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Oxidative stress is one of the underlying mechanisms of the toxic effects exerted by mercury (Hg) on human health. Several antioxidant compounds, including the olive oil phenol hydroxytyrosol (HT), were investigated for their protective action. Recently, we have reported that 5-S-lipoylhydroxytyrosol (Lipo-HT) has shown increased antioxidant activities compared to HT and exerted potent protective effects against reactive oxygen species (ROS) generation and oxidative damage in human hepatocellular carcinoma HepG2 cell lines. In this study, the effects of Lipo-HT and HT on oxidative alterations of human erythrocytes induced by exposure to 40 μM HgCl2 were comparatively evaluated. When administered to the cells, Lipo-HT (5–20 μM) proved nontoxic and it decreased the Hg-induced generation of ROS, the hemolysis, and the depletion of intracellular GSH levels. At all tested concentrations, Lipo-HT exhibited higher ability to counteract Hg-induced cytotoxicity compared to HT. Model studies indicated the formation of a mercury complex at the SH group of Lipo-HT followed by a redox reaction that would spare intracellular GSH. Thus, the enhanced erythrocyte protective action of Lipo-HT from Hg-induced damage with respect to HT is likely due to an effective chelating and reducing ability toward mercury ions. These findings encourage the use of Lipo-HT in nutraceutical strategies to contrast heavy metal toxicity in humans.

Background/Aims: The antimycobacterial riminophenazine clofazimine has previously been shown to up-regulate cellular phospholipase A2 and to induce apoptosis. In erythrocytes phospholipase A2 stimulates eryptosis, the suicidal erythrocyte death characterized by cell shrinkage and cell membrane scrambling with phosphatidylserine translocation to the erythrocyte surface. Phospholipase A2 is in part effective by fostering formation of prostaglandin E2, which triggers Ca2+ entry. Stimulators of Ca2+ entry and eryptosis further include oxidative stress and energy depletion. The present study tested, whether and how clofazimine induces eryptosis. Methods: Phosphatidylserine exposure at the cell surface was estimated from annexin V binding, cell volume from forward scatter, hemolysis from hemoglobin release, cytosolic Ca2+ activity ([Ca2+]i) from Fluo3-fluorescence, reactive oxygen species (ROS) from 2′, 7′-dichlorodihydrofluorescein diacetate (DCFDA) fluorescence, and cytosolic ATP level utilizing a luciferin-luciferase assay kit. Results: A 24-48 hours exposure of human erythrocytes to clofazimine (≥1.5 µg/ml) significantly increased the percentage of annexin-V-binding cells without appreciably modifying forward scatter. Clofazimine significantly increased [Ca2+]i, significantly decreased cytosolic ATP, but did not significantly modify ROS. The effect of clofazimine on annexin-V-binding was significantly blunted, but not fully abolished by removal of extracellular Ca2+, and by phospholipase A2 inhibitor quinacrine (25 µM). Clofazimine further augmented the effect of Ca2+ ionophore ionomycin (0.1 µM) on eryptosis. The clofazimine induced annexin-V-binding was, however, completely abrogated by combined Ca2+ removal and addition of quinacrine. Conclusion: Clofazimine stimulates phospholipid scrambling of the erythrocyte cell membrane, an effect in part dependent on entry of extracellular Ca2+, paralleled by cellular energy depletion and sensitive to phospholipase A2 inhibitor quinacrine.

Disclosure of the HIV status to infected children is often delayed due to psychosocial problems in their families. We aimed at improving the quality of life in families of HIV-infected children, thus promoting disclosure of the HIV status to children by parents. Parents of 17 HIV-infected children (4.2-18 years) followed at our Center for pediatric HIV, unaware of their HIV status, were randomly assigned to the intervention group (8 monthly sessions of family group psychotherapy, FGP) or to the control group not receiving psychotherapy. Changes in the Psychological General Well-Being Index (PGWB-I) and in the Short-Form State-Trait Anxiety Inventory (Sf-STAI), as well as the HIV status disclosure to children by parents, were measured. Ten parents were assigned to the FGP group, while 7 parents to the controls. Psychological well-being increased in 70% of the FGP parents and none of the control group (p=0.017), while anxiety decreased in the FGP group but not in controls (60% vs. 0%, p=0.03). HIV disclosure took place for 6/10 children of the intervention group and for 1/7 of controls. Family group psychotherapy had a positive impact on the environment of HIV-infected children, promoting psychological well-being and the disclosure of the HIV status to children.

Objectives: After active antiretroviral therapy, children with HIV are clinically well, whereas psy- chosocial issues continue to influence their quality of life. The International Classification of Functioning, Disability and Health (ICF) of the World Health Organization evaluates health status and environmental and social factors associated with health. We investigated the efficacy of the ICF to describe the health status and needs of a cohort of children and adolescents with HIV seen at a reference center for pediatric AIDS in Europe. Methods: A quantitative analysis of structured interviews was performed. Caregivers of children and adoles- cents with HIV infection in follow-up at 2 reference centers for pediatric AIDS were enrolled. Four major areas included in the ICF instrument were investigated: impairments of body structures; impairments of body functions; environmental factors; and activity limitations and restrictions to social life. Results: Forty-one families of children with HIV were enrolled. Body structures and functions were marginally impaired, whereas environmental factors and psychosocial issues had a relevant impact on quality of life. Most families consid- ered environmental factors to be "barriers"; these were poverty, unemployment, and single-parent family structure. Activity limitations and social restrictions were also reported in a few cases. Almost all parents reported problems in disclosing their child's HIV status because of the fear of social stigma. Conclusion: Psychosocial issues are part of the well-being of children with HIV. The ICF is a standard tool to evaluate the clinical and psychosocial status of children and adolescents with HIV infection and to measure the impact of therapeutic interventions and strategies on psychosocial functioning. (J Dev Behav Pediatr 31:000-000, 2010) Index terms: HIV, International Classification of Functioning, children, psychological issues, social issues.

Down syndrome (DS, trisomy 21) is the leading cause of chromosomal-related intellectual disability. At an early age, adults with DS develop with the neuropathological hallmarks of Alzheimer's disease, associated with a chronic oxidative stress. To investigate if non-protein bound iron (NPBI) can contribute to building up a pro-oxidative microenvironment, we evaluated NPBI in both plasma and erythrocytes from DS and age-matched controls, together with in vivo markers of lipid peroxidation (F2-isoprostanes, F2-dihomo-isoprostanes, F4-neuroprostanes) and in vitro reactive oxygen species (ROS) formation in erythrocytes. The serum iron panel and uric acid were also measured. Second, we explored possible correlation between NPBI, lipid peroxidation and cognitive performance. Here, we report NPBI increase in DS, which correlates with increased serum ferritin and uric acid. High levels of lipid peroxidation markers and intraerythrocyte ROS formations were also reported. Furthermore, the scores of Raven's Colored Progressive Matrices (RCPM) test, performed as a measure of current cognitive function, are inversely related to NPBI, serum uric acid, and ferritin. Likewise, ROS production, F2-isoprostanes, and F4-neuroprostanes were also inversely related to cognitive performance, whereas serum transferrin positively correlated to RCPM scores. Our data reveal that increased availability of free redox-active iron, associated with enhanced lipid peroxidation, may be involved in neurodegeneration and cognitive decline in DS. In this respect, we propose chelation therapy as a potential preventive/therapeutic tool in DS.

The organophosphorus pesticide bromfenvinphos ((E,Z)-O,O-diethyl-O-[1-(2,4-dichlorophenyl)-2-bromovinyl] phosphate) has been shown to decrease hematocrit and hemoglobin levels in blood presumably by triggering oxidative stress of erythrocytes. Oxidative stress is known to activate erythrocytic Ca(2+) permeable unselective cation channels leading to Ca(2+) entry and increase of cytosolic Ca(2+) activity ([Ca(2+)]i), which in turn triggers eryptosis, the suicidal death characterized by cell shrinkage and cell membrane scrambling with phosphatidylserine translocation to the erythrocyte surface. The present study explored, whether and how bromfenvinphos induces eryptosis. To this end, phosphatidylserine exposure at the cell surface was estimated from annexin-V-binding, cell volume from forward scatter, hemolysis from hemoglobin release, [Ca(2+)]i from Fluo3-fluorescence, and ROS formation from DCFDA dependent fluorescence. As a result, a 48hour exposure of human erythrocytes to bromfenvinphos (≥100μM) significantly increased the percentage of annexin-V-binding cells, significantly decreased forward scatter, significantly increased Fluo3-fluorescence, and significantly increased DCFDA fluorescence. The effect of bromfenvinphos on annexin-V-binding and forward scatter was significantly blunted, but not abolished by removal of extracellular Ca(2+). In conclusion, bromfenvinphos triggers cell shrinkage and phospholipid scrambling of the erythrocyte cell membrane, an effect in part due to stimulation of ROS formation and Ca(2+) entry.

Hydroxytyrosol (HT) is a phenolic antioxidant naturally occurring in virgin olive oil. In this study, we investigated the possible protective effects of HT on programmed suicidal death (eryptosis) induced by mercury (Hg) treatment in intact human erythrocytes (RBC). Our study confirms that the Hg-eryptosis is characterized by phosphatidylserine (PS) exposure at the cell surface, with cell shrinkage and ATP and glutathione depletion; calcium influx is also a key event that triggers eryptosis. Here we report that cell preconditioning with an optimal dose (1-5 μM) of HT prior to exposure to 2.5 μM HgCl2 causes a noteworthy decrease in PS-exposing RBC, almost restoring ATP and GSH content. Conversely, HT shows no effect against decrease in cell volume nor against influx of extracellular calcium. Taken together our data provide the first experimental evidence of the efficacy of HT in modulating the programmed suicidal death in non nucleated cells; the reported findings also confirm that the prevention of Hg toxicity should be regarded as an additional mechanism responsible for the health-promoting potential of this dietary phenol. Finally, virgin olive oil would appear to be a promising healthy food to reduce the adverse effects of chronic mercury exposure in humans.

Il volume è rivolto a medici, psicologi e a chi, nel prendersi cura di un bambino o di un adolescente con patologia reumatica, vuole sperimentare il test psicologico del Disegno della Figura Umana. Le Autrici, confortate da una lunga esperienza sul campo, propongono un approccio che, mentre considera l'indispensabile dimensione medicobiologica, dà ampio rilievo alla valutazione degli aspetti emotivi, cognitivi e di personalità dei giovani pazienti. Grazie ad una puntuale sintesi, mai semplificatoria, il lettore potrà acquisire un metodo di lettura del disegno e, contemporaneamente, affacciarsi sul vissuto interno dei piccoli pazienti affetti da patologia reumatica giovanile.

Hydroxytyrosol (HT) is a phenolic antioxidant naturally occurring in virgin olive oil. In this study, we investigated the possible protective effects of HT on the oxidative and morphological alterations induced by mercury (Hg) in intact human erythrocytes. These cells preferentially accumulate this toxic heavy metal. More importantly, Hg-induced echinocyte formation correlates with increased coagulability of these cells. Our results indicate that HT treatment (10-50 µM) prevents the increase in hemolysis and Reactive Oxygen Species (ROS) generation induced by exposure of cells to micromolar HgCl2 concentrations as well as the decrease in GSH intracellular levels. Moreover, as indicated by scanning electron microscopy, the morphological alterations are also significantly reduced by HT co-treatment. Taken together our data provide the first experimental evidence that HT has the potential to counteract mercury toxicity. The reported effect may be regarded as an additional mechanism underlying the beneficial cardio-protective effects of this dietary antioxidant, also endowed with significant anti-atherogenic and anti-inflammatory properties.

Mercury represents one of the main environmental pollutants and human exposure to this heavy metal occurs primarily through nutritional sources, including contaminated fish. This highly toxic compound is known to pose serious threats to human health, including neurological alterations. Moreover, based on its effects on cardiovascular health, mercury exposure is now considered an independent risk factor for cardiovascular diseases. The possibility of reducing heavy metal toxicity through diet has attracted the interest of those responsible for the public health service. In this respect, the use of phytochemicals able to significantly counteract oxidative alterations as an attractive tool for the reduction of mercury toxicity has been proposed. Here we review recent evidence supporting the beneficial role of olive oil hydroxytyrosol in preventing mercury-induced alterations in both human erythrocytes and neuroblastoma cells. This novel biological effect exerted by hydroxytyrosol represents an additional mechanism responsible for the much-claimed health benefits of this dietary phenol. Taken together the reported findings encourage the use of virgin olive oil, characterized by a high hydroxytyrosol content, as an innovative approach in designing combined dietary and/or nutraceutical strategies to contrast mercury toxicity in humans.

Introduction: Parenteral nutrition has significantly improved the prognosis of children with intestinal failure, but it has an inevitable impact on their lives. The aim of the present study was to assess the psychosocial well-being of these patients and their families. Materials and methods: Two groups of children (cases and controls) were enrolled with their families. Patients with primary intestinal failure aged 2-18 years who required or had previously required parenteral nutritional and healthy controls were included. We used four tests to investigate their quality of life, three administered to parents and one to children. Results: Sixteen children with primary intestinal failure (12 males; mean age 7.2 ± 4.8 years) and 12 healthy controls (6 males; mean age 9.3 ± 4.9 years) were enrolled. The International Classification of Functioning, Disability and Health, Children and Youth Version showed that specific environmental factors were perceived as barriers by patients’ caregivers (44% vs 0%; p=0.01) and 5/16 (31%) of them had medium-high levels of anxiety according to the State-Trait Anxiety Inventory. Conclusions: The quality of life of children on parenteral nutrition was only slightly impaired. Parents, instead, showed more anxious behavior related to their children’s parenteral nutrition.

Evaluation of phenolic profile, antioxidant power, and protective capacity against oxidation of red blood cells (RBCs) of olive oil phenolic extracts (OOPEs) from several Italian varieties were studied. Phenolic profiles, and quantification of seven selected bioactive compounds were performed by RP-HPLC. OOPEs exhibited high antioxidant activity, and this capacity was positively related to their phenolic amount. In particular, OOPE5 (cv Gentile di Larino, Molise region) displayed the highest phenolic and ortho-diphenolic content as well as the strongest scavenging activity determined using 2,2'-diphenyl-1-picrylhydrazyl (DPPH.) (87% DPPH center dot inhibition). Protective capacity against stressed RBCs was investigated through the evaluation of methemoglobin (MetHb) and malondialdehyde (MDA) levels. OOPE5 was the most active against methemoglobin production (53.7% reduction), whereas OOPE1 (cv Lavagnina, Liguria region) showed the highest protection toward malondialdehyde (83.3% reduction). Overall the selected oils showed qualitative and quantitative differences in phenol composition, and this variability influenced their protective effect against oxidative damages. (C) 2015 Elsevier Ltd. All rights reserved.

OBJECTIVES: To assess the features of fat redistribution, detected by clinical and ultrasound (US) methods, and the presence of metabolic disorders in HIV-infected children undergoing antiretroviral therapy. To evaluate if serum levels of resistin, a hormone produced only by visceral adipose tissue, are a marker of fat redistribution in these patients. DESIGN AND METHODS: Forty-five consecutive symptomatic HIV-infected children were considered for inclusion in the study. Patients were enrolled if treated for at least 6 months with antiretroviral therapy with or without protease inhibitor (PI) and if compliant to the study protocol. Patients were evaluated for: anthropometric measures, fat redistribution by clinical and US methods, serum lipids, parameters of insulin resistance by homeostasis model assessment for insulin resistance, serum resistin levels by an enzyme-linked immunosorbent assay. RESULTS: Eighteen children fulfilled the inclusion criteria and were enrolled in the study. Twelve (66%) children had clinical and/or US evidence of fat redistribution; 9 (75%) of them were on PI therapy; only 3 of 6 children without fat redistribution were on PI therapy (p

The aim of this study was to evaluate the psychological condition of young adults who had experienced idiopathic central precocious puberty (ICPP). Ten women aged 18.0 +/- 1.9 years who had previously been treated with GnRH agonists were studied 7 years after the conclusion of the treatment. The enrolled women participated in a group interview and completed standardized checklists; the Sexuality Evaluation Schedule Assessment Monitoring Relation and the Anxiety Scale Questionnaire were also completed. Adult age anxiety was normal even if it had been pathological at the onset of precocious puberty, whereas embarrassment was found in their sexual sphere as well as troubled relationships in either a single or couple situation; 80.0% of them had a negative body image compared to 40.0% of healthy controls. Only 10.0% of the women who had had ICPP studied had practiced masturbation compared to 100% in healthy controls. Of the ICPP patients, 80.0% were single, while 80.0% of healthy controls were involved in a relationship. In conclusion, our findings suggest that ICPP can lead to specific problems in the sexual sphere, and that families and patients need psychological support from the onset of ICPP.

The aim of this study was to investigate the psychological traits of adopted girls affected by idiopathic central precocious puberty (ICPP). Twelve adopted girls were evaluated before, during GnRH agonist (GnRHa) treatment, and after the treatment was stopped. Before, during and after treatment, adopted girls with ICPP showed a normal degree of anxiety, an adequate level of maturity, and a correct sexual identification. None of them had symbiotic character traits as previously reported in non-adopted girls with ICPP. The perception of their body was poor before treatment, but improved during GnRHa treatment and psychological support. The changes in the life of adopted girls are so numerous that precocious puberty may represent an additional risk for psychological discomfort. Therefore to treat precocious puberty it may not only be necessary to prevent premature changes in their body but also to give them enough time to face up to their emotional and psychological problems and to become competent adolescents.

Peripheral GH insensitivity may underlie idiopathic short stature in children. As the clinical and biochemical hallmarks of partial GH insensitivity have not yet been clearly elucidated, the identification of such patients is still difficult. We integrated functional, biochemical, and molecular studies to define the more reliable marker(s) of GH insensitivity. In particular, we measured GH receptor transducing properties through GH-induced protein tyrosine phosphorylation in patients' peripheral blood mononuclear cells and performed direct sequencing analysis of GH receptor-coding exons. Five of 14 idiopathic short stature patients with low basal IGF-I levels showed low or absent IGF-I increment after 4 d of GH administration. However, a prolonged GH stimulation induced in 3 of them an increase in IGF-I 40% above the baseline value. The IGF-binding protein-3 behavior paralleled that of IGF-I. The 2 GH-unresponsive subjects showed an abnormal tyrosine phosphorylation pattern after GH challenge. Sequence analysis of the GH receptor gene revealed a heterozygous mutation resulting in an Arg to Cys change (R161C) in exon 6 in only 1 patient, who had normal GH receptor responsiveness. Our findings indicate that abnormal GH receptor signaling may underlie idiopathic short stature even in the absence of GH receptor mutations. Thus, combining the 4-d IGF-I generation test and the analysis of GH-induced protein tyrosine phosphorylation is a useful tool to help identify idiopathic short stature patients with partial GH insensitivity.

It has been reported that girls at onset of idiopathic central precocious puberty (ICPP) and during treatment have symbiotic character traits. The aim of this study was to investigate the development of character in a group of adolescents. Ten adolescent girls aged 14 years treated for ICPP were evaluated. All the adolescents in the study had a negative body image compared with age-matched controls and expressed a strong inhibition of their femininity. Their poor body image is reflected by their limited self-esteem. These adolescents have not been able to operate a reorganization of their affective life and therefore go through the necessarily slow and painful separation from their family. Symbiotic traits are "hard-wired" into their lives. These results suggest that at ICPP onset, in addition to setting up an educational program for the parents, it is equally important to supply psychological support for the patients in order to gain a better interaction between biological, psychological and cultural influences.

The impact of treatment of central precocious puberty (CPP) with gonadotropin-releasing hormone agonists (GnRHa) on final height remains controversial. We analyzed the long term results of 23 girls with CPP treated with triptorelin or leuprolide. Their "near final height" (NFH) assessed at a bone age of at least 14 years and expressed as SDS, was compared either with predicted height before treatment (PAH) or with parental height (TH). We also compared NFH of 12 girls treated before 8 years of age (7.0 +/- 0.5 yr) with NFH of 11 girls treated after 8 years old (8.5 +/- 0.3 yr). The NFH of the 23 girls (-0.9 +/- 1.0 SDS) was not different either from PAH (-0.85 +/- 1.5 SDS) or from TH (-0.5 +/0.6 SDS). Earlier treated girls reached a NFH (-0.97 +/- 1.0 SDS) not different from later treated girls (-0.91 +/- 1.0 SDS; p = ns) and both groups reached parental height (NFH - TH = -0.44 +/- 1 and -0.09 +/- 0.83 SDS, respectively). In conclusion, our patients, treated either earlier or later, reached a near final height comparable to predicted height and familial target; however, these results might still improve further because the girls have not yet reached their final adult height.

Background JIA means arthritis of unknown origin, lasting more than 6 weeks and that arise before 16 years of age. It is characterized by pain, swelling, stiffness and functional limitation of joints. The Multidimensional Self-Concept Scale assesses global self-concept and six context-dependent self-concept domains that are functionally and theoretically important in the social-emotional adjustment of youth and adolescents: Social, Competence, Affect, Academic, Family, and Physical.