Early suppression of lymphoproliferative response in dogs with natural infection by Leishmania infantum.

Dogs are the domestic reservoirs of zoonotic visceral leishmaniasis caused by Leishmania infantum. Early detection of canine infections evolving to clinically patent disease may be important to leishmaniasis control. In this study we firstly investigated the peripheral blood mononuclear cell (PBMC) response to leishmanial antigens and to polyclonal activators concanavalin A, phytohemagglutinin and pokeweed mitogen, of mixed-breed dogs with natural L. infantum infection, either in presymptomatic or in patent disease condition, compared to healthy animals. Leishmania antigens did not induce a clear proliferative response in any of the animals examined. Furthermore, mitogen-induced lymphocyte proliferation was found strongly reduced not only in symptomatic, but also in presymptomatic dogs suggesting that the cell-mediated immunity is suppressed in progressive canine leishmaniasis. To test this finding, naive Beagle dogs were exposed to natural L. infantum infection in a highly endemic area of southern Italy. Two to 10 months after exposure all dogs were found to be infected by Leishmania, and on month 2 of exposure they all showed a significant reduction in PBMC activation by mitogens. Our results indicate that suppression of the lymphoproliferative response is a common occurrence in dogs already at the beginning of an established leishmanial infection. # 1999 Elsevier Science B.V. All rights reserved

Asymmetric nuclear matter in a Hartree-Fock approach to non-linear QHD

The Equation of State (EOS) for asymmetric nuclear matter is discussed starting from a phenomenological hadronic field theory of Serot-Walecka type including exchange terms. In a model with self interactions of the scalar sigma-meson we show that the Fock terms naturally lead to isospin effects in the nuclear EOS. These effects are quite large and dominate over the contribution due to isovector mesons. We obtain a potential symmetry term of "stiff" type, i.e. increasing with baryon density and an interesting behaviour of neutron/proton effective masses of relevance for transport properties of asymmetric dense matter.Comment: 12 pages (LATEX), 3 Postscript figures, revised versio

Cost-Utility Analysis of Biologic Therapies to Treat Chronic Plaque Psoriasis in Italy: The Importance of Using Updated and Adequate Social Tariffs to Calculate Quality-Adjusted Life-Years

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Compliance, persistence, costs and quality of life in young patients treated with antipsychotic drugs: results from the COMETA study

BACKGROUND: Little data is available on the real-world socio-economic burden and outcomes in schizophrenia. This study aimed to assess persistence, compliance, costs and Health-Related Quality-of-Life (HRQoL) in young patients undergoing antipsychotic treatment according to clinical practice. METHODS: A naturalistic, longitudinal, multicentre cohort study was conducted: we involved 637 patients aged 18–40 years, with schizophrenia or schizophreniform disorder diagnosed ≤10 years before, enrolled in 86 Italian Mental Health Centres and followed-up for 1 year. Comparisons were conducted between naïve (i.e., patients visiting the centre for the first time and starting a new treatment regimen) and non naïve patients. RESULTS: At enrolment, 84% of patients were taking atypical drugs, 3.7% typical, 10% a combination of the two classes, and 2% were untreated. During follow-up, 23% of patients switched at least once to a different class of treatment, a combination or no treatment. The mean Drug-Attitude-Inventory score was 43.4, with 94.3% of the patients considered compliant by the clinicians. On average, medical costs at baseline were 390.93€/patient-month, mostly for drug treatment (29.5%), psychotherapy (29.2%), and hospitalizations (27.1%). Patients and caregivers lost 3.5 days/patient-month of productivity. During follow-up, attitude toward treatment remained fairly similar, medical costs were generally stable, while productivity, clinical statusand HRQoL significantly improved. While no significantly different overall direct costs trends were found between naïve and non naïve patients, naïve patients showed generally a significant mean higher improvement of clinical outcomes, HRQoL and indirect costs, compared to the others. CONCLUSIONS: Our results suggest how tailoring the treatment strategy according to the complex and specific patient needs make it possible to achieve benefits and to allocate more efficiently resources. This study can also provide information on the most relevant items to be considered when conducting cost-effectiveness studies comparing specific alternatives for the treatment of target patients

Neutron-Proton Differential Flow as a Probe of Isospin-Dependence of Nuclear Equation of State

The neutron-proton differential flow is shown to be a very useful probe of the isospin-dependence of the nuclear equation of state (EOS). This novel approach utilizes constructively both the isospin fractionation and the nuclear collective flow as well as their sensitivities to the isospin-dependence of the nuclear EOS. It also avoids effectively uncertainties associated with other dynamical ingredients of heavy-ion reactions at intermediate energies.Comment: 10 pages + 3 figures. Phys. Rev. Lett. (2000) in pres

Evaluation of rK39 rapid diagnostic tests for canine visceral leishmaniasis : longitudinal study and meta-analysis

Canine visceral leishmaniasis is a vector-borne disease caused by the intracellular parasite Leishmania infantum. It is an important veterinary disease, and dogs are also the main animal reservoir for human infection. The disease is widespread in the Mediterranean area, and parts of Asia and South and Central America, and is potentially fatal in both dogs and humans unless treated. Diagnosis of canine infections requires serological or molecular tests. Detection of infection in dogs is important prior to treatment, and in epidemiological studies and control programmes, and a sensitive and specific rapid diagnostic test would be very useful. Rapid diagnostic tests (RDTs) have been developed, but their diagnostic performance has been reported to be variable. We evaluated the sensitivity of a RDT based on serological detection of the rK39 antigen in a cohort of naturally infected Brazilian dogs. The sensitivity of the test to detect infection was relatively low, but increased with time since infection and the severity of infection. We then carried out a meta-analysis of published studies of rK39 RDTs, evaluating the sensitivity to detect disease and infection. The results suggest that rK39 RDTs may be useful in a veterinary clinical setting, but the sensitivity to detect infection is too low for operational control programmes

The Doctor Is In(ternet): The Mediating Role of Health Anxiety in the Relationship between Somatic Symptoms and Cyberchondria

Cyberchondria is a dysfunctional behavioral pattern characterized by an excessive and anxiety-amplifying engagement in searching for reassuring health information on the Internet. Research demonstrated that somatic symptoms and health anxiety might foster maladaptive health-related behaviors, such as cyberchondria. However, the relationships between somatic symptoms, health anxiety, and cyberchondria have been scarcely examined. Accordingly, this study aimed to test the mediating effect of health anxiety on the association between somatic symptoms and cyberchondria. Four hundred and thirty-one adults from the community (158 males, 36.66%), aged between 18 and 74, were recruited via an online survey. Participants completed self-report measures of somatic symptoms, health anxiety, and cyberchondria. A mediation analysis demonstrated that the severity of somatic symptoms predicted increased levels of cyberchondria and that health anxiety partially mediated this association. Therefore, interventions aimed at decreasing health anxiety may also play a role in decreasing the risk of developing cyberchondria

The cost of severe haemophilia in Europe: the CHESS study

Background Severe haemophilia is associated with major psychological and economic burden for patients, caregivers, and the wider health care system. This burden has been quantified and documented for a number of European countries in recent years. However, few studies have taken a standardised methodology across multiple countries simultaneously, and sought to amalgamate all three levels of burden for severe disease. The overall aim of the ‘Cost of Haemophilia in Europe: a Socioeconomic Survey’ (CHESS) study was to capture the annualised economic and psychosocial burden of severe haemophilia in five European countries. A cross-section of haemophilia specialists (surveyed between January and April 2015) provided demographic and clinical information and 12-month ambulatory and secondary care activity for patients via an online survey. In turn, patients provided corresponding direct and indirect non-medical cost information, including work loss and out-of-pocket expenses, as well as information on quality of life and adherence. The direct and indirect costs for the patient sample were calculated and extrapolated to population level. Results Clinical reports for a total of 1,285 patients were received. Five hundred and fifty-two patients (43% of the sample) provided information on indirect costs and health-related quality of life via the PSC. The total annual cost of severe haemophilia across the five countries for 2014 was estimated at EUR 1.4 billion, or just under EUR 200,000 per patient. The highest per-patient costs were in Germany (mean EUR 319,024) and the lowest were in the United Kingdom (mean EUR 129,365), with a study average of EUR 199,541. As expected, consumption of clotting factor replacement therapy represented the vast majority of costs (up to 99%). Indirect costs are driven by patient and caregiver work loss. Conclusions The results of the CHESS study reflect previous research findings suggesting that costs of factor replacement therapy account for the vast majority of the cost burden in severe haemophilia. However, the importance of the indirect impact of haemophilia on the patient and family should not be overlooked. The CHESS study highlights the benefits of observational study methodologies in capturing a ‘snapshot’ of information for patients with rare diseases

Characterization of Composites Manufactured Through Reshaping of EoL Thermoplastic Polymers Reinforced with Recycled Carbon Fibers

This article investigates if and at what extent a recycling process based on grinding, melting and re-shaping of recycled carbon fibers reinforced thermoplastic polymers (rCFRPs) can affect their physical, mechanical and thermal properties. The aim is to establish if they can be taken into consideration in the manufacturing of new composite materials in different sectors: automotive, marine, sporting goods, etc. Composites materials were submitted to the measurement of the fibers length they are composed of, and then analyzed by means of tensile and impact tests and a dynamic mechanical analysis (DMA). All the characterizations were performed to both initial and recycled composites and, in some cases, they were replied also after the intermediate accelerated aging. Characterization performed confirmed that, as expected, the recycling process affects the properties of the composites, but in different manners and to a different extent when different polymers are involved. Tensile and impact tests pointed out that the polypropylene based composites showed a less stiff and a more brittle behaviour after the recycling process and the DMA confirmed this evidence, highlighting in addition a more viscous behavior of the polymer after the recycling. Conversely, the polyamide 6 based composites increased their stiffness and ductility after the recycling. For all the composites the tensile strength dropped, confirming the weakening of the materials