Cytokine Profiles in Sepsis Have Limited Relevance for Stratifying Patients in the Emergency Department: A Prospective Observational Study

INTRODUCTION: Morbidity, mortality and social cost of sepsis are high. Previous studies have suggested that individual cytokines levels could be used as sepsis markers. Therefore, we assessed whether the multiplex technology could identify useful cytokine profiles in Emergency Department (ED) patients. METHODS: ED patients were included in a single tertiary-care center prospective study. Eligible patients were >18 years and met at least one of the following criteria: fever, suspected systemic infection, ≥ 2 systemic inflammatory response syndrome (SIRS) criteria, hypotension or shock. Multiplex cytokine measurements were performed on serum samples collected at inclusion. Associations between cytokine levels and sepsis were assessed using univariate and multivariate logistic regressions, principal component analysis (PCA) and agglomerative hierarchical clustering (AHC). RESULTS: Among the 126 patients (71 men, 55 women; median age: 54 years [19-96 years]) included, 102 had SIRS (81%), 55 (44%) had severe sepsis and 10 (8%) had septic shock. Univariate analysis revealed weak associations between cytokine levels and sepsis. Multivariate analysis revealed independent association between sIL-2R (p = 0.01) and severe sepsis, as well as between sIL-2R (p = 0.04), IL-1β (p = 0.046), IL-8 (p = 0.02) and septic shock. However, neither PCA nor AHC distinguished profiles characteristic of sepsis. CONCLUSIONS: Previous non-multiparametric studies might have reached inappropriate conclusions. Indeed, well-defined clinical conditions do not translate into particular cytokine profiles. Additional and larger trials are now required to validate the limited interest of expensive multiplex cytokine profiling for staging septic patients

Notulae to the Italian native vascular flora: 3.

In this contribution new data concerning the distribution of native vascular flora in Italy are presented. It includes new records, exclusions, and confirmations to the Italian administrative regions for taxa in the genera Asplenium, Bolboschoenus, Botrychium, Chamaerops, Crocus, Galeopsis, Grafia, Helosciadium, Hieracium, Juniperus, Leucanthemum, Lolium, Medicago, Phalaris, Piptatherum, Potamogeton, Salicornia, Salvia, Seseli, Silene, Spiraea, Torilis and Vicia. Rhaponticoides calabrica is proposed as synonym novum of R. centaurium. Furthermore, new combinations in the genera Galatella and Lactuca are proposed

Notulae to the Italian alien vascular flora: 1

In this contribution, new data concerning the Italian distribution of alien vascular flora are presented. It includes new records, exclusions, and confirmations for Italy or for Italian administrative regions for taxa in the genera Agave, Arctotheca, Berberis, Bidens, Cardamine, Catalpa, Cordyline, Cotoneaster, Dichondra, Elaeagnus, Eragrostis, Impatiens, Iris, Koelreuteria, Lamiastrum, Lantana, Ligustrum, Limnophila, Lonicera, Lycianthes, Maclura, Mazus, Paspalum, Pelargonium, Phyllanthus, Pyracantha, Ruellia, Sorghum, Symphyotrichum, Triticum, Tulbaghia and Youngia

Distribution map of Ambrosia artemisiifolia L. (Asteraceae) in Italy

The spread of the invasive and allergenic Ambrosia artemisiifolia L. in Italy was analysed and mapped using distribution data from a wide range of sources. Ambrosia artemisiifolia occupies 1057 floristic quadrants which are mostly distributed in the Po plain. The distribution obtained represents the basis to implement urgent management strategies