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To offer a rapid investigation on potential source of infection in case of worker exposure (needle stick) to reduce anxiety and to offer an accurate assessment we stressed the analytical performances of two commercial HIV point of Care (POCT). This strategy could suggest to give or not a retroviral therapy in less than 4 hours, the expected time to have the optimal infection’s prophylaxis. 60 selected serum samples were previously analyzed, confirmed and classified for HIV positivity/negativity by conventional laboratory procedure: HIV Combo Ag/Ab Abbott diagnostic®, USA; Western Blot Matrix HIV 1/2 Abbott®, USA. Suddenly we investigated all samples by the new POCT test (HIV 1/2 Ag/Ab Combo InvernessMedical®, Chiba Japan) 60 selected serum are classified 40 as negative and 20 as positive. We analyzed our data by quantify agreement with kappa (Choen’s kappa coefficient) and we registered a poor strength of agreement between two immunocromatographic HIV tests but a perfect strength of agreement (Kappa=1.000) between CMIA test and Immunocromatographic Ag/Ab HIV and PNV, VVP, sensitivity and specificity are 100%. All acute healthcare settings should expect to have an access to an urgent HIV screening assay result ideally within four hours, and definitely within 24 h, to provide optimal support for exposure incidents. POCT can give a rapidly diagnostic evaluation on a possible source of infection enabling to give an accurate indication for a prophilactic treatment.

Aim. The scientific literature focused on factors involved in the onset of borderline personality disorder (BPD) has given a central role to the families of these patients. The role of the family in understanding the disorder has gradually changed thanks to research that investigated the interaction of several factors in the development of this psychopathology. Recently, scientific literature on DBP has allowed to consider parents as no longer "responsible" for the development of the disorder, but as directly involved in interpersonal problems of patients and therefore a potential "ally" in the management of crisis. The aim of this study is to describe and quantify the family burden of BPD patients and browse specific interventions for the family of these patients. Methods. PubMed and PsycINFO have been used for review with the following keywords: "borderline personality disorder", "family", "psychopathology", "burden", "psychoeducation", "caregiver", "caretaker". Results. Studies on family burden of BPD patients are still few. Research shows that the family burden of BPD patients is comparable with that of families of patients with schizophrenia. Clinical trials of interventions for caregivers of patients with BPD show that specific strategies can reduce the family burden and improve their self-efficacy. Discussion. Scientific literature highlights the relevance of problems of families with a BPD member and the importance of involving them in the treatment of these patients.

Introduction: Integration between primary care and mental health care is critical for health-care systems. Some years ago, the Emilia-Romagna Region undertook a project (the "Leggieri Project") aimed at rationalizing pathways to care and improving the quality of treatments for common psychiatric disorders. The aim of this study was to monitor and assess local implementation of the stepped care model outlined by the regional project. Materials and methods: We examined all new cases referred to Bologna Mental Health Centers (MHCs) from 2007 through 2009 (N = 15,534). Data on patients, referrals and treatments were collected from Department of Mental Health's Adult Psychiatry database. Standardized incidence rates, rates of referrals from general practitioners (GPs), and stepped care levels were investigated. We compared patient characteristics and treatments of cases referred by GPs and all other cases. A similar analysis was carried out for groups defined by stepped care level. Results: The annual incidence of MHC referral ranged from 64.7 to 65.8 per 10,000 adult inhabitants. On the whole, 52% of the new cases were referred to the MHCs by GPs: this rate increased over time from 48% to 54%. As for stepped care, MHC care was planned for 55% of the patients referred by GPs, 14% were managed with joint GP and MHC care, and 31% of the new cases were back-referred after a psychiatric consultation. The differences between these levels of care narrowed over the three-year period: cases managed with psychiatric consultations or joint GP-MHC care increased, while those managed exclusively by the MHC decreased. Almost 50% of all cases involving non-Italian immigrants were referred by GPs, although this rate was lower than that observed among Italian patients. These trends were evident in each departmental area. Patients referred by GPs were more likely to be elderly women with common psychiatric disorders. Among these, the cases managed in MHCs had the most severe diagnoses and received the most intensive and long-lasting treatments. Conclusions: Integration of primary care and mental health care is increasing and seems to be appropriate. In accordance with the recommendations of the regional project, integrated care is used above all for patients with common psychiatric disorders. Collaborative care for severe disorders requires further investigation. For these disorders, which often affect young patients and are frequently associated with comorbidity and a high risk of chronicity evolution, early detection and integrated care are crucial goals for the immediate future.

We recently described the diastereoselective synthesis of racemic water-soluble polyol-Cp Rhodium species rac-(1,2,4)-CpOOORh(NBD) [CpOOO= C5H3[CH(CH2)3CH)OH]3 A [1]. We report on the unexpected chiral response in the absence of chiral auxiliaries or anisotropic medium, observed in polar-donor solvating media (thf, dmso, methanol) through a positive signal (CD), consistent with negative rotatory power values (25D = -12). The calculated DFT spectra describe the metal orbitals involved in the UV transitions (300-500 nm) and allow for the interpretation of CD results. Since the central and planar chirality effects are both cancelled out by the presence of racemate, the chiral behaviour in solution has to be ascribed exclusively to the preferred helicity of A conformers with minor energy. The dynamic VT NMR experiments in pyridine show a strong OH(1)•••OH(2) intramolecular hydrogen bond interaction. However, the marked bathochromic effect shown by the CD spectra of A suggests the presence of strong intermolecular H-bonding interactions (mean /T~12 ppb/K), which may be generated by supramolecular conglomerate networks with a preferred chirality. It should be pointed out that helicity inversion requires only slight geometrical alterations (~30o of the related dihedral angles) and low-energy barriers (experimentally and theoretically calculated as 7-8 Kcal mol-1). Therefore, we believe that chiroptical behavior (of the polyol species A is provoked by the donor effects of high polar solvents (dmso, MeOH). [1] S. Bordoni, P. Natanti, S. Cerini, R. Tarroni, M. Monari, F. Piccinelli, L. Busetto; Organometallics 2008, 27, 945–954 and references therein.

The purpose of this work is to present a monitoring system based on analytical redundancy and directional residual generation using measurements obtained during the refueling process. In short this problem consists of building an unknown input observer with the role to estimate the friction force produced by the interaction between the wall of the fuel channel and the fuel assembly supporting brushes. This let to estimate the shape of the graphite bricks that comprise the core and, therefore, monitor any distortion of them. The theoretical machinery exploited in this work is the Kalman filter theory, which is used to estimate the information above mentioned.

Leptin, a protein produced and secreted by adipocytes, is know to regulate food intake and whole-body energy metabolism, but knowledge about its possible effect in bovine mammary gland is scarce. Leptin may be involved in the regulation of glucose transport even though this effect at the tissue level remains controversial. Once uptaken by the mammary gland, glucose is utilised in several ways but the majority, about 60-70%, is drained for lactose synthesis. This study was aimed at investigating the effect of leptin on glucose regulation in bovine mammary gland. We have examined the effects of leptin on the expression of GLUT1 mRNA, pyruvate kinase (PK) as well as glucose-6-phosphate dehydrogenase (G6PDH) activity. Treatment of mammary gland explants with recombinant leptin did not influence glucose assimilation, pathway transport (GLUT1 mRNA) and glucose metabolism (PK and G6PDH) in this tissue. The results from this study seem to exclude an involvement of leptin in glucose uptake and metabolism in bovine mammary gland.

The objective of this study was to investigate correlates of risk for having microalbuminuria in individuals with one or more cardiovascular risk factors.The study involved 1919 individuals who attended general practice settings, were aged 55 to 75 yr, and did not have a history of cardiovascular events or diabetes but had one or more cardiovascular risk factors. A tree-based regression technique and multivariate analysis were used to identify distinct, homogeneous subgroups of patients with different likelihood of having microalbuminuria; interaction between correlates of microalbuminuria and risk for microalbuminuria was also investigated.The prevalence of microalbuminuria was 5.9%. Patients who did not have hypertension and had postload glycemia140 mg/dl showed the lowest prevalence of microalbuminuria (1.9%) and represented the reference class. The likelihood of microalbuminuria was seven times higher in men with hypertension and homeostatic model assessment levels in the upper tertile and four times higher in women with the same characteristics. Individuals with hypertension and lower homeostatic model assessment levels and normotensive individuals with postload glycemiaor = 140 mg/dl had a more than three-fold increased likelihood of having microalbuminuria. Treatment with statins was associated with a 54% reduction in the likelihood of having microalbuminuria, whereas levels of triglycerides150 mg/dl and fibrinogen levels in the upper tertile were associated with a significantly higher risk for microalbuminuria.The likelihood of having microalbuminuria in a population-based study of elderly individuals is strongly related to the interaction between the components of the metabolic syndrome, particularly hypertension, insulin resistance, and impaired glucose tolerance.

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Ulteriore coautore: Ruffo F.

In the present study, the effects of high temperatures on immune responses in the clam Chamelea gallina (Bivalvia: Veneridae) were evaluated.

The effects of anoxia on the immune responses of a commercially important bivalve species, Chamelea gallina, were studied in two different experiments (24-h and 48-h exposure to deoxygenated seawater). After anoxic stress, the capability of clams to recover was also evaluated by maintaining animals for 24 h in aerated seawater. Total haemocyte count (THC), phagocytosis and lysozyme activity (in both haemocyte lysate and cell-free haemolymph) were chosen as cellular biomarkers of exposure to anoxic conditions. Anoxia significantly reduced THC with respect to controls in both experiments. However, clams which recovered from the 24-h anoxia test showed THC values similar to those of controls, whereas in the 48-h test recovery clam THC was similar to that of stressed clams. Significantly decreased phagocytic activity with respect to controls was also observed in both experiments. In the first experiment, haemocytes from recovery clams showed slightly higher phagocytic activity with respect to controls, whereas after 48 h of exposure haemocytes from recovery animals were unable to recover their phagocytic activity. After both 24-h and 48-h anoxia, lysozyme activity was significantly reduced in both haemocyte lysate and cell-free haemolymph. In recovery clams from 24-h anoxia, the lysozyme activity of lysate was significantly lower than in control and stressed clams, whereas in haemolymph it was significantly higher. Conversely, in recovery clams from 48-h anoxia, the enzyme activity of both media decreased significantly with respect to controls. Interestingly, an unexpected additional stress during the 48-h anoxia test was recorded: recovery clams spawned during the recovery phase. To validate the hypothesis that spawning acts as an additional type of stress, the survival-in-air test was also performed. Significant decreases in resistance to air exposure were observed after 48 h anoxia in both stressed and recovery animals. Results show that anoxia strongly affects the functional responses of haemocytes, reducing immunosurveillance in stressed clams. The present study also highlights that additional stress, such as spawning, may further decrease immunosurveillance and reduce the resistance of clams to exposure to air.