Agostino Nocerino

Non-anaplastic pleomorphic xanthoastrocytoma with neuroradiological evidences of leptomeningeal dissemination.

Case reportA case of a non-anaplastic pleomorphic xanthoastrocytoma (PXA) presenting with leptomeningeal dissemination (LMD) affecting a 9-year-old girl is presented.DiscussionThe neoplasia in this young girl had the otherwise classical clinical features of PXA: the relatively advanced paediatric age of the patient, the seizures as presenting sign; the primary site in the temporal lobe; and the MRI findings of the partially solid and cystic superficial lesion. Only the tumour involvement of the chiasma and the infundibulus was a relatively unusual finding. In a 5-year period, the tumour underwent malignant transformation, bringing the child to death because of the primary tumour progression. However, the leptomeningeal deposits remained unchanged throughout the clinical course.ConclusionTo our knowledge, this is the first case of a non-anaplastic PXA presenting with disseminated disease. Thus, it was thought important to describe this case in order to add further information regarding the spectrum of the presenting clinical features of this rare neoplasm and the phenomenon of LMD of non-malignant glioma.

Hansenula anomala killer toxin induces secretion and severe acute injury in the rat intestine

BACKGROUND & AIMS The yeast Hansenula anomala has been associated with gastrointestinal symptomatology and damage to the intestinal wall in humans. In vitro and in vivo, H. anomala secretes a toxin, killer toxin, which is lethal to other microorganisms. In view of the very high rate of killer phenotype expression recorded for H. anomala strains in nature, this study aimed to investigate the hypothesis that H. anomala killer toxin plays a role in the pathogenesis of H. anomala-induced enteritis. METHODS Effects of active and heat-inactivated H. anomala killer toxin on intestinal fluid homeostasis and electrolyte balance were investigated in rat small intestine using a standard intestinal perfusion technique. Sections of the perfused jejunum tracts were examined histologically. RESULTS H. anomala killer toxin induced a significant secretion of water and electrolytes. No significant change was observed when either heat-inactivated H. anomala killer toxin or control growth medium were tested. Histological analysis showed ischemic degeneration of villi and sloughing of surface epithelium in 50% of active H. anomala killer toxin-perfused jejuna. CONCLUSIONS This paper presents original observations compatible with the hypothesis that H. anomala killer toxin plays a role in the pathogenesis of H. anomala-induced enteritis.

Daptomycin for Children in Clinical Practice Experience.

Data on daptomycin use in the pediatric setting are scanty. We conducted a multicenter, retrospective study on 46 children treated with intravenous daptomycin at a mean dosage of 7.0 mg/kg/d, for a median of 14 days. Three children had adverse events possibly related to daptomycin. The drug was overall well tolerated, even with prolonged treatment.

Comparative effects of atrial natriuretic peptide and E. coli heat-stable toxin on rat intestinal transport.

Summary Conflicting data have been published in favor of or against a secretory effect of atrial natriuretic peptide (ANP) in the intestine. The reported effects resemble that of Escherichia coli heat-stable enterotoxin (ST). In this work the effects of ANP were studied in well established experimental systems and compared with that of ST. Both peptides induced a prompt secretion of water, Na, and Cl with no effects on K net transport in the in vivo rat perfused jejunum. The addition of ST, but not of ANP, evoked an increase of short circuit current in rat intestinal mucosa mounted in Ussing chambers. ST induced a significant increase in guanylate cyclase activity in intestinal homogenates, whereas ANP showed no effect. No binding sites for ANP were detected in basolateral or brush border membranes, nor in isolated enterocytes by a suction filtration technique. In conclusion, ANP acts as a short-lived intestinal secretagogue in the rat. Its mechanism of action is different from that of E. coli ST and appears to be indirect, since is not mediated by specific intestinal receptors and is not evident in vitro.

Severity Grading of Childhood Poisoning: The Multicentre Study of Poisoning in Children (MSPC) Score

Scores for severity grading of childhood poisoning may be useful in comparing different causes of poisoning, in order to identify the main risks and their changes over time. The Multicentre Study of Poisoning in Children score is based on four levels of severity (1-mild, 2-moderate, 3-severe, 4-very severe) involving nine target groups: seven relating to organ systems (gastrointestinal, nervous, respiratory, circulatory, renal, hepatic, skin), one to metabolic abnormalities and one to injuries from corrosive substances. Each patient is classified by the highest level attributed to any one of the nine groups. The score has been prospectively tested in 644 symptomatic children, aged 0-13 years, admitted to six pediatric hospitals of Northern Italy from January 1, 1991 to December 31, 1993. Poisoning was categorized as mild (1) in 357 children (53.8%), moderate (2) in 285 (42.9%), severe (3) in 18 (2.7%) and very severe (4) in 4 (0.6%). No deaths occurred. Severity grading according to The Multicentre Study of Poisoning in Children score confirms the prevalence of mild and moderate poisonings in children; the score seems to be an objective method suitable for epidemiological studies in different countries. Its clinical usefulness deserves more investigation.

Lessons learned from the H1N1 pandemic: the need to improve systematic vaccination in Sickle Cell Disease children. A multi center survey in Italy.

During the recent H1N1 pandemic, children with Sickle Cell Disease (SCD) experienced more hospitalizations and more complications than the general pediatric population. We performed a retrospective multicenter survey at 9 Pediatric Haematology-Oncology Units across Italy. H1N1 admission rate was 5.2%, with all admissions occurring before vaccine availability. Length Of Stay (LOS) was 6.06 days (7.85 for Acute Chest Syndrome), longer than in other countries. Vaccination coverage was not homogeneous, ranging from 0 to 99%; several family-related and health-system related barriers in accessing vaccinations were identified that should be ameliorated to improve coverage in this high risk group of children.

Biometric Watermarking via Wavelet Approach, Reverse Engineering in Info-Security and Dematerialization of Public Administration

Abstract This research wants to present a highly-performing system to establish the intellectual property of a file by using advanced Information Fusion (IF) techniques. IF is different depending on the fact that it can be a textual file, an image or multimedial; indeed, the further step consists in creating blue biometric codes with different watermarking mechanisms based on wavelet and wavelet packet respectively. Thanks to reverse engineering algorithms which this work have generated, such a system seems particularly appropriate to contexts like Public Administration or production companies which present complex industrial/documental processes where it is relevant to trace the access to information, and the sequence of accesses made by operators/users. Hence it seems also clear that such a system can be useful for all that concerns files/contents distributed online for what regards both the intellectual property and the access/modification/use of information.

Low-dose sirolimus in two cousins with autoimmune lymphoproliferative syndrome-associated infection

Autoimmune lymphoproliferative syndrome (ALPS) is characterized by non-malignant lymphoproliferation and autoimmunity, with a wide spectrum of clinical manifestations (OMIM 601859). Typical features include enlarged spleen and lymph nodes and autoimmune cytopenia. We describe a family with ALPS in which two cousins independently presented to their physicians with infection and discuss the therapeutic potential of sirolimus.

Microvillus Inclusion Disease and Tufting Enteropathy

The heterogeneous group of protracted diarrheas starting in the first months of life traditionally grouped under “intractable diarrhea of infancy” includes many different diseases. Some children are affected by diseases that impair the normal development of intestinal epithelium, causing a severe watery diarrhea that usually requires total parenteral nutrition. The first to be described was microvillus inclusion disease that usually starts in the first days of life with a secretory diarrhea that is worsened by feedings (early-onset microvillus inclusion disease). In a small percentage of cases, diarrhea starts later in life, between 1 and 3 months (late-onset microvillus atrophy). The early form is very severe, and intestinal transplantation should be strongly considered in these cases.