Exercise intolerance in chronic heart failure : mechanisms and therapies. Part I

Muscular fatigue and dyspnoea on exertion are among the most common symptoms in chronic heart failure; however their origin is still poorly understood. Several studies have shown that cardiac dysfunction alone cannot fully explain their origin, but the contribution of the multiorgan failure present in this syndrome must be highlighted. In this study, divided in two parts (see part II: pp. 643-648), we aimed to summarize the existing evidence and the most controversial aspects of the complex interplay of different factors involved in symptom generation. In this first part of the review, six key factors are revised: the heart, the lung, the skeletal muscle, the hormonal changes, the O-2 delivery to the periphery, the endothelium. In the second part, the role of the excitatory reflexes and the cardiac cachexia will be presented, and finally, the potential therapeutic implications are discussed. We believe that a better knowledge of the pathophysiology of this syndrome may contribute to the management of the patients and to the improvement in their stress tolerance and quality of life. Eur J Cardiovasc Prev Rehabil 17:637-642 (C) 2010 The European Society of Cardiolog

T Regulatory Cells Are Markers of Disease Activity in Multiple Sclerosis Patients

FoxP3+ Treg cells are believed to play a role in the occurrence of autoimmunity and in the determination of clinical recurrences. Contradictory reports are, however, available describing frequency and function of Treg cells during autoimmune diseases. We examined, by both polychromatic flow cytometry, and real-time RT-PCR, several Treg markers in peripheral blood mononuclear cells from patients with multiple sclerosis (MS), an autoimmune disease affecting the central nervous system. We found that Tregs, as defined by CD25, CD39, FoxP3, CTLA4, and GITR expression, were significantly decreased in stable MS patients as compared to healthy donors, but, surprisingly, restored to normal levels during an acute clinical attack. We conclude that Treg cells are not involved in causing clinical relapses, but rather react to inflammation in the attempt to restore homeostasis

Sequele psicosessuali delle neoplasie ginecologiche. Revisione della letteratura

Questo lavoro intende valutare l\u2019impatto del cancro ginecologico sulla qualit\ue0 della vita delle pazienti e pi\uf9 in generale della coppia, analizzando, attraverso un\u2019analisi critica della letteratura pi\uf9 recente, le conseguenze sul piano psicologico e su quello del funzionamento sessuale. Avendo come obiettivo il miglioramento dello stato di salute della donna, e non pi\uf9 meramente la sua guarigione \u2013 l\ue0 dove possibile - da uno stato di malattia, siamo interessati a tutto ci\uf2 che pu\uf2 contribuire a innalzare il livello di benessere della donna, attraverso una adeguata prevenzione delle possibili sequele negative

Assessing of arsenic controlling factors in the alluvial aquifer nearby Venice lagoon (NE, Italy)

Excess of arsenic in groundwater is a worldwide problem threatening the health of the millions of people directly exposed to As-rich water intake. The problem is particularly acute in naturally occurring unconsolidated aquifers where As-rich groundwater is an easily accessible resource of drinking water, such as in India, Bangladesh and Vietnam. Naturally occurring high concentrations of As in groundwater also notoriously mark the Venetian Alluvial Plain (VAP) in Italy, affecting in particular the shallower aquifers. The VAP is characterized by a patchy As distribution with variable extensions and concentrations. Although empirical evidences exist about the relationship between As occurrence and other factors, several aspects regarding the physical and geochemical processes controlling As in the VAP aquifers remain unclear. This study aims to elucidate the geochemical conditions that control As mobilization in the VAP, in order to improve the knowledge about As-controlling processes in the study area and use them as a proxy to evaluate occurrence of As in other world regions characterized by a similar hydrogeological and geochemical settings, such as the Bengal Delta Plain. To this end, we focused in detail on an agricultural zone nearby the Venice lagoon, affected by As contamination (called “Aree Agricole West”, AAW). The available data, collected by several hydrogeological surveys, show a spatial and temporal variability of As concentration, which can be associated to a variety of hydro-geochemical processes such as redox variations, sorption or reductive dissolution of As-rich iron oxy-hydroxides. In order to point out the consistency and the importance of these processes, we combined an advance exploration analysis with a PHREEQC 0D reactive model. The former part, performed by mean of Self-Organized Maps (SOM) algorithm, allows for identification of the main geochemical relationships within the study aquifer and the associated geochemical processes. The latter, instead, allows us for testing whether the supposed processes are able to fit the geochemical conditions of the study system. The results highlighted a strong effect of oxy-reductive potential on arsenic mobility, and it seems to be strictly correlated to organic matter degradation. The uprising of reduced condition, then, affects other mechanism such as reductive dissolution of iron hydroxides, ion exchange and sorption processes, causing arsenic mobilization. Moreover, this study shaded light on the existence of oxygen ingress as function of local water recharge events, which seems to be responsible of space/time redox variation. Thanks to the 0D model, it was possible to explain, in a semi-quantitative way, the effect of the oxygen ingress on the redox aquifer condition, and so to explain the arsenic variation. This study has to be intended as a first step toward a more detailed study, which will account for a 2D/3D reactive transport model aiming at elucidating arsenic mobility, including influence of recharge due to agricultural activities