Serum Albumin Is Inversely Associated With Portal Vein Thrombosis in Cirrhosis

We analyzed whether serum albumin is independently associated with portal vein thrombosis (PVT) in liver cirrhosis (LC) and if a biologic plausibility exists. This study was divided into three parts. In part 1 (retrospective analysis), 753 consecutive patients with LC with ultrasound-detected PVT were retrospectively analyzed. In part 2, 112 patients with LC and 56 matched controls were entered in the cross-sectional study. In part 3, 5 patients with cirrhosis were entered in the in vivo study and 4 healthy subjects (HSs) were entered in the in vitro study to explore if albumin may affect platelet activation by modulating oxidative stress. In the 753 patients with LC, the prevalence of PVT was 16.7%; logistic analysis showed that only age (odds ratio [OR], 1.024; P = 0.012) and serum albumin (OR, -0.422; P = 0.0001) significantly predicted patients with PVT. Analyzing the 112 patients with LC and controls, soluble clusters of differentiation (CD)40-ligand (P = 0.0238), soluble Nox2-derived peptide (sNox2-dp; P < 0.0001), and urinary excretion of isoprostanes (P = 0.0078) were higher in patients with LC. In LC, albumin was correlated with sCD4OL (Spearman's rank correlation coefficient [r(s)], -0.33; P < 0.001), sNox2-dp (r(s), -0.57; P < 0.0001), and urinary excretion of isoprostanes (r(s), -0.48; P < 0.0001) levels. The in vivo study showed a progressive decrease in platelet aggregation, sNox2-dp, and urinary 8-iso prostaglandin F2 alpha-III formation 2 hours and 3 days after albumin infusion. Finally, platelet aggregation, sNox2-dp, and isoprostane formation significantly decreased in platelets from HSs incubated with scalar concentrations of albumin. Conclusion: Low serum albumin in LC is associated with PVT, suggesting that albumin could be a modulator of the hemostatic system through interference with mechanisms regulating platelet activation

The CINDI Health Monitor Survey. Health behaviour among the Italian adult population, 2001-2002

<p>In accordance to the WHO-CINDI (Countrywide Integrated Non-communicable Diseases Intervention) Programme, in 2001-2002 Italy participated in the Health Monitor Survey (HMS) along with all the other CINDI member countries.</p><p>The survey aimed to investigate, by the use of a standard questionnaire, the self-reported health status, life-habits, social and health conditions, use of health services and other features of the study population.</p><p>Following the international CINDI protocol, the adult population (25-64 years of age) from six Italian demonstration areas were chosen: Bassiano-Lenola (LT), Brisighella (RA), Rovescala (PV), Sardinia (CA, SS), Udine (UD); Valle dell’Irno (SA). A total number of 4095 subjects, including both males and females were enrolled, with a participation rate of 53%, equal to 2202 subjects [45.7% males (M) and 54.3% females (F)]. All age groups were equally represented. From the analysis of the age-standardised rates, the following results were obtained. Self-reported “good state of health”: M 71%, F 56.9%; Hypertension: M 15.6%, F 17.5%; Diabetes: M 6.1%, F 4.2%; Back-illness: M 18%, F 22%; Gastritis: M 12.8%, F 12.6%; Headache: M 31.7%, F 54.6%; Insomnia: M 15.9%, F 28.5%; Daily smokers: M 35.7%, F 23.5%; Daily consumption of wine: M 40.2%, F 15.7%; BMI ≥ 30: M 12.3%, F 13.5%; Regular leisure physical activity: M 27.6%, F 23.1%; Hard physical activity: M 40.5%, F 24%. The results demonstrate how rural areas (Rovescala and Valle dell’Irno) experience worse health conditions. Thanks to the HMS, the population’s health needs have been focused and compared to those of other CINDI countries, in order to plan specific interventions aimed at the improvement of lifestyle and health conditions.</p&gt

Cervical Spondylotic Myelopathy: From the World Federation of Neurosurgical Societies (WFNS) to the Italian Neurosurgical Society (SINch) Recommendations

Cervical spondylotic myelopathy (CSM) is a progressively growing pathology to afford by a spinal surgeon due to the aging of the population, associated with better treatment manage-ment and the best diagnosis and treatment solutions are greatly discussed. Nowadays that scientific literature is progressively increasing to identify the gold standard in diagnosis and treatment can be very challenging. This is particularly evident in spinal surgery with many different indications not only in different countries but also in the same local reality. In this scenario, many neurosurgical societies works to identify some guideline or recommenda-tions to help spinal surgeons in daily practice. Furthermore, in an era in which legal issues are increasingly present in clinical practice to have some indications globally accepted can be very useful. World Federation of Neurosurgical Societies (WFNS) few years ago starts this process creating a list of recommendations originating from a worldwide steering com-mittee to respect all the local reality. The spinal section of Italian Neurosurgical Society de-cides to adopt the WFNS recommendations with some revision basing on Italian scenario. The steering committee of the Spinal Section of Italian Neurosurgical Society identify 7 groups to review the literature of the last 10 years about different topics on CSM and to analyses the WFNS recommendations to adapt it to the Italian daily practice. The state-ments were discussed and voted in 2 sessions to obtain the final version. A list of recom-mendations on natural course and clinical presentation; diagnostic tests; conservative and surgical treatment; anterior, posterior and combined surgical treatment; role of neurophys-iological monitoring and follow-up and outcome was created with only few new or revised statements respect the ones of WFNS. The Spine Section of Italian Neurosurgical Society create a list of recommendations that represent the more contemporary treatment concepts for CSM as presented in the highest quality clinical literature and best clinical practices available on this subject