Evaluation of cardiovascular risk in adults with type 1 diabetes: Poor concordance between the 2019 ESC risk classification and 10-year cardiovascular risk prediction according to the Steno Type 1 Risk Engine

Background: Patients with type 1 diabetes (T1D) have higher mortality risk compared to the general population; this is largely due to increased rates of cardiovascular disease (CVD). As accurate CVD risk stratification is essential for an appropriate preventive strategy, we aimed to evaluate the concordance between 2019 European Society of Cardiology (ESC) CVD risk classification and the 10-year CVD risk prediction according to the Steno Type 1 Risk Engine (ST1RE) in adults with T1D. Methods: A cohort of 575 adults with T1D (272F/303M, mean age 36 ± 12 years) were studied. Patients were stratified in different CVD risk categories according to ESC criteria and the 10-year CVD risk prediction was estimated with ST1RE within each category. Results: Men had higher BMI, WC, SBP than women, while no difference was found in HbA1c levels between genders. According to the ESC classification, 92.5% of patients aged 20 years) alone identified few patients (< 30%) among those aged ≥35 years, who were at very high risk according to ESC, in whom this condition was confirmed by ST1RE; conversely, the coexistence of two or more of these criteria identified about half of the patients at high/very high risk also according to this predicting algorithm. When only patients aged ≥ 50 years were considered, there was greater concordance between ESC classification and ST1RE prediction, since as many as 78% of those at high/very high risk according to ESC were confirmed as such also by ST1RE. Conclusions: Using ESC criteria, a large proportion (45%) of T1D patients without CVD are classified at very high CVD risk; however, among them, none of those < 35 years and only 12% of those ≥ 35 years could be confirmed at very high CVD risk by the ST1RE predicting algorithm. More studies are needed to characterize the clinical and metabolic features of T1D patients that identify those at very high CVD risk, in whom a very aggressive cardioprotective treatment would be justified

Survey of Dermatophytes in Stray Cats with and without Skin Lesions in Northern Italy

The aim of this study was to determine the prevalence of dermatophytes in stray cats with and without clinical lesions from different colonies in rural and urban areas of Milan and surroundings in northern Italy. Stray cats (273) were caught during a trap-neuter-release (TNR) program conducted in different colonies of northern Italy in both rural and urban areas. Each cat was examined in dark environment with a Wood's lamp prior to sample collection. Hair or scales exhibiting typical fluorescence were removed with a pair of sterile hemostats and cultured. The hair of all cats was then sampled by Mackenzie modified brush technique regardless of the presence or absence of skin lesions attributable to dermatophytosis. All the hair samples were subjected to fungal culture. 15 cats were positive (5.5%). Microsporum canis was the most common dermatophyte isolated (13/15). The only other isolated dermatophyte was Trichophyton mentagrophytes (2/15). Our estimated prevalence of dermatophytes in stray cats was much lower than other Italian studies on the same population

An oily fish diet improves subclinical inflammation in people at high cardiovascular risk: A randomized controlled study

Interest has arisen on the anti-inflammatory action of dietary components, including long-chain n-3 fatty acids (LCn3) and polyphenols (PP). The aim of this study was to evaluate the effects of diets rich in PP and oily fish (high-LCn3 diets) on markers of subclinical inflammation and growth factors in people at high cardiometabolic risk. Individuals with high waist circumference and one more component of metabolic syndrome were randomized to one of the following isoenergetic diets: Low LCn3&amp;PP, high LCn3, high PP, high LCn3&amp;PP. Before and after 8 weeks, fasting and postprandial plasma concentrations of hs-CRP and fasting serum concentrations of IL-1, IL-4, IL-6, IL-10, IL-17, INF-, TNF-, FGF, VEGF, PDGF-, G-CSF, and GM-CSF were determined. An oily fish diet reduced fasting plasma hs-CRP (1.28 ± 12.0, −12.5 ± 6.9, 22.5 ± 33.6, −12.2 ± 11.9; 8-week percent change, Mean ± SEM; low LCn3&amp;PP, high LCn3, high PP, high LCn3&amp;PP group, respectively), postprandial 6h-AUC hs-CRP (4.6 ± 16.3, −18.2 ± 7.2, 26.9 ± 35.1, −11.5 ± 11.8, 8-week percent change) and fasting IL-6 (20.8 ± 18.7, −2.44 ± 12.4, 28.1 ± 17.4, −9.6 ± 10.2), IL-17 (2.40 ± 4.9, −13.3 ± 4.9, 3.8 ± 4.43, −11.5 ± 4.7), and VEGF (−5.7 ± 5.8, −5.6 ± 7.5, 3.5 ± 5.8, −11.1 ± 5.5) (8-week percent change; p &lt; 0.05 for LCn3 effect for all; no significant effect for PP; 2-factor ANOVA). An oily fish diet improved subclinical inflammation, while no significant effect was observed for dietary polyphenols

Serological and molecular evaluation of Leishmania infantum infection in stray cats in a nonendemic area in Northern Italy

Infection by Leishmania species is increasing worldwide. It was hypothesized recently that cats act as a secondary reservoir for Leishmania infection. The aim of the present study was to assess the prevalence of Leishmania infantum antibodies and DNA in blood samples collected in a sample of stray cats in metropolitan area of Milan in northern Italy, which is a nonendemic area for leishmaniasis. An indirect immunofluorescence antibody test for L. infantum showed that 59 of 233 cats (25.3%) were seroreactive, 38 samples (16.3%) had antibody titers of 1 : 40, 15 (6.4%) had antibody titers of 1 : 80, and 6 (2.6%) had antibody titers of 1 : 160. Feline immunodeficiency virus (FIV) seropositive status was statistically associated with seroreactivity to L. infantum (P = 0.01) as shown by univariate and multivariate logistic regression (P = 0.0098; OR = 7.34). All blood samples that were tested using real-time PCR were negative for parasite DNA. These results were surprising, since no autochthonous human or canine cases of leishmaniasis have ever been reported in this region of northern Italy. It is possible that this high seroreactivity to L. infantum could be due to cross-reaction with antigens from other parasites. Additional studies that include parasite isolation are needed to clarify our findings on feline leishmaniasis in this region

Use of complementary and alternative medicine (CAM) in cancer patients. An italian multicenter survey

INTRODUCTION: Complementary and Alternative Medicine (CAM) include a wide range of products (herbs, vitamins, minerals, and probiotics) and medical practices, developed outside of the mainstream Western medicine. Patients with cancer are more likely to resort to CAM first or then in their disease history; the potential side effects as well as the costs of such practices are largely underestimated. PATIENTS AND METHOD: We conducted a descriptive survey in five Italian hospitals involving 468 patients with different malignancies. The survey consisted of a forty-two question questionnaire, patients were eligible if they were Italian-speaking and receiving an anticancer treatment at the time of the survey or had received an anticancer treatment no more than three years before participating in the survey. RESULTS: Of our patients, 48.9% said they use or have recently used CAM. The univariate analysis showed that female gender, high education, receiving treatment in a highly specialized institute and receiving chemotherapy are associated with CAM use; at the multivariate analysis high education (Odds Ratio, (OR): 1.96 95% Confidence Interval, CI, 1.27-3.05) and receiving treatment in a specialized cancer center (OR: 2.75 95% CI, 1.53-4.94) were confirmed as risk factors for CAM use. CONCLUSION: Roughly half of our patients receiving treatment for cancer use CAM. It is necessary that health professional explore the use of CAM with their cancer patients, educate them about potentially beneficial therapies in light of the limited available evidence of effectiveness, and work towards an integrated model of health-care provision

Prevalence of Haemoplasma infections in stray cats in Northern Italy

This study investigated the prevalence of feline haemoplasma infections in a number of stray cat colonies in Milan, Northern Italy. Blood samples from 260 stray cats were evaluated, with conventional PCR, for the presence of DNA associated with Mycoplasma haemofelis (Mhf) and "Candidatus Mycoplasma haemominutum" (CMhm). Odd ratios (OR) were calculated to identify risk factors for haemoplasma infections. PCR was positive in 86 out of 260 subjects (33.1%), with a prevalence of 10.8% (28/260 cats) for Mhf and 22.3% (58/260 cats) for CMhm. No coinfections were registered. There were significant associations between infections and season of sampling, that is, a negative association between winter sampling and a haemoplasma positive status (OR = 0.29, P = 0.001), or CMhm positive status (OR = 0.29, P = 0.01). Haemoplasma infections are common in stray cats in Milan. Thus, domestic cats with outdoor access should be routinely monitored and treated for ectoparasites to minimize risks of disease acquisition. Moreover, as these infections are transmitted via blood, feline blood donors from this area should be screened by PCR and preferably be drawn from a population of indoor cats regularly treated for fleas