Diversity of cervical microbiota in asymptomatic chlamydia trachomatis genital infection: a pilot study

Chlamydia trachomatis genital infection continues to be an important public health problem worldwide due to its increasing incidence. C. trachomatis infection can lead to severe sequelae, such as pelvic inflammatory disease, obstructive infertility, and preterm birth. Recently, it has been suggested that the cervico-vaginal microbiota may be an important defense factor toward C. trachomatis infection as well as the development of chronic sequelae. Therefore, the investigation of microbial profiles associated to chlamydial infection is of the utmost importance. Here we present a pilot study aiming to characterize, through the metagenomic analysis of sequenced 16s rRNA gene amplicons, the cervical microbiota from reproductive age women positive to C. trachomatis infection. The main finding of our study showed a marked increase in bacterial diversity in asymptomatic C. trachomatis positive women as compared to healthy controls in terms of Shannon's diversity and Shannon's evenness (P = 0.031 and P = 0.026, respectively). More importantly, the cervical microbiota from C. trachomatis positive women and from healthy controls significantly separated into two clusters in the weighted UniFrac analysis (P = 0.0027), suggesting that differences between the two groups depended entirely on the relative abundance of bacterial taxa rather than on the types of bacterial taxa present. Furthermore, C. trachomatis positive women showed an overall decrease in Lactobacillus spp. and an increase in anaerobes. These findings are part of an ongoing larger epidemiological study that will evaluate the potential role of distinct bacterial communities of the cervical microbiota in C. trachomatis infection

HCV genotype 3: An independent predictor of fibrosis progression in chronic hepatitis C

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Quality in the extra-analytical phases of urinalysis

The chemical, physical and morphologic urine examination has undergone radical changes over the last few years, so that the time has come for introducing further changes and modifications in various steps of this important test. The breakthroughs of new technologies have allowed making the laboratory report much more informative for the stakeholders. Nevertheless, important considerations for improving the quality throughout the testing process were also raised, especially in the preanalytical phase. Currently, it might be advisable to pursue consolidation and standardization of the analytical phase, as well as redefinition of clinical targets through construction of a complete, integrated and much more clinically meaningful report. This article aims to review the state of the art in urinalysis, as well as providing useful information for achieving more standardization and quality of this useful diagnostic test

intensive nutritional counselling and support and clinical outcomes in hemodialysis patients

Protein-energy wasting is frequently found in haemodialysis (HD) patients. Anorexia and hypophagia contribute to malnutrition, increased morbidity and mortality, but the clinical impact of correcting hypophagia remains uncertain. We evaluated whether correction of hypophagia influences morbidity and mortality in anorexic HD patients. Thirty-four HD patients were enrolled in a 2-year follow-up programme including regular nutritional assessment. Patients not meeting nutritional requirements during the follow-up, received nutritional counselling, consisting of advice, individually tailored diet and, in case of failure of dietary intervention, artificial nutrition. Biochemical, anthropometric, body composition parameters, morbidity and mortality were recorded in all patients at 12 and 24 months. At baseline, 14 patients (41%) were anorexic, and 20 patients (59%) non-anorexic. Anorexic patients were hypophagic and presented with reduced fat-free mass. After 12 and 24 months, cholesterol, albumin, lymphocyte count and BMI did not differ among groups, while FFM (%) in supplemented anorexic patients significantly improved, being not different any more vs non-anorexic (65.8±4.4 vs 65.4±8.9, respectively; p=n.s.; 65.8±4.4 vs 66.7±10.78, respectively; p=n.s.). Morbidity and mortality were not different among the two groups. In conclusion, in HD patients, nutritional counselling and nutritional support positively affect nutritional status in hypophagic patients and make the risk of morbidity and mortality in anorexic patients comparable to non-anorexic

Comparing inconsistency of pairwise comparison matrices depending on entries

Pairwise comparisons have been a long-standing technique for comparing alternatives/criteria and their role has been pivotal in the development of modern decision-making methods. Since several types of pairwise comparison matrices (e.g., multiplicative, additive, fuzzy) are proposed in literature, in this paper, we investigate, for which type of matrix, decision-makers are more coherent when they express their subjective preferences. By performing an experiment, we found that the additive approach provides the worst level of coherence

Fatigue in Patients on Chronic Hemodialysis: The Role of Indoleamine 2,3-Dioxygenase (IDO) Activity, Interleukin-6, and Muscularity

Fatigue is a frequent symptom in hemodialysis (HD), and the indolamine-2,3-dioxygenase (IDO) metabolic trap has been hypothesized in the pathogenesis of fatigue. The association between IDO activity according to fatigue and its relationship with muscle mass and function in HD patients was verified. Chronic HD patients were considered, and fatigue was assessed. The plasma kynurenines and tryptophan ratio (Kyn/Trp), as surrogate of IDO activity, and interleukin (IL)-6 were measured. Muscularity was assessed by BIA and muscle strength by hand-grip dynamometer. 50 HD patients were enrolled, and fatigue was present in 24% of the cohort. Patients with fatigue showed higher Kyn/Trp (p = 0.005), were older (p = 0.007), and IL-6 levels resulted higher than in non-fatigue patients (p < 0.001). HD patients with fatigue showed lower intracellular water (surrogate of muscle mass) (p < 0.001), as well as lower hand grip strength (p = 0.02). The Kyn/Trp ratio positively correlated with IL-6 and ECW/ICW (p = 0.004 and p = 0.014). By logistic regression analysis, higher ICW/h(2) was associated with lower odds of fatigue (OR, 0.10; 95% CI, 0.01 to 0.73). In conclusion, our cohort fatigue was associated with a higher Kyn/Trp ratio, indicating a modulation of IDO activity. The Kyn/Trp ratio correlated with IL-6, suggesting a potential role of IDO and inflammation in inducing fatigue and changes in muscularity

Ribavirin Impairs Salivary gland function During Combination Treatment With Pegylated Interferon Alfa-2a In HEpatitis C patients

Background: Xerostomia is a common adverse event of unknown etiology observed during pegylated interferon (PegIFN)/Ribavirin (Rbv) treatment. Objectives: To assess the frequency and mechanisms of xerostomia during PegIFN/Rbv therapy. Patients and Methods: Thirty-one naive patients with chronic hepatitis C consecutively received PegIFN-alpha 2a (180 mu g/week) plus Rbv (800-1200 mg/day). The controls were 10 patients with chronic hepatitis B who received PegIFN-alpha 2a (180 mu g/week). During treatment and follow-up, all patients underwent basal and masticatory stimulated sialometry, otorhinolaryngoiatric (ORL) examination, and a questionnaire survey to subjectively assess symptoms of oral dryness. Results: Twenty-seven patients on PegIFN/Rbv and 4 on PegIFN (87% vs. 40%, P = 0.006) reported xerostomia. Thirty patients on PegIFN/Rbv combination therapy and 2 patients on monotherapy had ORL signs of salivary gland hypofunction (97% vs. 20%, P < 0.0001). Mean basal (A) and stimulated (B) salivary flow rates (mL/min) progressively decreased during PegIFN/Rbv treatment (A, 0.49 at baseline vs. 0.17 at the end of treatment, P < 0.0001; B,1.24 at baseline vs. 0.53 at the end of treatment, P = 0.0004). At week 24 following PegIFN/Rbv treatment, salivary flow rates were similar to baseline (A, 0.53 at the end of follow-up vs. 0.49 at baseline; B,1.19 at the end of follow-up vs. 1.24 at baseline). Salivary function was unaffected in monotherapy patients. Conclusions: Rbv causes salivary gland hypofunction in hepatitis C patients receiving PegIFN/Rbv therapy, which promptly reverts to normal upon cessation of treatment

Abuses and Distortions in Emotional Processes as Risk Factors for Parricide

Parricide is a rare case of murder having a strong emotional impact on public opinion, especially when it is heinous and perpetrated by minors. Based on the analysis of the judicial files archived at the Minor Penal Institute "N. Fornelli" of Bari, the authors will report three impressive cases perpetrated by minors, by focusing on their emotional features. Differences between the crimes of parricide committed by adults and minors will be highlighted, by analyzing the peculiar relations between the problems underlying parricide and the role played by abuses and maltreatments experienced by minors perpetrating such crime. In particular, attention will be paid to the emotional processes aroused in minor parricide offenders

Pyoderma gangrenosum of the “sinus mammarum” in ulcerative colitis

The first part of this article deals with the report of a patient suffe - ring from pyoderma gangrenosum of the “sinus mammarum” associa - ted with asymptomatic ulcerative colitis. This is followed by a revision of the present epidemiological, etiological, pathogenetic and clinical knowledges about this systemic manifestation of chronic phlogosis of the colon. The Authors have analysed the treatment for this condition and emphasized the resistance of the cutaneous ulcer encountered to conven - tional medical therapy of the underlying colonic disease which proved to be efficacious only on the latter; this led to integrate traditional treatment with the use of perilesional injections of small doses of calcic heparin as an alternative to immunosuppressive drugs or surgery. Topical antithrombotic treatment, which can be justified by the histo - logical findings of phenomena of the vasculitis in the edge of pyoderma gangrenosum, demonstrated to be crucial and represents a peculiarity in the case here reported, which is unique in the literature as far as the Authors know, since it has not been experimented by anyone else