Cystic echinococcosis in Lombardy: epidemiological aspects and spatial analysis

AbstractA descriptive spatial analysis on the spreading of cattle cystic echinococcosis in non-endemic areas of Italy (Lombardy) was performed and the presence of clusters of hydatid disease in the studied area were evaluated. Positive cattle were from 285 out of 5708 farms (4.99 %) with significant differences among the provinces considered. Infection with Echinococcus granulosus was detected in 321 out of 112,521 dairy cattle (P = 0.29 %). CE-positive farms were distributed among 195 of the 812 municipalities included in the study (24.01 %) located in the central and south-eastern part of the region. By SaTScan, four significant clusters of infection were identified; they included 4–241 cattle farms and 4–24 positive animals. The most likely spatial cluster of 17 observed cases in 241 farms was located in the north-eastern part of Lombardy. SaTScan analysis suggest that a geographical surveillance in the area of the positive clusters occur is for and that's could be very useful to public health service to monitoring this zoonotic disease

Understanding the Pathogenesis of Red Mark Syndrome in Rainbow Trout (Oncorhynchus mykiss) through an Integrated Morphological and Molecular Approach

Red mark syndrome (RMS) is a widespread skin disorder of rainbow trout in freshwater aquaculture, believed to be caused by a Midichloria-like organism (MLO). Here, we aimed to study the pathologic mechanisms at the origin of RMS by analyzing field samples from a recent outbreak through gene expression, MLO PCR, quantitative PCR, and a histopathological scoring system proposed for RMS lesions. Statistical analyses included a One-Way Analysis of Variance (ANOVA) with a Dunnett’s multiple comparisons test to assess differences among gene expression groups and a nonparametric Spearman correlation between various categories of skin lesions and PCR results. In short, the results confirmed the presence of a high quantity of 16S gene copy numbers of Midichloria-like organisms in diseased skin tissues. However, the number of Midichloria-like organisms detected was not correlated to the degree of severity of skin disease. Midichloria-like organism DNA was found in the spleen and head kidney. The spleen showed pathologic changes mainly of hyperplastic type, reflecting its direct involvement during infection. The most severe skin lesions were characterized by a high level of inflammatory cytokines sustaining and modulating the severe inflammatory process. IL-1 β, IL-6, IL-10, MHC-II, and TCR were upregulated in severe skin lesions, while IL-10 was highly expressed in moderate to severe ones. In the moderate form, the response was driven to produce immunoglobulins, which appeared crucial in controlling the skin disease’s severity. Altogether our results illustrated a complex immune interaction between the host and Midichloria-like organism

Sviluppo di un approccio formativo innovativo interdisciplinare orientato alla realizzazione di policy istituzionali: percorso integrato di Coaching individuale e di Team, di Mentoring e Formazione d’aula

Introduction The increasing of people affected by chronic diseases implies a significant commitment of resources to ensure continuity of long-term healthcare services. Italian Healthcare Authorities have adopted a National Chronicity Plan focusing on empowerment as the center of a pact of care between professionals and patients and caregivers to deal with global healthcare needs through multidisciplinary management, with the ambitious aim of changing the history of chronicity. IPACS (Institutional & Public Coaching Services) has set as it’s own primary objective the development of the specific aspect of professional interdisciplinary role in the socio-health field, considered critical for implementing the policies on chronicity of the Ministry of Health. Material and Methods IPACS has developed an experiential integrated training device (Mentoring + Individual Coaching + Team Coaching + Classroom Training + Art) lasting 6 months addressed to healthcare professionals, conducted by Institutional mentors and coaches with credentials of the International Coach Federation (ICF). The IPACS protocol utilizes validated questionnaires, observation sheets and other training tools/devices such as training pills and initial and final post-assessment feedback. Results The use of a standard methodology for evaluation and observation in the integrated coaching protocol allows the measurement of training results and the validation of the relative impact on the achievement of the system objectives and plan of action. The data relating to a study protocol are entered in the IPACS Empowerment platform which measures and describes the evolution curve of the individual and the team's capabilities, as well as the effects on the organization, going to form the database for the Health Technology Assessment of training technology. Conclusions The IPACS integrated coaching protocol, a process innovation tool capable of modifying the evolution curve of the individual and the reference team's capabilities, as well as the effects on the organization, offers useful technological innovation

Morphometric study on tadpoles of Bombina variegata (Linnaeus, 1758) (Anura; Bombinatoridae)

The tadpoles of Yellow-bellied toad (Bombina variegata) can be easily recognized from other Italian anuran species, except those of B. pachypus (though the two congeneric species are allopatric). In this paper we report morphometric data on B. variegata tadpoles from a Lombard population living near a torrent at 450 m a.s.l. On a sample of 264 tadpoles (stages 19-44, according to Gosner, 1960) we measured the following five variables: snout-vent length, tail length, maximum tail height, total length and weight. We found a slight allometric relationship between snout-vent length and tail length, while, as expectes,.the weight is nearly proportional to the cube of linear measures. According to literature data, our results point to highly constant proportions during the development phases up to prometamorphic stages. The ratio between snout-vent length and tail length was about 0.75 during the whole growing phase, while from stage 42 the proportion increases as the resorption of the tail starts

Wild carnivores as source of zoonotic helminths in north-eastern Italy

AbstractTwo hundreds and sixty red foxes, eighteen badgers and eight stone martens from north-eastern Italy were examined for zoonotic parasites by SCT, with particular attention to Trichinella sp. and Echinococcus multilocularis. No adult worms of E. multilocularis were observed in the intestine of red foxes or mustelids. Out of 223 fox faecal samples analysed by a commercial CA-ELISA, 5.8 % was positive to Echinococcus coproantigens. Trichinella sp. was detected by digestion of muscle in 1.2 % of examined foxes (2/172), but not in mustelids (0/11). Toxocara canis, responsible for human toxocarosis, resulted to be common in fox population (48.5 %). This parasite was found both in young (53.3 % of cubs and 61.9 % of sub-adults) and in adult animals (42.7 %). Other zoonotic parasites as Uncinaria stenocephala (52.3 %) and Trichuris vulpis (0.4 %) were detected in fox populations

Feasibility and outcomes of ERAS protocol in elective cT4 colorectal cancer patients: results from a single-center retrospective cohort study

Background Programs of Enhanced Recovery After Surgery reduces morbidity and shorten recovery in patients undergoing colorectal resections for cancer. Patients presenting with more advanced disease such as T4 cancers are frequently excluded from undergoing ERAS programs due to the difficulty in applying established protocols. The primary aim of this investigation was to evaluate the possibility of applying a validated ERAS protocol in patients undergoing colorectal resection for T4 colon and rectal cancer and to evaluate the short-term outcome. Methods Single-center, retrospective cohort study. All patients with a clinical diagnosis of stage T4 colorectal cancer undergoing surgery between November 2016 and January 2020 were treated following the institutional fast track protocol without exclusion. Short-term postoperative outcomes were compared to those of a control group treated with conventional care and that underwent surgical resection for T4 colorectal cancer at the same institution from January 2010 to October 2016. Data from both groups were collected retrospectively from a prospectively maintained database. Results Eighty-two patients were diagnosed with T4 cancer, 49 patients were included in the ERAS cohort and 33 in the historical conventional care cohort. Both, the mean time of tolerance to solid food diet and postoperative length of stay were significantly shorter in the ERAS group than in the control group (3.14 +/- 1.76 vs 4.8 +/- 1.52; p < 0.0001 and 6.93 +/- 3.76 vs 9.50 +/- 4.83; p = 0.0084 respectively). No differences in perioperative complications were observed. Conclusions Results from this cohort study from a single-center registry support the thesis that the adoption of the ERAS protocol is effective and applicable in patients with colorectal cancer clinically staged T4, reducing significantly their length of stay and time of tolerance to solid food diet, without affecting surgical postoperative outcomes

Prenatal and postnatal determinants in shaping offspring's microbiome in the first 1000 days: Study protocol and preliminary results at one month of life

Background: Fetal programming during in utero life defines the set point of physiological and metabolic responses that lead into adulthood; events happening in "the first 1,000 days" (from conception to 2-years of age), play a role in the development of non-communicable diseases (NCDs). The infant gut microbiome is a highly dynamic organ, which is sensitive to maternal and environmental factors and is one of the elements driving intergenerational NCDs' transmission. The A.MA.MI (Alimentazione MAmma e bambino nei primi MIlle giorni) project aims at investigating the correlation between several factors, from conception to the first year of life, and infant gut microbiome composition. We described the study design of the A.MA.MI study and presented some preliminary results. Methods: A.MA.MI is a longitudinal, prospective, observational study conducted on a group of mother-infant pairs (n = 60) attending the Neonatal Unit, Fondazione IRCCS Policlinico San Matteo, Pavia (Italy). The study was planned to provide data collected at T0, T1, T2 and T3, respectively before discharge, 1,6 and 12 months after birth. Maternal and infant anthropometric measurements were assessed at each time. Other variables evaluated were: Pre-pregnancy/gestational weight status (T0), maternal dietary habits/physical activity (T1-T3); infant medical history, type of feeding, antibiotics/probiotics/supplements use, environment exposures (e.g cigarette smoking, pets, environmental temperature) (T1-T3). Infant stool samples were planned to be collected at each time and analyzed using metagenomics 16S ribosomal RNA gene sequence-based methods. Results: Birth mode (cesarean section vs. vaginal delivery) and maternal pre pregnancy BMI (BMI < 25 Kg/m2 vs. BMI ≥ 25 Kg/m2), significant differences were found at genera and species levels (T0). Concerning type of feeding (breastfed vs. formula-fed), gut microbiota composition differed significantly at genus and species level (T1). Conclusion: These preliminary and explorative results confirmed that pre-pregnancy, mode of delivery and infant factors likely impact infant microbiota composition at different levels. Trial registration: ClinicalTrials.gov identifier: NCT04122612

Early Life Microbiota Colonization at Six Months of Age: A Transitional Time Point

Background: Early life gut microbiota is involved in several biological processes, particularly metabolism, immunity, and cognitive neurodevelopment. Perturbation in the infant's gut microbiota increases the risk for diseases in early and later life, highlighting the importance of understanding the connections between perinatal factors with early life microbial composition. The present research paper is aimed at exploring the prenatal and postnatal factors influencing the infant gut microbiota composition at six months of age. Methods: Gut microbiota of infants enrolled in the longitudinal, prospective, observational study "A.MA.MI" (Alimentazione MAmma e bambino nei primi MIlle giorni) was analyzed. We collected and analyzed 61 fecal samples at baseline (meconium, T0); at six months of age (T2), we collected and analyzed 53 fecal samples. Samples were grouped based on maternal and gestational weight factors, type of delivery, type of feeding, time of weaning, and presence/absence of older siblings. Alpha and beta diversities were evaluated to describe microbiota composition. Multivariate analyses were performed to understand the impact of the aforementioned factors on the infant's microbiota composition at six months of age. Results: Different clustering hypotheses have been tested to evaluate the impact of known metadata factors on the infant microbiota. Neither maternal body mass index nor gestational weight gain was able to determine significant differences in infant microbiota composition six months of age. Concerning the type of feeding, we observed a low alpha diversity in exclusive breastfed infants; conversely, non-exclusively breastfed infants reported an overgrowth of Ruminococcaceae and Flavonifractor. Furthermore, we did not find any statistically significant difference resulting from an early introduction of solid foods (before 4 months of age). Lastly, our sample showed a higher abundance of clostridial patterns in firstborn babies when compared to infants with older siblings in the family. Conclusion: Our findings showed that, at this stage of life, there is not a single factor able to affect in a distinct way the infants' gut microbiota development. Rather, there seems to be a complex multifactorial interaction between maternal and neonatal factors determining a unique microbial niche in the gastrointestinal tract

Management of low rectal cancer complicating ulcerative colitis: Proposal of a treatment algorithm

Low rectal Carcinoma arising at the background of Ulcerative Colitis poses significant management challenges to the clinicians. The complex decision-making requires discussion at the multidisciplinary team meeting. The published literature is scarce, and there are significant variations in the management of such patients. We reviewed treatment protocols and operative strategies; with the aim of providing a practical framework for the management of low rectal cancer complicating UC. A practical treatment algorithm is proposed

Dietary Supplementation of Nile Tilapia (Oreochromis niloticus) With Panax ginseng Essential Oil: Positive Impact on Animal Health and Productive Performance, and Mitigating Effects on Atrazine-Induced Toxicity

The present study assessed the impact of Panax ginseng essential oil (GEO) supplementation on physiological parameters related to productive performance and health status in Nile tilapia reared under standard conditions and exposed to a sub-lethal atrazine (ATZ) concentration. Fish were allocated into 6 groups: the control group was reared in clean water and fed with a commercial basal diet (CNT), two groups were fed with the basal diet supplemented with two different levels of GEO (GEO1 and GEO2, respectively), one group was intoxicated with 1/5 of ATZ 96-h lethal concentration 50 (1.39 mg/L) (ATZ group), and the remaining two groups were fed with the GEO-supplemented diets and concurrently exposed to 1.39 mg ATZ/L (GEO1+ATZ and GEO2+ATZ, respectively). The experiment lasted for 60 days. GEO supplementation exerted a significantly positive influence on fish growth, feed utilization, and hepatic antioxidant defense systems at both levels of supplementation. ATZ exposure significantly reduced fish survival rates and impaired fish growth and feed utilization, with the lowest final weights, weight gain, total feed intake, and the highest feed conversion ratio being recorded in the ATZ-intoxicated group. ATZ exposure caused significant changes in intestinal digestive enzyme activity (decreased lipase activity), hematological indices (decreased hemoglobin, packed cell volume, erythrocytes, and leukocytes), blood biochemical variables (decreased total proteins, albumin, globulins, and immunoglobulin M; increased total cholesterol, triglycerides, and cortisol), and hepatic oxidative/antioxidant indices (decreased glutathione level, superoxide dismutase and catalase enzyme activity and mRNA expression levels, and increased malondialdehyde content). Moreover, in the hepatic tissue of ATZ-intoxicated Nile tilapia, histopathological alterations and upregulated mRNA expression levels of stress- and apoptosis-related genes (Hsp70, caspase 3, and p53) were observed. GEO supplementation in ATZ-treated groups significantly attenuated the aforementioned negative effects, though some parameters did not reach the CNT values. These findings provide further and partly new evidence that sub-lethal ATZ toxicity induces reduced survivability, growth retardation, impaired digestive function, anemia, immunosuppression, hepatic oxidative stress damage, and overall increased stress level in Nile tilapia, and suggest that GEO supplementation may be useful for mitigating this toxicity and provide more general support to the productive performance and health status of this fish species