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The article discusses a study which evaluates the clinical decision limit and performance of cardiac troponin (cTn) I assay. The study uses immunoassay and serum analysis for blood sample examination. The study reveals that the cTn assay has improved low-end analytical performance for myocardial injury detection.

Background: In haemodialysis is key to successfully obtaining cannulation of the arteriovenous fistula (AVF). The literature agrees that cannulation, failing in the initial maturation period, can lead to delayed dialysis, haematoma, scarring, needle phobia and loss of confidence in the cannulator. The introduction of plastic cannulae for haemodialysis has changed cannulation practice positively, preventing frequent complications such as infiltration or trauma. Despite that, most countries have continued to use metal cannulation, in particular in Europe. This study investigates the common use of plastic cannulae versus metal needles for cannulation in dialysis units and explores the implications of focusing on the side effects of cannulation., Methods: The study is a cross-sectional survey. A questionnaire was created by a team of experts from the European Dialysis Transplant Nurse Association/European Renal Care Association (EDTNA/ERCA) to address the study's aims and sent online to nurse members., Results: Data collected suggested a strong resistance towards using plastic cannulae, with few respondents claiming to use these cannulas. Most of the respondents were female (74%), Europeans, working in nephrology for more than 10 years and most worked in the public sector. There was a strong correlation between the use of plastic cannulae and fewer adverse events in elbow located AVF and newly created or fragile AVF., Conclusions: The results are in line with the current literature. Possible resistance to the use of the plastic device includes the difference in cost between the two devices in favour of metal needles. However, it should be considered that the lower number of adverse events, in particular infiltration and haematoma caused by the metal needle, involves a considerable saving both in money and in terms of time and distress for the patient., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: The early detection of neurocognitive disorders, especially when mild, is a key issue of health care systems including the Italian Dementia National Plan. The Mini-Mental State Examination (MMSE), i.e., the reference screening tool for dementia in Italian Memory Clinics, has low sensitivity in detecting mild cognitive impairment (MCI) or mild dementia., Objective: Availability of a 10-minute screening test sensitive to MCI and mild dementia, such as the Montreal Cognitive Assessment (MoCA), is relevant in the field. This study presents initial validity and reliability data for the Italian version of MoCA 7.1 that is being collected as part of a large ongoing longitudinal study to evaluate the rate of incident MCI and dementia in older adults., Methods: MoCA 7.1 and MMSE were administered to cognitive impaired patients ( n  = 469; 214 with MCI, 255 with dementia; mean age: 75.5; 52% females,) and healthy older adults ( n  = 123, mean age: 69.7, 64 % females)., Results: Test-retest (0.945, p  < 0.001) and inter-rater (0.999, p  < 0.001) reliability of MoCA 7.1, assessed on randomly selected participants with normal cognition, MCI, dementia, were significant. MoCA 7.1 showed adequate sensitivity (95.3%) and specificity (84.5%) in detecting MCI compared to MMSE (sensitivity: 53.8%; specificity: 87.5%). The Area Under the Curve of MoCA 7.1 was significantly greater than that of MMSE (0.963 versus 0.742). MoCA 7.1 showed similar results in detecting both MCI and dementia., Conclusion: MoCA 7.1 is a reliable and useful tool that can aid in the diagnosis of MCI and dementia in the Italian population., Competing Interests: Alessandro Pirani, Andrea Fabbo, Marco Bruno Rocchi, Cristina Tulipani, Matteo Galassi, and Mirco Neri have no conflict of interest to report. Ziad Nasreddine is the copyright owner of the MoCA test and received grants from Eli Lilly, Roche, Biogen for clinical trials, royalties for the use of the MoCA test in clinical trials, consulting fees from Biogen, Eli Lilly and Roche, payments from Biogen and Roche for data safety monitoring board or advisory board. Francesca Neviani received honoraria from Medicalnet and Aristea. The payments were made to her. Marco Bertolotti received support from Mylan Drug Company for attending the meeting of the European Atherosclerosis Society (Maastricht, Netherlands, 2019) and serves as member of the national board of the Italian Society for Cardiovascular Prevention and the regional board of the Italian Society of Gerontology and Geriatrics; he served as a former member of the regional board of the Italian Society for the Study of Atherosclerosis. Martino Belvederi Murri received an honorarium for a lecture on depression by an educational agency (Lopez Eventi e Congressi) for which he had to declare absence of conflict of interests. The payment was made to him., (© 2022 – The authors. Published by IOS Press.)

On May 2020, after 2 months of online teaching with no face-to-face lectures, the Education Committee of the Italian scientific Society of Medical Statistics and Clinical Epidemiology conceived an online survey to assess satisfaction of Italian academics of medical statistics with online teaching and remote exams. This survey highlighted teachers' perceptions as well as opportunities and limitations of online teaching of medical statistics, biostatistics, and epidemiology. Although 61% of Italian academics of medical statistics declared to be favorable to provide online teaching of medical statistics, biostatistics, and epidemiology in the future, we recognize that distance education cannot substitute the unique value of teaching and knowledge exchange that could only be transmitted through a personal interaction between students and teachers. These indications may be useful to improve the quality of the teaching process in the future., Competing Interests: The authors have no conflicts of interest to declare., (© 2021 The Authors. Teaching Statistics published by John Wiley & Sons Ltd on behalf of Teaching Statistics Trust.)

Contamination of pharmaceutical products and medical devices with pyrogens such as endotoxins is the most common cause of systemic inflammation and, in worst cases, of septic shock. Thus, quantification of pyrogens is crucial. The limulus amebocyte lysate (LAL)-based assays are the reference tests for in vitro endotoxin detection, in association with the in vivo rabbit pyrogen test (RPT), according to European Pharmacopoeia (EP 2.6.14), and U.S. Pharmacopoeia (USP <85>). However, several substances interfere with LAL assay, while RPT is not accurate, not quantitative, and raises ethical limits. Biological assays, as monocyte activation tests, have been developed and included in European Pharmacopoeia (EP 7.0; 04/2010:20630) guidelines as an alternative to RPT and proved relevant to the febrile reaction in vivo. Because this reaction is carried out by endogenous mediators under the transcriptional control of nuclear factor-kappaB (NF-kappaB), we sought to determine whether a NF-kappaB reporter-gene assay, based on MonoMac-6 (MM6) cells, could reconcile the basic mechanism of innate immune response with the relevance of monocytoid cell lines to the organism reaction to endotoxins. This article describes both optimization and characterization of the reporter cells-based assay, which overall proved the linearity, accuracy, and precision of the test, and demonstrated the sensitivity of the assay to 0.24 EU/mL endotoxin, close to the pyrogenic threshold in humans. Moreover, the assay was experimentally compared to the LAL test in the evaluation of selected interfering samples. The good performance of the MM6 reporter test demonstrates the suitability of this assay to evaluate interfering or false-positive samples.

The association of the pioneer organisms Streptococcus mutans ATCC 25175 or Streptococcus oralis ATCC 9811 with secondary colonizers Fusobacterium nucleatum ATCC 25586 or Porphyromonas gingivalis ATCC 33277 during biofilm development on titanium surfaces was evaluated by flow cytometry (FCM) using specific polyclonal antibodies. ELISA and FCM were employed, revealing high antibody sensitivity and specificity. Biofilm formation of four dual-species combinations was analyzed by crystal violet staining, while the association between streptococci and periodontal pathogens was assessed using FCM. Dual-species association between S. oralis and P. gingivalis or F. nucleatum showed a proportional decrease in S. oralis during biofilm development, with a concomitant increase in P. gingivalis or F. nucleatum. This trend was not observed in either of the dual-species associations of S. mutans with the periodontal pathogens. Our dual-species microbial model, which employed FCM, proved to be useful in the study of partnerships between bacteria in oral associations, showing that the presence of primary colonizers is required for the establishment of secondary colonizers in biofilms. The proposed experimental approach is technically simple to prepare and analyze, and also proved to be reproducible; hence, it is well-suited for investigating the development and dynamics of oral communities., (Copyright © 2016 Institut Pasteur. Published by Elsevier Masson SAS. All rights reserved.)

Introduction: Telomeres may be considered markers of biological aging, shorter telomere length is associated with some age-related diseases; in several studies short telomere length has also been associated to obesity in adults and adolescents. However the relationship between telomere complex functions and obesity is still not clear. Aim of the study was to assess telomere length (TL) in adults' obese subjects before and after weight loss obtained by placement of bioenteric intragastric balloon (BIB) for 6months., Methods: We enrolled 42 obese subjects before and after BIB placement as weight loss intervention. Blood samples were collected in order to obtain DNA from leukocyte to measure TL by quantitative PCR., Results: Data were analyzed only in 37 subjects with complete data; all presented important body weight loss (124.06±26.7 vs 105.40±23.14, p<0.001) and more interesting they presented a significant increase in TL (3.58±0.83 vs 5.61±3.29, p<0.001). Moreover we observed a significant positive correlation between TL elongation and weight loss (r=0.44, p=0.007) as well as an inverse correlation between TL at baseline and TL elongation (r=-0.35, p=0.03).The predictors of TL elongation were once again weight loss and short TL at baseline (respectively p=0.007 and p=0.003)., Conclusions: Our study shows that weight loss is associated to telomere lengthening in a positive correlation: the greater weight loss the greater telomere lengthening; moreover telomere lengthening is more significant in those subjects with shortest telomeres at baseline., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Background: Schizophrenia is a disabling complex mental disorder and despite all available treatment, many patients unfortunately remain partial- or non-responders. A large body of research has shown that oxytocin is an important prosocial peptide and there is initial evidence that the central oxytocin system is altered in several mental disorders. The aim of this study was to test the efficacy of oxytocin, as augmentation therapy, in a sample of patients with schizophrenia., Methods: We conducted an 8-month randomized, double-blind, controlled trial with a crossover design. We wanted to test the hypothesis that intranasal oxytocin could reduce symptoms in 32 patients with schizophrenia aged 18-45 with short-medium illness duration (<11 years). Patients were randomly assigned to either 40 International Units oxytocin once daily or a vehicle placebo group, in addition to their pre-study antipsychotic medication regimen. We subsequently conducted a multi-dimensional assessment including psychopathological, psychosocial and neuropsychological aspects., Results: Positive and Negative Syndrome Scale scores showed no significant differences in treatment effects between the experimental group and controls. Furthermore, no treatment effects were shown in any of the rating scales used in this study. However, a statistically significant period effect was shown in most outcome measurements., Conclusions: In our trial, oxytocin did not add any significant beneficial effects to anti-psychotic treatment in terms of clinical symptoms or psychosocial functioning. Further research should focus on different ways to administer oxytocin, or investigate predictors (such as past traumas, or biomarkers), which could identify subgroups of patients with different treatment responses to oxytocin. ClinicalTrials.gov Identifier: NCT01699997. ID number: RF-2010-2311148. URL: https://clinicaltrials.gov/ct2/show/NCT01699997., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Background: Diets enriched with n-3 polyunsaturated fatty acids (n-3 PUFAs) have been shown to exert a positive impact on muscle diseases. Flaxseed is one of the richest sources of n-3 PUFA acid α-linolenic acid (ALA). The aim of this study was to assess the effects of flaxseed and ALA in models of skeletal muscle degeneration characterized by high levels of Tumor Necrosis Factor-α (TNF)., Methods: The in vivo studies were carried out on dystrophic hamsters affected by muscle damage associated with high TNF plasma levels and fed with a long-term 30% flaxseed-supplemented diet. Differentiating C2C12 myoblasts treated with TNF and challenged with ALA represented the in vitro model. Skeletal muscle morphology was scrutinized by applying the Principal Component Analysis statistical method. Apoptosis, inflammation and myogenesis were analyzed by immunofluorescence. Finally, an in silico analysis was carried out to predict the possible pathways underlying the effects of n-3 PUFAs., Results: The flaxseed-enriched diet protected the dystrophic muscle from apoptosis and preserved muscle myogenesis by increasing the myogenin and alpha myosin heavy chain. Moreover, it restored the normal expression pattern of caveolin-3 thereby allowing protein retention at the sarcolemma. ALA reduced TNF-induced apoptosis in differentiating myoblasts and prevented the TNF-induced inhibition of myogenesis, as demonstrated by the increased expression of myogenin, myosin heavy chain and caveolin-3, while promoting myotube fusion. The in silico investigation revealed that FAK pathways may play a central role in the protective effects of ALA on myogenesis., Conclusions: These findings indicate that flaxseed may exert potent beneficial effects by preserving skeletal muscle regeneration and homeostasis partly through an ALA-mediated action. Thus, dietary flaxseed and ALA may serve as a useful strategy for treating patients with muscle dystrophies.

Creatine supplementation has been shown to protect neurons from oxidative damage due to its antioxidant and ergogenic functions. These features have led to the hypothesis of creatine supplementation use during pregnancy as prophylactic treatment to prevent CNS damage, such as hypoxic-ischemic encephalopathy. Unfortunately, very little is known on the effects of creatine supplementation during neuron differentiation, while in vitro studies revealed an influence on neuron excitability, leaving the possibility of creatine supplementation during the CNS development an open question. Using a multiple approach, we studied the hippocampal neuron morphological and functional development in neonatal rats born by dams supplemented with 1% creatine in drinking water during pregnancy. CA1 pyramidal neurons of supplemented newborn rats showed enhanced dendritic tree development, increased LTP maintenance, larger evoked-synaptic responses, and higher intrinsic excitability in comparison to controls. Moreover, a faster repolarizing phase of action potential with the appearance of a hyperpolarization were recorded in neurons of the creatine-treated group. Consistently, CA1 neurons of creatine exposed pups exhibited a higher maximum firing frequency than controls. In summary, we found that creatine supplementation during pregnancy positively affects morphological and electrophysiological development of CA1 neurons in offspring rats, increasing neuronal excitability. Altogether, these findings emphasize the need to evaluate the benefits and the safety of maternal intake of creatine in humans., (Copyright © 2015 IBRO. Published by Elsevier Ltd. All rights reserved.)

Background: Brugada syndrome (BrS) is a primary electrical disease associated with an increased risk of sudden cardiac death due to ventricular fibrillation. This pathology has nuclear heterogeneous genetic origins, and at present, molecular diagnostic tests on nuclear DNA cover only 30% of BrS patients. The aim of this study was to assess the possible involvement of mitochondrial (mt) DNA variants in BrS since their etiological role in several cardiomyopathies has already been described., Methods and Results: The whole mt genome of BrS patients was sequenced and analyzed. A specific mtDNA mutation responsible for BrS can be excluded, but BrS patient d-loop was found to be more polymorphic than that of control cases (P=0.003). Moreover, there appears to be an association between patients with the highest number of variants (n>20) and four mt Single Nucleotide Polymorphism (SNPs) (T4216C, A11251G, C15452A, T16126C) and the most severe BrS phenotype (P=0.002)., Conclusions: The high substitution rate found in BrS patient mtDNA is unlikely to be the primary cause of the disease, but it could represent an important cofactor in the manifestation of the BrS phenotype. Evidence suggesting that a specific mtDNA allelic combination and a high number of mtDNA SNPs may be associated with more severe cases of BrS represents the starting point for further cohort studies aiming to test whether this mt genetic condition could be a genetic modulator of the BrS clinical phenotype., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Background: Interventions including physical exercise may help improve the outcomes of late-life major depression, but few studies are available., Aims: To investigate whether augmenting sertraline therapy with physical exercise leads to better outcomes of late-life major depression., Method: Primary care patients (465 years) with major depression were randomised to 24 weeks of higher-intensity, progressive aerobic exercise plus sertraline (S+PAE), lower-intensity, non-progressive exercise plus sertraline (S+NPE) and sertraline alone. The primary outcome was remission (a score of ≤10 on the Hamilton Rating Scale for Depression)., Results: A total of 121 patients were included. At study end, 45% of participants in the sertraline group, 73% of those in the S+NPE group and 81% of those in the S+PAE group achieved remission (P = 0.001). A shorter time to remission was observed in the S+PAE group than in the sertraline-only group., Conclusions: Physical exercise may be a safe and effective augmentation to antidepressant therapy in late-life major depression., (© The Royal College of Psychiatrists 2015.)

Background: An increasing number of young people have made contact with the Child and Adolescent Mental Health Services (CAMHS). However, only a small proportion of the population with emotional problems, actually seek specialized care. Research concerning the help-seeking process and pathways to care of a clinical sample could help to develop effective health policies to facilitate access to specialized care., Aim: To analyze the access pattern for CAMHS, reasons of contact and care pathways of a consecutive sample of first-time patients. Our aim was to analyze the association between source of referral, socio-demographic and clinical variables., Methods: Standardized assessment instruments and information concerning access patterns and care pathways were collected from 399 patients at first-time contact with CAMHS in a Northern Italian Region., Results: Most patients were referred to CAMHS by school teachers (36 %) or health professionals (32 %), while only 17 % of the parents sought help by themselves. School issues (50 %) and emotional problems (17 %) were the most frequent reasons for contact. The proportion of first-time contacts with no diagnosis of mental disorder at their first consultation did not differ by source of referral. Parents of children who did not receive a clinical diagnosis of mental disorders described them as "psychosocially impaired" and their condition as "clinically severe" likewise parents of patients who received a psychiatric diagnosis. Patients with externalizing problems were more frequently referred by the parents themselves, while youth with internalizing problems were more often referred through health professionals. Families with non-traditional structures (adoptive, foster care, mono-parental) were more likely to consult CAMHS directly, while immigrant youth were more often referred by teachers., Conclusion: Socio-demographic and clinical characteristics can affect pathways to care. To improve early access to care for children and adolescents with ongoing mental disorders, a plan for proper action addressed to teachers and health professionals may well be important. This would improve their ability to recognize emotional and behavioral problems and use proper referral pathways, while informative intervention addressed to non-Italian families should inform them about the functioning and the mission of CAMHS.

In Saccharomyces cerevisiae, a typical apoptotic phenotype is induced by some stress factors such as sugars, acetic acid, hydrogen peroxide, aspirin and age. Nevertheless, no data have been reported for apoptosis induced by puromycin, a damaging agent known to induce apoptosis in mammalian cells. We treated S. cerevisiae with puromycin to induce apoptosis and evaluated the percentage of dead cells by using Hoechst 33342 staining, transmission electron microscopy (TEM) and Annexin V flow cytometry (FC) analysis. Hoechst 33342 fluorescence images were processed to acquire parameters to use for multiparameter analysis [and perform a principal component analysis, (PCA)]. Cell viability was evaluated by Rhodamine 123 (Rh 123) and Acridine Orange microscope fluorescence staining. The results show puromycin-induced apoptosis in S. cerevisiae, and the PCA analysis indicated that the increasing percentage of apoptotic cells delineated a well-defined graph profile. The results were supported by TEM and FC. This study gives new insights into yeast apoptosis using puromycin as inducer agent, and PCA analysis may complement molecular analysis facilitating further studies to its detection.

Background: In this study, we check for the presence of specific resistance genes by polymerase chain reaction (PCR) and then we used flow cytometry (FCM) to evaluate antibiotic-induced effects in different strains of Escherichia coli (E. coli)., Methods: The presence of resistance genes was investigated by PCR in 10 strains of E. coli isolated from Foglia River. Bacterial responses to different antibiotics were also tested with FCM techniques by evaluating both the degree of decrease in viability and the light scatter changes in all of the strains., Results: PCR revealed that only one strain exhibits the presence of one resistance gene. Despite this, analyses of strains using FCM evidenced the presence of viable subpopulations after antibiotic treatment. Furthermore, analyses of scatter signals revealed profound changes in the Forward Scatter and Side Scatter of the bacterial populations as a consequence of antibiotic exposure, confirming the viability and membrane potential data. The riverine strains were in general less sensitive to antibiotics than the reference strain (ATCC 25922)., Conclusions: Antibiotic resistance is a widespread phenomena. The multiparametric approach based on FCM used in this study, providing results about different aspects (cell viability, membrane potential, light scatter changes), may overcome the limitation of PCR and could represent an adequate method for the evaluation of bacteria responses to antibiotic exposure., (© 2014 International Clinical Cytometry Society.)

The goal of the study was to estimate the prevalence of current and lifetime mental disorders in a consecutive sample (n=300) of detainees and prison inmates held in an Italian prison and compare it with the prevalence observed in a sample randomized from the community (n=300) within the same age interval (18-55 years) and sex proportion of prisoners, and with a similar socio-economic status. Psychiatric disorders were identified with the Mini International Neuropsychiatric Interview (MINI). Current psychiatric disorders were present in 58.7% of prisoners and 8.7% of the comparison group. Lifetime psychiatric disorders were present in 88.7% of prisoners and 15.7% of the comparison group. Current anxiety disorders and current stress-related disorders were related to prisoners serving their first-ever prison sentence. A variable fraction of prisoners with an ongoing psychopathology is not diagnosed or does not receive proper treatment. The provision of effective treatment to prisoners with psychiatric disorders might have potentially substantial public health benefits., (Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.)

Background: The study of hallucination-like experiences (HLEs) in non-clinical populations is increasingly used to corroborate etiological models of psychosis. This method capitalizes on the absence of confounding factors that typically affect the study of hallucinations in clinical subjects., Aim: To estimate the prevalence of HLEs in young adults; validate the mutidimensionality and explore the correlates of latent HLEs clusters., Methods: Cross-sectional survey design. The extended 16-item Launay-Slade Hallucination Scale (LSHS-E) and the 12-item General Health Questionnaire (GHQ-12) were administered to 649 Italian college students (males: 47%). Confirmatory factorial analysis was used to test multidimensionality of the LSHS-E. Hierarchical nested, progressively constrained models were used to assess configural, metric and scalar invariance of the LSHS-E. Latent class analysis was used to test the existence of different profiles of responding across the identified hallucination-proneness dimensions., Results: Factor analysis showed that the four-factor model had the best fit. Factors were invariant across demographic variables and levels of psychological distress. Three latent classes were found: a large class with no HLEs (70% of participants), a multisensory HLEs class (18.8%), and a high hallucination-proneness class (11%). Among those reporting high levels of HLEs, approximately half reported scores indicative of considerable psychological distress., Conclusions: Although HLEs have a relatively high prevalence in the general population, the majority of those experiences happen in isolation and are not associated to psychological distress. Approximately half of those individuals experiencing high levels of HLEs report significant psychological distress. This may be indicative of general risk for mental health conditions rather than specific risk for psychosis., (Copyright © 2014 Elsevier Inc. All rights reserved.)

The underlying structures of clinical caseness and need of care in prodromal (i.e., at-risk) and early phases of schizophrenia remain poorly characterized in their essential psycho-behavioral coherence. To identify the schizophrenia proneness-related subtypes within a population of young help-seekers referred to a dedicated, community-based early detection program (Programma 2000). A sample of consecutive referrals (n = 168) for suspected psychosis or first-episode schizophrenia spectrum psychosis received a detailed clinical assessment, including the early recognition inventory for the retrospective assessment of the onset of schizophrenia checklist. We used exploratory factor analysis (EFA) to determine the underlying dimensional structure and latent class analysis (LCA) to identify putative vulnerability subtypes. EFA identified four factors: dysphoria (irritability tension), paranoid autocentrism, introversive withdrawal, and disturbed subjective experience. LCA distinguished three classes, interpretable as carrying different degrees of "proneness to schizophrenia psychosis," which best captured the underlying continuum of clinical severity. The validity of the three classes was supported by distinct patterns of association with major clinical variables (i.e., diagnostic staging at referral). Vulnerability to schizophrenia psychosis in young help-seekers may manifest in three major clinical prototypes, presenting common levels of dysphoria and social withdrawal but different degrees of paranoid autocentrism and disturbed subjective experience. Overall, the results provide the empirical background to dissect shared features of clinical caseness from more schizophrenia-specific vulnerability components. This is of value for the refinement of the clinical staging model as well as for the pragmatic implementation of multiple-gate screening programs.

The major environmental impact of landfills is emission of pollutants via the leachate and gas pathways. The hepatopancreas of the terrestrial isopod Armadillidium vulgare (Isopoda, Crustacea, Latreille 1804) plays an important role in the bioaccumulation of contaminants, such as heavy metals. To evaluate the effects of landfill leachate treatment, 2 different approaches were applied: 1) the detection of accumulation of trace elements (As, Cd, Cr, Cu, Sb, Zn, Pb, Ni, V) in hepatopancreatic cells, and 2) the evaluation of biological effect of contaminants on fresh hepatopancreatic cells by flow-cytometric analyses. The presence of 2 different cell types (herein referred to as "small" [S] cells and "big" [B] cells, in agreement with the literature based on morphological examinations) was detected for the first time by flow cytometry, which also highlighted their different response to stress stimuli. In particular, B cells appeared more sensitive to landfill leachate treatment, being more damaged in the short term, while S cells seemed more adaptive. Furthermore, S cells could represent a pool from which they are able to differentiate into B cells. These findings were also confirmed by principal component analyses, underlining that S SYBR Green I bright cells correlate with specific chemicals (Ca, Cu, Co), confirming their resistance to stress stimuli, and suggesting that the decrease of specific cell types may prime other elements to replace them in a homeostasis-preservation framework., (© 2013 SETAC.)

Disorders of human communication abilities can be classified into speech and language disorders. Speech disorders (e.g., dyspraxia) affect the sound generation and sequencing, while language disorders (e.g., dyslexia and specific language impairment, or SLI) are deficits in the encoding and decoding of language according to its rules (reading, spelling, grammar). The diagnosis of such disorders is often complicated, especially when a patient presents more than one disorder at the same time. The present review focuses on these challenges. We have combined data available from the literature with an in silico approach in an attempt to identify putative miRNAs that may have a key role in dyspraxia, dyslexia and SLI. We suggest the use of new miRNAs, which could have an important impact on the three diseases. Further, we relate those miRNAs to the axon guidance pathway and discuss possible interactions and the role of likely deregulated proteins. In addition, we describe potential differences in expressional deregulation and its role in the improvement of diagnosis. We encourage experimental investigations to test the data obtained in silico.

Quantitative real-time PCR represents a highly sensitive and powerful technology for the quantification of DNA. Although real-time PCR is well accepted as the gold standard in nucleic acid quantification, there is a largely unexplored area of experimental conditions that limit the application of the Ct method. As an alternative, our research team has recently proposed the Cy0 method, which can compensate for small amplification variations among the samples being compared. However, when there is a marked decrease in amplification efficiency, the Cy0 is impaired, hence determining reaction efficiency is essential to achieve a reliable quantification. The proposed improvement in Cy0 is based on the use of the kinetic parameters calculated in the curve inflection point to compensate for efficiency variations. Three experimental models were used: inhibition of primer extension, non-optimal primer annealing and a very small biological sample. In all these models, the improved Cy0 method increased quantification accuracy up to about 500% without affecting precision. Furthermore, the stability of this procedure was enhanced integrating it with the SOD method. In short, the improved Cy0 method represents a simple yet powerful approach for reliable DNA quantification even in the presence of marked efficiency variations.

Objective: Studies in the general population report that unusual subjective experiences are relatively common. Such experiences have been conceptualized either as extreme personality traits or as vulnerability markers for psychosis, and often grouped under the expression "schizotypal experiences". This study investigates the heterogeneity of schizotypal traits using factor and latent class analysis., Methods: One thousand and thirty-two adolescents were recruited for this study. Schizotypal experiences were assessed with the Oxford-Liverpool Inventory of Feelings and Experiences (O-LIFE); psychological distress was assessed with the General Health Questionnaire (GHQ). Confirmatory Factorial Analysis (CFA) and Latent Class Analysis (LCA) were performed on the O-LIFE and on the association with the GHQ and demographic variables., Results: CFA replicated the original 4-factor structure of the O-LIFE. Three latent classes (LC) of schizotypal features were identified: participants in LC1 (26% of the total sample) showed minimal level of item endorsement; LC2 accounted for 52% of the sample and showed overall higher item endorsement compared to LC1, especially for disorganization and positive signs of schizotypy, but not for negative affective items. LC3 (22%) showed an overall higher level of item endorsement across schizotypal dimensions, and positive association with psychological distress and family history of psychosis., Discussion: Different latent class of schizotypal features can be empirically defined in adolescent community samples. The most extreme class is defined not only by a profile of higher positive replies to the items, but also by anhedonia, high psychological distress, and family history of psychosis. These findings can inform prevention research in schizophrenia., (Copyright © 2012 Elsevier Masson SAS. All rights reserved.)

The aim of this study was to identify the main components that determine firefighters' level of physical fitness using a stair-climbing test. The age, weight, height, body fat, and VO(2max) of the firefighters were recorded before the trial, and percentage of heart rate reserve (%HRR) was recorded during the stair climbing. Nonlinear modeling of HRR time series and Principal Component Analysis (PCA) was applied to the data to isolate a small number of variables that quantify overall individual physical fitness. The HRR was represented as a function of time using the sum of linear and trigonometric functions. Four main factors that influence performance, obtained from PCA analysis, emerged (78.2% of total explained variance): the capacity to carry the extra load (22.8% of total variance); the effect of body fat (19.6% of total variance); the influence of age in the task (19.3% of total variance); and the overall fitness level (16.4% of total variance). This approach allowed us to make a rapid assessment of each subject's fitness level. Such an assessment could be used in planning individualized functional training programs to improve each firefighter's job performance and reduce injuries and hence save time, energy, and financial resources.

In celiac disease (CD), the intestinal lesions can be patchy and partial villous atrophy may elude detection at standard endoscopy (SE). Narrow Band Imaging (NBI) system in combination with a magnifying endoscope (ME) is a simple tool able to obtain targeted biopsy specimens. The aim of the study was to assess the correlation between NBI-ME and histology in CD diagnosis and to compare diagnostic accuracy between NBI-ME and SE in detecting villous abnormalities in CD. Forty-four consecutive patients with suspected CD undergoing upper gastrointestinal endoscopy have been prospectively evaluated. Utilizing both SE and NBI-ME, observed surface patterns were compared with histological results obtained from biopsy specimens using the k-Cohen agreement coefficient. NBI-ME identified partial villous atrophy in 12 patients in whom SE was normal, with sensitivity, specificity, and accuracy of 100%, 92.6%, and 95%, respectively. The overall agreement between NBI-ME and histology was significantly higher when compared with SE and histology (kappa score: 0.90 versus 0.46; P = 0.001) in diagnosing CD. NBI-ME could help identify partial mucosal atrophy in the routine endoscopic practice, potentially reducing the need for blind biopsies. NBI-ME was superior to SE and can reliably predict in vivo the villous changes of CD.

Background and Purpose: A large number of subjective experiences and beliefs with some degree of affinity with psychotic symptoms can be found in the general population. However, the appraisal of these psychotic-like experiences in terms of associated distress, raised preoccupation, and the conviction with which the experience is held can be more discriminative in distinguishing people in need for care from those who simply hold unusual or uncommon beliefs because of cultural reasons., Method: In this study, 81 patients with a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, diagnosis of schizophrenia or an affective disorder with psychotic features were compared on the Peters et al Delusions Inventory (PDI) to 210 people from the same local area, who had never received a formal diagnosis of a mental disorder., Results: Patients scored higher than controls on the PDI total score and on its distress, preoccupation, and conviction subscales. A stepwise logistic regression model showed PDI-preoccupation (odds ratio, 2.46; 95% confidence interval, 1.52-3.98) and, marginally, PDI-distress (odds ratio = 1.58; 95% confidence interval, 0.93-2.58) adding discriminative power to PDI total score in distinguishing patients from controls., Conclusions: The evaluation of the severity of delusion-like experiences and beliefs is important in discriminating patients diagnosed with psychosis from people who are not in need of care., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Background: To date, no studies have assessed in detail the characteristics, organisation, and functioning of Child and Adolescent Mental Health Services (CAMHS). This information gap represents a major limitation for researchers and clinicians because most mental disorders have their onset in childhood or adolescence, and effective interventions can therefore represent a major factor in avoiding chronicity. Interventions and mental health care are delivered by and through services, and not by individual, private clinicians, and drawbacks or limitations of services generally translate in inappropriateness and ineffectiveness of treatments and interventions: therefore information about services is essential to improve the quality of care and ultimately the course and outcome of mental disorders in childhood and adolescence.The present paper reports the results of the first study aimed at providing detailed, updated and comprehensive data on CAMHS of a densely populated Italian region (over 4 million inhabitants) with a target population of 633,725 subjects aged 0-17 years., Methods: Unit Chiefs of all the CAMHS filled in a structured 'Facility Form', with activity data referring to 2008 (data for inpatient facilities referred to 2009), which were then analysed in detail., Results: Eleven CAMHS were operative, including 110 outpatient units, with a ratio of approximately 20 child psychiatrists and 23 psychologists per 100,000 inhabitants aged 0-17 years. All outpatient units were well equipped and organized and all granted free service access. In 2008, approximately 6% of the target population was in contact with outpatient CAMHS, showing substantial homogeneity across the eleven areas thereby. Most patients in contact in 2008 received a language disorder- or learning disability diagnosis (41%). First-ever contacts accounted for 30% of annual visits across all units. Hospital bed availability was 5 per 100,000 inhabitants aged 0-17 years., Conclusion: The percentage of young people in contact with CAMHS for mental disorders is in line with those observed in previous epidemiological studies. The overall number of child psychiatrists per 100,000 inhabitants is one of the highest in Europe and it is comparable with the most well equipped areas in the US. This comparison should be interpreted with caution, however, because in Italy, child psychiatrists also treat neurological disorders. Critical areas requiring improvement are: the uneven utilisation of standardised assessment procedures and the limited availability of dedicated emergency services during non-office hours (e.g., nights and holidays).

Males were consistently found to be more likely than females to report left-hand preference in single-hand tasks, but the literature reports negative results too. Using data from a large sample in Sardinia, we aimed at testing the links of left-handedness with sex, age, residence, and seasonality of birth. A total of 4239 participants (males = 1589; females = 2650) were recruited in public places such as high schools, university classes, or gyms in one of the major islands of Italy. Hand preference was established with the question: Which hand do you normally use to write legibly? The monthly distribution of births was studied with the Rayleigh test. In the sample, 270 female participants reported left-hand preference in writing (10.2%) versus 161 male participants (10.1%). Left-hand preference in writing was negatively related to age, with increasing left-hand preference in the younger generations. Left-hand preference in writing was not more common in urban than in suburban or rural settings. The month of birth was found to have a seasonal effect on the left-handed (p=.031) but not on the right-handed (p=.80) participants, and this seasonal effect was more evident in males (p=.04) than in females (p =.26). In our sample males were not more likely to report left-hand preference in writing than females. On the other hand, left-hand preference does vary by age and, in all likelihood, this is an effect of the reduced cultural pressure to write with the right hand in the younger generations.

Objective: Past meta-analyses on suicide in eating disorders included few available studies., Method: PubMed/Medline search for papers including sample n ≥40 and follow-up ≥5 years: 40 studies on anorexia nervosa (AN), 16 studies on bulimia nervosa (BN), and three studies on binge eating disorder (BED) were included., Results: Of 16,342 patients with AN, 245 suicides occurred over a mean follow-up of 11.1 years (suicide rate=0.124 per 100 person-years). Standardized mortality ratio (SMR) was 31.0 (Poisson 95% CI=21.0-44.0); a clear decrease in suicide risk over time was observed in recent decades. Of 1768 patients with BN, four suicides occurred over a mean follow-up of 7.5 years (suicide rate=0.030 per 100 person-years): SMR was 7.5 (1.6-11.6). No suicide occurred among 246 patients with BED (mean follow-up=5.3 years)., Conclusion: AN and BN share many risk factors for suicide: the factors causing lower suicide rates per person-year in BN compared to AN should be investigated., (© 2010 John Wiley & Sons A/S.)

Background: Clinical Laboratory and Standards Institute (CLSI) published EP17-A guideline, recommending new definitions for low end performances: Limit of Blank (LoB), Limit of Detection (LoD) and Limit of Quantitation (LoQ). The aim of this study was to determine LoB, LoD and LoQ by applying EP17-A to Hybritech and World Health Organization (WHO) calibrated Access Total PSA assays, and verify the correlation between results generated by the same reagent with both calibrations, particularly at low end concentrations., Methods: According to EP17-A, serum pools of anonymous routine patient samples residuals were analyzed on a UniCelDxI800 with the chemiluminescent Access®Hybritech®TotalPSA assay., Results: LoB: 0.0046 μg/L Hybritech, 0.005 μg/L WHO calibration; LoD: 0.014 μg/L Hybritech, 0.015 μg/L WHO; LoQ at 20% coefficient of variation (CV%) 0.0414 μg/L Hybritech, 0.034 μg/L WHO. Regression Hybritech y=0.2398×+4.2017 (R2=0.9515); WHO y=0.2248×+3.4335 (R2=0.9596) with no statistical difference. Comparison between Hybritech and WHO at low PSA levels indicated an excellent Pearson's and intraclass correlation (r=0.999, p<0.001; ICC=0.974, p<0.001)., Conclusions: Our results show that the Access Total PSA assay is suitable for prostate cancer recurrence and PSA velocity evaluation; Hybritech and WHO calibrated values can both be used for clinical purposes even at low levels., (Copyright © 2011 Elsevier B.V. All rights reserved.)

Delusional beliefs and experiences can predict the development of mental disorders within the spectrum of psychosis. The nature, content and prevalence of delusional experiences in the general population are still disputed topics. This study investigates the latent structure of delusion proneness in the non-clinical population. Eight hundred young adults (400 from Italy and 400 from the United Kingdom) completed the Peters et al. delusions inventory, a general population measure of delusional proneness. Latent class analysis was used to explore the latent structure of delusion proneness. Four classes were identified: low delusion proneness (including 28% of the sample), grandiosity (13%), paranoid thinking (41%) and positive psychotic beliefs (18%). Latent structures of sub-clinical symptoms can be observed also in non-clinical population; paranoid thinking is the most common delusional theme., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

Background: Real-time PCR has recently become the technique of choice for absolute and relative nucleic acid quantification. The gold standard quantification method in real-time PCR assumes that the compared samples have similar PCR efficiency. However, many factors present in biological samples affect PCR kinetic, confounding quantification analysis. In this work we propose a new strategy to detect outlier samples, called SOD., Results: Richards function was fitted on fluorescence readings to parameterize the amplification curves. There was not a significant correlation between calculated amplification parameters (plateau, slope and y-coordinate of the inflection point) and the Log of input DNA demonstrating that this approach can be used to achieve a "fingerprint" for each amplification curve. To identify the outlier runs, the calculated parameters of each unknown sample were compared to those of the standard samples. When a significant underestimation of starting DNA molecules was found, due to the presence of biological inhibitors such as tannic acid, IgG or quercitin, SOD efficiently marked these amplification profiles as outliers. SOD was subsequently compared with KOD, the current approach based on PCR efficiency estimation. The data obtained showed that SOD was more sensitive than KOD, whereas SOD and KOD were equally specific., Conclusion: Our results demonstrated, for the first time, that outlier detection can be based on amplification shape instead of PCR efficiency. SOD represents an improvement in real-time PCR analysis because it decreases the variance of data thus increasing the reliability of quantification.

The present study examined data on symptom patterns in the week prior to admission for suicide attempt, in a nationwide representative sample of patients. Socio-demographic, clinical, and treatment data was gathered for 1,547 patients admitted over a 12-day index period during the year 2004 to 130 public and 36 private psychiatric facilities in Italy. Patients were evaluated in terms of whether they had been admitted for having attempted suicide or not. A detailed checklist was used to assess symptom pattern at admission; diagnoses were based on ICD-10 categories. Two-hundred thirty patients (14.8%) in the sample had been admitted for suicide attempt. Patients with depression or with personality disorders were more frequently observed among suicide attempters. First-contact patients were significantly more likely to have been admitted after a suicide attempt, the only exception being individuals with bipolar disorder, manic phase. No diagnosis was statistically related to admission after suicide attempt, once symptoms pattern at admission had been accounted for. Disordered eating behavior, depressive symptoms, substance abuse, and non-prescribed medication abuse were positively related to attempted suicide, as were any traumatic events in the week prior to admission; symptoms of psychosis (hallucinations/delusions) and lack of self-care were negatively associated with suicide attempt admission. Greater attention to symptoms immediately preceding or concomitant with admission after a suicide attempt can be a key factor in establishing the best treatment plan and discharge strategy, the most effective community-service referral, and targeted intervention programmes for patients hospitalized for a suicide attempt.

Despite evidence from case series, the comorbidity of eating disorders with psychosis is less investigated than their comorbidity with anxiety and mood disorders. We investigated the occurrence of symptoms of psychosis in 112 female patients diagnosed with DSM-IV eating disorders (anorexia nervosa=61, bulimia nervosa=51) and 631 high school girls in the same health district as the patients: the items of the SCL-90R symptom dimensions "paranoid ideation" and "psychoticism" were specifically examined. No case of co-morbid schizophrenia was observed among patients. Compared with controls, the patients with anorexia nervosa were more likely to endorse the item "Never feeling close to another person"; the patients with bulimia nervosa were more likely to endorse the item "Feeling others are to blame for your troubles". Both groups of patients were more likely than controls to endorse the item "Idea that something is wrong with your mind". The students who were identified by the EAT and the BITE as being "at risk" for eating disorders were more likely to assign their body a causative role in their problems. Symptoms of psychosis can be observed in patients with eating disorders, but these could be better explained within the psychopathology of the disorders rather than by assuming a link with schizophrenia., (2009 Elsevier Ltd. All rights reserved.)

Background and Purposes: Neurological involvement in systemic sclerosis is unusual despite the possible cerebral localization of vascular lesions. The aim of this study was to evaluate cognitive performances and cerebral vasoreactivity in young scleroderma patients without any signs or symptoms of nervous system involvement., Methods: Sixteen scleroderma patients and 16 sex- and age-matched healthy subjects without vascular risk factors were included. A neuropsychological assessment for the evaluation of different areas of cognition was performed. For an assessment of cerebrovascular reactivity (CVR), each subject was submitted to hypercapnia with transcranial Doppler ultrasonography using the Breath-Holding Index (BHI)., Results: Patients had significantly lower adjusted mean levels of performance with respect to controls in the Modified Card Sorting Test (P < 0.001) and in the Trail Making Test Parts A and B (P < 0.001 and P < 0.05 respectively). Regarding CVR, BHI values were significantly lower in patients with respect to controls: 0.82 +/- 0.44 vs. 1.34 +/- 0.18, P < 0.0001., Conclusions: These findings show the presence of reduced performances of executive functions in scleroderma patients. The associated alteration of CVR in the absence of other apparent causes of cerebrovascular impairment suggests that cognitive problems may be related to an alteration in cerebral perfusion regulation specifically linked to the disease. Further studies are needed to evaluate whether cognitive changes may be positively influenced by treatments aimed to improve vessels functionality in scleroderma patients.

A common pattern of apoptotic death is DNA cleavage, initially producing large fragments (50 kbp), followed by the production of nucleosomic/oligonucleosomic fragments. Nevertheless, apoptosis without DNA fragmentation, at least of the nucleosomic type, has been reported. To investigate the spatial relationship between DNA cleavage and chromatin condensation, we applied the TUNEL technique to the ultrastructural analysis of apoptotic cells. A modified method, utilizing a gold-conjugated antidigoxigenin antibody, was carried out on U937 versus Molt-4 cells, both exposed to UVB radiation or staurosporine treatment. Gold particle density in the different domains of apoptotic cells was evaluated by a four-way ANOVA test. Gold labelling was more strongly localised in condensed chromatin than in the diffuse chromatin. U937 cells, which evidenced in vitro oligonucleosomic fragmentation after both UVB and staurosporine treatments, revealed a significantly higher gold particle density, when compared with Molt-4, which did not show, on the other hand, oligonucleosomic cleavage even in the presence of < or = 50 kbp cleavage. Thus, a correlation between DNA fragment sizes and gold particle density appears. TUNEL applied to electron microscopy is an effective approach to study the relationship between apoptotic chromatin condensation and DNA cleavage. Both these events indeed appear in the apoptotic nucleus, but their reciprocal correlation is still greatly unknown. Microsc. Res. Tech. 2009. (c) 2009 Wiley-Liss, Inc.

The aim of this research was to determine physiologic responses to typical activities of military Italian firefighters. Heart rate (HR), metabolic equivalent units (MET), skin temperature ( T.Sk.), and galvanic skin response (GSR) were measured in 13 firefighters (age = 36.3 +/- 6.9 yr; period of military fire service = 16.8 +/- 7 yr) during the acclimation phase (5 min standing, still dressed in their protective clothing), the work phase (simulated firefighting situations), and the following 24 hours. Multivariate linear step-wise regression showed that body mass index was highly correlated with mean and minimal HR values during the acclimation phase (beta 0.59, p < 0.001; beta 1.90, p = 0.003) and with mean and maximum HR values during the work phase (beta 1.08, p = 0.05; beta 1.17, p = 0.04), increasing cardiovascular stress. Firefighting tasks were associated with high energy expenditure. The minimum and mean MET values, during the acclimation phase, were significantly correlated with age (beta 0.49, p = 0.008 and beta 0.46, p < 0.01). During the work phase, maximal MET values were also strongly correlated with weight (beta 0.51, p = 0.03). No correlations between predictor and dependent variables were found for GSR; however, the high GSR levels recorded during the work phase returned to normal values only 12 hours after completion of the work phase, indicating that high levels of psychological stress remain, even after physical recovery. The data obtained in this study demonstrate that the physical fitness and anthropometric characteristics of firefighters influence the performance of firefighting tasks. These results may be useful to set up specific training that meets the real needs of firefighters in terms of physical fitness.

The death in London of the former secret service agent Alexander Livtinenko on 23 November 2006 generally attracted the attention of the public to the rather unknown radionuclide (210)Po. This paper presents the results of a monitoring programme of (210)Po background levels in the urines of noncontaminated people living in Central Italy (near the Republic of S. Marino). The relationship between age, sex, years of smoking, number of cigarettes per day, and (210)Po concentration was also studied. The results indicated that the urinary (210)Po concentration follows a surprisingly perfect Log-normal distribution. Log (210)Po concentrations were positively correlated to age (p < 0.0001), number of daily smoked cigarettes (p = 0.006), and years of smoking (p = 0.021), and associated to sex (p = 0.019). Consequently, this study provides upper reference limits for each sub-group identified by significantly predictive variables.

Background: Cardiac troponins currently represent the preferred biomarkers for the detection of myocardial necrosis. The objective of the present study was to compare the performance of the Access AccuTnl assay (Beckman Coulter) measured on two different platforms, the UniCel Dxl 800 and the Access 2 (Beckman Coulter). In particular, the serum cardiac troponin I (cTnl) concentration corresponding to 10% coefficient of variation (CV), the cTnl assay minimum detectable concentration (MDC), and the serum cTnl 99th percentile in healthy subjects were calculated., Methods: The Access AccuTnl is a paramagnetic particle chemiluminescent immunoassay. Imprecision profiles were determined according to the Clinical and Laboratory Standards Institute EP5-A protocol using serum pools. The MDC was calculated as mean +3 SD of 20 determinations of the zero calibrator during one run. The 99th percentile was determined analyzing serum samples from 679 healthy blood donors (523 males, 156 females; 18-71 years old)., Results: cTnl concentrations are given in microg/L. 10% CV values (95% confidence interval, CI) were 0.0577 (0.0467-0.0750) (UniCel Dxl 800) and 0.0486 (0.0255-0.0596) (Access 2). MDC values were 0.011 (UniCel Dxl 800) and 0.012 (Access 2). The 99th percentile (95% CI) value was 0.0340 (0.0298-0.0410)., Conclusions: Our data confirm the reliability of the evaluated cTnl assay and demonstrate the comparability of the cTnl values between the platforms studied.

The first aim of this paper was to investigate if expertise in rhythmic gymnastics influences postural performance even in an easy non-specific task such as bipedal posture. Rhythmic gymnastics is a unique female sport which encompasses aspects of both artistic gymnastics and ballet and includes the use of a small apparatus (rope, hoop, ball, clubs and ribbon). Most previous studies have shown that expertise achieved by artistic gymnasts and dancers improves postural steadiness only in the situations for which those athletes are trained. Literature has not yet compared rhythmic gymnasts to other athletes in terms of their postural strategies. Hence, the study presented herein tested a group of high level rhythmic gymnasts and a group of female university students, trained in other sports, in the bipedal posture under eyes open and closed conditions. A force platform was used to record body sway. (1) Distance from the centre of sway, (2) lateral and (3) antero-posterior displacements were analyzed in time and frequency domains. Comparing the two groups, it was found that rhythmic gymnasts had better strategies than students in simple postural tasks, especially in lateral directions and in the period from 0.05 to 2 s. The most interesting finding in this study is that rhythmic gymnastics training seems to have a direct effect on the ability to maintain bipedal posture, which may confirm the "transfer" hypothesis of rhythmic gymnastics expertise to bipedal postural sway, especially in medio-lateral displacements. This finding has never been reported in previous studies on artistic gymnasts and ballet dancers. Furthermore, the present study confirmed the visual dependence of all the athletes, irrespective of their disciplines, in their postural trials.

Aeromonads in waters and foods can represent a risk to human health. Factors such as sodium chloride concentration and temperature can affect growth and viability of several food and water-borne pathogens. The behaviour of an Aeromonas hydrophila strain in the presence of 1.7%, 3.4% and 6% NaCl concentrations at 24 degrees C and 4 degrees C was studied over a 188 day period. Viability and membrane potential were assessed by flow cytometry; growth was evaluated by plate count technique. Flow cytometry evidenced that A. hydrophila retained viability over the period although varying according to temperature and salt concentrations. Colony Forming Units were generally lower in number than viable cells especially in the presence of 6% NaCl, indicating the occurrence of stressed cells which maintain metabolic activity yet are not able to grow on agar plates. In conclusion, A. hydrophila showed a long-term halotolerance even at elevated (6%) NaCl concentrations and a lesser sensitivity to salt at low temperature; therefore, low temperature and salt, which are two important factors limiting bacterial growth, do not assure safety in the case of high initial contamination. Finally, cytometry appears a valid tool for the rapid detection of the viability of pathogenic bacteria in food and environmental matrices to control and prevent health risks.