Role of Alginates Combined with Natural Extracts to Prevent the Gastric Acid-Related Damage

The human stomach is extremely vulnerable to various attacks able to cause erosion and mucosal epithelium damage which lead to gastrointestinal tract bleeding and/or ulcer perforations and finally worsen the original disease. A prolonged exposition to strong acidic environment causes coagulation necrosis resulting from the desiccating action of the acid on proteins in exposed tissues with inflammation and accumulation of intracellular radical oxygen species. Therapeutic strategies aim to treat both symptoms and epithelial damage with chemical or mechanical approaches. In this context, alginates seem to have great importance, especially if combined with other molecules known to have some properties on gastric epithelial cells, for example, vitamin D3, extract of prickly pear and olive leaves, and a tyndalized probiotic. This natural composition is able to exert a gastroprotective effect to maintain or restore the integrity of gastric epithelium through an antioxidant pathway, inhibiting apoptosis and activating survival kinases better than other pharmacological or natural active principles

Guidelines for the use and interpretation of diagnostic methods in adult food allergy

Food allergy has an increasing prevalence in the general population and in Italy concerns 8 % of people with allergies. The spectrum of its clinical manifestations ranges from mild symptoms up to potentially fatal anaphylactic shock. A number of patients can be diagnosed easily by the use of first- and second-level procedures (history, skin tests and allergen specific IgE). Patients with complex presentation, such as multiple sensitizations and pollen-food syndromes, frequently require a third-level approach including molecular diagnostics, which enables the design of a component-resolved sensitization profile for each patient. The use of such techniques involves specialists' and experts' skills on the issue to appropriately meet the diagnostic and therapeutic needs of patients. Particularly, educational programs for allergists on the use and interpretation of molecular diagnostics are needed

On the behavior of mud floc size distribution: Model calibration and model behavior

In this paper, we study a population balance equation (PBE) where flocs are distributed into classes according to their mass. Each class i contains i primary particles with mass mp and size Lp. All differently sized flocs can aggregate, binary breakup into two equally sized flocs is used, and the floc’s fractal dimension is d0 = 2, independently of their size. The collision efficiency is kept constant, and the collision frequency derived by Saffman and Turner (J Fluid Mech 1:16–30, 1956) is used. For the breakup rate, the formulation by Winterwerp (J Hydraul Eng Res 36(3):309–326, 1998), which accounts for the porosity of flocs, is used. We show that the mean floc size computed with the PBE varies with the shear rate as the Kolmogorov microscale, as observed both in laboratory and in situ. Moreover, the equilibrium mean floc size varies linearly with a global parameter P which is proportional to the ratio between the rates of aggregation and breakup. The ratio between the parameters of aggregation and breakup can therefore be estimated analytically from the observed equilibrium floc size. The parameter for aggregation can be calibrated from the temporal evolution of the mean floc size. We calibrate the PBE model using mixing jar flocculation experiments, see Mietta et al. (J Colloid Interface Sci 336(1):134–141, 2009a, Ocean Dyn 59:751–763, 2009b) for details. We show that this model can reproduce the experimental data fairly accurately. The collision efficiency ? and the ratio between parameters for aggregation and breakup ? and E are shown to decrease linearly with increasing absolute value of the ? -potential, both for mud and kaolinite suspensions. Suspensions at high pH and different dissolved salt type and concentration have been used. We show that the temporal evolution of the floc size distribution computed with this PBE is very similar to that computed with the PBE developed by Verney et al. (Cont Shelf Res, 2010) where classes are distributed following a geometrical series and mass conservation is statistically ensured. The same terms for aggregation and breakup are used in the two PBEs. Moreover, we argue, using both PBEs, that bimodal distributions become monomodal in a closed system with homogeneous sediment, even when a variable shear rate is applied.WaterbouwkundeCivil Engineering and Geoscience

Italian study on buckwheat allergy: prevalence and clinical features of buckwheat-sensitized patients in Italy.

Buckwheat allergy is considered a rare food allergy outside of Asia. In Europe, buckwheat has been described mainly as a hidden allergen. Data on the prevalence of buckwheat hypersensitivity in non-Asian countries is very poor. The aim of this multicenter study was to evaluate the prevalence of buckwheat sensitization and its association with other sensitizations among patients referred to allergy clinics in different geographic areas of Italy. All patients referred to 18 Italian allergy clinics from February through April 2011 were included in the study and evaluated for sensitization to buckwheat and other allergens depending on their clinical history. A total of 1,954 patients were included in the study and 61.3% of them were atopic. Mean prevalence of buckwheat sensitization was 3.6% with significant difference between Northern (4.5%), Central (2.2%) and Southern (2.8%) regions. This is, to our knowledge, the largest epidemiological survey on buckwheat allergy reported outside of Asia. Buckwheat is an emerging allergen in Italy, being more frequently associated to sensitization in Northern regions

A survey of clinical features of allergic rhinitis in adults

Background: Allergic rhinitis (AR) has high prevalence and substantial socio-economic burden.Material/Methods: The study included 35 Italian Centers recruiting an overall number of 3383 adult patients with rhinitis (48% males, 52% females, mean age 29.1, range 18-45 years). For each patient, the attending physician had to fill in a standardized questionnaire, covering, in particular, some issues such as the ARIA classification of allergic rhinitis (AR), the results of skin prick test (SPT), the kind of treatment, the response to treatment, and the satisfaction with treatment.Results: Out of the 3383 patients with rhinitis, 2788 (82.4%) had AR: 311 (11.5%) had a mild intermittent, 229 (8.8%) a mild persistent, 636 (23.5%) a moderate-severe intermittent, and 1518 (56.1%) a moderate-severe persistent form. The most frequently used drugs were oral antihistamines (77.1%) and topical corticosteroids (60.8%). The response to treatment was judged as excellent in 12.2%, good in 41.3%, fair in 31.2%, poor in 14.5%, and very bad in 0.8% of subjects. The rate of treatment dissatisfaction was significantly higher in patients with moderate-to-severe AR than in patients with mild AR (p<0.0001). Indication to allergen immunotherapy (AIT) was significantly more frequent (p<0.01) in patients with severe AR than with mild AR.Conclusions: These findings confirm the appropriateness of ARIA guidelines in classifying the AR patients and the association of severe symptoms with unsuccessful drug treatment. The optimal targeting of patients to be treated with AIT needs to be reassessed

Tocilizumab for patients with COVID-19 pneumonia. The single-arm TOCIVID-19 prospective trial

BackgroundTocilizumab blocks pro-inflammatory activity of interleukin-6 (IL-6), involved in pathogenesis of pneumonia the most frequent cause of death in COVID-19 patients.MethodsA multicenter, single-arm, hypothesis-driven trial was planned, according to a phase 2 design, to study the effect of tocilizumab on lethality rates at 14 and 30 days (co-primary endpoints, a priori expected rates being 20 and 35%, respectively). A further prospective cohort of patients, consecutively enrolled after the first cohort was accomplished, was used as a secondary validation dataset. The two cohorts were evaluated jointly in an exploratory multivariable logistic regression model to assess prognostic variables on survival.ResultsIn the primary intention-to-treat (ITT) phase 2 population, 180/301 (59.8%) subjects received tocilizumab, and 67 deaths were observed overall. Lethality rates were equal to 18.4% (97.5% CI: 13.6-24.0, P=0.52) and 22.4% (97.5% CI: 17.2-28.3, P&lt;0.001) at 14 and 30 days, respectively. Lethality rates were lower in the validation dataset, that included 920 patients. No signal of specific drug toxicity was reported. In the exploratory multivariable logistic regression analysis, older age and lower PaO2/FiO2 ratio negatively affected survival, while the concurrent use of steroids was associated with greater survival. A statistically significant interaction was found between tocilizumab and respiratory support, suggesting that tocilizumab might be more effective in patients not requiring mechanical respiratory support at baseline.ConclusionsTocilizumab reduced lethality rate at 30 days compared with null hypothesis, without significant toxicity. Possibly, this effect could be limited to patients not requiring mechanical respiratory support at baseline.Registration EudraCT (2020-001110-38); clinicaltrials.gov (NCT04317092)