Role of leukocytes, gender, and symptom domains in the influence of depression on hospitalization and mortality risk: Findings from the Moli-sani study

Background: Major depressive disorder is a mental illness associated with chronic conditions like cardiovascular disease (CVD). Circulating inflammation has been proposed as a potential mechanism underlying this link, although the role of specific biomarkers, gender, and symptom domains is not well elucidated. Methods: We performed multivariable Cox regressions of first hospitalization/all-cause mortality and CVD, ischemic heart (IHD), and cerebrovascular disease (CeVD) causes vs. depression severity in an Italian population cohort (N = 13,191; age ≥ 35 years; 49.3% men; 4,856 hospitalizations and 471 deaths, median follow-up 7.28 and 8.24 years, respectively). In models adjusted for age, sex, and socioeconomic status, we estimated the proportion of association explained by C-reactive protein (CRP), platelet count, granulocyte-to-lymphocyte ratio (GLR), and white blood cell count (WBC). Gender-by-depression interaction and gender-stratified analyses were performed. Associations of polychoric factors tagging somatic and cognitive symptoms with incident clinical risks were also tested, as well as the proportion explained by a composite index of circulating inflammation (INFLA score). Results: Significant proportions of the influence of depression on clinical risks were explained by CRP (4.8% on IHD hospitalizations), GLR (11% on all-cause mortality), and WBC (24% on IHD/CeVD hospitalizations). Gender-by-depression interaction was significantly associated only with all-cause mortality (p = 0.03), with moderate depression showing a + 60% increased risk in women, but not in men. Stable associations of somatic, but not of cognitive, symptoms with increased hospitalization risk were observed (+ 16% for all causes, + 14% for CVD causes), with INFLA score explaining small but significant proportions of these associations (2.5% for all causes, 8.6% for IHD causes). Conclusions: These findings highlight the importance of cellular components of inflammation, gender, and somatic depressive symptoms in the link between depression and clinical (especially CVD) risks, pointing to the existence of additional pathways through which depression may play a detrimental effect on the cardiovascular system

The Pleistocene tectono-sedimentary evolution of the Apenninic foreland basin between Trigno and Fortore rivers (Southern Italy) through a sequence stratigraphic perspective

A basin-scale, integrated approach, including sedimentological, geomorphological and soil data, enables the reliable reconstruction of the infilling history of the southern Apenninic foredeep, with its subsequent inclusion in the wedge-top of the foreland basin system. An example is shown from the Molise-Apulian Apennines (Southern Italy), between Trigno and Fortore rivers, where the Pleistocene tectono-sedimentary evolution of the basin is framed into a sequence-stratigraphic scheme. Specifically, within the traditional subdivision into Quaternary marine (Qm) and Quaternary continental (Qc) depositional cycles, five third-order depositional sequences (Qm1, Qm2, Qc1, Qc2 and Qc3) are identified based on recognition of four major stratigraphic discontinuities. The lower sequence boundaries are represented by angular unconformities or abrupt facies shifts and are generally associated with distinctive pedological and geomorphological features. Three paleosols, observed at top of depositional sequences Qm2, Qc1 and Qc2, represent pedostratigraphic markers that can be tracked basinwide. The geomorphological response to major tectonosedimentary events is marked by a series of paleosurfaces with erosional, depositional and complex characteristics. Detailed investigation of the relationships between stratigraphic architecture and development of unconformities, paleosols and paleosurfaces suggests that the four sequence boundaries were formed in response to four geomorphological phases/tectonic events which affected the basin during the Quaternary. The first three tectonic events (Lower-Middle Pleistocene), marking the lower boundaries of sequences Qm2, Qc1 and Qc2, respectively, are interpreted to be related to the tectonic regime that characterized the last phase of thrusting recorded in the Southern Apennines. In contrast, sequence Qc3 does not display evidence of thrust tectonics and accumulated as a result of a phase of regional uplift starting with the Middle Pleistocene

The Pleistocene tectono-sedimentary evolution ofthe Apenninic foreland basin between Trigno and Fortore rivers (Southern Italy) through a sequencestratigraphic perspective

A basin-scale, integrated approach, including sedimentological, geomorphological and soil data, enables the reliable reconstruction of the infilling history of the southern Apenninic foredeep, with its subsequent inclusion in the wedge-top of the foreland basin system. An example is shown from the Molise-Apulian Apennines (Southern Italy), between Trigno and Fortore rivers, where the Pleistocene tectono-sedimentary evolution of the basin is framed into a sequence-stratigraphic scheme. Specifically, within the traditional subdivision into Quaternary marine (Qm) and Quaternary continental (Qc) depositional cycles, five third-order depositional sequences (Qm1, Qm2, Qc1, Qc2 and Qc3) are identified based on recognition of four major stratigraphic discontinuities. The lower sequence boundaries are represented by angular unconformities or abrupt facies shifts and are generally associated with distinctive pedological and geomorphological features. Three paleosols, observed at top of depositional sequences Qm2, Qc1 and Qc2, represent pedostratigraphic markers that can be tracked basinwide. The geomorphological response to major tectonosedimentary events is marked by a series of paleosurfaces with erosional, depositional and complex characteristics. Detailed investigation of the relationships between stratigraphic architecture and development of unconformities, paleosols and paleosurfaces suggests that the four sequence boundaries were formed in response to four geomorphological phases/tectonic events which affected the basin during the Quaternary. The first three tectonic events (Lower-Middle Pleistocene), marking the lower boundaries of sequences Qm2, Qc1 and Qc2, respectively, are interpreted to be related to the tectonic regime that characterized the last phase of thrusting recorded in the Southern Apennines. In contrast, sequence Qc3 does not display evidence of thrust tectonics and accumulated as a result of a phase of regional uplift starting with the Middle Pleistocene

Dietary anthocyanins and health: data from FLORA and ATHENA EU projects.

Adherence to a 'Mediterranean diet' has been shown to be beneficial to human health. Fruit and vegetables represent some of the main components of the Mediterranean diet and their role has been increasingly considered in the process of preventing or reducing the risk of chronic degenerative diseases, such as cerebrovascular or coronary heart disorders, cancer and neurodegenerative diseases. To investigate the beneficial effect of these dietary compounds, two EU-funded projects were conducted during the last 10 years. Their results from experimental models suggest that dietary anthocyanin enrichment is beneficial against a number of ischemic and degenerative conditions. On the other hand, human studies demonstrated that anthocyanin supplementation can counteract the inflammatory response to stress conditions, such as a fatty meal. Moreover, an intervention trial in patients with breast cancer undergoing radiotherapy is presently testing the possible beneficial effect of the administration of a product enriched in anthocyanins on the inflammatory response to radiation and on its consequent skin toxicity, as well as on systemic low-grade inflammation reaction

Pandemic and seasonal vaccine coverage and effectiveness during the 2009-2010 pandemic influenza in an Italian adult population.

OBJECTIVES: To evaluate the response to pandemic vaccination and seasonal and pandemic vaccine effectiveness (VE) in an Italian adult population, during the 2009-2010 influenza season. METHODS: Data were recorded by interviewing 19,275 subjects ( 6535 years), randomly recruited from the general population of the Moli-sani project. Events [influenza-like illness (ILI), hospitalization and death], which had occurred between 1 November 2009 and 31 January 2010 were considered. VE was analyzed by multivariable Poisson regression analysis. RESULTS: Pandemic vaccine coverage was very low (2.4%) in subjects at high-flu risk, aged 35-65 years (N = 8,048); there was no significant preventive effect of vaccine against ILI. Seasonal vaccine coverage was 26.6% in the whole population (63% in elderly and 21.9% in middle-aged subjects at high-flu risk). There was a higher risk to develop ILI in middle-age [VE: -17% (95% CI: -35,-1)] or at high flu-risk [VE: -17% (95% CI: -39, 2)] vaccinated groups. CONCLUSIONS: Coverage of pandemic vaccine was very low in a Southern Italy population, with no protective effect against ILI

Nut consumption is inversely associated with both cancer and total mortality in a Mediterranean population: prospective results from the Moli-sani study

Nut intake has been associated with reduced inflammatory status and lower risk of CVD and mortality. The aim of this study was to examine the relationship between nut consumption and mortality and the role of inflammation. We conducted a population-based prospective investigation on 19 386 subjects enrolled in the Moli-sani study. Food intake was recorded by the Italian version of the European Project Investigation into Cancer and Nutrition FFQ. C-reactive protein, leucocyte and platelet counts and the neutrophil:lymphocyte ratio were used as biomarkers of low-grade inflammation. Hazard ratios (HR) were calculated using multivariable Cox proportional hazard models. During a median follow-up of 4.3 years, 334 all-cause deaths occurred. As compared with subjects who never ate nuts, rare intake (2 times/month) was inversely associated with mortality (multivariable HR=0.68; 95 % CI 0.54, 0.87). At intake 8 times/month, a greater protection was observed (HR=0.53; 0.32, 0.90). Nut intake (v. no intake) conveyed a higher protection to individuals poorly adhering to the Mediterranean diet (MD). A significant reduction in cancer deaths (HR=0.64; 95 % CI 0.44, 0.94) was also observed, whereas the impact on CVD deaths was limited to an inverse, but not significant, trend. Biomarkers of low-grade inflammation were reduced in nut consumers but did not account for the association with mortality. In conclusion, nut intake was associated with reduced cancer and total mortality. The protection was stronger in individuals with lower adherence to MD, whereas it was similar in high-risk groups (diabetics, obese, smokers or those with the metabolic syndrome), as compared with low-risk subjects. Inflammation did not explain the observed relationship