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<0.001) or gynecological infections (35.3% vs. 21.6%;p<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 (<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

Foetal exposure to maternal stressful events increases the risk of having asthma and atopic diseases in childhood

Background:The natural history of asthma and atopic diseases beginsin utero.Studies investigating the influence of foetal exposure to maternal stressful life eventsduring pregnancy (SLEP) on asthma and atopic diseases are lacking.Aim:To test whether the children of mothers who had experienced SLEP are at anincreased risk for asthma, atopic eczema and allergic rhinitis.Methods:The association between maternal SLEP (at least one among: divorce,mourning or loss of the job) and the occurrence of asthma and atopic diseases inchildhood was studied in a population (n = 3854) of children, aged 3–14 yrs, livingin Northern Italy. The parents filled in a standardized questionnaire about the chil-dren’s health and the events occurred to their mothers during pregnancy.Results:Three hundred and thirty-three (9%) of the mothers experienced SLEP.Their children had a statistically significantly higher lifetime prevalence of wheezing(31.6% vs. 23.1%), asthma (8.9% vs. 5.6%), allergic rhinitis (10.9% vs. 7.3%) andatopic eczema (29.7% vs. 21.1%) than those of mothers without SLEP. Afteradjusting for potential confounders, the foetal exposure to SLEP was positivelyassociated with wheezing (OR: 1.41, 95% CI: 1.03–1.94), asthma (OR: 1.71, 95%CI: 1.02–2.89), allergic rhinitis (OR: 1.75, 95% CI: 1.08–2.84) and atopic eczema(OR: 1.53, 95% CI: 1.11–2.10).Conclusion:The children of mothers who had experienced SLEP were at a moder-ately increased risk of having wheezing, asthma, eczema and allergic rhinitis duringtheir childhood. Maternal stress during pregnancy might enhance the expression ofasthma and atopic phenotypes in children.Pediatric Allergy and Immunology724Pediatric Allergy and Immunology23(2012) 724–729ª2012 John Wiley & Sons A/S. Published by Blackwell Publishing Lt

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

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

Normality ranges of urine oxidative stress markers (8-OHdG and isoprostane) in Italian people free from respiratory diseases-Preliminary results

BACKGROUND: The study of oxidative stress (OxS) is becoming increasingly important in respiratory disease research. To our knowledge, the reference ranges of urinary 8-hydroxy-deoxy-guanosine (8-OHdG) and 8-isoprostane (isoprostane), a DNA and a lipid oxidation product respectively, have not yet been determined in subjects without respiratory diseases. AIM: To assess the reference range of OxS markers in Italian people aged 20-64 free from respiratory diseases (controls). METHODS: 8-OHdG and isoprostane were measured in spot-urine samples collected in the frame of Gene-Environment Interactions in Respiratory Diseases (GEIRD) study, a nested multi-case control survey. The biomarkers levels were corrected on creatinine concentration. Only controls (n=239) were considered for the aim of this work. The possible effects of potential determinants on OxS-biomarkers were studied before determining the normality range in selected subgroups of controls. Multiple linear regression was fitted to data using the logarithm of 8OHdG or isoprostane as dependent variables and sex, age, season, smoke, body mass index, as covariates. The appropriate percentiles were calculated. RESULTS: Both 8OHdG and isoprostane concentrations were significantly higher in smokers than in non smokers (p=0.025 and 0.047 respectively), while the other covariates did not influence OxS. The 95% 8OHdG normality range in non smokers varied from 0.26 to 25.94 ng/mg. The 95% isoprostane reference interval was 0.03 -5.42 ng/mg in non smokers. CONCLUSION: Provisional 95% normality range for urinary 8OHdG and isoprostane were determined in subjects free from respiratory diseases

Association between daily levels of air pollution and school absences in the proximity of a cement plant in Italy

Background: Emission of dust represents the main hazard associated with cement production and may cause adverse respiratory health effects to the population living nearby. Aim: To evaluate the association between daily levels of PM10 and a morbidity indicator (school absenteeism) in children aged 7-14 years attending a school within 2km from a cement plant in Fumane (Northern Italy). Methods: Data on absences of students (average: 461 students/year) and daily concentrations of PM10 from a fixed monitoring station placed in the schoolyard were collected for 3 school years (541 school days from November 2007 to June 2010). The association between pollution in the same day (Lag 0) and in the previous 4 days (Lag 1 to 4) and school absenteeism was studied using generalized additive Poisson regression models, adjusting for short-term trend, day of the week, flu epidemics and daily temperature. Results: During the considered period, the daily average concentration of PM10 was 34.8 µg/m³. An increase of 10 µg/m³ of PM10 was associated with a significant increase of 2.2% in school absences (RR:1.022; 95%CI: 1.007-1.037) two days after (lag2). The association between average level of pollutants from Lag 0 to Lag 4 and school absences confirmed the presence of a statically significant association with PM10 levels (RR:1.016; 95%CI:1.003-1.029 for each + µg/m³ of PM10). Conclusions: Daily PM10 levels are associated with school absences, a proxy indicator of short-term morbidity, in children who attend schools in proximity to a cement plant. Primary prevention interventions aimed at reducing air pollution in the area are recommended

Bioethanol production from globe artichoke residues: From the field to the fermenter

The suitability of globe artichoke crop residues to be transformed into bioethanol was assessed in this paper from the field to the fermenter. A 2-year field trial on “Opera F1” (OF1), a hybrid variety of globe artichoke, resulted in an average annual production of residues of 14 t/ha. The residual biomass of OF1 is made up of 24% glucan and 17% hemicelluloses and is rich in soluble sugars. Water extraction (WE) (100 °C, 15 min) was initially applied to remove simple sugars that can be transformed into saccharification and fermentation inhibitors during the pretreatments. Subsequent dilute acid hydrolysis (DAH) (H2SO4 2%, 121 °C, 1 h) produced a slurry with 17.7, 4.2, and 0.5% (dry matter: DM) of soluble sugars, acetic acid, and total furanic compounds, respectively, and a solid fraction with 52% glucan and 14% xylan, with practically 100% digestibility. Slurry enzymatic hydrolysis (45 FPU/g DM, 7 CBU/g DM, 24 h) had a 69% glucan yield, showing an inhibition of the saccharification process due to the presence of simple sugars and inhibitors. Co-fermentation of the enzymatic slurry with Escherichia coli MS04 produced 12.5 g/L ethanol with a volumetric productivity of 0.52 g/L/h and 76.0% fermentation efficiency after 24 h of fermentation. Considering all sugars generated during DAH, the applied strategy allowed a production of 283 kg/t DM and 2399 kg/ha of bioethanol, against the theoretical value of 2806 kg/ha