The role of RET genomic variants in infantile hypertrophic pyloric stenosis

Infantile hypertrophic pyloric stenosis (IHPS) is a common childhood pathology affecting approximately 1-5 children pro 1000 newborns, with a genetic background as suggested by the familial occurrence. RET is a candidate gene for IHPS due to its role in the development of the intrinsic innervation and ganglia of the smooth musculature and the association of RET variants with another motility disorder (Hirschsprung's disease). Accordingly, we investigated RET-IHPS associations through sequencing of the complete RET coding region in 32 IHPS patients. Genotype frequencies were compared between patients and 48 controls using the Cochran-Armitage trend test or Fischer's test for exact p-values. We found 19 RET variants in IHPS, including polymorphisms in the promoter region (c.-200 G>A and c.-196 C>A). There was no statistically significant difference between the frequencies of the variants in both groups. There was no deviation from the Hardy-Weinberg equilibrium, yet a significant correlation (linkage disequilibrium) for variants in the promoter region, in exons 11, 13, 14 and 19 and in the 3' UTR. We conclude that RET variants are present in IHPS patients yet show no significant statistical association with the IHPS phenotype, suggesting at best an adjuvant role for RET in IHPS.

[Burnout in emergency health care workers]

Some studies reported high levels of severe burnout syndrome in emergency workers. We compared different categories of health care workers (129 of Medicine Department e 47 of Laboratory analysis Department) and emergency workers (42 of 118 and 37 of Emergency Department) Subjects were administered the Organizational Checkup System (OCS) to evaluate subjects' risk of burnout and their perception of their own work role and of their organizational environment The operators of 118 showed a condition of wellbeing and a less tendency to burnout. This Finding was accompanied to a better perception of their own work role and of their organizational environment.

[Analysis of audiometric data as a contribution to the noise risk assessment]

METHODS

We have matched the annual rate of change for average of at 3, 4 and 3-4 kHz between 2617 workers of 15 Italian thermoelectric power plants exposed to noise and 90 workers non-exposed (ANCOVA test controlling for relevant confounders: age and high frequency hearing threshold level).

RESULTS

Overall, workers exposed to noise did not show a statistically significant hearing loss (F: 1.03 p = 0.30 for 4-6 kHz). Five subgroups in two power plants showed a significant hearing loss suggesting a specific re-evaluation of prevention strategies

CONCLUSIONS

The statistical analysis of hearing loss progression in a population of workers exposed to noise can be an effective instrument of occupational risk assessment and monitoring of the effectiveness of prevention strategies.

[Peculiarity of the occupational physician]

Aim of this contribution is to consider, although in a concise way, the peculiarity of the Occupational Physician's activity operating in Health care sector, that employs about 5% of Italian workers. Particularly, we bring into focus the global roll that the Occupational Physician must fulfil in a reality where he is the protagonist towards the safeguard of the worker's safe, already submitted to several occupational risks, and about the safety of the third parties, which is more important than in other sectors. Shared elaboration in this article shows that Occupational Physician of the Health care sector has the same problems and expectations everywhere, in our Country.

Atomistic Simulation of Mobile Defect Clusters in Metals

The structure, stability and thermally-activated motion of interstitial and vacancy clusters in Fe and Cu have been studied using atomic scale computer simulation. All studied interstitial clusters and perfect interstitial loops (PILs) in Fe are mobile whereas their mobility in Cu can be suppressed at large sizes (bigger than 49–61 self-interstitials depending on the temperature) due to dissociation. A comparative study of relaxed configurations has shown that the structure of small perfect dislocation loops of vacancy and self-interstitial nature is very similar. Molecular dynamics simulation has demonstrated that small perfect vacancy loops (PVLs) in Fe consisting of more than 37 vacancies are stable over a wide temperature range and produce atomic displacements by a thermally-activated movement in the direction of the Burgers vector. The mechanism is qualitatively similar to that of SIA clusters studied earlier. Motion of vacancy loops in Cu does not occur because they transform into sessile configurations similar to stacking fault tetrahedra. These results point to the possibly important contribution of vacancy loop mobility to the difference in radiation damage between bcc and fcc metals, and between fcc metals with different stacking fault energy.

The Structure of Defects Formed by Absorption of Crystal Dislocations in Interfaces in the HCP Metals

Atomic-scale computer simulation has been used to investigate the interaction of crystal dislocations with two interfaces in hexagonal-close-packed (HCP) metals, namely the {1012} twin boundary and a <1210>/90° tilt boundary that is incommensurate in the direction perpendicular to the tilt axis. Crystal dislocations are absorbed in the tilt boundary with concomitant reconstruction of their cores. In the twin boundary, a broader range of interactions is observed, including defect transmission from matrix to twin and decomposition in the interface into discrete defects. The role of crystallographic features and interfacial structure is elucidated by comparing interaction processes in the two interfaces. The core structure of interfacial defects can be complex and contributes significantly to total defect energy.

Mobility of Self-Interstitial Clusters in FE and CU

Molecular dynamics (MD) simulation has been used to study the thermally activated mobility of clusters of self-interstitial atoms (SIAs) in Fe and Cu. Such clusters are formed in metals during irradiation with energetical particles and, according to the cascade production bias model, they play an important role in the microstructure evolution of metals under irradiation. An extensive simulation of clusters from 2 to 30 interstitials has been carried out for the temperature range ≍360-1200K using long-range interatomic pair potentials. The results show that clusters bigger than two SIAs are one-dimensionally mobile. Di-interstitials have two migration mechanisms depending on the temperature. At low temperature the mechanism is one-dimensional whereas at high temperature the probability of rotation and three-dimensional migration increases. It was found that in both metals the effective migration energy of clusters estimated via their jump frequency does not depend on the cluster size, although the cluster jump frequency decreases as the cluster size increases. The mechanism of cluster migration and problems of the treatment of one-dimensional mobility are discussed.

[Swiss clinical practice guidelines for skin cancer in organ transplant recipients]

Swiss clinical practice guidelines for skin cancer in organ transplant recipients Transplant patients have increased over the last decades. As a consequence of long-term immunosuppression, skin cancer, in particular squamous cell carcinoma (SCC), has become an important problem. Screening and education of potential organ transplant recipients (OTRs) regarding prevention of sun damage and early recognition of skin cancer are important before transplantation. Once transplanted, OTRs should be seen yearly by a dermatologist to ensure compliance with sun avoidance as well as for treatment of precancerosis and SCC. Early removal is the best treatment for SCC. Reduction of immunosuppression, switch to mTOR inhibitors and chemoprevention with acitretin may reduce the incidence of SCC. The dermatological follow-up of OTRs should be integrated into a comprehensive post-transplant management strategy.

Defective cerebral gamma-aminobutyric acid-A receptor density in patients with systemic lupus erythematosus and central nervous system involvement. An observational study

Gamma-aminobutyric acid-A (GABA-A) receptors play a crucial role in regulating neuronal excitability and cognitive functions. Single-photon emission computerized tomography (SPECT) analysis of GABA-A receptors binding by 123I-labelled Iomazenil (123I-IMZ) has been applied in some neuropsychiatric disorders to investigate conditions where GABA-A receptor density can be detected in several pathophysiological conditions. In this study we investigate cerebral GABA-A receptor density in a small series of patients with systemic lupus erythematosus (SLE) and cognitive impairment characterized by recurrent, episodic memory loss. Nine female patients with SLE and cognitive alterations underwent to a clinical neuropsychiatric evaluation including digital video-EEG, brain MRI, 99mTc-ECD brain SPECT and 123I-IMZ brain SPECT. All patients tested showed diffuse or focal GABA-A receptor density reduction. This is, to our knowledge, the first report on GABA-A receptor density abnormalities associated with cognitive defects in SLE patients. We hypothesize that in our series a decrease in GABA-A receptor density might be related to the neurological manifestations. Further studies are needed to clarify this aspect and the possible mechanisms. GABA-A receptor density impairment might be due to the SLE-related cerebral vasculopathy, or to neuronal-reacting auto-antibodies or drugs which could interfere with GABA-A receptors expression/binding. This study may support the concept that cognitive impairment in systemic lupus erythematosus could be the outcome of fine-tuned neurotransmission alterations.