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Objective: To describe the clinical and ultrasound characteristics of recurrent granulosa cell and Sertoli–Leydig cell tumors. Methods: This was a retrospective observational study performed at Fondazione Policlinico Universitario A. Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico, IRCCS, Rome (Gemelli center), Italy. Patients with a histological diagnosis of recurrent granulosa cell tumor or Sertoli–Leydig cell tumor were identified from the database of the Department of Gynecological Oncology. Those who had undergone a preoperative ultrasound examination at the Gemelli center between 2012 and 2020 were included, and the data retrieved from the original ultrasound reports. In all of these reports, the recurrent tumors were described using International Ovarian Tumor Analysis (IOTA) terminology. If a patient had more than one episode of relapse, information from all episodes was collected. If there was more than one recurrent tumor at the same ultrasound examination, all tumors were included. One expert sonographer also reviewed all available ultrasound images to identify typical ultrasound patterns using pattern recognition. Results: We identified 30 patients with a histological diagnosis of recurrent granulosa cell tumor (25 patients, 55 tumors) or Sertoli–Leydig cell tumor (five patients, seven tumors). All 30 had undergone at least one preoperative ultrasound examination at the Gemelli center and were included. These women had a total of 66 episodes of relapse, of which a preoperative ultrasound examination had been performed at the Gemelli center in 34, revealing 62 recurrent lesions: one in 22/34 (64.7%) episodes of relapse, two in 4/34 (11.8%) episodes and three or more in 8/34 (23.5%) episodes. Most recurrent granulosa cell tumors (38/55, 69.1%) and recurrent Sertoli–Leydig tumors (6/7, 85.7%) were classified as solid or multilocular‐solid tumors, while 8/55 (14.5%) recurrent granulosa cell tumors and 1/7 (14.3%) recurrent Sertoli–Leydig cell tumors were unilocular cysts and 9/55 (16.4%) recurrent granulosa cell tumors were multilocular cysts. The nine unilocular cysts had contents that were anechoic (n = 2) or had low‐level echogenicity (n = 7), had either smooth (n = 4) or irregular (n = 5) internal cyst walls, and ranged in largest diameter from 8 to 38 mm, with three being < 20 mm and five being 20–30 mm. On retrospective review of the images, two typical ultrasound patterns were described: small solid tumor measuring < 2 cm (15/62, 24.2%) and tumor with vascularized echogenic ground‐glass‐like content (12/62, 19.4%). Conclusions: Some granulosa cell and Sertoli–Leydig cell recurrences manifest one of two typical ultrasound patterns, while some appear as unilocular cysts. These are usually classified as benign, but in patients being followed up for a granulosa cell tumor or Sertoli–Leydig cell tumor, a unilocular cyst should be considered suspicious of recurrence. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

Background: Population-based surveys on the quality of life of people with Down syndrome (DS) are difficult to perform because of ethical and legal policies regarding privacy and confidential information, but they are essential for service planning. Little is known about the sample size and variability of quality of life of people with DS living in the city of Rome, which has a population of 2.7 million inhabitants. The aim of the present study is to explore the needs and challenges in health, social integration and daily life, of people with DS living in Rome. Methodology: A cross-sectional, census-based survey was conducted in 2006. All family doctors (3016 in total) of the National Health Service were involved by the Statistical Bureau of the Municipality of Rome. As per the census, every resident citizen is registered with a family doctor and every person with disabilities is coded. Associations for Down Syndrome encouraged their members to participate in the research. Questionnaires were completed by families of people with DS, in accordance with privacy laws. Findings: An initial survey, conducted via a letter and a telephone contact with family doctors, identified 884 people with DS residing in the city of Rome. Data on the medical and social conditions of 518 people with DS, ranging in age from 0 to 64 years, were collected. Some 88% of these were living with their original family; 82.1% had one or more siblings, and 19.5% had lost one or both parents. A full 100% of children with DS were enrolled in the public school system. This ensures that they are fully occupied and entirely integrated in society. After secondary school there is a lack of opportunities. Thus, only 10% of adults were working with a regular contract. A mere 42.2% of people with DS aged 25-30 were involved in some form of regular activity (although not always on a daily basis). After the age of 30, the percentage of people demonstrating decline in function increased sharply, while disability-related support decreased. In other words, as people with DS age, daily life evolves increasingly around the home, with only occasional outdoor activities. Conclusion: The health, employment and social needs of the majority of people with DS in the city of Rome are not being met. The findings of this study underscore the urgent need for more comprehensive inclusion in society of adults with DS and for the provision of support services to create an enabling environment for inclusion. Because of the variability of performance among individuals with DS, there is a need to create more case-specific options in terms of work, living arrangements, social networking and medical services. Schooling and social inclusion in childhood alone do not guarantee a satisfactory quality of life in adulthood. It is argued herewith that policy of inclusion and support should extend over the entire lifetime of people with DS.

Background: The World Health Organization (WHO) has approved the 11th Revision of the International Classification of Diseases (ICD‐11). A version of the ICD‐11 for Mental, Behavioural and Neurodevelopmental Disorders for use in clinical settings, called the Clinical Descriptions and Diagnostic Requirements (CDDR), has also been developed. The CDDR includes behavioural indicators (BIs) for assessing the severity of disorders of intellectual development (DID) as part of the section on neurodevelopmental disorders. Reliable and valid diagnostic assessment measures are needed to improve identification and treatment of individuals with DID. Although appropriately normed, standardised intellectual and adaptive behaviour assessments are considered the optimal assessment approach in this area, they are unavailable in many parts of the world. This field study tested the BIs internationally to assess the inter‐rater reliability, concurrent validity, and clinical utility of the BIs for the assessment of DID. Methods: This international study recruited a total of 206 children and adolescents (5–18 years old) with a suspected or established diagnosis of DID from four sites across three countries [Sri‐Lanka (n = 57), Italy (n = 60) and two sites in India (n = 89)]. Two clinicians assessed each participant using the BIs with one conducting the clinical interview and the other observing. Diagnostic formulations using the BIs and clinical utility ratings were collected and entered independently after each assessment. At a follow‐up appointment, standardised measures (Leiter‐3, Vineland Adaptive Behaviour Scales‐II) were used to assess intellectual and adaptive abilities. Results: The BIs had excellent inter‐rater reliability (intra‐class correlations ranging from 0.91 to 0.97) and good to excellent concurrent validity (intra‐class correlations ranging from 0.66 to 0.82) across sites. Compared to standardised measures, the BIs had more diagnostic overlap between intellectual and adaptive functioning. The BIs were rated as quick and easy to use and applicable across severities; clear and understandable with adequate to too much level of detail and specificity to describe DID; and useful for treatment selection, prognosis assessments, communication with other health care professionals, and education efforts. Conclusion: The inclusion of newly developed BIs within the CDDR for ICD‐11 Neurodevelopmental Disorders must be supported by information on their reliability, validity, and clinical utility prior to their widespread adoption for international use. BIs were found to have excellent inter‐rater reliability, good to excellent concurrent validity, and good clinical utility. This supports use of the BIs within the ICD‐11 CDDR to assist with the accurate identification of individuals with DID, particularly in settings where specialised services are unavailable. [ABSTRACT FROM AUTHOR]

Aim. To evaluate clinical characteristics and perinatal outcomes in a heterogeneous population of Caucasians born in Italy and High Migration Pressure Countries (HMPC) women with GDM living in Piedmont, North Italy. Methods. We retrospectively analyzed data from 586 women referring to our unit (2015–2020). Epidemiological (age and country of origin) and clinical-metabolic features (height, weight, family history of DM, parity, previous history of GDM, OGTT results, and GDM treatment) were collected. The database of certificates of care at delivery was consulted in relation to neonatal/maternal complications (rates of caesarean sections, APGAR score, fetal malformations, and neonatal anthropometry). Results. 43.2% of women came from HMPC; they were younger p < 0.0001 and required insulin treatment more frequently than Caucasian women born in Italy (χ2 = 17.8, p = 0.007). Higher fasting and 120-minute OGTT levels and gestational BMI increased the risk of insulin treatment (OGTT T0: OR = 1.04, CI 95% 1.016–1.060, p = 0.005 ; OGTT T120: OR = 1.01, CI 95% 1.002–1.020, p = 0.02 ; BMI: OR = 1.089, CI 95% 1.051–1.129, p < 0.0001). Moreover, two or more diagnostic OGTT glucose levels doubled the risk of insulin therapy (OR = 2.03, IC 95% 1.145–3.612, p = 0.016). We did not find any association between ethnicities and neonatal/maternal complications. Conclusions. In our multiethnic GDM population, the need for intensive care and insulin treatment is high in HPMC women although the frequency of adverse peripartum and newborn outcomes does not vary among ethnic groups. The need for insulin therapy should be related to different genetic backgrounds, dietary habits, and Nutrition Transition phenomena. Thus, nutritional intervention and insulin treatment need to be tailored. [ABSTRACT FROM AUTHOR]

Background: A better understanding of the burden of respiratory syncytial virus (RSV) infections in primary care is needed for policymakers to make informed decisions regarding new preventive measures and treatments. The aim of this study was to develop and evaluate a protocol for the standardised measurement of the disease burden of RSV infection in primary care in children aged < 5 years.Methods: The standardised protocol was evaluated in Italy and the Netherlands during the 2019/20 winter. Children aged < 5 years who consulted their primary care physician, met the WHO acute respiratory infections (ARI) case definition, and had a laboratory confirmed positive test for RSV (RT-PCR) were included. RSV symptoms were collected at the time of swabbing. Health care use, duration of symptoms and socio-economic impact was measured 14 days after swabbing. Health related Quality of life (HRQoL) was measured using the parent-proxy report of the PedsQL™4.0 generic core scales (2-4 years) and PedsQL™4.0 infant scales (0-2 years) 30 days after swabbing. The standardised protocol was evaluated in terms of the feasibility of patient recruitment, data collection procedures and whether parents understood the questions.Results: Children were recruited via a network of paediatricians in Italy and a sentinel influenza surveillance network of general practitioners in the Netherlands. In Italy and the Netherlands, 293 and 152 children were swabbed respectively, 119 and 32 tested RSV positive; for 119 and 12 children the Day-14 questionnaire was completed and for 116 and 11 the Day-30 questionnaire. In Italy, 33% of the children had persistent symptoms after 14 days and in the Netherlands this figure was 67%. Parents had no problems completing questions concerning health care use, duration of symptoms and socio-economic impact, however, they had some difficulties scoring the HRQoL of their young children.Conclusion: RSV symptoms are common after 14 days, and therefore, measuring disease burden outcomes like health care use, duration of symptoms, and socio-economic impact is also recommended at Day-30. The standardised protocol is suitable to measure the clinical and socio-economic disease burden of RSV in young children in primary care. [ABSTRACT FROM AUTHOR]

To provide a contribution to the Thematic Strategy for Soil Protection, here we present the results of a study focused on the potentially toxic elements (PTE) content in agricultural soils' representative for the Mediterranean region. To reach this aim, samples of 22 Italian (NE Peloritani Mountains, Sicily) and 18 Turkish (Amik Plain, Hatay) soils were collected and analyzed to evaluate their PTE content. The Italian and Turkish sites have been selected because they represent very important cultivation zones. In Amik Plain (Turkey), the dominant crops consist of cotton, wheat, corn and olives, whereas in NE Peloritani Mountains, Sicily (Italy), an appreciate citrus variety, known as the "Interdonato lemon", guaranteed by Protected Geographical Indication label, is produced. The collected results include: (1) the assessment of PTE levels in soils; (2) the identification of the PTE sources; (3) the relationships between PTE contents and soil properties (pH, electrical conductivity, organic matter, CaCO3, and clay). Several multivariate statistical methods such as correlation matrix, cluster analysis and main component analysis were applied to individuate the anthropogenic vs natural origin of the PTE sources. The detected PTE levels are in decreasing order Mn > Zn > V > Cr > Cu > Ni > As > Pb > Co > Sb > Se > Cd for the Italian soils, and Mn > Ni > V > Zn > Cr > Cu > Pb > Co > As > Se > Sb > Cd for the Turkish soils. The overall obtained results allowed to define: (a) a main lithogenic source for PTE detected in the Italian soils, except for Zn which origin is also associated to anthropogenic input; (b) a lithogenic origin for all of the PTE detected for the Turkish soils, with an associate anthropogenic contribution for Cr, Ni, V, Cu and V. The results obtained in this work enhance the knowledge in the individuation of PTE pollution sources in agricultural soils of the European Mediterranean region. [ABSTRACT FROM AUTHOR]

Crystalline rocks can produce dangerous radiation levels on the basis of their content in radioisotopes. Here, we report radiological data from 10 metamorphic and igneous rock samples collected from the crystalline basement of the Peloritani Mountains (southern Italy). In order to evaluate the radiological properties of these rocks, the gamma radiation and the radon emanation have been measured. Moreover, since some of these rocks are employed as building materials, we assess the potential hazard for population connected to their use. Gamma spectroscopy was used to measure the 226Ra, 232Th and 40K activity concentration, whereas the radon emanation was investigated by using a RAD 7 detector. The results show 226Ra, 232Th and 40K activity concentration values ranging from (17 ± 4) to (56 ± 8) Bq kg−1, (14 ± 3) to (77 ± 14) Bq kg−1 and (167 ± 84) to (1760 ± 242) Bq kg−1, respectively. Values of the annual effective dose equivalent outdoor range from 0.035 to 0.152 mSv y−1, whereas the gamma index is in the range of 0.22–0.98. The 222Rn emanation coefficient and the 222Rn surface exhalation rate vary from (0.63 ± 0.3) to (8.27 ± 1.6)% and from (0.12 ± 0.03) to (2.75 ± 0.17) Bq m−2 h−1, respectively. The indoor radon derived from the building use of these rocks induces an approximate contribution to the annual effective dose ranging from 8 to 176 μSv y−1. All the obtained results suggest that the crystalline rocks from the Peloritani Mountains are not harmful for the residential population, even though they induce annual effective doses due to terrestrial gamma radiation above the worldwide average values. Moreover, their use as building materials does not produce significant health hazards connected to the indoor radon exposure. [ABSTRACT FROM AUTHOR]

The seismic vulnerability of masonry building aggregates is very difficult to determine, since it is affected by many uncertainties. The most uncertain quantities concern the historical periodization of structural aggregates. Moreover, the studies made at the urban scale can hardly be thorough, and usually the knowledge achieved on the single units is not fully satisfactory, so that the structural designer has to deal with uncompleted architectonical surveys and partial data; one of the most important problems concerns the lack of knowledge about the boundary conditions between adjacent structures. In order to perform mechanical analyses, an extensive knowledge of materials and techniques adopted is required. In this paper, an integrated methodology for the seismic assessment of building aggregate is presented. It concerns a multidisciplinary knowledge-based approach calibrated over the historical centres and the urban aggregates; the procedure joins different aspects, such as the use of modern technologies for an integrated knowledge, plans reconstructions through archival documents, laser scanner digital survey of urban fronts, non-destructive investigations of the materials. GIS and BIM platforms have been used to implement and collect data in order to perform detailed analyses. The information allowed to assess the seismic vulnerability of the building aggregates and the expected damage scenarios through empirical methodologies. The city of Scarperia, founded a few kilometres from Florence during the Medieval Age and characterized by a medium seismicity, has been chosen as a case study for the presented procedure. [ABSTRACT FROM AUTHOR]

Objective: To develop Austrian, Italian, and Polish general population value sets for the EORTC QLU-C10D, a cancer-specific utility instrument based on the EORTC QLQ-C30, and to descriptively compare their index scores for distinct health states.Methods: The QLU-C10D descriptive system comprises 10 health attributes and each can take on 4 levels. A standardised and pre-tested methodology has been applied for valuations including a web-based discrete choice experiment (DCE). It was administered in 1000 general population respondents per country recruited via online panels, aiming at representativeness for core socio-demographic variables.Results: In all three countries, the attributes with the largest impact on utility were physical functioning, pain, and role functioning. Cancer-specific dimensions with the largest impact were nausea and fatigue or bowel problems. Utility values of the worst health state (i.e. severe problems on all 10 dimension) were -0.111 (Austria), 0.025 (Italy), and 0.048 (Poland). Country-specific utilities differed for a selection of health states across the continuum. Austrian utilities were systematically lower for moderately and severely impaired health states.Conclusion: QLU-C10D cancer-specific utilities can now be calculated in three more countries. Differences between countries indicate that careful consideration is required when using non-country-specific value sets in economic evaluations. [ABSTRACT FROM AUTHOR]

Background This prospective cohort study aimed at evaluating patterns of polypharmacy and aggressive and violent behavior during a 1-year follow-up in patients with severe mental disorders. Methods A total of 340 patients (125 inpatients from residential facilities and 215 outpatients) were evaluated at baseline with the Structured Clinical Interview for DSM-IV Axis I and II, Brief Psychiatric Rating Scale, Specific Levels of Functioning scale, Brown-Goodwin Lifetime History of Aggression, Buss-Durkee Hostility Inventory, Barratt Impulsiveness Scale, and State-Trait Anger Expression Inventory-2. Aggressive behavior was rated every 15 days with the Modified Overt Aggression Scale and treatment compliance with the Medication Adherence Rating Scale. Results The whole sample was prescribed mainly antipsychotics with high levels of polypharmacy. Clozapine prescription and higher compliance were associated with lower levels of aggressive and violent behavior. Patients with a history of violence who took clozapine were prescribed the highest number of drugs. The patterns of cumulative Modified Overt Aggression Scale mean scores of patients taking clozapine (n = 46), other antipsychotics (n = 257), and no antipsychotics (n = 37) were significantly different (P = . 001). Patients taking clozapine showed a time trend at 1-year follow-up (24 evaluations) indicating a significantly lower level of aggressive behavior. Patient higher compliance was also associated with lower Modified Overt Aggression Scale ratings during the 1-year follow-up. Conclusion Both inpatients and outpatients showed high levels of polypharmacy. Clozapine prescription was associated with lower Modified Overt Aggression Scale ratings compared with any other antipsychotics or other psychotropic drugs. Higher compliance was associated with lower levels of aggressive and violent behavior. [ABSTRACT FROM AUTHOR]

Analyzes a teacher training course taught for two subsequent years in Italy in which students investigate how computers can be used as tools to improve the learning process. The course topics examined, working method adopted, and results obtained are discussed, and suggestions are made for training present and future teachers. (Author/MBR)

Purpose: To estimate the contribution of cryopreservation to the cumulative live birth rate (CLBR) after law modification in Italy in the era of vitrification and freeze-all. Methods: The Italian National Registry performed a cycle-based data collection. Nine Italian IVF clinics were involved incorporating a total of 10,260 fresh cycles performed between January 2015 and April 2016 resulting in 9273 oocyte retrievals and 3266 subsequent warming cycles from the same oocyte retrievals performed up to December 2016. Mean female age was 37 ± 4.3 years. Primary outcome measure was CLBR per oocyte retrieval. Confounding factors were tested in multivariate regression analysis, and the relative impact of cryopreservation to the CLBR in different patient categories was calculated. Results: CLBR per oocyte retrieval was 32.6%, 26.5%, 18.7%, 13.0%, and 5.5% for women younger than 36, aged 36–39, 40–41, and older than 41 years, respectively. The total relative contribution of oocyte/embryo cryopreservation was 40.6% (95% CI 38.41–42.75). An association between maternal age, number of oocytes retrieved, fertilization rate, cryopreservation, and cumulative live birth was shown. When adjusted for confounders, a 2.3-fold increase was observed in the chance of live birth when cryopreservation was performed (OR 2.3; 95% CI 1.99–2.56). In high responder patients (> 15 oocytes retrieved) where freeze-all was applied in 67.6% of cycles to avoid the risk of hyper stimulation syndrome, the relative contribution of vitrification to the CLBR was 80.6%. Conclusions: Cryopreservation is essential in IVF and should always be available to patients to optimize success rates. Multicentric, cycle-based data analyses are crucial to provide infertile couples, clinicians, and regulatory bodies with accurate information on IVF effectiveness including fresh and cryopreserved cycles. [ABSTRACT FROM AUTHOR]

Background. Nosocomial water systems may be contaminated by Legionella spp; therefore, health care facilities represent a potential health risk for patients and health care staff. Active, well-planned clinical and environmental surveillance in hospitals is the most important instrument of prevention. Aim and Methods. The aim of the present article was to outline the state of the art in legionellosis control and prevention among Italian health care facilities by reporting some experiences in the field. Results. Our results showed that Legionella spp. are largely reported as both hospital water system contaminants and etiological agents in water-related health care-associated infections (HCAI) in Italy. Among the numerous sources of HCAI, water is the most investigated, although it has been demonstrated that air sampling may provide additional information for risk assessment. Conclusions. More appropriate risk assessment is needed, especially in large facilities. In addition, more sensitive diagnostic tests should be used and dedicated training courses should be implemented in health care facilities. [ABSTRACT FROM AUTHOR]

The ancient city of Spradon, which is located in the Ispartakule area of the district of Avcılar in İstanbul, dates back to the Late Roman period. A total of 90 individuals, including 58 in graves, were found at the excavation site. Osteoarchaeological investigation concerning skull morphology has been focused on metopic suture. Of the 6 metopic suture examples seen in the roman society of Spradon, 5 were observed in young adults, while 1 belonged to a senior adult. A metopic suture was observed in 5 of the 38 females (13.2%) and in 1 of the 31 males (3.2%). The metopic suture rate in the ancient city of Spradon was calculated as 8.7%, and rates were found to be similar with other Roman period populations in Anatolia. When the comparison is made on Old Anatolian Populations, metopic suture is seen especially in coastal regions of Anatolia in geographical sense. In addition, there is less metopic suture in the internal regions. Statistical Analysis supports this hypothesis. [ABSTRACT FROM AUTHOR]

Introduction We characterized five patients affected with von Willebrand disease ( VWD) carrying the p.Arg1379Cys mutation. One was diagnosed as VWD type 1 and four as type 2M. The 2M patients also have the variant p.Ala1377Val in cis with p.Arg1379Cys. Aim To evaluate the role of p.Ala1377Val and p.Arg1379Cys von Willebrand factor ( VWF) variants to explain patients' phenotype. Methods Conventional phenotype tests were used to evaluate patients' plasma and platelets. Direct sequence analysis of exon 28 was carried out. The allele frequency of p.Ala1377Val was evaluated using online database. pc DNA3.1- VWF- WT and mutant (A1377V, R1379C and A1377V-R1379C) expression vectors were transiently transfected in HEK293 cells. The capacity of WT and mutant recombinant (r) VWF (along with patients' plasma VWF) to bind glycoprotein Ibα (GpIbα) were evaluated, using two ELISA assays. One with a wild-type ( WT) recombinant (r)GpIbα at increasing ristocetin concentrations (from 0 to 1.50 mg mL−1) and the other with a gain-of-function mutant rGpIbα ( VWF: GPIbM). Results The substitution c.4130C>T (p.Ala1377Val) was reported as rare variant in online databases. At 0.25 mg mL−1 of ristocetin, WT, A1377V and R1379C showed 6, 7.5 and 12-fold increased binding to rGpIbα, respectively. A1377V-R1379C rVWF showed no increased binding to rGpIbα at the same ristocetin concentration and reached the highest binding, of only 3-fold increased, at 1.50 mg mL−1 of ristocetin. The VWF: GPIbM showed strongly reduced values for the A1377V-R1379C rVWF and the 2M patients' plasma. Conclusion Our study showed that the presence of both p.Ala1377Val and p.Arg1379Cys mutations (synergistic effect) abolishes the binding of rVWF to rGpIbα, explaining patients' 2M phenotype. [ABSTRACT FROM AUTHOR]

Surveys on the occurrence of type A trichothecenes in wheat, and particularly for the T-2 and HT-2 toxins, and information on the biology and epidemiology of the causative Fusarium species (i.e. F. langsethiae, F. sporotrichioides) are scarce in Italy, as compared to the more common type B trichothecene, deoxynivalenol and its producers. This 4-year monitoring of phytopathogenic Fusarium species on 183 seed lots of durum wheat shows wide distribution of F. langsethiae in Italy and the potential of several isolates of this fungus to produce high amounts of T-2 and HT-2 in wheat. Fusarium langsethiae was observed for approximately 48% of the analysed samples, with a maximum incidence for a single lot of 10.5%. Fusarium sporotrichioides was observed only in 2011, with an average incidence of 2% (range, 0-3%). A collection of F. langsethiae isolates representative of the main cultivation areas in Italy was established. These isolates showed great variability for their toxin production in vitro. Of 28 strains, all except one isolate can produce the T-2 and HT-2 toxins. HT-2 was generally in greater amounts than T-2, with an average concentration ratio for HT-2 to T-2 of 2.1 (range, 0.7-5.4). The artificial inoculation of wheat with three isolates of F. langsethiae produced no Fusarium head blight symptoms under field conditions. However, significantly higher incidence of F. langsethiae was seen on the kernels of inoculated plants, compared to the uninoculated controls. [ABSTRACT FROM AUTHOR]

Background In the countries with high G6 PD deficiency prevalence, blood donors are not routinely screened for this genetic defect. G6 PD deficiency is often asymptomatic, blood donors may be carriers of the deficiency without being aware of it. The aim of the study was to evaluate the prevalence of G6 PD deficiency among the Italian blood donors. Design and Methods From October 2009 to April 2011, 3004 blood donors from a large hospital transfusion centre were screened for G6 PD deficiency using differential pH-metry and the characterization of G6 PD mutations was performed on G6 PD-deficient subjects. The haematological features of G6 PD-deficient and normal donors were also compared. Results Thirty-three subjects (25 men and 8 women) with low G6 PD activity were identified, corresponding to 1·1% of the examined blood donor population. The frequencies of class II severe alleles ( Mediterranean, Valladolid, Chatham and Cassano) and class III mild alleles (Seattle, A- and Neapolis) were 48% and 43%, respectively. The haematological parameters of G6 PD- donors were within normal range; however, the comparison between normal and G6 PD- class II donors showed significant differences. Conclusion In Italy, the presence of blood donors with G6 PD deficiency is not a rare event and the class II severe variants are frequent. The identification of G6 PD-deficient donors and the characterization of the molecular variants would prevent the use of G6 PD-deficient RBC units when the haemolytic complications could be relevant especially for high risk patients as premature infants and neonates and patients with sickle cell disease submitted to multiple transfusions. [ABSTRACT FROM AUTHOR]

The Health Commission of the Conference between the Italian State and Regions recognized the need to establish an institutional accreditation model for Haemophilia Centres (HCs) to be implemented by 21 Regions in order to provide patients with haemophilia and allied inherited coagulations disorders with high and uniform standards of care. The Italian National Blood Centre, on behalf of the Commission, convened a panel of clinicians, patients, experts, representatives from Regions and Ministry of Health. The agreed methodology included: systematic literature review and best practice collection, analysis of provisions and regulations of currently avalable services, priority setting, definition of principles and criteria for the development of recommendations on the optimal requirements for HCs. The result was the formulation of two recommendations sets. Two sets of recommendations were produced. The first concerns regional policy planning, in which the following aspects of comprehensive haemophilia care should be considered for implementation: monitoring and auditing, multidisciplinary approach to clinical care, protocols for emergency management, home treatment and its monitoring, patient registries, drug availability and procurement, recruitment and training of health care professionals. The second set concerns the accreditation process and lists 23 organizational requirements for level 1 HCs and 4 additional requirements for level 2 HCs. These recommendations help to provide Italian Regional Health Authorities with an organizational framework for the provision of comprehensive care to patients with inherited coagulation disorders based on current scientific evidence. [ABSTRACT FROM AUTHOR]

[ABSTRACT FROM AUTHOR]

In this paper we present the geological effects induced by the 2012 Emilia seismic sequence in the Po Plain. Extensive liquefaction phenomena were observed over an area of ~ 1200 km² following the 20 May, ML 5.9 and 29 May, ML 5.8 mainshocks; both occurred on about E-W trending, S dipping blind thrust faults. We collected the coseismic geological evidence through field and aerial surveys, reports from local people and Web-based survey. On the basis of their morphologic and structural characteristics, we grouped the 1362 effects surveyed into three main categories: liquefaction (485), fractures with liquefaction (768), and fractures (109). We show that the quite uneven distribution of liquefaction effects, which appear concentrated and aligned, is mostly controlled by the presence of paleo-riverbeds, out-flow channels and fans of the main rivers crossing the area; these terrains are characterised by the pervasive presence of sandy layers in the uppermost 5 m, a local feature that, along with the presence of a high water table, greatly favours liquefaction. We also find that the maximum distance of observed liquefaction from the earthquake epicentre is ~ 30 km, in agreement with the regional empirical relations available for the Italian Peninsula. Finally, we observe that the contour of the liquefaction observations has an elongated shape almost coinciding with the aftershock area, the InSAR deformation area, and the I ≥ 6 EMS area. This observation confirms the control of the earthquake source on the liquefaction distribution, and provides useful hints in the characterisation of the seismogenic source responsible for historical and pre-historical liquefactions. [ABSTRACT FROM AUTHOR]

Lipomatous myopathy is a degenerative muscle pathology characterized by the substitution of muscle cells with adipose tissue, sporadically reported in cattle, pigs, and rarely in sheep, horses and dogs. This study investigated the pathology of this myopathy in 40 muscle samples collected from regularly slaughtered Piedmontese cattle living in Piedmont region (Italy). None of the animals showed clinical signs of muscular disease. Muscle specimens were submitted to histological and enzymatic investigations. Gross pathology revealed a different grade of infiltration of adipose tissue, involving multiple or single muscles. The most affected regions were the ventral abdomen and the shoulders, especially the cutaneous muscles and the muscles of the thoracic group. Morphological staining revealed an infiltration of adipose tissue varying in distribution and severity, changes in muscle fibre size and increased number of fibres with centrally located nuclei, suggesting muscle degeneration–regeneration. Necrosis and non-suppurative inflammatory cells were also seen. Furthermore, proliferation of connective tissue and non-specific myopathic changes were present. Chemical and physical characteristics of the affected tissue were also evaluated. The authors discuss about the aetiopathogenesis and classification of this muscle disorder whose histological lesions were similar to those reported in human dystrophies. [ABSTRACT FROM PUBLISHER]

Heritage peach (Prunus persica L. Batsch) varieties in Emilia-Romagna, Italy's leading peach-producing region, are largely marked by melting, juicy, aromatic white-fleshed fruit with a short shelf-life and susceptibility to bruising. While these varieties have rapidly been replaced since the 1950's by yellow-fleshed peaches from US breeding programmes with improved handling resistance, the Fruit Research Unit of the Agricultural Research Council, at Forlì, has begun an effort to safeguard and characterise the heritage varieties of Emilia-Romagna. The programme has screened 26 local heritage accessions using a set of 16 highly polymorphic microsatellite (simple sequence repeat; SSR) markers to assess genetic diversity, to elucidate inter-relationships, and to resolve any cases of homonymy. Seven international peach cultivars have been included in order to standardise allele scoring. This study resulted in 19 unique molecular profiles among the heritage accessions, and a relatively high mean observed heterozygosity value of 0.49 for a germplasm pool from a restricted region, an indicator of potential genetic diversity. The main morphological features of the heritage peaches are reported, and potential benefits for future breeding programmes discussed. [ABSTRACT FROM AUTHOR]

Objective To conduct a long-term, prospective, randomized controlled trial evaluating rituximab (RTX) therapy for severe mixed cryoglobulinemia or cryoglobulinemic vasculitis (CV). Methods Fifty-nine patients with CV and related skin ulcers, active glomerulonephritis, or refractory peripheral neuropathy were enrolled. In CV patients who also had hepatitis C virus (HCV) infection, treatment of the HCV infection with antiviral agents had previously failed or was not indicated. Patients were randomized to the non-RTX group (to receive conventional treatment, consisting of 1 of the following 3: glucocorticoids; azathioprine or cyclophosphamide; or plasmapheresis) or the RTX group (to receive 2 infusions of 1 gm each, with a lowering of the glucocorticoid dosage when possible, and with a second course of RTX at relapse). Patients in the non-RTX group who did not respond to treatment could be switched to the RTX group. Study duration was 24 months. Results Survival of treatment at 12 months (i.e., the proportion of patients who continued taking their initial therapy), the primary end point, was statistically higher in the RTX group (64.3% versus 3.5% [ P < 0.0001]), as well as at 3 months (92.9% versus 13.8% [ P < 0.0001]), 6 months (71.4% versus 3.5% [ P < 0.0001]), and 24 months (60.7% versus 3.5% [ P < 0.0001]). The Birmingham Vasculitis Activity Score decreased only after treatment with RTX (from a mean ± SD of 11.9 ± 5.4 at baseline to 7.1 ± 5.7 at month 2; P < 0.001) up to month 24 (4.4 ± 4.6; P < 0.0001). RTX appeared to be superior therapy for all 3 target organ manifestations, and it was as effective as conventional therapy. The median duration of response to RTX was 18 months. Overall, RTX treatment was well tolerated. Conclusion RTX monotherapy represents a very good option for severe CV and can be maintained over the long term in most patients. [ABSTRACT FROM AUTHOR]

This paper focuses on the analysis and modelling of credit risk, measured through the value of nonperforming loans. Taking into account the new regulatory framework introduced by Basel II, possible stress scenarios in the context of Pillar 2 are also identified. The analysis is conducted for three countries-Portugal, Spain and Italy. The null hypothesis of linearity is rejected for all three countries, for both the self-exciting threshold autoregressive (SETAR) and threshold autoregressive (TAR) alternatives, and this feature is taken into account when credit risk is modelled, making SETAR and TAR models a plausible alternative to linear models. Copyright © 2010 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Between 2006 and 2008, 146 isolates of Fusarium spp. were obtained from bakanae-diseased rice plants and seeds from the major rice-growing regions of Italy. These isolates were identified based on translation elongation factor (EF-1α) sequence and pathogenicity tests were used to assess their aggressiveness against the susceptible rice cultivar Galileo. Use of the EF-1α sequence gave reliable identification and showed that Fusarium fujikuroi, the causal agent of bakanae disease, was the most abundant Fusarium spp. isolated. These data were confirmed by inoculation of the isolates to rice seeds which were then germinated in the greenhouse, showing that only F. fujikuroi isolates were able to cause bakanae disease. Pathogenic isolates were identified with different levels of aggressiveness. Phylogenetic analysis based on EF-1α sequences generated a tree which separated the various Fusarium species into different clusters with high bootstrap values. [ABSTRACT FROM AUTHOR]

In Italy, rainfall is the primary trigger of landslides that frequently cause fatalities and large economic damage. Using a variety of information sources, we have compiled a catalogue listing 753 rainfall events that have resulted in landslides in Italy. For each event in the catalogue, the exact or approximate location of the landslide and the time or period of initiation of the slope failure is known, together with information on the rainfall duration D, and the rainfall mean intensity I , that have resulted in the slope failure. The catalogue represents the single largest collection of information on rainfall-induced landslides in Italy, and was exploited to determine the minimum rainfall conditions necessary for landslide occurrence in Italy, and in the Abruzzo Region, central Italy. For the purpose, new national rainfall thresholds for Italy and new regional rainfall thresholds for the Abruzzo Region were established, using two independent statistical methods, including a Bayesian inference method and a new Frequentist approach. The two methods proved complementary, with the Bayesian method more suited to analyze small data sets, and the Frequentist method performing better when applied to large data sets. The new regional thresholds for the Abruzzo Region are lower than the new national thresholds for Italy, and lower than the regional thresholds proposed in the literature for the Piedmont and Lombardy Regions in northern Italy, and for the Campania Region in southern Italy. This is important, because it shows that landslides in Italy can be triggered by less severe rainfall conditions than previously recognized. The Frequentist method experimented in this work allows for the definition of multiple minimum rainfall thresholds, each based on a different exceedance probability level. This makes the thresholds suited for the design of probabilistic schemes for the prediction of rainfall-induced landslides. A scheme based on four probabilistic thresholds is proposed. The four thresholds separate five fields, each characterized by different rainfall intensity-duration conditions, and corresponding different probability of possible landslide occurrence. The scheme can be implemented in landslide warning systems that operate on rainfall thresholds, and on precipitation measurements or forecasts. [ABSTRACT FROM AUTHOR]

Background Randomized controlled trials have generated strong evidence on the efficacy of electrical device therapy in selected patients with heart failure (HF). The enrolment criteria of these three trials generated patient profiles that helped to shape current guidelines on chronic heart failure (CHF) treatment and sudden cardiac death (SCD) prevention. We investigated the prevalence of trial-generated profiles for implantable defibrillator or cardiac resynchronization therapy candidacy among HF outpatients; we explored differences between real-world and trial populations and we evaluated 1-year survival without device treatment. Methods We reviewed Italian Network on Congestive Heart Failure (IN-CHF) registry patients ( n = 4977) enrolled in a period (1995–2000) roughly concurrent with the MADIT-II and SCD-HeFT trials. Results Regarding device eligibility, 14.5% IN-CHF patients at entry satisfied MADIT-II criteria, 6.8% satisfied CARE-HF criteria and as many as 47.9% fulfilled SCD-HeFT criteria. One-year overall mortality among non-implanted patients was 1.5 to 2-fold higher in each of these subgroups than in control arms of the corresponding trials. Among registry patients, different trial-profile combinations were associated with a wide range of 1-year outcomes (mortality, 8–35%; SCD/total mortality ratio, 0.35–0.57). Despite clear differences between registry and trial patients in pharmacological therapy (and clinical characteristics), none of the main drug classes independently predicted 1-year mortality in any of the IN-CHF subgroups. Conclusions As many as half the IN-CHF outpatients fulfilled current criteria for device implantation. Various subgroups had higher 1-year mortality than patients in trial control arms – a finding that may not be entirely attributable to differences in drug therapy (especially beta blockers). [ABSTRACT FROM AUTHOR]

Aim: To evaluate the reliability of culture-independent methods in comparison with culture-dependent ones for the detection of Arcobacter spp. in estuarine waters of Southern Italy. Methods and Results: PCR and fluorescent in situ hybridization (FISH) procedures were used to detect arcobacters directly in water samples and after enrichment cultures. The samples totally were positive by molecular methods (PCR and FISH) but only 75% were culture positive, confirming the limitation of these latter to detect Arcobacter spp. in natural samples. Culturable arcobacters were retrieved in all times except in July, and isolated species were ascribed only to Arcobacter cryaerophilus. Conclusions: Culturable and nonculturable forms of Arcobacter in the estuarine environment were present. PCR assays were more sensitive than traditional culture in detecting Arcobacter butzleri and A. cryaerophilus. FISH comparatively to PCR technique may provide information about cell morphology and viability of single cells. Significance and Impact of the Study: Our investigation indicates the existence of an environmental reservoir of potential pathogenic arcobacters in an estuarine Italian area, which may survive under a viable but not culturable state. [ABSTRACT FROM AUTHOR]

Background Subcutaneous immunotherapy is effective for the treatment of respiratory allergy, and it is largely used in Italy, but no systematic safety assessment has been carried out so far. Objective To assess prospectively the safety of injection immunotherapy in a multicentre, real-life survey. Methods Eleven Italian allergy departments recorded the clinical characteristics of systemic reactions (SRs) due to immunotherapy. Vaccines were prescribed according to guidelines; only standardized depot extracts were used. SRs were graded according to the EAACI recommendations, and were classified as immediate or delayed. Results One thousand seven hundred and thirty-eight patients (847 males, age range 5–71) received immunotherapy from eight different manufacturers, for a total of 2038 courses (300 patients received two extracts). A total of 60 785 injections were given over a mean immunotherapy duration of 3 years. Overall, 95 reactions were observed in 57 patients (3.28%), corresponding to 4.7% of the courses and 1.56/1000 injections. Twenty-five patients experienced more than one adverse event. There were 34 grade 2, 60 grade 3 and one grade 4 reactions and no fatality. SRs occurred more frequently in patients with asthma than in patients with rhinitis alone (4.1% vs. 1.1%), and were equally distributed between the build-up and the maintenance phase. Ragweed and grass extracts caused significantly more side effects than other allergens. Conclusion In this large prospective study, the rate of SRs was low, thus confirming that injection immunotherapy has an acceptable risk/benefit ratio when prescribed and carried out according to recommendations. [ABSTRACT FROM AUTHOR]

Most patients with advanced or metastatic cancer experience pain and despite several guidelines, undertreatment is well documented. A multicenter, open-label, prospective, non-randomised study was launched in Italy in 2006 to evaluate the epidemiology, patterns and quality of pain care of cancer patients. To assess the adequacy of analgesic care, we used a standardised measure, the pain management index (PMI), that compares the most potent analgesic prescribed for a patient with the reported level of the worst pain of that patient together with a selected list of clinical indicators. A total of 110 centres recruited 1801 valid cases. 61% of cases were received a WHO-level III opioid; 25.3% were classified as potentially undertreated, with wide variation (9.8-55.3%) according to the variables describing patients, centres and pattern of care. After adjustment with a multivariable logistic regression model, type of recruiting centre, receiving adjuvant therapy or not and type of patient recruited (new or already on follow-up) had a significant association with undertreatment. Non-compliance with the predefined set of clinical indicators was generally high, ranging from 41 to 76%. Despite intrinsic limitations of the PMI that may be considered as an indicator of the poor quality of cancer pain care, results suggest that the recourse to WHO third-level drugs still seems delayed in a substantial percentage of patients. This delay is probably related to several factors affecting practice in participating centres and suggests that the quality of cancer pain management in Italy deserves specific attention and interventions aimed at improving patients' outcomes. [ABSTRACT FROM AUTHOR]

The association of HLA-B27 with ankylosing spondylitis (AS) is the strongest among all inflammatory diseases. However, the exact role of these molecules in disease pathogenesis is still unknown. The existence of HLA-B27 variants rarely found in patients introduces a further level of complexity. It is now accepted that other genes of minor impact contribute to modify disease susceptibility and these genes might be diverse in different populations depending on the genetic background. We report here a study performed in Sardinia, an outlier population in which two major HLA-B27 subtypes are present, B *2705 strongly associated with AS and B *2709 which is not, and show the co-occurrence of the B *2705 allele with a single nucleotide polymorphism (SNP) mapping at 3′-UTR of the receptor 1 (VIPR1) for the vasoactive intestinal peptide (VIP), a neuropeptide with anti-inflammatory properties. This same SNP is associated with a different kinetics of down-modulation of the VIPR1 mRNA in monocytes after exposure to lipopolysaccharide (P=0.004). This particular setting, HLA-B *2705 and a functional polymorphism in VIPR1 gene, might be due to a founder effect or might be the result of a selective pressure. Irrespectively, the consequent downregulation of this receptor in the presence of a ‘danger’ signal might influence susceptibility to AS.Genes and Immunity (2008) 9, 659–667; doi:10.1038/gene.2008.60; published online 31 July 2008 [ABSTRACT FROM AUTHOR]

The article focuses on the geographic information system (GIS)-assisted modelling for the prediction of the debris flow velocity. It mentions that the empirical analysis and field based estimates of debris flow discharge during the debris flow events that occurred in Sarno, Italy in May 1998 were obtained. It notes that the velocity and dynamic pressure of debris flow are critical determinants for hazard assessment and vulnerability analysis. The implementation of GIS on the prediction of debris flow velocity and dynamic pressure constitute an important step towards the real-time hazard mitigation in regions with volcanic deposit, in which debris flow represents a major hazard.

A sensitive, accurate and precise method for the simultaneous determination of nivalenol (NIV), deoxynivalenol (DON), T-2 toxin (T-2) and HT-2 toxin (HT-2) in different food matrices, including wheat, maize, barley, cereal-based infant foods, snacks, biscuits and wafers, has been developed. The method, using liquid chromatography coupled with atmospheric pressure chemical ionization triple quadrupole mass spectrometry (LC-APCI-MS/MS), allowed unambiguous identification of the selected trichothecenes at low µg per kg levels in such complex food matrices. A clean-up procedure, based on reversed phase SPE Oasis® HLB columns, was used, allowing good recoveries for all studied trichothecenes. In particular, NIV recoveries significantly improved compared to those obtained by using Mycosep® #227 columns for clean-up of the extracts. Limits of detection in the various investigated matrices ranged 2.5-4.0 µg kg-1 for NIV, 2.8-5.3 µg kg-1 for DON, 0.4-1.7 µg kg-1 for HT-2 and 0.4-1.0 µg kg-1 for T-2. Mean recovery values, obtained from cereals and cereal products spiked with NIV, DON, HT-2 and T-2 toxins at levels from 10 to 1000 µg kg-1, ranged from 72 to 110% with mean relative standard deviation lower than 10%. A systematic investigation of matrix effects in different cereals and cereal products was also carried out by statistically comparing the slopes of standard calibration curve with matrix-matched calibration curve for each of the four toxins and the eight matrices tested. For seven of the eight matrices tested, statistically significant matrix effects were observed, indicating that, for accurate quantitative analysis, matrix-matched calibration was necessary. The method was applied to the analysis of 57 samples of ground wheat originated from South Italy and nine cereal food samples collected from retail markets. [ABSTRACT FROM AUTHOR]

The article discusses a study on the genetic differences in rich and poor Danish Iron-age villages and mtDNA haplogroups. The author analyzes 22 individuals from different types of settlements representing the lowest level and highest level of society. He explains that Roman Iron age was a formative period of the society from archaic chiefdoms to a true state formation.

Background. The purpose of our study was to evaluate the incidence and outcome of invasive fungal infection (IFI) among patients who underwent autologous or allogeneic hematopoietic stem cell transplantation (HSCT) at 11 Italian transplantation centers. Methods. This cohort-retrospective study, conducted during 1999-2003, involved HSCT patients admitted to 11 tertiary care centers or university hospitals in Italy, who developed IFIs (proven or probable). Results. Among 3228 patients who underwent HSCT (1249 allogeneic HSCT recipients and 1979 autologous HSCT recipients), IFI occurred in 121 patients (overall incidence, 3.7%). Ninety-one episodes (2.8% of all patients) were due to molds, and 30 (0.9%) were due to yeasts. Ninety-eight episodes (7.8%) occurred among the 1249 allogeneic HSCT recipients, and 23 (1.2%) occurred among the 1979 autologous HSCT recipients. The most frequent etiological agents were Aspergillus species (86 episodes) and Candida species (30 episodes). The overall mortality rate was 5.7% among allogeneic HSCT recipients and 0.4% among autologous HSCT recipients, whereas the attributable mortality rate registered in our population was 65.3% (72.4% for allogeneic HSCT recipients and 34.7% for autologous HSCT recipients). Etiology influenced the patients' outcomes: the attributable mortality rate for aspergillosis was 72.1% (77.2% and 14.3% for allogeneic and autologous HSCT recipients, respectively), and the rate for Candida IFI was 50% (57.1% and 43.8% for allogeneic and autologous HSCT recipients, respectively). Conclusions. IFI represents a common complication for allogeneic HSCT recipients. Aspergillus species is the most frequently detected agent in these patients, and aspergillosis is characterized by a high mortality rate. Conversely, autologous HSCT recipients rarely develop aspergillosis, and the attributable mortality rate is markedly lower. Candidemia was observed less often than aspergillosis among both allogeneic and autologous HSCT recipients; furthermore, there was no difference in either the incidence of or the attributable mortality rate for candidemia among recipients of the 2 transplant types. [ABSTRACT FROM AUTHOR]

No recent data on the experience of caries among Italian 12-year-olds are available. In 2004, an epidemiological survey called ‘National Pathfinder among Children’s Oral Health in Italy’ was promoted and carried out. This study reports the actual oral health status of Italian 12-year-olds according to gender, residence area and geographical distribution. Clinical examinations were carried out from March 2004 to April 2005, according to WHO criteria, and included dental caries (decay at the dentinal lesion level) and Community Periodontal Index (CPI). 5,342 children (2,670 males, 2,672 females) were examined by 7 ad hoc calibrated raters. Dental caries experience was found in 43.1% (95% CI 41.8–44.4%) of the study population. The mean DMFT score was 1.09 (95% CI 0.98–1.21). Significant differences (p < 0.05) were observed among geographical sections for DT, FT and DMFT. An inverse relationship was observed between mean DMFT and gross national product per capita (p < 0.001). Gingival bleeding was observed in 23.8% of children, while 28.7% had calculus. Significant differences in CPI scores among sections were found throughout the sample in both males and females (p < 0.001). Over the past two decades, mean DMFT fell from over 5 to its present level, halving every decade; consequently, the recorded level of dental caries has become aligned with that in other Western European countries. Nevertheless, differences in DMFT values remain between children from different socioeconomic backgrounds. Copyright © 2007 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Anal canal duplication (ACD) represents an extremely rare intestinal congenital anomaly of unknown origin. Usually evidenced within 2 years of age, nearly 45% of reported cases present associated malformations such as presacral mass, anorectal malformation (ARM) and genitourinary anomalies. The confirmative diagnosis is istopathological, with evidence of an anal mucosal lining (squamous ± transitional epithelium), surrounded from a smooth muscle coat and anal glands. We review a conjoined experience from two European pediatric surgical departments. From 1970 to 2005, 12 patients were observed, seven in Pescara, Italy (1997–2005), five in Barcelona, Spain (1970–2004)—mean age at diagnosis 17.8 months, range 0–60; M:F = 1:11. Clinical presentation, diagnostic-surgical approach, and complications were reviewed. According to clinical presentation, patients could be divided in three age groups: asymptomatic (mean age 4.8 months, six patients—one with an associated complex genitourinary malformation, one with a presacral mature teratoma, one with ACD evidenced hysthologically on a retroanal mass removed during the correction of an ARM), mildly symptomatic—constipation, mucous discharge (mean age 29.2 months, four patients—one with associated presacral ependymoma and intestinal neuronal dysplasia type B, one with presacral mass) and complicated—perineal abscess, recurrent fistula (mean age 34 months, two patients). In 11 cases a perianal orifice was evident (ten posteriorly located). The pelvic-MRI was the preferred diagnostic tool in Pescara (5/7, with presacral mass in two patients), fistulography in Barcelona (5/5), where one presacral mass was discovered intraoperatively. Eleven patients underwent surgical removal of the ACD (five perineal approach, five posterior sagittal approach, and one PSARP). Histopathological findings confirmed the diagnosis in operated cases (11). The parents of the male patient denied the consent to surgical treatment. The only major post-operative complication was a sphincteric insufficiency (one case), surgically treated. When facing a perianal orifice, attention should be paid to ACD, particularly in female patients with coexistent genitourinary or intestinal malformations. Pelvic US and MRI are the gold standard to evidence the not rarely associated presacral mass. Surgical early removal (mucosectomy or perineal/posterior sagittal approach, depending on length of ACD and associated presacral mass) is warranted, also in asymptomatic patients, because of the risk of inflammatory complications and cancer (the latter reported in literature in adults). [ABSTRACT FROM AUTHOR]

The article presents information on the RNA sequence of Parietaria mottle virus (PMoV). PMoV was initially isolated from the weed "Parietaria officinalis" in Italy. PMoV has been causing diseases in tomatoes growing in France, Italy, and Greece. The RNA of PMoV was extracted from purified viral preparations by using RNeasy kit. The sequence of PMoV RNA 1 contains 3,518 nucleotides, and a single open reading frame. The sequence of PMoV RNA 2 contains 2,922 nucleotides, and encoded proteins.

In 2002 the Italian Standardisation Organisation (UNI) - Nuclear Energy Commission (UNICEN) - appointed a working group with the main task of writing a set of standards on drinking water measurements. To date two standards have been designed, namely, for total alpha- and beta-activity, and 222Rn. Further procedures are under development for measuring 226Ra and U isotopes, and gamma-emitting radionuclides in water. The paper gives an overview of these standards, both developed and under study, with special attention to the validation of the methods. [ABSTRACT FROM AUTHOR]

Few population studies are available on epidemiological indexes of hereditary ataxias. An investigation on the prevalence rate of these movement disorders is in progress for the Veneto region, the main area of northeast Italy with a population of 4,490,586 inhabitants. The first results of this epidemiological survey concern the province of Padua, which numbers 845,203 residents (January 1, 2002). The prevalence rate of inherited ataxias has been estimated at 93.3 cases per million inhabitants. The most common types appeared to be the autosomal dominant forms, namely spinocerebellar ataxia type 1 and 2, with a prevalence of 24 per 1,000,000. In the same population, with a prevalence rate of 6 per 1,000,000, Friedreich's ataxia was defined as the prominent recessive autosomal form. There were very rare cases of ataxia telangiectasia, ataxia with vitamin E deficiency and cerebellar ataxia with congenital muscular dystrophy, a recently identified autosomal recessive disease. [ABSTRACT FROM AUTHOR]

The occurrence ofArcobacter spp. was studied in seawater and plankton samples collected from the Straits of Messina, Italy, during an annual period of observation by using cultural and molecular techniques. A PCR assay with three pairs of primers targeting the 16S and 23S rRNA genes was used for detection and identification of Arcobacter butzleri, Arcobacter cryaerophilus, and Arcobacter skirrowii in cultures and environmental samples. Only one of the Arcobacter species, A. butzleri, was isolated from seawater and plankton samples. With some samples the A. butzleri PCR assay gave amplified products when cultures were negative. A. cryaerophilus and A. skirrowii were never detected by culture on selective agar plates; they were detected only by PCR performed directly with environmental samples. Collectively, our data suggest that culturable and nonculturable forms of Arcobacter are present in marine environments. The assay was useful for detecting Arcobacter spp. both as free forms and intimately associated with plankton. This is the first report showing both direct isolation of A. butzleri and the presence of nonculturable Arcobacter spp. in the coastal environment of the Mediterranean Sea. [ABSTRACT FROM AUTHOR]

Reports that the value of marine reserves to protect threatened and vulnerable species, such as the dusky grouper (Epinephelus marginatus), is often uncertain because of a lack of knowledge about their ecology and habitat utilization. Investigation into this issue through the installation of a Wireless Communication System for location-based positioning of fish tagged with coded acoustic transmitters to determine site fidelity of juvenile dusky groupers within a marine reserve, Island of Ustica, Sicily, Italy; Details of the system which was based on five wireless hydrophones distributed along the coastline of the reserve, each monitoring acoustic signals from transmitters within a reception cell; Retransmitting of the hydrophones' detected signals as a radio signal to a land-based receiver and data logger; Findings that the unique identifiers for each hydrophone permitted the identification of the detection cell containing the tagged fish; Evidence that the Wireless Hydrophone System combined with manual tracking provided a valuable tool for investigating site fidelity in the dusky grouper.

A case-control study of non-familial melanoma including 183 incident cases and 179 controls was conducted in North-Eastern Italy to identify important risk factors and determine how combination of these affects risk in a Mediterranean population. Presence of dysplastic nevi (OR = 4.2, 95% CI = 2.4-7.4), low propensity to tan (OR = 2.4, 95% CI = 1.1-5.0), light eye (OR = 2.4, 95% CI = 1.1-5.2), and light skin colour (OR = 4.1, 95% CI = 1.4-12.1) were significantly associated with melanoma risk after adjustment for age, gender and pigmentation characteristics. A chart which identifies melanoma risk associated with combinations of these factors is presented; it can be used to identify subjects who would most benefit from preventive measures in Mediterranean populations. According to the combination of these factors, a relative risk range from 1 to 98.5 was found. Light skin colour, high number of sunburns with blistering, and low propensity to tan were significantly associated with melanoma thickness, possibly indicating that individuals with these characteristics underestimate their risk and seek attention when their lesion is already advanced. [ABSTRACT FROM AUTHOR]

Remotely sensed data (airborne hyperspectral Multispectral Infrared and Visible Imaging Spectroradiometer (MIVIS) data) were used to map active hydrothermal areas at Vulcano island (Sicily), related to a shallow magmatic chamber inducing hot fluid movements in the overlying rocks. A multispectral analysis was carried out using selected MIVIS band combinations and field spectra of selected altered surfaces. Results were checked by field survey, especially in the most active La Fossa crater area, where the zonation of a superficial high sulphidation hydrothermal system was reconstructed. The band selection used was able to clearly discriminate between fresh and hydrothermally altered rocks, especially at La Fossa crater; but differences between advanced argillic and the silicic alteration facies, as identified by field spectra, were not recognized, probably due to the occurrence of fumaroles. Despite the bias introduced by vegetation cover, illumination conditions and buildings, previously unrecognized sites of potential hydrothermal alteration and fumaroles were mapped in the northern sector of Vulcano island. [ABSTRACT FROM AUTHOR]

This article reports the clinical signs of scrapie occurring in sheep–goat flocks in Italy. The research, carried out on over 500 goats and 550 sheep, yielded an interesting clinical picture, especially of goat scrapie. The affected animals, aged between 2 and 8 years, showed neurological signs that could be classified into three categories: changes in mental status, abnormalities of movement and changes in sensation. Some general clinical signs were also observed. The clinical suspicion was confirmed by histopathological and biochemical investigations. [ABSTRACT FROM AUTHOR]

BACKGROUND: Although linkage studies strongly suggest that proopiomelanocortin (POMC) alterations could play a role in the genetic predisposition to obesity, systematic POMC mutational analysis did not completely confirm this hypothesis. OBJECTIVES: To verify the presence of mutations of the POMC coding region in Italian children with very early onset obesity. SUBJECTS AND METHODS: Eighty seven unrelated Italian obese children and adolescents were studied. Mean age at obesity onset was 4.7 ± 2.5y. The POMC gene coding region was screened using single-strand conformation polymorphism (SSCP) analysis. Bi-directional automatic sequencing of PCR products was performed for all individuals who showed an aberrant SSCP pattern. RESULTS: Three new mutations have been identified in the heterozygous state in three patients: (a) G3834C, resulting in the substitution of Ser with Thr at codon 7 within the POMC signal peptide; (b) C3840T, resulting in the substitution of Ser with Leu at codon 9 of the pre-proopiomelanocortin signal peptide; and (c) C7406G, producing the substitution of Arg with Gly at codon 236 within the β-endorphin peptide. A polymorphism consisting of a 9 bp insertion, AGC AGC CGC, between position 6997 and 6998 has been found at the heterozygous state in nine patients. They showed leptin levels adjusted for BMI, gender and pubertal stage significantly higher than obese subjects homozyous for the POMC wild-type allele. CONCLUSIONS: Mutations in codons 7 and 9 of the signal peptide may alter the translocation of the pre-proopiomelanocortin into the endoplasmic reticulum and, therefore, can be implicated in obesity. Although further studies are required, the polymorphism between position 6997 and 6998 may represent one of the genetic variations that explain the linkage between obesity and POMC. [ABSTRACT FROM AUTHOR]

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Presents an epidemiologic study concerning the prevalence and evolution of vascular disease in the population of San Valentino in Central Italy in 1994. Basis on non-invasive tests of the venous study; Relation of the carotid-femoral arteriosclerotic lesions to the occurrence of future cardiovascular events and of occult arteriosclerotic coronary disease.

Two hundred and seventy epilepsy patients referred to the Epilepsy Centre of the “C. Mondino” Institute of Neurology and 230 healthy subjects comparable for age, sex and education completed a sleep questionnaire of 112 multiple choice questions including those that concern sleep hygiene practice. The percentage of subjects with habitually inappropriate sleep hygiene habits was significantly higher in controls than in epilepsy patients for 7 out of the 9 sleep hygiene practices considered (P at chi square less than 0.05). No significant relationship between kind and/or severity of epilepsy and the degree of sleep hygiene practice was found. The data show that sleep hygiene practice is more adequate in epilepsy than in control subjects. It is possible that the appropriate sleep hygiene practice of epilepsy patients derives from the fact that they habitually refrain from a lot of practices which possibly aggravate both the course of epilepsy and seizure‐related complications. [ABSTRACT FROM AUTHOR]

The Prevalence of Early Atherosclerosis study aims to define the prevalence of subclinical atherosclerosis in a typical population of central Italy. A concomitant study evaluates the prevalence of venous diseases. The prevalence of superficial and deep venous disease, the prevalence of venous thrombosis and pulmonary embolism, and the prevalence of the most common venous malformations were studied through use of medical history, a questionnaire, and noninvasive investigations. The costs of venous problems were also considered. Of some 2000 inhabitants, 746 (379 women; mean age 46.3 ±7 years; range eight to nienty-four) have been screened. No significant difference in trend increase of the relationship age/percent of subjects with venous problems was observed for superficial venous disease. The increase in the proportion of subjects with lipodermatosclerosis and venous ulcerations appeared to be correlated with age (r=0.543). Evidence accepted for pulmonary embolisms was pulmonary angiogram or evidence on ventilation-h perfusion lung scans. According to these criteria the number of documented deep vein thromboses and pulmonary embolisms was very limited with a larger number of suspected disease entities. There was no significant correlation between age and pulmonary embolism or deep venous thrombosis distribution. The number of venous and/or arteriovenous malformations was comparable along the age axis in the different age groups. Only a limited number of these malformations (in less that 1% of subjects) had caused a clinical problem. The treatments used for venous problems have been reported in a questionnaire and subdivided into occasional treatments and chronic treatments (when used for periods longer than twelve months). The percent of subjects using different treatment was also studied. Treatments were divided in: (1) over-the-counter products (or any treatment not requiring prescription); (2) specialized drug (for venous diseases); (3) compression; (4) surgery (any type of surgical treatment); (5) sclerotherapy; (6) combined treatments (ie, sclerotherapy and surgery); (7) alternative treatments (herbal products etc). Finally, the average costs per year for treatment, for investigations, and the costs due to lost working days were recorded. In conclusion some 12% of the evaluated population sample (male population 46%) had or had been affected in the past by a venous problem and 50% of them had received some type of treatment. [ABSTRACT FROM AUTHOR]