In Vitro Antibacterial Activity of Manuka (Leptospermum scoparium J.R. et G. Forst) and winter Savory (Satureja montana L.) Essential Oils and Their Blends against Pathogenic E. coli Isolates from Pigs

Neonatal diarrhoea (ND), post-weaning diarrhoea (PWD) and oedema disease (OD) are among the most important diseases affecting pig farming due to economic losses. Among the main aetiological agents, strains of Escherichia coli are identified as the major responsible pathogens involved. Several strategies have been put in place to prevent these infections and, today, research is increasingly studying alternative methods to antibiotics to reduce the antibiotic resistance phenomenon. Essential oils (EOs) are among the alternative tools that are being investigated. In this study, the in vitro effectiveness of winter savory and manuka essential oils and their mixtures in different proportions against strains of E. coli isolated from episodes of disease in pigs was evaluated. The EOs alone demonstrated slight antibacterial effectiveness, whereas the blends, by virtue of their synergistic action, showed remarkable activity, especially the 70%–30% winter savory–manuka blend, showing itself as a potential tool for prevention and therapy

Prevalence of metabolic syndrome: a comparative analysis in an unselected sample of mediterranean subjects.

Abstract AIM: The metabolic syndrome (MS) is associated with increased cardiovascular and cerebrovascular risk. This study aimed to compare the difference of the three established diagnostic criteria of MS, developed by Adult Treatment Panel III (ATP III), American Heart Association (AHA) and National Heart Lung and Blood Institute (NHLBI), and International Diabetes Federation (IDF), with regard to the prevalence of the syndrome and the ability to correctly identify individuals with cardiovascular or cerebrovascular disease or subclinical atherosclerosis. METHODS: We studied 947 consecutive patients underwent clinical evaluation between the 1997-2002. The project design included a medical assessment, biochemical analyses and the ecocolordoppler examination of carotid arteries. RESULTS: The MS prevalence was 37% in ATPIII subjects, 36% in AHA/NHLBI subjects and 43% in IDF subjects. Excluding patients with diabetes (N.=259), the MS prevalence ranged from 32% (ATPIII and AHA/NHLBI subjects) and 40% (IDF subjects). By most criteria, MS-positive subjects had significant incidence of carotid atherosclerosis (P<0.05) and cardiovascular events (P<0.05) than MS-negative subjects, but not cerebrovascular events. Finally, patients with MS had higher serum levels of fibrinogen (P<0.04). CONCLUSION: Subclinical atherosclerosis and cardiovascular events were increased in presence of the MS, irrespective of the several definitions

Valutazione in vitro dell'attivita antibatterica ed antivirale degli oli essenziali di manuka e santoreggia nei confronti di Escherichia coli patogeni e Suid Herpesvirus 1.

Nel corso degli ultimi anni, studi condotti sull’efficacia degli oli essenziali come potenziali antibatterici stanno sempre più intensificandosi anche in virtù delle problematiche connesse col fenomeno in netta ascesa dell’antibiotico-resistenza. Se da un lato sono molteplici le ricerche che valutano l’efficacia in vitro di queste sostanze naturali nei confronti di diversi agenti patogeni, ancora poche sono le prove in vivo che sono state effettuate (Shaaban et al., 2012; Raut e Karuppayil, 2014). In letteratura ancora meno numerose sono le ricerche volte alla verifica dell’attività antivirale di oli essenziali ed estratti naturali di origine vegetale che però in alcuni casi hanno evidenziato potenzialità e prospettive di impiego interessanti, soprattutto nei confronti di virus provvisti di envelope (Thormar, 2011). Tra gli oli essenziali di cui sono state valutate le attività antibatteriche e in parte antivirali vi sono senza dubbio quelli ottenuti da piante appartenenti alla Famiglia delle Labiate, particolarmente efficaci in virtù della loro forte presenza di sostanze attive come timolo e carvacrolo (Cowan, 1999). Altro olio essenziale di crescente interesse è quello che si ottiene dalla manuka, una pianta appartenente alla Famiglia delle Myrtaceae di origine neozelandese. I fiori vengono utilizzati per produrre il miele di manuka, che è il suo uso principale(Porter e Wilkins, 1999). Nell’allevamento suino diverse patologie ad eziologia batterica rappresentano un notevole problema, sia di natura sanitaria che economica, ed interessano soprattutto i soggetti allo svezzamento e nelle prime fasi di allevamento. Tra questi agenti particolare rilievo è rivestito dai ceppi di Escherichia coli responsabili della malattia degli edemi (O:139), della diarrea post-svezzamento (O:149) e della diarrea del suinetto sotto scrofa (O:8) (Fairbrother et al., 2005; DebRoy et al., 2009; Zimmerman et al., 2012). Tra le malattie virali di particolare importanza nell’allevamento suinicolo un ruolo di rilievo è senza alcun dubbio occupato dalla Malattia di Aujeszky (SuHV-1) (Wittmann, 1991), questo virus provvisto di envelope è stato utilizzato come modello per le sperimentazioni in vitro. Alla luce di quanto accennato il presente lavoro di tesi si è incentrato sulla valutazione dell’attività antibatterica ed antivirale in vitro di oli essenziali di manuka e santoreggia e loro miscelazioni nei confronti dei patogeni sopracitati. Per quanto riguarda l’attività antibatterica sono state effettuate prove per individuare i valori di MIC ed MBC di entrambi gli oli e loro miscelazioni in diverse proporzioni. I migliori risultati sia di MIC che di MBC si sono ottenuti per la miscela 70/30 santoreggia-manuka nei confronti del ceppo O:149. Buoni valori inibenti e battericidi sono comunque stati rilevati anche per le altre miscele, rispetto agli oli usati singolarmente, nei confronti degli altri ceppi batterici. Per quanto concerne la verifica dell’attività antivirale nei confronti di SuHV-1 si è proceduto dapprima con la valutazione della citotossicità su linee cellulari MDBK, CRFK e RK13 della miscela che aveva fornito i migliori risultati contro i ceppi batterici. Appurato che la prima diluizione non tossica impiegabile era quella pari a 1:1024, questa è stata impiegata per il test del Plaque Assay affiancato dalla valutazione quali-quantitativa del virus mediante qPCR. Il test Plaque Assay ha evidenziato una buona efficacia della miscela consentendo di passare da valori di 1,5 x 105 pfu/ml a valori pari a 1,5 x 104 pfu/ml. La qPCR ha evidenziato un leggero effetto antivirale senza tuttavia mostrare un decremento del titolo virale particolarmente significativo. In conclusione il potenziale impiego degli oli essenziali saggiati, soprattutto in sinergia tra loro, sembra rappresentare una concreta alternativa alle molecole di sintesi almeno per quanto riguarda i ceppi batterici responsabili delle patologie del suino sostenute da E. coli. Per quanto concerne l’impiego come antivirali, sebbene i risultati non siano particolarmente incoraggianti, è di auspicio che la ricerca prosegua nelle prove di attività antivirale degli oli essenziali sfruttandone quanto più possibile la loro azione sinergica

Appropriateness of antiplatelet therapy for primary and secondary cardio- and cerebrovascular prevention in acutely hospitalized older people

Aims: Antiplatelet therapy is recommended for the secondary prevention of cardio- and cerebrovascular disease, but for primary prevention it is advised only in patients at very high risk. With this background, this study aims to assess the appropriateness of antiplatelet therapy in acutely hospitalized older people according to their risk profile. Methods: Data were obtained from the REPOSI register held in Italian and Spanish internal medicine and geriatric wards in 2012 and 2014. Hospitalized patients aged ≥65 assessable at discharge were selected. Appropriateness of the antiplatelet therapy was evaluated according to their primary or secondary cardiovascular prevention profiles. Results: Of 2535 enrolled patients, 2199 were assessable at discharge. Overall 959 (43.6%, 95% CI 41.5–45.7) were prescribed an antiplatelet drug, aspirin being the most frequently chosen. Among patients prescribed for primary prevention, just over half were inappropriately prescribed (52.1%), being mainly overprescribed (155/209 patients, 74.2%). On the other hand, there was also a high rate of inappropriate underprescription in the context of secondary prevention (222/726 patients, 30.6%, 95% CI 27.3–34.0%). Conclusions: This study carried out in acutely hospitalized older people shows a high degree of inappropriate prescription among patients prescribed with antiplatelets for primary prevention, mainly due to overprescription. Further, a large proportion of patients who had had overt cardio- or cerebrovascular disease were underprescribed, in spite of the established benefits of antiplatelet drugs in the context of secondary prevention

Prognostic value of degree and types of anaemia on clinical outcomes for hospitalised older patients

Study objective This study investigated in a large sample of in-patients the impact of mild-moderate-severe anaemia on clinical outcomes such as in-hospital mortality, re-admission, and death within three months after discharge. Methods A prospective multicentre observational study, involving older people admitted to 87 internal medicine and geriatric wards, was done in Italy between 2010 and 2012. The main clinical/laboratory data were obtained on admission and discharge. Based on haemoglobin (Hb), subjects were classified in three groups: group 1 with normal Hb, (reference group), group 2 with mildly reduced Hb (10.0–11.9 g/dL in women; 10.0–12.9 g/dL in men) and group 3 with moderately-severely reduced Hb (<10 g/dL in women and men). Results Patients (2678; mean age 79.2 ± 7.4 y) with anaemia (54.7%) were older, with greater functional impairment and more comorbidity. Multivariable analysis showed that mild but not moderate-severe anaemia was associated with a higher risk of hospital re-admission within three months (group 2: OR = 1.62; 95%CI 1.21–2.17). Anaemia failed to predict in-hospital mortality, while a higher risk of dying within three months was associated with the degree of Hb reduction on admission (group 2: OR = 1.82;95%CI 1.25–2.67; group 3: OR = 2.78;95%CI 1.82–4.26) and discharge (group 2: OR = 2.37;95%CI 1.48–3.93; group 3: OR = 3.70;95%CI 2.14–6.52). Normocytic and macrocytic, but not microcytic anaemia, were associated with adverse clinical outcomes. Conclusions Mild anaemia predicted hospital re-admission of older in-patients, while three-month mortality risk increased proportionally with anaemia severity. Type and severity of anaemia affected hospital re-admission and mortality, the worst prognosis being associated with normocytic and macrocytic anaemia

Risk factors for three-month mortality after discharge in a cohort of non-oncologic hospitalized elderly patients: Results from the REPOSI study

Background: Short-term prognosis, e.g. mortality at three months, has many important implications in planning the overall management of patients, particularly non-oncologic patients in order to avoid futile practices. The aims of this study were: i) to investigate the risk of three-month mortality after discharge from internal medicine and geriatric wards of non-oncologic patients with at least one of the following conditions: permanent bedridden status during the hospital stay; severely reduced kidney function; hypoalbuminemia; hospital admissions in the previous six months; severe dementia; ii) to establish the absolute risk difference of three-month mortality of bedridden compared to non-bedridden patients. Methods: This prospective cohort study was run in 102 Italian internal medicine and geriatric hospital wards. The sample included all patients with three-months follow-up data. Bedridden condition was defined as the inability to walk or stand upright during the whole hospital stay. The following parameters were also recorded: estimated GFR <= 29 mL/min/1.73 m(2); severe dementia; albuminemia << 2.5 g/dL; hospital admissions in the six months before the index admission. Results: Of 3915 patients eligible for the analysis, three-month follow-up were available for 2058, who were included in the study. Bedridden patients were 112 and the absolute risk difference of mortality at three months was 0.13 (CI 95% 0.08-0.19, p << 0.0001). Logistic regression analysis also adjusted for age, sex, number of drugs and comorbidity index found that bedridden condition (OR 2.10, CI 95% 1.12-3.94), severely reduced kidney function (OR 2.27, CI 95% 1.22-4.21), hospital admission in the previous six months (OR 1.96, CI 95% 1.22-3.14), severe dementia (with total or severe physical dependence) (OR 4.16, CI 95% 2.39-7.25) and hypoalbuminemia (OR 2.47, CI 95% 1.12-5.44) were significantly associated with higher risk of three-month mortality. Conclusions: Bedridden status, severely reduced kidney function, recent hospital admissions, severe dementia and hypoalbuminemia were associated with higher risk of three-month mortality in non-oncologic patients after discharge from internal medicine and geriatric hospital wards