103 research outputs found

    The Ag85B protein of Mycobacterium tuberculosis may turn a protective immune response induced by Ag85B-DNA vaccine into a potent but non-protective Th1 immune response in mice

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    Clarifying how an initial protective immune response to tuberculosis may later loose its efficacy is essential to understand tuberculosis pathology and to develop novel vaccines. In mice, a primary vaccination with Ag85B-encoding plasmid DNA (DNA-85B) was protective against Mycobacterium tuberculosis (MTB) infection and associated with Ag85B-specific CD4+ T cells producing IFN-gamma and controlling intramacrophagic MTB growth. Surprisingly, this protection was eliminated by Ag85B protein boosting. Loss of protection was associated with a overwhelming CD4+ T cell proliferation and IFN-gamma production in response to Ag85B protein, despite restraint of Th1 response by CD8+ T cell-dependent mechanisms and activation of CD4+ T cell-dependent IL-10 secretion. Importantly, these Ag85B-responding CD4+ T cells lost the ability to produce IFN-gamma and control MTB intramacrophagic growth in coculture with MTB-infected macrophages, suggesting that the protein-dependent expansion of non-protective CD4+ T cells determined dilution or loss of the protective Ag85B-specific CD4+ induced by DNA-85B vaccination. These data emphasize the need of exerting some caution in adopting aggressive DNA-priming, protein-booster schedules for MTB vaccines. They also suggest that Ag85B protein secreted during MTB infection could be involved in the instability of protective anti-tuberculosis immune response, and actually concur to disease progression

    Serological screening for Celiac Disease in 382 pre-schoolers with Autism Spectrum Disorder

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    Background: Recent investigations suggest a possible common genetic background between Autism Spectrum Disorders (ASD) and Celiac Disease (CD). However, studies regarding this association are scarce and often limited by the small sample sizes and/or large heterogeneity among ASD groups in terms of demographic and clinical features. The present study aims to investigate the overall CD prevalence (biopsy proven-CD patients plus screening detected tTG and EMA positive cases) in a large population of pre-schoolers with ASD referred to a tertiary care University Hospital. Methods: We retrospectively collected data about 382 children (mean age: 46.97 ± 13.55 months; age-range: 18-72 months) consecutively diagnosed as ASD (according to the Diagnostic and Statistical Manual of Mental Disorders 4th edition criteria) over the period 2010-2013, and who performed a serological CD screening. Results: The overall CD prevalence was 2.62%, which is statistically significant higher to that reported in the Italian paediatric population (p = 0.0246). Half of these children had no symptoms or risk factors related to CD when they performed the serological screening. Conclusions: If replicated, these data suggest the importance of regular screening for CD in young patients with ASD, and are of relevance for clinical and public health

    Preditores de comportamentos de autocuidado em indivĂ­duos com insuficiĂȘncia cardĂ­aca no Brasil

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    Objetivo: Identificar preditores de comportamentos de autocuidado em indivĂ­duos com insuficiĂȘncia cardĂ­aca no Brasil.MĂ©todo: Estudo transversal com 405 pacientes com insuficiĂȘncia cardĂ­aca. Os comportamentos de autocuidado foram analisados atravĂ©s do Self-Careof Heart Failure Index (Índice de Autocuidado na InsuficiĂȘncia CardĂ­aca). CaracterĂ­sticas clĂ­nicas e sociodemogrĂĄficas foram investigadas como preditores da manutenção do autocuidado, de sua administração, e da confiança, por meio de regressĂ”es logĂ­sticas. Resultados: Os preditores da manutenção do autocuidado foram o nĂșmero de filhos (p<0.01), a fração de ejeção do ventrĂ­culo esquerdo (p<0.01), sentimentos positivos sobre a doença (p=0.03), obesidade (p=0.02), e doença renal dialĂ­tica crĂŽnica (p<0.01). Os preditores de administração do autocuidado foram ter filhos casados (p<0.01) e apneia (p<0.01). Os preditores de confiança no autocuidado foram renda familiar (p<0.01), nĂșmero de internaçÔes nos 12 meses anteriores (p=0.01), nĂșmero de doses de medicação diĂĄrias (p<0.01), e sedentarismo (p<0.01).ConclusĂŁo: Encontrou-se alguns preditores associados aos comportamentos de autocuidado, de modo que educação intensiva e auxĂ­lio social deveriam ser oferecidos aos pacientes com essas caracterĂ­sticas.Descritores: InsuficiĂȘncia cardĂ­aca. Autocuidado. AutogestĂŁo. Comportamento relacionados com a saĂșde. Enfermage

    What is the future for agroforestry in Italy?

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    The successful promotion of agroforestry in Italy depends on both a recognition of tradition and the opportunities for innovation. In Italy, agroforestry has traditionally been a key component of landscape management. Complex systems, based on the integration among crops–livestock–fruit/forest trees, provided a wide variety of products (e.g. food, feed, fibers, fuelwood and timber) and other ecosystem services (e.g. soil erosion control and biodiversity preservation). Silvopastoral systems have been used for centuries and are still managed in marginal areas. The integration of fruits trees (in primis olive trees) with crops and grazing was widely practiced and is still profitable. Coltura promiscua was historically developed integrating fruit and forest trees and particularly multifunctional trees (e.g. Juglans regia L. and Prunus avium L.) to support vines and intercrops. Building on recent research, projects have also focused on innovation in agroforestry. The adoption of shade tolerant forage species and crops has been studied in silvopastoral and olive systems. Silvopastoral systems can significantly offset the greenhouse gas emissions produced by livestock and shield grazing animals from “heat waves”. Integration of fast growing timber trees (like Populus) in arable systems can help reverse the decline in plantation forestry in Italy. Finally, the constraints imposed by the EU agricultural policy, especially the prevalent provisions for monocrops severely limiting the introduction of innovative agroforestry approaches, are discussed. New political measures and certification actions are strongly required

    Laryngopharyngeal reflux diagnosis in obstructive sleep apnea patients using the pepsin salivary test

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    Background: To investigate the presence of laryngopharyngeal reflux in patients with obstructive sleep apnea (OSA) employing the salivary pepsin concentration method. To compare the results of pepsin concentration with the severity of the pathology. Methods: Seventy-five OSA patients (44 males, 31 females) were enrolled in the study. For each patient, the AHI (apnea–hypopnea index) and the BMI (body mass index) were initially evaluated. All the patients enrolled were assessed using the reflux symptom index (RSI) and the reflux finding score (RFS) in order to perform a clinical diagnosis of laryngopharyngeal reflux. In all patients a salivary sample was taken to estimate the presence of pepsin and its concentration. Results: The incidence of LPR (laryngopharyngeal reflux) in OSA patients, evaluated using the salivary pepsin concentration test (PEP-test), was found to be 32% of cases. Linear regression testing did not show any correlation between AHI and pepsin concentration in salivary samples (p = 0.1). Conclusion: A high number of patients with OSA seem to show positivity for salivary pepsin, correlated to an LPR. There does not appear to be a correlation between the severity of apnea and the grade of salivary pepsin reflux. On the other hand, direct correlation between BMI and the value of pepsin in salivary specimens was observed

    Stakeholders' views on the global guidelines for the sustainable use of non‐native trees

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    A large number of non‐native trees (NNTs) have been introduced globally and widely planted, contributing significantly to the world's economy. Although some of these species present a limited risk of spreading beyond their planting sites, a growing number of NNTs are spreading and becoming invasive leading to diverse negative impacts on biodiversity, ecosystem functions and human well‐being. To help minimize the negative impacts and maximize the economic benefits of NNTs, Brundu et al. developed eight guidelines for the sustainable use of NNTs globally—the Global Guidelines for the Use of NNTs (GG‐NNTs). Here, we used an online survey to assess perceptions of key stakeholders towards NNTs, and explore their knowledge of and compliance with the GG‐NNTs. Our results show that stakeholders are generally aware that NNTs can provide benefits and cause negative impacts, often simultaneously and they consider that their organization complies with existing regulations and voluntary agreements concerning NNTs. However, they are not aware of or do not apply most of the eight recommendations included in the GG‐NNTs. We conclude that effectively managing invasions linked to NNTs requires both more communication efforts using an array of channels for improving stakeholder awareness and implementation of simple measures to reduce NNT impacts (e.g. via GG‐NNTs), and a deeper understanding of the barriers and reluctance of stakeholders to manage NNT invasions. Read the free Plain Language Summary for this article on the Journal blog

    Prescription appropriateness of anti-diabetes drugs in elderly patients hospitalized in a clinical setting: evidence from the REPOSI Register

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    Diabetes is an increasing global health burden with the highest prevalence (24.0%) observed in elderly people. Older diabetic adults have a greater risk of hospitalization and several geriatric syndromes than older nondiabetic adults. For these conditions, special care is required in prescribing therapies including anti- diabetes drugs. Aim of this study was to evaluate the appropriateness and the adherence to safety recommendations in the prescriptions of glucose-lowering drugs in hospitalized elderly patients with diabetes. Data for this cross-sectional study were obtained from the REgistro POliterapie-SocietĂ  Italiana Medicina Interna (REPOSI) that collected clinical information on patients aged ≄ 65 years acutely admitted to Italian internal medicine and geriatric non-intensive care units (ICU) from 2010 up to 2019. Prescription appropriateness was assessed according to the 2019 AGS Beers Criteria and anti-diabetes drug data sheets.Among 5349 patients, 1624 (30.3%) had diagnosis of type 2 diabetes. At admission, 37.7% of diabetic patients received treatment with metformin, 37.3% insulin therapy, 16.4% sulfonylureas, and 11.4% glinides. Surprisingly, only 3.1% of diabetic patients were treated with new classes of anti- diabetes drugs. According to prescription criteria, at admission 15.4% of patients treated with metformin and 2.6% with sulfonylureas received inappropriately these treatments. At discharge, the inappropriateness of metformin therapy decreased (10.2%, P < 0.0001). According to Beers criteria, the inappropriate prescriptions of sulfonylureas raised to 29% both at admission and at discharge. This study shows a poor adherence to current guidelines on diabetes management in hospitalized elderly people with a high prevalence of inappropriate use of sulfonylureas according to the Beers criteria
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