Sequential monitoring of lymphocyte subsets and of T-and-B cell neogenesis indexes to identify time-varying immunologic profiles in relation to graft-versus-host disease and relapse after allogeneic stem cell transplantation

T and B lymphocyte subsets have been not univocally associated to Graft-versus-host disease (GVHD) and relapse of hematological alignancies after stem cell transplantation (SCT). Their sequential assessment together with B and T cell neogenesis indexes has been not thoroughly analysed in relation to these changing and interrelated immunologic/clinic events yet. Lymphocyte subsets in peripheral blood (PB) and B and T cell neogenesis indexes were analysed together at different time points in a prospective study of 50 patients. Principal component analysis (PCA) was used as first step of multivariate analysis to address issues related to a high number of variables versus a relatively low number of patients. Multivariate analysis was completed by Fine-Gray proportional hazard regression model. PCA identified 3 clusters of variables (PC1-3), which correlated with acute GVHD: PC1 (pre-SCT: KRECs 656608/ml, unswitched memory B 44%, CD8+TCM cells>4%; HR 1.9, p = 0.01), and PC3 (at aGVHD onset: CD4+TEMRA69%, switched memory CD19+ = 0 cells and KRECs<6614/ml at +90; HR 0.1, p = 0.008). All these immunologic parameters were independent indicators of chronic GVHD and relapse, also considering the possible effect of previous steroid-therapy for acute GVHD. Specific time-varying immunologic profiles were associated to GVHD and relapse. Pre-SCT host immune-microenvironment and changes of B cell homeostasis could influence GVH- and Graft-versus-Tumor reactions. The paradoxical increase of EM Treg in PB of patients with GVHD could be explained by their compartmentalization outside lymphoid tissues, which are of critical relevance for regulation of GVH reactions

Intestinal polyposis: case histories from 2001 to 2009

Le poliposi intestinali sono patologie rare, con molteplici manifestazioni cliniche ed istologiche, caratterizzate dalla presenza di un numero di polipi a carico del tratto gastroenterico superiore ad 8. Si distinguono , in base al carattere istologico, in adenometosi e non adenomatosi; in base al meccanismo di insorgenza in familiari e sporadiche. Tra le piu' frequenti sono la poliposi adenomatosa familiare (PAF) e la sindrome di Peutz Jeghers (PJS). La prima è una patologia familiare a trasmissione autosomica domnante che colpisce 1/10000 nuovi nati, si manifesta con un numero elevatissimo di polipi adenomatosi e si accompagna ad un rischio di sviluppare cancro del colon del 100%; si accompagna a manifestazioni extraintestinali di natura neoplastica e non. La PJS è una poliposi familiare a trasmissione autosomica dominante con una incidenza di 1/120000 che si manifesta con lesioni amartomatose del tratto gastroeneterico ad eccezione dell'esofago ed extraintestinali maligne a carico di polmoni, tiroide, mammella, ovaia, testicoli e utero; è caratteristica la lentigginomi mucocutanea . Numerose altre poliposi vengono classificate in base ai due criteri suddetti. Nel nostro lavoro abbiamo rivisto la casistica di pazienti afferiti all'Unità Operativa Complessa di Gastroenterologia del Dipartimento Materno Infantile dal 1999 al 2009. Abbiamo descritto l'anamnesi, il quadro clinico di presentazione, le indagini eseguite per giungere alla diagnosi, e la sorveglianza messa in atto successivamente alla diagnosi

Bugs à la carte: Microbial contamination of electronic menus

The use of electronic menus has become frequent, with numerous advantages for customers and the restaurateur. As a result, mobile technological devices including tablet computers are increasingly used to replace the classic paper menu. This trend raises questions about control measures to avoid the transmission of pathogens through this new technology as it has been shown that tablet computers can frequently harbor pathogenic bacteria. We propose that the risks associated with contamination of electronic menus in restaurants and the efficacy of cleaning protocols should be evaluated

Monitoring of the health status of slaughtered pigs by scoring of the pluck lesions

The evaluation of lung lesions at the slaughterhouse allows the monitoring of swine health and welfare and provides valuable data for epidemiological purposes [1]. The aims of this study were (i) to determine the prevalence of gross lesions at abattoir on the pluck of heavy weight pigs (~160 kg, 9 months of age) destined for PDO ham production and (ii) to investigate the correlation between the severity of lung and pleura lesions and carcass weight. The study was carried out in a slaughterhouse located in Northern Italy between December 2020 and March 2021. Enzootic Pneumonia-like lesions were assessed scoring each lung lobe from 0 to 4, with a maximum score of 28. Pleuritis lesions were evaluated using the Slaughterhouse Pleurisy Evaluation System (‘SPES’ score) with a maximum score of 4. Liver lesions were ranked from 0 to 2, relying on the number of milk-spot lesions. Other lesions such as pericarditis, lung scars and abscesses were also recorded. Data were collected from 73 batches coming from 63 farms, for a total of 7245 pigs. Descriptive statistics of the different lesions were performed at farm-level while the association between the mean value of lung and pleura scores with the mean value of the carcass weight was assessed using a linear regression at batch-level. A p-value ≤0.05 was considered significant. Overall, 60% of the lungs presented lesions with 98% of the EP-like lesions located in the cranio-ventral lobes. The average lung and pleurisy scores were 2.48±1.43 and 1.07±0.43, respectively, with 37% of the pleura presenting severe damage (score ≥3). The average liver score was 0.38±0.34, with 29% of the livers damaged. Pericarditis and lung scars values were 5% and 1%, respectively. The results of the mean values of the examined lesions were comparable to other previously reported in the literature [2]. No statistically significant correlation was found between the lung (R2 =0.007) and pleura (R2 =0.001) scores and the mean carcass weight at batch level. Such findings are in contrast with other studies reporting an effect of the respiratory lesions on the productive parameters [3]. These discrepancies may depend on the different scoring methods used in the studies, duration of the finishing stage and health management of the pigs. This study supports the evaluation of pluck lesions at the slaughterhouse for the monitoring of the health and welfare status in fattening pig farms

Transition of gastroenterological patients from paediatric to adult care. A position statement by the Italian Societies of Gastroenterology

In 2013, four Italian Gastroenterological Societies (the Italian Society of Paediatric Gastroenterology, Hepatology and Nutrition, the Italian Society of Hospital Gastroenterologists and Endoscopists, the Italian Society of Endoscopy, and the Italian Society of Gastroenterology) formed a joint panel of experts with the aim of preparing an official statement on transition medicine in Gastroenterology. The transition of adolescents from paediatric to adult care is a crucial moment in managing chronic diseases such as celiac disease, inflammatory bowel disease, liver disease and liver transplantation. Improved medical treatment and availability of new drugs and surgical techniques have improved the prognosis of many paediatric disorders, prolonging survival, thus making the transition to adulthood possible and necessary. An inappropriate transition or the incomplete transmission of data from the paediatrician to the adult Gastroenterologist can dramatically decrease compliance to treatment and prognosis of a young patient, particularly in the case of severe disorders. For these reasons, the Italian gastroenterological societies decided to develop an official shared transition protocol. The resulting document discusses the factors influencing the transition process and highlights the main points to accomplish to optimize compliance and prognosis of gastroenterological patients during the difficult transition from childhood to adolescence and adulthood

Characteristics of the 50 patients and transplant.

<p>Characteristics of the 50 patients and transplant.</p

Comparison of immunological variables between patients with and without acute GVHD.

<p>Comparison of immunological variables between patients with and without acute GVHD.</p

Steroid effect on lymphocyte subsets and index of B/T cell neogenesis at day +90.

<p>Steroid effect on lymphocyte subsets and index of B/T cell neogenesis at day +90.</p