The Coexistence of asthma and Chronic Ostructive Pulmonary Disease (COPD): prevalence and risk factors in young, middle-aged and elderly people from the general population

Background: The joint distribution of asthma and chronic obstructive pulmonary disease (COPD) has not been well described. This study aims at determining the prevalence of self-reported physician diagnoses of asthma, COPD and of the asthma-COPD overlap syndrome and to assess whether these conditions share a common set of risk factors. Methods: A screening questionnaire on respiratory symptoms, diagnoses and risk factors was administered by mail or phone to random samples of the general Italian population aged 20–44 (n = 5163) 45–64 (n = 2167) and 65–84 (n = 1030) in the frame of the multicentre Gene Environment Interactions in Respiratory Diseases (GEIRD) study. Results: A physician diagnosis of asthma or COPD (emphysema/chronic bronchitis/COPD) was reported by 13% and 21% of subjects aged &lt;65 and 65–84 years respectively. Aging was associated with a marked decrease in the prevalence of diagnosed asthma (from 8.2% to 1.6%) and with a marked increase in the prevalence of diagnosed COPD (from 3.3% to 13.3%). The prevalence of the overlap of asthma and COPD was 1.6% (1.3%–2.0%), 2.1% (1.5%–2.8%) and 4.5% (3.2%–5.9%) in the 20–44, 45–64 and 65–84 age groups. Subjects with both asthma and COPD diagnoses were more likely to have respiratory symptoms, physical impairment, and to report hospital admissions compared to asthma or COPD alone (p&lt;0.01). Age, sex, education and smoking showed different and sometimes opposite associations with the three conditions. Conclusion: Asthma and COPD are common in the general population, and they coexist in a substantial proportion of subjects. The asthma-COPD overlap syndrome represents an important clinical phenotype that deserves more medical attention and further research.</br

Dissipationless Formation and Evolution of the Milky Way Nuclear Star Cluster

Abridged: In one widely discussed model for the formation of nuclear star clusters (NSCs), massive globular clusters spiral into the center of a galaxy and merge to form the nucleus. It is now known that at least some NSCs coexist with supermassive black holes (SBHs); this is the case, for instance, in the Milky Way (MW). In this paper, we investigate how the presence of a SMBH at the center of the MW impacts the merger hypothesis for the formation of its NSC. Starting from a model consisting of a low-density nuclear stellar disk and the SMBH, we use N-body simulations to follow the successive inspiral and merger of globular clusters. The clusters are started on circular orbits of radius 20 pc, and their initial masses and radii are set up in such a way as to be consistent with the galactic tidal field at that radius. The total accumulated mass by ~10 clusters is about 1.5x10^7 Solar masses. Each cluster is disrupted by the SMBH at a distance of roughly one parsec. The density profile that results after the final inspiral event is characterized by a core of roughly this radius, and an envelope with density that falls off as 1/r^2. These properties are similar to those of the MW NSC, with the exception of the core size, which in the MW is a little smaller. But by continuing the evolution of the model after the final inspiral event, we find that the core shrinks substantially via gravitational encounters in a time (when scaled to the MW) of 10 Gyr as the stellar distribution evolves toward a Bahcall-Wolf cusp. We also show that the luminosity function of the MW NSC is consistent with the hypothesis that a large fraction of the mass comes from (~10Gyr) old stars, brought in by globular clusters. We conclude that a model in which a large fraction of the mass of the MW NSC arose from infalling globular clusters is consistent with existing observational constraints.Comment: 15 pages, 13 figures. ApJ accepte

Seventy years of asthma in Italy: age, period and cohort effects on incidence and remission of self-reported asthma from 1940 to 2010

Background: It is well known that asthma prevalence has been increasing all over the world in the last decades. However, few data are available on temporal trends of incidence and remission of asthma. Objective: To evaluate the rates of asthma incidence and remission in Italy from 1940 to 2010. Methods: The subjects were randomly sampled from the general Italian population between 1991 and 2010 in the three population-based multicentre studies: ECRHS, ISAYA, and GEIRD. Individual information on the history of asthma (age at onset, age at the last attack, use of drugs for asthma control, co-presence of hay-fever) was collected on 35,495 subjects aged 20–84 and born between 1925–1989. Temporal changes in rates of asthma incidence and remission in relation to age, birth cohort and calendar period (APC) were modelled using Poisson regression and APC models. Results: The average yearly rate of asthma incidence was 2.6/1000 (3,297 new cases among 1,263,885 person-years). The incidence rates have been linearly increasing, with a percentage increase of +3.9% (95%CI: 3.1–4.5), from 1940 up to the year 1995, when the rates begun to level off. The stabilization of asthma incidence was mainly due to a decrease in the rates of atopic asthma after 1995, while non-atopic asthma has continued to increase. The overall rate of remission was 43.2/1000person-years, and it did not vary significantly across generations, but was associated with atopy, age at asthma onset and duration of the disease. Conclusions: After 50 years of a continuous upward trend, the rates of asthma incidence underwent a substantial stabilization in the late 90s. Despite remarkable improvements in the treatment of asthma, the rate of remission did not change significantly in the last seventy years. Some caveats are required in interpreting our results, given that our estimates are based on self-reported events that could be affected by the recall bias

The colours of BL Lac objects: a new approach to their classification

We selected a sample of 437 BL Lac objects, taken from the RomaBZCat catalogue, for which spectroscopic information and SDSS photometry is available. We propose a new classification of BL Lacs in which the sources' type is not defined only on the basis of the peak frequency of the synchrotron component in their Spectral Energy Distribution (types L and H), but also on the relevance of this component with respect to the brightness of the host galaxy (types N and G, for nuclear or galaxy dominated sources). We found that the SDSS colour index u-r=1.4 is a good separator between these two types. We used multiband colour-colour plots to study the properties of the BL Lac classes and found that in the X-ray to radio flux ratio vs u-r plot most of the N (blue) sources are located in a rather narrow strip, while the G-sources (red) are spread in a large area, and most of them are located in galaxy clusters or interacting systems, suggesting that their X-ray emission is not from a genuine BL Lac nucleus but it is related to their environment. Of the about 135 sources detected in the gamma-rays by Fermi-GST, nearly all belong to the N-type, indicating that only this type of sources should be considered as genuine BL Lac nuclei. The J-H, H-K plot of sources detected in the 2MASS catalogue is consistent with that of the "bona fide" BL Lac objects, independently of their N or G classification from the optical indices, indicating the existence in G-type sources of a K-band excess possibly due to a steep, low frequency peaked emission which deserves further investigations. We propose to use these colour plots as a further tool for searching candidate counterparts of newly discovered high-energy sources.Comment: 11 pages, 7 figures. Submitted 29/08/2011 to MNRAS, first referee report received 31/10/2011, accepted 21/02/201

XIPE: the X-ray Imaging Polarimetry Explorer

X-ray polarimetry, sometimes alone, and sometimes coupled to spectral and temporal variability measurements and to imaging, allows a wealth of physical phenomena in astrophysics to be studied. X-ray polarimetry investigates the acceleration process, for example, including those typical of magnetic reconnection in solar flares, but also emission in the strong magnetic fields of neutron stars and white dwarfs. It detects scattering in asymmetric structures such as accretion disks and columns, and in the so-called molecular torus and ionization cones. In addition, it allows fundamental physics in regimes of gravity and of magnetic field intensity not accessible to experiments on the Earth to be probed. Finally, models that describe fundamental interactions (e.g. quantum gravity and the extension of the Standard Model) can be tested. We describe in this paper the X-ray Imaging Polarimetry Explorer (XIPE), proposed in June 2012 to the first ESA call for a small mission with a launch in 2017 but not selected. XIPE is composed of two out of the three existing JET-X telescopes with two Gas Pixel Detectors (GPD) filled with a He-DME mixture at their focus and two additional GPDs filled with pressurized Ar-DME facing the sun. The Minimum Detectable Polarization is 14 % at 1 mCrab in 10E5 s (2-10 keV) and 0.6 % for an X10 class flare. The Half Energy Width, measured at PANTER X-ray test facility (MPE, Germany) with JET-X optics is 24 arcsec. XIPE takes advantage of a low-earth equatorial orbit with Malindi as down-link station and of a Mission Operation Center (MOC) at INPE (Brazil).Comment: 49 pages, 14 figures, 6 tables. Paper published in Experimental Astronomy http://link.springer.com/journal/1068

Febrile and gynaecological infections in pregnancy increase the risk of childhood respiratory disorders in the offspring

Emerging evidence suggests that foetal and early life environmental factors are critical for determining the susceptibility to allergic and respiratory diseases. In the present study, we investigated whether maternal febrile infections (FI) or gynaecological infections (GI) during pregnancy are associated with allergic respiratory diseases in the offspring, and whether specific pregnancy trimesters are involved.We enrolled 4,577 children, aged 3-14yr. Their parents filled in a standardized questionnaire about children’s respiratory health and the events occurred during pregnancy and at birth. We evaluated the incidence of wheezing, asthma and rhinitis, and the occurrence of five respiratory symptoms in the last 12 months.Children born to mothers who reported FI and GI had more respiratory symptoms in the last 12 months (IRR:1.40, 95%CI:1.12-1.74 and IRR:1.60, 95%CI:1.24-2.06, respectively). This association was stronger when FI occurred in the 1st trimester of pregnancy (IRR:2.12, 95%CI:1.37-3.28).The incidence of asthma was significantly higher in the children whose mothers reported FI or GI in the 1st trimester of pregnancy (HR:2.61, 95%CI:1.01-6.76 and HR:3.50, 95%CI:1.24-9.91, respectively). GI in the 3rd trimester were associated with higher risk of wheezing (HR:1.55, 95%CI:1.11-2.17) and rhinitis (HR:1.82; 95%CI:1.02-3.26).FI and GI might increase the risk of developing respiratory symptoms and diseases, especially when occurring in specific trimesters of pregnancy. These findings suggest that FI and GI might interfere with foetal programming of respiratory and immune system through different mechanisms

Febrile and gynecological infections during pregnancy are associated with a greater risk of childhood eczema

Background:Mounting evidence suggests that fetal exposures may exert long-termeffects on the function of the skin and of the immune system. This study aimed atassessing whether maternal complications during pregnancy are associated with anincreased risk of eczema during childhood.Methods:The associations between hypertension/preeclampsia, febrile infections, orgynecological infections during pregnancy and the occurrence of childhood eczema werestudied in a population (n=3907) of children, aged 3–14 yrs, living in Italy. Theirparents filled in a standardized questionnaire about the presence of children’s eczemaand the events that occurred during pregnancy, birth, and the first year of the child’s life.Results:7.7%, 3.8%, and 6.1% of the pregnancies were complicated by hypertension/preeclampsia, febrile infections, and gynecological infections, respectively. The preva-lence of eczema was significantly higher in children born to mothers who had experiencedfebrile (35.5% vs. 22.0%; p&lt;0.001) or gynecological infections (35.3% vs. 21.6%;p&lt;0.001) compared with those born to mothers who had not suffered from that specificpregnancy complication, while hypertension/preeclampsia was not significantly associ-ated with childhood eczema. After adjusting for potential confounders, the risk ofeczema was significantly higher in children born to mothers who reported febrileinfections during the 1st trimester (OR: 2.32; 95%CI: 1.11–4.82) and gynecologicalinfections during the 3rd trimester of pregnancy (OR: 2.73; 95%CI:1.73–4.31).Conclusions:Fetal exposure to febrile and gynecological infections might enhance therisk of eczema in the offspring, especially when occurring in specific trimesters ofpregnancy. These findings suggest that febrile and gynecological infections mightinterfere with fetal and perinatal programming of the immune function and skinthrough different mechanisms

Guided implant surgery and sinus lift in severely resorbed maxillae: A retrospective clinical study with up to 10 years of follow-up

Objectives In the posterior maxilla, due to the presence of maxillary sinus, residual bone height lower than 3mm is a critical factor that can affect implant stability and survival. The use of guided surgery may facilitate the surgical procedures and the implant insertion in case of severely resorbed maxillae. Moreover, it may have beneficial effects on the long-term survival and success of implant-supported restorations. This study aimed to evaluate implant supported restorations on severely resorbed maxilla (&lt;3 mm) after sinus lift with collagenated xenograft and guided surgery. Methods Forty-three patients with need for implant rehabilitation and residual bone height between 1 and 3 mm were recruited. Surgical and prosthetical aspects were planned following digital approach with the use of Realguide 5.0 (3diemme, Varese, Italy). Lateral window sinus lift was performed and implants were placed simultaneously to the augmentation procedure with a tooth-supported pilot drill surgical template. A pre-hydrated collagenated porcine bone matrix was adopted as regenerative material. Computer-aided-design/computer-aided-manufacturing (CAD/CAM) restorations were delivered after six months of healing. Milled titanium chamfer abutments with CAD/CAM crowns were used. Bone height at implant site level was measured using an image software analysis applied to the pre- and post-surgical radiographs and at the follow-up. Biological and technical complications were recorded during all the follow-up periods. Results Fifty-four sinus were treated. After a mean follow-up time of 5.11 years (SD: 2.47), no implants were lost nor showed signs of disease. The mean pristine bone height was 2.07 mm (SD: 075). At the final evaluation the augmented sinus height was 12.83 mm (SD: 1.23). Two cases experienced minor perforation of the membrane, while five patients developed minimal post-operative complications, completely resolved with pharmacologic therapy. No mid-term biological complications were experienced by the patients. No cases experienced peri-implant mucositis and peri-implantitis during the whole follow-up period. Four patients (7.4%) faced an unscrewing of the prosthesis. Conclusions The present study showed the efficacy in the mid-term of the digital planning and the guided surgery in restoring severely resorbed posterior maxilla with dental implants

A prospective case series on surgical treatment of circumferential and semi-circumferential defects due to peri-implantitis

Different surgical treatment strategies for peri-implantitis with the use of graft material and membranes have been suggested without any longitudinal remarkable success rate. The present preliminary study was aimed to analyze a new clinical approach based on the disinfection of the implant connection, the disinfection of the implant surface and GBR approach in the treatment of circumferential and semi-circumferential bony defect resulting from peri-implantitis. Six consecutive patients were selected for the present study. After removal of factors that could potentially influence peri-implant pathology, the prosthetic rehabilitation was always removed and a full thickness flap was elevated to allow access to the peri-implant defect and the exposed implant surface. Once the defect was degranulated and the implant surface cleaned, a mixture (50:50) of autogenous bone and allograft was used. Guided bone regeneration technique using membranes was adopted and the flaps were closed for a submerged healing. Six months thereafter, a new re-opening procedure was performed and cleaned superstructures and crowns were repositioned. Patients were followed for one year thereafter and recalled for a customized oral hygiene every three months. Radiological and periodontal analysis was performed before surgery and every six months. The studied procedure was associated with a pronounced increase in REC and CAL with stable peri-implant conditions at 6 and 12 months. PI, BOP and PD values were significantly reduced both at 6 and 12 months. At 12 months, a mean PD gain of 4.5 mm and a bone loss reduction of 5.1 mm was obtained. Within the limitation of the present preliminary study, the proposed technique might represent a promising result for treatment of circumferential and semi-circumferential bone defects around implants affected by peri-implantitis

Cover crops for managing weeds, soil chemical fertility and nutritional status of organically grown orange orchard in Sicily

Cover crops can offer significant advantages in the agronomic management of citrus orchards in Mediterranean environments. Therefore, a three-year research was conducted in eastern Sicily aimed at studying the effects of four cover crop sequences (Sinapis arvensis-Trigonella foenum-graecum-T. foenum-graecum; Medicago scutellata-Avena sativa-Lolium perenne; Vicia faba minor-A. sativa-A. sativa; A. sativa-V. faba. minor-L. perenne) on weeds, major soil chemical properties and nutritional status of an organically grown orange orchard. The results highlighted that, among the studied cover crop sequences, Vicia faba-Avena-Avena was the most beneficial for weeds control within the orchard (92%, of cover crop cover, and 586 and 89 g DW m–2 of cover crop aboveground biomass and weeds aboveground biomass, respectively). Overall, the chemical fertility of the soil was positively influenced. In particular, it was observed an increase of the content of total nitrogen and available phosphorus in the soil by both Sinapis-Trigonella-Trigonella (0.75 g kg–1 and 59.0 mg kg–1, respectively) and Vicia faba-Avena-Avena (0.70 g kg–1 and 56.0 mg kg–1, respectively) cover crop sequences. Medicago-Avena-Lolium sequence seemed to be the most useful to ensure a better nutritional status of the orange orchard