Antibiotic susceptibility, heteroresistance, and updated treatment strategies in helicobacter pylori infection

In this review, we discuss the problem of antibiotic resistance, heteroresistance, the utility of cultures and antibiotic susceptibility tests in Helicobacter pylori (Hp) eradication, as well as the updated treatment strategies for this infection. The prevalence of antibiotic resistance is increasing all over the world, especially for metronidazole and clarithromycin, because of their heavy use in some geographical areas. Heteroresistance (simultaneous presence of both susceptible and resistant strains in different sites of a single stomach) is another important issue, as an isolate could be mistakenly considered susceptible if a single biopsy is used for antimicrobial tests. We also examined literature data regarding eradication success rates of culture-guided and empiric therapies. The empiric therapy and the one based on susceptibility testing, in Hp eradication, may depend on several factors such as concomitant diseases, the number of previous antibiotic treatments, differences in bacterial virulence in individuals with positive or negative cultures, together with local antibiotic resistance patterns in real-world settings. Updated treatment strategies in Hp infection presented in the guidelines of the Toronto Consensus Group (2016) are reported. These suggest to prolong eradication therapy up to 14 days, replacing the old triple therapy with a quadruple therapy based on proton pump inhibitor (PPI), bismuth, metronidazole, and tetracycline for most of the patients, or as an alternative quadruple therapy without bismuth, based on the use of PPI, amoxicillin, metronidazole, and clarithromycin. The new drug vonoprazan, a first-in-class potassium-competitive acid blocker recently approved in Japan, is also considered to be a promising solution for Hp eradication, even for clarithromycin-resistant strains. Furthermore, there is growing interest in finding new therapeutic strategies, such as the development of vaccines or the use of natural resources, including probiotics, plants, or nutraceuticals.In this review, we discuss the problem of antibiotic resistance, heteroresistance, the utility of cultures and antibiotic susceptibility tests in Helicobacter pylori (Hp) eradication, as well as the updated treatment strategies for this infection. The prevalence of antibiotic resistance is increasing all over the world, especially for metronidazole and clarithromycin, because of their heavy use in some geographical areas. Heteroresistance (simultaneous presence of both susceptible and resistant strains in different sites of a single stomach) is another important issue, as an isolate could be mistakenly considered susceptible if a single biopsy is used for antimicrobial tests. We also examined literature data regarding eradication success rates of culture-guided and empiric therapies. The empiric therapy and the one based on susceptibility testing, in Hp eradication, may depend on several factors such as concomitant diseases, the number of previous antibiotic treatments, differences in bacterial virulence in individuals with positive or negative cultures, together with local antibiotic resistance patterns in real-world settings. Updated treatment strategies in Hp infection presented in the guidelines of the Toronto Consensus Group (2016) are reported. These suggest to prolong eradication therapy up to 14 days, replacing the old triple therapy with a quadruple therapy based on proton pump inhibitor (PPI), bismuth, metronidazole, and tetracycline for most of the patients, or as an alternative quadruple therapy without bismuth, based on the use of PPI, amoxicillin, metronidazole, and clarithromycin. The new drug vonoprazan, a first-in-class potassium-competitive acid blocker recently approved in Japan, is also considered to be a promising solution for Hp eradication, even for clarithromycin-resistant strains. Furthermore, there is growing interest in finding new therapeutic strategies, such as the development of vaccines or the use of natural resources, including probiotics, plants, or nutraceuticals

Corrigendum: Gender Inequality in Precarious Academic Work: Female Adjunct Professors in Italy

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Sostenere la motivazione degli alunni autistici. Un progetto di didattica inclusiva con la musicoterapia

This contribution presents the preliminary data of an exploratory study on social motivation within the inclusion oriented scholastic context concerning children and adolescents with autism spectrum disorders. To measure social behavior and the development of relational and communicative skills the Social Responsiveness Scale (SRS) (Constantino e Gruber, 2005) will be applied. The present study seeks to investigate the following possibilities: the use of SRS as an instrument for an inclusive education, that measures both the weaknesses and the strengths of the students with ASD; the validity of a music therapy program in the construction and distribution of body-soundmusic-centered communication, and subsequently the ability to recognize and develop autonomously the basic components of comprehension and communication processes. Future research might compare the data obtained in this study to verify, also on a national level, the impact of an inclusive education using music therapy activities, and its effects towards a better support of childrenand adolescents with autism spectrum disorders and towards an increased well-being in their scholastic and academic development.This contribution presents the preliminary data of an exploratory study on social motivation within the inclusion oriented scholastic context concerning children and adolescents with autism spectrum disorders. To measure social behavior and the development of relational and communicative skills the Social Responsiveness Scale (SRS) (Constantino e Gruber, 2005) will be applied. The present study seeks to investigate the following possibilities: the use of SRS as an instrument for an inclusive education, that measures both the weaknesses and the strengths of the students with ASD; the validity of a music therapy program in the construction and distribution of body-soundmusic-centered communication, and subsequently the ability to recognize and develop autonomously the basic components of comprehension and communication processes. Future research might compare the data obtained in this study to verify, also on a national level, the impact of an inclusive education using music therapy activities, and its effects towards a better support of childrenand adolescents with autism spectrum disorders and towards an increased well-being in their scholastic and academic development

Cloud for eGov: the state of the art

Specifically, the paper provides a detailed analysis of the state of the art regarding technological, regulatory and interoperability aspects, devoting particular attention to those projects (and related experience) in the field of cloud and distributed computing. The paper's aim is to evaluate benefits and risks of the applicability of solutions that are already in place for the specified areas of interest. The key factors that determine relevant regulations, with particular emphasis on the European target, have been listed in the paper. Finally, the main Italian projects and the situation in some European countries have also been mentioned

Ripensare la didattica disciplinare attraverso il corpo ed il movimento

As the World Health Organization has pointed out, in the contemporary worldthere are more and more cases of overweight and obese young people.These problems are seriously tackled by the recent legislation of educationand training system (Law 107/2015), with particular regard to the preventionof obesity and stressing the importance of the physical and dietary education.Schools are, indeed, the place where it is possible to improve thehabits of the future citizen.Therefore to what extent is learning-teaching process related to body element?After a general introduction, the essay presents some considerations,regarding the international discoveries about the school system:those could be essential ideas for the didactic renovation and for the professionalismof teachers.Come testimoniano i dati forniti dall’Organizzazione mondiale della sanità,nel mondo contemporaneo sono sempre maggiori i casi di giovani insovrappeso e obesi.Tale problematica è stata affrontata anche dalle recenti disposizioni normativein materia di istruzione e formazione (Legge 107/2015), attraverso un esplicitorimando alla prevenzione dell’obesità, sottolineando l’importanza dell’educazione motoria e alimentare, poiché è proprio negli ambienti scolastici, infatti, che è possibile intervenire sulle abitudini del futuro cittadino del domani.In che misura il processo di apprendimento-insegnamento entra in relazionecon la sfera corporea? Dopo un’introduzione più generale il contributo intende presentare alcune riflessioni, alla luce delle scoperte attuate in ambito internazionale che investono il mondo della scuola e che possono rappresentare degli spunti fondamentali di rinnovamento per la didatticae la professionalità del docente

Ripensare la didattica disciplinare attraverso il corpo ed il movimento

As the World Health Organization has pointed out, in the contemporary worldthere are more and more cases of overweight and obese young people.These problems are seriously tackled by the recent legislation of educationand training system (Law 107/2015), with particular regard to the preventionof obesity and stressing the importance of the physical and dietary education.Schools are, indeed, the place where it is possible to improve thehabits of the future citizen.Therefore to what extent is learning-teaching process related to body element?After a general introduction, the essay presents some considerations,regarding the international discoveries about the school system:those could be essential ideas for the didactic renovation and for the professionalismof teachers.Come testimoniano i dati forniti dall’Organizzazione mondiale della sanità,nel mondo contemporaneo sono sempre maggiori i casi di giovani insovrappeso e obesi.Tale problematica è stata affrontata anche dalle recenti disposizioni normativein materia di istruzione e formazione (Legge 107/2015), attraverso un esplicitorimando alla prevenzione dell’obesità, sottolineando l’importanza dell’educazione motoria e alimentare, poiché è proprio negli ambienti scolastici, infatti, che è possibile intervenire sulle abitudini del futuro cittadino del domani.In che misura il processo di apprendimento-insegnamento entra in relazionecon la sfera corporea? Dopo un’introduzione più generale il contributo intende presentare alcune riflessioni, alla luce delle scoperte attuate in ambito internazionale che investono il mondo della scuola e che possono rappresentare degli spunti fondamentali di rinnovamento per la didatticae la professionalità del docente

Use of Almond Skins to Improve Nutritional and Functional Properties of Biscuits: An Example of Upcycling

Upcycling food industry by-products has become a topic of interest within the framework of the circular economy, to minimize environmental impact and the waste of resources. This research aimed at verifying the effectiveness of using almond skins, a by-product of the confectionery industry, in the preparation of functional biscuits with improved nutritional properties. Almond skins were added at 10 g/100 g (AS10) and 20 g/100 g (AS20) to a wheat flour basis. The protein content was not influenced, whereas lipids and dietary fiber significantly increased (p < 0.05), the latter meeting the requirements for applying "source of fiber" and "high in fiber" claims to AS10 and AS20 biscuits, respectively. The addition of almond skins altered biscuit color, lowering L* and b* and increasing a*, but improved friability. The biscuits showed sensory differences in color, odor and textural descriptors. The total sum of single phenolic compounds, determined by HPLC, was higher (p < 0.05) in AS10 (97.84 µg/g) and AS20 (132.18 µg/g) than in control (73.97 µg/g). The antioxidant activity showed the same trend as the phenolic. The p-hydroxy benzoic and protocatechuic acids showed the largest increase. The suggested strategy is a practical example of upcycling when preparing a health-oriented food product

Use of Almond Skins to Improve Nutritional and Functional Properties of Biscuits: An Example of Upcycling

Upcycling food industry by-products has become a topic of interest within the framework of the circular economy, to minimize environmental impact and the waste of resources. This research aimed at verifying the effectiveness of using almond skins, a by-product of the confectionery industry, in the preparation of functional biscuits with improved nutritional properties. Almond skins were added at 10 g/100 g (AS10) and 20 g/100 g (AS20) to a wheat flour basis. The protein content was not influenced, whereas lipids and dietary fiber significantly increased (p < 0.05), the latter meeting the requirements for applying “source of fiber” and “high in fiber” claims to AS10 and AS20 biscuits, respectively. The addition of almond skins altered biscuit color, lowering L* and b* and increasing a*, but improved friability. The biscuits showed sensory differences in color, odor and textural descriptors. The total sum of single phenolic compounds, determined by HPLC, was higher (p < 0.05) in AS10 (97.84 µg/g) and AS20 (132.18 µg/g) than in control (73.97 µg/g). The antioxidant activity showed the same trend as the phenolic. The p-hydroxy benzoic and protocatechuic acids showed the largest increase. The suggested strategy is a practical example of upcycling when preparing a health-oriented food product.info:eu-repo/semantics/publishedVersio

A randomized blinded retrospective study: the combined use of micro-needling technique, low-level laser therapy and autologous non-activated platelet-rich plasma improves hair re-growth in patients with androgenic alopecia

Introduction Mini-invasive therapies based on autologous non-activated Platelet-Rich Plasma (ANA-PRP), Low-Level Laser Therapy (LLL-T), and Micro-Needling Technique (MN-T) used in combining for hair re-growth need to be standardized. Objectives The work aims to showin vivooutcomes resulted from retrospective case-series study in which ANA-PRP + MN-T + LLL-T were used in combined in patients affected by Androgenic alopecia. Methods 23 patients were treated, of which 13 males were classified in stage I-V by the Norwood-Hamilton scale, and 10 females were classified in stage I-III by the Ludwig scale. Assessment of hair re-growth was evaluated with photography, physician's and patient's global assessment scale, and standardized phototrichograms during a follow-up: T0 - baseline, T1 - 12 weeks, T2 - 23 weeks, T3 - 44 weeks, T4 - 58 weeks. Results Interesting outcomes represented by a hair density increase of 81 +/- 5 hairs/cm(2)and 57 +/- 7 hairs/cm(2)respectively at T1 and T2 compared with baseline (173 +/- 5 hairs/cm(2)at T1 and 149 +/- 9 hairs/cm(2)at T2 versus 92 +/- 2 hairs/cm(2)at baseline) were observed using computerized trichograms. Expert Opinion The main limitation in the autologous regenerative therapies and biotechnologies in hair-regrowth is the extreme variability of PRP products used, in the absence of standardized protocols and widely shared. Appropriate PRP preparations have to be pick after carefully thinking about their bio-molecular specifications and intended indications for use in patients. This approach will aid in matching the optimal PRP product to specific patient factors, leading to improved outcomes and the elucidation of the cost-effectiveness of this treatment. The combined use of biotechnologies as the association of PRP with micro-needling and low-level laser therapy may improve the results in terms of hair count and hair density compared with those obtained by alone PRP. All the procedures must be performed in the full respect of international and local rules. Conclusions The effect of the combined use of MN-T, LLL-T, and ANA-PRP has been demonstrated