C reactive protein in healthy term newborns during the first 48 hours of life

Background Early-onset neonatal sepsis (EOS) is a serious and potentially life-threatening disease in newborns. C reactive protein (CRP) is the most used laboratory biomarker for the detection of EOS. Little is known about normal reference values of CRP during the perinatal period as several factors are able to influence it. Objectives To identify an appropriate range of CRP values in healthy term newborns during the first 48 hours of life. Design CRP determination was performed in 859 term newborns at 12, 24 and 48 hours of life. Mode of delivery, maternal vaginal culture results, intrapartum antimicrobial prophylaxis (IAP) and other perinatal variables were recorded. Results CRP mean values were significantly higher at 48 hours (4.10 mg/L) than at both 24 (2.30 mg/L) and 12 hours of life (0.80 mg/L). CRP levels were affected by a number of perinatal proinflammatory variables. In particular, CRP mean values were significantly higher in babies born by vaginal delivery (3.80 mg/L) and emergency caesarean section (3.60 mg/L) than in babies born by elective caesarean section (2.10 mg/L). Completed course of IAP led to lower CRP mean values (2.90 mg/L) than IAP not completed (3.80 mg/L) or not performed (4.70 mg/L). Conclusions Postnatal age and mode of delivery significantly influence CRP values. Reliable reference values are crucial in order to obtain an adequate diagnostic accuracy

SARS-CoV-2 Breakthrough Infections: Incidence and Risk Factors in a Large European Multicentric Cohort of Health Workers

The research aimed to investigate the incidence of SARS-CoV-2 breakthrough infections and their determinants in a large European cohort of more than 60,000 health workers

Inter-Method Differences in the Measurement of Some Specific Plasma Proteins: Commutability of Control Materials

Peer Reviewe

Confronto tra differenti metodologie di campionamento e studi di caratterizzazione del particolato atmosferico urbano di Padova

Nell\u2019ambito degli studi di caratterizzazione del particolato atmosferico urbano della citt\ue0 di Padova, avviati con il progetto SITECOS, sono state recentemente effettuate alcune campagne di monitoraggio impiegando contemporaneamente tre differenti sistemi di campionamento e misura di PM1, PM2.5 e PM10: il campionatore Zambelli Explorer plus che opera in condizioni certificate, il sistema PCIS (Personal Cascade Impactor Sampler) che consiste in un impattore multistadio di piccole dimensioni utile al monitoraggio dell\u2019esposizione personale, e il contatore ottico di particelle Grimm mod. 1108. Attraverso un confronto dell\u2019insieme dei risultati sperimentali (campagne di misura effettuate nel mese di novembre del 2006 e del 2007) si \ue8 potuto stabilire che il campionatore multistadio PCIS \ue8 in grado di fornire valori di concentrazione di PM10, PM2,5 e PM1 statisticamente equivalenti al sistema certificato Zambelli con un livello di confidenza del 95%. Al contrario, il confronto tra le prestazioni del contatore ottico di particelle OPC-Grimm e il sistema di campionamento certificato Zambelli ha evidenziato che le due metodologie di misura forniscono valori di concentrazione di PM10, PM2,5 e PM1 statisticamente differenti (livello di confidenza del 95%). Le differenze sistematiche evidenziate (ad esempio l\u2019OPC sovrastima di circa il 30% la concentrazione di PM2.5) sono imputabili alla non completa conoscenza della composizione delle particelle aerodisperse, ovvero alla loro densit\ue0 in funzione della classe dimensionale campionata, i cui valori determinano l\u2019accuratezza con cui la misura in conteggio pu\uf2 essere convertita in PM. Una volta verificate le prestazioni, il campionatore multistadio PCIS \ue8 stato impiegato per completare gli studi di caratterizzazione del particolato atmosferico urbano di Padova, effettuando in particolare l\u2019analisi della distribuzione dimensionale di alcune sue componenti. Si \ue8 pertanto confermato che gli ioni di origine secondaria come nitrati, solfati e ammonio presentano concentrazioni maggiori nelle frazioni pi\uf9 fini del particolato. Al contrario, calcio e magnesio che sono tipicamente di origine crostale, sono maggiormente presenti nella frazione grossolana. Nel complesso la componente inorganica solubile totale diminuisce (in termini di %) nelle frazioni pi\uf9 fini dove invece aumenta la frazione carboniosa. Il TC (%) \ue8 risultato essere sempre piuttosto elevato ed in linea con i valori previsti per il PM urbano della Pianura Padana (30-60%). Si osserva inoltre che la conc.% di TC diminuisce nei giorni di picco del PM (aumenta quindi la concentrazione assoluta di TC in funzione della concentrazione di PM10, PM2,5 e PM1), a dimostrazione che le elevate concentrazioni di PM riscontrate nei periodi invernali ed autunnali risentono maggiormente dell\u2019incremento della componente secondaria. I dati di concentrazione dei principali componenti del particolato atmosferico sono stati infine elaborati tramite l\u2019applicazione di modelli statistici, al fine di ricavare una prima classificazione delle possibili fonti emissive e una stima del loro contributo. Lo studio preliminare di assegnazione delle fonti emissive (PCA e analisi fattoriale effettuata sui dati di PM2,5 acquisiti nell\u2019ambito del progetto SITECOS) ha evidenziato che le principali sorgenti del particolato atmosferico urbano di Padova sono tre (processi secondari, processi di combustione e contributo crostale) e che specifiche componenti del particolato sono significativamente correlabili ad esse

Andamento dei marcatori sierologici della malattia celiaca nella dieta priva di glutine. Behavior of celiac disease serology during gluten free diet.

Background. Actually, the guidelines are not clear about monitoring of patients with celiac disease (CD) on gluten free-diet (GFD) and sensitivity and accuracy of CD-specific serology as an outcome measurement tool have not been well established and continue to be debated. In the present study we describe the changes of anti tissue-transglutaminase antibodies (t-TG), anti-gliadin antibodies (AGA) and endomysial antibodies (EMA) over time in diagnosed CD patients placed on the GFD to determine which of these markers is a valuable complement for monitoring of GFD. Methods. We selected 44 CD patients on gluten-free diets in which have been assessed at the time of diagnosis, 6 months, 12 months and 2 years after dietary restriction IgA and IgG a-tTG, IgA and IgG AGA and IgA EMA. Results. After 6 months GFD treatment the percentage of positive patients was: 54% for IgA a-tTG, 38% for IgG a-tTG, 47% for EMA, 30% for IgA AGA, 56% for IgG AGA. After 12 months GFD treatment the percentage of positive patients was: 36% for IgA a-tTG, 14% for IgG a-tTG, 9% for EMA, 21% for IgA AGA and 23% for IgG AGA. After 24 months GFD treatment all patients were negative for EMA, IgA AGA and IgG AGA, while 3% and 5% were respectively positive for IgA a-tTG IgA e IgG a-tTG. Conclusions. The effect of treatment was evident as early as 6 months after patients started treatment, but not all CD markers had the same performance. On the basis of obtained results we suggest for monitoring of CD patients on GFD the only determination of a-tTG

Methodology to Evaluate Clinical Impact of 0/3 Hour High-Sensitivity Cardiac Troponin T Protocol on Managing Acute Coronary Syndrome in Daily Emergency Department Practice

Sex-/age-differentiated cutoffs and the magnitude of serial changes in high-sensitivity cardiac troponins (hs-cTn) for acute coronary syndrome (ACS) diagnosis algorithms are still under discussion. This study presents a methodology to evaluate decision-making limits and to assess whether sex-specific cutoffs could improve diagnostic accuracy

Reference range of serum calcitonin in pediatric population

Background: Children belonging to the multiple endocrine neoplasia type 2 (MEN 2) pedigree and carrying germline RET mutations are candidates for prophylactic thyroidectomy, the timing of which is based on the mutation-associated risk and the calcitonin (CT) levels. Design: The aim of this study was to establish the reference range for serum CT in a pediatric population. The study included 2740 subjects (1339 females and 1401 males) ranging in age from 1 day to 16 years and undergoing blood testing for any medical condition not affecting serum CT. Results: Overall, serum CT was undetectable in 61.5% of the samples and detectable in 38.5%. Detectable samples were more frequent in the first 2 years of life. Thereafter, undetectable samples became more frequent, particularly in females. Mean serum CT concentrations were higher in the first year of life (9.81 ± 8.8 pg/mL; range, 2.0-48.9 pg/mL) and the second year of life (4.56 ± 2.64 pg/mL; range, 2.0-14.7 pg/mL). A significant decrease of serum CT levels was observed thereafter (P < .001), and starting from the third year of life serum CT levels were similar to those found in adults. No gender difference was found in any age group. Based on these results, age-specific CT reference ranges are needed in the pediatric population, and especially in the first 2 years of life. Conclusions: This is the first study defining the reference range for serum CT in the pediatric population and large enough to be statistically meaningful. Our proposal may facilitate the process of decision making when dealing with gene carriers of MEN 2

Genetic influence in liver steatosis prevalence and proatherothrombotic/inflammatory profile in familial combined hyperlipoproteinemia

13nononemixedFrancesca Santilli;Patrizia Blardi;Francesca Scarpini;Angela Acciavatti;Linda Ceccatelli;Antonio Magliocca;Tiziana Avolio;Monica Bocchia;Carlo Scapellato;Walter Renato Gioffrè;Alberto Auteri;Silvia Cristina Ferracane;Luca PuccettiFrancesca, Santilli; Blardi, Patrizia; Francesca, Scarpini; Angela, Acciavatti; Linda, Ceccatelli; Antonio, Magliocca; Tiziana, Avolio; Bocchia, Monica; Carlo, Scapellato; Walter Renato, Gioffrè; Alberto, Auteri; Silvia Cristina, Ferracane; Puccetti, Luc

Decreased plasma endogenous soluble RAGE, and enhanced adipokine secretion, oxidative stress and platelet/coagulative activation identify non-alcoholic fatty liver disease among patients with familial combined hyperlipidemia and/or metabolic syndrome

Objective: In patients with familial combined hyperlipidemia (FCHL), without metabolic syndrome (MS), occurrence of non-alcoholic fatty liver disease (NAFLD) is related to a specific pro-inflammatory profile, influenced by genetic traits, involved in oxidative stress and adipokine secretion. Among FCHL or MS patients, hyperactivity of the ligand-receptor for advanced glycation-end-products (RAGE) pathway, as reflected by inadequate protective response by the endogenous secretory (es)RAGE, in concert with genetic predisposition, may identify those with NAFLD even before and regardless of MS. Methods: We cross-sectionally compared 60 patients with vs. 50 without NAFLD. Each group included patients with FCHL alone, MS alone, and FCHL plus MS. Results: NAFLD patients had significantly lower plasma esRAGE, IL-10 and adiponectin, and higher CD40 ligand, endogenous thrombin potential and oxidized LDL. The effects of MS plus FCHL were additive. The genotypic cluster including LOX-1 IVS4-14A plus ADIPO 45GG and 256 GT/GG plus IL-10 10-1082G, together with higher esRAGE levels highly discriminate FCHL and MS patients not developing NAFLD. Conclusions: Among FCHL or MS patients, noncarriers of the protective genotypic cluster, with lower esRAGE and higher degree of atherothrombotic abnormalities coincide with the diagnosis of NAFLD. This suggests an interplay between genotype, adipokine secretion, oxidative stress and platelet/coagulative activation, accelerating NAFLD occurrence as a proxy for cardiovascular diseas