Serum Biomarkers of Renal Fibrosis: A Systematic Review

Chronic kidney disease (CKD) is a widely diffuse pathological condition which deeply impacts upon an affected patient’s quality of life and its worldwide rate is predicted to further rise. The main biological mechanism underlying CKD is renal fibrosis, a non-reversible process representing, for the affected system, a point of no return of tissue damage and dysfunction, deeply reducing the possible therapeutic strategies at the disposal of physicians. The best tool clinicians can use to address the extent of renal fibrosis at any level (glomeruli, tubule-interstitium, vasculature) is kidney biopsy that, despite its overall safety, remains an invasive procedure showing some shortcomings. Thus, the identification of novel non-invasive renal fibrosis biomarkers would be of fundamental importance. Here, when systematically reviewing the available evidence on serological biomarkers associated with renal fibrosis evaluated in patients suffering from CKD in the last five years, we found that despite the presence of several promising biomarkers, the level of observed evidence is still very scattered. Probably, the use of multiple measures capable of addressing different aspects involved in this condition would be the most suitable way to capture the high complexity characterizing the renal fibrotic process, having consequently a great impact on clinical practice by maximizing prevention, diagnosis, and management

Antimicrobial activities of essential oils against common hospital Fungi species

Introduction: In hospitals and other healthcare settings the presence of airborne and sedimented fungi is an extrinsic risk factor for opportunistic infections involving both immunocompromised and non-immunocompromised persons. In hospitalized patients, it is estimated that 9% of hospital-acquired infections are caused by fungi. Lethality rate varies from 40% to 100% depending on the immunosuppression degree of stakeholders. To prevent healthcare-associated infections, the control of environmental fungal contamination through use of sanitizing/disinfecting practices is basic. However, the widespread use of common disinfectants could promote the growth of antibiotic-resistant superbugs and cause environmental harm. These aspects stimulated the search of new antimicrobial agents. The aim of this study was to evaluate the antimicrobial activity of essential oils of Mentha insularis Req., Mentha pulegium L., Mentha requienii Bentham, Artemisia caerulescens L. ssp. densiflora (Viv), Rosmarinus officinalis L. var. albiflorus, Rosmarinus officinalis L. var. lavandulescens, and Ocotea puchury major Mart. against fungi species frequently found in hospitals and potentially responsible for opportunistic mycoses. Methods: The essential oils’ antifungal activity was carried out by agar disc diffusion technique. Results: All tested essential oils are effective, though to a different degree, against both molds that yeasts assessed. The major antifungal activity was showed by Mentha oils. Particularly, Mentha requienii and Mentha insularis oils were active until 1:8 dilution against Rhodotorula spp. and 1:16 dilution against mixed molds, while M. pulegium was strongly active until 1:2 against both fungi. Conclusions: To the best of our knowledge, few or no data are available in literature on the activity of essential oils against hospital environmental isolates of fungi. Results suggest their potential application in sanitation procedures of the hospital, and in general, of the “care settings”

Iridoid Glycosides from Escallonia Species

Phytochemical study of Escallonia myrtoidea, E. illinita, E. alpina and E. pulverulenta led to the isolation of asperuloside and other C10-iridoid glycosides. From E. myrtoidea a new iridoid glycoside was isolated and identified as 6'0β-D-glucosylasperuloside by spectroscopic means. The findings are in accordance with the inclusion of Escallonia in the Saxifragacea

Reducing the diagnostic delay in Antiphospholipid Syndrome over time: a real world observation

Abstract Background Antiphospholipid Syndrome (APS) is a rare autoimmune disorder with an estimated prevalence of 40–50 cases per 100.000 persons. Patients suffering from low prevalence diseases are more likely to face diagnostic challenges, given the limited knowledge of most clinicians. The main aim of this study was to investigate the time between symptoms occurrence and the diagnosis of APS patients using the Piedmont and Aosta Valley Rare Disease Registry. Secondly, to evaluate the individual impact of the diagnostic gap by gathering patients’ personal experiences through a self-administered questionnaire. Results Data from the Piedmont and Aosta Valley Rare Disease Registry was used. In addition, personal experiences were analyzed through a self-administered questionnaire. A total of 740 APS patients included in the Piedmont and Aosta Valley Rare Disease Registry were analyzed. Diagnostic delay (as defined by time between symptoms’ occurrence and the diagnosis of APS) was significantly reduced over time. In particular, when comparing the diagnostic delay between patients diagnosed between 1983 and 1999 and patients diagnosed between 2000 and 2015, we found a significant statistical difference (Mann-Whithey U Test; mean rank 1216.6 vs. 1066.9, respectively; p < 0.0001). When analyzing the self-administered questionnaires, patients with a perception of having suffered for a diagnostic delay had a higher prevalence of symptoms suggestive of an autoimmune condition but not highly suggestive of APS (45%), followed by “extra criteria” APS manifestation (30%) and by thrombotic events (25%). The first clinical manifestation of patients who did not have the perception of having suffered a diagnostic delay was thrombotic events (45.5%), followed by autoimmune manifestation not linked to APS (45.5%), and “extra criteria” APS manifestations (9%). Conclusions While the diagnostic delay of APS has been reduced during the last years, the time between symptoms occurrence and the diagnosis of rare diseases still represents a critical issue to be addressed in order to prevent major complications