ULTRASOUND AS FIRST LINE STEP IN ANAEMIA DIAGNOSTICS

This review covers the role of ultrasonography as an essential non-invasive diagnosti

Febrile and gynaecological infections in pregnancy increase the risk of childhood respiratory disorders in the offspring

Emerging evidence suggests that foetal and early life environmental factors are critical for determining the susceptibility to allergic and respiratory diseases. In the present study, we investigated whether maternal febrile infections (FI) or gynaecological infections (GI) during pregnancy are associated with allergic respiratory diseases in the offspring, and whether specific pregnancy trimesters are involved.We enrolled 4,577 children, aged 3-14yr. Their parents filled in a standardized questionnaire about children’s respiratory health and the events occurred during pregnancy and at birth. We evaluated the incidence of wheezing, asthma and rhinitis, and the occurrence of five respiratory symptoms in the last 12 months.Children born to mothers who reported FI and GI had more respiratory symptoms in the last 12 months (IRR:1.40, 95%CI:1.12-1.74 and IRR:1.60, 95%CI:1.24-2.06, respectively). This association was stronger when FI occurred in the 1st trimester of pregnancy (IRR:2.12, 95%CI:1.37-3.28).The incidence of asthma was significantly higher in the children whose mothers reported FI or GI in the 1st trimester of pregnancy (HR:2.61, 95%CI:1.01-6.76 and HR:3.50, 95%CI:1.24-9.91, respectively). GI in the 3rd trimester were associated with higher risk of wheezing (HR:1.55, 95%CI:1.11-2.17) and rhinitis (HR:1.82; 95%CI:1.02-3.26).FI and GI might increase the risk of developing respiratory symptoms and diseases, especially when occurring in specific trimesters of pregnancy. These findings suggest that FI and GI might interfere with foetal programming of respiratory and immune system through different mechanisms

Febrile and gynecological infections during pregnancy are associated with a greater risk of childhood eczema

Background:Mounting evidence suggests that fetal exposures may exert long-termeffects on the function of the skin and of the immune system. This study aimed atassessing whether maternal complications during pregnancy are associated with anincreased risk of eczema during childhood.Methods:The associations between hypertension/preeclampsia, febrile infections, orgynecological infections during pregnancy and the occurrence of childhood eczema werestudied in a population (n=3907) of children, aged 3–14 yrs, living in Italy. Theirparents filled in a standardized questionnaire about the presence of children’s eczemaand the events that occurred during pregnancy, birth, and the first year of the child’s life.Results:7.7%, 3.8%, and 6.1% of the pregnancies were complicated by hypertension/preeclampsia, febrile infections, and gynecological infections, respectively. The preva-lence of eczema was significantly higher in children born to mothers who had experiencedfebrile (35.5% vs. 22.0%; p<0.001) or gynecological infections (35.3% vs. 21.6%;p<0.001) compared with those born to mothers who had not suffered from that specificpregnancy complication, while hypertension/preeclampsia was not significantly associ-ated with childhood eczema. After adjusting for potential confounders, the risk ofeczema was significantly higher in children born to mothers who reported febrileinfections during the 1st trimester (OR: 2.32; 95%CI: 1.11–4.82) and gynecologicalinfections during the 3rd trimester of pregnancy (OR: 2.73; 95%CI:1.73–4.31).Conclusions:Fetal exposure to febrile and gynecological infections might enhance therisk of eczema in the offspring, especially when occurring in specific trimesters ofpregnancy. These findings suggest that febrile and gynecological infections mightinterfere with fetal and perinatal programming of the immune function and skinthrough different mechanisms

Numerical and experimental investigation of a piston thermal barrier coating for an automotive diesel engine application

This paper investigates the potential of coated pistons in reducing fuel consumption and pollutant emissions of a 1.6l automotive diesel engine. After a literary review on the state-of-the-art of the materials used as Thermal Barrier Coatings for automotive engine applications, anodized aluminum has been selected as the most promising one. In particular, it presents very low thermal conductivity and heat capacity which ensure a high “wall temperature swing” property. Afterwards, a numerical analysis by utilizing a one-dimensional Computational Fluid Dynamics engine simulation code has been carried out to investigate the potential of the anodized aluminum as piston Thermal Barrier Coating. The simulations have highlighted the potential of achieving up to about 1% in Indicated Specific Fuel Consumption and 6% in heat transfer reduction. To confirm the simulation results, the coated piston technology has been experimentally evaluated on a prototype engine and compared to the baseline aluminum pistons. Despite the promising potential for Indicated Specific Fuel Consumption reduction highlighted by the numerical simulation, the experimental campaign has indicated a slight worsening of the engine efficiency (up to 2% at lower load and speed) due to the slowdown of the combustion process. The primary cause of these inefficiencies is attributed to the roughness of the coating

Foetal exposure to maternal stressful events increases the risk of having asthma and atopic diseases in childhood

Background:The natural history of asthma and atopic diseases beginsin utero.Studies investigating the influence of foetal exposure to maternal stressful life eventsduring pregnancy (SLEP) on asthma and atopic diseases are lacking.Aim:To test whether the children of mothers who had experienced SLEP are at anincreased risk for asthma, atopic eczema and allergic rhinitis.Methods:The association between maternal SLEP (at least one among: divorce,mourning or loss of the job) and the occurrence of asthma and atopic diseases inchildhood was studied in a population (n = 3854) of children, aged 3–14 yrs, livingin Northern Italy. The parents filled in a standardized questionnaire about the chil-dren’s health and the events occurred to their mothers during pregnancy.Results:Three hundred and thirty-three (9%) of the mothers experienced SLEP.Their children had a statistically significantly higher lifetime prevalence of wheezing(31.6% vs. 23.1%), asthma (8.9% vs. 5.6%), allergic rhinitis (10.9% vs. 7.3%) andatopic eczema (29.7% vs. 21.1%) than those of mothers without SLEP. Afteradjusting for potential confounders, the foetal exposure to SLEP was positivelyassociated with wheezing (OR: 1.41, 95% CI: 1.03–1.94), asthma (OR: 1.71, 95%CI: 1.02–2.89), allergic rhinitis (OR: 1.75, 95% CI: 1.08–2.84) and atopic eczema(OR: 1.53, 95% CI: 1.11–2.10).Conclusion:The children of mothers who had experienced SLEP were at a moder-ately increased risk of having wheezing, asthma, eczema and allergic rhinitis duringtheir childhood. Maternal stress during pregnancy might enhance the expression ofasthma and atopic phenotypes in children.Pediatric Allergy and Immunology724Pediatric Allergy and Immunology23(2012) 724–729ª2012 John Wiley & Sons A/S. Published by Blackwell Publishing Lt

Normality ranges of urine oxidative stress markers (8-OHdG and isoprostane) in Italian people free from respiratory diseases-Preliminary results

BACKGROUND: The study of oxidative stress (OxS) is becoming increasingly important in respiratory disease research. To our knowledge, the reference ranges of urinary 8-hydroxy-deoxy-guanosine (8-OHdG) and 8-isoprostane (isoprostane), a DNA and a lipid oxidation product respectively, have not yet been determined in subjects without respiratory diseases. AIM: To assess the reference range of OxS markers in Italian people aged 20-64 free from respiratory diseases (controls). METHODS: 8-OHdG and isoprostane were measured in spot-urine samples collected in the frame of Gene-Environment Interactions in Respiratory Diseases (GEIRD) study, a nested multi-case control survey. The biomarkers levels were corrected on creatinine concentration. Only controls (n=239) were considered for the aim of this work. The possible effects of potential determinants on OxS-biomarkers were studied before determining the normality range in selected subgroups of controls. Multiple linear regression was fitted to data using the logarithm of 8OHdG or isoprostane as dependent variables and sex, age, season, smoke, body mass index, as covariates. The appropriate percentiles were calculated. RESULTS: Both 8OHdG and isoprostane concentrations were significantly higher in smokers than in non smokers (p=0.025 and 0.047 respectively), while the other covariates did not influence OxS. The 95% 8OHdG normality range in non smokers varied from 0.26 to 25.94 ng/mg. The 95% isoprostane reference interval was 0.03 -5.42 ng/mg in non smokers. CONCLUSION: Provisional 95% normality range for urinary 8OHdG and isoprostane were determined in subjects free from respiratory diseases

The Coexistence of asthma and Chronic Ostructive Pulmonary Disease (COPD): prevalence and risk factors in young, middle-aged and elderly people from the general population

Background: The joint distribution of asthma and chronic obstructive pulmonary disease (COPD) has not been well described. This study aims at determining the prevalence of self-reported physician diagnoses of asthma, COPD and of the asthma-COPD overlap syndrome and to assess whether these conditions share a common set of risk factors. Methods: A screening questionnaire on respiratory symptoms, diagnoses and risk factors was administered by mail or phone to random samples of the general Italian population aged 20–44 (n = 5163) 45–64 (n = 2167) and 65–84 (n = 1030) in the frame of the multicentre Gene Environment Interactions in Respiratory Diseases (GEIRD) study. Results: A physician diagnosis of asthma or COPD (emphysema/chronic bronchitis/COPD) was reported by 13% and 21% of subjects aged &lt;65 and 65–84 years respectively. Aging was associated with a marked decrease in the prevalence of diagnosed asthma (from 8.2% to 1.6%) and with a marked increase in the prevalence of diagnosed COPD (from 3.3% to 13.3%). The prevalence of the overlap of asthma and COPD was 1.6% (1.3%–2.0%), 2.1% (1.5%–2.8%) and 4.5% (3.2%–5.9%) in the 20–44, 45–64 and 65–84 age groups. Subjects with both asthma and COPD diagnoses were more likely to have respiratory symptoms, physical impairment, and to report hospital admissions compared to asthma or COPD alone (p&lt;0.01). Age, sex, education and smoking showed different and sometimes opposite associations with the three conditions. Conclusion: Asthma and COPD are common in the general population, and they coexist in a substantial proportion of subjects. The asthma-COPD overlap syndrome represents an important clinical phenotype that deserves more medical attention and further research.</br

Association between daily levels of air pollution and school absences in the proximity of a cement plant in Italy

Background: Emission of dust represents the main hazard associated with cement production and may cause adverse respiratory health effects to the population living nearby. Aim: To evaluate the association between daily levels of PM10 and a morbidity indicator (school absenteeism) in children aged 7-14 years attending a school within 2km from a cement plant in Fumane (Northern Italy). Methods: Data on absences of students (average: 461 students/year) and daily concentrations of PM10 from a fixed monitoring station placed in the schoolyard were collected for 3 school years (541 school days from November 2007 to June 2010). The association between pollution in the same day (Lag 0) and in the previous 4 days (Lag 1 to 4) and school absenteeism was studied using generalized additive Poisson regression models, adjusting for short-term trend, day of the week, flu epidemics and daily temperature. Results: During the considered period, the daily average concentration of PM10 was 34.8 µg/m³. An increase of 10 µg/m³ of PM10 was associated with a significant increase of 2.2% in school absences (RR:1.022; 95%CI: 1.007-1.037) two days after (lag2). The association between average level of pollutants from Lag 0 to Lag 4 and school absences confirmed the presence of a statically significant association with PM10 levels (RR:1.016; 95%CI:1.003-1.029 for each + µg/m³ of PM10). Conclusions: Daily PM10 levels are associated with school absences, a proxy indicator of short-term morbidity, in children who attend schools in proximity to a cement plant. Primary prevention interventions aimed at reducing air pollution in the area are recommended

Seventy years of asthma in Italy: age, period and cohort effects on incidence and remission of self-reported asthma from 1940 to 2010

Background: It is well known that asthma prevalence has been increasing all over the world in the last decades. However, few data are available on temporal trends of incidence and remission of asthma. Objective: To evaluate the rates of asthma incidence and remission in Italy from 1940 to 2010. Methods: The subjects were randomly sampled from the general Italian population between 1991 and 2010 in the three population-based multicentre studies: ECRHS, ISAYA, and GEIRD. Individual information on the history of asthma (age at onset, age at the last attack, use of drugs for asthma control, co-presence of hay-fever) was collected on 35,495 subjects aged 20–84 and born between 1925–1989. Temporal changes in rates of asthma incidence and remission in relation to age, birth cohort and calendar period (APC) were modelled using Poisson regression and APC models. Results: The average yearly rate of asthma incidence was 2.6/1000 (3,297 new cases among 1,263,885 person-years). The incidence rates have been linearly increasing, with a percentage increase of +3.9% (95%CI: 3.1–4.5), from 1940 up to the year 1995, when the rates begun to level off. The stabilization of asthma incidence was mainly due to a decrease in the rates of atopic asthma after 1995, while non-atopic asthma has continued to increase. The overall rate of remission was 43.2/1000person-years, and it did not vary significantly across generations, but was associated with atopy, age at asthma onset and duration of the disease. Conclusions: After 50 years of a continuous upward trend, the rates of asthma incidence underwent a substantial stabilization in the late 90s. Despite remarkable improvements in the treatment of asthma, the rate of remission did not change significantly in the last seventy years. Some caveats are required in interpreting our results, given that our estimates are based on self-reported events that could be affected by the recall bias