Pregnancy outcomes and cytomegalovirus DNAaemia in HIV infected pregnant women with CMV

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The Recently Identified P2Y-Like Receptor GPR17 Is a Sensor of Brain Damage and a New Target for Brain Repair

Deciphering the mechanisms regulating the generation of new neurons and new oligodendrocytes, the myelinating cells of the central nervous system, is of paramount importance to address new strategies to replace endogenous damaged cells in the adult brain and foster repair in neurodegenerative diseases. Upon brain injury, the extracellular concentrations of nucleotides and cysteinyl-leukotrienes (cysLTs), two families of endogenous signaling molecules, are markedly increased at the site of damage, suggesting that they may act as “danger signals” to alert responses to tissue damage and start repair. Here we show that, in brain telencephalon, GPR17, a recently deorphanized receptor for both uracil nucleotides and cysLTs (e.g., UDP-glucose and LTD4), is normally present on neurons and on a subset of parenchymal quiescent oligodendrocyte precursor cells. We also show that induction of brain injury using an established focal ischemia model in the rodent induces profound spatiotemporal-dependent changes of GPR17. In the lesioned area, we observed an early and transient up-regulation of GPR17 in neurons expressing the cellular stress marker heat shock protein 70. Magnetic Resonance Imaging in living mice showed that the in vivo pharmacological or biotechnological knock down of GPR17 markedly prevents brain infarct evolution, suggesting GPR17 as a mediator of neuronal death at this early ischemic stage. At later times after ischemia, GPR17 immuno-labeling appeared on microglia/macrophages infiltrating the lesioned area to indicate that GPR17 may also acts as a player in the remodeling of brain circuitries by microglia. At this later stage, parenchymal GPR17+ oligodendrocyte progenitors started proliferating in the peri-injured area, suggesting initiation of remyelination. To confirm a specific role for GPR17 in oligodendrocyte differentiation, the in vitro exposure of cortical pre-oligodendrocytes to the GPR17 endogenous ligands UDP-glucose and LTD4 promoted the expression of myelin basic protein, confirming progression toward mature oligodendrocytes. Thus, GPR17 may act as a “sensor” that is activated upon brain injury on several embryonically distinct cell types, and may play a key role in both inducing neuronal death inside the ischemic core and in orchestrating the local remodeling/repair response. Specifically, we suggest GPR17 as a novel target for therapeutic manipulation to foster repair of demyelinating wounds, the types of lesions that also occur in patients with multiple sclerosis

Rate , correlates and outcomes of repeat pregnancy in HIV-infected women

Objectives: The aim of the study was to assess the rate, determinants, and outcomes of repeat pregnancies in women with HIV infection. Methods: Data from a national study of pregnant women with HIV infection were used. Main outcomes were preterm delivery, low birth weight, CD4 cell count and HIV plasma viral load. Results: The rate of repeat pregnancy among 3007 women was 16.2%. Women with a repeat pregnancy were on average younger than those with a single pregnancy (median age 30 vs. 33 years, respectively), more recently diagnosed with HIV infection (median time since diagnosis 25 vs. 51 months, respectively), and more frequently of foreign origin [odds ratio (OR) 1.36; 95% confidence interval (CI) 1.10–1.68], diagnosed with HIV infection in the current pregnancy (OR: 1.69; 95% CI: 1.35–2.11), and at their first pregnancy (OR: 1.33; 95% CI: 1.06–1.66). In women with sequential pregnancies, compared with the first pregnancy, several outcomes showed a significant improvement in the second pregnancy, with a higher rate of antiretroviral treatment at conception (39.0 vs. 65.4%, respectively), better median maternal weight at the start of pregnancy (60 vs. 61 kg, respectively), a higher rate of end-of-pregnancy undetectable HIV RNA (60.7 vs. 71.6%, respectively), a higher median birth weight (2815 vs. 2885 g, respectively), lower rates of preterm delivery (23.0 vs. 17.7%, respectively) and of low birth weight (23.4 vs. 15.4%, respectively), and a higher median CD4 cell count (+47 cells/μL), with almost no clinical progression to Centers for Disease Control and Prevention stage C (CDC-C) HIV disease (0.3%). The second pregnancy was significantly more likely to end in voluntary termination than the first pregnancy (11.4 vs. 6.1%, respectively). Conclusions: Younger and foreign women were more likely to have a repeat pregnancy; in women with sequential pregnancies, the second pregnancy was characterized by a significant improvement in several outcomes, suggesting that women with HIV infection who desire multiple children may proceed safely and confidently with subsequent pregnancies

Is "option B+" also being adopted in pregnant women in high-income countries? Temporal trends from a national study in Italy

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Good prenatal detection rate of major birth defects in HIV-infected pregnant women in Italy

What's already known about this topic? Exposure to antiretroviral treatment in pregnancy does not seem to increase the risk of birth defects, but there is no information on the rate of prenatal detection of such defects. What does this study adds? We provide for the first time, in a national case series, information about prenatal detection rate in women with HIV (51.6% for any major defect, 66.7% for chromosomal abnormalities, and 85% for severe structural defect

Consequences of presentation with advanced HIV disease in pregnancy : data from a national study in Italy

Among 469 women with a diagnosis of HIV in pregnancy, 74 (15.8%) presented with less than 200 CD4 cells per cubic millimeter. The only variable significantly associated with this occurrence was African origin (odds ratio: 2.22, 95% confidence intervals: 1.32 to 3.75, P = 0.003). Four women with low CD4 (5.6%), compared with none with higher CD4 counts, had severe AIDS-defining conditions (P < 0.001) during pregnancy or soon after delivery, and one transmitted HIV to the newborn. Early preterm delivery (<32 weeks) was significantly more frequent with low CD4 (6.2% vs. 1.4%, P = 0.015). An earlier access to HIV testing, particularly among immigrants of African origin, can prevent severe HIV-related morbidity

La casa a schiera nel tessuto storico delle città italiane medievali: il caso studio di Iglesias

La casa a schiera rappresenta il tipo elementare urbano per eccellenza, che si contrappone al tipo a corte più caratteristico dei centri rurali. Da queste due tipologie abitative si sono originati la maggior parte dei tessuti edilizi dei centri urbani mediterranei. Dal tipo a schiera gli organismi edilizi si sono evoluti, per mezzo di successivi raddoppi delle cellule e per rifusione di più unità edilizie, dando vita ad organismi più complessi a carattere plurifamiliare costituenti i tessuti storici delle nostre città. Il centro storico di Iglesias, cittadina situata nella regione sudoccidentale della Sardegna, è costituito da un borgo fortificato e presenta diversi esempi del tipo a schiera, originati in periodi diversi sotto differenti dominazioni e contesti sociali. Seppure il tema della casa a schiera e della sua evoluzione sia già stati studiato per altri centri storici italiani dalla scuola muratoriana, ed in particolare da Gianfranco Caniggia tra gli anni ‘70 e ‘80 del novecento, l'esempio iglesiente suggerisce nuovi spunti di riflessione per la sua peculiarità. Tale specificità è riscontrabile anche nel costruito urbano di Cagliari, città con la quale ha avuto in comune gli stessi dominatori, e rappresenta un unicum nel panorama italiano e che nell'Europa meridionale abbiamo ritrovato solamente nelle regioni attorno a Porto (PT). Questa singolarità è rappresentata dalla rotazione della giacitura dei tetti delle schiere che si presentano parallele rispetto al fronte strada. Ciò genera conseguenze sia nell'ambito del paesaggio urbano, in cui i profili degli isolati sono scanditi dalla successione dei timpani di facciata delle coperture, sia in quello costruttivo, in cui la diversa giacitura impone soluzioni peculiari per le coperture. Il paper, riallacciandosi agli studi di altri contesti in area mediterranea, si prefigge di indagare le cause e le conseguenze di questa scelta costruttiva.The terraced house is the urban elementary type par excellence, on the contrary of the court type, that is the most characteristic in rural centres. These two building types have originated most of the urban fabrics of the Mediterranean urban centres. From the terraced type, building organisms have evolved, by means of successive cell duplicates and by merging different building units, giving rise to more complex multi-family organisms that compose the historical fabrics of our cities. The historic center of Iglesias, a town in the southwestern region of Sardinia, is a fortified village with several examples of terraced type, originated in different periods under different domination and social contexts. Although the theme of the terraced house and its evolution has already been studied by the Muratori’s school considering other Italian historic centres, and in particular by Gianfranco Caniggia between the '70s and' 80s of the twentieth century, the Iglesias case study suggests new ideas of reflection for its peculiarity. This specificity represents a unique case in the Italian landscape, it can also be seen in Cagliari, a town which had the same rulers of Iglesias, and regarding Southern Europe, we can found it only in the regions around Porto (PT). This singularity is represented by the rotation of the layout of the roof ridges that are perpendicular to the road front. This affects both the urban landscape, in which the profiles of the urban blocks are marked by the succession of the roof gables, and the buildings construction, in which this different layering imposes peculiar solutions for the roofing. The paper, considering the studies of other contexts in the Mediterranean area, seeks to investigate the causes and consequences of this constructive choice

L'edilizia modulare: la lezione della casa a schiera storica di Iglesias

Il paradigma della “casa conclusa” frutto di un progetto mirato a soddisfare un programma funzionale stabilito a priori, legato alle necessità di un arco temporale assai ridotto, non è più compatibile con l’esigenza di sviluppo sostenibile con il quale oggi, con la crisi edilizia, siamo chiamati a confrontarci. Le famiglie mutano le loro esigenze durante il corso della propria vita per far fronte al variare della composizione del nucleo familiare, delle situazioni economica, sociale e lavorativa. Non altrettanto riesce a fare la casa conclusa. In Italia, e nelle economie più povere in misura maggiore, la casa è un bene che si trasmette alle generazioni future. Pertanto, le scelte impostate in sede di progetto si ripercuotono sul ventaglio di opportunità per un successivo riutilizzo o sullo sforzo economico e di risorse necessari per il suo adattamento. Una casa modulare, in grado di adattarsi a diversi scenari abitativi per mezzo dell’aggiunta di moduli codificati nelle dimensioni e nelle modalità di assemblaggio, può essere la soluzione per coniugare il paradigma della sostenibilità ambientale e del riuso con quello della casa come bene transgenerazionale. Eppure, il rilancio di questo principio non necessita di nuovi prodotti della mente. È sufficiente riscoprire il passato quando la modularità dell’alloggio derivava da questioni normative e l’evoluzione modulare era una condizione ordinaria nella maggior parte dei nostri centri storici. Il paper, ripercorrendo l’evoluzione tipologica della casa a schiera di Iglesias, città medievale nella regione sudoccidentale della Sardegna, e confrontandola con alcuni progetti contemporanei di scala internazionale, sintetizza alcuni principi fortemente attuali che possono applicarsi al paradigma della casa modulare in risposta ai modelli della crisi dell’identità edilizia attuale.The “concluded house” paradigm as a result of a project aimed at satisfying a priori established functional program, linked to a very short time needs, is no longer compatible with the need for sustainable development to which today, with the building crisis, we are called to deal with. Families change their needs to cope the change in the family size and economic, social and work situation. Not so successful makes the “concluded house”. In Italy, and especially in the poorest economies, the house is a good that passes on to future generations and therefore the design choices influence the range of subsequent opportunities for reuse or the economic effort and resources necessary for his adaptation. A “modular house”, able to adapt itself to different living scenarios by adding modules codified in dimensions and assembly methods, can be the solution to combine the paradigm of environmental sustainability and reuse with that of the home as a transgenerational good. Yet the relaunch of this principle does not require new products of the mind, but it is sufficient to rediscover the past, when the modularity of the accommodation derived from normative questions and modular evolution was ordinary in most of our historic centers. The paper, retracing the typological evolution of the terraced house of the historic center of Iglesias, a medieval city in south-western region of Sardinia, and comparing them with some contemporary international project, summarize some strongly current principles, inspired more from conditions of necessity than from rational choices, which can be applied to the paradigm of the “modular house” in response to the current models of the contemporary building identity crisis

L’EDILIZIA MODULARE: LA LEZIONE DELLA CASA A SCHIERA STO RICA DI IGLESIAS

Il paradigma della “casa conclusa” frutto di un progetto mirato a soddisfare un programma funzionale stabilito a priori, legato alle necessità di un arco temporale assai ridotto, non è più compatibile con l’esigenza di sviluppo sostenibile con il quale oggi, con la crisi edilizia, siamo chiamati a confrontarci. Le famiglie, ossia gli utenti dell’edilizia cosiddetta “di base”, mutano le loro esigenze durante il corso della propria vita per far fronte al variare della composizione del nucleo familiare, delle situazioni economica, sociale e lavorativa. Non altrettanto riesce a fare la casa conclusa. In Italia, e nelle economie più povere in misura maggiore, la casa è un bene che si trasmette alle generazioni future. Pertanto, le scelte impostate in sede di progetto si ripercuotono sul ventaglio di opportunità per un successivo riutilizzo o sullo sforzo economico e di risorse necessari per il suo adattamento. Una casa modulare, in grado di adattarsi a diversi scenari abitativi, verificabili anche in tempi successivi, per mezzo dell’aggiunta di moduli codificati nelle dimensioni e nelle modalità di assemblaggio, può essere la soluzione per coniugare il paradigma della sostenibilità ambientale e del riuso con quello della casa come bene transgenerazionale che garantisce la continuità culturale ereditaria. Eppure, il rilancio di questo principio non necessita di nuovi prodotti della mente. È sufficiente riscoprire il passato quando la modularità dell’alloggio derivava da questioni normative e l’evoluzione modulare era una condizione ordinaria nella maggior parte dei nostri centri storici. Il paper, ripercorrendo l’evoluzione tipologica della casa a schiera del centro storico di Iglesias, città medievale nella regione sudoccidentale della Sardegna, e confrontandoli con alcuni progetti contemporanei di scala internazionale, sintetizza alcuni principi fortemente attuali che possono applicarsi al paradigma della casa modulare in risposta ai modelli della crisi dell’identità edilizia attuale.The “concluded house” paradigm as a result of a project aimed at satisfying a priori established functional program, linked to a very short time needs, is no longer compatible with the need for sustainable development to which today, with the building crisis, we are called to deal with. Families change their needs to cope the change in the family size and economic, social and work situation. Not so successful makes the “concluded house”. In Italy, and especially in the poorest economies, the house is a good that passes on to future generations and therefore the design choices influence the range of subsequent opportunities for reuse or the economic effort and resources necessary for his adaptation. A “modular house”, able to adapt itself to different living scenarios that can happen at a later time, by adding modules codified in dimensions and assembly methods, can be the solution to combine the paradigm of environmental sustainability and reuse with that of the home as a transgenerational good that guarantees hereditary cultural continuity. Yet the relaunch of this principle does not require new products of the mind, but it is sufficient to rediscover the past, when the modularity of the accommodation derived from normative questions and modular evolution was ordinary in most of our historic centers. The paper, retracing the typological evolution of the terraced house of the historic center of Iglesias, a medieval city in south-western region of Sardinia, and comparing them with some contemporary international project, summarize some strongly current principles, inspired more from conditions of necessity than from rational choices, which can be applied to the paradigm of the “modular house” in response to the current models of the contemporary building identity crisis