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In order to determine the influence of the ondulations in fabrics on the damping properties of fiber-reinforced plastics, the structural dynamic properties of fabric- and unidirectionally reinforced plastics are investigated. The free decay behavior of flat beam-like specimens is investigated under fixed-free boundary conditions. As the material damping is consistently higher in fabric-reinforced specimens compared to unidirectionally reinforced ones, a contribution of an additionally acting mesomechanic kinematic in fabric weaves is implied. Based on a degree of ondulation, it is possible to classify the enhancement of the material damping and determine the corresponding energy dissipation. The study provides valuable quantitative relations of the additional damping effect due to the mesomechanic kinematic. Compared to the unidirectionally reinforced material, plain weave enhances the material damping by 37…52% at O˜PL=0.0133{\tilde{O}}_{{\rm{PL}}}=0.0133, whereas twill weave 2/2 enhances it by 31…40% at O˜T2=0.0098{\tilde{O}}_{{\rm{T2}}}=0.0098. The consideration of the findings contributes to a deeper understanding of the visco-elastic dynamic behavior of fabric-reinforced plastics and allows further applications in research, development, and industry.

Mycobacterium bovis and Mycobacterium avium subsp. paratuberculosis, respectively the causative agents of bovine tuberculosis (bTB) and bovine paratuberculosis (PTB), share a high number of antigenic proteins. This characteristics makes the differential diagnosis of the diseases difficult. The interferon gamma (IFN-γ), C-X-C motif chemokine ligand 10 (CXCL10), matrix metallopeptidase 9 (MMP9), interleukin 22 (IL-22) and thrombospondin 1 (THBS1) bovine genes have already been shown to be accurate transcriptional biomarkers of bTB. In order to improve the diagnosis of bTB and PTB, in the present study we evaluated the risk of false positivity of these bTB biomarkers in cattle with PTB.

The azide transfer reaction and copper(I)-catalyzed alkyne-azide cycloaddition (CuAAC) can be used to convert the amino groups in chitosan to triazole 1,2,3-moieties. The resulting polymer has been named chitotriazolan. This synthesis was performed with six different quaternary ammonium alkynes and three amine alkynes to obtain a series of nine water-soluble chitotriazolan derivatives. The structure and complete conversion of the azide were confirmed by FT-IR and proton NMR spectroscopy. The derivatives were investigated for antibacterial activity against S. aureus, E. faecalis, E. coli, and P. aeruginosa. The activity of the quaternized chitotriazolan derivatives varied depending on the structure of the quaternary moiety and the species of bacteria. The basic protonable derivatives were less active or inactive against the bacteria.

Antimicrobial resistance (AMR) is a complex and somewhat unpredictable phenomenon. Historically, the utilization of avoparcin in intensive farming during the latter part of the previous century led to the development of resistance to vancomycin, a crucial antibiotic in human medicine with life-saving properties. Currently, in the European Union, there is a growing reliance on the ionophore antibiotic monensin (MON), which acts both as a coccidiostat in poultry farming and as a preventative measure against ketosis in lactating cows. Although many researchers claim that MON does not induce cross-resistance to antibiotics of clinical relevance in human medicine, some conflicting reports exist. The numerous applications of MON in livestock farming and the consequent dissemination of the compound and its metabolites in the environment require further investigation to definitively ascertain whether MON represents a potential vector for the propagation of AMR. It is imperative to emphasize that antibiotics cannot substitute sound animal husbandry practices or tailored dietary regimens in line with the different production cycles of livestock. Consequently, a rigorous evaluation is indispensable to assess whether the economic benefits associated with MON usage justify its employment, also considering its local and global environmental ramifications and the potential risk of instigating AMR with increased costs for its control.

The defeat of the twentieth century revolutionary movements leaves a gigantic void. The space of hope can be taken up again by the renewal of the utopian dimension. Utopia must be conceived as a criterion of meaning, as an indication of direction and not as a social model to be realized. Recognizing Marx’s brilliant diagnostic skills but criticizing his erroneous prognosis and his ruinous therapies, we must draw from the critique of the category of fetishism the implications that allow us to understand why global capitalism does not generate a subject capable of becoming aware of its possible overcoming. The very category of politics, as a projection of evil on the adversary, has become useless if one must imagine the current condition of interdependence as capable of evolving towards a pact of balance and peace among peoples, classes, genders, with an eco-friendly use of natural resources. Utopia can be built over a very long period, transforming the level of awareness to experiment projects of evolutionary coexistence.

Acute hemophagocytic lymphohistiocytosis (HLH) is a life-threatening disease, with an annual incidence of 1 : 800,000 people. The disease is characterized by a cytokine storm, with concomitant macrophage and natural killer (NK) cell activation; death can occur from multiple organ failure or complications such as bleeding diathesis. Therefore, HLH treatment remains a challenging one. We hereby present a case of a 76-year-old man with severe HLH in whom hemoadsorption was successfully applied. Due to the failure of the immunomodulatory therapy , continuous venovenous hemodiafiltration therapy with the CytoSorb® adsorber was successfully applied for 48 hours. Upon therapy discontinuation, the biological and clinical condition reverted, unfortunately evolving towards the patient’s death.

The article presents a study on the impact of autologous priming on blood conservation in patients after cardiac surgery. Topics include the need for alternative perfusion techniques to lower hemodilution, the effectiveness of a protocol of retrograde autologous prime (RAP) and venous antegrade prime (VAP), and the increase in postoperative hematocrits. It also discusses the use of a retrospective review to examine patients' data on their surgeries.

Electrocardiogram (ECG) artifacts are a common problem in emergency medicine. Generally these artifacts are induced by movement disorders, which generate electrical interference with the ECG recording. If these disorders are not promptly recognized, consequences can lead to hospitalization and execution of unnecessary diagnostic tests, thereby increasing the costs and clinical risks such as nosocomial infections and thromboembolism. We present a pseudoatrial flutter generated by a Parkinson’s-like movement.

Longitudinal imaging of bone marrow would shed insight into long-term cellular dynamics within this compartment. Here, the authors develop a multi-photon imaging approach for the mouse femur and reveal extensive vascular plasticity within the bone marrow during bone healing and steady-state homeostasis.

Contents The objective of this study was to characterize follicular dynamics in pre-pubertal, pubertal and post-pubertal periods, as well as the effect of high-energy intake on follicular development and age at puberty in heifers. Thirty-one Nelore ( Bos indicus) heifers, 6 months old, were randomly assigned to receive two different diets: one of low (GI) and other of high dietary energy intake (GII). Animals were evaluated in relation to body weight gain by being weighed every 21 days. Heifers were evaluated every other day by real-time linear ultrasonography to characterize ovarian structures development from weaning to post-pubertal period. Blood samples were collected to determine plasmatic concentrations of progesterone by RIA method. The ovulation was determined when progesterone concentrations were >1 ng/mL in three consecutive samples, and by ultrasound images of corpus luteum; and oestrous behaviour in some animals. Age at puberty differed among heifers of GII (17.00 ± 0.46 months) compared with heifers of GI (19.87 ± 0.47 months; p ≤ 0.05). Maximum size of the dominant follicles at pre-pubertal period was greater in GII heifers than in GI (10.52 ± 0.33 and 9.76 ± 0.15 mm, respectively; p ≤ 0.05). As heifers approached first ovulation time, size of dominant follicle increased (11.75 ± 0.37 mm for GI and 12.52 ± 0.91 mm for GII; p ≤ 0.05). Body weight at puberty was not different in both groups (302.33 ± 27.31 kg for GI and 326.19 ± 27.78 kg for GII heifers; p > 0.05). We conclude that animals receiving high dietary energy intake attained the puberty earlier and the development of follicles were different than in low dietary energy intake. [ABSTRACT FROM AUTHOR]

Expression and recognition have a basis and a centre on which they can develop: the moving body. It would be enough to take the body as a measure for all things to instantly find our bearings again. What direction would the body suggest we consider with critical attention, based on the centre – hence on our hierarchy of actions, institutions and values – and on the limit – hence on the use of our vital force and of the planet’s? It would offer a value system and an evaluation method to choose the appropriate action. An elementary system, because elementary needs are the ones that should be satisfied to be able to pursue greater goals: nourishment, housing, physical and psychic care, safety, upbringing, education.Bodily matters reveal that their formative and cognitive importance is based on their being a potential measure for a new arrangement of our whole civilisation.

Rat models are widely used in preclinical studies investigating fracture healing. The interfragmentary movement at a fracture site is critical to the course of healing and therefore demands definition in order to aptly interpret the experimental results. Estimation of this movement requires knowledge of the fixation stiffness and loading. The characteristic loading for the rat femur has been estimated, but the stiffness of fixation used in rat studies has yet to be fully described. This study aimed to determine the 6 degree of freedom stiffness of four commonly used implants, two external fixators (RatExFix and UlmExFix), a locking plate, and a locking intramedullary nail, in all degrees of freedom and estimate the interfragmentary movement under specific physiological loads. The external fixator systems allow the greatest movement. Mounted 45° anterolateral on the femur, the RatExFix allows an average of 0.88 mm of motion in each anatomic direction while the stiffer UlmExFix allows about 0.6 mm of motion. The nail is far stiffer than the other implants investigated while the plate allows movement of an intermediate magnitude. Both the nail and plate demonstrate higher axial than shear stiffness. The relatively large standard deviations in external fixator shear motion imply strong dependence on bone axis alignment across the gap and the precise orientation of the specimen relative to the loading. The smaller standard deviation associated with the nail and plate results from improved alignment and minimization of the influence of rotational positioning of the specimen due to the reduced implant eccentricity relative to the specimen axis. These results show that the interfragmentary movement is complex and varies significantly between fixation devices but establishes a baseline for the evaluation of the results of different studies.

Mice are extensively used for experimental bone-healing studies. However, there are few established nondestructive in vivo techniques for longitudinal fracture-healing analysis in mice, including in vivo micro-computed tomography (μCT) and radiography. Importantly, none of the established methods can discriminate between non-mineralized fibrous tissue and cartilage in the soft fracture callus. Therefore, the objective was to establish high-resolution in vivo magnetic resonance imaging (MRI) for the longitudinal assessment of soft callus formation during bone healing in mice. C57BL/6J mice received a femur osteotomy stabilized using an external fixator and were randomly assigned to five groups. Group 1 mice were scanned three times longitudinally during fracture healing using an optimized MRI scanning protocol to establish an algorithm to characterize the different fracture-callus tissues. Mice of groups 2-4 were scanned once on day 10, 14 or 21, respectively, euthanized after scanning and their femurs subjected to ex vivo μCT and histomorphometric analysis to compare the data assessed by MRI with μCT and histology. Control group 5 mice were not scanned. After 28 days, mice of groups 1 and 5 were euthanized and the fracture-healing outcome was evaluated by bending-test, μCT and histology to determine whether the repeated anesthesia, handling and the MRI measurements themselves influenced fracture healing. The callus-tissue values determined by MRI were mostly comparable to those obtained by μCT and histomorphometric analysis. However, at time points characterized by small relative bone or cartilage areas, MRI measurements were weakly comparable to histomorphometric data, possibly due to the inferior spatial resolution. Importantly, at the early and intermediate phases of healing, cartilage and fibrous-tissue values obtained by MRI were highly accurate. Furthermore, repeated anesthesia, handling and MRI scans did not impact bone healing. Therefore, we demonstrated the feasibility of high-resolution in vivo MRI for longitudinal assessment of soft callus formation during murine endochondral fracture healing.

Dans l’œuvre de Carl Gustav Jung le terme « philosophie » est employé de manière ambivalente : d’une part, en déclarant que ses buts et ses méthodes sont seulement d’ordre clinique et scientifique, il veut prendre ses distances d’avec toute philosophie ; d’autre part, dans plusieurs essais, il utilise le mot « philosophie » dans le sens propre aux philosophes antiques, tel un synonyme de sagesse qui devrait être recherchée et pratiquée dans la vie quotidienne. Dans ce dernier sens, Jung conçoit la philosophie antique de manière très semblable à ce que fit Pierre Hadot (1922-2010) lorsqu’il fit observer que les exercices spirituels, et la manière de vivre qui en résulte, représentent l’essence propre de la philosophie antique. Dans ce croisement entre l’héritage jungien et le travail de Pierre Hadot, s’engendre la proposition de l’auteur de cet article, celle qu’il désigne comme « analyse biographique à orientation philosophique ». Dans ce cadre, la position analytique est reformulée en tant que développement professionnel d’une vocation existentielle à la recherche d’un style de vie façonné par une tension constante à transcender l’ego comme épicentre, tant vers les autres que vers le monde, ouvrant ainsi à une quête de la vérité et de l’authenticité.

El presente trabajo analiza las técnicas argumentativas y estrategias lingüísticas utilizadas en la construcción del ethos político de la presidenta argentina Cristina Fernández. Tomamos como objeto de estudio el discurso que pronunció el 10 de diciembre del 2007 al iniciar su mandato, porque lo consideramos clave en la construcción de la identidad de la mandataria y en la definición de su proyecto político. El objetivo general es analizar las relaciones existentes entre discurso político y argumentación. El marco teórico y metodológico es el análisis crítico del discurso (Van Dijk & Wodak, 2003). En cuanto al estudio de la argumentación, nos basamos en la propuesta de Perelman y Olbrechts-Tyteca (1994). El concepto de ethos es estudiado desde los postulados de Maingueneau (1996) y Charaudeau (2006). Asimismo el análisis permite establecer características del discurso de la presidenta que lo diferencian de discursos de otros mandatarios pronunciados en situaciones similares y que influyen en la eficacia de la persuasión.

Group B Streptococcus (GBS) remains the leading cause of severe bacterial infections (sepsis, meningitis, pneumonia) in neonates. We compared the detection of GBS from recto-vaginal swabs on blood agar and two chromogenic media and evaluated their antibiotic susceptibility. A total of 1351 swabs were taken from pregnant women at 35-37 weeks of gestation. Following enrichment in Todd Hewitt broth + nalidixic acid and colistin, the samples were plated on Columbia CNA agar (CNA), chromID Strepto B agar (STRB) and Granada Agar (GRAN), respectively. GBS were found in 22.4% of recto-vaginal swabs from pregnant women. Sensitivity, specificity, positive and negative predictive values of GBS detection were 88%, 88%, 81% and 96% for CNA, 99%, 97%, 90% and 99% for STRB and 94%, 99%, 98% e 99% for GRAN; Cohen’s k index concordances for CNA, STREB and GRAN were 0.68, 0.92 and 0.96, respectively. All isolates were susceptible to penicillin, whereas resistances of erythromycin and clindamycin were 40% and 42%, respectively. To conclude, selective broth enrichment combined with chromogenic plates is recommended for GBS screening in pregnant women.

Introduction. Mass Spectrometry technology “Matrix-assisted laser desorption Ionisation/Time-of-Flight (MALDI-TOF MS)” offers a promising new approach for identification of bacteria and fungi of clinical interest. The objective of this study is to evaluate the comparison of microbial identifications obtained with the system Axima/Saramis bioMérieux and identifications obtained by conventional manual or automatic (Vitek 2- bioMérieux).The work was divided into a pilot phase in which the staff has been trained and are set instrument parameters and an operational phase. Methods. MALDI-TOF is a system for the detection and identification of species-specific highly conserved proteins (ribosomal DNA and ligands). Part of a bacterial colony, is deposited on a polymeric substrate, extracted by the addition of the matrix (acid α-Cyano-4-hydroxycinnamic) and analyzed by MALDI-TOF.The mass spectra obtained are compared with the database Saramis (Anagnostec) containing the reference spectra of common pathogens. Results. During the pilot phase were analyzed 303 microorganisms (281 bacteria and 22 fungi), of which 207 (68.3%) correctly identified to species level, 35 (11.6%) identified as a species but not the main one and 49 (16.2%) did not identified. In the second phase of the study were analyzed microorganisms 1417 (1341 bacteria and 76 fungi) in a period of 60 days in 1240 (87.5%) correctly identified to species level, 121 (8.5%) identified as a species but not the main one and 41 (2.9%) unidentified. Conclusions. By reducing the response time (15 min/1 sample), the use of MALDI-TOF system, bioMérieux facilitates the workflow in the clinical laboratory, and positive impact on length of stay and costs. In addition, the rapid identification of yeasts at the species level is definitely a value added important and independent execution of test sensitivity. Finally, a good operator training translates into improved overall system performance.

Alterações bucais podem ser importantes para a investigação de comprometimentos sistêmicos, principalmente quando relacionados à condição de imunossupressão em transplantes, e há o risco de infecções. No crescente aumento do número de pacientes transplantados de órgãos e tecidos, tem-se tornado fundamental a formação de equipes multidisciplinares para atender pacientes transplantados, das quais a Odontologia pode e deve ser parte. Esta revisão de literatura propõe-se a apresentar e discutir a relevância das complicações bucais relacionadas às condições antes e após transplantes de órgãos e tecidos, as quais podem gerar complicações graves e, conseqüentemente, interferir no sucesso da terapêutica médica.

Objective. Aim of this study was to determine the prevalence and distribution of the Norovirus (NoVs) infections, from October 2007 to April 2008, in children hospitalized for gastroenteritis. Materials and methods. From October 2007 to April 2008 faecal specimens were obtained from 220 infants and children (130 males, 90 males) of whom 58 under 1, 60 between 1 and 2, 28 between 2 and 3, 74 between 3 and 12 years old, admitted for gastroenteritis to the Department of Paediatrics at the Campo di Marte’s Hospital in Lucca, Italy. All the specimens were examined both for the presence of bacteria (Salmonella spp, Shigella spp, Campylobacter spp, Yersinia spp, Aeromonas spp and enteropathogenic E. coli) and for the presence of rotaviruses (HRVs) and adenoviruses (AdVs). Sixty-eight frozen stool samples negative for bacteria and viruses were examined for NoVs. HRVs and AdVs were detected by the immunochromatographic test RIDAQUICK Rotavirus/Adenovirus Combi test (R-Biopharm, Germany). NoVs detection was carried out by the enzyme immunoassay RIDASCREEN Norovirus 3rd Generation EIA (R-Biopharm, Germany). In the RIDASCREEN Norovirus test, specific monoclonal antibodies against antigens of several different genotypes are used in a sandwich type method. In a validation study of the RIDASCREEN Norovirus ELISA 3rd Generation at the Institute of Virology of the University of Dresden, the test correlation with the RT PCR showed the following performance, sensitivity (83.0%), specificity (100.0%), PPV (100.0%), NPV (83.0%). Results. HRVs were detected in 41.8% (89/220), AdVs in 4.1% (9/220) and Enteropathogenic bacteria were detected only in 7 (3.2%) patient. NoVs were detected in 18 of 68 studied cases (26.5%). Eighty-three of the NoVs and 49% of the HRVs infections occurred in children up two years old. Conclusions. The present results point out the importance of NoVs infections in childhood hospitalization, mainly in the first two years of life.The study shows the need to implement norovirus ELISA detection assays for clinical diagnosis and for planning an active surveillance among paediatric cases requiring hospitalization due to gastroenteritis for the development of effective preventive measures.

Numerous transport and growth medium systems have been developed for enhanced growth of genital mycoplasmas. In this investigation a total of 161 patient specimens were cultured on the Urée-Arginine LYO 2 screening broth from the Mycoplasma IST 2 kit, on the U.M.M.lyo regenerated screening broth from the Mycofast Screening EvolutioN 2 kit and on A7 agar as control of Mycoplasma hominis and Ureaplasma urealyticum culture. Rates of recovery of these organisms with commercial kits were compared with the standard culture on A7 agar. We evaluated the performance of both screening test: a) Urée-Arginine LYO 2 screening broth test sensitivity was 100%, specificity 96.2%, positive predictive value 93.2% and negative predictive value100%; b) U.M.M.lyo regenerated screening broth test sensitivity was 80%, specificity 100%, positive predictive value 100% and negative predictive value 90.6%. The results of the identification and enumeration obtained on A7 agar complied a) with Mycoplasma IST 2 strip for 100% of M. hominis and 85% of U. urealyticum b) with Mycofast Screening EvolutioN 2 strip for 50% of M. hominis and 100% of U. urealyticum. According our study Urée-Arginine LYO 2 screening broth is an optimal medium for the recovery of M. hominis and U. urealyticum. Moreover we confirmed the screening positive tests evaluating sensitivity and specificity through the agar test culture.The Mycoplasma IST 2 strip gives an indicative enumeration and for this reason it is necessary a sub-culture on A7 agar for any positive screening. This study shows that Mycofast Screening EvolutioN 2 does not allow an optimal recovery of the genital micoplasmas, particularly Mhominis and for this reason we recommend the combination of Mycofast Screening EvolutioN 2 with A7 agar. We have also studied susceptibilities of M. hominis and U. urealyticum to different antibiotics and their association with G. vaginalis.

Abstract Background The impact of viral subtype on the rate of sustained virological response (SVR) to antiviral therapy in patients chronically infected with hepatitis C genotype 1 subtype 1a and 1b has not been extensively investigated. The aim of this study is to determine whether the HCV genotype 1 subtypes 1a and 1b respond differently to treatment with PEGylated interferon (PEG-IFN) plus ribavirin. Methods For 48 weeks, 388 “naïve”genotype 1 patients were treated weekly with PEG-IFN α-2a or PEG-INF α-2b combined with daily ribavirin (1000–1200 mg/day). The numbers of patients in whom HCV-RNA was undetectable were compared after 4 (rapid virological response, RVR), 12 (early virological response, EVR), and 48 (end treatment virological response, ETR) weeks of treatment as well as 24 weeks after the last treatment (sustained virological response, SVR). Results The rate of SVR was higher in subtype 1a patients than subtype 1b patients (55% vs. 43%; p 10 IU/ml (OR: 3.2; 95% CI: 2.7 to 6.9) and fibrosis score < S3 (OR: 3.8; 95% CI:3.2 to 7.4), were all independent predictors of SVR. Conclusion Dual antiviral therapy is more effective against HCV subtype 1a than against subtype 1b and this difference is independent of other factors that may favour viral clearance. Trial registration ClinicalTrials.gov Identifier: NCT01342003

Abstract Background Despite recommendations by Health Authorities, influenza immunization coverage remains low in children with chronic diseases. Different medical providers involved in the management of children with chronic conditions may affect the pattern of influenza vaccine recommendations and coverage. The likelihood of vaccination by type of provider in children with chronic conditions is poorly understood. Therefore, the objectives of this study were to analyze the pattern and the effect of recommendations for seasonal influenza immunization provided by different physician profiles to families of children with chronic diseases and to measure the frequency of immunization in the study population. Methods We recruited children with chronic diseases aged 6 months–18 years who subsequently presented to specialty clinics for routine follow-up visits, during spring 2009, in three Italian Regions Families of children with chronic diseases were interviewed during routine visits at reference centers through a face-to-face interview. We analyzed the following immunization predictors: having received a recommendation toward influenza immunization by a health provider; child’s sex and age; mothers and fathers’ age; parental education and employment; underlying child’s disease; number of contacts with health providers in the previous year. Influenza immunization coverage was calculated as the proportion of children who received at least one dose of seasonal influenza vaccine in the previous season. We calculated prevalence ratios and we used a generalized linear model with Poisson family, log link and robust error variance to assess the effect of socio-demographic variables, underlying diseases, and recommendations provided by physicians on influenza immunization. Results We enrolled 275 families of children with chronic diseases. Overall influenza coverage was 57.5%, with a low of 25% in children with neurological diseases and a high of 91.2% in those with cystic fibrosis. While 10.6% of children who did not receive any recommendation toward influenza immunization were immunized, among those who received a recommendation 87.5-94.7% did, depending on the health professional providing the recommendation. Receiving a recommendation by any provider is a strong predictor of immunization (PR = 8.5 95% CI 4.6;15.6) Most children received an immunization recommendation by a specialty (25.8%) or a family pediatrician (23.3%) and were immunized by a family pediatrician (58.7%) or a community vaccinator (55.2%). Conclusions Receiving a specific recommendation by a physician is a strong determinant of being immunized against seasonal influenza in children with chronic diseases independently of other factors. Heterogeneity exists among children with different chronic diseases regarding influenza recommendation despite international guidelines. Increasing the frequency of appropriate recommendations toward influenza immunization by physicians is a single powerful intervention that may increase coverage in children with chronic conditions.

Abstract Background A higher prevalence of coeliac disease has recently been reported among patients with HCV-related chronic hepatitis. Moreover, development of clinically overt coeliac disease has been described in a number of HCV-related chronic hepatitis patients during α-interferon therapy. This prospective study was designed to evaluate 1) the prevalence of coeliac disease in patients with HCV-related chronic hepatitis; 2) the prevalence of HCV infection in patients with coeliac disease; 3) whether PEG interferon-α treatment might favour the development of coeliac disease in patients with chronic hepatitis C. Materials and methods Two hundred-ten consecutive patients (M/F = 140/70, range of age 35–58 years, median age 46.5 years) with biopsy proven chronic hepatitis C underwent serological screening for antiendomysial and tissue transglutaminase IgA antibodies. One hundred ninety-four coeliac patients (M/F = 52/142, range of age 18–74 years, median age 34 years) were screened for HCV antibodies. Positivity for HCV antibodies in coeliac disease patients was confirmed by detection of serum HCV-RNA by RT-PCR. This work was carried out in accordance to ethical guidelines of Declaration of Helsinki and was approved by Institutional Ethics Committee of the Second University of Naples. All patients gave informed written consent. Results 1) none of the 210 HCV-related chronic hepatitis patients were positive for coeliac disease serologic screening; 2) prevalence of HCV infection among coeliac patients was 1.54% (3/194) which is comparable to that reported in the Southern Italy population; 3) PEG interferon-α treatment was not associated with development of coeliac disease either clinical or serological. Conclusions 1) coeliac disease is not associated with HCV infection; 2) PEG interferon-α does not trigger celiac disease.

Abstract Background Medical professionals go online for literature searches and communication with families. We administered a questionnaire to members of the Italian Society of Pediatrics to assess determinants of their use of the Internet, of social platforms and of personal health records during clinical practice. Methods All the 9180 members of the Italian Society of Pediatrics were invited to fill in a questionnaire concerning use of the Internet and usefulness of Internet-based tools during clinical practice. The questionnaire was administered through the SurveyMonkey® web platform. Logistic regression analysis was used to study factors affecting use and influence of the Internet in clinical practice. Results A total of 1335 (14.5%) members returned the questionnaire. Mean age was 49.2 years, 58.6% were female. 32.3% had access to the Internet through a Smartphone. 71.9% of respondents used the Internet during clinical practice, mainly searching for guidelines and drug references. Use of the Internet during clinical practice was more frequent among younger pediatricians (OR 0.964; 95% CI 0.591-0.978), males (OR 1.602; 95% CI 1.209-2.123) and those living in Northern and Central Italy (OR 1.441; 95% CI 1.111-1.869), while it was lower among family pediatricians. 94.6% of respondents were influenced in their clinical practice by information found on the Internet, in particular younger pediatricians (OR 0.96, 95% CI 0.932-0.989), hospital pediatricians (OR 2.929, 95% CI 1.708-5.024), and other pediatric profiles (OR 6.143, 95%CI 1.848-20.423). 15.9% of respondents stated that social networks may be useful in pediatric practice. Slightly more than half (50.5%) of respondents stated that personal health records may be clinically relevant. Registrars and hospital pediatricians were more likely to perceive personal health records as useful tools for clinical practice. Additional resources pediatricians would like to access were free bibliographic databases and tools for interacting with families. Conclusions Italian pediatricians frequently use the Internet during their practice. One-third of them access the Internet through a Smartphone. Interaction with families and their empowerment can be improved by the use of Internet tools, including personal health records, toward which respondents show a significant interest. Though, they show a general resistance to the introduction of social networks in clinical practice.

Abstract Background Maternal effects mediated by egg size and quality may profoundly affect offspring development and performance, and mothers may adjust egg traits according to environmental or social influences. In avian species, context-dependency of maternal effects may result in variation in egg composition, as well as in differential patterns of covariation among selected egg components, according to, for example, position in the laying sequence or offspring sex. We investigated variation in major classes of egg yolk components (carotenoids, vitamins and steroid hormones) in relation to egg size, position in the laying sequence and embryo sex in clutches of the Yellow-legged Gull (Larus michahellis). We also investigated their covariation, to highlight mutual adjustments, maternal constraints or trade-offs in egg allocation. Results Laying sequence-specific patterns of allocation emerged: concentration of carotenoids and vitamin E decreased, while concentrations of androgens increased. Vitamin A, estradiol and corticosterone did not show any change. There was no evidence of sex-specific allocation or covariation of yolk components. Concentrations of carotenoids and vitamins were positively correlated. Egg mass decreased along the laying sequence, and this decrease was negatively correlated with the mean concentrations of carotenoids in clutches, suggesting that nutritionally constrained females lay low quality clutches in terms of carotenoid content. Finally, clutches with smaller decline in antioxidants between first- and last-laid eggs had a larger increase in yolk corticosterone, suggesting that a smaller antioxidant depletion along the laying sequence may entail a cost for laying females in terms of increased stress levels. Conclusions Since some of the analyzed yolk components (e.g. testosterone and lutein) are known to exert sex-specific phenotypic effects on the progeny in this species, the lack of sex-specific egg allocation by mothers may either result from trade-offs between contrasting effects of different egg components on male and female offspring, or indicate that sex-specific traits are controlled primarily by mechanisms of sexual differentiation, including endogenous hormone production or metabolism of exogenous antioxidants, during embryonic development.

Abstract Background People often search for information on influenza A(H1N1)v prevention on the web. The extent to which information found on the Internet is consistent with recommendations issued by the World Health Organization is unknown. Methods We conducted a search for "swine flu" accessing 3 of the most popular search engines through different proxy servers located in 4 English-speaking countries (Australia, Canada, UK, USA). We explored each site resulting from the searches, up to 4 clicks starting from the search engine page, analyzing availability of World Health Organization recommendations for swine flu prevention. Results Information on hand cleaning was reported on 79% of the 147 websites analyzed; staying home when sick was reported on 77.5% of the websites; disposing tissues after sneezing on 75.5% of the websites. Availability of other recommendations was lower. The probability of finding preventative recommendations consistent with World Health Organization varied by country, type of website, and search engine. Conclusions Despite media coverage on H1N1 influenza, relevant information for prevention is not easily found on the web. Strategies to improve information delivery to the general public through this channel should be improved.

Abstract A 12 year old boy presented with an acute onset of anisocoria and blurred vision. Ocular motility was normal but his right pupil was dilated, round but sluggishly reactive to light. There was no history of trauma, eye drops' instillation, nebulised drugs or local ointments. His past medical history was negative. A third nerve palsy was considered but the performed cerebral MRI was normal. On further anamnestic investigation the boy revealed that he had spent the morning doing gardening, and especially working on a "trumpet plant". Datura and Brugmansia are well known toxic plant; all Datura and Brugmasia plants contain, primarily in their seeds and flowers, tropane alkaloids such as scopolamine, hyoscyamine and atropine. Systemic and local intoxications have already been described. The day after anisocoria was much less evident and completely resolved in three days. We present this case of an unusual cause of mydriasis to underline once more the importance of a well and deeply conducted medical history.

Abstract Background In patients with chronic hepatitis C virus (HCV) genotype 2 or 3, 24 weeks' treatment with pegylated interferon alfa (PEG-IFN-alpha) and ribavirin induces a sustained virological response (SVR) in almost 80% of cases. Evidence suggests that a similar response rate may be obtained with shorter treatment periods, especially in patients with a rapid virological response (RVR). The aim of this study was to compare the efficacy of 12 or 24 weeks of treatment in patients with chronic HCV genotype 2 or 3 and to identify patients suitable for 12 weeks treatment. Methods Two hundred and ten patients received PEG-IFN-alpha-2a (180 ug/week) and ribavirin (800-1200 mg/day) for 4 weeks. Patients with a RVR (HCV RNA not detectable) were randomized (1:1) to either 12 (group A1) or 24 (group A2) weeks of combination therapy. Patients without a RVR continued with 24-weeks' combination therapy (group B). HCV RNA was monitored at weeks 4, 8, 12, and 24, and at week 24 post-treatment. Results At study end, end of treatment response (ETR) was observed in 62 (86%) patients of group A1 and in 55 (77%) patients of group A2 (p < 0.05) Relapse rate was 3% each in groups A1 and A2, and 6% in group B. Among patients with a HCVRNA test 24 weeks after the end of treatment, SVR was observed in 60 (83%) of group A1 patients and in 53 (75%) of group A2 patients. Rapid virological response, low baseline HCV RNA levels, elevated alanine aminotransferase levels and low fibrosis score, were the strongest covariates associated with SVR, independent of HCV genotype. No baseline characteristic was associated with relapse. Conclusion In HCV patients with genotype 2 or 3, 12-week combination therapy is as efficacious as 24-week therapy and several independent covariates were predictive of SVR. Trial registration Trial number ISRCTN29259563

Abstract Background Cancer prevention trials using different types of antioxidant supplements have been carried out at several occasions and one of the investigated compounds has been the antioxidant N-acetyl-L-cysteine (NAC). Studies at the cellular level have previously demonstrated that a single supplementation of NAC induces a ten-fold more rapid differentiation in normal primary human keratinocytes as well as a reversion of a colon carcinoma cell line from neoplastic proliferation to apical-basolateral differentiation 1. The investigated cells showed an early change in the organization of the cytoskeleton, several newly established adherens junctions with E-cadherin/β-catenin complexes and increased focal adhesions, all features characterizing the differentiation process. Methods In order to investigate the molecular mechanisms underlying the proliferation arrest and accelerated differentiation induced by NAC treatment of NHEK and Caco-2 cells in vitro, we performed global gene expression analysis of NAC treated cells in a time series (1, 12 and 24 hours post NAC treatment) using the Affymetrix GeneChip™ Human Genome U95Av2 chip, which contains approximately 12,000 previously characterized sequences. The treated samples were compared to the corresponding untreated culture at the same time point. Results Microarray data analysis revealed an increasing number of differentially expressed transcripts over time upon NAC treatment. The early response (1 hour) was transient, while a constitutive trend was commonly found among genes differentially regulated at later time points (12 and 24 hours). Connections to the induction of differentiation and inhibition of growth were identified for a majority of up- and down-regulated genes. All of the observed transcriptional changes, except for seven genes, were unique to either cell line. Only one gene, ID-1, was mutually regulated at 1 hour post treatment and might represent a common mediator of early NAC action. The detection of several genes that previously have been identified as stimulated or repressed during the differentiation of NHEK and Caco-2 provided validation of results. In addition, real-time kinetic PCR analysis of selected genes also verified the differential regulation as identified by the microarray platform. Conclusion NAC induces a limited and transient early response followed by a more consistent and extensively different expression at later time points in both the normal and cancer cell lines investigated. The responses are largely related to inhibition of proliferation and stimulation of differentiation in both cell types but are almost completely lineage specific. ID-1 is indicated as an early mediator of NAC action.