Effectiveness of Preventive Measures in Keeping Low Prevalence of SARS-CoV-2 Infection in Health Care Workers in a Referral Children’s Hospital in Southern Italy

The coronavirus disease 2019 (COVID-19) pandemic now represents a major threat to public health. Health care workers (HCW) are exposed to biological risk. Little is currently known about the risk of HCW operating in pediatric wards for SARS-CoV-2 infection. The aim is to assess the prevalence of SARS-CoV-2 infection in HCW in a third-level children’s hospital in Southern Italy. An observational cohort study of all asymptomatic HCW (physician, technicians, nurses, and logistic and support operators) was conducted. HCW were screened, on a voluntary basis, for SARS-CoV-2 by RT-PCR on nasopharyngeal swab performed during the first wave of COVID-19. The study was then repeated, with the same modalities, at a 7-month interval, during the “second wave” of the COVID-19 pandemic. At the initial screening between 7 and 24 April 2020, 525 HCW were tested. None of them tested positive. At the repeated screening, conducted between 9 and 20 November 2020, 627 HCW were tested, including 61 additional ones resulting from COVID-emergency recruitment. At this second screening, eight subjects (1.3%) tested positive, thus being diagnosed as asymptomatic carriers of SARS-CoV-2. They were one physician, five nurses, and two HCW from the logistic/support services. They were employed in eight different wards/services. In all cases, the epidemiological investigation showed convincing evidence that the infection was acquired through social contacts. The study revealed a very low circulation of SARS-CoV-2 infection in HCW tested with RT-PCR. All the infections documented in the second wave of epidemic of SARS-CoV-2 were acquired outside of the workplace, confirming that in a pediatric hospital setting, HCW education, correct use of personal protective equipment, and separation of the COVID-patient pathway and staff flow may minimize the risk derived from occupational exposure

Bioinspiring Chondrosia reniformis (Nardo, 1847) collagen-based hydrogel: a new extraction method to obtain a sticky and self-healing collagenous material

Collagen is a natural and abundant polymer that serves multiple functions in both invertebrates and vertebrates. As collagen is the natural scaffolding for cells, collagen-based hydrogels are regarded as ideal materials for tissue engineering applications since they can mimic the natural cellular microenvironment. Chondrosia reniformis is a marine demosponge particularly rich in collagen, characterized by the presence of labile interfibrillar crosslinks similarly to those described in the mutable collagenous tissues (MCTs) of echinoderms. As a result single fibrils can be isolated using calcium-chelating and disulphide-reducing chemicals. In the present work we firstly describe a new extraction method that directly produces a highly hydrated hydrogel with interesting self-healing properties. The materials obtained were then biochemically and rheologically characterized. Our investigation has shown that the developed extraction procedure is able to extract collagen as well as other proteins and Glycosaminoglycans (GAG)-like molecules that give the collagenous hydrogel interesting and new rheological properties when compared to other described collagenous materials. The present work motivates further in-depth investigations towards the development of a new class of injectable collagenous hydrogels with tailored specifications.The authors gratefully acknowledge the financial support from the European Union Seventh Framework Programme (FP7/2007–2013) under grant agreement ERC-2012-ADG 20120216-321266 (ERC Advanced Grant project ComplexiTE), as well as from the European Regional Development Fund (ERDF) under the projects “Accelerating tissue engineering and personalized medicine discoveries by the integration of key enabling nanotechonologies, marine-derived biomaterials and stem cells” (NORTE-01-0145-FEDER-000021), supported by Norte Portugal Regional Operational Program (NORTE 2020), under the PORTUGAL 2020 Partnership Agreement, and 0687_NOVOMAR_1_P, co-financed by transborder cooperation programme POCTEP. The authors are also thankful to the Area Marina Protetta Portofino (Italy) for permission to collect sponge specimens and to Daniela Candia (University of Milan, Italy) and Marco Giovine (University of Genoa, Italy) for the logistical support on the sponge sampling and immediate processing. We are grateful to the two anonymous referees for improving the quality of the present article.info:eu-repo/semantics/publishedVersio

Substance use in the club scene of Rome : a pilot study

Date of Acceptance: 28/08/2014 Copyright © 2014 Alessandro Emiliano Vento et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly citedOver the last few years, a wide number of unregulated substances have been marketed on the Web and in smart and head shops; they are usually advertised as legal alternatives to commonly known drugs and are defined as “smart drugs,” “legal highs,” and “novel psychoactive substances” (NPS). Aim of our work is to describe use habits and distribution of NPS in a population of young adults in Rome club scene. Methods. A self-administered questionnaire was proposed to subjects over 18 years of age at the entrance of 5 nightclubs in Rome. Socioeconomic characteristics and substance use were investigated. Results. Preliminary results give evidence that 78% of respondents have a lifetime history of NPS use. In addition, 56% of the sample has consumed illicit drugs in the past and 39% has used psychoactive substances in the 12 hours preceding the questionnaire administration. Conclusions. A significant proportion of subjects report use of novel psychoactive substances; traditional illicit drugs consumption, particularly cocaine, appears to be very high as well in the club scene. These data highlight a serious public health challenge, since pharmacological, toxicological, and psychopathological effects linked to interactions among all these substances may be unpredictable and sometimes fatal in vulnerable individualsPeer reviewedFinal Published versio

Altered expression of mitochondrial and extracellular matrix genes in the heart of human fetuses with chromosome 21 trisomy

<p>Abstract</p> <p>Background</p> <p>The Down syndrome phenotype has been attributed to overexpression of chromosome 21 (Hsa21) genes. However, the expression profile of Hsa21 genes in trisomic human subjects as well as their effects on genes located on different chromosomes are largely unknown. Using oligonucleotide microarrays we compared the gene expression profiles of hearts of human fetuses with and without Hsa21 trisomy.</p> <p>Results</p> <p>Approximately half of the 15,000 genes examined (87 of the 168 genes on Hsa21) were expressed in the heart at 18–22 weeks of gestation. Hsa21 gene expression was globally upregulated 1.5 fold in trisomic samples. However, not all genes were equally dysregulated and 25 genes were not upregulated at all. Genes located on other chromosomes were also significantly dysregulated. Functional class scoring and gene set enrichment analyses of 473 genes, differentially expressed between trisomic and non-trisomic hearts, revealed downregulation of genes encoding mitochondrial enzymes and upregulation of genes encoding extracellular matrix proteins. There were no significant differences between trisomic fetuses with and without heart defects.</p> <p>Conclusion</p> <p>We conclude that dosage-dependent upregulation of Hsa21 genes causes dysregulation of the genes responsible for mitochondrial function and for the extracellular matrix organization in the fetal heart of trisomic subjects. These alterations might be harbingers of the heart defects associated with Hsa21 trisomy, which could be based on elusive mechanisms involving genetic variability, environmental factors and/or stochastic events.</p

Male Decapacitation Factor SPINK3 Blocks Membrane Hyperpolarization and Calcium Entry in Mouse Sperm

Mammalian sperm acquire ability to fertilize through a process called capacitation, occurring after ejaculation and regulated by both female molecules and male decapacitation factors. Bicarbonate and calcium present in the female reproductive tract trigger capacitation in sperm, leading to acrosomal responsiveness and hyperactivated motility. Male decapacitating factors present in the semen avert premature capacitation, until detached from the sperm surface. However, their mechanism of action remains elusive. Here we describe for the first time the molecular basis for the decapacitating action of the seminal protein SPINK3 in mouse sperm. When present in the capacitating medium, SPINK3 inhibited Src kinase, a modulator of the potassium channel responsible for plasma membrane hyperpolarization. Lack of hyperpolarization affected calcium channels activity, impairing the acquisition of acrosomal responsiveness and blocking hyperactivation. Interestingly, SPINK3 acted only on non-capacitated sperm, as it did not bind to capacitated cells. Binding selectivity allows its decapacitating action only in non-capacitated sperm, without affecting capacitated cells.Fil: Zalazar, Lucia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata. Instituto de Investigaciones Biológicas. Universidad Nacional de Mar del Plata. Facultad de Ciencias Exactas y Naturales. Instituto de Investigaciones Biológicas; ArgentinaFil: Stival, Cintia Estefanía. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario. Instituto de Biología Molecular y Celular de Rosario. Universidad Nacional de Rosario. Facultad de Ciencias Bioquímicas y Farmacéuticas. Instituto de Biología Molecular y Celular de Rosario; ArgentinaFil: Nicolli, Anabella Rita. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario. Instituto de Biología Molecular y Celular de Rosario. Universidad Nacional de Rosario. Facultad de Ciencias Bioquímicas y Farmacéuticas. Instituto de Biología Molecular y Celular de Rosario; ArgentinaFil: de Blas, Gerardo Andrés. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto de Histología y Embriología de Mendoza Dr. Mario H. Burgos. Universidad Nacional de Cuyo. Facultad de Ciencias Médicas. Instituto de Histología y Embriología de Mendoza Dr. Mario H. Burgos; ArgentinaFil: Krapf, Dario. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario. Instituto de Biología Molecular y Celular de Rosario. Universidad Nacional de Rosario. Facultad de Ciencias Bioquímicas y Farmacéuticas. Instituto de Biología Molecular y Celular de Rosario; ArgentinaFil: Cesari, Andreina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata. Instituto de Investigaciones Biológicas. Universidad Nacional de Mar del Plata. Facultad de Ciencias Exactas y Naturales. Instituto de Investigaciones Biológicas; Argentina. Universidad Nacional de Mar del Plata. Escuela Superior de Medicina.; Argentin

Rehabilitation approach in robot assisted total knee arthroplasty: an observational study

Background The purpose of this study is to evaluate the impact of total knee arthroplasty (TKA) with the aid of Navio Robot, comparing it with standard prosthetic surgery on the functional outcomes of patients after an intensive rehabilitation program. Method A case–control observational study was conducted on patients undergoing TKA for severe KOA. All patients underwent the same intensive hospital rehabilitation program of 14 daily sessions lasting 3 h. The following rating scales were administered: Numeric Rating Scale (NRS), Knee Society Score (KSS) and 12-Item Short Form Survey scale. Patient assessments were performed 1 week post-surgery (T0), 1 month post-surgery (T2), and 3 months post-surgery (T3). The primary outcomes were active knee extension and fexion and pain severity. The secondary outcomes were functional capacity and quality of life. Results Using repeated measures ANOVA, we observed at T1 a statistically diferent diference for the treatment group compared to the control group about KSS (p&lt;0.05), pain (p&lt;0.05), and knee fexion (p&lt;0.05). No statistically signifcant diference between the two groups was observed for knee extension (p=0.09) and the SF-12 scale (p=0.52). At T2 instead, we observed a statistically signifcant diference for the treatment group compared to the control group as regards KSS (p&lt;0.05) and knee fexion (p&lt;0.05), while no statistically signifcant diference was observed for pain (p=0.83), knee extension (p=0.60), and the SF-12 scale (0.44). Conclusions Our study has demonstrated that robot-NAVIO assisted knee prosthesis surgery, associated with a specifc intensive rehabilitation treatment, in the short and medium term, determines good pain control, better fexion recovery and a improvement of functional capacity

Hyperhomocysteinemia and C677T MTHFR genotype in patients with retinal vein thrombosis.

Introduction: Elevated homocysteine (Hcy) is associated with the risk of deep vein thrombosis, pulmonary embolism, ischemic heart disease, and stroke. Several studies have suggested that hyperhomocysteinemia (HHcy) may predispose to retinal vein thrombosis (RVT) development. The aim of this study is to investigate the relationship between Hcy, C677T methylenetetrahydrofolate reductase (MTHFR) genotype, and RVT in patients compared with controls. Materials and Methods: We evaluated the Hcy plasma level of 3114 consecutive participants in 2 Italian centers during a 2-year period. Hyperhomocysteinemia was found in 99 patients and 136 healthy participants. Of the 99 patients, 20 had RVT with a high prevalence of HHcy in the RVT subgroup (20.2%). This result suggested a possible relationship between HHcy and RVT development. We investigated 105 consecutive patients with recent diagnosis of RVT, and we compared them with 226 healthy controls to evaluate whether HHcy may be a risk factor for RVT. Results: the prevalence of HHcy was higher in patients compared with controls (34.3% vs 14.2%; P < .001). The MTHFR C677T genotype was found in 69 of 105 (65.7%) patients with RVT (heterozygosity: 40 of 105 and homozygosity: 29 of 105). The control group showed the presence of MTHFR C677T genotype in 169 of 226 participants (74.8%; heterozygosity: 100 of 226 and homozygosity: 69 of 226) without difference between the 2 groups (P = .08). Conclusion: our study suggests that HHcy is a possible risk factor for RVT development, while no association was found between RVT and the C677T MTHFR genotype

Aerodynamic Properties and Drug Solubility of Dry Powders Prepared by Spray Drying: Clarithromycin Versus its Hydrochloride Salt

Aerodynamic Properties and Drug Solubility of Dry Powders Prepared by Spray Drying: Clarithromycin Versus its Hydrochloride Salt. Russo P, Manniello M.D., Simonetti A., Petrone A.M., Porta A., Del Gaudio P., Aquino R.P. Department of Pharmacy (DIFARMA), University of Salerno, Fisciano (SA) – Italy; ([email protected]). Introduction and Objectives. The antibiotic therapy for a direct administration to the lung in cystic fibrosis patients has to provide suitable drug availability, possibly in the lower respiratory tract characterized by the presence of thick secretions. Apart from deposition, systemic or local pharmacological activity of an inhalation product depends on drug dissolution into the biological fluids lining the lung. Therefore, one of the crucial step in the therapeutic management of the respiratory disease is the drug solubilization in this site of action. Clarithromycin (CLA; fig.1) is a broad spectrum and a well know macrolide antibiotic usually prescribed particularly for the treatment of respiratory infections, interestingly showing an additional anti-inflammatory effect (Pukhalsky et al., 2004); CLA is characterized by a very poor water solubility (0.33 mg/L). One of the common strategy, for increasing drug solubility in aqueous medium is represented by the production of dry powders in amorphous form using the spray drying technique (Yonemochi et al., 1999). Moreover, CLA has a dimethylamino group, which can be salified for solubility/dissolution improvement (fig.1). Hence, the aim of the present study was to obtain respirable powders of clarithromycin, while improving drug aqueous solubility. Powders were produced with CLA or CLA hydrochloride and characterized in terms of drug content, aerodynamic properties and drug solubility. Finally, in order to assess the effect of the spray-drying process on the antibiotic activity of the engineered particles, microbiological tests were performed. Materials and Methods. Several batches of micronized particles were prepared by spray drying different feed solutions; critical process parameters were solvent composition (isopropyl alcohol/water ratio), drug concentration and pH of the liquid feeds (table 1). Saturated solubility measurements were carried out keeping an excess amount of CLA raw material (RM), CLA spray-dried suspension and hydrochloride spray-dried in phosphate buffer (0.05 M, pH 6.75) at 37°C for 72h. After filtration, the solubility was measured by HPLC method and expressed in mg/ml. The results were reported as mean of three measurements and standard deviation. Particle size distribution of Raw Material and engineered particles was determined using a light-scattering laser granulometer, while particle morphology was assessed by scanning electron microscopy (SEM). The in vitro deposition of the micronized powders was evaluate by means of a Single-Stage Glass Impinger (SSGI; apparatus A; European Pharmacopoeia 8.0), using a proper device for the aerosolization. The antibacterial assay was carried out in MHB by microdilution method using 96-well microtiter plates. Briefly, 200 µl of 1X107 CFU/ml of P. aeruginosa ATCC 27853 were incubated at 37°C with different concentration of drug (4, 6 and 8 µg/ml). Results and Discussion. Morphology and aerodynamic properties of spray-dried particles were strongly dependent on organic solvent concentration as well as on pH of the liquid feeds processed, both influencing drug solubility. Adding clarithromycin to hydroalcoholic mixtures, alkaline feeds (pH~10.5; #1, #2, tab.1) in form of suspensions were obtained.   The resulting spray-dried powders showed good process yield, but unsatisfactory aerodynamic properties, due to a high particle size (tab. 1) and the presence of residual drug crystals mixed to spherical particles (fig.2; #2). With the aim to obtain clear feeds in form of solutions, we tested clarithromycin in its hydrochloride salt form, obtained lowering pH values of feed solutions (pH 6.5). Micronized salified powders showed higher process yield and very interesting FPF values, thanks to smaller and wrinkled particles (fig.2 #4, #6; tab.1). Moreover, water solubility of spray-dried powders was strongly influenced by clarithromycin form. Powders obtained from alkaline feed suspensions showed lower solubility in a phosphate buffer 0.05 M, pH 6.75 (fig.3, # 1). A substantial increase in drug solubility was obtained, at the same conditions, with powders dried from feed solution containing clarithromycin hydrochloride (fig.3 #9-#5). To verify the ability of the produced formulations to was performed. Three different drug concentrations were tested in a multi-well plate. Clarithromycin raw material (RM, line C, figure 4) and #1 (line D, figure 4) showed a lower activity against P. aeruginosa growth compared to #4, #5, #6, containing the hydrochloride form. This different behavior against P. aeruginosa may be due to the lower CLA solubility; at higher concentration, clarithromycin precipitates in RM and #1 wells, becoming unavailable for antibiotic purpose. Conclusions. Clarithromycin inhalable powders containing the drug in its hydrochloride form showed good aerodynamic properties and higher water solubility. Thanks to a fine-tuning of the process parameters and liquid feed composition, no excipients were necessary to obtain respirable powders. The spray drying process of CLA hydrochloride not only preserved antimicrobial activity, but also, increasing drug solubility, improved drug efficacy against P. aeruginosa. References. Pukhalsky, A. L., Shmarina, G. V., Kapranov, N. I., Kokarovtseva, S. N., Pukhalskaya, D., & Kashirskaja, N. J. (2004). Anti-inflammatory and immunomodulating effects of clarithromycin in patients with cystic fibrosis lung disease. Mediators Inflamm, 13(2), 111-117. doi: 10.1080/09629350410001688495 Yonemochi, E., Kitahara, S., Maeda, S., Yamamura, S., Oguchi, T., & Yamamoto, K. (1999). Physicochemical properties of amorphous clarithromycin obtained by grinding and spray drying. Eur J Pharm Sci, 7(4), 331-338

Metal-Enhanced Near-Infrared Fluorescence by Micropatterned Gold Nanocages

In metal-enhanced fluorescence (MEF), the localized surface plasmon resonances of metallic nanostructures amplify the absorption of excitation light and assist in radiating the consequent fluorescence of nearby molecules to the far-field. This effect is at the base of various technologies that have strong impact on fields such as optics, medical diagnostics and biotechnology. Among possible emission bands, those in the near-infrared (NIR) are particularly intriguing and widely used in proteomics and genomics due to its noninvasive character for biomolecules, living cells, and tissues, which greatly motivates the development of effective, and eventually multifunctional NIR-MEF platforms. Here we demonstrate NIR-MEF substrates based on Au nanocages micropatterned with a tight spatial control. The dependence of the fluorescence enhancement on the distance between the nanocage and the radiating dipoles is investigated experimentally and modeled by taking into account the local electric field enhancement and the modified radiation and absorption rates of the emitting molecules. At a distance around 80 nm, a maximum enhancement up to 2-7 times with respect to the emission from pristine dyes (in the region 660 nm-740 nm) is estimated for films and electrospun nanofibers. Due to their chemical stability, finely tunable plasmon resonances, and large light absorption cross sections, Au nanocages are ideal NIR-MEF agents. When these properties are integrated with the hollow interior and controllable surface porosity, it is feasible to develop a nanoscale system for targeted drug delivery with the diagnostic information encoded in the fluorophore.Comment: 41 pages, 18 figure