Guideline on management of the acute asthma attack in children by Italian Society of Pediatrics.

BACKGROUND: Acute asthma attack is a frequent condition in children. It is one of the most common reasons for emergency department (ED) visit and hospitalization. Appropriate care is fundamental, considering both the high prevalence of asthma in children, and its life-threatening risks. Italian Society of Pediatrics recently issued a guideline on the management of acute asthma attack in children over age 2, in ambulatory and emergency department settings. METHODS: The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology was adopted. A literature search was performed using the Cochrane Library and Medline/PubMed databases, retrieving studies in English or Italian and including children over age 2 year. RESULTS: Inhaled ß2 agonists are the first line drugs for acute asthma attack in children. Ipratropium bromide should be added in moderate/severe attacks. Early use of systemic steroids is associated with reduced risk of ED visits and hospitalization. High doses of inhaled steroids should not replace systemic steroids. Aminophylline use should be avoided in mild/moderate attacks. Weak evidence supports its use in life-threatening attacks. Epinephrine should not be used in the treatment of acute asthma for its lower cost / benefit ratio, compared to β2 agonists. Intravenous magnesium solphate could be used in children with severe attacks and/or forced expiratory volume1 (FEV1) lower than 60% predicted, unresponsive to initial inhaled therapy. Heliox could be administered in life-threatening attacks. Leukotriene receptor antagonists are not recommended. CONCLUSIONS: This Guideline is expected to be a useful resource in managing acute asthma attacks in children over age 2

Hydroxyindole-O-methyltransferase (HIOMT) activity in the retina of melatonin-proficient mice

Numerous pieces of evidence support the expression by the mammalian retina of Hydroxyindole-O-methyltransferase (HIOMT, EC 2.1.1.4), the enzyme directly responsible for the biosynthesis of the pineal chronobiotic hormone melatonin (MLT). However, conflicting results obtained so far by enzyme-kinetic and immune-detection techniques still make HIOMT presence and relevance in the eye a matter of debate. This work aimed at evaluating unambiguously HIOMT activity in the mouse retina, a valuable model for studying the effects of MLT variations on ocular pathophysiology. Since laboratory mouse strains can bear genetic polymorphisms yielding defective enzymes of MLT biosynthesis, retinas and control pineal glands used in this study were obtained in a MLT-proficient crossing of A/J mice, the A/J/C57BL/10 strain. To improve the radiochemical reference assay, we tested different homogenization procedures coupled with HPLC detection. Concomitantly, we quantified MLT, and its precursor N-acetyl-serotonin (NAS) by HPLC coupled to electrochemical detection in retinas isolated from either light- or dark-adapted mice. Results showed that the standard radio-chemical assay was successful for pineal HIOMT only, whereas specific homogenization buffers and HPLC were required to detect retinal activity, presumably due to interfering methyl-transferases inhibited by NAS. Under present conditions, retinal HIOMT Vmax accounted for by ≈ 40 fmol/h/mg protein, 2.6-hundreds-fold lower than the pineal counterpart, displaying equivalent KMs (≈10 μM). Moreover, NAS and MLT rapidly decreased in light-exposed isolated retinas, corroborating light-sensitive in-situ MLT formation. Conclusively, we measured mouse retinal HIOMT kinetics under basal conditions, a useful result to elucidate the regulatory patterns, the possible impact on eye health, and therapeutic approaches related to this enzyme

Leachate analyses of volcanic ashes from Stromboli volcano: A proxy for the volcanic gas plume composition?

Many volcanoes show a change in chemical composition of the gas phase prior to periods of eruptive activity. Fine‐grained tephra erupted from active vents and transported through volcanic plumes can adsorb, and therefore rapidly scavenge, volatile elements such as sulfur, halogens, and metal species in the form of soluble salts adhering to ash surfaces. Analysis of such water‐soluble surface materials is a suitable supplement for remote monitoring of volcanic gases at inaccessible volcanoes. In this work, ash samples of the 2004 to 2009 eruptive activity of Stromboli volcano were sampled, leached, and analyzed for major and trace elements. Data analysis and interpretation was focused on determining the relationship between chemical composition of water‐soluble components adhering to volcanic ash and the volcano’s activity state. First results show significant temporal variations in ash leachate compositions, reflecting changes in the eruptive style of the volcano. In particular, we reveal that ash leachates S/F and Mg/Na ratios showed marked increases prior to a large‐scale explosion on 15 March 2007.PublishedD172041.2. TTC - Sorveglianza geochimica delle aree vulcaniche attiveJCR Journalreserve

Recurrent respiratory infections between immunity and atopy

Recurrent respiratory infections (RRIs) are frequent in children and are characterized by more than 6 airway infections in 1 year or more than 1 upper airway infection per month in the period between September and April or more than 3 lower airway infections in 1 year. Often pediatric RRIs are related to predisposing factors, such as reduced airway size, poor tussive reflex, and immaturity of the immune system. RRIs due to immature immune system are a transient condition, with spontaneous resolution in the school age. However, some RRIs are expression of more complex diseases. Red flags are the onset of symptoms in the first year of life, the involvement of other systems, unusual pathogens, slowing of growth, severe infections of the lower airways, and recurrence of the infection site. To help the pediatrician in the RRI differential diagnosis, we have created a roadmap based on scientific literature data and clinical practice that identifies 6 macro areas: immunodeficiencies, simple minimal genetic immunodeficiency, atopy, obesity, nutritional deficiencies, autoinflammatory diseases, and complex diseases

Carnitine partially improves oxidative stress, acrosome integrity, and reproductive competence in doxorubicin-treated rats

Doxorubicin has been largely used in anticancer therapy in adults, adolescents, and children. The efficacy of l-carnitine as an antioxidant substance has been confirmed both in humans and rats. Carnitine, present in testis and epididymis, is involved in sperm maturation. It is also effective in infertility treatment. As a continuation of a previous study, we evaluated whether some spermatic qualitative parameters, DNA integrity, chromatin structure, and fertility status, could be ameliorated by the carnitine treatment in adult rats, which were subsequently exposed to doxorubicin at pre-puberty. Pre-pubertal male rats were distributed into four groups: Sham ControlDoxorubicinl-carnitinel-carnitine+Doxorubicin (l-carnitine injected 1h before doxorubicin). At 100days of age, all groups were reassigned into two sets: One set was submitted to the evaluation of sperm motility, acrosome integrity, mitochondrial activity, sperm chromatin structure analysis (SCSA), and evaluation of the oxidative stress. The other set of rats was destined to the evaluation of reproductive competence. The percentage of spermatozoa with intact acrosome integrity was higher in the Carnitine+Doxorubicin group when compared with the Doxorubicin group. However, sperm motility and mitochondrial activity were not improved by carnitine pre-treatment. Both values of malondialdehyde and nitrite (indirect measurement of nitric oxide) concentrations were statistically higher in the only doxorubicin-treated group when compared to the Carnitine+Doxorubicin group. Fertility index and implantation rate were lower in Doxorubicin group, when compared to Carnitine+Doxorubicin group. Moreover, the percentage of spermatozoa with damaged DNA was higher in the Doxorubicin-treated group when compared to the Carnitine+Doxorubicin group. l-carnitine, when administered before doxorubicin, partially preserved the acrosome integrity, an important feature related to sperm fertilization ability that positively correlated with the reproductive competence and sperm DNA integrity at adulthood. In conclusion, l-carnitine attenuated the long-term alterations caused by doxorubicin in the germ cells and improved male reproductive capacity in adulthood.National Council for the Improvement of Higher Education (CAPES/Brazil)Fed Univ Sao Paulo UNIFESP, Lab Dev Biol, Dept Morphol & Genet, Botucatu St 740,Leitao da Cunha Bldg,2nd Floor, BR-04023900 Sao Paulo, SP, BrazilFed Univ Sao Paulo UNIFESP, Lab Dev Biol, Dept Morphol & Genet, Botucatu St 740,Leitao da Cunha Bldg,2nd Floor, BR-04023900 Sao Paulo, SP, BrazilWeb of Scienc

Magma dynamics during the 2007 Stromboli eruption (Aeolian Islands. Italy): mineralogical, geochemical and isotopic data

After the 6 month-long effusive event of 2002-2003, a new lava effusion occurred at Stromboli between 27 February and 2 April 2007. Despite the different durations, approximately the same volume of magma was emitted in both eruptions, in the order of 107 m3 . A paroxysmal eruption occurred at the summit craters in both the 2002–2003 and 2007 episodes, during which a significant amount of low porphyritic (LP), volatile- rich magma was erupted. In both cases, the paroxysm did not interrupt the lava emission. Here, we present compositional data, including texture, mineralogy, chemistry and Sr and Nd isotope ratios of bulk-rock, groundmass and separated minerals of lavas erupted in 2007, together with chemistry and Sr and Nd isotope composition of the pumices emitted during the 15 March paroxysm. As a whole, the lavas have the same texture and chemistry that characterize the highly porphyritic (HP) products usually erupted at Stromboli during normal Strombolian activity and effusive events. Compared to the previous HP products, the 2007 lavas show minor but systematic mineralogical and isotopic variations which are consistent with a modest increase of the magma supply rate of the volcano. Compositional variations during the entire duration of the event are very modest. Glass chemistry changes in lavas erupted in the second half of March can be explained by theminormixing between the volatile-rich LPmagma rising through the shallowmagmatic systemduring the 15 March paroxysm and the degassed residing HP magma. A first conclusion of this study is that there is no compositional evidence supporting major changes in the magma dynamics of the volcano accompanying the effusive activity, as also suggested for the 2002–2003 event. The activity of Stromboli is controlled by a steady state feeding system in which refilling, mixing, degassing and crystallization at shallow level continuously operate,withmodest oscillations in themagma supply rate. Switching between normal Strombolian and effusive activity is related to periods of relatively more vigorous refilling of the shallow system, leading to progressive pressure increase in the upper conduits associated with only minor compositional variations in the erupted products

Differences in chemical, physical and microbiological characteristics of Italian burrata cheeses made in artisanal and industrial plants of Apulia Region

The burrata cheese is a traditional product from Southern Italy, consisting of an envelope of pasta filata (stretched curd) filled with cream and pasta filata strips (usually leftovers from mozzarella production). Physical [water activity (aw), pH], chemical (moisture, NaCl content) and microbiological [total viable count (TVC), Listeria monocytogenes, Salmonella spp., Yersinia enterocolitica, Bacillus cereus, Escherichia coli, Enterobacteriaceae, coagulase-positive staphylococci] characteristics of burrata cheeses manufactured in artisanal and industrial plants were evaluated. The artisanal burrata showed lower aw values in the filling and the final product. The same was recorded in the filling for the moisture, probably due to differences between the types of cream used in the artisanal and the industrial cheesemaking. The pH value of the filling differed between the two groups but no difference was recorded in the final product. Microbiological differences were also recorded, with higher values for TVC and E. coli in artisanal than industrial burrata. All samples were negative for the other microbialdeterminations, with the exception of coagulase-positive staphylococci and Y. enterocolitica, which were detected in artisanal burrata. Differences in cheesemaking process were probably responsible for the strong variability of the physical and chemical data between the two cheeses; furthermore, differences in the hygienic features were also recorded. Even though artisanal products showed lower aw and pH values and higher NaCl concentration, the higher E. coli loads highlighted the need for a more accurate compliance with hygienic procedures along the artisanal cheesemaking process

Characterisation of the microflora contaminating the wooden vats used for traditional sicilian cheese production

Traditional Sicilian cheese productions are carried out employing traditional wooden vats, called tina. Many studies have highlighted the beneficial role of wooden dairy equipment by contributing to enriching the milk microflora and improving the acidification processes. The present work was undertaken to evaluate the safety of the wooden vats used to coagulate milk. To this purpose, the different microbial populations hosted onto the internal surfaces of the vats used to produce two different stretched cheeses, namely Caciocavallo Palermitano and Vastedda della valle del Bel\uecce DOP, were investigated for the presence of spoilage and pathogenic microorganisms as well as for bacteria with inhibitory effect in vitro against pathogenic microorganisms. A wide biodiversity of protechnological lactic acid bacteria (LAB), in terms of species, was revealed. Several LAB inhibited the growth of Listeria monocytogenes ATCC 7644. The wooden vats analysed resulted safe for three main findings: absence of the main pathogenic species, presence of high levels of LAB, anti-Listeria activity of many LAB

Hyperpigmented spots at fundus examination: a new ocular sign in neurofibromatosis type I

Background: Neurofibromatosis Type I (NF1), also termed von Recklinghausen disease, is a rare genetic disorder that is transmitted by autosomal dominant inheritance, with complete penetrance and variable expressivity. It is caused by mutation in the NF1 gene on chromosome 17 encoding for neurofibromin, a protein with oncosuppressive activity, and it is 50% sporadic or inherited. The disease is characterized by a broad spectrum of clinical manifestations, mainly involving the nervous system, the eye and skin, and a predisposition to develop multiple benign and malignant neoplasms. Ocular diagnostic hallmarks of NF1 include optic gliomas, iris Lisch nodules, orbital and eyelid neurofibromas, eyelid café-au-lait spots. Choroidal nodules and microvascular abnormalities have recently been identified as additional NF1-related ocular manifestations. The present study was designed to describe the features and clinical significance of a new sign related to the visual apparatus in NF-1, represented by hyperpigmented spots (HSs) of the fundus oculi. Results: HSs were detected in 60 (24.1%) out of 249 patients with NF1, with a positive predictive value of 100% and a negative predictive value of 44.2%. None of the healthy subjects (150 subjects) showed the presence of HSs. HSs were visible under indirect ophthalmoscopy, ultra-wide field (UWF) pseudocolor imaging and red-only laser image, near-infrared reflectance (NIR)-OCT, but they were not appreciable on UWF green reflectance. The location and features of pigmentary lesions matched with the already studied NF1-related choroidal nodules. No significant difference was found between the group of patients (n = 60) with ocular HSs and the group of patients (n = 189) without ocular pigmented spots in terms of age, gender or severity grading of the disease. A statistically significant association was demonstrated between the presence of HSs and neurofibromas (p = 0.047), and between the presence of HSs and NF1-related retinal microvascular abnormalities (p = 0.017). Conclusions: We described a new ocular sign represented by HSs of the fundus in NF1. The presence of HSs was not a negative prognostic factor of the disease. Following multimodal imaging, we demonstrated that HSs and choroidal nodules were consistent with the same type of lesion, and simple indirect ophthalmoscopy allowed for screening of HSs in NF1