Cardiovascular Disease Risk Factors, Depression Symptoms and Antidepressant Medicine Use in the Look AHEAD (Action for Health in Diabetes) Clinical Trial of Weight Loss in Diabetes

Aims/hypothesis - To determine the associations of baseline depression symptoms and use of antidepressant medicines (ADMs) with baseline cardiovascular disease (CVD) risk factors in Look AHEAD (Action for Health in Diabetes) trial participants. Methods - Look AHEAD participants (n = 5,145; age 58.7 ± 6.8 years; BMI 35.8 ± 5.8 kg/m2) were assessed for CVD risk factors (elevated HbA1c or insulin use, elevated BP or antihypertensive use, elevated lipid levels or lipid-lowering medication, current smoking, BMI ≥30 kg/m2, lower peak exercise capacity assessed as metabolic equivalents [METs], and ankle–brachial index \u3c0.9 or \u3e1.3). Participants also completed the Beck Depression Inventory (BDI) and reported their use of ADMs. Results - Of the participants, 14.7% had BDI scores ≥11, consistent with mild-moderate depression, and 16.5% took ADMs; 4.4% had both depression markers (i.e. elevated symptom scores and took ADMs). In logistic regression analyses of CVD risk (elevated risk factor or use of medication to control the risk factor), controlled for demographic factors, continuous BDI scores and ADM use were each independently associated with elevated BP (or medication), current smoking, BMI ≥30 kg/m2 and lower MET values. ADM use was also associated with elevated serum lipids or use of lipid-lowering medication. Conclusions/interpretation - Among Look AHEAD participants, depression symptoms or ADM use on entry to the study were each independently associated with a wide range of CVD risk factors. Future research should assess the temporal dynamics of the relationships of depression symptoms and ADM use with CVD risk factors

Legionella spp. contamination in indoor air: preliminary results of an Italian multicenter study.[La contaminazione indoor da Legionella spp: risultati preliminari di una indagine multicentrica italiana]

To propose a standardized protocol for the evaluation of Legionella contamination in air

INDAGINE MULTICENTRICA SULLA PRESENZA DI LEGIONELLA SPP NELL’ARIA DI STRUTTURE SANITARIE: METODI DI CAMPIONAMENTO A CONFRONTO

INTRODUZIONE La letteratura in materia di controllo e prevenzione della legionellosi indica le modalità di campionamento delle matrici ambientali, ma non dell'aria. Scopo dello studio è confrontare diversi metodi di campionamento dell’aria per la ricerca di Legionella, verso la standardizzazione di specifici protocolli. METODI Sono stati selezionati 11 ospedali con una contaminazione idrica da Legionella >1.000 ufc/L. La contaminazione dell’aria è stata valutata per un periodo di 8h mediante campionamento attivo su substrato solido (Surface Air System, SAS) e liquido (Coriolis) e passivo (piastre di sedimentazione). Complessivamente, 1000 L/h di aria (200 L ogni 12’ durante 2’ di flussaggio idrico) sono stati aspirati con SAS e Coriolis; le piastre di sedimentazione sono state esposte per 1h. In parallelo, l'acqua è stata campionata 3 volte [T0, dopo 4h; dopo 8h]. Il liquido di raccolta del Coriolis è stato sottoposto a indagine colturale e molecolare. I ceppi isolati da acqua e aria, dopo tipizzazione con sieri monovalenti, sono stati sottoposti a Sequence Based Type (SBT).RISULTATI L.pneumophila (Lpn) è stata rilevata nell’aria e nell’acqua di 4 strutture: in 1 con SAS (Lpn sg 1), in 1 con piastre di sedimentazione (Lpn sg 3), in 2 sia con SAS (Lpn sg 1 e sg 10, rispettivamente) sia con piastre di sedimentazione (Lpn sg 1+7 e Lpn sg 10, rispettivamente). Il Coriolis ha dato esiti positivi in 8 strutture solo con indagini molecolari. Il metodo SBT ha confermato un’omologia tra Lpn isolata da acqua e aria in 3 strutture: ST1+ ST1919 nella 1^ e ST93 nella 2^. Nella 3^ struttura è stato isolato un nuovo ceppo (ST293), nella 4^ il profilo allelico di Lpn rilevato nell’aria (ST269) è risultato diverso da quello nell’acqua (ST657). CONCLUSIONI Dai risultati ottenuti con l’impiego di diversi metodi di campionamento emerge che la ricerca di Legionella nell’aria non può sostituire la ricerca nell’acqua e che lo studio molecolare potrebbe fornire un utile supporto

Intratumoral heterogeneity and clonal evolution in liver cancer

Clonal evolution of a tumor ecosystem depends on different selection pressures that are principally immune and treatment mediated. We integrate RNA-seq, DNA sequencing, TCRseq and SNP array data across multiple regions of liver cancer specimens to map spatio-temporal interactions between cancer and immune cells. We investigate how these interactions reflect intra-tumor heterogeneity (ITH) by correlating regional neo-epitope and viral antigen burden with the regional adaptive immune response. Regional expression of passenger mutations dominantly recruits adaptive responses as opposed to hepatitis B virus and cancer-testis antigens. We detect different clonal expansion of the adaptive immune system in distant regions of the same tumor. An ITH-based gene signature improves singlebiopsy patient survival predictions and an expression survey of 38,553 single cells across 7 regions of 2 patients further reveals heterogeneity in liver cancer. These data quantify transcriptomic ITH and how the different components of the HCC ecosystem interact during cancer evolutio

Intratumoral heterogeneity and clonal evolution in liver cancer

Clonal evolution of a tumor ecosystem depends on different selection pressures that are principally immune and treatment mediated. We integrate RNA-seq, DNA sequencing, TCRseq and SNP array data across multiple regions of liver cancer specimens to map spatio-temporal interactions between cancer and immune cells. We investigate how these interactions reflect intra-tumor heterogeneity (ITH) by correlating regional neo-epitope and viral antigen burden with the regional adaptive immune response. Regional expression of passenger mutations dominantly recruits adaptive responses as opposed to hepatitis B virus and cancer-testis antigens. We detect different clonal expansion of the adaptive immune system in distant regions of the same tumor. An ITH-based gene signature improves singlebiopsy patient survival predictions and an expression survey of 38,553 single cells across 7 regions of 2 patients further reveals heterogeneity in liver cancer. These data quantify transcriptomic ITH and how the different components of the HCC ecosystem interact during cancer evolutio