Turbulent Flow Chromatography: A Unique Two-Dimensional Liquid Chromatography

Among 2D-LC techniques, a particular approach is commercialized by Thermo Fisher Scientific that may enable the direct introduction of biological samples into an online automated extraction system without any additional pre-treatment: the TurboFlow technology. It combines chemical and size exclusion capability of chromatography columns packed with porous particles in which a turbulent solvent flow is able to separate smaller molecules from larger ones (e.g. proteins). Once extracted, the small molecules can also be transferred to an analytical column for improving separation prior to detection. This is done through a unique plumbing and customized valve-switching arrangement that allows the focusing of molecules onto the second column. This enables a very efficient chromatographic separation. The use of the TurboFlow not only eliminates extensive sample preparation, thus reducing inter-operator variability and matrix effects, but also increases the capacity for high-throughput analyses due to a unique multiplexing technology, in which multiple LC channels are connected to a single detector

Assessing attitudes towards insulin pump therapy in adults with type 1 diabetes: Italian validation of the Insulin Pump Attitudes Questionnaire (IT-IPA questionnaire)

Aims: The aim of the study was to adapt the German version of the insulin pump therapy (IPA) questionnaire to Italian (IT-IPA) and to evaluate its psychometric properties in adults with type 1 diabetes. Methods: We conducted a cross-sectional study, data were collected through an online survey. In addition to IT-IPA, questionnaires evaluating depression, anxiety, diabetes distress, self-efficacy, and treatment satisfaction were administered. The six factors identified in the IPA German version were assessed using confirmatory factor analysis; psychometric testing included construct validity and internal consistency. Results: The online survey was compiled by 182 individuals with type 1 diabetes: 45.6% continuous subcutaneous insulin infusion (CSII) users and 54.4% multiple daily insulin injection users. The six-factor model had a very good fit in our sample. The internal consistency was acceptable (Cronbach's α = 0.75; 95% IC [0.65-0.81]). Diabetes treatment satisfaction was positively correlated with a positive attitude towards CSII therapy (Spearman's rho = 0.31; p < 0.01), less Technology Dependency, higher Ease of Use, and less Impaired Body Image. Furthermore, less Technology Dependency was associated with lower diabetes distress and depressive symptoms. Conclusions: The IT-IPA is a valid and reliable questionnaire evaluating attitudes towards insulin pump therapy. The questionnaire can be used for clinical practice during consultations for shared decision-making to CSII therapy

Livestock-associated methicillin-resistant Staphylococcus aureus responsible for human colonization and infection in an area of Italy with high density of pig farming

BACKGROUND: Livestock-Associated MRSA (LA-MRSA) belonging to ST398 lineage, common among pigs and other animals, emerged in Central and Northern Europe, becoming a new risk factor for MRSA among farm workers. Strains belonging to ST398 can be responsible for human colonization and infection, mainly in areas with high livestock-farming. The aim of this study was to investigate the occurrence of livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) human colonization and infections in an area of the Lombardy Region (Italy), the Italian region with the highest density of pig farming. METHODS: In the period March-April 2010, 879 nasal swabs were taken from subjects at admission to a local hospital serving an area of the Lombardy Region devoted to agriculture and farming. In the period March 2010-February 2011, all MRSA strains from community-acquired infection (CAI) observed in the same hospital, were collected. Molecular characterization of the isolates included SCCmec typing, spa typing and multilocus sequence typing (MLST). RESULTS: Out of 879 nasal swabs examined, 9 (1%) yielded MRSA. Five strains were assigned to sequence type (ST)398 (spa t899, 3 isolates; t108 and t2922, 1 isolate each) and were therefore categorized as LA-MRSA. The other 4 isolates were likely of hospital origin. No strains were positive for Panton-Valentine Leukocidin genes. Twenty MRSA isolates were detected from CAI, 17 were from skin and soft-tissue infections and 3 from other infections. An MRSA isolate from otitis externa was t899/ST398 and PVL-negative, hence categorized as LA-MRSA. Four isolates were assigned to t127/ST1. Eight strains were PVL-positive community acquired (CA)-MRSA and belonged to different clones, the most frequent being ST8. CONCLUSIONS: In an area of Italy with high density of pig farming, LA-MRSA is able to colonize the population and rarely to produce infections. Typical CA-MRSA is more common than LA-MRSA among CAI

Livestock-associated methicillin-resistant Staphylococcus aureus responsible for human colonization and infection in an area of Italy with high density of pig farming

Background: Livestock-Associated MRSA (LA-MRSA) belonging to ST398 lineage, common among pigs and other animals, emerged in Central and Northern Europe, becoming a new risk factor for MRSA among farm workers. Strains belonging to ST398 can be responsible for human colonization and infection, mainly in areas with high livestock-farming. The aim of this study was to investigate the occurrence of livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) human colonization and infections in an area of the Lombardy Region (Italy), the Italian region with the highest density of pig farming. Methods: In the period March-April 2010, 879 nasal swabs were taken from subjects at admission to a local hospital serving an area of the Lombardy Region devoted to agriculture and farming. In the period March 2010-February 2011, all MRSA strains from community-acquired infection (CAI) observed in the same hospital, were collected. Molecular characterization of the isolates included SCCmec typing, spa typing and multilocus sequence typing (MLST). Results: Out of 879 nasal swabs examined, 9 (1%) yielded MRSA. Five strains were assigned to sequence type (ST)398 (spa t899, 3 isolates; t108 and t2922, 1 isolate each) and were therefore categorized as LA-MRSA. The other 4 isolates were likely of hospital origin. No strains were positive for Panton-Valentine Leukocidin genes. Twenty MRSA isolates were detected from CAI, 17 were from skin and soft-tissue infections and 3 from other infections. An MRSA isolate from otitis externa was t899/ST398 and PVL-negative, hence categorized as LA-MRSA. Four isolates were assigned to t127/ST1. Eight strains were PVL-positive community acquired (CA)-MRSA and belonged to different clones, the most frequent being ST8. Conclusions: In an area of Italy with high density of pig farming, LA-MRSA is able to colonize the population and rarely to produce infections. Typical CA-MRSA is more common than LA-MRSA among CAI

Spesa sanitaria e invecchiamento della popolazione: il ruolo delle patologie croniche

La letteratura individua diverse cause per l’aumento della spesa sanitaria e fra queste, nei paesi dell’Occidente, l’invecchiamento della popolazione è certamente uno dei fattori principali, soprattutto dove l’indice di vecchiaia si associa anche ad indice di dipendenza sempre più elevato. Occorre tuttavia notare che non tutta la letteratura è d’accordo circa il vero effetto che l’invecchiamento ha sulla spesa, soprattutto se consideriamo solo quella sanitaria in senso stretto, escludendo le spese che derivano dalla long term care. Un secondo motivo importante di aumento della spesa sanitaria è certamente correlato alle malattie croniche. In questo lavoro, partendo dai dati contenuti negli archivi informatici utilizzati dall’Asl di Brescia per motivi gestionali-amministrativi ci proponiamo di studiare il fenomeno della spesa nella popolazione anziana cercando di distinguere, per quanto possibile, il costo che deriva dal semplice aumento dell’età da quello che può essere attribuito all’aggravarsi della patologia cronica. Sebbene infatti i due fenomeni siano fra loro strettamente legati, le implicazioni dal punto di vista di policy sono molto diverse: mentre l’invecchiamento della popolazione è in qualche modo un fattore inevitabile sul quale la Asl e l’intero Ssn non possono agire, la malattia cronica può in qualche modo essere, se non prevenuta, almeno posticipata e/o arginata nelle sue complicanze