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Background and Purpose - The best time for administering anticoagulation therapy in acute cardioembolic stroke remains unclear. This prospective cohort study of patients with acute stroke and atrial fibrillation, evaluated (1) the risk of recurrent ischemic event and severe bleeding; (2) the risk factors for recurrence and bleeding; and (3) the risks of recurrence and bleeding associated with anticoagulant therapy and its starting time after the acute stroke. Methods - The primary outcome of this multicenter study was the composite of stroke, transient ischemic attack, symptomatic systemic embolism, symptomatic cerebral bleeding and major extracranial bleeding within 90 days from acute stroke. Results - Of the 1029 patients enrolled, 123 had 128 events (12.6%): 77 (7.6%) ischemic stroke or transient ischemic attack or systemic embolism, 37 (3.6%) symptomatic cerebral bleeding, and 14 (1.4%) major extracranial bleeding. At 90 days, 50% of the patients were either deceased or disabled (modified Rankin score ≥3), and 10.9% were deceased. High CHA2DS2-VASc score, high National Institutes of Health Stroke Scale, large ischemic lesion and type of anticoagulant were predictive factors for primary study outcome. At adjusted Cox regression analysis, initiating anticoagulants 4 to 14 days from stroke onset was associated with a significant reduction in primary study outcome, compared with initiating treatment before 4 or after 14 days: hazard ratio 0.53 (95% confidence interval 0.30-0.93). About 7% of the patients treated with oral anticoagulants alone had an outcome event compared with 16.8% and 12.3% of the patients treated with low molecular weight heparins alone or followed by oral anticoagulants, respectively (P=0.003). Conclusions - Acute stroke in atrial fibrillation patients is associated with high rates of ischemic recurrence and major bleeding at 90 days. This study has observed that high CHA2DS2-VASc score, high National Institutes of Health Stroke Scale, large ischemic lesions, and type of anticoagulant administered each independently led to a greater risk of recurrence and bleedings. Also, data showed that the best time for initiating anticoagulation treatment for secondary stroke prevention is 4 to 14 days from stroke onset. Moreover, patients treated with oral anticoagulants alone had better outcomes compared with patients treated with low molecular weight heparins alone or before oral anticoagulants. © 2015 American Heart Association, Inc.

Il lavoro analizza la dispersione del reddito nella regione Friuli Venezia Giulia e la confronta con la situazione nazionale e internazionale. L'analisi statistica è basata sui dati dell'indagine europea Eu-Silc condotta per l'Italia dall'Istat a partire dal 2004. I risultati mettono in luce una situazione di minore disuguaglianza interna alla regione che, tuttavia, presenta diversi indici di rischio povertà rappresentati da gap reddituali e di occupazione consistenti sia tra generazioni che tra generi e una problematicità importante per quanto riguarda i lavoratori marginali.

UDP-glucuronosyltrasferases (UGTs) are detoxifying enzymes, which convert endogenous substrates, dietary constituents and potential carcinogens to inactive hydrophilic glucuronides. Although the liver is considered the most important organ for glucuronidation, UGTs are also expressed in extrahepatic tissues. Since UGTs may be important to protect cells from cancer in organs naturally exposed to potential carcinogens such as smoking and diet derivatives, we investigated the UGT expression in normal and malignant tissues from urinary bladder and large intestine. The study was carried out by immunohistochemistry, using an antiserum recognizing all the UGT1A isoforms. Our results showed that UGTs were highly expressed on the surfaces of the normal bladder as well as in normal large bowel mucosa. The neoplastic counterpart showed a general protein down-regulation associated with a different cellular localization. We found that 3/11 papillary and 3/6 invasive urothelial carcinomas were virtually negative, whereas 2/2 papillomas and 8/11 papillary bladder carcinomas still expressed the protein. In colon cancer the enzyme down-regulation was even more dramatic. In fact, a faint diffused cytoplasmic expression or scattered cell positivity was observed only in adenomas with low grade dysplasia (5/5) and in 2/11 carcinomas. Interestingly, 5/5 adenomas with high grade dysplasia, 9 carcinomas, the lymph nodes and liver metastases were UGT-negative, suggesting that the loss of UGT is associated with the early phase of neoplastic transformation. Based on our results we suggest that UGTs constitutive expression in the normal mucosa could protect these organs from carcinogens released in the bladder or introduced directly with the diet in the colon.

We used Fourier Transibrm Infrared Spectroscopy (FTIR) combined with flow cytometry to study the apoptosis and necrosis processes in Jurkat, a lymphocyte cell lìne. The apoptosis was induced in the cells by a chemical agent, the actinomycin D, while the necrosis was induced lowering the pH value to 4.2. The apoptotic events were analysed by flow cytometry (using annexin V and propidium iodide) and contemporary monitored by FTIR spectroscopy at diflèrent times after the treatment. This comparison allowed us to find in the IR spectrum, between 3000 cm 1 and 2800 c--1, a "marker band" of the apoptosis corresponding to the exposure of phosphatidylserine on the outer leaflet of the membrane. A marker of a specific cellular process obtained by using a non-destructive technique such as FTIR spectroscopy, has a great signifìcance in the diagnostic medicine providing a tool for detecting pathologies in vivo.

We have previously shown that urokinase receptor physically and functionally interacts with alpha(v)beta5 vitronectin receptor, leading to tumor breast cell migration and invasion. Here, the link between these 2 receptors was further investigated by analyzing the expression levels of urokinase receptor and alpha(v)beta5 integrin in 35 human breast carcinomas and 5 benign breast lesions. The occurrence of a positive correlation between urokinase receptor and alpha(v)beta5 protein levels in benign and malignant tumor specimens prompted us to investigate whether engaged urokinase receptors might modulate alpha(v)beta5 expression. Here, we report the receptor-dependent ability of catalytically inactive urokinase to upregulate the alpha(v) and beta5 chains in MDA-MB-231 and MCF-7 breast carcinoma cell lines in a time- and concentration-dependent manner. This effect is dependent on protein kinase C activity and requires new protein synthesis. Accordingly, the availability of assembled alpha(v)beta5 receptors on the cell surface increases upon urokinase treatment, as shown by immunoprecipitation and immunocytochemical analyses. Exposure to urokinase leads to enhanced tumor cell migration and invasion, which is prevented by the "phosphorylation-like" urokinase receptor antagonist His-uPA(138E/303E), the DNA-binding drug mithramycin, the protein kinase C inhibitor calphostin C and anti-alpha(v)beta5 antibodies. Finally, urokinase enables benign breast MCF-10A cells to cross Matrigel in a alpha(v)beta5-and urokinase receptor-dependent manner, indicating that urokinase controls a regulatory circuitry crucial to breast tumor progression. Copyright 2002 Wiley-Liss, Inc.