Methylsulfonylmethane and boswellic acids versus glucosamine sulfate in the treatment of knee arthritis: Randomized trial

Until now glucosamine sulfate (GS) has been the most widely used supplement and has been shown to be efficacious in the treatment of osteoarthritis (OA). Methylsulfonylmethane (MSM) and boswellic acids (BA) are new effective supplements for the management of inflammation and joint degeneration, according to previous experimental studies. The aim of our study is to test the effectiveness of association of MSM and BA in comparison with GS in knee arthritis.In this prospective randomized clinical trial, MEBAGA (Methylsulfonylmethane and Boswellic Acids versus Glucosamine sulfate in the treatment of knee Arthritis), 120 participants affected by arthritis of the knee were randomly assigned to an experimental group (MB group) or a control group (GS group) treated for 60 days with 5 g of MSM and 7.2 mg of BA or with 1500 mg of GS daily, respectively. At the 2-month (T1) and 6-months (T2) follow-up , the efficacy of these two nutraceuticals was assessed using the visual analog pain scale (VAS) and the Lequesne Index (LI) for joint function, along with the use of anti-inflammatory drugs (non-steroidal anti-inflammatory drugs and anti-cyclooxygenase-2).The repeated measures ANOVA analysis shows that for VAS, LI, and the use of anti-inflammatory drugs scores there are improvements due to the time in the two groups (respectively, F=26.0; P<0.0001; F=4.15; P=0.02; F=3.38; P=0.04), with a tendency to better values for the MB group at T2.On the basis of these preliminary data, we could support the efficacy of the MSM in association with BA in the treatment of OA. These results are consistent with the anti-inflammatory and chondroprotective effects previously occurred in experimental studies. This new combination of integration (MSM and BS) has presented good results and satisfactory in comparison with GS, until now the cornerstone of the treatment of arthritis in according to guidelines

High-risk sexual behavior and HIV/STDs cascade of care in migrants: results from an Italian dedicated outpatient clinic.

Introduction: Ethnical segregation and migration influence sexual health. Differences in sexual networks and the risk of sexually transmitted diseases (STDs) between racial/ethnic minorities and the native population have been described in the literature. Methodology: We collected data on sexual behavior and physical examination. Basing on CDC 2015 guidelines on STDs, anamnesis, and clinical features, screening for HIV/STDs was proposed. Results: We enrolled 209 migrants, the median age was 32.5 (26-40) years, and 146 (69.9%) were male. The most represented nationalities were Nigerian, Senegalese, and Somali, with 85 (40.7%), 68 (32.5%), and 16 (7.7%) people, respectively. Twenty-two (10.5%) patients referred perianal/genital lesions, 6 (2.9%) abdominal/pelvic discomfort, and 183 (87.6%) were asymptomatic. Almost all symptomatic patients accepted the tests. 52/183 (28.4%) asymptomatic subjects accepted the tests, and only 24/52(46.2%) performed them. Among symptomatic patients were 6 (24%) HBsAg positivities and one (4%) HCV infection. Four (16%) people had latent syphilis; in 12 (48%) people, HPV-related genital warts were present, 7 (28%) people had Molluscum contagiosum, and 6 (24%) women had pelvic inflammatory diseases. Among patients referring no symptoms, there were 10 (41.7%) HBsAg positivities, one (4.2%) HIV infection, four (16.7%) latent syphilis, one (4.2%) HPV-related genital infection, and one (4.2%) PID. Being Nigerian and having symptoms were associated with a more high acceptance of the STDs test. Having a high-risk behavior was significantly associated with the development of at least one STD. Conclusions: migrants have high-risk sexual behavior. Despite this, they have a low perception of HIV/STDs risk and healthcare needs. Particular attention should be given to improve access to HIV/STDs services that provide screening and treatment and increase the perception of healthcare needs

Infectious diseases screening approach among refugees: results from a single-center study.

Introduction: Our aim was to evaluate a screening program, with active case-finding and treatment for active tuberculosis (TB), latent tuberculosis infection (LTBI), blood-borne viruses (BBV), and sexually transmitted diseases (STDs) among refugees living in facility centers. Methodology: We collected data on refugees arriving to our attention in migrant centers in Sardinia, Italy. Socio-demographical data, anamnesis, and clinical features were collected. TST Mantoux was conducted, and X-ray chest (XRC) was performed if TST was positive. Blood-borne virus screening was proposed to all patients. Screening for STDs was offered according to guidelines, anamnesis, and physical examination. Results: Eighty-one patients were included. Seventy (86.4%) were male, and the mean age was 24.8±5.7 years. Thirty-three (40.7%) had scabies. Overall, 40/81 (49.4%) had a positive TST Mantoux. One (2.5%) was hospitalized and died for multi-drug-resistant TB. One (2.5%) patient had intestinal-TB. 52/81 (64.2%) refused HIV screening, whereas no positivity was found among tested migrants. Sixty-two (76.5%) accepted HCV screening, and one (1.6%) had a positive test. Fifty-eight (71.6%%) accepted HBV testing, and 29 (50%) of them had positive serology. Ten (12.3%) patients had anal or genital lesions due to syphilis, Molluscum contagiosum, and HPV in 7 (70%), 2 (20%), and one (10%) case, respectively. Conclusions: Infectious diseases control and prevention are a key strategy among refugees. The stay in a migrant center is an extraordinary occasion for healthcare provision. This condition could allow a broad screening program in which quick BBV screening tests could be a good method to implement uptake. More information and educational programs would allow a higher understanding and acceptance of HIV screening

Ultrasound assisted extraction and liposome encapsulation of olive leaves and orange peels:how to transform biomass waste into valuable resources with antimicrobial activity

Every year million tons of by-products and waste from olive and orange processing are produced by agri-food industries, thus triggering environmental and economic problems worldwide. From the perspective of a circular economy model, olive leaves and orange peels can be valorized in valuable products due to the presence of bioactive compounds such as polyphenols exhibiting beneficial effects on human health.The aqueous extracts of olive leaves and orange peels rich in phenolic compounds were prepared by ultrasound-assisted extraction. Both extracts were characterized in terms of yield of extraction, total phenolic content and antioxidant capacity; the polyphenolic profiles were deeper investigated by HPLC-MS analysis.Each extract was included in liposomes composed by a natural phospholipid, 1,2-dioleoyl-sn-glycero-3-phosphocholine, and cholesterol prepared according to the thin-layer evaporation method coupled with a sonication process.The antimicrobial activity of the extracts, free and loaded in liposomes, was investigated according to the broth macrodilution method against different strains of potential bacterial pathogenic species: Staphylococcus aureus (NCIMB 9518), Bacillus subtilis (ATCC 6051) and Enterococcus faecalis (NCIMB 775) as Gram-positive, while Escherichia coli (NCIMB 13302), Pseudomonas aeruginosa (NCIMB 9904) and Klebsiella oxytoca (NCIMB 12259) as Gram-negative.The encapsulation of olive leaves extract in liposomes enhanced its antibacterial activity against S. aureus by an order of magnitude

The XMM deep survey in the CDF-S II. a 9-20 keV selection of heavily obscured active galaxies at z>1.7

We present results on a search of heavily obscured active galaxies z>1.7 using the rest-frame 9-20 keV excess for X-ray sources detected in the deep XMM-CDFS survey. Out of 176 sources selected with the conservative detection criteria (>8 sigma) in the first source catalogue of Ranalli et al., 46 objects lie in the redshift range of interest with the median redshift z~2.5. Their typical rest-frame 10-20 keV luminosity is 1e+44 erg/s, as observed. Among optically faint objects that lack spectroscopic redshift, four were found to be strongly absorbed X-ray sources, and the enhanced Fe K emission or absorption features in their X-ray spectra were used to obtain X-ray spectroscopic redshifts. Using the X-ray colour-colour diagram based on the rest-frame 3-5 keV, 5-9 keV, and 9-20 keV bands, seven objects were selected for their 9-20 keV excess and were found to be strongly absorbed X-ray sources with column density of nH > 0.6e+24 cm-2, including two possible Compton thick sources. While they are emitting at quasar luminosity, ~3/4 of the sample objects are found to be absorbed by nH > 1e+22 cm-2. A comparison with local AGN at the matched luminosity suggests an increasing trend of the absorbed source fraction for high-luminosity AGN towards high redshifts.Comment: 9 pages, 7 figures. Accepted for publication in A&

Increased plasma homocysteine predicts arrhythmia recurrence after minimally invasive epicardial ablation for nonvalvular atrial fibrillation

ObjectiveMinimally invasive epicardial ablation via right minithoracotomy is an emerging option for patients with drug-refractory nonvalvular atrial fibrillation. To guide the development of rational treatment algorithms, factors predisposing to recurrence of arrhythmia need to be quantified and eventually treated. We addressed the association of the plasma levels of homocysteine and the recurrence of atrial fibrillation after minimally invasive ablation.MethodsWe obtained peripheral blood samples from 104 patients at follow-up after arrhythmia surgery; the homocysteine concentration was expressed as micromoles per liter. Prospective follow-up was conducted through electrocardiogram Holter monitoring (average 18.5 ± 5.8 months). Stratified analysis (high vs low homocysteine) was based on the cutoff value for the last quartile of homocysteine concentration (16 μmol/L). Time-to-event and diagnostic performance analyses were performed.ResultsThe rate of freedom from atrial fibrillation was 89.4% at the end of follow-up. Elevated circulating homocysteine level, persistent type of atrial fibrillation, and increased left atrial dimension independently predicted the recurrence of atrial fibrillation during the follow-up (adjusted Cox regression). Patients with a high homocysteine level were more likely to have atrial fibrillation recurrence (stratified Kaplan–Meier, P < .001). The cutoff value for elevated homocysteine (16 μmol/L) yielded a good diagnostic performance in the prediction of atrial fibrillation recurrence (area under the receiver operating characteristic curve, 0.807).ConclusionsThe homocysteine level measured during the follow-up reliably predicts the risk of recurrence after epicardial ablation of nonvalvular atrial fibrillation via minithoracotomy. Specific treatments to reduce plasma homocysteine could be considered in the future in these patients

X-ray selection of Compton Thick AGN at high redshift

Compton Thick (CT) AGN are a key ingredient of Cosmic X-ray Background (CXB) synthesis models, but are still an elusive component of the AGN population beyond the local Universe. Multi-wavelength surveys are the only way to find them at z > 0.1, and a deep X-ray coverage is crucial in order to clearly identify them among star forming galaxies. As an example, the deep and wide COSMOS survey allowed us to select a total of 34 CT sources. This number is computed from the 64 nominal CT candidates, each counted for its N H probability distribution function. For each of these sources, rich multi-wavelength information is available, and is used to confirm their obscured nature, by comparing the expected AGN luminosity from spectral energy distribution fitting, with the absorption-corrected X-ray luminosity. While Chandra is more efficient, for a given exposure, in detecting CT candidates in current surveys (by a factor ~2), deep XMM-Newton pointings of bright sources are vital to fully characterize their properties: NH distribution above 10^25 cm^-2, reflection intensity etc., all crucial parameters of CXB models. Since luminous CT AGN at high redshift are extremely rare, the future of CT studies at high redshift will have to rely on the large area surveys currently underway, such as XMM-XXL and Stripe82, and will then require dedicated follow-up with XMM-Newton, while waiting for the advent of the ESA mission Athena.Comment: 6 pages, 7 figures, to appear in Astronomische Nachrichten, presented at the XMM-Newton: The Next Decade conference, ESAC, Madrid, Spain, 9 - 11 May 201

Evidence for feedback in action from the molecular gas content in the z~1.6 outflowing QSO XID2028

Gas outflows are believed to play a pivotal role in shaping galaxies, as they regulate both star formation and black hole growth. Despite their ubiquitous presence, the origin and the acceleration mechanism of such powerful and extended winds is not yet understood. Direct observations of the cold gas component in objects with detected outflows at other wavelengths are needed to assess the impact of the outflow on the host galaxy interstellar medium (ISM). We observed with the Plateau de Bure Interferometer an obscured quasar at z~1.5, XID2028, for which the presence of an ionised outflow has been unambiguously signalled by NIR spectroscopy. The detection of CO(3-2) emission in this source allows us to infer the molecular gas content and compare it to the ISM mass derived from the dust emission. We then analyze the results in the context of recent insights on scaling relations, which describe the gas content of the overall population of star-forming galaxies at a similar redshifts. The Star formation efficiency (~100) and gas mass (M_gas=2.1-9.5x10^{10} M_sun) inferred from the CO(3-2) line depend on the underlying assumptions on the excitation of the transition and the CO-to-H2 conversion factor. However, the combination of this information and the ISM mass estimated from the dust mass suggests that the ISM/gas content of XID2028 is significantly lower than expected for its observed M⋆, sSFR and redshift, based on the most up-to-date calibrations (with gas fraction <20% and depletion time scale <340 Myr). Overall, the constraints we obtain from the far infrared and millimeter data suggest that we are observing QSO feedback able to remove the gas from the host