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Corn plants showing symptoms of midribs chlorosis, and leaf reddening, short internodes, ear proliferation, and plant growth reduction were collected in Peru from fields in nine localities in the provinces of Huancayo, Chupaca, and Jauja in the Junín region, and tested to verify phytoplasma presence and identity. Primers amplifying the phytoplasma ribosomal 16S and ribosomal protein genes were used. The phytoplasma presence was detected in symptomatic samples from all the surveyed areas. The sequencing of the obtained amplicons indicated the presence of ‘Candidatus Phytoplasma asteris’ and ‘Ca. P. pruni’-related strains. A BLASTn search of sequenced genes showed that the two ‘Candidatus Phytoplasma’ strains identified in corn shares 100% and 99.82% identity with the ‘Ca. P. asteris’ strains from maize and 99.92% and 99.55% with ‘Ca. P. pruni’-related strains, respectively. The RFLP analyses allowed to enclose these phytoplasma strains in the 16SrI-B and 16SrIII-J subgroups; however, the two phytoplasmas were, in some cases, present in mixed infection. The 16SrIII-J phytoplasma is for the first time reported associated with the maize bushy stunt disease and this represent a relevant information for the disease epidemiology towards its appropriate management in the affected area.

Crisis Resolution Teams (CRT) have shown positive clinical and service-use results in various countries but evidence in the south of Europe is scarce. The aim is to assess the impact of the Crisis Intervention Team (CIT) in Spain with respect to the course of symptomatology and mental health services use in patients served.Prospective observational cohort study. Assessment of the psychopathological severity (HoNOS scale) of the clinical course (CGI scale) and use of medical services.A positive clinical course was observed following the intervention. The mean difference in HoNOS (Health of the Nation Outcome Scales) scores between baseline and discharge was 7 points (p 0.05). On discharge, more than 60% of patients had improved their symptomatology according to the CGI scale (Clinical Global Impression) and most were discharged due to improvement or goal achievement. A tendency to reduction in the number of admissions to acute units and day hospital was observed, along with fewer emergency room visits. In contrast, an increase in the number of admissions to subacute units was seen. During the intervention, the median number of visits to the center was 15 and the median duration of care provision by the CIT was 39 days.The CIT intervention promotes patients' clinical improvement and has a positive impact in terms of reducing acute hospitalizations and emergency room visits.

“Huanglongbing” (HLB) is one of the most devastating diseases of citrus orchards worldwide. Samples from 183 citrus plants of different cultivars and rootstock/cultivar combinations, showing HLB symptoms in three Caribbean countries (Cuba, Jamaica, and Guadeloupe-France), were collected to verify the possible co-infection of ‘Candidatus Phytoplasma’ and ‘Candidatus Liberibacter’ species. The 64% of the samples resulted positive to the ‘Ca. L. asiaticus’ and the 27% to diverse ‘Ca. Phytoplasma’-related species, moreover about the 14% of the samples infected with ‘Ca. Liberibacter’ were also found positive to phytoplasmas, indicating the presence of mixed infection especially in the orchards located in Cuba. Moreover, in one of the samples from Jamaica mixed phytoplasma infection was detected. Moreover the detection of only phytoplasmas in 11 symptomatic citrus samples collected from Cuba and Guadeloupe without ‘Ca. Liberibacter’ detection, confirmed that the symptomatology cannot be the sole criterium to discriminate between the presence of the two pathogens, and molecular detection is necessary to identify single or mixed infections. Diaphorina citri insects collected from Cuba and Guadeloupe resulted infected with ‘Ca. L. asiaticus’ confirming its active role in the dissemination of the pathogen. Only one insect of the Cicadidae family, collected in Guadeloupe, was found positive for phytoplasma presence. Considering that the phytoplasmas belonging to some ‘Candidatus species’ were detected in the three countries in different citrus varieties, a relevant role as phytoplasma reservoir can be attribute to citrus orchards.

Background: Hemodialysis (HD) sessions induce changes in plasma electrolytes that lead to modifications of QT interval, virtually associated with dangerous arrhythmias. It is not known whether such a phenomenon occurs even during peritoneal dialysis (PD). The aim of the study is to analyze the relationship between dialysate and plasma electrolyte modifications and QT interval during a PD exchange. Methods: In 15 patients, two manual PD 4-h exchanges were performed, using two isotonic solutions with different calcium concentration (Ca++1.25 and Ca1.75++mmol/L). Dialysate and plasma electrolyte concentration and QT interval (ECG Holter recording) were monitored hourly. A computational model simulating the ventricular action potential during the exchange was also performed. Results: Dialysis exchange induced a significant plasma alkalizing effect (p < 0.001). Plasma K+ significantly decreased at the third hour (p < 0.05). Plasma Na+ significantly decreased (p < 0.001), while plasma Ca++ slightly increased only when using the Ca 1.75++mmol/L solution (p < 0.01). The PD exchange did not induce modifications of clinical relevance in the QT interval, while a significant decrease in heart rate (p < 0.001) was observed. The changes in plasma K+ values were significantly inversely correlated to QT interval modifications (p < 0.001), indicating that even small decreases of K+ were consistently paralleled by small QT prolongations. These results were perfectly confirmed by the computational model. Conclusions: The PD exchange guarantees a greater cardiac electrical stability compared to the HD session and should be preferred in patients with a higher arrhythmic risk. Moreover, our study shows that ventricular repolarization is extremely sensitive to plasma K+ changes, also in normal range.

Background JAM3 gene, located on human chromosome 11q25, encodes a member of the junctional adhesion molecule (JAM) family. Mutations of this gene are associated with hemorrhagic destruction of the brain, subependymal calcification, and congenital cataracts (HDBSCC). Case report Herein, we present a newborn male with a prenatal suspicion of bilateral cataracts but without fetal ultrasound findings of cortical malformations. He was postnatally diagnosed with a clinical picture of HDBSCC and Early-onset Developmental and Epileptic Encephalopathy (DEE), associated to a homozygous variant of JAM3 gene. Conclusion Identification of this variant in affected individuals has implications for perinatal and postnatal management and genetic counseling. To the best of our knowledge, this is the first case reported of a child with a JAM3 variant in Italy, from a different ethnic background than the other reported children until now (Saudi Arabian, Turkish, Afghani, and Moroccan origin). JAM3 screening could be requested in prenatal diagnosis of fetal congenital cataracts and included in Next-Generation DNA Sequencing panels.

There are no studies based on a person-centered approach addressing sex-related differences in the characteristics of treatment-seeking patients with gambling disorder (GD). The main objective of the current study is to identify empirical clusters of GD based on several measures of the severity of gambling behavior, and considering the potential role of patient sex as a moderator. An agglomerative hierarchical clustering method was applied to an adult sample of 512 treatment-seeking patients (473 men and 39 women) by using a combination of the Schwarz Bayesian Information Criterion and log-likelihood function. Three clusters were identified in the subsample of men: cluster M1 (low-mild gambling severity level, 9.1%), cluster M2 (moderate level, 60.9%), and cluster M3 (severe level, 30.0%). In the women subsample, two clusters emerged: cluster W1 (mild-moderate level, 64.1%), and cluster W2 (severe level, 35.9%). The most severe GD profiles were related to being single, multiple gambling preference for nonstrategic plus strategic games, early onset of the gambling activity, higher impulsivity levels, higher dysfunctional scores in the personality traits of harm avoidance, and self-directedness, and higher number of lifespan stressful life events (SLE). Differences between the empirical men and women clusters were found in different sociodemographic and clinical measurements. Men and women have distinct profiles regarding gambling severity that can be identified by a clustering approach. The sociodemographic and clinical characterization of each cluster by sex may help to establish specific preventive and treatment interventions.

Liquidambar styraciflua was introduced in Bogotá (D. C.) Colombia, in the 1990s as an urban tree. Yellowing and deformation of the tree crowns began to appear in 2007, leading to the hypothesis of a possible phytoplasma infection. To detect and identify phytoplasmas, samples were collected from 21 liquidambar trees from Bogota in 2009, 2010 and 2011 and subjected to nested PCR, RFLP and sequencing analyses of 16S ribosomal DNA. Nested PCR assays with group-specific primers and RFLP analyses identified phytoplasmas belonging to the 16SrI-B (aster yellows), 16SrV-B (jujube witches' broom), 16SrVII-A (ash yellows), 16SrIX (pigeon pea witches' broom) and 16SrXII-A ("stolbur") groups/subgroups, in single or mixed infections. Sequence analysis and phylogenetic evaluation of samples with single phytoplasma infections confirmed the presence of phytoplasmas related to 'Candidatus Phytoplasma asteris', 'Ca. P. fraxini', and 'Ca. P. solani'. In 2010 and 2013 two further surveys involving 100 trees each time were carried out to estimate the prevalence of the disease: the average prevalence with severe symptoms was 28%, with mild symptoms, 56%, and with minor symptoms 16% of the trees. No symptomless trees were observed. Phytoplasma presence in liquidambar trees from Bogota carries economic, environmental and epidemiological consequences, and urgent measures should be implemented to avoid the spreading of the disease to other tree species and to the agricultural areas surrounding the city.

Background/Objectives: The aim of this study was to compare resting energy expenditure (REE) measured (MREE) by indirect calorimetry (IC) and REE predicted (PREE) from established predictive equations in a large sample of obese Caucasian adults. Subjects/Methods: We evaluated 1851 obese patients (body mass index (BMI)>30 kg m−2) aged between 18a and 65 years. Data were obtained by comparing MREE with PREE, derived from different equations, within and between normal weight and obese groups. The mean differences between PREE and MREE as well as the accuracy prediction within ±10% level were investigated in the whole sample and in three subgroups, classified by BMI (Group 1=30–39.9 kg m−2; Group 2=40–49.9 kg m−2; Group 3>50 kg m−2). Results: We observed that FAO, Henry and Muller3 (body composition (BC)) equations provided good mean PREE–MREE (bias −0.7, −0.3 and 0.9% root mean standard error (RMSE) 273, 263 and 269 kcal per day, respectively); HB and Henry equations were more accurate individually (57 and 56.9%). Only the Muller1 (BC) equation gave the lowest PREE–MREE difference (bias −1.7% RMSE 228 kcal per day) in females, while Johnstone and De Lorenzo equations were the most accurate (55.1 and 54.8%). When the sample was split into three subgroups according to BMI, no differences were found in males; however, the majority of the equations included in this study failed to estimate REE in severely obese females (BMI>40 kg m−2). Overall, prediction accuracy was low (~55%) for all predictive equations, regardless of BMI. Conclusions: Different established equations can be used for estimating REE at the population level in both sexes. However, the accuracy was very low for all predictive equations used, particularly among females and when BMI was high, limiting their use in clinical practice. Our findings suggest that the validation of new predictive equations would improve the accuracy of REE prediction, especially for severely obese subjects (BMI>40 kg m−2).

A phytoplasma-associated disease was iden-tified in Brassica campestris (sarson) plants during a survey conducted in Punjab province of Pakistan in 2014–2016. The symptomatic plants showed character-istic symptoms of phyllody and witches’ broom. Phytoplasma presence was detected by polymerase chain reaction on 16S ribosomal and tuf DNAs, follow-ed by RFLP analysis and sequence comparison of the 16S rRNA and tuf genes. The phytoplasma detected was classified in a new ribosomal subgroup designed 16SrIX-H. The phytoplasma presence in phloem tissues of symptomatic sarson samples was also confirmed through light microscopy and transmission studies to healthy plants through dodder and the leafhopper Orosius albicinctus. This is the first report of identifica-tion of 16SrIX-H subgroup phytoplasma associated with sarson and its natural vector in Pakistan.

Background/objectives: Anemia, leukopenia and, although less frequently, thrombocytopenia are possible hematological complications of anorexia nervosa considered strictly secondary to chronic malnutrition. This is a retrospective study on the prevalence of these disorders in a large cohort of 318 female patients with AN (20.4±5.6 years, body mass index (BMI) 15.9±1.6 kg/m2), recruited in the Outpatient Unit for Malnutrition secondary to Eating Disorders at the Department of Clinical Medicine and Surgery, Federico II University Hospital, since February 1991 to December 2012. Subjects/methods: Patients were studied on an outpatient basis after obtaining medical history, clinical examination, routine hematobiochemical and endocrine tests, electrocardiography, psychiatric interview and bioelectrical impedance analysis and, in particular, phase angle determination. All patients with other comorbidities, in particular with mean corpuscular volume

The original article can be found online.

The enamel defects (EDs) may present with a variety of clinical manifestations with increasing severity from the sole appearance of pale discoloration to remarkable structural alterations. EDs are responsible for higher caries receptivity. In vivo reflectance confocal microscopy (RCM) allows to image in vivo at microscopic resolution of the dental surface, thus avoiding the tooth extraction and the sample preparation because of its ability to optically scan living tissues along their depth. Aim of this study is the in vivo assessment at microscopic resolution of dental surfaces affected by EDs without resorting to invasive methods such as teeth extractions, to define histological findings occurring in chromatic and/or structural EDs. For the purpose, 15 children, referring at the Dental Clinic of the Second University of Naples, affected by several degrees of EDs, were enrolled and underwent in vivo RCM imaging to microscopically define the ED confocal features using a commercially available hand-held reflectance confocal microscope with neither injuries nor discomfort. Totally, 29 teeth were imaged. Results demonstrated images good in quality and the capability to detect EDs such as unevenness, grooves, and lack of mineralization according to their clinical degree of disarray. The present in vivo microscopic study on EDs allowed to highlight structural changes in dental enamel at microscopic resolution in real-time and in a non-invasive way, with no need for extraction or processing the samples. Further experiments could define the responsiveness to remineralizing procedures as therapeutic treatments The enamel defects (EDs) may present with a variety of clinical manifestations with increasing severity from the sole appearance of pale discoloration to remarkable structural alterations. EDs are responsible for higher caries receptivity. In vivo reflectance confocal microscopy (RCM) allows to image in vivo at microscopic resolution of the dental surface, thus avoiding the tooth extraction and the sample preparation because of its ability to optically scan living tissues along their depth. Aim of this study is the in vivo assessment at microscopic resolution of dental surfaces affected by EDs without resorting to invasive methods such as teeth extractions, to define histological findings occurring in chromatic and/or structural EDs. For the purpose, 15 children, referring at the Dental Clinic of the Second University of Naples, affected by several degrees of EDs, were enrolled and underwent in vivo RCM imaging to microscopically define the ED confocal features using a commercially available hand-held reflectance confocal microscope with neither injuries nor discomfort. Totally, 29 teeth were imaged. Results demonstrated images good in quality and the capability to detect EDs such as unevenness, grooves, and lack of mineralization according to their clinical degree of disarray. The present in vivo microscopic study on EDs allowed to highlight structural changes in dental enamel at microscopic resolution in real-time and in a non-invasive way, with no need for extraction or processing the samples. Further experiments could define the responsiveness to remineralizing procedures as therapeutic treatments.

Obesity is a chronic complex disease, consequence of an unbalance between energy intake and expenditure and of the interaction between predisposing genotype and facilitating environmental factors. The aim of the study was to evaluate body composition, abdominal fat, and metabolic changes in a group of severely obese patients before and after laparoscopic gastric bypass (LGBP) at standardized (10% and 25%) total weight loss.Twenty-eight patients (14 M, 14 F; age 41.71 +/- 6.9 years; body mass index (BMI) 49.76 +/- 5.8 kg/m(2)) were treated with laparoscopic gastric bypass. All evaluations before surgery and after achieving ~10% and ~25% weight loss (WL). Body composition was assessed by bioimpedance analysis; resting metabolic rate (RMR) was measured by indirect calorimetry.Body weight, BMI, and waist circumference significantly decreased at 10% and 25% WL. We observed a significant reduction of both RMR (2,492 +/- 388 at entry vs. 2,098 +/- 346.6 at 10% WL vs. 2,035 +/- 312 kcal per 24 h at 25% WL, p = 0.001 vs. baseline) as well as of RMR corrected for fat-free mass (FFM; 35.7 +/- 6.7 vs. 34.9 +/- 9.0 at 10% WL vs. 33.5 +/- 5.4 at 25% WL kilocalorie per kilogram FFM x 24 h, p = 0.041 vs. baseline). Body composition analysis showed a relative increase in FFM and a reduction of fat mass at 25% WL. A significant reduction in blood glucose, insulin, homeostasis model assessment index was observed. Ultrasonography showed a marked decrease in the signs of hepatic steatosis.In conclusion, our study confirms that LGBP is a safe procedure in well-selected severely obese patients and has early favorable effects on both metabolic parameters and body composition. Longer-term observations are required for in-depth evaluation of body composition changes.

An island wide survey carried over 18 months across 79 tomato (Lycopersicum esculentum L.) plantations in 30 localities on 12 varieties revealed that symptoms related to phytoplasma-associated diseases are widespread in this species in Mauritius. Typical witches, broom and stunting and/or yellowing were observed in 74.6 % of fields visited. Phytoplasmas belonging to three groups: stolbur (16SrXII), aster yellows (16SrI) and elm yellows (16SrV) were identified in tomato leaf and fruit samples by nested-PCR assays followed by RFLP and/or sequencing analyses. Mixed phytoplasma and virus infections (PVY, TYLCV) were detected in 28.8 % of symptomatic sample tested. Survey results indicate a widespread distribution of all identified phytoplasmas across local tomato plantations (pathogens were detected in 8 out of 9 districts) irrespective of the variety grown. Use of insect-proof nets for seedling production, avoid re-planting a new tomato crop in the vicinity of phytoplasma infected ones and uprooting of symptomatic plants are the recommended measures to reduce the pathogen dissemination and resulted to be effective in reducing the pathogen presence in the Country.

The classic mini-abdominoplasty is a surgery generally indicated for cases in which cutaneous laxity of the abdomen's inferior region is associated with adiposity. However, in some cases, the characteristics of the abdomen are such that resort to a traditional mini-abdominoplasty would involve an unsatisfactory final result due to the unavoidable caudalization of the navel. In answer to this problem, Pontes developed the type 4 modified mini-abdominoplasty. This procedure adds to the classic technique a complete resection of the navel and its transposition so that it leaves a residual vertical scar. With our version of the technique, the scar is more aesthetic in shape and appearance, horizontal, and parallel to the suprapubic scar.

OBJECTIVE: To evaluate in female patients with anorexia nervosa the accuracy of a specific predictive formula for basal metabolic rate (BMR) already proposed in the literature and to derive a new disease-specific equation with the same purpose. DESIGN: Cross-sectional study. SUBJECTS: One-hundred and twenty adolescent girls (

Hospital malnutrition is high in every country it was investigated, but no nationally representative prevalence study, considering potential geographical interfering factors, has yet been performed. We designed a multidisciplinary, cross-sectional, nation-wide survey: the PIMAI study (Project: Iatrogenic MAlnutrition in Italy). Adult (>18 years old) patient inclusion was managed on a four-strata randomisation model according to sex and age (

Methods From September 2010 up to May 2013 seven patients (four male and three female, aged 67,66 ± 10,85, pre op LVEF 47,85 ± 6,46) with a story of previous CABG (three patients using left internal mammary artery + saphenous vein; four patients using LIMA + radial artery; one patient using also the right internal mammary artery, number of by pass 2.85 ± 0.63) were admitted in our department for valvular or ascending aorta disease. All patients had previous coronarography with patent arterial conduit in six patients, while in one patient an occluded LIMA graft on the LAD and a patent radial artery graft from the LIMA on the first and second obtuse marginal were observed. Reoperations were performed on beating heart. Arterial conducts were not isolated to avoid possible injury and the procedures were performed cross-clamping the aorta, on pump, perfusing the coronary trough the patents graft and with a retrograde perfusion with a cannula in the coronary sinus.

To evaluate whether bioimpedance analysis (BIA) is a useful tool for predicting basal metabolic rate (BMR), sex, age, height, weight, BMI, and single-frequency BIA variables (resistance index and phase angle) were assessed in 61 young adult non-diabetic obese patients (BMI >35 kg/m 2 ). BMR was measured by indirect calorimetry. In both sexes BMR significantly correlated with weight, BMI, and resistance index. Using multiple regression analysis, the fol- lowing prediction equations were derived: (1) considering individual characteristics: BMR (kcal/day)=780+11.4xweight (+221 for men); (2) including also BIA variables: BMR=- 96+8.4xresistance index+8.3xweight+82.5xphase angle. Thus, in young adult, severely obese individuals, BIA vari- ables are significant predictors of BMR.

Eating disorders are frequently observed in young people. They can induce major complications involving several organs, either directly or through protein energy malnutrition. Gastrointestinal problems are the most common and somewhat different in restrictive and bulimic anorexia. Delayed gastric emptying prevails in restrictive anorexia, with slower intestinal transit and atrophy of the smooth muscles of the gastrointestinal tract. In bulimic anorexia, vomiting is the cause of several oesophageal and gastric lesions, from oesophagitis to perforation of the oesophagus or stomach. C.G. is a 16-year old boy who weighs 41.8 kg, is 174 cm tall and has a BMI 13.7 (kg/m2). At 14 he started to suffer from restrictive anorexia, then bulimic anorexia for the last two months. The day before admission, the patient ate a large quantity of "sfoglia-telle" in about 2 hours during a bulimic crisis. After 8 hours, he had spontaneous vomiting, malaise, abdominal tension and slight mental confusion. Physical examination showed a tense and tender abdomen with infrequent peristalsis, mental confusion and dehydration. Laboratory evaluation confirmed dehydration (serum albumin 5.7 g/dL); a plain abdomen film showed marked gastrectasia. Instrumental examinations (abdominal CT scan, upper endoscopy) confirmed the diagnosis of gastrectasia with tight pyloric stenosis.

Methods Three patients with a story of ascending aorta aneurysm were selected from October 2012 to December 2012. Trans thoracic echocardiography, angio CT scan and a coronarography were performed during the pre op evaluation. The surgical procedure was performed on beating heart in off pump using a low dose of heparin (5000 UI). A side clamp was used to plicate longitudinally the ascending aorta at the level of maximum dilatation from the sino tubular junction up to the troncus anonymous with controlled hypotension (70 mmHg).The plication was performed with a double layer of 3/0 prolene suture reinforced with two strips of Teflon along the plication. Furthermore, an opened longitudinally 32 mm Dacron tube was wrapped around the ascending aorta and sutured to the plication with a double 3/0 prolene suture.

Background Inside the spectrum of non-alcoholic fatty liver disease, simple fatty liver is generally thought of as being "non progressive", differently from non-alcoholic steatohepatitis, which increases in severity due to the presence of apoptosis/inflammation and fibrosis. The "benignity" of fatty liver is widely accepted but conceptually difficult to maintain because the mechanisms underlying this entity are the same ones that determine the more severe form. Findings provide evidence that iron overload is associated with increased liver damage and collagen deposition. Transforming growth factor-beta1 released by hepatic stellate cells during chronic liver injury plays a critical role in liver apoptosis and fibrogenesis. Objective To verify whether both the forms of non-alcoholic fatty liver disease were really dissimilar, evaluating the serum profile of two key parameters, indexes of severity. Methods A total of 123 patients (57 females) participated, forming three groups: forty five patients with fatty liver, 42 patients with non-alcoholic steatohepatitis and 36 with chronic hepatitis C. All had a biopsy-proven diagnosis. Measurements Serum concentrations of transforming growth factor-beta1 and ferritin. Results High concentrations of transforming growth factor-beta1 were noticed in patients suffering from both fatty liver and non-alcoholic steatohepatitis, 129.1 (45.4) versus 116.8 (42.2) ng/mL, P = 0.2; they were significantly superior to those of chronic hepatitis C patients 87.5 (39.5) ng/mL, P < 0.001. Ferritin levels were on average above normal values and similar in the three groups (P = 0.9), also when adjusted for gender (P = 0.5) and age (P = 0.3). Conclusion No difference between serum concentrations of transforming growth factor-beta1 and ferritin in fatty liver and non-alcoholic steatohepatitis suggests that these forms share more common aspects, regarding their progression, than previously thought.