Mechanisms of antidiarrhoeal effects by diosmectite in human intestinal cells

Rotavirus (RV) induces diarrhoea through a sequence of enterotoxic and cytotoxic effects. The former are NSP4-dependent, induce calcium-dependent chloride secretion and involve oxidative stress. Diosmectite (DS) is a natural clay that has been recommended as an active therapy for diarrhoea, but the mechanism of its effect is not clear. Electrical parameters may be used to measure the direct enterotoxic and cytotoxic effects in polar epithelial intestinal cells. To investigate the effects of DS on RV-induced enterotoxic and cytotoxic damage. Caco-2 cells were used as a model of RV infection to evaluate chloride secretion, epithelial integrity, oxidative stress and viral infectivity in Ussing chambers

Quality of Life in osteoporotic patients

Background: Osteoporosis is responsible for fragility fractures, which are associated with impaired quality of life (QoL) and disability. Objective: The aim of the study was to evaluate the QoL in patients affected by osteoporosis and possible determinants. Methods: One-hundred thirty-four subjects followed at the osteoprosis outpatient clinic at our institution completed the QUALEFFO-41 questionnaire for quality of life. All subjects had undergone bone densitometry measurement and the FRAX index, summarizing the risk of fragility fracture, was calculated for each of them. The QoL in these subjects and its possible determinants were investigated with univariate and multiple linear regression analysis. Results: Subjects with osteoporosis had lower scores in the domains of physical and social function of the QUALEFFO questionnaire in comparison with subjects with normal bome mineral density. Main factors associated with impairment in QoL were high FRAX score and body mass index (BMI). Conclusion: Physical and social function is reduced in osteoporotic subjects. High BMI and an increased risk of fragility fracture were main determinants of impairment in the QoL in this study

Clinical impact of COVID-19 on tuberculosis

: During COVID-19 pandemic, a lot of diseases suffered from a limited access to health care services, owing to the use of resources, both technical and financial, mainly directed towards such a dramatic outbreak. Among these, tuberculosis (TB) has been one of the most penalized, with a huge delay both in diagnosis and in start of treatment, with a consequential dramatic increase in morbidity and mortality. COVID-19 and tuberculosis share similar common pathogenetic pathways, and both diseases affect primarily the lungs. About the impact of TB on COVID-19 severity and mortality, data are unclear and literature reports are often conflicting. Certainly, considering the management of coinfected patients, there are pharmacokinetic interactions between several drugs used for the therapy of SARS-CoV-2 infection and the treatment of TB

Checklist of gypsophilous vascular flora in Italy

Our understanding of the richness and uniqueness of the flora growing on gypsum substrates in Italy has grown significantly since the 19th century and, even today, new plant species are still being discovered. However, the plants and plant communities, growing on gypsum substrates in Italy, are still a relatively unknown subject. The main aim of this paper was to elaborate a checklist of the Italian gypsophilous flora, to increase knowledge about this peculiar flora and for which conservation efforts need to be addressed. Through a structured group communication process of experts (application of the Delphi technique), a remarkable number of experienced Italian botanists have joined together to select focal plant species linked to gypsum substrates. From the results obtained, 31 plant species behave as absolute or preferent taxa (gypsophytes and gypsoclines) and form the ‘core’ Italian gypsophilous flora. The most abundant life forms were chamaephytes and hemicryptophytes, belonging to Poaceae and Brassicaceae; as for chorotypes, the most represented are Mediterranean and narrow endemics. By improving on previously available information about the flora with a clear preference for gypsum in Italy, this undertaking represents an important contribution to the knowledge of a habitat which is today considered a priority for conservation

Antibiotic therapy for pan-drug-resistant infections

: Antibiotic resistance occurs when microorganisms resist the drugs used against the infection caused by them and neutralize their effects over time using various mechanisms. These mechanisms include preventing drug absorption, changing drug targets, drug inactivating, and using efflux pumps, which ultimately cause drug resistance, which is named pan-drug-resistant (PDR) infection if it is resistant to all antimicrobial agents. This type of drug resistance causes many problems in society and faces the health system with difficulties; therefore their treatment is crucial and encourages doctors to develop new drugs to treat them. PDR Gram-negative bacteria, including Pseudomonas aeruginosa, Acinetobacter baumannii, Klebsiella pneumoniae, and Escherichia coli are among the most significant resistant bacteria to many antimicrobial agents, and only a limited range of antibiotics, especially synergistically are effective on them. For the therapy of PDR A. baumannii, tigecycline in combination with colestimethate, imipenem, amikacin, and ampicillin-sulbactam are the most effective treatments. The utilization of β-lactamase inhibitors such as ceftolozane-tazobactam, ceftazidime-avibactam, or imipenem-cilastatin-relebactam has the most efficacy against PDR P. aeruginosa. The PDR K. pneumoniae has been treated in the last decades with tigecycline and colistin, but currently, nitrofurantoin, fosfomycin, and pivmecillinam seem to be the most effective agent for the therapy of PDR E. coli. While these drugs impressively struggle with PDR pathogens, due to the daily increase in antibiotic resistance in microorganisms worldwide, there is still an urgent need for the expansion of novel medicines and methods of combating resistance

Diagnostic Performance of Neutrophil to Lymphocyte Ratio, Monocyte to Lymphocyte Ratio, Platelet to Lymphocyte Ratio, and Platelet to Mean Platelet Volume Ratio in Periprosthetic Hip and Knee Infections: A Systematic Review and Meta-Analysis

The current literature on the diagnosis of periprosthetic joint infection provides controversial evidence on the diagnostic accuracy of MLR, NLR, PVR, and PLR. Therefore, this critical literature search and meta-analysis was aimed to summarize the diagnostic accuracy of these biomarkers for the diagnosis of hip and knee prosthetic infection. According to the PRISMA flowchart, we searched MEDLINE, Scopus, and Web of Science, for studies on these ratios for diagnosing PJI. Sensitivity, specificity, positive and negative likelihood ratio, diagnostic odds ratio, and AUC were analyzed. We included 11 articles in our meta-analysis, including 7537 patients who underwent total hip and knee arthroplasties; among these, 1974 (26%) patients reported a joint infection. The pooled sensitivity and specificity were 0.72 and 0.74, respectively, for NLR, 0.72 and 0.77 for PVR, and 0.77 and 0.75 for PLR. The sensitivity of MLR ranges from 0.54 to 0.81, while the specificity ranges from 0.78 to 0.81. Regarding the evaluation of AUCs, the best diagnostic performance was achieved by MLR (AUC = 0.77) followed by PLR (AUC = 0.75), NLR (AUC = 0.73), and PVR (AUC = 0.70). This meta-analysis demonstrates a fair diagnostic accuracy of these ratios, thus not being useful as a screening tool

Gamma nail versus percutaneous compression plate for the treatment of intertrochanteric hip fractures: a multicenter pair-matched study

Purpose: To compare functional outcomes, complication rates, and survival in patients with intertrochanteric fracture treated with percutaneous compression plate (PCCP) or gamma nail (GN). Methods: A retrospective study of prospectively collected data of patients treated with PCCP or GN for AO/OTA 31.A1 or AO/OTA 31.A2 fractures was conducted. Sixty-eight consecutive patients treated with PCCP between 2018 and 2020 were enrolled and matched with 68 patients with comparable characteristics treated with GN. The activities of daily living (ADL) index and specific scales for walking ability and need for walking aids at 4 months and 1 year after fracture fixation were chosen as primary outcomes. Postoperative complications and one-year survival were recorded and compared between the two groups. Results: Walking ability and ADLs index decreased and the need for walking aids increased in both groups compared to the prefracture state at both follow-up intervals (p < 0.001), regardless of the treatment received. There was no difference between the two implants in the rate of implant-related complications. One-year survival rate was 78.9% (95% CI 67.0-86.9) and 82.4% (95% CI 71.0-89.5) in patients undergoing PCCP or GN, respectively, with no significant difference between the two groups. Conclusions: Walking ability, ADLs, complication rate, and 1-year survival are not significantly different when patients undergoing PCCP or GN are compared. The choice of implant may not be decisive for the outcome of treatment of intertrochanteric fractures, provided that stable fixation is ensured

Architettura tra ricerca e progetto

Il libro documenta gli esiti del Laboratorio di Composizione Architettonica II A del Prof. Giancarlo Priori. Nella presente pubblicazione, che accompagna la mostra dei progetti che si terrà nel Comune di Guidonia Montecelio, sono illustrati i risultati del Corso che prevedeva il progetto del Nuovo Municipio di Guidonia, seguendo gli insegnamenti della teoria dei frattali messa a punto da Benoit B. Mandelbrot. Questo studio sui frattali che viene esteso anche in altre discipline, al di fuori dell’architettura, aiuta a comprendere le problematiche della complessità e del caos. I progetti che vengono presentati esplorano questa possibilità, molti rappresentano anche una metodologia che tende a coniugare i valori della tradizione e della continuità con quelli della innovazione. Una ricerca, questa sui frattali e l’architettura, che include nella disciplina, oltre al valore dell’autonomia anche quello dell'eteronomia, ossia di quegli aspetti culturali esterni all'architettura, ma che possono influenzarla, in una crescita senza fine. Il concetto di città assume, così, un valore fondamentale, diventa il luogo della molteplicità e del pluralismo, dove il pensiero dell'uomo trova facilmente il modo di alimentarsi e di approfondirsi