italian national survey on molecular epidemiology of pseudomonas aeruginosa from pulmonary infection of cystic fibrosis patients

Pulmonary infection sustained by Pseudomonas aeruginosa is the leading cause of morbidity and mortality of patients affected by Cystic Fibrosis (FC), the most common inherited disease among Caucasian. P. aeruginosa is a ubiquitous microorganism, widely diffuse in the natural and nosocomial environment; however the initial source of acquisition and the way of transmission of this pathogen among CF patients are not yet elucidated. The acquisition of P. aeruginosa by the environment and/or patients to patients transmission was speculated. Moreover in some countries (Australia, United Kingdom) some highly virulent and transmissible strains, called epidemic strains, have spread within the CF care Centres. Aim of the present study was to determine the presence of possible diffuse lineages and the cross-infection degree of P. aeruginosa among Italian CF patients. For this purpose we carried out a national survey, determining the genetic relationship, by molecular typing of a collection of 530 strains recovered from respiratory specimens of 335 patients colonised in follow-up at 8 Regional Reference CF Care Centres located in 3 geographic Italian areas.To investigate a possible environmental acquisition of P. aeruginosa, the genetic relationship between strains from FC, from natural environment, household and nosocomial sources. The molecular epidemiological survey was assessed using DNAfingerprinting methods (Box-PCR e Multi Locus Sequence Typing)

Consumption of energy drinks among Italian University students : a cross-sectional multicenter study

Purpose The aim of the study was to evaluate the caffeinated Energy Drinks (EDs) consumption among a large sample of Italian undergraduates and its association with some of the major lifestyle risk factors. Methods Students attending twelve public Italian universities were involved between October 2021 and May 2022. Information on socio-demographic characteristics, ED consumption, and on health-related behaviors of participants was collected by the use of a web-based questionnaire. Results A total of 2165 students participated in the study and 15.2% of them reported having used caffeinated EDs in the last six months, mainly once a month (41.5%). In comparison with non-users, ED users showed a higher proportion of males (p < 0.001) and a higher father’s educational level (p = 0.003), came mainly from Northern universities (p = 0.004) and life sciences degree courses (p < 0.001). Besides, ED users reported higher BMI values (p = 0.003), more particular dietary regimens (p < 0.001), higher levels of weekly moderate–vigorous physical activity (p < 0.001) and participation in sports (p < 0.001) and in team sports (p = 0.003), and higher proportion of smokers (p < 0.001) and alcohol drinkers (p = 0.005). ED use was negatively related with female gender (OR 0.546; 95% CI 0.374–0.798), the Mediterranean diet (OR 0.587; 95% CI 0.362–0.951) and coming from the center of Italy (OR 0.500; 95% CI 0.275–0.909) and positively associated with tobacco smoke (OR 1.712; 95% CI 1.176–2.492) and participation in a team sport (OR 1.686; 95% CI 1.051–2.707). Conclusion These findings could encourage figures engaged in education to increase the students’ awareness on this issue in order to prevent the excessive use of EDs and associated unhealthy behaviors, especially in the most interested subgroups

A machine-learning based bio-psycho-social model for the prediction of non-obstructive and obstructive coronary artery disease

Background: Mechanisms of myocardial ischemia in obstructive and non-obstructive coronary artery disease (CAD), and the interplay between clinical, functional, biological and psycho-social features, are still far to be fully elucidated. Objectives: To develop a machine-learning (ML) model for the supervised prediction of obstructive versus non-obstructive CAD. Methods: From the EVA study, we analysed adults hospitalized for IHD undergoing conventional coronary angiography (CCA). Non-obstructive CAD was defined by a stenosis < 50% in one or more vessels. Baseline clinical and psycho-socio-cultural characteristics were used for computing a Rockwood and Mitnitski frailty index, and a gender score according to GENESIS-PRAXY methodology. Serum concentration of inflammatory cytokines was measured with a multiplex flow cytometry assay. Through an XGBoost classifier combined with an explainable artificial intelligence tool (SHAP), we identified the most influential features in discriminating obstructive versus non-obstructive CAD. Results: Among the overall EVA cohort (n = 509), 311 individuals (mean age 67 ± 11 years, 38% females; 67% obstructive CAD) with complete data were analysed. The ML-based model (83% accuracy and 87% precision) showed that while obstructive CAD was associated with higher frailty index, older age and a cytokine signature characterized by IL-1β, IL-12p70 and IL-33, non-obstructive CAD was associated with a higher gender score (i.e., social characteristics traditionally ascribed to women) and with a cytokine signature characterized by IL-18, IL-8, IL-23. Conclusions: Integrating clinical, biological, and psycho-social features, we have optimized a sex- and gender-unbiased model that discriminates obstructive and non-obstructive CAD. Further mechanistic studies will shed light on the biological plausibility of these associations. Clinical trial registration: NCT02737982

Beta-Blocker Use in Older Hospitalized Patients Affected by Heart Failure and Chronic Obstructive Pulmonary Disease: An Italian Survey From the REPOSI Register

Beta (β)-blockers (BB) are useful in reducing morbidity and mortality in patients with heart failure (HF) and concomitant chronic obstructive pulmonary disease (COPD). Nevertheless, the use of BBs could induce bronchoconstriction due to β2-blockade. For this reason, both the ESC and GOLD guidelines strongly suggest the use of selective β1-BB in patients with HF and COPD. However, low adherence to guidelines was observed in multiple clinical settings. The aim of the study was to investigate the BBs use in older patients affected by HF and COPD, recorded in the REPOSI register. Of 942 patients affected by HF, 47.1% were treated with BBs. The use of BBs was significantly lower in patients with HF and COPD than in patients affected by HF alone, both at admission and at discharge (admission, 36.9% vs. 51.3%; discharge, 38.0% vs. 51.7%). In addition, no further BB users were found at discharge. The probability to being treated with a BB was significantly lower in patients with HF also affected by COPD (adj. OR, 95% CI: 0.50, 0.37-0.67), while the diagnosis of COPD was not associated with the choice of selective β1-BB (adj. OR, 95% CI: 1.33, 0.76-2.34). Despite clear recommendations by clinical guidelines, a significant underuse of BBs was also observed after hospital discharge. In COPD affected patients, physicians unreasonably reject BBs use, rather than choosing a β1-BB. The expected improvement of the BB prescriptions after hospitalization was not observed. A multidisciplinary approach among hospital physicians, general practitioners, and pharmacologists should be carried out for better drug management and adherence to guideline recommendations

The Sex-Specific Detrimental Effect of Diabetes and Gender-Related Factors on Pre-admission Medication Adherence Among Patients Hospitalized for Ischemic Heart Disease: Insights From EVA Study

Background: Sex and gender-related factors have been under-investigated as relevant determinants of health outcomes across non-communicable chronic diseases. Poor medication adherence results in adverse clinical outcomes and sex differences have been reported among patients at high cardiovascular risk, such as diabetics. The effect of diabetes and gender-related factors on medication adherence among women and men at high risk for ischemic heart disease (IHD) has not yet been fully investigated.Aim: To explore the role of sex, gender-related factors, and diabetes in pre-admission medication adherence among patients hospitalized for IHD.Materials and Methods: Data were obtained from the Endocrine Vascular disease Approach (EVA) (ClinicalTrials.gov Identifier: NCT02737982), a prospective cohort of patients admitted for IHD. We selected patients with baseline information regarding the presence of diabetes, cardiovascular risk factors, and gender-related variables (i.e., gender identity, gender role, gender relations, institutionalized gender). Our primary outcome was the proportion of pre-admission medication adherence defined through a self-reported questionnaire. We performed a sex-stratified analysis of clinical and gender-related factors associated with pre-admission medication adherence.Results: Two-hundred eighty patients admitted for IHD (35% women, mean age 70), were included. Around one-fourth of the patients were low-adherent to therapy before hospitalization, regardless of sex. Low-adherent patients were more likely diabetic (40%) and employed (40%). Sex-stratified analysis showed that low-adherent men were more likely to be employed (58 vs. 33%) and not primary earners (73 vs. 54%), with more masculine traits of personality, as compared with medium-high adherent men. Interestingly, women reporting medication low-adherence were similar for clinical and gender-related factors to those with medium-high adherence, except for diabetes (42 vs. 20%, p = 0.004). In a multivariate adjusted model only employed status was associated with poor medication adherence (OR 0.55, 95%CI 0.31–0.97). However, in the sex-stratified analysis, diabetes was independently associated with medication adherence only in women (OR 0.36; 95%CI 0.13–0.96), whereas a higher masculine BSRI was the only factor associated with medication adherence in men (OR 0.59, 95%CI 0.35–0.99).Conclusion: Pre-admission medication adherence is common in patients hospitalized for IHD, regardless of sex. However, patient-related factors such as diabetes, employment, and personality traits are associated with adherence in a sex-specific manner

Orthostatic Intolerance and Postural Orthostatic Tachycardia Syndrome in Joint Hypermobility Syndrome/Ehlers-Danlos Syndrome, Hypermobility Type: Neurovegetative Dysregulation or Autonomic Failure?

Background. Joint hypermobility syndrome/Ehlers-Danlos syndrome, hypermobility type (JHS/EDS-HT), is a hereditary connective tissue disorder mainly characterized by generalized joint hypermobility, skin texture abnormalities, and visceral and vascular dysfunctions, also comprising symptoms of autonomic dysfunction. This study aims to further evaluate cardiovascular autonomic involvement in JHS/EDS-HT by a battery of functional tests. Methods. The response to cardiovascular reflex tests comprising deep breathing, Valsalva maneuver, 30/15 ratio, handgrip test, and head-up tilt test was studied in 35 JHS/EDS-HT adults. Heart rate and blood pressure variability was also investigated by spectral analysis in comparison to age and sex healthy matched group. Results. Valsalva ratio was normal in all patients, but 37.2% of them were not able to finish the test. At tilt, 48.6% patients showed postural orthostatic tachycardia, 31.4% orthostatic intolerance, 20% normal results. Only one patient had orthostatic hypotension. Spectral analysis showed significant higher baroreflex sensitivity values at rest compared to controls. Conclusions. This study confirms the abnormal cardiovascular autonomic profile in adults with JHS/EDS-HT and found the higher baroreflex sensitivity as a potential disease marker and clue for future research

Italian national survey on molecular epidemiology of Pseudomonas aeruginosa from pulmonary infection of Cystic Fibrosis patients

Pulmonary infection sustained by Pseudomonas aeruginosa is the leading cause of morbidity and mortality of patients affected by Cystic Fibrosis (FC), the most common inherited disease among Caucasian. P. aeruginosa is a ubiquitous microorganism, widely diffuse in the natural and nosocomial environment; however the initial source of acquisition and the way of transmission of this pathogen among CF patients are not yet elucidated. The acquisition of P. aeruginosa by the environment and/or patients to patients transmission was speculated. Moreover in some countries (Australia, United Kingdom) some highly virulent and transmissible strains, called epidemic strains, have spread within the CF care Centres. Aim of the present study was to determine the presence of possible diffuse lineages and the cross-infection degree of P. aeruginosa among Italian CF patients. For this purpose we carried out a national survey, determining the genetic relationship, by molecular typing of a collection of 530 strains recovered from respiratory specimens of 335 patients colonised in follow-up at 8 Regional Reference CF Care Centres located in 3 geographic Italian areas.To investigate a possible environmental acquisition of P. aeruginosa, the genetic relationship between strains from FC, from natural environment, household and nosocomial sources. The molecular epidemiological survey was assessed using DNAfingerprinting methods (Box-PCR e Multi Locus Sequence Typing)

Paesaggi del Novecento. Autori e progetti

Per tutto il corso del Novecento, l’aspirazione a un contatto più genuino tra l’uomo e l’ambiente naturale ha condotto ad intravedere nel progetto di paesaggio una “occasione necessaria” per proporre inedite e più consapevoli modalità di prefigurazione dei luoghi. Il volume si interroga sul progetto di paesaggio attraverso la lente della cultura figurativa, ovvero quella capacità del pensiero di tradurre le idee in progetti, i concetti in forme. Le opere che vi sono presentate sono significative non solo in quanto esperienze di una cultura progettuale matura e operante, ma anche per la loro capacità di interpretare temi che si intrecciano con le arti visive, le scienze naturali e sociali. Più che proporsi come un atlante di realizzazioni, questa raccolta vuole costruire un termine di confronto attraverso quattro categorie che con i progetti si è tentato di intercettare: paesaggi della memoria, paesaggi domestici, paesaggi d’invenzione, paesaggi dell’emergenza. I contributi, sempre costruiti a partire dal rapporto tra pensiero e sua concretizzazione, tentano di restituire un panorama complesso e variegato, facendo emergere quella costellazione di autori e progetti che ha dato vita ai Paesaggi del Novecent

Assessment of Dietary Supplement Consumption among Italian University Students: the Multicenter DiSCo Study

Objective: To analyze the consumption of dietary supplements (DSs) and related sociodemographic characteristics or behaviors among Italian undergraduates. Research Methods & Procedures: A questionnaire-based cross-sectional study was carried out between October 2021 and May 2022 involving undergraduates from twelve public universities. The use of DSs in the previous six months, the aim and the reason for use, the purchasing channel and related adverse effects were explored and compared by gender. A logistic regression was performed to highlight possible associations between sociodemographic, anthropometric and behavioral characteristics of participants and supplement consumption. Results: The use of DSs was reported by 71.5% of the 2,165 respondents. Supplementation was related with greater age (OR 1.266, CI95% 0.965-1.660), gender (OR 1.266, CI95% 0.965-1.660 for males), particular diet regimens (OR 3.559, CI95% 1.247-10.159), sport (OR 1.713, CI95% 1.138-2.581) and type of sport (0.608, CI95% 0.411-0.899 for team sports). Women were more keen to use DSs following a doctor’s prescription and to buy them in a pharmacy (p<0.001) but reported more adverse effects (p=0.018) than men. The main aim pursued was general health; proteins, amino acids and non-caffeinated energy supplements were consumed to improve physical performance, and caffeinated energy supplements for mental performance. Conclusions: Diet supplementation was common in the sample examined, especially among females, and associated with particular dietary regimens and sport, especially individual sports. Female consumers follow specialists’ indications more than males. These results highlight the need of educational interventions about diet supplementation for this category of users

What changed in the Italian internal medicine and geriatric wards during the lockdown

Not availabl