Acute idiopathic pericarditis: current immunological theories

Alida LP Caforio,1 Renzo Marcolongo,2 Antonio Brucato,3 Luca Cantarini,4 Massimo Imazio,5 Sabino Iliceto11Division of Cardiology, Department of Cardiology, Thoracic and Vascular Sciences, University of Padua, Padua; 2Haematology and Clinical Immunology, Department of Medicine, University of Padua, Padua, 3Internal Medicine, Ospedali Riuniti, Bergamo, 4Rheumatology Unit, Policlinico Le Scotte, University of Siena, Siena, 5Department of Cardiology, Maria Vittoria Hospital, Torino, ItalyAbstract: Idiopathic recurrent acute pericarditis (IRAP) is a rare disease of suspected immune-mediated pathogenesis. It represents a diagnosis of exclusion. It is necessary to rule out infectious and noninfectious causes of pericardial inflammation, including systemic autoimmune and immune-related disorders, eg, Sjögren's disease, systemic lupus erythematosus. Since pericarditis may precede diagnosis of these disorders, IRAP diagnosis is often made after a long follow-up. According to the two main pathogenetic theories IRAP may represent an organ-specific autoimmune disease or an autoinflammatory disease (AInfD). The main evidence for autoimmunity in IRAP is provided by the detection of serum antiheart and antiintercalated-disk autoantibodies, and the response to anti-inflammatory or immunosuppressive therapy. The findings of familial forms and of proinflammatory cytokines in the pericardial fluid in IRAP would be in keeping with both organ-specific autoimmune disease and AInfD. In fact, AInfD are genetic disorders characterized by primary dysfunction of the innate immune system, due to mutations of genes involved in the regulation of the inflammatory response, in the absence of antigen specific T cells or autoantibodies. In AInfD there are active disease phases with raised non-cardiac specific inflammatory markers, such as C-reactive protein, as well as symptom-free intervals with possible C-reactive protein normalization. A minority of IRAP patients (6%) carry a mutation in the TNFRSF1A gene, encoding the receptor for tumor necrosis factor-alfa. This suggests that some IRAP patients may have an atypical or subclinical form of AInfD. Thus, IRAP may represent a syndrome with distinct pathogenetic mechanisms in different patients' subsets.Keywords: pericarditis, autoimmunity, autoantibodies, heart disease, immune factor

Opto‐Electronic Characterization of Photocatalysts Based on p,n‐Junction Ternary and Quaternary Mixed Oxides Semiconductors (Cu2O‐In2O3 and Cu2O‐In2O3‐TiO2)

Semiconductor materials are the basis of electronic devices employed in the communication and media industry. In the present work, we report the synthesis and characterization of mixed metal oxides (MOs) as p,n‐junction photocatalysts, and demonstrate the correlation between the preparation technique and the properties of the materials. Solid‐state UV-visible diffuse reflectance spectroscopy (UV‐VIS DRS) allowed for the determination of the light absorption properties and the optical energy gap. X‐ray photoelectron spectroscopy (XPS) allowed for the determination of the surface speciation and composition and for the determination of the valence band edge. The opto‐electronic behavior was evaluated measuring the photocurrent generated after absorption of chopped visible light in a 3‐electrode cell. Scanning electron microscopy (SEM) measurements allowed for auxiliary characterization of size and morphology, showing the formation of composites for the ternary Cu2O‐In2O3 p,n‐mixed oxide, and even more for the quaternary Cu2O‐In2O3‐TiO2 MO. Light absorption spectra and photocurrent‐time curves mainly depend upon the composition of MOs, while the optical energy gap and defective absorption tail are closely related to the preparation methodology, time and thermal treatment. Qualitative electronic band structures of semiconductors are also presented

Evidence-based considerations exploring relations between sars-cov-2 pandemic and air pollution: Involvement of pm2.5-mediated up-regulation of the viral receptor ace-2

The COVID-19/SARS-CoV-2 pandemic struck health, social and economic systems worldwide, and represents an open challenge for scientists —coping with the high inter-individual variability of COVID-19, and for policy makers —coping with the responsibility to understand environmental factors affecting its severity across different geographical areas. Air pollution has been warned of as a modifiable factor contributing to differential SARS-CoV-2 spread but the biological mechanisms underlying the phenomenon are still unknown. Air quality and COVID-19 epidemiological data from 110 Italian provinces were studied by correlation analysis, to evaluate the association between particulate matter (PM)2.5 concentrations and incidence, mortality rate and case fatality risk of COVID-19 in the period 20 February–31 March 2020. Bioinformatic analysis of the DNA sequence encoding the SARS-CoV-2 cell receptor angiotensin-converting enzyme 2 (ACE-2) was performed to identify consensus motifs for transcription factors mediating cellular response to pollutant insult. Positive correlations between PM2.5 levels and the incidence (r = 0.67, p < 0.0001), the mortality rate (r = 0.65, p < 0.0001) and the case fatality rate (r = 0.7, p < 0.0001) of COVID-19 were found. The bioinformatic analysis of the ACE-2 gene identified nine putative consensus motifs for the aryl hydrocarbon receptor (AHR). Our results confirm the supposed link between air pollution and the rate and outcome of SARS-CoV-2 infection and support the hypothesis that pollution-induced over-expression of ACE-2 on human airways may favor SARS-CoV-2 infectivity

Anabolic effects and inhibition of interleukin 6 production induced by neridronate on human osteoblasts

Bisphosphonates (BPs) are pharmacological compounds widely used in the treatment of a variety of bone-related diseases, particularly where the bone-turnover is skewed in favour of osteolysis. The mechanisms by which BPs reduce bone-resorption directly acting on osteoclasts (OCs) are now largely clarified even at molecular level. The researches concerning the BPs effects on osteoblasts (OBs) have instead shown variable results. Objectives: We have investigated the efficacy of neridronate (NER), an amino-BP, as anabolic agent on human OBs. Moreover, we have tried to verify if NER is able to negatively modulate the production of IL-6 on OBs stimulated or not by the pro-inflammatory cytokine Il-1b. Methods: We have tested if different concentrations of NER (from 10-11M to 10-3M), added to primary human OB cultures, could affect the cells number, the endogenous cellular alkaline phosphatase (ALP) activity, the collagen I (COLI) synthesis, the formation of mineralized nodules and the IL-6 production. Our experimental approach was performed testing a wide range of NER concentrations because, under physiological conditions, OBs seems to be exposed to variable and transient levels of the drug. Results: Our results show that NER doesn't negatively affect in vitro the viability, proliferation and cellular activity of human OBs, even after 20 days of exposure to concentrations ²10-5 M (therapeutic dose). In addition, NER seems to enhance the differentiation of cultured OBs in mature bone-forming cells. A maximum increase of COL-I synthesis (+25% after 4 days; p<0.05), ALP activity (+50% after 10 days; p<0.01) and mineralized nodules (+48% after 20 days; p<0.05) was observed in cultures treated with NER 10-8M. A maximal reduction of IL-6 secretion (-24% on IL-1b stimulated cultures and -29% on unstimulated cultures) was observed for NER 10-9 M. Conclusions: These results encourage the use of neridronate in therapy of demineralizing metabolic bone disorders

efficacy and safety of amtolmetin guacyl in the symptomatic treatment of the osteoarthritis

Forty-two patients affected by osteoarthritis have been treated with two parallel schemes, in double blind, according to parallel groups, to have a correct evaluation of the efficacy and safety of Amtolmetin Guacyl administration on at full stomach or empty stomach. As parameters of efficacy the spontaneus pain and the pain caused by movements, the function and joint pain have been considered, while gastric tolerance has been evaluated by means of daily records made by patients and the general tolerance through an annotation of adverse events, vital signs as well as parameters of laboratory. The drug worked for both groups, but it has been particulary efficent in those who have assumed the drug on a empty stomach. The general tolerance has been good and some adverse side effects, concerning the gastric tolerance, have disappeared by reducing the dosage of the drug. As a result of this study we can assume that amtolmetin guacyl is much more efficent when it is assumed on a empty stomach, with its conseguent advantages in terms of compliance and its possible utilization in case of need

Scavenging effect of lazaroids U78517F, U74389F, U74500A on oxygen free radicals produced by stimulated human polymorphonuclear leucocytes and by chemical method

Authors investigated the scavenger capability of lazaroids, a new group of compounds (21-aminosteroid) that are reported in the literature to have interesting anti-lipid peroxidation properties. Authors tested the degree of scavenger activity related to the oxygen derived free radicals (ODFR) with different methods: 1) chemiluminescence; 2) production of superoxide anion from activated polymorphonuclear cells; 3) production of hydroxyl radical through a chemical procedure. Results showed a global scavenger activity of the three lazaroids (U78517F, U74389F, U74500A) in all the various tests, but differences of intensity of their action were noted among in each compound. We can thus attribute to these compounds a scavenger activity on the oxygen free radicals; this activity may facilitate their already known anti-lipid peroxidation action. Therefore, clinical use of lazaroids can be hypothesized for the diseases in which inflammation plays an important pathogenetic role via the production of oxygen free radicals and the resulting lipid peroxidation associated with tissue damage

Age is not the only risk factor in COVID-19: the role of comorbidities and of long staying in residential care homes

Background: The actual SARS-CoV-2 outbreak caused a highly transmissible disease with a tremendous impact on elderly people. So far, few studies focused on very elderly patients (over 80 years old). In this study we examined the clinical presentation and the outcome of the disease in this group of patients, admitted to our Hospital in Rome. Methods: This is a single-center, retrospective study performed in the Sant’Andrea University Hospital of Rome. We included patients older than 65 years of age with a diagnosis of COVID-19, from March 2020 to May 2020, divided in two groups according to their age (Elderly: 65–80 years old; Very Elderly &gt; 80 years old). Data extracted from the each patient record included age, sex, comorbidities, symptoms at onset, the Pneumonia Severity Index (PSI), the ratio of the partial pressure of oxygen in arterial blood (PaO2) to the inspired oxygen fraction (FiO2) (P/F) on admission, laboratory tests, radiological findings on computer tomography (CT), length of hospital stay (LOS), mortality rate and the viral shedding. The differences between the two groups were analyzed by the Fisher’s exact test or the Wilcoxon signed-rank test for categorical variables and the Mann-Whitney U test for continuous variables. To assess significance among multiple groups of factors, we used the Bonferroni correction. The survival time was estimated by Kaplan-Meier method and Log Rank Test. Univariate and Multivariate logistic regression were performed to estimate associations between age, comorbidities, provenance from long-stay residential care homes (LSRCH) s and clinical outcomes. Results: We found that Very Elderly patients had an increased mortality rate, also due to the frequent occurrence of multiple comorbidities. Moreover, we found that patients coming from LSRCHs appeared to be highly susceptible and vulnerable to develop severe manifestations of the disease. Conclusion: We demonstrate that there were considerable differences between Elderly and Very Elderly patients in terms of inflammatory activity, severity of disease, adverse clinical outcomes. To establish a correct risk stratification, comorbidities and information about provenience from LSRCHs should be considered

Maxwell Equations in Complex Form of Majorana - Oppenheimer, Solutions with Cylindric Symmetry in Riemann S_{3} and Lobachevsky H_{3} Spaces

Complex formalism of Riemann - Silberstein - Majorana - Oppenheimer in Maxwell electrodynamics is extended to the case of arbitrary pseudo-Riemannian space - time in accordance with the tetrad recipe of Tetrode - Weyl - Fock - Ivanenko. In this approach, the Maxwell equations are solved exactly on the background of static cosmological Einstein model, parameterized by special cylindrical coordinates and realized as a Riemann space of constant positive curvature. A discrete frequency spectrum for electromagnetic modes depending on the curvature radius of space and three parameters is found, and corresponding basis electromagnetic solutions have been constructed explicitly. In the case of elliptical model a part of the constructed solutions should be rejected by continuity considerations. Similar treatment is given for Maxwell equations in hyperbolic Lobachevsky model, the complete basis of electromagnetic solutions in corresponding cylindrical coordinates has been constructed as well, no quantization of frequencies of electromagnetic modes arises.Comment: 39 page

Study of radiation effects on bipolar transistors

Abstract In this paper it was shown that the irradiation with neutrons and carbon ions leads to gain degradation in bipolar transistors due to generation of defects. The density of these generated defects is independent of the type of irradiation (neutrons or carbon ions). Thus, it is possible to evaluate Δ(1/β), once the expected Frenkel pair density is known. The dependence of the damage constant on collector current is a power law function, with the exception of the lateral pnp transistors, that shows a higher sensitivity to radiation and a different behaviour. Neutrons give a smaller density of Frenkel pairs (CF) than the two sorts of carbon ions of high energy (CHE) and medium energy (CME). It was found that CME causes a higher concentration of CF. The calculated ratio R=CF/Φ, where CF is the Frenkel pair density and Φ fluence does not depend on Φ, for a given type of radiation. However, it depends on the incoming particle type. Its smallest calculated value was obtained for neutrons (R=6.1×10), which increases to 1.25×103 for CHE and to 1.1×104 for CME

Diff-Quik® staining method for detection and identification of monosodium urate and calcium pyrophosphate crystals in synovial fluids

OBJECTIVE To evaluate whether the Diff Quik (DQ) staining method might prove useful in identifying monosodium urate (MSU) and calcium pyrophosphate dihydrate (CPPD) crystals on permanent mounted stained slides. METHODS 27 synovial fluid (SF) samples obtained from the knees of 21 patients with acute CPPD disease and 6 with acute gout were studied. Wet analysis for crystal detection and identification was performed within one hour of joint aspiration. In addition, 16 inflammatory synovial effusions obtained from patients with knee arthritis induced by non-crystalline inflammatory diseases were studied. For each SF, a DQ stained slide was analysed by two of the authors trained in SF analysis. The observers were blinded to the type of crystals present in the SF. Each slide was analysed by compensated polarised as well as transmitted light microscopy. An SF was considered positive if intracellular and/or extracellular crystals were clearly identified. In addition, the observer was asked to identify the type of the crystals using compensated polarised light microscopy. Sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) of the DQ staining method were determined. RESULTS 51 true positive and 28 true negative cases were correctly classified (39 CPPD samples, 12 MSU samples, 28 samples of crystal unrelated arthropathies). Overall, four false positive and three false negative cases were reported. In all the false positive cases, extracellular CPPD crystals were erroneously identified, whereas CPPD crystals present in the SF were not identified in the three false negative cases. All MSU specimens were correctly diagnosed. The overall specificity, sensitivity, and accuracy using DQ stained slides for crystal confirmation were respectively 87.5%, 94.4%, and 91.9%. The PPV was 92.7% and the NPV 90.3%. In particular, the specificity, sensitivity, and accuracy for CPPD detection were 90.9%, 92.9%, and 91.9%, with a PPV of 90.7 and an NPV of 93.0%. All the MSU specimens were correctly identified, providing 100% sensitivity, specificity, accuracy, PPV, and NPV. CONCLUSIONS Stained preparations of SF, including DQ stained smears, could provide a useful tool for delayed SF analysis suitable for quality controls, including cytological examination and crystals detection and identification