Sero-Epidemiological Study of Bordetella pertussis Infection in the Italian General Population

A multicenter study was conducted to estimate the prevalence of pertussis IgG antibodies (anti-PTx) in the Italian population. Serum samples (4154) collected in the years 2019-2020 from subjects aged 6 to 90 years were tested. The anti-PTx IgG levels were determined by ELISA test. The limit of detection was 5 IU/mL (International Units per milliliter); values >= 40 IU/mL and >= 100 IU/mL indicate an infection that has occurred in recent years and a recent infection (occurred during the last year), respectively. The mean concentration of anti-PTx IgG antibodies in the tested samples was 13 IU/mL; 1.0% of subjects had a titer >= 100 IU/mL, 5.3% a titer between 40 and 100 IU/mL, and 38.9% a titer < 5 IU/mL. The mean antibody concentration was significantly higher in males than in females. The age group 25-39 years had the lowest percentage of negative subjects (36.9%) and the highest prevalence of subjects with antibody titers >= 100 IU/mL (1.3%). In the age group >= 65 years, the prevalence of subjects with titers between 40 and 100 IU/mL (6.7%) and the percentage of negative subjects (44.8%) was higher than in the other age groups. The results highlight the possible role of adolescents and adults in the transmission of B. pertussis

Diferencias relacionadas con el sexo en pacientes con IAMCEST: análisis por puntuación de propensión

Supplementary data associated with this article can be found in the online version available at https://doi.org/ 10.24875/RECICE.M19000061.[EN] Introduction and objectives: Female sex is believed to be a significant risk factor for mortality among patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary interventions (pPCI). Methods: We collected data on all consecutive STEMI patients treated with pPCI within 12 hours and compared the males vs the females. The primary endpoint was long-term mortality one month after hospital discharge. The secondary endpoint was 30-days mortality. Results: From March 2006 to December 2016, 1981 patients underwent pPCI at our hospital, 484 (24.4%) were females. Compared with men, women were older (mean age 71.3 ± 11.6 vs 62.9 ± 11.8 years, P < .001), less smokers (26.7% vs 72.7%; P < .001), more diabetic (28.0% vs 22.3%; P < .002), more hypertensive (69.6% vs 61.3%; P < .001), presented more often with shock at baseline (13.2% vs 9.0%; P = .006), had longer symptoms-to-balloon time frames (5.36 ± 3.97 vs 4.47 ± 3.67 hours; P < .001). Also, women were less likely to receive glycoprotein IIb-IIIa inhibitors (59.5% vs 71.4%; P < .001) and stents (79.5% vs 86.6%; P = .01). During the 30-day and long-term follow-up (mean 4.9 ± 3.2 years) the female sex was associated with a higher mortality rate (8.9% vs 4.0%, P < .001 and 23.8% vs 18.4%, P = .01, respectively). After propensity score matching, 379 men and 379 women were selected. Female sex continued to be associated with a higher death rate at 30 days (9.5% vs 5.5%; P = .039) but not in the long term among survivors (25.6% vs 21.4%; P = .170). Conclusions: Compared to men, women with STEMI undergoing pPCI had higher 30-day mortality rates. However, among survivors, the long-term mortality rate was similar. Even if residual confounding cannot be ruled out, this difference in the outcomes may be partially explained by biological sex-related differences.[ES]Introducción y objetivos: El sexo femenino se considera un importante factor de riesgo de mortalidad en el infarto agudo de miocardio con elevación del segmento ST (IAMCEST) tratado con intervención coronaria percutánea primaria (ICPp). Métodos: Se analizó a todos los pacientes consecutivos con IAMCEST tratados con ICPp dentro de las primeras 12 horas, y se compararon varones y mujeres. El objetivo principal fue la mortalidad a largo plazo en los supervivientes después del primer mes del alta, y el objetivo secundario fue la mortalidad a los 30 días. Resultados: Desde marzo de 2006 hasta diciembre de 2016 se trató con ICPp 1.981 a pacientes, de los cuales 484 (24,4%) eran mujeres. En comparación con los varones, las mujeres tenían mayor edad (edad media 71,3 ± 11,6 frente a 62,9 ± 11,8 años, p < 0,001) y la frecuencia de fumadoras era más baja (26,7 frente a 72,7%; p < 0,001), mientras que era más alta la frecuencia de diabetes (28,0 frente a 22,3%; p < 0,002), hipertensión arterial (69.6 frente a 61,3%, p < 0,001) y shock al ingreso (13,2 frente a 9,0%; p = 0,006), y más largo el tiempo desde el comienzo de los síntomas hasta la intervención con balón (5,36 ± 3,97 frente a 4,47 ± 3,67 horas; p < 0,001). Además, la frecuencia de tratamiento con inhibidores de la glucoproteína IIb-IIIa (59,5 frente a 71,4%; p < 0,001) y stent (79,5 frente a 86,6%, p = 0,01) fue inferior. Tanto a los 30 días como a largo plazo (media 4,9 ± 3,2 años), el sexo femenino se asoció con una mortalidad más alta (8,9 frente a 4,0%, p < 0,001, y 23,8 frente a 18,4%, p = 0,01, respectivamente). Se seleccionaron 379 mujeres y 379 varones emparejados por puntuación de propensión. Se mantuvo la asociación entre sexo femenino y mayor mortalidad a los 30 días (9,5 frente a 5,5%; p = 0,039), pero no a largo plazo (25,6 frente a 21,4%; p = 0,170). Conclusiones: En comparación con los varones, las mujeres con IAMCEST tratadas con ICPp tuvieron mayor mortalidad a los 30 días. Sin embargo, entre los supervivientes, la mortalidad a largo plazo fue similar. Aunque no puede descartarse el efecto de variables residuales de confusión, las diferencias en el pronóstico podrían explicarse en parte por diferencias biológicas relacionadas con el sexo.S

The BEHAVE application as a tool to monitor inclusive interventions for subjects with neurodevelopmental disorders

In the last few years, many educational and therapeutic interventions for young people with neurodevelopmental disorders are based on systematic monitoring of the outcomes. These interventions are typically conducted using single-case experimental designs, (SCEDs) a set of methods aimed at testing the effect of an intervention on a single subject or a small number of subjects. In SCEDs, an effective process of decision-making needs accurate, precise, and reliable data but also that caregivers and health professionals can gather information with minimal effort. The use of Information Communication Technologies in SCEDs can support the process of data collection and analysis, facilitating the collection of accurate and reliable data, providing reports accessible also by non-experts, and promoting interactions and sharing among clinicians, educators, and caregivers. The present paper introduces the BEHAVE application, a web-based highly customizable application, designed to implement SCEDs, supporting both data collection and automatic analysis of the datasets. Moreover, the paper will describe two case studies of kindergarten children with neurodevelopmental disorders, highlighting how the BEHAVE application supported the entire process, from data collection in multiple contexts to decision-making based on the analysis provided by the system. In particular, the paper describes the case studies of Carlo and Dario, two children with severe language and communication impairments, and the inclusive education interventions carried out to maximize their participation in a typical home and school setting increasing their mand repertoire. Results revealed an increase in the mand repertoire in both children who become able to generalize the outcomes to multiple life contexts. The active participation of the caregivers played a crucial role in the ability of children to use the learned skills in settings different from the ones they were learned in

Gender-related differences among patients with STEMI: a propensity score analysis

Se puede consultar material adicional a este artículo en su versión electrónica disponible en https://doi.org/10.24875/ RECIC.M19000072.[ES] Introducción y objetivos: El sexo femenino se considera un importante factor de riesgo de mortalidad en el infarto agudo de miocardio con elevación del segmento ST (IAMCEST) tratado con intervención coronaria percutánea primaria (ICPp). Métodos: Se analizó a todos los pacientes consecutivos con IAMCEST tratados con ICPp dentro de las primeras 12 horas, y se compararon varones y mujeres. El objetivo principal fue la mortalidad a largo plazo en los supervivientes después del primer mes del alta, y el objetivo secundario fue la mortalidad a los 30 días. Resultados: Desde marzo de 2006 hasta diciembre de 2016 se trató con ICPp a 1.981 pacientes, de los cuales 484 (24,4%) eran mujeres. En comparación con los varones, las mujeres tenían mayor edad (edad media 71,3 ± 11,6 frente a 62,9 ± 11,8 años, p < 0,001) y la frecuencia de fumadoras era más baja (26,7 frente a 72,7%; p < 0,001), mientras que era más alta la frecuencia de diabetes (28,0 frente a 22,3%; p < 0,002), hipertensión arterial (69.6 frente a 61,3%, p < 0,001) y shock al ingreso (13,2 frente a 9,0%; p = 0,006), y más largo el tiempo desde el comienzo de los síntomas hasta la intervención con balón (5,36 ± 3,97 fren- te a 4,47 ± 3,67 horas; p < 0,001). Además, la frecuencia de tratamiento con inhibidores de la glucoproteína IIb-IIIa (59,5 frente a 71,4%; p < 0,001) y stent (79,5 frente a 86,6%, p = 0,01) fue inferior. Tanto a los 30 días como a largo plazo (media 4,9 ± 3,2 años), el sexo femenino se asoció con una mortalidad más alta (8,9 frente a 4,0%, p < 0,001, y 23,8 frente a 18,4%, p = 0,01, res­pec­tivamente). Se seleccionaron 379 mujeres y 379 varones emparejados por puntuación de propensión. Se mantuvo la asociación entre sexo femenino y mayor mortalidad a los 30 días (9,5 frente a 5,5%; p = 0,039), pero no a largo plazo (25,6 frente a 21,4%; p = 0,170). Conclusiones: En comparación con los varones, las mujeres con IAMCEST tratadas con ICPp tuvieron mayor mortalidad a los 30 días. Sin embargo, entre los supervivientes, la mortalidad a largo plazo fue similar. Aunque no puede descartarse el efecto de variables residuales de confusión, las diferencias en el pronóstico podrían explicarse en parte por diferencias biológicas relacionadas con el sexo.[EN] Introduction and objectives: Female sex is believed to be a significant risk factor for mortality among patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary interventions (pPCI). Methods: We collected data on all consecutive STEMI patients treated with pPCI within 12 hours and compared the males vs the females. The primary endpoint was long-term mortality one month after hospital discharge. The secondary endpoint was 30-days mortality. Results: From March 2006 to December 2016, 1981 patients underwent pPCI at our hospital, 484 (24.4%) were females. Compared with men, women were older (mean age 71.3 ± 11.6 vs 62.9 ± 11.8 years, P < .001), less smokers (26.7% vs 72.7%; P < .001), more diabetic (28.0% vs 22.3%; P < .002), more hypertensive (69.6% vs 61.3%; P < .001), presented more often with shock at baseline (13.2% vs 9.0%; P = .006), had longer symptoms-to-balloon time frames (5.36 ± 3.97 vs 4.47 ± 3.67 hours; P < .001). Also, women were less likely to receive glycoprotein IIb-IIIa inhibitors (59.5% vs 71.4%; P < .001) and stents (79.5% vs 86.6%; P = .01). During the 30-day and long-term follow-up (mean 4.9 ± 3.2 years) the female sex was associated with a higher mortality rate (8.9% vs 4.0%, P < .001 and 23.8% vs 18.4%, P = .01, respectively). After propensity score matching, 379 men and 379 women were selected. Female sex continued to be associated with a higher death rate at 30 days (9.5% vs 5.5%; P = .039) but not in the long term among survivors (25.6% vs 21.4%; P = .170). Conclusions: Compared to men, women with STEMI undergoing pPCI had higher 30-day mortality rates. However, among survivors, the long-term mortality rate was similar. Even if residual confounding cannot be ruled out, this difference in the outcomes may be partially explained by biological sex-related differences.S

Biomarkers for site-specific response to neoadjuvant chemotherapy in epithelial ovarian cancer: relating MRI changes to tumour cell load and necrosis.

Funder: We acknowledge funding from Cancer Research UK BIDD grant C1353/A12762 and Cancer Research UK and Engineering and Physical Sciences Research Council support to the Cancer Imaging Centre at the Institute of Cancer Research and Royal Marsden Hospital in association with the Medical Research Council and Department of Health C1060/A10334, C1060/A16464 and National Health Service funding to the National Institute for Health Research Biomedical Research Centres at Royal Marsden Hospital/Institute of Cancer Research and Cambridge, Experimental Cancer Medicine Centres, the Clinical Research Facility in Imaging, and the Cancer Research Network. We are also grateful for financial support from Addenbrooke’s Charitable Trust. The views expressed in this publication are those of the author(s) and not necessarily those of the National Health Service, the National Institute for Health Research or the Department of Health.BACKGROUND: Diffusion-weighted magnetic resonance imaging (DW-MRI) potentially interrogates site-specific response to neoadjuvant chemotherapy (NAC) in epithelial ovarian cancer (EOC). METHODS: Participants with newly diagnosed EOC due for platinum-based chemotherapy and interval debulking surgery were recruited prospectively in a multicentre study (n = 47 participants). Apparent diffusion coefficient (ADC) and solid tumour volume (up to 10 lesions per participant) were obtained from DW-MRI before and after NAC (including double-baseline for repeatability assessment in n = 19). Anatomically matched lesions were analysed after surgical excision (65 lesions obtained from 25 participants). A trained algorithm determined tumour cell fraction, percentage tumour and percentage necrosis on histology. Whole-lesion post-NAC ADC and pre/post-NAC ADC changes were compared with histological metrics (residual tumour/necrosis) for each tumour site (ovarian, omental, peritoneal, lymph node). RESULTS: Tumour volume reduced at all sites after NAC. ADC increased between pre- and post-NAC measurements. Post-NAC ADC correlated negatively with tumour cell fraction. Pre/post-NAC changes in ADC correlated positively with percentage necrosis. Significant correlations were driven by peritoneal lesions. CONCLUSIONS: Following NAC in EOC, the ADC (measured using DW-MRI) increases differentially at disease sites despite similar tumour shrinkage, making its utility site-specific. After NAC, ADC correlates negatively with tumour cell fraction; change in ADC correlates positively with percentage necrosis. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov NCT01505829

L'EDILIZIA RURALE E IL PAESAGGIO DEL G.A.L. BORBA, LINEE GUIDA PER LA CONSERVAZIONE E IL RECUPERO

Le presenti linee guida per il recupero dell’edilizia rurale e del paesaggio del G.A.L. Borba nascono in attuazione della Misura 7.6.3 del Piano di Sviluppo Locale ambito di sviluppo tematico Valorizzazione del patrimonio architettonico e paesaggistico “Integrazione del manuale esistente, in particolare per la sua applicabilità ai nuovi territori GAL”. Nello specifico la Misura 7 si propone di “sostenere interventi preordinati a realizzare le potenzialità di crescita delle zone rurali e a favorirne lo sviluppo sostenibile, in primo luogo incoraggiando lo sviluppo di servizi e infrastrutture atti a promuovere l’inclusione sociale e a invertire le tendenze al declino so- cio-economico e allo spopolamento delle zone rurali”. La SM 7.6. sostiene “studi/investimenti relativi alla manutenzione, al restauro e alla riquali cazione del patrimonio culturale e naturale dei villaggi, del paesaggio rurale e dei siti ad alto valore naturalistico, compresi gli aspetti socioeconomici di tali attività, nonché azioni di sensibilizzazione in materia di ambiente”. La misura 7.6.3 prevede l’adeguamento del Manuale per il recupero degli insediamenti storici, dell’architettura rurale e degli elementi del paesaggio antropizzato, allo scopo di fornire gli indirizzi e le modalità più consone per garantire che le opere sui beni siano realizzate in linea con le peculiarità locali e siano coerenti con i contenuti e gli obiettivi del Piano Paesaggistico Regionale. A seguito infatti dell’ampliamento dell’area Gal, verso i comuni della Langa Astigiana e dell’Alto Ovadese, il manuale già redatto nel corso della precedente programmazione dovrà essere necessariamente integrato. L’occasione rende possibile anche una revisione complessiva del manuale attualmente in uso. L’obiettivo della guida è quello di fornire linee di indirizzo, suggerimenti più che imposizioni, su come affrontare gli interventi di recupero dell’edilizia rurale e del paesaggio: uno strumento metodologico e conoscitivo rivolto alle Amministrazioni Pubbliche, agli Enti Locali, alle Commissioni Locali per il Paesaggio e più in generale ai professionisti del settore. Lo scopo delle linee guida è anzitutto la conservazione dell’impostazione strutturale dell’edificio nel rispetto della morfologia che contraddistingue le tipologie edilizie, ricorrendo anche all’uso di materiali e tecniche costruttive compatibili con l’esistente

A single-dose, randomized, cross-over, two-way, open-label study for comparing the absorption of boswellic acids and its lecithin formulation

Background: The oral administration of the gum resin extracts of Indian frankincense (Boswellia serrata Roxb. ex Colebr) results in very low plasma concentrations of boswellic acids (BAs), being far below the pharmacologically active concentrations required in vitro for anti-inflammatory activity. For that reason the use of Indian frankincense in clinical practice and pharmaceutical development has substantially lagged behind. Recently the application of new formulation technologies resulted in a formulation of frankincense extract with lecithin, which revealed improved absorption and tissue penetration of BAs in a rodent study, leading for the first time to plasma concentrations of BAs in the range of their anti-inflammatory activity. Purpose: In order to verify these encouraging results in humans, the absorption of a standardized Boswellia serrata extract (BE) and its lecithin formulation (CSP) was comparatively investigated in healthy volunteers. Study design: According to a randomized cross-over design with two treatments, two sequences and two periods, 12 volunteers alternatively received the lecithin-formulated Boswellia extract (CSP) or the non-formulated Boswellia extract (BE) at a dosage of 2 × 250 mg capsules. Methods: The plasma concentrations of the six major BAs (KBA, AKBA, βBA, αBA, AβBA, AαBA) were determined using LC/MS. Results: With the exception of KBA, a significantly higher (both in terms of weight-to-weight and molar comparison) and quicker absorption of BAs from the lecithin formulation was observed, leading to Cmax in the range required for the interaction with their molecular targets. Conclusion: These findings pave the way to further studies evaluating the clinical potential of BAs, and verify the beneficial effect of lecithin formulation to improve the absorption of poorly soluble phytochemicals