Relationship between heart rate recovery and inflammatory markers in patients with polycystic ovary syndrome: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Polycystic ovary syndrome (PCOS) is an endocrine disease closely related to several risk factors for cardiovascular disease. An abnormal heart rate recovery (HRR), an easily-obtained measure derived from exercise stress test and closely related to an increased risk for cardiovascular mortality, has been recently described in PCOS women. A subclinical increase of the inflammation markers has been also observed in the PCOS. This study was designed to study the relationships between HRR and inflammatory markers in PCOS women.</p> <p>Methods</p> <p>Two-hundred forty-three young PCOS patients without known risk factors for cardiovascular risk were enrolled. All patients underwent hormonal and metabolic profile, white blood cells (WBCs) count and C-reactive protein (CRP). HRR was calculated as the difference between heart rate at peak exercise and heart rate at first minute of the cool-down period. Abnormal HRR was defined as ≤18 beats/min for standard exercise testing.</p> <p>Results</p> <p>Eighty-nine out of 243 patients presented abnormal HRR. Serum CRP (1.8 ± 0.7 vs. 1.1 ± 0.4 mg/dl, <it>p </it>< 0.001) and WBCs (7.3 ± 1.8 vs. 6.6 ± 1.5 10⁹cells/l, <it>p </it>< 0.001) concentrations were significantly higher in PCOS patients with abnormal <it>versus </it>normal HRR. HRR was significantly associated with both CRP (r = -0.33, <it>p </it>< 0.001) and WBCs (r = -0.29, <it>p </it>< 0.001), although in a stepwise multiple regression HRR resulted independently associated with CRP (beta = -0.151, p = 0.001) alone. In a logistic multivariate model, the group within the highest quartile of CRP (odds ratio 1.59, 95% CI 1.07–2.33) was more likely to have abnormal HRR than those within the lowest quartile.</p> <p>Conclusion</p> <p>Abnormal HRR and inflammatory markers are closely associated in PCOS women acting probably in concert to increase the cardiovascular risk profile of these patients.</p

Influence of apico-coronal positioning of tissue-level implants on marginal bone stability during supracrestal tissue height establishment: A multi-center prospective study

Introduction Supracrestal tissue height establishment is a crucial factor influencing peri-implant marginal bone modifications prior to prosthesis delivery. If mucosal thickness is insufficient, peri-implant marginal bone resorption occurs to allow appropriate supracrestal tissue height formation. This study evaluates if marginal bone resorption occurring around tissue-level implants before prosthetic loading could be compensated by adapting apico-coronal positioning to mucosal thickness. Methods Patients requiring placement of one single implant in the posterior mandible were treated with tissue-level implants with a 3-mm high transmucosal machined component and moderately rough implant body. Based upon vertical mucosal thickness measured after buccal flap reflection, implants were placed with the treated part: (group 1) 2 mm below crestal level in presence of thin mucosa (&lt;2.5 mm); (group 2) 1 mm below the crestal level in presence of medium mucosa (2.5-3.5 mm); (group 3) at equicrestal level in presence of thick mucosa (&gt;3.5 mm). Results Forty-nine implants, placed in 49 patients were included in final analysis (group 1: 18 implants; group 2: 16 implants; group 3: 15 implants). Mean marginal bone resorption after 5 months of healing was 0.66 +/- 0.49 mm, 0.32 +/- 0.41 mm, and 0.22 +/- 0.52 mm in groups 1, 2, and 3, respectively. Inter-group analysis highlighted significant differences between the three groups after ANOVA test (p = 0.025). However, adaptation of apico-coronal implant positioning in relation to mucosal thickness, allowed to avoid early exposure of the treated surface in 100%, 93.7%, and 53.3% of the implants in groups 1, 2, and 3, respectively. Conclusion During supracrestal tissue height formation, tissue-level implants inserted adapting apico-coronal positioning in relation to mucosal thickness exhibited greater marginal bone resorption at sites with thin mucosa than at sites with medium or thick mucosa. However, anticipating supracrestal tissue height establishment by adapting apico-coronal implant positioning in relation to mucosal thickness may effectively prevent unwanted exposure of treated implant surface

Sandwich panel with lattice core for aircraft anti-ice system made by Selective Laser Melting

Additive Manufacturing (AM) technology offers the possibility to build strong and light components with complex structures, as lattice, optimizing the strength/mass ratio. The goal of this work is the characterization of an innovative sandwich panel with trabecular core made by Selective Laser Melting (SLM), used as heat exchanger for many industrial applications, for example in aerospace field [1]. In this case study, the panel is integrated into the leading edges of aircraft wings and acts as hot air anti-icing system and, at the same time, as impact absorber (Figure 1). The system, due to its lightness and shape, leads to the optimization of the heat exchange, the improvement of the thermal efficiency, and the reduction of fuel use and gas emission. A set of experimental and numerical tests is conducted on lattice specimens through a Design of Experiment (DOE). Different design parameters were varied to understand how they affect the mechanical and thermal behavior: six different cell shapes (Figure 2), varying cell size and volume fraction, were tested. The same experimental program is carried out for two different metal alloys: AlSi10Mg and Ti6Al4V. Mechanical tests involve compression test on single core and on the whole panel, flexural and impact test. Further analisys on failure mechanism is carried out by observation with Optical Microscope. Thermal behavior of the system is also investigated by preliminary thermal simulations, whose results are validated by experimental measuraments of the temperature gradients on the external surface. [1] C. Ferro et al., Technologies, 2017, 5, 35; doi:10.3390/technologies502003

Appropriateness in allergic respiratory diseases health care in Italy: definitions and organizational aspects

In a historical period in which sustainability of the National Health Service is mandatory because of the international economical situation, the limited available resources at national level and the tendency of passing from a "population medicine" model towards the concept of "individualized medicine", the debate on appropriateness of medical and surgical procedures is of central importance. The choosing wisely campaign, started in United States in 2012 and then spread all over the world, tries to summarize which are the most inappropriate procedures for each medical and surgical speciality; as far as allergic respiratory diseases, the most relevant Italian societies and the American Academy defined the allergological procedures with the highest probability of inappropriateness. In Italy, a recent decree of the Ministry of Health defined a list of more than 200 procedures that will be considered as inappropriate in certain conditions; many of these procedures concern allergology, including allergic respiratory diseases. In this commentary we discuss the above mentioned decree and the concept of appropriateness in the field of allergic respiratory diseases, trying to figure out some practical considerations based on the current health resources available in the field of allergology in Italy

MEK1/2 regulate normal BCR and ABL1 tumor-suppressor functions to dictate ATO response in TKI-resistant Ph+ leukemia

Resistance to tyrosine kinase inhibitors (TKIs) remains a clinical challenge in Ph-positive variants of chronic myeloid leukemia. We provide mechanistic insights into a previously undisclosed MEK1/2/BCR::ABL1/BCR/ABL1-driven signaling loop that may determine the efficacy of arsenic trioxide (ATO) in TKI-resistant leukemic patients. We find that activated MEK1/2 assemble into a pentameric complex with BCR::ABL1, BCR and ABL1 to induce phosphorylation of BCR and BCR::ABL1 at Tyr360 and Tyr177, and ABL1, at Thr735 and Tyr412 residues thus provoking loss of BCR's tumor-suppression functions, enhanced oncogenic activity of BCR::ABL1, cytoplasmic retention of ABL1 and consequently drug resistance. Coherently, pharmacological blockade of MEK1/2 induces dissociation of the pentameric MEK1/2/BCR::ABL1/BCR/ABL1 complex and causes a concurrent BCRY360/Y177, BCR::ABL1Y360/Y177 and cytoplasmic ABL1Y412/T735 dephosphorylation thereby provoking the rescue of the BCR's anti-oncogenic activities, nuclear accumulation of ABL1 with tumor-suppressive functions and consequently, growth inhibition of the leukemic cells and an ATO sensitization via BCR-MYC and ABL1-p73 signaling axes activation. Additionally, the allosteric activation of nuclear ABL1 was consistently found to enhance the anti-leukemic effects of the MEK1/2 inhibitor Mirdametinib, which when combined with ATO, significantly prolonged the survival of mice bearing BCR::ABL1-T315I-induced leukemia. These findings highlight the therapeutic potential of MEK1/2-inhibitors/ATO combination for the treatment of TKI-resistant leukemia

Allergic diseases in the elderly: Biological characteristics and main immunological and non-immunological mechanisms

Life expectancy and the number of elderly people are progressively increasing around the world. Together with other pathologies, allergic diseases also show an increasing incidence in geriatric age. This is partly due to the growing emphasis on a more accurate and careful diagnosis of the molecular mechanisms that do not allow to ignore the real pathogenesis of many symptoms until now unknown, and partly to the fact that the allergic people from 20 years ago represent the elderly population now. Moreover, environmental pollution predisposes to the onset of allergic asthma and dermatitis which are the result of internal pathologies more than the expression of allergic manifestations. At the same time the food contamination permits the onset of allergic diseases related to food allergy. In this review we provide the state of the art on the physiological changes in the elderly responsible for allergic diseases, their biological characteristics and the major immunological and extra immunological mechanisms. Much emphasis is given to the management of several diseases in the elderly, including anaphylactic reactions. Moreover, some new features are discussed, such as management of asthma with the support of physical activity and the use of the AIT as prevention of respiratory diseases and for the purpose of a real and long lasting benefit. The mechanisms of adverse reactions to drugs are also discussed, due to their frequency in this age, especially in polytherapy regimens. Study of the modifications of the immune system is also of great importance, as regards to the distribution of the lymphocytes and also the presence of a chronic inflammatory disease related to the production of cytokines, especially in prevision of all the possible therapies to be adopted to allow an active and healthy aging

Inhibition of Feline Immunodeficiency Virus Infectionin Vitroby Envelope Glycoprotein Synthetic Peptides

AbstractSixty-six 20- to 23-amino-acid synthetic peptides, partially overlapping by 10–12 amino acids, spanning the entire sequence of the envelope SU and TM glycoproteins of the Petaluma isolate of FIV, have been used to investigate the Env domains involved in viral infection. Peptides 5 to 7, spanning amino acids225E–P264located in a conserved region of the SU protein, and peptides 58 to 61, spanning amino acids757N–P806and encompassing hypervariable region 8 of TM protein, exhibited a remarkable and specific antiviral effect against the homologous and one heterologous isolate, as judged by inhibition of FIV-induced syncytium formation and p25 production in CrFK cells. Peptides 5 and 7, but not peptides 58 and 59, also inhibited viral replication of a fresh FIV isolate on nontransformed lymphoid cells. By flow cytometry, peptides 5, 7, 58, and 59 were shown to bind the surface of FIV permissive cells. The antiviral activity of peptides 5 and 7, however, was time-dependent, as inhibition of FIV replication was seen when the peptides were administered before or within 3 hr after virus inoculation; in contrast, TM peptides 58 and 59 exerted a potent inhibitory effect when added up to 24 hr after virus inoculation. Circular dychroism analysis showed that peptide 5 folds to a helical conformation in the presence of a hydrophobic environment. Although the basis for the antiviral action of the peptides is not understood, our data suggest that the inhibitory peptides may act by interacting with cell-surface molecules involved in viral infection

L’Oscillometria a impulsi nuovo test di funzionalità respiratoria per i bambini con asma

L’asma è una malattia infiammatoria cronica delle vie aeree che può interessare l’intero albero bronchiale. Recenti evidenze dimostrano che la disfunzione delle piccole vie aeree (o small airway dysfunction, SAD) è un fattore importante nella patogenesi e nell’espressione clinica della malattia. A causa delle difficoltà nella valutazione delle vie aeree periferiche con tecniche non invasive, risulta ancora poco chiaro il ruolo della SAD nell’asma pediatrico, che è invece assodato in età adulta. Secondo recenti lavori, le piccole vie aeree sono interessate già nelle prime fasi dell’asma, ma la spirometria, il test convenzionale per la valutazione della funzione polmonare, non esamina in modo sensibile la loro funzione, risultando alterata solo quando la disfunzione periferica diventa molto rilevante. L’infiammazione cronica e la SAD rappresentano fattori di rischio per la persistenza e la gravità dell’asma, lo scarso controllo della malattia e la progressiva riduzione della funzione polmonare con l’età. Identificare e quantificare il coinvolgimento sia delle vie aeree centrali che periferiche risulta pertanto clinicamente molto rilevante per una diagnosi precoce e per ottenere un buon controllo dell’asma, ridurre l’iperreattività bronchiale e monitorare la risposta al trattamento di fondo. Questo articolo descrive le evidenze recenti sul ruolo della SAD nello sviluppo e nel controllo dell’asma pediatrico e valuta il contributo di una nuova tecnica diagnostica disponibile in ambito ambulatoriale, l’oscillometria a impulsi, nella diagnosi precoce di SAD in età prescolare e scolare, nel monitoraggio dell’asma (in associazione alla spirometria) e nella gestione terapeutica

Allergic diseases in the elderly: Biological characteristics and main immunological and non-immunological mechanisms

Life expectancy and the number of elderly people are progressively increasing around the world. Together with other pathologies, allergic diseases also show an increasing incidence in geriatric age. This is partly due to the growing emphasis on a more accurate and careful diagnosis of the molecular mechanisms that do not allow to ignore the real pathogenesis of many symptoms until now unknown, and partly to the fact that the allergic people from 20 years ago represent the elderly population now. Moreover, environmental pollution predisposes to the onset of allergic asthma and dermatitis which are the result of internal pathologies more than the expression of allergic manifestations. At the same time the food contamination permits the onset of allergic diseases related to food allergy. In this review we provide the state of the art on the physiological changes in the elderly responsible for allergic diseases, their biological characteristics and the major immunological and extra immunological mechanisms. Much emphasis is given to the management of several diseases in the elderly, including anaphylactic reactions. Moreover, some new features are discussed, such as management of asthma with the support of physical activity and the use of the AIT as prevention of respiratory diseases and for the purpose of a real and long lasting benefit. The mechanisms of adverse reactions to drugs are also discussed, due to their frequency in this age, especially in polytherapy regimens. Study of the modifications of the immune system is also of great importance, as regards to the distribution of the lymphocytes and also the presence of a chronic inflammatory disease related to the production of cytokines, especially in prevision of all the possible therapies to be adopted to allow an active and healthy aging

Relationships between geogenic radon potential and gamma ray maps with indoor radon levels at Caprarola municipality (central Italy)

Exposures to relatively high indoor radon (222Rn) levels represents a serious public health risk because Rn is associated with lung cancer (Darby et al., 2001; WHO, 2009; Oh et al., 2016; Sheen et al., 2016). The risk is high because radon, and its short-lived decay products in the atmosphere, contributes for about 60% of the total annual effective dose (UNSCEAR, 2000; WHO, 2009). Cancer risk is increased by smoking being almost 9 times higher than the risk to non-smokers exposed to similar levels (EPA, 2009). Due to these reasons, it is very important to assess the indoor exposure of public to radon and their daughters. Rn is a natural ubiquitous gas and its abundance is mainly controlled by the geology, and in particular by the soil and rock content of its parent nuclide (238U). Furthermore, bedrock characteristics (i.e. permeability and porosity) and also fault activity can affect the amount of Rn released in the ground (Ciotoli et al., 2007; Barnet et al., 2018). As such, in conditions of permeable and/or fractured bedrock and high uranium content, high indoor radon concentrations are expected (Bossew and Lettner, 2007; Gruber et al., 2013; Cinelli et al., 2015; Ielsch et al., 2017; Ciotoli et al., 2017). A non-natural contribution that controls the indoor Rn levels is home construction type and building materials (Vauptic et al., 2002; Appleton, 2007). Additionally, meteorological factors, such as wind, temperature and humidity, can affect the rate of Rn entry into the buildings (Porstendörfer et al., 1994; Miles et al., 2005; Schubert et al., 2018). In this work, we propose a new geospatial technique to construct the geogenic radon potential (GRP) map of the Caprarola municipality (northern Lazio, central Italy) characterized by recent (about 100 Kyr) volcanic deposits with high content in radon parent nuclides (Ciotoli et al., 2017). GRP map has been obtained by using Empirical Bayesian Kriging Regression (EBKR) technique with soil gas radon, as the response variable, and a number of proxy variables (i.e. content of the radiogenic parent nuclides, the emanation coefficient of the outcropping rocks, the diffusive 222Rn flux from the soil, the soil-gas CO2 concentration, the Digital Terrain Model (DTM), the permeability of the outcropping rocks and the gamma dose radiation of the shallow lithology. Furthermore, possible relationships between predicted soil radon values (i.e. GRP) and gamma radiation distribution with the indoor concentrations measured in private and public buildings has been investigated, respectively. The obtained results confirm that GRP maps provide the local administration of a useful tool for land use planning and that, the mapping of gamma emission, allows to a fast and effective evaluation of indoor radon hazard because it is mainly influenced by the building materials rather than other anthropic controls