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Several studies have shown the efficacy and effectiveness of the Early Start Denver Model, both in university and in community-based settings. However, a limited number of studies have investigated predictors of outcomes. In this study, we examined outcomes in 32 children diagnosed with autism spectrum disorder after 1 year of community-based Early Start Denver Model intervention, with the aim to identify predictors of treatment objectives acquisition, as measured by the Early Start Denver Model Curriculum Checklist. At a group level, the participants demonstrated improvement in their communication as well as adaptive functioning skills, while they showed a decrease in symptom severity. The large heterogeneity in outcomes identified was related to the pre-treatment non-verbal abilities, symptom severity, action and gesture repertoire, and lexical comprehension. We discussed our results in terms of implications for developing "personalized" interventions for children with autism spectrum disorder.

Simple Summary: Competition and predation are the main factors shaping interspecific coexistence in wildlife communities. Species reappearance and introductions may alter these dynamics. The Eurasian beaver Castor fiber is a widespread species in Europe, and it is part of the diet of many birds and mammalian carnivores of all sizes. Additionally, competition with other herbivorous mammals at feeding sites could occur. For this reason, we computed the overlap of activity rhythms among the recently reappeared Eurasian beaver and its potential predators (red fox Vulpes vulpes and grey wolf Canis lupus) and competitors (coypu Myocastor coypus) in Central Italy. The beaver was confirmed as a mostly crepuscular species, avoiding the bright moonlight nights and the activity of its predators, which is potentially shaped by the behaviour of their main prey. Analyses of temporal partitioning and overlaps in activity rhythms are pivotal to shed light on interspecific coexistence between similar species or prey and predators. In this work, we assessed the overlap of activity rhythms between the Eurasian beaver Castor fiber and its potential competitors and predators through camera trapping in an area in Central Italy. Interspecific overlaps of temporal activity patterns were estimated for the beavers, potential predators (the red fox Vulpes vulpes and the grey wolf Canis lupus), and a potential competitor, the coypu Myocastor coypus. The beavers showed a mostly crepuscular behaviour. Although high temporal overlap was observed between the Eurasian beavers and the red foxes and grey wolves, the activity of the beavers did not overlap with that of the predators. Accordingly, the beavers were more active on the darkest nights, i.e., avoiding bright moonlight. [ABSTRACT FROM AUTHOR]

Objectives: To estimate the economic costs of oral lichen planus (OLP) through a multicenter university hospital–based outpatient study conducted in Italy and Finland. Materials and methods: A multicenter retrospective study was conducted on patients affected by OLP to evaluate the economic cost of managing the disease. Direct costs concerning diagnostic procedures, therapeutic management, and follow-up visits were obtained from clinical records. Statistics was performed with IBM SPSS Statistics. Results: One hundred and eight patients with a confirmed diagnosis of OLP (81 women and 27 men), 58 Italians and 50 Finnish, were enrolled in this study. The mean annual cost was 1087.2 euros per patient. The mean annual cost was higher in Finnish than in Italian cohort (1558.7 euros vs. 680.7 euros—p < 0.05). Within the Italian cohort, the local immunosuppressive therapy group and atrophic and erosive OLP type had a higher cost (p < 0.05). Within the Finnish cohort, the local immunosuppressive therapy group had a higher cost (p < 0.05). Conclusions: OLP-related costs are very similar to other chronic oral disorders (i.e., periodontitis) with differences between investigated countries. Moreover, patients with more severe clinical features, who need immunosuppressive therapy, are facing more expensive costs. Clinical relevance.: In this multicenter cost of illness study, we estimated the direct health care costs of OLP and we found that patients with more severe clinical features, who therefore need symptomatic therapy, are facing more expensive costs. [ABSTRACT FROM AUTHOR]

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

Purpose: Inadequate oral intake may play an important role in the onset of malnutrition in patients with Crohn's disease (CD). The aims of this cross-sectional study were: (1) to compare dietary intake in clinically active and quiescent CD patients, and (2) to assess patients' nutritional adequacy relative to the dietary reference values (DRVs) for the Italian population using LARN (Livelli di Assunzione di Riferimento di Nutrienti ed energia per la popolazione italiana). Methods: Patients aged between 18 and 65 years with a diagnosis of CD were recruited. All participants underwent anthropometry and were instructed to fill in a 3-day food record. Disease activity was clinically defined using the Crohn's disease activity index (CDAI). Results: Overall, 117 patients, 71 males and 46 females, with a mean age of 39.6 ± 13.8 years and a mean body weight of 65.4 ± 11.8 kg, were ultimately included. Our findings showed that the amount of nutrients was similar between patients with active and quiescent disease. The mean intake of macronutrients was adequate, except for fiber, while dietary micronutrients were insufficient. Median intakes of sodium, phosphorus, and fluorine met LARN recommendations in both sexes, and the DRVs were accomplished by many patients (53/117; 104/117 and 98/117, respectively). Interestingly, dietary amounts of iron and zinc were barely acceptable in males but not in females. However, a few of the patients (< 15) met the LARN for potassium, calcium, and magnesium, regardless of sex and CDAI. With respect to vitamins, no relevant difference was found between the active and quiescent groups, and none of them met recommended values in both sexes. Conclusions: This study showed that the assessment of dietary intake can be crucial for optimizing dietary intervention with focused nutrition counseling, to improve nutritional status in CD patients. [ABSTRACT FROM AUTHOR]

In July 2017, a survey was conducted in a fig collection plot at Locorotondo (south of Italy) to investigate the possible presence of phytoplasmas in plants showing yellowing, deformed leaves, short internodes, mottling and mosaic. Samples were collected from symptomatic plants and tested by nested PCR assays using universal and specific primers to amplify the 16S rDNA of these prokaryotes. PCR results detected the presence of phytoplasma sequences in twenty plant samples that resulted clustering two phylogenetically distinct phytoplasmas, i.e., "Candidatus Phytoplasma asteris" and "Candidatus Phytoplasma solani" affiliated to 16SrI and 16SrXII ribosomal groups, respectively. The presence of phytoplasmas belonging to both ribosomal groups was confirmed with group specific quantitative PCR and RFLP assays on 16S ribosomal amplicons. Results of this study indicate for the first time the occurrence of phytoplasmas in fig; however, more work should be carried out to verify their association with the symptoms observed on diseased fig plants. [ABSTRACT FROM AUTHOR]

Background: Xylella fastidiosa is a Gram-negative bacterium which lives in the xylem of plants, causing its occlusion and other alterations inducing eventually the death of the infected plants. In Salento, the sub-peninsula in the south-eastern of Apulia Region (southern Italy), the infection of X. fastidiosa has been associated with the widespread presence of CoDiRO (complex of parasitic agents that constitute the so-called 'olive quick decline syndrome') and currently represents a serious local emergence. The need to adopt specific agronomic measures to contrast the further disease spread has been recently raised. The extensive NMR-based metabolomic approach to study the metabolic effects of CoDiRO on local olive cultivars such as Ogliarola salentina and Cellina di Nardò was used. Results: In this study, the effects of a CE approved fertilizer containing zinc, copper, and citric acid, known as DENTAMET, on CoDiRO-exhibiting olive trees infected by X. fastidiosa were studied by H NMR spectroscopy. The changes in the metabolomic profiles of aqueous extracts obtained from leaves of the two olive cultivars are reported. Upon the DENTAMET treatments, different and opposite polyphenolic and sugars patterns in the two cultivars, which showed a different incidence and severity of disease before the treatments, were detected. Conclusions: Differences in the sugars and polyphenols content of treated versus untreated trees could potentially contribute to the syndrome monitoring and might be related to the X. fastidiosa presence. [ABSTRACT FROM AUTHOR]

Background/objectives: Anemia, leukopenia and, although less frequently, thrombocytopenia are possible hematological complications of anorexia nervosa considered strictly secondary to chronic malnutrition. This is a retrospective study on the prevalence of these disorders in a large cohort of 318 female patients with AN (20.4±5.6 years, body mass index (BMI) 15.9±1.6 kg/m2), recruited in the Outpatient Unit for Malnutrition secondary to Eating Disorders at the Department of Clinical Medicine and Surgery, Federico II University Hospital, since February 1991 to December 2012.Subjects/methods: Patients were studied on an outpatient basis after obtaining medical history, clinical examination, routine hematobiochemical and endocrine tests, electrocardiography, psychiatric interview and bioelectrical impedance analysis and, in particular, phase angle determination. All patients with other comorbidities, in particular with mean corpuscular volume <80 fl, were excluded for suspected genetic alteration in the synthesis of hemoglobin.Results: Hematologic data showed that 16.7% of patients had anemia, 7.9% neutropenia and 8.9% thrombocytopenia. These abnormalities were strictly related to the duration of illness (P=0.028), and to protein energy malnutrition, in particular, BMI and phase angle (P<0.001).Conclusions: Our study offers description of the incidence of hematologic defects in a selected and large sample of AN female patients, suggesting that its incidence is related to the degree and duration of protein energy malnutrition. [ABSTRACT FROM AUTHOR]

Objective:To evaluate the prevalence of β3-adrenergic receptor (ADRB3) Trp64Arg polymorphism and its relationship with the metabolic syndrome in severe obesity.Design:Cross-sectional outpatients study.Patients and methods:In 265 (100 men) severely obese non-diabetic subjects and 78 (25 men) healthy volunteers, genomic DNA was isolated from peripheral leukocytes. In obese patients, plasma concentrations of leptin, lipids, glucose and insulin, the homeostasis model assessment index and blood pressure have been measured. The Trp64Arg mutation was identified with the real-time TaqMan method.Results:Neither genotype distribution nor allele frequency differed between the two groups. The metabolic syndrome prevalence was 59% in obese subjects, and was higher in men than in women (65 vs 55%: P=0.03). The body mass index (BMI) was related to age tertiles (β=0.08; P<0.001; multiple linear regression) in Trp64Arg-positive obese subjects.Conclusion:We confirm the high prevalence of the metabolic syndrome among severely obese subjects. ADRB3 polymorphism was significantly related to insulin resistance only in obese male subjects. Moreover, increased BMI was related to age in obese subjects with the ADRB3 polymorphism.Sponsorship:MIUR, COFIN 2004.European Journal of Clinical Nutrition (2007) 61, 1213–1219; doi:10.1038/sj.ejcn.1602640; published online 14 February 2007 [ABSTRACT FROM AUTHOR]

Objective:To evaluate long-term mortality rate of anorexia nervosa (AN) patients in a southern Italy population compared to the most recent literature.Design:Retrospective and review setting.Patients and interventions:One hundred and forty-seven female AN patients, consecutively admitted from 1994 to 1997 to the Outpatient Unit, were re-examined between June and November 2003. Our data are compared with 10 other studies published since 1988.Results:One hundred and twenty-three deaths in 2240 patients, amounting to a total mortality rate of 5.25% were reported in the literature. Deaths due to suicide, AN-related and AN-unrelated diseases were 1.20, 3.07 and 0.98%, respectively. After correcting for unrelated deaths, mortality rate was 4.27%. In our 8-year follow-up, we found a mortality rate of 2.72% (1.82% after correcting for unrelated deaths). Standardized mortality ratio was 9.7.Conclusion:We interpret our favourable findings as a consequence of an integrated, clinical–nutritional and psychiatric approach. Finally, considering AN demographic characteristics, that is young female subjects in Westernized societies, mortality rate is confirmed to be dramatically high.Sponsorship:‘Federico II’ University of Naples.European Journal of Clinical Nutrition (2007) 61, 119–122. doi:10.1038/sj.ejcn.1602491; published online 2 August 2006 [ABSTRACT FROM AUTHOR]

Aim:To evaluate the current use of Home Parenteral Nutrition (HPN) in a Southern European region.Subjects and methods:A total of 159 (86 m, 73 f) HPN patients, mean age 60.1±14.2 years, BMI 18.8±3.3 kg/m2, consecutively referred to the Artificial Nutrition outpatient Unit of the Federico II University Hospital in Naples (Italy), from January 2000 to December 2002 and treated for at least 4 weeks. Retrospective evaluation of baseline disease, indications and duration of HPN treatment, type of venous access, complications.Results:In all, 140 (88%) were cancer and 19 (12%) noncancer patients. Main indications were carcinosis in 68 for total, and hypophagia/dysphagia in 62 patients for partial/integrative (to oral-enteral nutrition) HPN; mean duration of HPN was 81.45±110.86 days of treatment and infection rate 2.89‰ in the whole population and 2.66‰ in the 36 patients treated for more than 3 months. No other major complications have been observed.Conclusion:HPN is confirmed to be a safe and effective treatment when prescribed and administered by a trained team.European Journal of Clinical Nutrition (2006) 60, 58–61. doi:10.1038/sj.ejcn.1602267; published online 31 August 2005 [ABSTRACT FROM AUTHOR]

To analyse the association of the UCP2 gene, alone or in combination with the PPARγ2 gene, with obesity. Cross-sectional, case–control study. From a working population of 4500 Italian Caucasian employees of the Italian telephone company participating in a firm-sponsored health screening programme, we selected all those with obesity [ n = 122; body mass index (BMI) ≥ 30 kg/m2]. For each case, three nonobese age- and sex-matched individuals were selected as controls from the same population ( n = 374). Included in the study were also 76 severely obese (BMI ≥ 40 kg/m2) patients consecutively admitted to the obesity clinic of the department. Diabetic individuals were excluded. The −866G/A UCP2 and the Pro12Ala PPARγ2 polymorphisms were determined on genomic DNA of the studied individuals. Several metabolic and anthropometric measures were also obtained, like plasma glucose, insulin, triglycerides, total cholesterol, high-density lipoprotein (HDL) cholesterol and BMI. BMI, plasma glucose, insulin, triglycerides, total and HDL cholesterol were not significantly different in carriers and noncarriers of the −866G/A variant. No significant association was observed between the −866G/A UCP2 gene polymorphism and moderate or severe obesity. This was also observed when the UCP2 polymorphism was analysed in combination with the PPARγ2 polymorphisms. The −866G/A variants of the UCP2 gene are not associated with either obesity or other features of the metabolic syndrome in the studied groups of the Italian population. This negative finding is not modified after a combined analysis of the UCP2 polymorphism and the Pro12Ala polymorphism of PPARγ2. [ABSTRACT FROM AUTHOR]

Background: Based on recent findings, we speculated the existence of the lung, heart, and kidney axis as the main pathway for the COVID-19 disease progression. Methods: This paper reports on an observational study conducted by a team of researchers and doctors of the 118-Pre-Hospital and Emergency Department of SG Moscati of Taranto City in Italy. The study was conducted on a totality of 185 participants that were divided into three groups. The study group included COVID-19 affected patients (PP n = 80), the first control group included patients with different pathologies (non-COVID-19 NNp n = 62) of the SG Moscati Hospital, and the second control group included healthy individuals (NNh n = 43). The core of the current trial was focused on assessing the level of the vitamin D (serum 25(OH) D concentration), IL-6, and the renal glomerular filtrate (eGFR) in COVID-19 disease and non-COVID-19 patients in both groups. Results: It was observed that the majority of COVID-19-infected patients showed a progressive multi-organ involvement, especially in regard to the lung, kidney, and heart. The majority of the COVID-19 patients exhibited preexisting comorbidities which include cardiovascular, respiratory, and renal disorders accompanied by a severely low level of vitamin D, extremely high level of IL-6, and low glomerular filtration rate (eGFR). The significant overall damages exerted by the immune-mediated responses under the hyper-expression of proinflammatory cytokines and interleukins, such as IL-6, may be facilitated by either a decreased level of vitamin D or the ageing process. The reduced presence of vitamin D was often found together with a reduced functionality of renal activity, as revealed by the low eGFR, and both were seen to be concomitant with an increased mortality risk in patients with lung disorders and heart failure (HF), whether it is showed at baseline or it develops during manifestation of COVID-19. Therefore, the documentation of the modifiable risk factors related to SARS-CoV-2 and lung impairment in older patients with kidney and heart disease may help the clinician to better manage the situation. Conclusions: This paper addresses how a low level of vitamin D and older age may be indicative of systemic worsening in patients with COVID-19, with a goal of providing a broader context in which to view a better therapeutic approach. [ABSTRACT FROM AUTHOR]

We performed an epidemiologic study to assess the prevalence of chronic viral hepatitis in inflammatory bowel disease (IBD) and to detect their possible relationships. Methods: It was a single centre cohort cross-sectional study, during October 2016 and October 2017. Consecutive IBD adult patients and a control group of non-IBD subjects were recruited. All patients underwent laboratory investigations to detect chronic hepatitis B (HBV) and C (HCV) infection. Parameters of liver function, elastography and IBD features were collected. Univariate analysis was performed by Student's t or chi-square test. Multivariate analysis was performed by binomial logistic regression and odds ratios (ORs) were calculated. We enrolled 807 IBD patients and 189 controls. Thirty-five (4.3%) had chronic viral hepatitis: 28 HCV (3.4%, versus 5.3% in controls, p = 0.24) and 7 HBV (0.9% versus 0.5% in controls, p = 0.64). More men were observed in the IBD–hepatitis group (71.2% versus 58.2%, p < 0.001). Patients with IBD and chronic viral hepatitis had a higher mean age and showed a higher frequency of diabetes, hypertension and wider waist circumference. They suffered more frequently from ulcerative colitis. Liver stiffness was greater in subjects with IBD and chronic viral hepatitis (7.0 ± 4.4 versus 5.0 ± 1.2 KPa; p < 0.001). At multivariate analysis, only old age directly correlated with viral hepatitis risk (OR = 1.05, 95%CI 1.02–1.08, p < 0.001). In conclusion, the prevalence of HBV/HCV in IBD is low in our region. Age may be the only independent factor of viral hepatitis–IBD association. Finally, this study firstly measured liver stiffness in a large scale, showing higher values in subjects with both diseases. [ABSTRACT FROM AUTHOR]

Rosemary (Rosmarinus officinalis) family Lamiaceae, is a common and attractive evergreen shrubby species growing wild in the Mediterranean area, but cultivated for aromatic, ornamental and medicinal purposes. The interest towards this species is strongly arising, due to the biological activity of essential oils extracted from leaves and flowers. In the spring 2011, symptoms of yellowing, necrotic spots, leaf rolling and stunting were observed on rosemary plants in three commercial aromatic plant-growing farms of Piana di Albenga (Liguria, northen Italy); in 2012 other plants showing witches' broom symptoms were collected in the same area. To verify phytoplasma presence and to determine their identity, symptomless and symptomatic samples were tested by direct PCR with universal primers P1A/P7A, followed by nestedPCR using primers F1/B6 or R16F2n/R2. Only from symptomatic samples bands of the expected length were obtained and RFLP analyses using restriction enzyme Tru1I allowed the classification of phytoplasmas as members of ribosomal group 16SrXII-A (stolbur) in the 2011 samples and 16SrI-B (aster yellows) in the 2012 samples. The presence of phytoplasma in rosemary represents the first report for this species. Considering that Liguria is the most important Italian region for aromatic plants production, for a rapid and efficient eradication of this disease it is necessary to eliminate all symptomatic plants that could play a role in the epidemiology of stolbur and aster yellows, as well as vectors (leafhoppers) and weeds, using suitable mechanical methods. Specific phytoplasma control of mother-plants before their vegetative propagation is also a necessity to prevent economic losses in rosemary crops. [ABSTRACT FROM AUTHOR]

• Current rehabilitation practices are poorly defined in Dravet Syndrome. • This survey provides a comprehensive view of rehabilitation in Italy. • Speech therapy and neuropsychomotricity are prescribed for almost all children. • Many adolescents and adults discontinue rehabilitation despite significant morbidities. • Neurovisual training, Augmentative and Alternative Communication, and Occupational therapy are rarely used. Dravet syndrome, a developmental and epileptic encephalopathy, manifests with varying degrees of cognitive and communication impairment, postural and movement disorders (such as ataxia, coordination issues, and crouch gait) and behavioural challenges (including attention deficit/hyperactivity, oppositional/defiant behaviour, and autistic traits). Rehabilitation is a valuable tool for most patients, typically prescribed to address the most pressing issues. However, current practices often fall short in proactively preventing and treating known challenges associated with the syndrome, as indicated by the latest literature, at different life stages. Furthermore, there is a notable lack of evidence regarding treatment types and efficacy specific to people with Dravet Syndrome. Conducted in collaboration with one of the Italian Patient associations, this national survey provides a comprehensive view of the rehabilitation landscape in Dravet Syndrome, as perceived by caregivers. It outlines the types of treatments for 51 patients, based on age and relevant clinical features. The findings reveal a heterogenous rehabilitation approach, only partly tailored to the presence of specific comorbidities, and underline numerous unmet needs. Compared to the past there is indirect evidence that more patients are offered early rehabilitation. Nonetheless, while nowadays speech therapy and neuropsychomotor therapy are nearly universal for children up to the age of 10, some begin physiotherapy and psychotherapy thereafter, with a majority discontinuing treatments. Therefore, families of adolescent and adult patients often face a lack of comprehensive support, predominantly offered when epilepsy is more challenging to control affecting rehabilitation adherence and effectiveness. Finally, a negligible minority is offered treatments such as neurovisual training, augmentative and alternative communication, and occupational therapy. Many of these considerations could apply to other developmental and epileptic encephalopathy with lifelong disability. This survey calls for more data collection on this important topic for more efficient allocation of rehabilitation resources. [ABSTRACT FROM AUTHOR]

Objectives: Sarcopenic obesity has not yet been widely defined. The aim of this study was to evaluate the prevalence of sarcopenia in a group of severely obese adults from southern Italy by using two different indexes: percentage of skeletal muscle mass (SMP) and skeletal muscle mass normalized for height (SMI); and to determine SMP and SMI cutoff points in a southern Italy reference population. Methods: Skeletal muscle mass of 131 consecutive obese adult outpatients (51 men and 80 women; ages 45-67 y; body mass index 44.6 ± 7.7 kg/m²), was assessed by bioimpedance analysis. SMP and SMI cutoff points to identify moderate and severe sarcopenia were calculated in a reference group of 500 young southern Italy adults (100 men and 400 women; ages 18-40 y; body mass index 25.2 ± 5.6 kg/m²) and applied to assess the prevalence of sarcopenia in the study population. Results: SMP cutoff points to identify moderate and severe sarcopenia were, 28.8% to 35.6% and ≤28.7% in men and 23.1% to 28.4% and ≤23% in women, respectively. The corresponding values for SMI were 8.44 to 9.53 kg/m² and ≤8.43 kg/m² in men, 6.49 to 7.32 kg/m² and 6.48 kg/m² in women. According to SMP, 23 of 51 (45.1%) men and 19 of 80 (23.8%) women were moderately sarcopenic; 28 of 51 (54.9%) men and 61 of 80 (76.3%) women met the definition of severe sarcopenia. Based on SMI, only 2 of 51 (3.9%) men were moderately sarcopenic. Conclusions: This study confirms that sarcopenia rates vary widely in obese patients depending on the criteria used. SMP as a screening tool to identify a sarcopenia at-risk population. [ABSTRACT FROM AUTHOR]

Brown adipose tissue, where Uncoupling Protein 1 (UCP1) activity uncouples mitochondrial respiration, is an important site of facultative energy expenditure. This tissue may normally function to prevent obesity. Our aim was to investigate by sequence analysis the presence of UCP1 gene variations that may be associated with obesity. We studied 100 severe obese adults (BMI > 40kg/m²) and 100 normal-weight control subjects (BMI range = 19-24.9kg/m²). We identified 7 variations in the promoter region, 4 in the intronic region and 4 in the exonic region. Globally, 72% of obese patients bore UCP1 polymorphisms. Among UCP1 variants, g.IVS4-208T>G SNP was associated with obesity (OR: 1.77; 95% CI = 1.26-2.50; P = .001). Further, obese patients bearing the g.-451C>T (CT+TT) or the g.940G>A (GA+AA) genotypes showed a higher BMI than not polymorphic obese patients (P = .008 and P = .043, resp.). In conclusion, UCP1 SNPs could represent "thrifty" factors that promote energy storage in prone subjects. [ABSTRACT FROM AUTHOR]

Inflammatory bowel diseases (IBD) have a large economic burden on health systems. Our single-centre observational retrospective study aimed to assess an economic evaluation in two IBD outpatient cohorts (biological and conventional therapy) in relation to disease activity within a three-year follow-up. Four hundred and seventeen consecutive IBD patients referred to our tertiary gastroenterology unit (Bari-Puglia-Southern Italy) on January 2014-December 2016 were included. For each group (conventional/biological), we assessed direct/indirect costs and clinical/endoscopic activity within the first year and along the three-year follow-up. Statistical analyses: Wilcoxon signed-rank test (continuous variables), chi-square and Fisher's test (categorical variables), Spearman ranks (single outcome) and ANOVA (detection time, clinical/endoscopic scores) were used. Continuous variables were expressed as mean ± standard deviation and range and/or median, interquartile range and range; categorical variables were expressed as proportions with 95% confidence interval. Direct and indirect cost items of 2014 and 2014-2016 were higher in patients treated with biological than conventional therapy. Subjects on biological therapy were younger and showed clinical and endoscopic moderate-to-severe disease activity. After three years, they reached a significant improvement from baseline. Conversely, disease activity was mild when conventional treatment had a beneficial effect. In conclusion, overall IBD management cost matches with clinical course and needs long-term evaluation in critical patients.

Background: Nonalcoholic fatty liver disease (NAFLD) is common in inflammatory bowel diseases (IBD). Herein, NAFLD prevalence and risk factors in a large IBD cohort were evaluated and compared to that of a non-IBD sample., Methods: Crohn's disease/ulcerative colitis outpatients referred to IBD service of our Gastroenterology Unit were enrolled. Subjects affected by functional and motor gastrointestinal disorders, in whom IBD was ruled out, referred to general outpatient service in the same area, were considered as nonIBD group. Exclusion criteria were based on previous diagnosis of nonNAFLD chronic liver diseases and secondary causes of fat liver overload. Characteristics of IBD and liver status were collected. Risk factors for metabolic syndrome were analyzed. Ultrasonographic presence and degree of steatosis were assessed. Data were examined by univariate and multivariate analyses., Results: For this study 465 IBD and 189 non-IBD subjects were consecutively enrolled. NAFLD was found in 28.0% and 20.1% in IBD and non-IBD subjects, respectively (P = 0.04). IBD patients with NAFLD were younger than non-IBD ones. There was no significant difference in steatosis grade and association between NAFLD and IBD behavior, extension, activity, and drugs. In the IBD group, multivariate analysis demonstrated that NAFLD was independently associated to metabolic syndrome (OR=2.24, 95%CI 1.77-28.81), diabetes (OR=1.71, 95%CI 1.43-12.25), fasting blood glucose (OR=1.36, 95%CI 1.13-1.68), and abdominal circumference (OR=1.68, 95%CI 1.15-14.52)., Conclusions: NAFLD is more common and occurs at a younger age in IBD than in nonIBD subjects. However, further investigation is required to ascertain possible NAFLD pathogenic IBD-related factors other than conventional/metabolic ones. 10.1093/ibd/izy051&#95;video1izy051.video15774874877001.

Objective: Several studies support the view that Helicobacter pylori is acquired in early life and within families. However, the exact route of transmission remains unknown. Given that H. pylori colonizes only the human gastric mucosa, the hypothesis that history of vomiting in siblings may be a relevant risk factor was tested in a paediatric setting., Methods: One hundred urban children (age range 0.8-16.6 years, median 9), 44% with evidence of active H. pylori infection, were recruited. A structured questionnaire dealing with socio-economic issues was completed. Vomiting siblings and siblings of vomiting index children were screened for H. pylori by means of (13)C-urea breath test. Serum samples from index children were assayed for immunoglobulin G to hepatitis A (HAV) and Epstein-Barr virus (EBV) in order to check for faecal-oral and oral-oral exposure, respectively., Results: Vomiting siblings of H. pylori-infected index children and siblings of H. pylori-infected vomiting index children had a high rate of active H. pylori infection (60 and 67%, respectively). History of vomiting in siblings was positively associated with active H. pylori infection in the index children (multivariate odds ratio 2.4, 95% confidence interval 1.3-4.3). Seropositivity for HAV and EBV was found in 1 and 68 index children, respectively. The agreement between active H. pylori infection and EBV seropositivity was not significant (kappa = 0.26)., Conclusions: History of vomiting in siblings is an independent risk factor for H. pylori. Nowadays, transmission of H. pylori in urban children may involve the gastro-oral route more than the faecal-oral or oral-oral pathways.