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While there is evidence for the effects of positive psychology interventions (PPIs) in the Western world, we know little about their effects on Arab cultures. This review aimed to assess the effects of PPIs on well‐being and mental health across Arab countries. Systematic searches of randomised controlled trials (RCTs) and quasi‐experimental studies investigating PPIs in Arabia were conducted in six English and Arabic databases from the inception of positive psychology in 1998 to 28 February 2022. The quality of the studies was assessed using the Cochrane risk‐of‐bias tools. The protocol was published in the BMJ Open. Forty‐four studies from 10 Arab countries (n = 3598 participants) were included. Of these, 12 were RCTs and 32 were quasi‐experimental. The studies mainly focused on adults (73%) and healthy populations (86%). PPIs included mindfulness, positive thinking, strengths, hope, optimism, self‐compassion, positive traits, and multiple PPIs. Nearly all studies (91%) mentioned cultural adaptation; however, little detail was given. This is the first review in Arabia. PPIs appear to be effective for promoting well‐being and reducing mental health issues. However, there were some risks of bias concerns. Future research should include younger and clinical populations, using larger samples and providing more details about adaptation. [ABSTRACT FROM AUTHOR]

This article discusses the feasibility and accuracy of using the SonosyncTM system, which allows for real-time image streaming and remote control of ultrasound systems, for second trimester ultrasound scans. The study involved 52 low-risk patients, with one skilled operator and five residents in obstetrics and gynecology performing the examinations. The results showed that the SonosyncTM system was able to successfully perform the ultrasound examinations, with good agreement in fetal measurements compared to traditional scanning methods. However, the traditional method had a higher image quality score. The authors conclude that this technology could open up new possibilities in fetal medicine. [Extracted from the article]

PROGNOSTIC SCORING SYSTEMS FOR SEVERE CRS AND ICANS AFTER AUTOLOGOUS ANTI-CD19 CAR T CELLS IN LARGE B-CELL LYMPHOMA: A DESCAR-T REGISTRY STUDY FORM THE LYSA B Background: b Cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) are common immune-related toxicities associated with chimeric antigen receptor (CAR)-T-cell therapy. B S. Legouill b Honoraria: Janssen-Cilag, Kite/Gilead and Novartis B G. Cartron b Honoraria: Roche, Bristol Myers Squibb, Onwards Therapeutics, MedxCell, EmerCell, MabQ, Sanofi, Abbvie, Takeda, Roche, Janssen, Roche, Novartis and Myltenyi B D. Beauvais b Honoraria: Kite/Gilead B F. Gros b Honoraria: Bristol Myers Squibb, Novartis and Kite/Gilead B P. Bories b Honoraria: Bristol Myers Squibb, Kite/Gilead, Novartis and Abbvie B M. Rubio b Honoraria: Novartis and Kite/Gilead. [Extracted from the article]

Transition-metal-based materials are among the most active and durable catalysts for the effective electrocatalysis of oxygen-related reactions. Herein, we present a study on bifunctional catalysts as air electrodes aimed at metal-air batteries based on nickel and cobalt spinel (NiCo2O4) supported on electrospun carbon nanofibers. The physicochemical features of these transition-metal-based catalysts are essential for the understanding of their electrochemical activity. Results show that the major presence of oxidized Ni and Co species (Ni3+ and Co3+) produces higher activity for the oxygen evolution reaction (OER), whereas lower oxidation states of the metals (Ni2+, Co2+, Ni0 and Co0) together with the presence of N-doped carbon lead to enhanced oxygen reduction reaction (ORR) performance. This study highlights the importance of designing catalysts in terms of crystallographic structure and proper oxidation states of the elements for maximizing their performance. [ABSTRACT FROM AUTHOR]

This research was carried out according to the Italian Consensus Conference on Specific Learning Disability guidelines for screening initiatives. It describes a three‐year screening project involving 2.469 students, aged 8–15 years, from various classes of primary, lower and upper secondary schools of Sicily. Students were assessed for reading and spelling skills. Overall, 4.9% met the risk criteria for suspected reading disorder, 6.1% for spelling disorder, while 8.5% for both conditions. Results showed that out of 932 pupils in the primary school, 4.6% met the risk criteria for reading disorder and 6.5% for spelling disorder; out of 855 pupils of the lower secondary school, 5.3% for reading disorder and 5.5% for spelling disorder; out of 652 pupils of the upper secondary school, 4.9% for reading disorder and 6.1% for spelling disorder. No significant difference in the prevalence of students at risk of reading disorder or spelling disorder, within the three grade‐levels over 3 years, was found. At project conclusion further clinical investigation to verify the screening results on student sub‐sample (57%) was carried out. The percentage of students with SLD was equal to 3.15%, in the primary school, 3.76% in the lower secondary school and 2.51%, in the upper secondary school. [ABSTRACT FROM AUTHOR]

Gametes from gravid Antarctic toothfish (Dissostichus mawsoni) were combined in vitro and buoyancy measurements were made on fertilised eggs during early development. Eggs were strongly positively buoyant, indicating that they would ascend quickly in the water column and reside near or in association with the underside of sea ice, which covers most of the spawning habitat during winter. An association with sea ice may provide: protection from the turbulence of ice‐free surface waters, a mechanism that modifies the velocity of advection by surface currents, and a habitat with a concentrated planktonic food source during spring months. An association with sea ice would also create spatial differences in egg advection patterns for eggs produced spanning a large geographic area. The effects of climate change on sea ice formation and melting patterns, or fishery‐induced changes in the spatial density of adults could then influence juvenile advection patterns and influence survival. [ABSTRACT FROM AUTHOR]

Background: Acute myeloid leukaemia (AML) patients are at high risk of invasive aspergillosis (IA) after first induction chemotherapy (CHT). Although IA risk factors have been identified, few data are available on impact of IA, occurring during induction phase, on overall AML outcome. Patients and results: The end point of this multicentre, case‐control, study was to evaluate whether IA, occurring after first induction CHT, can affect treatment schedule and patient's outcome. We identified 40 AML patients (cases) who developed IA during first induction phase, 31 probable (77.5%) and 9 proven (22.5%). These cases were matched with a control group (80 AML) without IA, balanced according to age, type of CHT, AML characteristics and cytogenetic‐molecular risk factors. The overall response rate to induction CHT was the same in the 2 groups. In the 40 cases with IA, the overall response rate to antifungal treatment was favourable (80%) but it was significantly affected by the achievement of leukaemia complete remission (CR) with induction CHT. In fact, in cases with AML responsive to induction CHT, responses of IA to antifungal therapy were 96% compared to 21% in cases of AML not responsive to induction treatment (P <.0001). The adherence to the schedule and full doses of CHT were reported in 35% of cases (14/40) and in 76% of controls (61/80) (P =.0001; OR 6.7; 95% CI 2.7‐16.6). After first induction CHT, a significant higher number of cases (15/40; 37.5%) compared to controls (9/80; 11%) could not receive additional cycles of CHT (P =.0011, OR 4.8; 95% CI 1.9‐12.3). The IA‐related mortality was 22.5%. The median OS of cases was significantly worse than OS of controls with a difference of 12.3 months (12.1 vs 24.4 months, P =.04). However, the occurrence of IA during first induction phase did not have a significant impact on the OS of cases who achieved a CR of AML with induction CHT which are able to proceed, despite the IA, with their therapeutic program, achieving the same OS as the control group with AML in CR (P = ns). Conclusions: These data show that IA during first induction CHT can delay the subsequent therapeutic program and has a significant impact on OS, specifically in AML patients who did not achieved a CR of AML with the first course of CHT. [ABSTRACT FROM AUTHOR]

Background: Students with intellectual disabilities (IDs) have various learning difficulties and are at risk for school failure. Large inter‐individual differences are described for reading, but it is unclear how these vary as a function of grade. The aim of this study was to examine various reading fluency, accuracy and comprehension parameters in second‐to‐eighth‐grade Italian children with either borderline intellectual functioning (BIF) or mild ID (MID). Methods: We examined 106 children with BIF (67 M and 39 F) and 168 children with MID (107 M and 61 F). The children were in the second to eighth grade and were comparable for chronological age (7 to 14 years). They were administered a battery of tests that assessed fluency and accuracy of word, pseudo‐word and text reading, as well as text comprehension. Standardised scores allowed us to compare the performance of the two groups with normative values. Results: Children with ID obtained generally low scores compared with normative values. Those with MID had greater difficulty than those with BIF. Furthermore, difficulty was greater for speed than for accuracy measures and for words than for pseudo‐words. Difficulty (particularly in the case of reading speed) tended to be pronounced at later grades. Marked individual differences were present independently of MID–BIF subgrouping, as well as stimulus category and reading parameter. Conclusions: As a group, children with ID showed difficulty in reading acquisition; the effect was greater for children with more severe ID, but large individual differences were observed in children with both BIF and MID. Relatively spared pseudo‐word reading skills indicate efficient use of the grapheme‐to‐phoneme conversion routine. This processing mode may prove more ineffective at higher levels of schooling when even in regular orthographies such as Italian typically developing children rely on lexical activation. [ABSTRACT FROM AUTHOR]

Summary: Invasive fungal infections (IFI) of the Central Nervous System (IFI‐CNS) and Paranasal Sinuses (IFI‐PS) are rare, life‐threatening infections in haematologic patients, and their management remains a challenge despite the availability of new diagnostic techniques and novel antifungal agents. In addition, analyses of large cohorts of patients focusing on these rare IFI are still lacking. Between January 2010 and December 2016, 89 consecutive cases of Proven (53) or Probable (36) IFI‐CNS (71/89) and IFI‐PS (18/89) were collected in 34 haematological centres. The median age was 40 years (range 5‐79); acute leukaemia was the most common underlying disease (69%) and 29% of cases received a previous allogeneic stem cell transplant. Aspergillus spp. were the most common pathogens (69%), followed by mucormycetes (22%), Cryptococcus spp. (4%) and Fusarium spp. (2%). The lung was the primary focus of fungal infection (48% of cases). The nervous system biopsy was performed in 10% of IFI‐CNS, and a sinus biopsy was performed in 56% of IFI‐PS (P = 0.03). The Galactomannan test on cerebrospinal fluid has been performed in 42% of IFI‐CNS (30/71), and it was positive in 67%. Eighty‐four pts received a first‐line antifungal therapy with Amphotericine B in 58% of cases, Voriconazole in 31% and both in 11%. Moreover, 58% of patients received 2 or more lines of therapy and 38% were treated with a combination of 2 or more antifungal drugs. The median duration of antifungal therapy was 60 days (range 5‐835). A surgical intervention was performed in 26% of cases but only 10% of IFI‐CNS underwent neurosurgical intervention. The overall response rate to antifungal therapy (complete or partial response) was 57%, and 1‐year overall survival was 32% without significant differences between IFI‐CNS and IFI‐PS. The overall mortality was 69% but the IFI attributable mortality was 33%. Mortality of IFI‐CNS/PS remains high but, compared to previous historical data, it seems to be reduced probably due to the availability of newer antifungal drugs. The results arising from this large contemporary cohort of cases may allow a more effective diagnostic and therapeutic management of these very rare IFI complications in haematologic patients. [ABSTRACT FROM AUTHOR]

Background: Adolescence has been recognized as a critical period for mental health during which it is fundamental to the well‐being of adolescents to provide early and appropriate mental health interventions. Self‐image perceptions play a particularly relevant role during adolescence since individuals are extensively involved in reorganizing their identity and relationships. Although the self‐image development implies adaptive outcomes for most adolescents, some age‐related tasks can be difficult to deal with and lead to psychological suffering for a minority of them. Method: This study examined how domain‐specific self‐image was associated with psychological distress in 128 treatment‐seeking adolescents aged 13–18 (60.9% female). The adolescents completed the Offer Self‐Image Questionnaire to measure their global and domain‐specific self‐image and the Youth‐Outcome Questionnaire to assess their psychological distress. Results: Regression analyses indicated that impulse control, emotional tone, family, and social functioning significantly predict worse psychological functioning in the entire group. Moreover, significant gender differences emerged showing a more complex set of risk factors among adolescent females, thus suggesting the need for gender‐targeted preventive and treatment strategies. Conclusions: The findings highlight that adolescents’ feelings and concerns about their self‐image may be key factors to consider in planning, developing, and delivering effective public mental health services for adolescents. [ABSTRACT FROM AUTHOR]

Summary: The total net heat flux of the flame from a burning solid fuel is an important issue for the formulation of comprehensive solid‐phase models useful for the fire testing of materials, but measurements are often affected by significant inaccuracy. In this study, an evaluation is conducted using a state‐of‐the‐art model, coupling the descriptions of both gas‐ and solid‐phase processes, for a thick poly(methyl methacrylate) slab burning in a cone calorimeter. It is observed that the total net heat flux (conductive and radiant flame heat fluxes minus surface reradiation losses) remains approximately constant (about 18 kW/m2) as the intensity of the cone irradiance increases from 15 to 60 kW/m2. The influences of some model assumptions and the solid degradation kinetics on this process variable are also assessed. Acceptable agreement is obtained between the predicted and the measured mass loss rates. [ABSTRACT FROM AUTHOR]

Reaction-induced overheating during the pyrolysis of lignocellulosic material has been reported by various authors, but it is still one of the less understood aspects of the process. This Review outlines the experimental results for a mixed kinetic-transport control in which exothermicity is displayed clearly. The thermal conditions and the feedstock properties that enhance these events are discussed. Intraparticle activity, at the microscopic level, of homogeneous and heterogeneous reactions of vapor-phase tars is the main cause of the strong exothermicity, which is more significant for hardly porous materials. Pyrolytic (thermal) runaway is also sometimes observed for fixed-bed pyrolyzers. This is initiated by the fast release rate of tarry vapors at low temperatures (in the presence of catalytically active ash and significant contents of extractives and hemicelluloses) over wide spatial extensions. Then, the acceleration of the sample heating rate triggers the degradation of the other chemical components. [ABSTRACT FROM AUTHOR]

Background and Objective: Communication between patients and health care practitioners is expected to benefit health outcomes. The objective of this review was to assess the effects of experimentally varied communication on clinical patients' pain.Databases and Data Treatment: We searched in July 2012, 11 databases supplemented with forward and backward searches for (quasi-) randomized controlled trials in which face-to-face communication was manipulated. We updated in June 2015 using the four most relevant databases (CINAHL, Cochrane Central, Psychinfo, PubMed).Results: Fifty-one studies covering 5079 patients were included. The interventions were separated into three categories: cognitive care, emotional care, procedural preparation. In all but five studies the outcome concerned acute pain. We found that, in general, communication has a small effect on (acute) pain. The 19 cognitive care studies showed that a positive suggestion may reduce pain, whereas a negative suggestion may increase pain, but effects are small. The 14 emotional care studies showed no evidence of a direct effect on pain, although four studies showed a tendency for emotional care lowering patients' pain. Some of the 23 procedural preparation interventions showed a weak to moderate effect on lowering pain.Conclusions: Different types of communication have a significant but small effect on (acute) pain. Positive suggestions and informational preparation seem to lower patients' pain. Communication interventions show a large variety in quality, complexity and methodological rigour; they often used multiple components and it remains unclear what the effective elements of communication are. Future research is warranted to identify the effective components. [ABSTRACT FROM AUTHOR]

Background Self-image is the subjective perception about one's own self, body, mental functioning, social attitudes, and adjustment in different aspects of life. Research has linked negative self-image with a number of problem behaviors and psychiatric symptoms in adolescence; however, studies of the relationship between self-image and anxiety disorders are still scarce. Method This study involved a community sample of 1305 high-school students (51.4% female) who ranged in age from 14 to 19 years old. They completed self-report measures of self-image and social anxiety disorder ( SAD). Results A quarter of the students reported high levels of social anxiety. Statistical analyses showed significant differences between these students and the other students in all the self-image subscales. Several dimensions of impaired self-image (emotional tone, social attitudes, vocational and educational goals, family relationships, external mastery, and psychological health) were associated with high levels of social anxiety, with some gender differences underpinning these relationships. Conclusions Clinicians treating SAD in youth may wish to consider that a negative self-image may play a critical role in the onset and retention of social anxiety symptoms. [ABSTRACT FROM AUTHOR]

A model is presented for the glowing combustion of thick moist wood samples exposed to fire-level heat fluxes. It includes the description of all the relevant heat and mass transfer phenomena and assumes that the thermally controlled drying, the finite-rate kinetics pyrolysis, and the mixed kinetic-diffusive controlled combustion take place at infinitely thin fronts. The solution, based on the integral method, shows that apart from short initial and final transients, an ablation regime is established given high external heat fluxes and/or high moisture contents, high wood density and thermal conductivity, and low char density. Drying, pyrolysis, and combustion take place simultaneously along a constant-thickness layer that propagates at a constant rate (the same for the three fronts) towards the cold sample side. Good quantitative agreement is obtained between model predictions and measurements. [ABSTRACT FROM AUTHOR]

SUMMARY In this paper, a numerical meshless particle method is presented in order to solve the magnetoencephalography forward problem for analyzing the complex activation patterns in the human brain. The forward problem is devoted to compute the scalp potential and magnetic field distribution generated by a set of current sources representing the neural activity, and in this paper, it has been approached by means of the smoothed particle hydrodynamics method suitably handled. The Poisson equation generated by the quasi-stationary Maxwell's curl equations, by assuming Neumann boundary conditions has been considered, and the current sources have been simulated by current dipoles. The adopted meshless particle model has provided good results in agreement with the analytical ones and by overcoming the drawback of the mesh generation. The numerical model has been validated, at first, in computing the electric potential and the external magnetic field for a dipole plunged near the upper surface of a homogeneous sphere simulating the human brain. Simulation results obtained by simulating two concentric spheres with different conductivities are also reported. Moreover, in order to better assess the validity of the proposed approach, a realistic human brain cortex model has been also simulated and compared with boundary element method results. A satisfactory agreement has been reached. Copyright © 2012 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

A detailed two-dimensional mathematical model is studied for the unsteady heat-and mass-transfer equations coupled with a quasi-steady formulation of the electromagnetic field for the microwave-induced pyrolysis of a wood block. The aspects examined include the description of the flow field based on either the assumption of constant pressure and one-dimensional flow velocity directed along the wood fibers or the linked two-dimensional variation of pressure and velocity in accordance with the Darcy law and deviations from the assumptions of local thermal equilibrium between the solid and gas/vapor phase. © 2011 American Institute of Chemical Engineers AIChE J, 52: 610-624, 2012 [ABSTRACT FROM AUTHOR]

Zanotti S, Gibertini S, Di Blasi C, Cappelletti C, Bernasconi P, Mantegazza R, Morandi L & Mora M (2011) Histopathology 59, 1215-1228 Osteopontin is highly expressed in severely dystrophic muscle and seems to play a role in muscle regeneration and fibrosis Aims: To increase our understanding of profibrotic mechanisms in dystrophic muscle. Methods and results: Extracellular matrix, fibrosis-related molecules and histopathology were assessed in skeletal muscle of patients with Duchenne muscular dystrophy (DMD), Becker muscular dystrophy (BMD), and congenital muscular dystrophy type 1A (MDC1A).Osteopontin expression was much higher in DMD and MDC1A than in BMD and control muscle. Osteopontin was expressed in mononuclear cell infiltrates, on some muscle fibre surfaces, in regenerating fibres, and in calcified fibres. In all pathological muscles, matrix metalloproteinase (MMP)-1 was increased around groups of fibres that were also characterized by absence of collagen 1. The amounts of MMP-2, MMP-9 and tissue inhibitor of MMP -1 transcripts were also increased, whereas their proteins were variably expressed in muscle fibres (surface or cytoplasm) and at foci of necrosis and regeneration. Inflammatory cells, fibroblasts and myofibroblasts were more numerous in DMD and MDC1A than in BMD muscle. Conclusions: Several fibrosis-related factors are greatly altered in severely dystrophic skeletal muscle. Osteopontin was the most conspicuously upregulated, both as transcript and as protein, in muscle fibres and infiltrating cells, indicating an intimate involvement in fibrosis, and also in inflammation and muscle regeneration, although its precise roles in these processes remain to be elucidated. [ABSTRACT FROM AUTHOR]

The article presents a case study of an 81-year-old man with asymptomatic papulonodular eruption on the trunk and limbs that lasts for 20 days. The patient was diagnosed of chronic myelomonocytic disorder on smears from peripheral blood (PB) and bone marrow aspiration (BMA). He died of acute monoblastic leukaemia after four months since the start of skin eruption. It clarifies the equivocal immunohistochemical result of undetermined cell distinction found on the skin biopsy sample.

Background The study was performed to determine whether sucrose-induced insulin resistance could increase the expression of cardiac matrix metalloproteinases (MMPs), indices of matrix remodelling, and whether the addition of 1·25 g die−1 of L-arginine (ARG) to a sucrose diet could prevent both the sucrose-induced metabolic abnormalities and elevated cardiac expression of matrix metalloproteinases in an insulin resistant stage that precedes frank type 2 diabetes. Materials and methods Experiments were performed on 38 male Sprague-Dawley rats, 16 rats maintained a standard chow diet (ST), 12 rats were switched to a sucrose enriched diet (SU) and 10 rats to a sucrose plus L-arginine (1·25 g die−1) enriched diet (SU + ARG) for a period of 8 weeks. After 8 weeks of different diets, an intravenous glucose tolerance test (IVGTT) was performed and samples were drawn for the measurements of insulin, glucose, triglycerides, free fatty acids (FFA), plasma cyclic guanosine-monophosphate (c-GMP) and retroperitoneal, omental, epididymal fat pad and heart were dissected and weighed. Results At the end of the study, retroperitoneal fat, heart weight/body weight ratio, fasting plasma glucose, serum insulin, and serum triglyceride levels and integrated insulin area after IVGTT were significantly higher in SU than in SU + ARG and ST. All these parameters were comparable between SU + ARG and ST animals. FFA levels were significantly different among groups, with highest levels in SU and lowest levels in ST. Fasting plasma c-GMP levels and the integrated c-GMP area after IVGTT, an index of nitric oxide activity, were significantly lower in SU than in SU + ARG and ST, the result was similar in SU + ARG and in ST MMP-9 protein expression increased 10·5-fold, MMP-2 protein expression increased 2·4-fold and the expression of tissue inhibitors of metalloproteinase (TIMP-1) increased 1·7-fold in SU rats as compared to ST animals. This was accompanied with a significant increase of cardiac triglyceride concentrations. In contrast, cardiac MMP-9, MMP-2, and TIMP-1 protein expressions were not different between SU + ARG and ST animals. Cardiac triglyceride levels were not significantly different between SU + ARG and ST rats. Conclusions SU rats developed insulin resistance and hyperlipidaemia, accompanied with increased fat deposition in the heart and enhanced MMP protein expression. Conversely, ARG supplementation prevents these metabolic abnormalities and restored MMP/TIMP-1 balance. [ABSTRACT FROM AUTHOR]

Background: Routine clinicopathologic practice is expected to refine/validate the scoring system proposed in 2005 by the International Society for Cutaneous Lymphomas (ISCL) for the diagnosing early mycosis fungoides (eMF), classical type. Methods: An evaluation of 72 cases of erythematous and scaling dermatoses was employed with a partial implementation of the ISCL algorithm. Results: The selected cases fulfilled the clinical criteria proposed by the ISCL; routine histopathology allowed to reach the ISCL minimum score for a diagnosis of eMF in 45 cases. A clonal T-cell population was found in 4 out of 12 cases tested with the polymerase chain reaction, three of which with an already established clinicopathologic diagnosis of eMF. An aberrant immunophenotype was found in 11 cases, all of which already labeled as eMF on the basis of clinical and histopathologic features. 6 out of 27 patients with inconclusive clinicopathologic data underwent a new skin biopsy, which allowed to reach a diagnosis of eMF in two cases. Conclusions: The diagnosis of eMF still rests upon clinical features and conventional histology; a new skin biopsy is recommended for cases with no clear-cut diagnostic features. [ABSTRACT FROM AUTHOR]

Art often provides valuable hints for technological innovations especially in the field of Image Processing and Computer Graphics. In this paper we survey in a unified framework several methods to transform raster input images into good quality mosaics. For each of the major different approaches in literature the paper reports a short description and a discussion of the most relevant issues. To complete the survey comparisons among the different techniques both in terms of visual quality and computational complexity are provided. [ABSTRACT FROM AUTHOR]

Introduction: The Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines provide a stepwise treatment to rhinitis, which classifies the disease according to its duration and severity. Objectives: The aim of the study was to verify whether these variables influence drug prescriptions for rhinitis and asthma. Methods: A multi-centre cross-sectional pharmaco-epidemiological survey was carried out on 1610 allergic rhinitis patients and the relationship between the clinical features of rhinitis and drug therapy for rhinitis and asthma was evaluated. Results: A total of 1321 adult patients were enrolled. Mild intermittent rhinitis was diagnosed in 7.7%of the patients, moderate/severe intermittent in 17.1%, mild persistent in 11.6%, and moderate/severe persistent in 63.6%. A high level of rhinitis-asthma comorbidity (616/1321 = 46.6%) was found. The majority of patients [1060 (80.24%)] were treated. Significant associations between the severity of rhinitis and the presence of therapy ( P = 0.008), the use of oral antihistamines ( P < 0.001), topical nasal steroids ( P = 0.020) and systemic steroids ( P = 0.005) were found. A weak association was found between the features of rhinitis and the therapy for asthma, and v ice versa the comorbidity with asthma increases the prescription of inhalant ( P < 0.001) and oral steroids ( P = 0.015) to treat rhinitis. Conclusion: The severity of rhinitis influences patient request for rhinitis therapy and the type of medication more than the duration. These features of rhinitis seem to poorly influence asthma therapy. As the ARIA classification is able to reveal a relevant impairment notwithstanding therapy, its role in treated patients merits further study. [ABSTRACT FROM AUTHOR]

Background Allergic rhinitis and asthma comorbidity is supported by both the similar underlying pathogenesis and immunologic mechanisms. The aim of this study was to verify whether the characteristics of rhinitis classified according to the new Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines correlate with the prevalence of asthma. Methods From 1 March to 30 June 2002, a multi-centre cross-sectional study was conducted by 154 allergists chosen from throughout Italy. Duration, severity of rhinitis (according to the ARIA classification) and the type of allergic sensitizations were compared with the prevalence of asthma. Results One thousand three hundred and twenty-one consecutive rhinitis-allergic patients aged 18 years or older were enrolled for the study. The majority of patients, 1060 (80.24%), were on medication at the time of their specialist visit. Mild intermittent rhinitis was diagnosed in 7.7% of patients, moderate/severe intermittent in 17.1%, mild persistent in 11.6%, and moderate/severe persistent in 63.6%. The prevalence of asthma was 48% in patients with mild intermittent rhinitis, 49.6% in moderate–severe intermittent rhinitis, 36.6% in mild persistent rhinitis and 47.5% in moderate severe persistent patients. No correlation between the ARIA categories of rhinitis and the prevalence of asthma was found. A multivariate analysis, after adjustment for age, sex, type of sensitization, level of severity and duration of rhinitis classified according to the ARIA guidelines, demonstrated that age, over 41 years [risk ratio (RR) 1.260, 95% confidence interval (CI) 1.072–1.482] and especially over 51 years (RR 1.460, 95% CI 1.237–1.723), sensitization to indoor allergens (mite and cat), (RR 1.203, 95% CI 1.060–1.366), and polysensitization (RR 1.178, 95% CI 1.004–1.383) are significant risk factors for asthma. Conclusion In allergic rhinitis (AR) patients referred to a specialist, the features of AR as defined by the ARIA classification are not able to predict the presence of asthma, therefore all such patients should be assessed for asthma. [ABSTRACT FROM AUTHOR]

In asthma a dysregulation of eosinophil apoptosis and an imbalance of metalloproteinase-9 (MMP-9) and tissue inhibitor metalloproteinase-1 (TIMP-1) play an important role in airway inflammation and remodelling. We evaluated the effects of a low dose of inhaled fluticasone proprionate (FP) (100 μg bid by Diskus) for 4 weeks in 24 steroid naive patients with mild persistent asthma, symptomatic and with a sputum eosinophilia ≥3% on clinical outcomes and inflammatory markers such as the induced sputum eosinophils, the induced sputum apoptotic eosinophils, the levels of MMP-9 and TIMP-1 and their molar ratio in the induced sputum supernatants. After FP treatment forced expiratory volume (FEV1) and FEV1/forced vital capacity values, PEF (L/min), sputum apoptotic eosinophils, and MMP-9/TIMP-1 molar ratio in sputum supernatants of asthmatic subjects were significantly increased in comparison with baseline, while sputum eosinophils significantly decreased. Change (Δ) in FEV1 after treatment with FP negatively correlated with the Δ in sputum eosinophils, while the Δ in MMP-9 values positively correlated with Δ in TIMP-1 values. This study shows that the clinical improvement achieved by the use of low doses of FP in asthmatics is related, at least in part, to the resolution of eosinophilic inflammation and the downregulation of remodelling markers. [ABSTRACT FROM AUTHOR]

A case of cloacal exstrophy (CE) was detected by ultrasound as early as 22 weeks of gestation in association with myelocystocele complex, an unusual form of occult spinal dysraphism often associated with such a disease. The ultrasonographic diagnosis was made through the detection of a wavy cord-like segment of soft tissue protruding from the anterior abdominal wall, just below the umbilical cord insertion, strongly resembling the trunk of an elephant. Our article enforces the suggestion that the ultrasound elephant trunk-like image should be added to the existing major criteria for making prenatal diagnosis of CE. [ABSTRACT FROM AUTHOR]

Pfeiffer syndrome is characterized by bilateral coronal craniosynostosis, midface hypoplasia, beaked nasal tip, broad and medially deviated thumbs and great toes. Originally, it was described in eight persons from three generations in a pedigree consistent with an autosomal dominant transmission. Since then, several reports have documented its high clinical and genetic heterogeneity. The condition is usually detected in the newborn period or later, and very few prenatal ultrasound diagnoses have been reported. We present a case of Pfeiffer syndrome prenatally diagnosed at 20 weeks' gestation, in which the sonographic features of craniosynostosis, hypertelorism associated with an extreme proptosis, and broad thumb led to the diagnosis, confirmed after termination of pregnancy by dysmorphological, pathological and radiological evaluation. DNA analysis of the fibroblast growth factor receptor 2 (FGFR2) showed a missense mutation consisting in a transversion G --> C at nucleotide 870. This led to a Trp290Cys amino acidic substitution. We discuss the relevant findings of our and previously published cases. Our report demonstrates that a careful sonographic examination can lead to an early prenatal diagnosis of Pfeiffer syndrome also in cases without cloverleaf skull. [ABSTRACT FROM AUTHOR]

Glucocorticoid receptors (GRs) are transcription factors that, upon activation by glucocorticoids, translocate to the cell nucleus, and bind to specific response elements (GREs) in the promoter region of target genes. We analysed stress- and circadian-induced changes in nuclear translocation and GRE binding of GRs in the hippocampus and the prefrontal cortex of the rat brain. Nuclear translocation and binding to GRE were measured in nuclear extracts by Western blot and gel shift, respectively. When glucocorticoid levels were low, as during the light period of the circadian cycle, nuclear GRs and GRE binding were almost undetectable. However, the increase in glucocorticoid levels observed during the dark phase of the circadian cycle or after stress induced a massive nuclear translocation of GRs and GRE binding. These effects were corticosterone-dependent because they were suppressed by adrenalectomy and restored by the injection of corticosterone. Furthermore, GR translocation and GRE binding were of higher amplitude or lasted longer in the hippocampus than in the prefrontal cortex. By contrast, extracellular levels of glucocorticoids, measured by microdialysis in freely moving animals, were identical in the two structures. These results suggest that specific intracellular regulations of GR activity contribute to differentiate the effects of glucocorticoids in different regions of the brain. [ABSTRACT FROM AUTHOR]

Endodermal cysts of the central neuraxis are benign, non-neoplastic epithelium-lined cysts arising from endodermal tissue that have been displaced early in fetal life. Intracranial endodermal cysts are rare and usually located in the posterior fossa. The present study involves a 36-year-old man with a typical epithelial cyst in the posterior fossa. Microscopically, the cyst has a simple columnar epithelium with mucus-producing cells, containing an area composed of dysplastic epithelium with evidence of an intraepithelial carcinoma. The atypical cells have a high proliferative fraction demonstrated by Ki-67 immunostain. Based on these findings, the authors view this case as evidence of a malignant transformation of a classic endodermal cyst. The clinicopathologic features and a review of the literature are discussed. [ABSTRACT FROM AUTHOR]

Background: Topical corticosteroids are beneficial in the treatment of allergic respiratory disorders; they exert effects on a number of cells involved in allergic inflammatory reactions. On the other hand, major histocompatibility complex (MHC)-unrestricted cytotoxicity (i.e., natural killer [NK] cell activity) may play a role in the inflammatory allergic reaction. The objective was to gain insight into the mechanisms of the therapeutic effects of fluticasone propionate (FP), an inhaled corticosteroid used in asthma and rhinitis therapy. Therefore, we evaluated the NK and lymphokine-activated killer (LAK) activity of effector cells in vitro treated or not with FP. Methods: Evaluations were made on peripheral blood mononuclear cells (PBMNCs), obtained from healthy volunteers (n=10) and from asthmatic atopic subjects (n=10) with allergy to Parietaria. Results: Asthmatic patients had significantly increased NK activity (P=0.0008), and interleukin (IL)-2- (P=0.0005) and interferon (IFN)-a-induced LAK activities (P=0.0005). In both groups, FP 10 x7 M significantly reduced NK activity (P<0.0001), IL-2-induced LAK activity (P<0.0001), and IFN-a- induced LAK activity (P<0.0001). Similar results were obtained with FP 10 x8 M. Conclusions: Since MHC-unrestricted cytotoxicity has been implicated in the development of allergen-induced eosinophilic airway inflammation, inhibition of NK and LAK activity by FP may contribute to the steroid therapeutic effect in asthma. [ABSTRACT FROM AUTHOR]