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Salvatore Settineri,1 Fabio Frisone,2 Emanuele Maria Merlo,2 Daniele Geraci,3 Gabriella Martino31Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy; 2Department of Cognitive Sciences, Psychology, Educational and Cultural Studies (COSPECS), University of Messina, Messina, Italy; 3Department of Clinical and Experimental Medicine, University of Messina, ItalyBackground: The pathological reality of diabetes and the incidents in following the prescribed therapies have been considered and are still a serious and relevant problem in the health sector.Objective: This review aims at highlighting the importance of clinical psychological phenomena that underlie the notion of therapies.Methods: The review was conducted through search engines such as PubMed, Medline, Web of Science and Google Scholar. The articles related to compliance, adherence, concordance, empowerment and the self-management of diabetes were included, in order to highlight the possible similarities and differences that these terms bring with them in them management of diabetes.Results: Starting from 252 initial publications, 101 articles were selected that highlighted the practical implications that each term has compared to the others.Conclusion: The review can represent a bridge between the medical approach and clinical psychology, in which integration can suggest paths aiming at improving patients’ existential conditions and adaptation.Keywords: compliance, adherence, concordance, empowerment, self-management, diabetes

Recent development of nanotechnology allows precise assessment of the risks workers are exposed to. To assess the risks, a specific risk assessment model has been developed with reference to workplaces where nanoparticles are present. This model allows identification and quantification of the health hazards for workers. The use of nanomaterials presents some uncertainties regarding effective level of danger, and risk assessment takes this into consideration with the help of an appropriate index. An evaluation algorithm considers both normal work conditions and abnormal/emergency situations. Evaluation outcome consists of several risk levels with several subdivisions. For each single level, it is possible to develop specific behavioral guidelines. The present evaluation model has been implemented in research laboratories. The results are middle to high-level risks. [ABSTRACT FROM AUTHOR]

Pollen allergens are multivalent proteins that cross‐link IgE antibodies on mast or basophil cells, inducing secretion of biologic mediators, and resulting in various allergic symptoms. The IgE‐binding regions of the Parietaria judaica (Pj) pollen major allergen rPar j 2 were investigated. Twenty‐nine single sera from Pj‐allergic subjects were tested by Western blot against five recombinant peptides. At least four putative IgE‐binding epitopes were identified. The analysis of their diffusion suggested a heterogeneous IgE‐binding response. In fact, 75% of the sera reacted with peptide 1–54, 48% with peptide 48–101, 24% with peptide 1–30, 7% with peptide 29–54, and none with peptide 48–76. These five peptides were analyzed with the histamine‐release assay. Only peptide 48–101 was capable of inducing degranulation and release of histamine. These results suggest that the recombinant rPar j 2 allergen contains IgE epitopes that are heterogeneously recognized by sensitive patients, and that therefore the therapeutic approach based on the use of haptenic peptides needs a careful evaluation. [ABSTRACT FROM AUTHOR]

The relationship between maternal hormones and factors secreted by the implanting embryo is still controversial. We have analysed the in-vitro effect of oestradiol and human embryo-derived histamine-releasing factor (EHRF) on histamine release from rat uterine mast cells. Rat uterine mast cells which were preincubated with oestradiol and then challenged with human EHRF gave histamine release values two- to threefold higher than those without preincubation. The enhancement observed was time- and temperature-dependent. A similar enhancement was obtained with human sensitized basophils but not with rat peritoneal mast cells. Oestradiol, used as a direct challenge, did not induce any histamine release from either rat uterine or peritoneal mast cells, or from human sensitized basophils. Oestradiol preincubation also enhanced the histamine release induced by anti-IgE but did not enhance the histamine release induced by substance P or compound 48/80, two secretagogues that are not mediated by IgE. Moreover, uterine fragments derived from rats at various oestrus phases, with different amounts of endogenous oestrogen, were challenged in vitro with EHRF. The release of histamine by mast cells was higher at the proestrus and preimplantation phases than at dioestrus. All these findings suggest that the interaction of oestradiol with rat uterine mast cells was capable of enhancing in vitro the histamine releasing effect of EHRF. [ABSTRACT FROM AUTHOR]

The interaction between human early pregnancy factor (EPF) and a specific receptor present on human peripheral blood mononuclear cells (PMBC) has been assessed. EPF was radioiodiated by the lactoperoxidase method to a high specific activity, and the [125I]EPF obtained bound in a specific and saturable manner to the receptors on PBMC. Saturation of the binding sites occurred at 10(-9) M. There were 6600 specific binding sites per cell in cells partially purified from pregnant women and fewer in those from non-pregnant women. Unlabelled EPF was capable of competing for binding sites with [125I]EPF, while the binding of [125I]EPF was not inhibited by human chorionic gonadotrophin. A new assay was used that permits the culture of PBMC and the detection of the surface IgG expression in the same microplate. With this method the influence in vitro of human EPF on lymphocyte expression was tested. The results demonstrated a specific inhibition of surface IgG expression of PBMC using a very low concentration of EPF (10 pg/ml). [ABSTRACT FROM AUTHOR]

Sixty-six sera were analysed by solid-phase conglutinin binding assay, to detect the levels of circulating immune complexes (CIC), and by enzyme-linked immunosorbent assay (ELISA) to show a correlation with antibodies to Thermoactinomyces vulgaris. Sixty per cent of patients with usual interstitial pulmonary fibrosis (UIP), were positive for CIC; and T. vulgaris antibodies were detected in 60% of the same patients. In comparison, there was a low frequency of positive results in bronchitis patients (5% for CIC and 35% for T. vulgaris), and in normal blood donors (0% for CIC and 30% for T. vulgaris). Further- more 31% of patients with lung cancer were found positive for CIC, but not for T. vulgaris. Immune complexes purified on Protein A-Sepha rose and by sucrose density gradient from patients with UIP, showed a sedimentation coefficient higher than 19 S. The purified material was found to contain IgG and IgM as antibodies. Binding of immune complexes, purified by sedimentation on sucrose gradient, to conglutinin was inhibited by the presence of T. vulgaris antigen; thus suggesting that this antigen might be present in the complexes. [ABSTRACT FROM AUTHOR]

In this paper are presented preliminary results on the identification of a histamine-releasing factor. This factor was partially purified by means of affinity heparin-Sepharose chromatography from media in which 2-cell human embryos were cultured. The culture was performed in preparation for an in-vitro fertilization (IVF) programme. The mean value of histamine release evoked by the embryo-derived histamine-releasing factor (EHRF) was 56.7%. The release was not due to cytotoxicity since no histamine release was obtained with unsensitized cells and when the assay was performed at 4 degrees C. As a control, no histamine release was obtained using medium from unfertilized oocytes or medium alone. The EHRF could be one of the first signals from the embryo to the uterus. The immunosuppressive activity of histamine is well known, and we suggest that the local secretion of histamine in vivo by uterine mast cells, alone or in cooperation with other factors and/or mechanisms could play a role in preventing maternal immuno-rejection at the implantation stage. [ABSTRACT FROM AUTHOR]

Abstract Background Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has recently emerged as an important pathogen in neonatal intensive care units (NICUs). The purposes of this study were to characterize methicillin-resistant isolates from an outbreak in a NICU, to examine the genetic traits and clonality of CA-MRSA, and to review the characteristics and outcomes of the neonatal cases and investigate the routes of entry and transmission of the MRSA outbreak strain in the NICU under study. Methods The study NICU practiced an active surveillance program for multidrug-resistant organisms, including weekly cultures for detection of MRSA from nasal swabs among all the admitted neonates. All first isolates from surveillance cultures and all clinical isolates were submitted for susceptibility testing and genotyping. Data from each infant’s medical records were prospectively included in a database, and the clinical features and outcomes of the colonized/infected infants were assessed. Results A total of 14 infants were colonized or infected by a strain of ST1-MRSA-IVa between April and August 2011. The CA-MRSA strain appeared to have been introduced to the NICU by an infected infant transferred from another hospital. The outbreak was successfully contained by multifaceted infection control interventions. Conclusions The results of this study confirm that NICU is a healthcare setting with a critical permeability to CA-MRSA. Active surveillance including molecular typing can help to detect and monitor the spread of antimicrobial drug-resistant organisms, and thus trigger timely control interventions.

Abstract Background Compared to those in higher socioeconomic groups, diabetic patients in lower socioeconomic groups have less favourable metabolic control and experience more diabetes-related complications. They encounter specific barriers that hinder optimal diabetes self-management, including a lack of social support and other psychosocial mechanisms in their immediate social environments. Powerful Together with Diabetes is a culturally sensitive social network intervention specifically targeted to ethnic Dutch, Moroccan, Turkish, and Surinamese diabetic patients in lower socioeconomic groups. For ten months, patients will participate in peer support groups in which they will share experiences, support each other in maintaining healthy lifestyles, and learn skills to resist social pressure. At the same time, their significant others will also receive an intervention, aimed at maximizing support for and minimizing the negative social influences on diabetes self-management. This study aims to test the effectiveness of Powerful Together with Diabetes. Methods/Design We will use a quasi-experimental design with an intervention group (Group 1) and two comparison groups (Groups 2 and 3), N = 128 in each group. Group 1 will receive Powerful Together with Diabetes. Group 2 will receive Know your Sugar, a six-week group intervention that does not focus on the participants' social environments. Group 3 receives standard care only. Participants in Groups 1 and 2 will be interviewed and physically examined at baseline, 3, 10, and 16 months. We will compare their haemoglobin A1C levels with the haemoglobin A1C levels of Group 3. Main outcome measures are haemoglobin A1C, diabetes-related quality of life, diabetes self-management, health-related, and intermediate outcome measures. We will conduct a process evaluation and a qualitative study to gain more insights into the intervention fidelity, feasibility, and changes in the psychosocial mechanism in the participants' immediate social environments. Discussion With this study, we will assess the feasibility and effectiveness of a culturally sensitive social network intervention for lower socioeconomic groups. Furthermore, we will study how to enable these patients to optimally manage their diabetes. This trial is registered in the Dutch Trial Register: NTR1886