Glances in Immunology of HIV and HCV Infection

Since the identification of HIV and HCV much progress has been made in the understanding of their life cycle and interaction with the host immune system. Despite these viruses markedly differ in their virological properties and in their pathogenesis, they share many common features in their immune escape and survival strategy. Both viruses have developed sophisticated ways to subvert and antagonize host innate and adaptive immune responses. In the last years, much effort has been done in the study of the AIDS pathogenesis and in the development of efficient treatment strategies, and a fatal infection has been transformed in a potentially chronic pathology. Much of this knowledge is now being transferred in the HCV research field, especially in the development of new drugs, although a big difference still remains between the outcome of the two infections, being HCV eradicable after treatment, whereas HIV eradication remains at present unachievable due to the establishment of reservoirs. In this review, we present current knowledge on innate and adaptive immune recognition and activation during HIV and HCV mono-infections and evasion strategies. We also discuss the genetic associations between components of the immune system, the course of infection, and the outcome of the therapies

Sull'evoluzione commerciale della Street Art

Il 14 febbraio 2008, un’opera di Banksy, Keep it spotless (2007, vernice spray su tela, cm 214 x 305), viene venduta da Sotheby's New York a 1.870.000 $, a sette volte la stima1. Mai prima d’ora uno street artist aveva raggiunto valori così alti. In Italia, opere di Street Art sono presenti nelle collezioni permanenti di musei come il MACRO (Museo d’arte contemporanea) di Roma o il Museo del Novecento di Milano. Il Graffiti Writing, invece, è ormai presente nei manuali di storia dell’arte. Questi due movimenti, appartenenti alla grande famiglia della cosiddetta “Arte Urbana”, termine con la quale si indica ogni tipo di intervento artistico realizzato nel tessuto urbano, sono le correnti artistiche più rappresentative del periodo a cavallo tra i due secoli. Sviluppatisi sul finire del Novecento, Graffiti Writing e Street Art, stanno dominando i primi decenni degli anni Duemila e possono essere considerate le forme artistico-espressive più attuali dell’arte contemporanea. Questa tesi verte sull’analisi storico-artistica dei due movimenti, ripercorrendo la loro storia, le evoluzioni stilistiche e le tecniche, attraverso anche i loro protagonisti e le principali esperienze curatoriali atte allo sviluppo e la diffusione di queste espressioni artistiche. Inizialmente si analizzerà il Writing, movimento controverso e radicale, odiato o amato, che non prevede vie di mezzo. Il Writing è un fenomeno che nasce nelle culture underground, si tratta di un movimento fortemente indipendente e semi-clandestino. Nel corso degli anni sono stati evidenziati diversi nomi per cercare di etichettare o quanto meno inquadrare all’interno di un ambito artistico questo movimento così sfuggente. Il termine “graffiti” è stato menzionato per la prima volta dai giornalisti americani, con un’accezione dispregiativa, in riguardo alle prime tag sparse per la città di New York. Gli storici dell’arte più tradizionali definiscono questa corrente: “Graffitismo”2, termine utilizzato poiché il supporto viene considerato come punto focale del movimento. Infatti: “la materialità artificiale della città costituisce per l’uomo di oggi, altrettanto artificiale, ciò che la pietra naturale ha costituito agli albori della civiltà: una “tabula” su cui esprimersi. Ed anche l’enigmaticità degli antichi segni somiglia all’enigmaticità di quelli presenti.”3 Il termine risulta accettabile per le prime analisi su questo fenomeno, in riferimento alla scena newyorchese degli anni Ottanta, sebbene si vedrà in seguito come molti artisti attribuiti al Graffitismo, in realtà non hanno nulla a che vedere con i giovani che lavorano sul tessuto urbano. Al giorno d’oggi questo termine risulta ormai riduttivo e leggermente passatista. Associato a “Graffitismo” talvolta è possibile trovare anche l’espressione “Graffiti Art”. Questa definizione risulta ancora meno corretta della prima, poiché gli iniziatori del movimento non erano interessati al mondo dell’arte e decisamente non si ritenevano artisti. Il fenomeno, infatti, è iniziato come forma espressiva di comunicazione e solo successivamente è approdato nella sfera artistica. Meglio allora utilizzare il termine “Writing”, termine scelto dagli stessi protagonisti (i writer appunto) che esplicita la cifra caratteristica del movimento, ossia la scrittura. Il Writing verrà analizzato ripercorrendo le sue origini, approfondendo quindi la scena americana, in particolare quella newyorchese. Nel primo capitolo si ripercorrerà la sua storia, dalle origini negli anni Sessanta, all’assalto dei vagoni della metropolitana negli anni Settanta, fino ad arrivare al riconoscimento da parte del mondo artistico negli anni Ottanta. Verranno in seguito esaminati i principali esponenti di questo movimento. Con l’avvento del nuovo millennio si impongono nello spazio urbano nuove forme artistiche. La Street Art in tutte le sue declinazioni diventa padrona indiscussa delle strade. Il Writing e la Street Art diventano le espressioni artistiche più diffuse in tutto il pianeta: risulta quasi impossibile, infatti, trovare delle città urbanizzate totalmente prive di qualche forma di Arte Urbana. Edifici abbandonati, muri periferici, facciate di palazzi, segnali stradali nell’Arte Urbana, tutto il tessuto cittadino viene considerato come una candida tela su cui dipingere, riuscendo anche nell’intento di trasformare i non-luoghi in luoghi4. Verranno in seguito approfonditi alcuni dei principali sotto-generi della Street Art con i loro rispettivi artisti più rappresentativi: Stencil Art, ossia una delle prime espressioni di Street Art, con il suo pioniere Blek le Rat; Poster Art, tecnica preferita da uno tra i più brillanti street artist degli anni Duemila, ossia Shepard Fairey; poi ancora Sticker Art e le opere di pittura murale a mano libera, con un’attenzione particolare agli italiani Blu e Ericailcane (al primo dei quali è dedicato un approfondimento in chiusura di questa tesi). Dopo aver descritto le peculiarità tecnico-stilistiche e la concezione artistico-culturale su cui si fondano i movimenti del Writing e della Street Art, si analizzerà l’influenza che questi movimenti hanno avuto nel mondo dell’arte, in particolare sull’andamento delle quotazioni di mercato, sulla nascita di gallerie specializzate e sulla tendenza a realizzare mostre e manifestazioni specifiche per lo sviluppo e la diffusione di queste espressioni artistiche. A questo scopo, sarà necessario approfondire la figura di Banksy, uno dei più – se non il più – conosciuti street artist a livello mondiale. Con l’avvento di Bansky e dei suoi trasgressivi interventi, tutti i media hanno iniziato ad interessarsi di Writing e di Street Art: i giornali pubblicano articoli sui due movimenti, nascono siti internet specializzati per la diffusione e per la tutela delle opere di arte urbana e vengono anche realizzati numerosi documentari5. Il Writing e la Street Art si espandono in maniera tale che invadono anche altri settori e altri mercati. Il campo che più viene influenzato dalle culture underground è quello della moda e alcuni street artist decidono così di reinventarsi imprenditori ottenendo successi travolgenti. Ne sono un esempio le esperienze di Obey Clothing e Eckō unltd. L’ultima sezione della tesi sarà dedicata allo sforzo di circostanziare il movimento del Writing e della Street Art in Italia. Nel territorio italiano, come in tutto il mondo, il Writing è il movimento che si sviluppa prima rispetto alla Street Art. Il Writing americano, dopo aver viaggiato in Europa, approda in Italia sul finire degli anni Ottanta e si espande a macchia d’olio in tutte le principali città italiane. Lo stile americano, già contagiato dalle influenze europee, trova in Italia un terreno molto fertile e si evolve in uno stile nazionale del tutto peculiare. Milano, Bologna e Roma sono i centri con più fermento, dove si sviluppano i primi stili ed emergono i primi writer. Dieci anni più tardi si accostano al Writing le prime opere di Street Art e in poco tempo gli street artist nostrani raggiungono le vette della Street Art mondiale, dimostrando uno stile unico, che unisce innovazione e tradizione. Artisti come Lucamaleonte, Orticanoodles, Ozmo e Sten & Lex sono invitati a partecipare nei festival di Arte Urbana più importanti a livello internazionale e sono inseriti nei principali volumi specializzati in Street Art. Negli ultimi anni le amministrazioni locali italiane hanno rivalutato l’importanza dell’Arte Urbana all’interno dell’ambito cittadino e hanno iniziato a incentivare manifestazioni di Writing e Street Art, per la riqualificazione e lo sviluppo di aree urbane. Il Writing e la Street Art sono i movimenti artistici più influenti degli ultimi trent’anni. Hanno influenzato il mondo dell’arte e molte altre sfere del nostro vivere quotidiano. L’obiettivo di questa tesi è proprio quello di dimostrare che possono essere considerati a pieno titolo le correnti artistiche caratterizzanti degli inizi del nuovo millennio

Knee osteoarthritis in a chestnut farmer – Case Report

Introduction Several studies have dealt with the issue of professional risk factors and onset of knee osteoarthritis (OA). In particular, occupational epidemiological studies have provided evidence that activities resulting in biomechanical overload may be linked with an increased risk of knee OA – also among farmers. To our knowledge, no cases of knee OA among chestnut farmers have been reported in the literature. Case report We report the case of a 70-year-old Caucasian male who has worked for more than 50 years on a chestnut farm. In 2007, an X-ray and a MRI, performed after a workplace accident to his left knee, showed the presence of knee OA. His job required a range of repetitive tasks, such as squatting, kneeling, climbing, walking on sloping terrain, assuming uncomfortable postures, and lifting and carrying heavy loads for the great majority of the working day. All the aforementioned tasks are known occupational risk factors for knee OA. Regarding individual risk factors, at the time of the first diagnosis of knee OA, the worker was 64-years-old with a body mass index of 26.5 kg/m2. He reported no cases of arthritis among his relatives and no sports playing on his part. In addition, his medical history revealed the presence of two minor lumbar disc herniations and tendinitis of the long head of the biceps. Conclusions Considering the lack of major individual risk factors for knee OA, it is reasonable to suppose that five decades of exposure to biomechanical overload as a chestnut farmer was a relevant risk factor for the onset of the disease

A novel ventilated thermoplastic mesh bandage for post-operative management of large soft tissue defects: a case series of three dogs treated with autologous platelet concentrates

A ventilated thermoplastic mesh bandage was used for the post-operative management of large soft tissue defects in three dogs. Once the granulation tissue appeared, the wounds were treated with liquid or jellified autologous platelet concentrates, Platelet Rich Plasma (PRP) and Platelet Lysate (PL), to improve the wound healing process. After cleaning the wound with sterile physiological solution, a dressing was performed with several layers of cotton. A window through the layers of cotton was opened above the wound. Then, the platelet concentrate was topically applied, and the bandage was completed by placing, over the access window, a ventilated thermoplasticmeshmodeled according to the size and shape of the wound. After 24 h, it was replaced by a low adhesion bandage. The thermoplastic mesh avoids the direct contact between the wound and the external layers of the bandage, preventing the drainage of the topical agent and the removal of the growing healthy granulation tissue. The bandage proposed in this study is easily applied by the veterinarian and well-tolerated by the animal, ensuring high welfare standards in stressed patients presenting compromised clinical conditions

A drug-induced microscopic colitis in an older woman: a case report

We presented a case of a 87-year-old woman hospitalized for chronic watery diarrhea, affected by multimorbidities. After excluding other caus-es of diarrhea by biohumoral and microbiological tests, endoscopy was performed without revealing any macroscopic abnormalities, but, at histological examination of random biopsies, the characteristic features of collagenous colitis were found. Lansoprazolo and sertraline, chronically taken by the patient, was discontinued, and budesonide was started with prompt clinical improvement. Collagenous colitis is a rare cause of chronic diarrhea in advanced age, but it should be suspected in patients with polypharmacotherapy, after an accurate differential diagnosis

Review Article Glances in Immunology of HIV and HCV Infection

Since the identification of HIV and HCV much progress has been made in the understanding of their life cycle and interaction with the host immune system. Despite these viruses markedly differ in their virological properties and in their pathogenesis, they share many common features in their immune escape and survival strategy. Both viruses have developed sophisticated ways to subvert and antagonize host innate and adaptive immune responses. In the last years, much effort has been done in the study of the AIDS pathogenesis and in the development of efficient treatment strategies, and a fatal infection has been transformed in a potentially chronic pathology. Much of this knowledge is now being transferred in the HCV research field, especially in the development of new drugs, although a big difference still remains between the outcome of the two infections, being HCV eradicable after treatment, whereas HIV eradication remains at present unachievable due to the establishment of reservoirs. In this review, we present current knowledge on innate and adaptive immune recognition and activation during HIV and HCV mono-infections and evasion strategies. We also discuss the genetic associations between components of the immune system, the course of infection, and the outcome of the therapies

Observed Differences between Males and Females in Surgically Treated Carpal Tunnel Syndrome Among Non-manual Workers: A Sensitivity Analysis of Findings from a Large Population Study

Objectives: We aimed at assessing whether differences among males and females in carpal tunnel syndrome (CTS) epidemiology might be attributable to segregation with respect to occupational biomechanical exposures or differential access to care by sex. Methods: We analysed surgically treated cases of CTS occurring among non-manual workers in Tuscany between 1997 and 2000. We conducted a Monte Carlo simulation to estimate the difference in occupational biomechanical exposures between males and females necessary to explain the observed incidence rate ratios. We also accounted for the sex-specific probability of receiving surgery after the diagnosis of CTS, as women were reported to be more likely to undergo surgery in a subset of our study population. We quantified the hypothetical biomechanical overload through the hand activity level (HAL) metric proposed by the American Conference of Governmental Industrial Hygienists. To quantify the effect of HAL on CTS risk, we assumed a prior distribution based on findings from two large cohort studies of industrial workers. Results: After adjustment for the probability of receiving surgery, women showed a 4-fold incidence of CTS as compared with men. To explain this association among non-manual workers, women should have an average value of HAL at least 5 points higher. Conclusions: Our analysis does not support the hypothesis that the difference in CTS incidence between males and females is entirely attributable to occupational risk factors or to differential access to surgery. The causal pathway between sex and CTS might include more determinants such as hormonal factors, anthropometric characteristics, and non-occupational exposure to biomechanical overload (e.g. household tasks)

Effectiveness of a 'Global Postural Reeducation' program for persistent Low Back Pain: A non-randomized controlled trial

Background. The aim of this non-randomized controlled trial was to evaluate the effectiveness of a Global Postural Reeducation (GPR) program as compared to a Stabilization Exercise (SE) program in subjects with persistent low back pain (LBP) at short- and mid-term follow-up (ie. 3 and 6 months). Methods. According to inclusion and exclusion criteria, 100 patients with a primary complaint of persistent LBP were enrolled in the study: 50 were allocated to the GPR group and 50 to the SE group. Primary outcome measures were Roland and Morris Disability Questionnaire (RMDQ) and Oswestry Disability Index (ODI). Secondary outcome measures were lumbar Visual Analogue Scale (VAS) and Fingertip-to-floor test (FFT). Data were collected at baseline and at 3/6 months by health care professionals unaware of the study. An intention to treat approach was used to analyze participants according to the group to which they were originally assigned. Results. Of the 100 patients initially included in the study, 78 patients completed the study: 42 in the GPR group and 36 in the SE group. At baseline, the two groups did not differ significantly with respect to gender, age, BMI and outcome measures. Comparing the differences between groups at short- and mid-term follow-up, the GPR group revealed a significant reduction (from baseline) in all outcome measures with respect to the SE group. The ordered logistic regression model showed an increased likelihood of definitive improvement (reduction from baseline of at least 30% in RMDQ and VAS scores) for the GPR group compared to the SE group (OR 3.9, 95% CI 2.7 to 5.7). Conclusions. Our findings suggest that a GPR intervention in subjects with persistent LBP induces a greater improvement on pain and disability as compared to a SE program. These results must be confirmed by further studies with higher methodological standards, including randomization, larger sample size, longer follow-up and subgrouping of the LBP subjects. © 2010 Bonetti et al; licensee BioMed Central Ltd

Using PubMed Search Strings for Efficient Retrieval of Manual Therapy Research Literature

Abstract Objective The aim of this study was to construct PubMed search strings that could efficiently retrieve studies on manual therapy (MT), especially for time-constrained clinicians. Methods Our experts chose 11 Medical Subject Heading terms describing MT along with 84 additional potential terms. For each term that was able to retrieve more than 100 abstracts, we systematically extracted a sample of abstracts from which we estimated the proportion of studies potentially relevant to MT. We then constructed 2 search strings: 1 narrow (threshold of pertinent articles ≥ 40%) and 1 expanded (including all terms for which a proportion had been calculated). We tested these search strings against articles on 2 conditions relevant to MT (thoracic and temporomandibular pain). We calculated the number of abstracts needed to read (NNR) to identify 1 potentially pertinent article in the context of these conditions. Finally, we evaluated the efficiency of the proposed PubMed search strings to identify relevant articles included in a systematic review on spinal manipulative therapy for chronic low back pain. Results Fifty-five search terms were able to extract more than 100 citations. The NNR to find 1 potentially pertinent article using the narrow string was 1.2 for thoracic pain and 1.3 for temporomandibular pain, and the NNR for the expanded string was 1.9 and 1.6, respectively. The narrow search strategy retrieved all the randomized controlled trials included in the systematic review selected for comparison. Conclusion The proposed PubMed search strings may help health care professionals locate potentially pertinent articles and review a large number of MT studies efficiently to better implement evidence-based practice