Search

Background: Epigenetic biomarkers in cancer have emerged as promising tools for early detection, prognosis, and treatment response prediction. In cervical cells, hypermethylation of the host and viral HPV-genome increases with the severity of lesions, providing a useful biomarker in the triage of hr-HPV-positive women and during treatment. The present study focuses on evaluating the clinical performance of the FAM19A4/miR124-2 methylation test in a population-based cervical screening program. Methods: Previously collected cervical samples, after bisulfite-converted DNA, were analyzed by PreCursor-M+ kit (distributed by Fujirebio Europe), for DNA methylation. The sensitivity, specificity, and negative/positive predictive values of DNA methylation were compared to histology, colposcopy, the HPV-DNA test, and cytology results. Results: Among the 61-sample set, the specificity of methylation vs. positive histology (≥CIN2) and colposcopy (≥G2) were 87% and 90%, whereas the sensitivity was 50% and 33.3%, respectively. The combination of methylation analysis with standard methods increases diagnostic accuracy. Conclusions: Overall, we found a good specificity of DNA methylation in comparison to currently used techniques. Further larger studies could support the use of FAM19A4/miR124-2 as reliable biomarkers in the prevention of cervical cancer as triage in the screening protocol.

It takes ∼3.5 years to reach a diagnosis of bronchiectasis from onset of symptoms: the long patient's journey in Italy https://bit.ly/46XMWAz.

BACKGROUND: We performed an analysis of the cost and relative merits of different strategies for the diagnosis of multidrug-resistant/extensively drug-resistant TB (MDR/XDR-TB) in different settings.METHODS: We systematically reviewed the published evidence on cost/cost-effectiveness of rapid MDR/pre-XDR-TB and other methods for XDR-TB testing up to September 2022. PRISMA guidelines were followed. Collected data were analysed using Stata v17 software. Cost data were reported in USD ($) and summarised by mean, standard deviation, and range. Country income level was defined according to the World Bank country classification. Three simplified scenarios were also used to explore testing implications, based on low, intermediate and high TB incidence.RESULTS: Of 157 records, 25 studies were included with 24 reporting the cost of Xpert/RIF and two that evaluated the implementation of the MTBDRplus test. The total rapid test cost ranged from $12.41-$218, including $1.13-$74.60 for reagents/consumables and $0.40-$14.34 for equipment.CONCLUSION: The cost of MDR/XDR-TB diagnostics is lower in low resource settings. However, the cost-effective implementation of MDR/XDR-TB diagnostic algorithms requires careful consideration of local resources to avoid missed identification and the use of inappropriate regimen.

Background: Given the diagnostic accuracy of HPV-DNA tests in terms of self-collected samples, in order to implement self-sampling in cervical screening programs, the standardization of the pre-analytical phase, including decisions concerning the choice of medium, the volume of elution, and storage conditions, are necessary, in addition to understanding the potential factors involved in acceptability by women. On this basis, we carried out a cross-sectional study to assess (i) the stability of dry vaginal self-collected samples stored at room temperature for up to 4 weeks after elution in 2 mL of eNat® (Copan) medium, and (ii) the acceptability of self-collection in enrolled women. Methods: 185 women were enrolled in the LILT (Italian League Against Tumors) regional project. A self-sampling kit, including a dry FLOQSwab® (Copan), instructions for use, and a satisfaction questionnaire, were supplied for each woman and sent by mail to the laboratory. The HPV-DNA test was carried out using the AnyplexTM II HPV HR (Seegene) kit. To evaluate the specimen’s stability, 185 dry vaginal swabs were eluted in eNat®, a lyses-based molecular medium and tested for HPV detection at two different time points (<6 days and 1 month after elution). The Cohen’s Kappa coefficients and McNemar test were used to assess the agreement of HPV-DNA at different times. Results: We found high agreement in terms of HPV-DNA results among the samples tested at two different time points (Cohen K = 0.98; p < 0.0001). Moreover, most of the women found it easy to use self-collection devices and the pictorial instructions clear to understand. Approximately half of the enrolled women declared preferring self-sampling to clinician-collected methods. Conclusion: Our results display the high reliability and accuracy of HPV-DNA tests using dry vaginal self-collection FLOQSwabs® devices eluted in 2 mL of molecular medium. The analysis of the questionnaire showed a high acceptability of self-collection am

The 6-minute walking test (6MWT) is a simple assessment tool to evaluate exercise capacity. Existing six-minute walking dis- tance (6MWD) prediction equations were developed using healthy children [1]. Our aim was to evaluate the predictors of 6MWD in healthy Italian children. Methods: In our cross-sectional study, we performed 6MWT in 5614 children aged 6–11 years between November 2016 and May 2017. We used Student t test for independent data or Mann–Whitney test to compare the quantitative variables between age groups and gender. We assessed a multiple linear regression model to estimate a pre- diction equation for the 6MWD. Performance and goodness of fit of the models were assessed using the root-mean-square error and R-squared measures. A p-value \ 0.05 was considered significant. Results: Mean distance walked for all participants was 595.5 ± 80.9 m (range 360–800 m). We observed significant differ- ences about gender and age: males walked longer distances than females (598.8 ± 83.9 m vs 592.1 ± 77.6 m; p = 0.0016), while in younger children (6–8 years) correlations between 6MWD and demographic/anthropometric data were significantly higher compared with older children (9–11 years; p \ 0.0001). The regression model showed that age, gender and height were positively related to 6MWD, while weight was negatively related (6MWD = 107.91 ? 25.02 9 age (years) ? 7.52 9 gender (M) ? 2.62 9 height (m) - 2.25 9 weight (kg). Conclusions: Our study confirmed that demographic and anthropo- metric characteristics can influence the test performance in healthy subjects. In our model, age, gender, height and weight significantly add information and should be taken into account in this particular growth phase. The 6MWT is feasible in education’s environment: school could be a main setting to implement primary prevention by using motor assessment.

INTRODUCTION: The 6-minute walk test (6MWT) is a simple assessment tool to evaluate exercise capacity. The result of the test is the distance that a subject can walk at a constant and normal pace within 6 minutes (6MWD) and reflects walking function at a submaximal level (Crapo RO et al., 2002). Use of 6MWT on healthy children has been relevant to assess exercise tolerance (Rostagno C., 2003) and to compare it to pathological conditions (Paridon SM et al.,2006). Our aim was to find reference values for the 6MWT in healthy Italian chil- dren. METHODS: The 6MWT was performed by 5614 children between 6 and 11 years, following the instructions outlined in the ATS guidelines (Crapo RO et al., 2002). Summary statistics are expressed as means and standard deviations or percentages, as appropriate. Age- related percentiles (mean±SD of 3rd, 10th, 25th, 50th, 75th, 90th and 97th centiles) of the 6MWD were developed for males and females. Pearsons correlation coefficients were calculated between 6MWD and demographic data. A multiple linear regression model was as- sessed to predict expected 6MWT performance. All analyses were conducted using STATA/SE, a p-value of less than 0.05 was consid- ered significant. RESULTS: Males walked longer distances than females, respectively 598.8±83.9 m vs 592.1±77.6 m (p=0.0016). Values ranged between 513.3±60.4 m for 6 years old children to 656.1±71.6 m for 11. The 50th percentile values resulted in 511 m, 554 m, 603 m, 624 m, 649 m and 670.8 m for boys aged 6 to 11 years old, respectively. Differently, the 50th percentile values resulted in 512 m, 543 m, 597 m, 620 m, 643 m and 655 m for girls aged 6 to 11 years old. A moderate correlation was found between 6MWD and age, weight and height (re- spectively rho = 0.58; 0.32; 0.52; p < 0.0001). In regression analysis, we found that age, gender and height were positively related to 6MWD, while weight was negatively related with 6MWD [6MWD = 107.91 + 25.02× age (years) +7.52× gender (M) +2.62×

School-based PE programs are poor nationwide and they need to be potentiated against a rising prevalence of chronic diseases and physical inactivity. Our aim was to evaluate the effectiveness of 40 versus 20 physical education (PE) classes on physical fitness of a cohort of northwestern Italian primary schoolchildren. Methods: 5751 schoolchildren aged 6–11years were studied between November 2017 and May 2018 from 25 primary schools of Lombardy. Pupils underwent either a control group (CON, # = 2553; $ = 2864) or an experimental group (PLUS, # = 158; $ = 176) in which they attended 20 or 40 PE classes, respectively. Sixty-minute classes were delivered once a week (CON) or biweekly (PLUS) by qualified PE teaching assistants through an approximate school semester. Anthropometrics, cardiorespiratory (six-minute walking test, 6MWT), musculoskeletal (standing broad jump, SBJ) and motor fitness (4 9 10 m shuttle run test, SRT) were evaluated at baseline and upon completion of the study. Wilcoxon matched-pairs signed rank test was performed. Results: At the end of the study, PLUS group revealed a better dis- tribution of BMI categories (under weight UW Dpost–pre = - 5.4%; normal weight NW Dpost–pre = ? 8.9%; overweight OW Dpost–pre = - 3.6%) compared to controls (UW Dpost–pre = - 0.4%; NW Dpost– pre = ? 1.6%; OW Dpost–pre = - 1%). PLUS children improved almost all fitness performances by a greater extent (6MWT: pre 606.8 ± 104/post 644.5 ± 93.5 m, p \ 0.0001; SBJ: pre 119.1 ± 25.3/post 124.8 ± 25.9 cm, p \ 0.0001; SRT: pre 14.9 ± 2.5/post 13.8 ± 1.9 s, p \ 0.0001) with respect to CON children (6MWT: pre 611.4 ± 102.1/post 623.6 ± 92.4 m, p \ 0.0001; SBJ: pre 116.8 ± 25.3/post 123.4 ± 24 cm, p \ 0.02; SRT: pre 14.8 ± 2.4/post 14.3 ± 2 s, p \ 0.0001). Means and SD. Conclusions: This design confirms the need to implement well- structured, school-based PE programs. Particularly, higher frequency of PE classes is advocated in order to ameliorate health-related physical fitness c

Purpose: Physical fitness is considered an important indicator of health. Health-related fitness qualities in children have been identified: cardiorespiratory fitness, musculoskeletal fitness, motor fitness, and body composition or body mass index (BMI) [1]. Growth charts for BMI that apply to the whole Italian population has been already studied [2]. Therefore, this study was conducted to establish normative values of fitness components from Italian children using field-based and well-standardized tests [3, 4] that can be easily applied in a school setting, and to create a Physical Fitness Performance Index (PFPI). Methods: This cross-sectional study examined the physical fitness among a random and large representative sample of schoolchildren aged 6–10 years. Fitness data were collected during the 2016–2017 school year from 25 schools in Lombardy. A sample of 5106 children (height 131.2 ± 10.1 cm, weight 30.5 ± 8.4 kg, BMI 17.4 ± 2.9 kg/ m2) was assessed using a complete test battery (six-minute walking test_6MWT, standing broad jump_SBJ, and 4 9 10 m shuttle run test_SRT). Gender and age-specific percentiles for the physical fitness tests were expressed as curves values (3rd, 10th, 25th, 50th, 75th, 90th and 97th centiles), and the PFPI was also calculated according to percentiles. Results: Boys scored higher in all the physical fitness tests when compared to girls (M: 6MWT, 616.7 ± 87.4 m; SBJ, 121.6 ± 23.8 cm; SRT, 14.5 ± 2.2 s; F: 6MWT, 607.9 ± 82.6 m; SBJ, 113.7 ± 23.6 cm; SRT, 15.0 ± 2.2 s; p \ 0.001). There was also a trend towards increased physical fitness levels as the age increased in both boys and girls (p \ 0.0001). Correlations between scores on individual test items were moderate to high (r from .549 to .700), and all individual test item scores significantly correlated with PFPI (p \ 0.0001). Conclusions: Primary schools are a favorable environment for implementing practices that support health and the PFPI can be used by teachers for easily rating

The affiliation for the fifth author is incorrect. Roberto Codella is not affiliated with #4–8 but with #4 and #8: School of Exercise Sciences, Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy and Metabolism Research Center, IRCCS Policlinico San Donato, San Donato Milanese, Italy.

The 6-minute walking test (6MWT) is a simple assessment tool to evaluate exercise capacity. Existing six-minute walking dis- tance (6MWD) prediction equations were developed using healthy children [1]. Our aim was to evaluate the predictors of 6MWD in healthy Italian children. Methods: In our cross-sectional study, we performed 6MWT in 5614 children aged 6–11 years between November 2016 and May 2017. We used Student t test for independent data or Mann–Whitney test to compare the quantitative variables between age groups and gender. We assessed a multiple linear regression model to estimate a pre- diction equation for the 6MWD. Performance and goodness of fit of the models were assessed using the root-mean-square error and R-squared measures. A p-value \ 0.05 was considered significant. Results: Mean distance walked for all participants was 595.5 ± 80.9 m (range 360–800 m). We observed significant differ- ences about gender and age: males walked longer distances than females (598.8 ± 83.9 m vs 592.1 ± 77.6 m; p = 0.0016), while in younger children (6–8 years) correlations between 6MWD and demographic/anthropometric data were significantly higher compared with older children (9–11 years; p \ 0.0001). The regression model showed that age, gender and height were positively related to 6MWD, while weight was negatively related (6MWD = 107.91 ? 25.02 9 age (years) ? 7.52 9 gender (M) ? 2.62 9 height (m) - 2.25 9 weight (kg). Conclusions: Our study confirmed that demographic and anthropo- metric characteristics can influence the test performance in healthy subjects. In our model, age, gender, height and weight significantly add information and should be taken into account in this particular growth phase. The 6MWT is feasible in education’s environment: school could be a main setting to implement primary prevention by using motor assessment.