Streptococcus pneumoniae colonisation in children and adolescents with asthma: Impact of the heptavalent pneumococcal conjugate vaccine and evaluation of potential effect of thirteen-valent pneumococcal conjugate vaccine

none14noBackground: The main aim of this study was to evaluate Streptococcus pneumoniae carriage in a group of school-aged children and adolescents with asthma because these results might indicate the theoretical risk of invasive pneumococcal disease (IPD) of such patients and the potential protective efficacy of the 13-valent pneumococcal conjugate vaccine (PCV13). Methods: Oropharyngeal samples were obtained from 423 children with documented asthma (300 males, 70.9 %), and tested for the autolysin-A-encoding (lytA) and the wzg (cpsA) gene of S. pneumoniae by means of real-time polymerase chain reaction. Results: S. pneumoniae was identified in the swabs of 192 subjects (45.4 %): 48.4 % of whom were aged = 15 years (p < 0.001). Carriage was significantly less frequent among the children who had received recent antibiotic therapy (odds ratio [OR 0.41]; 95 % confidence interval [95 % CI] 0.22-0.76). Multivariate analyses showed no association between carriage and vaccination status, with ORs of 1.05 (95 % CI 0.70-1.58) for carriers of any pneumococcal serotype, 1.08 (95 % CI 0.72-1.62) for carriers of any of the serotypes included in 7-valent pneumococcal conjugate vaccine (PCV7), and 0.76 (95 % CI 0.45-1.28) for carriers of any of the six additional serotypes of PCV13. Serotypes 19 F, 4 and 9 V were the most frequently identified serotypes in vaccinated subjects. Conclusions: These results showed that carriage of S. pneumoniae is relatively common in all school-aged children and adolescents with asthma, regardless of the severity of disease and the administration of PCV7 in the first years of life. This highlights the problem of the duration of the protection against colonisation provided by pneumococcal conjugate vaccine, and the importance of re-colonization by the same pneumococcal serotypes included in the previously used vaccine.Esposito, Susanna; Terranova, Leonardo; Patria, Maria Francesca; Marseglia, Gian Luigi; Miraglia del Giudice, Michele; Bodini, Alessandro; Martelli, Alberto; Baraldi, Eugenio; Mazzina, Oscar; Tagliabue, Claudia; Licari, Amelia; Ierardi, Valentina; Lelii, Mara; Principi, NicolaEsposito, Susanna; Terranova, Leonardo; Patria, Maria Francesca; Marseglia, GIAN LUIGI; Miraglia del Giudice, Michele; Bodini, Alessandro; Martelli, Alberto; Baraldi, Eugenio; Mazzina, Oscar; Tagliabue, Claudia; Licari, Amelia; Ierardi, Valentina; Lelii, Mara; Principi, Nicol

Determination of disease severity in COVID-19 patients using deep learning in chest X-ray images

PURPOSEChest X-ray plays a key role in diagnosis and management of COVID-19 patients and imaging features associated with clinical elements may assist with the development or validation of automated image analysis tools. We aimed to identify associations between clinical and radiographic features as well as to assess the feasibility of deep learning applied to chest X-rays in the setting of an acute COVID-19 outbreak.METHODSA retrospective study of X-rays, clinical, and laboratory data was performed from 48 SARS-CoV-2 RT-PCR positive patients (age 60±17 years, 15 women) between February 22 and March 6, 2020 from a tertiary care hospital in Milan, Italy. Sixty-five chest X-rays were reviewed by two radiologists for alveolar and interstitial opacities and classified by severity on a scale from 0 to 3. Clinical factors (age, symptoms, comorbidities) were investigated for association with opacity severity and also with placement of central line or endotracheal tube. Deep learning models were then trained for two tasks: lung segmentation and opacity detection. Imaging characteristics were compared to clinical datapoints using the unpaired student’s t-test or Mann-Whitney U test. Cohen’s kappa analysis was used to evaluate the concordance of deep learning to conventional radiologist interpretation.RESULTSFifty-six percent of patients presented with alveolar opacities, 73% had interstitial opacities, and 23% had normal X-rays. The presence of alveolar or interstitial opacities was statistically correlated with age (P = 0.008) and comorbidities (P = 0.005). The extent of alveolar or interstitial opacities on baseline X-ray was significantly associated with the presence of endotracheal tube (P = 0.0008 and P = 0.049) or central line (P = 0.003 and P = 0.007). In comparison to human interpretation, the deep learning model achieved a kappa concordance of 0.51 for alveolar opacities and 0.71 for interstitial opacities.CONCLUSIONChest X-ray analysis in an acute COVID-19 outbreak showed that the severity of opacities was associated with advanced age, comorbidities, as well as acuity of care. Artificial intelligence tools based upon deep learning of COVID-19 chest X-rays are feasible in the acute outbreak setting

Chemical–physical properties, morphology, and magnetic investigations on new cystine functionalized ultra-small super-paramagnetic iron-oxide nanoparticles

Several experimental techniques have been used to investigate the chemical physical properties of new functionalized ultra-small iron oxide nanoparticles (USPION), which are of interest for biomedical applications. Methods: The chemical composition of oleate-coated iron oxide (OA-NPs) and cystine-coated iron oxide (Cy-NPs) nanoparticles was investigated by means of analytical methods and Fourier Transform Infrared (FT-IR) spectroscopy. Atomic Force Microscopy (AFM) and Transmission Electron Microscopy (TEM) investigations, at high and low resolutions, on both OA-NPs and Cy-NPs, were performed to investigate their morphology. The magnetization and susceptibility behavior of OA-NPs and Cy-NPs were studied by SQUID magnetometry. Results: The combination of different experimental techniques was of help in characterizing the chemical structure of both magnetic core and surface-coating of OA-NPs and Cy-NPs. AFM/TEM images and magnetic measurements were analyzed in terms of crystallinity, polidispersity, average magnetic core size and coating effects of these nanoparticles. Conclusions: These results show that the preparations reported in the present paper are effective in obtaining nanoparticles of 4 nm magnetic core size and the procedure is highly reproducible. The presence of the external cystine shell, fundamental for biomedical applications, does not affect the polidispersity, the crystallinity or the average core size. Moreover, similar values of the average core dimensions have been obtained by three different techniques (AFM and TEM images, magnetic measurements

Вплив змішаного бактеріального лізату (ОМ-85 BV) на імуногенність, безпеку та переносимість інактивованої вакцини проти грипу у дітей із рецидивною інфекцією дихальних шляхів

It is known that the immunogenicity and efficacy of conventional inactivated influenza vaccines (IIVs) are not completely satisfactory in children. The aim of this prospective, randomised, single-blind study was to compare the immune response to, and the effectiveness and safety of, an IIV (Fluarix, GlaxoSmithKline Biologicals, Rixensart, Belgium) administered to 68 children aged 36–59 months affected by recurrent respiratory tract infections (RRTIs) who were vaccinated with (n=33) or without (n=35) the mixed bacterial lysate OM-85 BV (Broncho-vaxom, Vifor Pharma, Geneva, Switzerland). OM-85 BV had no effect on seroconversion or seroprotection rates, geometric mean titres, or dendritic cells, which were not significantly different between the two groups. Moreover, OM-85 BV did not significantly increase the pool of the memory B cells that produce IgG and IgM antibodies against the influenza antigens. However, respiratory morbidity was significantly lower in the children treated with OM-85 BV (p&lt;0.05), thus confirming its positive effect on the incidence of RRTIs. There was no difference in the incidence of adverse events between the two groups. These findings show that the immune response of children to influenza vaccine is not significantly influenced by the administration of OM-85 BV. However, the use of OM-85 before and at the same time as IIV seems to reduce respiratory morbidity, and seems to be safe and well tolerated.Key words: Bacterial lysate, Children, Influenza, Influenza vaccine, OM-85 BV, Recurrent respiratory tract infection.Известно, что иммуногенность и эффективность стандартных инактивированных вакцин против гриппа (IIV) не имеет должного результата у детей. Целью данного проспективного рандомизированного простого слепого исследования было сравнить иммунный ответ на эффективность и безопасность вакцины IIV (Fluarix, GlaxoSmithKline Biologicals, Rixensart, Belgium). В исследовании принимали участие 68 детей с рецидивирующей респираторной инфекцией (РРИ), средний возраст которых составлял 36–59 месяцев. Детям была назначена вакцина в комбинации с (n=33) или без (n=35) бактериального лизата ОМ-85 BV (Broncho-vaxom,Vifor Pharma, Geneva, Switzerland). ОМ-85 BV не оказала никакого влияния на показатели сероконверсии или серопротекции, среднее геометрическое значение титров или дендритные клетки, данные которых не особо отличались между двумя группами. Более того, применение вакцины ОМ-85 BV незначительно увеличило пул В-клеток памяти, которые производят антитела IgG и IgM против антигенов гриппа. У детей, получавших OM-85 BV (р&lt;0,05), была значительно ниже частота РРИ, что подтверждает ее эффективность. Разницы в частоте побочных эффектов между двумя группами не обнаружено. Это доказывает, что иммунная реакция детей на введение вакцины ОМ-85 BV против гриппа не ярко выражена. Хотя можно отметить, что использование ОМ-85 BV ранее и в комбинации с IIV уменьшает количество случаев заболеваемости респираторными инфекциями, а также является безопасным методом вакцинации.Ключевые слова: бактериальный лизат, дети, грипп, вакцина против гриппа, ОM-85BV, рецидивирующая респираторная инфекция.Відомо, що імуногенність і ефективність стандартних інактивованих вакцин проти грипу (IIV) не мають належного результату у дітей.Метою даного проспективного рандомізованого простого сліпого дослідження було порівняти імунну відповідь на ефективність і безпеку вакцини IIV (Fluarix, GlaxoSmithKline Biologicals, Rixensart, Belgium). У дослідженні брали участь 68 дітей із рецидивною респіраторною інфекцією (РРІ), середній вік яких складав 36–59 місяців. Дітям була призначена вакцина в комбінації з (n=33) або без (n=35) бактеріального лізату ОМ-85 BV (Broncho-vaxom,Vifor Pharma, Geneva, Switzerland). ОМ-85 BV не здійснила ніякого впливу на показники сероконверсії або серопротекції, середнє геометричне значення титрів або дендритні клітини, дані яких не дуже відрізнялись між двома групами. Більш того, застосування вакцини ОМ-85 BV незначно збільшувало пул В-клітин пам'яті, які виробляють антитіла IgG та IgM проти антигенів грипу. У дітей, які отримували OM-85 BV (р&lt;0,05), була значно нижчою частота РРІ, що підтверджує її ефективність. Різниці у частоті побічних ефектів між двома групами не виявлено. Це доводить, що імунна реакція дітей на введення вакцини ОМ-85 BV проти грипу невиразна. Хоча можна відмітити, що використання ОМ-85 BV раніше та у комбінації з IIV зменшує кількість випадків захворюваності респіраторними інфекціями, а також є безпечним методом вакцинації.Ключові слова: бактеріальний лізат, діти, грип, вакцина проти грипу, ОM-85BV, рецидивна респіраторна інфекція

Micro and nanofluidic platforms for advanced diagnostics

Aims: Sensitivity, selectivity and tunability are keywords to develop effective and reliable diagnostic and bioanalytical tools. In this context, micro and nanofluidic devices constitute a powerful and versatile answer to the growing and urgent demand for innovative solutions. Nevertheless, a precise control of size and functionality of such structures is necessary for ensuring advanced manipulation and sensing capabilities, up to single molecule level. Methods: We report here on different strategies for the development of micro and nanofluidic platforms for advanced diagnostics based on the exploitation of the elastic properties of deformable materials, and on surface chemical functionalization processes. Results: We demonstrated that applying a macroscopic mechanical compression to elastomeric nanostructures it is possible to increase their confining power and vary the dynamics of DNA translocation process, while the use of the chemical functionalization allows to tune both the size and the functionality of the biosensor. Conclusion: We believe that a smart integration of these two approaches would allow a significant step forward for the fabrication of next-generation lab-on-chip devices for biomedical diagnostic applications

Differences in dietary habits between patients with inflammatory bowel disease in clinical remission and a healthy population

Background Although patients with active inflammatory bowel disease (IBD) change their dietary habits according to suggestions from their healthcare team, no restriction is required in the remission phase. Accordingly, we compared eating patterns in IBD patients with drug-induced clinical remission with those in healthy subjects. Methods A total of 150 IBD patients, 84 with Crohn’s disease (CD) and 66 with ulcerative colitis (UC), in clinical remission, receiving immunomodulator/biologic therapy, and 100 healthy volunteers (controls) were enrolled. The IBD diagnosis had previously been established by a combined assessment of symptoms, endoscopy, histology and abdominal imaging. Clinical remission was defined as a Harvey Bradshaw index <5 for CD and a partial Mayo score <2 for UC. An experienced nutritionist guided the compilation of a food diary for 7 days according to current guidelines. Macronutrient and fiber intake was evaluated using dedicated software. Comparison between continuous variables was performed using Student’s t-test or analysis of variance plus Bonferroni post-hoc analysis. Categorical variables were tested with the χ2test. Results No difference in protein and carbohydrate intake was observed. IBD patients ate more calories (1970.7±348.4 vs. 1882.1±280.2 kcal/day, P=0.03), more lipids (68.9±15.2 vs. 59.4±19.0 g/day, P<0.001) and less fibers (11.9±4.7 vs. 15.5±8.3 g/day, P<0.001) than controls. No significant difference in total calories, proteins, lipids, carbohydrates or fibers was seen between CD and UC patients. Conclusion IBD patients have a different macronutrient and fiber intake compared to healthy subjects, even when clinical remission and no symptoms do not dictate dietary restrictions. Therefore, psychological issues may be involved

CT after Lung Microwave Ablation: Normal Findings and Evolution Patterns of Treated Lesions

Imaging-guided percutaneous ablative treatments, such as radiofrequency ablation (RFA), cryoablation and microwave ablation (MWA), have been developed for the treatment of unresectable primary and secondary lung tumors in patients with advanced-stage disease or comorbidities contraindicating surgery. Among these therapies, MWA has recently shown promising results in the treatment of pulmonary neoplasms. The potential advantages of MWA over RFA include faster ablation times, higher intra-tumoral temperatures, larger ablation zones and lower susceptibility to the heat sink effect, resulting in greater efficacy in proximity to vascular structures. Despite encouraging results supporting its efficacy, there is a relative paucity of data in the literature regarding the role of computer tomography (CT) to monitor MWA-treated lesions, and the CT appearance of their morphologic evolution and complications. For both interventional and non-interventional radiologists, it is crucial to be familiar with the CT features of such treated lesions in order to detect incomplete therapy or recurrent disease at early stage, as well as to recognize initial signs of complications. The aim of this pictorial essay is to describe the typical CT features during follow-up of lung lesions treated with percutaneous MWA and how to interpret and differentiate them from other radiological findings, such as recurrence and complications, that are commonly encountered in this setting

Ultrasmall superparamagnetic iron oxide nanoparticles with titanium-N,N-dialkylcarbamato coating

This work deals with the preparation and physical-chemical characterization of new ultrasmall iron oxide superparamagnetic nanoparticles (USPIONs) functionalized with titanium-N,N-dialkylcarbamato. The preparation was performed starting with monodispersed USPIONs covered with oleic acid, synthesized by thermal-decomposition, and subsequently functionalized with metal-carbamato by a ligand-exchange reaction. The surface and coating structure was characterized by infrared (FT-IR) spectroscopy on the solid powders and thermogravimetry (TG) coupled with an FT-IR detector in order to better investigate the self-assembling properties of the coating. A detailed dimensional and morphological study was carried out by transmission electron microscopy (TEM) and atomic force microscopy (AFM) analysis. Zero-field-cooled (ZFC) and fieldcooled (FC) magnetic susceptibility curves as well as the magnetization behavior as a function of temperature were investigated on both the starting oleic- USPIONs and those covered by titanium-N,N-dialkylcarbamato. These results confirmed the superparamagnetic properties of the new nanoparticles (NPs), highlighting the quite high saturation value of the magnetization. Based on the results obtained by combining different experimental techniques, a model of the coating structure and ligand organization around the magnetic core is proposed for both NPs, i.e. the starting USPIONs covered by oleic acid and the new USPIONs functionalized by titanium-N,N-dialkylcarbamato

Precursors of Magnetic Resonance Imaging Contrast Agents Based on Cystine-coated Iron-oxide Nanoparticles

Super Paramagnetic Iron-Oxide Nanoparticles (SPION) are currently used as magnetic resonance imaging (MRI) contrast agents. The functionalization of their surface with organic and biocompatible molecules has the purpose to produce carriers selective for different tissues and organs. In this paper, we present the preparation of new cystine-coated ultra small super paramagnetic iron-oxide nanoparticles (USPION) of different core size, from 4 nm to 11 nm. The physical-chemical characterization of these nanoparticles was performed by using several experimental techniques, such as atomic force microscopy (AFM), high resolution transmission electron microscopy (HRTEM) and magnetic measurements. 1H NMR relaxation times at different magnetic field strengths have been measured for several waterdispersions of cystine-coated iron-oxide nanoparticles of the smallest dimensions (4 nm). These preliminary results confirm their potentialities as molecular imaging probes and MRI contrast agents