S. aureus and IgE-mediated diseases: pilot or copilot? A narrative review

Introduction: S. aureus is a major opportunistic pathogen that has been implicated in the pathogenesis of several chronic inflammatory diseases including bronchial asthma, chronic rhinosinusitis with nasal polyps (CRSwNP), chronic spontaneous urticaria (CSU), and atopic dermatitis. S. aureus can induce the production of both polyclonal and specific IgE that can elicit an inflammatory cascade. Areas covered: The link between the sensitization to S. aureus enterotoxins and the severity of several chronic inflammatory diseases is reviewed in detail, as well as its therapeutic implications. Expert opinion: An anti-IgE strategy to inhibit S. aureus enterotoxins would be a valid approach to treat several endotypes of severe asthma, CRSwNP and CSU in which IgE against S. aureus enterotoxins should represent, not only a marker of severity of the diseases but also a target of a treatment

On the effects of bilateral agreements in world wine trade

During the last decades there have been significant changes in trade regulations that are modifying the global trade of wine. The number of non-tariff measures (NTMs) adopted in the wine sector is relevant. Similarly, a large number of bilateral trade agreements have been adopted. Despite the regulation is heavy, the impact of these policy instruments on trade is not always clear, nor quantified at global scale. We investigate the effects that bilateral NTMs are showing on global imports of wine. In particular, we estimate a gravity model to explain how bilateral NTMs influence wine trade, and we disentangle these effects for different segments of the international market of wine. Our results suggest that bilateral NTMs tend to favour imports of wine. Differences emerge across market segments and types of regulations. In particular, the Technical Barriers to Trade favour (friction) bottled (bulk) wine; pre-shipment inspections enhance imports of bottled wine; the Sanitary and Phytosanitary Standards are the most trade-enhancing NTMs, regardless of the market segment

A causal statistical family of dissipative divergence type fluids

In this paper we investigate some properties, including causality, of a particular class of relativistic dissipative fluid theories of divergence type. This set is defined as those theories coming from a statistical description of matter, in the sense that the three tensor fields appearing in the theory can be expressed as the three first momenta of a suitable distribution function. In this set of theories the causality condition for the resulting system of hyperbolic partial differential equations is very simple and allow to identify a subclass of manifestly causal theories, which are so for all states outside equilibrium for which the theory preserves this statistical interpretation condition. This subclass includes the usual equilibrium distributions, namely Boltzmann, Bose or Fermi distributions, according to the statistics used, suitably generalized outside equilibrium. Therefore this gives a simple proof that they are causal in a neighborhood of equilibrium. We also find a bigger set of dissipative divergence type theories which are only pseudo-statistical, in the sense that the third rank tensor of the fluid theory has the symmetry and trace properties of a third momentum of an statistical distribution, but the energy-momentum tensor, while having the form of a second momentum distribution, it is so for a different distribution function. This set also contains a subclass (including the one already mentioned) of manifestly causal theories.Comment: LaTex, documentstyle{article

Upper and lower airway inflammation in severe asthmatics: a guide for a precision biologic treatment

Background and aims: Severe asthma may require the prescription of one of the biologic drugs currently available, using surrogate markers of airway inflammation (serum IgE levels and allergic sensitization for anti-IgE, or blood eosinophils for anti-IL5/IL5R). Our objective: to assess upper and lower airway inflammation in severe asthmatics divided according to the eligibility criteria for one of the target biologic treatments. Methods: We selected 91 severe asthmatics, uncontrolled despite high-dose ICS-LABA, and followed for >6 months with optimization of asthma treatment. Patients underwent clinical, functional and biological assessment, including induced sputum and nasal cytology. They were then clustered according to the eligibility criteria for omalizumab or mepolizumab/benralizumab. Results: Four clusters were selected: A (eligible for omalizumab, n = 23), AB (both omalizumab and mepolizumab, n = 26), B (mepolizumab, n = 22) and C (non-eligible for both omalizumab and mepolizumab, n = 20). There was no difference among clusters for asthma control (Asthma Control Test and Asthma Control Questionnaire 7), pre-bronchodilator forced expiratory volume in 1 s, serum IgE and fractional exhaled nitric oxide levels. Sputum eosinophils were numerically higher in clusters AB and B, in agreement with the higher levels of blood eosinophils. Allergic rhinitis was more frequent in clusters A and AB, while chronic rhinosinusitis with nasal polyps prevalence increased progressively from A to C. Eosinophils in nasal cytology were higher in clusters AB, B and C. Conclusion: Eosinophilic upper and lower airway inflammation is present in the large majority of severe asthmatics, independently from the prescription criteria for the currently available biologics, and might suggest the use of anti-IL5/IL5R or anti IL4/13 also in patients without blood eosinophilia. The reviews of this paper are available via the supplemental material section

Mepolizumab Improves Outcomes of Chronic Rhinosinusitis with Nasal Polyps in Severe Asthmatic Patients: A Multicentric Real-Life Study

Objective: The upcoming introduction of mepolizumab represents a promising treatment for chronic rhinosinusitis with nasal polyps (CRSwNP). The present study aimed to evaluate the effectiveness of mepolizumab on sinonasal outcomes of comorbid CRSwNP and severe asthma in a real-life setting. The primary endpoint was to evaluate changes in the SinoNasal Outcome Test (SNOT)-22 score, Nasal Polyp (NP) score, and blood eosinophil count during a 12-month treatment with mepolizumab. Secondary endpoints were to quantify mepolizumab's effects on the mentioned parameters, identify clinical variables influencing the degree of response to treatment, and portray responder and nonresponder patients. Methods: A multicentric retrospective no-profit observational study on severe asthmatic patients, treated with mepolizumab, and comorbid CRSwNP was conducted. All patients were followed for at least 12 months. SNOT-22 score, NP score, and blood eosinophil count (and other CRS-specific variables) were collected at baseline and after 12 months. Results: Forty-three patients were included. A statistically significant reduction was observed for SNOT-22 score (mean t0 SNOT-22 54.8 +/- 25.9; mean t12 SNOT-22 31.5 +/- 21.3, p < 0.0001), NP score (median t0 NPS 3 (IQR 3); median t12 NPS 2 (IQR 4), p < 0.0001), and blood eosinophil count (mean t0 blood eosinophils 804.7 +/- 461.5 cell/mu L; mean t12 blood eosinophils 107.5 +/- 104.6 cell/mu L, p < 0.0001) after 12 months of treatment. Twenty patients (47%) gained improvement both in clinical and endoscopic outcome. Mepolizumab responder patients presented a t0 SNOT-22 significantly higher than nonresponders (p = 0.0011). Conclusions: Mepolizumab improved CRSwNP outcomes in a population of severe asthmatic patients. No clinical feature emerged to outline the profile of a "typical" responder patient, except for baseline SNOT-22 score, which seemed to affect the response to treatment. Further studies would be necessary to supplement these preliminary evaluations

Secondary cytomegalovirus infections: How much do we still not know? Comparison of children with symptomatic congenital cytomegalovirus born to mothers with primary and secondary infection

congenital cytomegalovirus (cCMV) infection can follow primary and secondary maternal infection. growing evidence indicate that secondary maternal infections contribute to a much greater proportion of symptomatic cCMV than was previously thought. We performed a monocentric retrospective study of babies with cCMV evaluated from august 2004 to february 2021; we compared data of symptomatic children born to mothers with primary or secondary infection, both at birth and during follow up. among the 145 babies with available data about maternal infection, 53 were classified as having symptomatic cCMV and were included in the study: 40 babies were born to mothers with primary infection and 13 babies were born to mothers with secondary infection. Analyzing data at birth, we found no statistical differences in the rate of clinical findings in the two groups, except for unilateral sensorineural hearing loss (SNHL) which was significantly more frequent in patients born to mother with secondary infection than in those born to mother with primary infection (46.2 vs. 17.5%, P = 0.037). during follow up, we found a higher rate of many sequelae (tetraparesis, epilepsy, motor and speech delay, and unilateral SNHL) in the group of children born to mothers with secondary infection, with a statistical difference for tetraparesis and unilateral SNHL. otherwise, only children born to mothers with primary infection presented bilateral SNHL both at birth and follow up. Our data suggest that the risk of symptomatic cCMV and long-term sequelae is similar in children born to mother with primary and secondary CMV infection; it is important to pay appropriate attention to seropositive mothers in order to prevent reinfection and to detect and possibly treat infected babies

The 2009 L’Aquila (central Italy) MW6.3 earthquake: Main shock

A MW 6.3 earthquake struck on April 6, 2009 the Abruzzi region (central Italy) producing vast damage in the L’Aquila town and surroundings. In this paper we present the location and geometry of the fault system as obtained by the analysis of main shock and aftershocks recorded by permanent and temporary networks. The distribution of aftershocks, 712 selected events with ML 2.3 and 20 with ML 4.0, defines a complex, 40 km long, NW trending extensional structure. The main shock fault segment extends for 15–18 km and dips at 45 to theSW, between 10 and 2 km depth. The extent of aftershocks coincides with the surface trace of the Paganica fault, a poorly known normal fault that, after the event, has been quoted to accommodate the extension of the area.We observe a migration of seismicity to the north on an echelon fault that can rupture in future large earthquakes.PublishedL183083.1. Fisica dei terremotiJCR Journalreserve

Il consolidamento degli apparati decorativi mediante dispositivi a memoria di forma: il progetto di ricerca sui dipinti murali di via dell’Abbondanza a Pompei

Il progetto di ricerca, iniziato durante il cantiere di restauro, recentemente concluso, ha riguardato gli interventi di consolidamento, conservazione e restauro su alcune facciate delle antiche botteghe di via dell'Abbondanza (Regio IX, Insulae 7 e 11) nel sito archeolo-gico di Pompei. Questi fronti sono caratterizzati da alcuni dei dipinti murali più importanti e le iscrizioni elettorali. Il progetto denominato “Da Asellina a Verecundus: ricerca, restauro e monitoraggio sulle pitture di alcune celebri botteghe di via dell'Abbondanza a Pompei (Regio IX, Insulae 7 e 11)” nato dalla collaborazione fra la Soprintendenza Ar-cheologica di Pompei, la Facoltà di Architettura Valle Giulia dell’Università di Roma La Sapienza, la Facoltà di Architettura e il Centro DIAPReM dell’Università di Ferrara e la II Facoltà di Ingegneria (sede di Forlì) dell’Università di Bologna, con l’obiettivo della salva-guardia di alcune strutture architettoniche e degli apparati pittorici e decorativi fra i più importanti di tutta la città. L’intervento di restauro, in particolare, ha riguardato alcune botteghe poste sul braccio del decumano massimo compreso fra il Foro e Porta Sarno. Tali facciate, riportate alla luce durante gli scavi condotti nel 1912 da Vittorio Spinazzola, appartengono all’officina coactiliaria (Regio IX, VII, 7-5); ad una casa privata (Regio IX, VII, 3); all’officina infectoria (Regio IX, VII, 2); all’officina coactiliaria (Regio IX, VII,1); al compitum (Regio IX, XI, 1); al thermopolium di Asellina, rivendita di bevande calde (Regio IX, XI, 2). Una sezione del progetto di ricerca ha riguardato la sperimentazione di nuovi dispositivi tecnologici finalizzati al restauro di pitture murali e basati su leghe a memoria di forma (SMA) per risolvere i problemi di consolidamento altrimenti risolto per mezzo di non-reversibile o invadente metodologie. Una delle applicazioni innovative di questi dispositivi riguarda il movimento delle lastre in policarbonato in grado di proteggere le pit-ture murali. Il particolare contesto del progetto di ricerca è collocato sul confine tra l'area scavata e l'area ancora sepolta, così, è stato particolarmente interessante mettere a fuoco le ricerche sul consolidamento delle decorazioni e pitture murali, anche attraverso lo studio delle interventi di Vittorio Spinazzola durante i lavori di scavo, all'inizio del XX secolo

Gastrointestinal stromal tumour of the duodenum in childhood: a rare case report

<p>Abstract</p> <p>Background</p> <p>Gastrointestinal stromal tumours (GISTs) are uncommon primary mesenchymal tumours of the gastrointestinal tract mostly observed in the adults. Duodenal GISTs are relatively rare in adults and it should be regarded as exceptional in childhood. In young patients duodenal GISTs may be a source of potentially lethal haemorrhage and this adds diagnostic and therapeutic dilemmas to the concern about the long-term outcome.</p> <p>Case presentation</p> <p>A 14-year-old boy was referred to our hospital with severe anaemia due to recurrent episodes of upper gastrointestinal haemorrhage. Endoscopy, small bowel series, scintigraphy and video capsule endoscopy previously done elsewhere were negative. Shortly after the admission, the patient underwent emergency surgery for severe recurrence of the bleeding. At surgery, a 4 cm solid mass arising from the wall of the fourth portion of the duodenum was identified. The invasion and the erosion of the duodenal mucosa was confirmed by intra-operative pushed duodenoscopy. The mass was resected by a full-thickness duodenal wall excision with adequate grossly free margins. Immunohistochemical analysis of the specimen revealed to be positive for CD117 (c-KIT protein) consistent with a diagnosis of GIST. The number of mitoses was < 5/50 HPF. Mutational analysis for c-KIT/PDGFRA tyrosine kinase receptor genes resulted in a wildtype pattern. The patient had an uneventful course and he has remained disease-free during two years of follow-up.</p> <p>Conclusion</p> <p>Duodenal GISTs in children are very rare and may present with massive bleeding. Cure can be achieved by complete surgical resection, but even in the low-aggressive tumours the long-term outcome may be unpredictable.</p

Comparison Study of MS-HRM and Pyrosequencing Techniques for Quantification of APC and CDKN2A Gene Methylation

There is increasing interest in the development of cost-effective techniques for the quantification of DNA methylation biomarkers. We analyzed 90 samples of surgically resected colorectal cancer tissues for APC and CDKN2A promoter methylation using methylation sensitive-high resolution melting (MS-HRM) and pyrosequencing. MS-HRM is a less expensive technique compared with pyrosequencing but is usually more limited because it gives a range of methylation estimates rather than a single value. Here, we developed a method for deriving single estimates, rather than a range, of methylation using MS-HRM and compared the values obtained in this way with those obtained using the gold standard quantitative method of pyrosequencing. We derived an interpolation curve using standards of known methylated/ unmethylated ratio (0%, 12.5%, 25%, 50%, 75%, and 100% of methylation) to obtain the best estimate of the extent of methylation for each of our samples. We observed similar profiles of methylation and a high correlation coefficient between the two techniques. Overall, our new approach allows MS-HRM to be used as a quantitative assay which provides results which are comparable with those obtained by pyrosequencing