Mitochondrial hyperfusion via metabolic sensing of regulatory amino acids

The relationship between nutrient starvation and mitochondrial dynamics is poorly understood. We find that cells facing amino acid starvation display clear mitochondrial fusion as a means to evade mitophagy. Surprisingly, further supplementation of glutamine (Q), leucine (L), and arginine (R) did not reverse, but produced stronger mitochondrial hyperfusion. Interestingly, the hyperfusion response to Q + L + R was dependent upon mitochondrial fusion proteins Mfn1 and Opa1 but was independent of MTORC1. Metabolite profiling indicates that Q + L + R addback replenishes amino acid and nucleotide pools. Inhibition of fumarate hydratase, glutaminolysis, or inosine monophosphate dehydrogenase all block Q + L + R-dependent mitochondrial hyperfusion, which suggests critical roles for the tricarboxylic acid (TCA) cycle and purine biosynthesis in this response. Metabolic tracer analyses further support the idea that supplemented Q promotes purine biosynthesis by serving as a donor of amine groups. We thus describe a metabolic mechanism for direct sensing of cellular amino acids to control mitochondrial fusion and cell fate

Adherence to evidence-based recommendations for surgical site infection prevention: Results among Italian surgical ward nurses.

BACKGROUND:The aims of the study were to assess the level of knowledge, the attitudes and the adherence to evidence-based recommendations for surgical site infection (SSI) prevention and to describe any influences that may motivate nurses to adopt evidence-based practices for SSI prevention. METHODS:The present study was a national cross-sectional survey conducted from June to November 2017. For each hospital that agreed to participate, 30 nurses were randomly selected. The questionnaire was aimed at exploring socio-demographic and practice characteristics, knowledge of, attitudes toward, and reported practices regarding evidence-based procedures for SSI prevention. RESULTS:Out of 55 hospitals that were contacted, 36 agreed to participate (a response rate of 65%). Of the original sample of 1313 nurses, a total of 1305 returned the questionnaire, a response rate of 99.4%. Regarding knowledge, only 53.8% knew that preoperative hair removal, if necessary, should take place shortly before surgery, and 28.9% of the sample did not know the right definition of "bundle". Over three quarters of participants stated that they always perform hand antisepsis before and after biological sample collection while 9.7% considered that wearing gloves during this practice is sufficient to prevent SSI. Furthermore, 91% of nurses reported that they always performed hand antisepsis before and after invasive procedures. CONCLUSION:The study findings highlight the areas that were most lacking in nurses' training and for which targeted activities are needed. These data could support healthcare managers to implement interventions focused at enabling adherence to effective prevention practices to reduce risk to all patients

Preventable pediatric hospitalizations and access to primary health care in Italy

The aim of this study was to quantify the burden of avoidable pediatric hospital admissions for Ambulatory care-sensitive conditions (ACSC) and to identify factors related to these preventable hospitalizations. The study was conducted by retrospectively reviewing all medical records of children admitted in a non-teaching 474-bed acute care hospital located in Catanzaro (Italy) for an avoidable hospitalization diagnosis. Two control clinical records involving children hospitalized for clinical conditions not classified as ACSC were randomly selected for each clinical record that included an ACSC. Among the 4293 pediatric hospitalizations, 451 (10.5%) were judged to be preventable. Of these, the most frequent discharge diagnoses were: dehydration (29.7%), pneumonia (17.7%), seizures (15.7%) and chronic obstructive pulmonary disease (12.9%).Children admitted for a preventable hospitalization were more likely to be females, to be younger, to be residents in the same province as the hospital and less likely to have had at least one Community-Based Pediatrician (CBP) access in the previous year and to have used the district health service. The burden of pediatric preventable hospitalizations found in this study is quite high, and the results show that there is still work that lies ahead on the way to improve interaction between hospital and community-based services

Obesity, Blood Pressure, and Intraocular Pressure: A Cross-Sectional Study in Italian Children

Introduction: Several studies in the adult population have shown that obesity is an independent risk factor for elevated intraocular pressure (IOP), whereas data in the paediatric population are sparse and controversial. The purpose of the present study is to investigate the relationship between body mass index (BMI), blood pressure (BP), and IOP in healthy school children. Methods: The survey was conducted among a random sample of 8-year-old Italian students. Data were collected on their health status and behaviours related to obesity (physical activity, food and drinking habits, etc.). Physical examinations, conducted at school, included measurements of height, weight, BP, and IOP. Results: Five hundred and seventy-six subjects were recruited (92.8% response rate); 42.4% were overweight or obese, 58.9% consumed inadequate daily servings of fruit and vegetables, and 87.5% were involved in sedentary activities. Elevated BP/hypertension (HTN) affected 3.6% and high IOP was revealed in 12.5% of the children. In the multivariate analysis, elevated BP/HTN was the only significant determinant of ocular HTN (OR 5.36, 95% CI 1.95-14.73, p = 0.001). Conclusions: Our results show that high IOP affects 12.5% of 8-year-old school children and appears to be associated with high BP related to a high BMI

Chemical risk and safety awareness, perception, and practices among research laboratories workers in Italy

Introduction: Exposure to chemical compounds occurs in numerous occupational settings, among which the research and healthcare laboratories have not been adequately investigated. These settings are characterized by an extreme variability of the used compounds and by the frequent turnover of young researchers. The main objectives of the study were to explore the occupational exposure to hazardous chemical substances among research laboratory workers; to assess their awareness and perceptions regarding chemical hazards; to investigate adherence to guidelines on safe handling of chemical compounds; and to analyze the effects of several factors on these outcomes of interest. Methods: The survey was conducted among research laboratories workers who were exposed to chemical substances during their activity. Subjects completed a questionnaire exploring knowledge, attitudes and behaviors related to chemical hazards involved in research activities. Results: Enrolled subjects were 237, for an 81.7% response rate. More than 90 hazardous chemical substances were used in the surveyed laboratories. A correct knowledge on hazardous chemicals was significantly more likely in younger researchers, in those manipulating a higher number of hazardous chemicals, and in those with a higher number of years of training in the attended laboratory; 54.4% of the workers said they felt very exposed to chemical risk. Correct practices in the laboratories were significantly more likely in researchers who perceived to have a low exposure to chemicals, but a high exposure to biological risk, who agreed with the statement that colleagues handle chemicals following safety procedures and who perceived to have received an adequate training in the management of accidents and first aid. Conclusions: Our results showed significant gaps in knowledge and scarce preparedness in the adherence to safety processes to prevent and contain risks related to use of chemical compounds in research laboratories

Oral health status and the impact on oral health-related quality of life among the institutionalized elderly population: A cross-sectional study in an area of southern italy

Background: The objectives of this study were to describe the oral health status in the institutionalized geriatric population in an area of southern Italy and to identify the impact of oral health on the Oral Health Related Quality of Life (OHRQoL). Methods: Data were collected from individuals aged ≥60 years in randomly selected Calabrian long-term care facilities. The dental health status was assessed recording the decayed, missing, or filled dental elements due to the car-ious lesions (DMFT) index, the presence of visible dental plaque, and the gingival condition. The influence of the dental health status on the self-perceived value of life was assessed using the Geriatric Oral Health Assessment Index (GOHAI). Results: Among the 344 elderly individuals in-cluded, 18.4% reported frequent tooth-brushing, and only 39.9% reported the need of dental care. The DMFT index was 26.4. Less than a third of the participants had a GOHAI score of ≤50 which is suggestive of highly compromised OHRQoL. The GOHAI score was significantly better for elderly individuals with no self-perceived need of dental care and with a lower DMFT index. Con-clusions: The burden of oral conditions among residents in long-term care facilities was consider-able, with a high prevalence of missing teeth and dentures. Strategies targeting care providers are needed

Vaccination coverage among health-care workers: pre–post intervention study to assess impact of an on-site vaccination-dedicated clinic

Background: Several studies have revealed low vaccinations coverage among health-care workers (HCWs) for all vaccinations. The aim of our study was to evaluate the impact of the implementation of an on-site vaccination-dedicated clinic on the vaccination coverage rates of HCWs. Research design and methods: A quasi-experimental pre–post intervention study was carried out among undergraduate and postgraduate students attending medical and health-care professions schools. Results: We enrolled 804 students, 404 in the control and 400 in the experimental group. A significantly higher increase of vaccination coverage in the experimental group than in the control group for all the investigated vaccinations (p < 0.001) was found. The odds of adherence to vaccinations in the experimental group, compared to the control group, ranged from 6.9-fold (95% CI 3.51–13.44) to 18.9-fold (95% CI 10.85–32.96). The increase in the coverage rate in the control group was between 2.5% and 3.5%, whereas in the experimental group, higher increases were found, ranging from 34.8% to 71%. Conclusions: The extraordinary increase in the adherence to HCWs recommended vaccinations found in the study seems to indicate a significant role of enabling factors in the complex process of decision-making and implementation of health-related behaviors