancers of all types and a subgroup of high grade serous carcinoma that represents the predominant histotype. Results: A possible threshold to discriminate positive and negative cases has been proposed. BRCA1 and PARP1 immunohistochemical expression did not significantly correlate with overall survival. The evaluation of survival for the combinations of BRCA1+/-, PARP1+/- showed a longer patient survival when the positivity and negativity were in contrast compared to when they were in agreement. Conclusions: Although BRCA1 and PARP1 expression do not appear to be correlated with overall survival, further investigation and follow-up together with a larger number of cases could clarify the function; the standardised immunohistochemical method could better select the patient group sensitive to PARP1 inhibitors.

INTRODUCTION: A pathologic grading system (PGS) for malignant pleural mesothelioma (MPM) is warranted to better identify different risk categories of patients, plan therapeutic options, and activate clinical trials. METHODS: A series of 940 patients with MPM (328 in a training set and 612 in a validation set) that was diagnosed between October 1980 and June 2015 at the participant institutions was retrospectively assembled. A PGS was constructed by attributing to each histologic parameter, independent at multivariate analysis with excellent reproducibility (κ > 0.75), different scores based on the increase in corresponding hazard ratios. The relevant PGS score thus ranged from 0 to 8 points for individual patients with MPM. CONCLUSIONS: The PGS was constructed by taking into consideration the histological subtyping of MPM (epithelioid/biphasic = 0 points; sarcomatoid = 2 points), necrosis (absent = 0 points versus present = 1 point), mitotic count per 1 mm2 (cutoffs as follows: 1-2 = 0 points, 3-5 = 1 point, 6-9 = 2 points, or ≥10 = 4 points), and Ki-67 labeling index based on 2000 cells (

Malignant mesothelioma is a rare and aggressive tumor with limited therapeutic options. We report a case of a malignant peritoneal mesothelioma (MPM) epithelioid type, with environmental asbestos exposure, in a 36-year-old man, with a long survival (17 years). The patient received standard treatment which included cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). Methods and Results: Molecular analysis with comparative genomic hybridization (CGH)-array was performed on paraffin-embedded tumoral samples. Multiple chromosomal imbalances were detected. The gains were prevalent. Losses at 1q21, 2q11.1→q13, 8p23.1, 9p12→p11, 9q21.33→q33.1, 9q12→q21.33, and 17p12→p11.2 are observed. Chromosome band 3p21 (BAP1), 9p21 (CDKN2A) and 22q12 (NF2) are not affected. Conclusions: the defects observed in this case are uncommon in malignant peritoneal mesothelioma. Some chromosomal aberrations that appear to be random here, might actually be relevant events explaining the response to therapy, the long survival and, finally, may be considered useful prognostic factors in peritoneal malignant mesothelioma (PMM).

Purpose Our purpose was to retrospectively evaluate the incidence and morphologic features of diabetic mastopathy in a group of patients with diabetes, searching for specific sonographic characteristics of diabetic mastopathy. Methods One hundred twenty diabetic patients underwent breast clinical examination, mammography, and sonography. All detected breast lesions were confirmed histopathologically. Results Breast lesions were found in 11 of the 120 patients (9%), including two cases of invasive ductal carcinomas and nine cases of diabetic mastopathy. In seven of those nine cases (77%), diabetic mastopathy appeared as a hypoechoic solid mass with irregular margins, inhomogeneous echotexture, and marked posterior shadowing. In the other two cases (23%), it appeared as a mildly inhomogeneous, hypoechoic solid mass. Conclusions Diabetic mastopathy is a diagnostic challenge and needs to be suspected in all patients with diabetes mellitus. Imaging features are nonspecific and highly susggestive on breast sonography in most cases. Core-needle biopsy confirmation remains mandatory for a definitive diagnosis. © 2014 Wiley Periodicals, Inc. J Clin Ultrasound, 43:113–117, 2015

This procedure is aimed at solving the chromatic quantification problem in histological images, as well as other fields. On digital images, this is possible using colorimetric software applications. Our solution was to adopt a pre-processing step of the analog signal coming from a video-source (cabling a suitable, dedicated unit to the video-line before signal grabbing). The unit is a hardware device that processes the voltage values of the video signal image section, line by line in the raster image exploiting the vertical interval. The output is a luminance-free video signal compatible with real-time needs (1/25 second), that is in turn compatible with the normal exploration speed of a histological slide. Some experimental results are presented.