The integration of biodiversity into One Health.

A better understanding of the links between biodiversity, health and disease presents major opportunities for policy development, and can enhance our understanding of how health-focused measures affect biodiversity, and conservation measures affect health. The breadth and complexity of these relationships, and the socio-economic drivers by which they are influenced, in the context of rapidly shifting global trends, reaffirm the need for an integrative, multidisciplinary and systemic approach to the health of people, livestock and wildlife within the ecosystem context. Loss of biodiversity, habitat fragmentation and the loss of natural environments threaten the full range of life-supporting services provided by ecosystems at all levels of biodiversity, including species, genetic and ecosystem diversity. The disruption of ecosystem services has direct and indirect implications for public health, which are likely to exacerbate existing health inequities, whether through exposure to environmental hazards or through the loss of livelihoods. One Health provides a valuable framework for the development of mutually beneficial policies and interventions at the nexus between health and biodiversity, and it is critical that One Health integrates biodiversity into its strategic agenda.

Effect of diets supplemented with different conjugated linoleic acid (CLA) isomers on protein expression in C57/BL6 mice.

BACKGROUND: The individual genetic variations, as a response to diet, have recently caught the attention of several researchers. In addition, there is also a trend to assume food containing beneficial substances, or to supplement food with specific compounds. Among these, there is the conjugated linoleic acid (CLA), which has been demonstrated to reduce fat mass and to increase lean mass, even though its mechanism of action is still not known. We investigated the effect of CLA isomers (CLA c9,t11 and CLA t10,c12) on the proteomic profile of liver, adipose tissue, and muscle of mouse, with the aim of verifying the presence of a modification in fat and lean mass, and to explore the mechanism of action. METHODS: C57/BL6 mice were fed for 2 months with different diets: (1) standard chow, (2) CLA c9,t11 diet, (3) CLA t10,c11 diet, (4) CLA isomers mixture diet, and (5) linoleic acid diet. The proteomic profile of liver, white adipose tissue, and muscle was investigated. Statistical significance of the spots with an intensity higher than twofold in expression compared to the control was tested using student's t test (two-tail). RESULTS: We found that both isomers modulate the proteomic profiles of liver, adipose tissue, and muscle by different mechanisms of action. Liver steatosis is mostly due to the isomer CLA t10,c12, since it alters the expression of lipogenetic proteins; it acts also reducing the adipose tissue and increasing fatty acid oxidation in muscle. Conversely, CLA c9,t11 has no relevant effects on liver and adipose tissue, but acts mostly on muscle, where it enhances muscular cell differentiation. CONCLUSIONS: Administration of CLA in humans has to be carefully personalized, since even considering the presence of a species-specific effect, adverse effects might occur on long-term supplementation. Here we demonstrated that, in mouse, CLA is effective in reducing fat mass, but it also induces liver steatosis. The increase of lean mass is linked to an induction of cell proliferation, which, on long-term supplementation, might also lead to adverse effects.

The role of HIV type 1 phenotype and genotype in long-term responders to zidovudine therapy.

We performed a cross-sectional and partly retrospective virological evaluation of 31 long-term responders (LTRs) to zidovudine (ZDV) (persistent increase in the CD4+ cell counts without progression of HIV infection throughout a period of ZDV therapy > 3 years) and 17 well-matched controls who developed a marked immunological deterioration over a 24-month period of ZDV therapy. The biological phenotype of HIV-1 was assessed by testing the capacity of the isolates to replicate in the MT-2, HUT-78, C-8166, and U-937 T cell lines, and mutations at codons 215 and 41 of RT were checked in proviral DNA from uncultured PBMCs. Show/low non-syncytium-inducing (S/L-NSI) and rapid/high syncytium-inducing (R/H-SI) variants were detected in 25 (81%) and 2 (6%) LTRs, respectively. HIV-1 could not be isolated in the remaining four LTRs (13%). Conversely, 12 of 17 (71%) controls yielded R/H-SI variants. Conversion from the S/L-NSI to R/H to R/H-SI phenotype occurred in 5 controls but in none of the 18 LTRs tested. Mutant sequences in proviral DNA from control PBMCs were consistently detected (94%), while a wild-type sequence of the residues investigated was found in the majority of LTRs (77%). In our series, patients who received immunological and clinical benefits even after prolonged ZDV treatment had S/L-NSI viruses and a low risk to develop ZDV resistance. Conversely, subjects who demonstrated an immunological and clinical deterioration yielded R/H-SI variants or shifted from S/L-NSI to R/H-SI phenotypes and were at higher risk to develop mutations indicating ZDV resistance.

Pathological patient in protocol definition for bench testing of mechanical cardiac support system.

Clinical techniques for the restoration of a failing heart are mainly based on the use of mechanical assist devices. In recent years, with the growing need for mechanical circulatory support, these devices have been shown to be a useful therapeutic tool, thanks to their intrinsic capability to unload the failing ventricle, allowing the heart to recover. Mechanical circulatory support systems (MCSS) require an accurate biomechanical characterization of the complex interaction that occurs between the patient and the mechanical support. A protocol for MCSS testing is proposed which takes into account several working conditions, in a modified test mock loop apparatus able to mimic various pathological conditions. Both physiological and pathological conditions can be replicated to show the actual efficacy of a MCSS device in correctly supporting a wide spectrum of ventricular conditions. The test bench is able to simulate the recovery of the pathological condition quite accurately, showing, at the same time, that this set up can be a reliable choice to characterize cardiac support devices. Thus the results of this experimentation can be useful to clinicians in forecasting the response of the heart affected by a cardiac disease and to set appropriate parameters for suitable assistance.

Intestinal microsporidiosis in AIDS patients with diarrhoeal illness in Apulia (south Italy)

Microsporidia are intracellular parasitic protozoa very common in immunocompromised patients in many parts of the world. There is a scarcity of data on the prevalence of these parasites in Italy. In this study we examined stool samples of 56 HIV+ patients with diarrhoea to find microsporidial spores, using the light microscopy Ryan modified trichrome stain. Microsporidia were found in one out of 56 patients, who was Cryptosporidium coinfected. Intestinal microsporidiosis seems to be less frequent in AIDS patients from Italy than in those from other countries.

Hospitalization rate due to measles in an area of the South East of Italy during an outbreak in the years 2002-2003.

AIM: Usually measles is not severe, but serious complications can occur and thus hospitalization is needed. The aim of this study was to assess the reasons of hospitalizations of the persons affected by measles and the severity of disease as a result of measles infection. METHODS: During an outbreak from 2002 to 2003 in the province of Taranto, 73 hospitalized persons affected by measles were evaluated. RESULTS: The age of the 73 hospitalized patients ranged between 1 and 42 years old (median age 14.5 years). An hospitalizations rate of 63% was reported in the first 4 months of 2003. Measles-related complications were observed in 35.6% of cases. In 14 cases (19%) we observed a pneumonia with a concomitant myocardititis and pancreatitis in 2 cases. Postmeasles encephalitis was diagnosed in 7 cases (9.5%). In 2 cases a concomitant myelitis occurred, with the presence of sequelae at the time of discharge but none permanent. Measles related appendicitis was observed in 5 males (6.8%) and appendectomy was performed in all cases. Data analysis showed that the patients with an age <15 years old had a higher risk of complications than patients with an age > or =15 years. None death was reported. CONCLUSIONS: At present, measles and its related complications continue to be a serious illness even in industrialized countries, only a complete immunization vaccine strategy could permit measles' eradication.

Epidemiological, clinical and therapeutic evaluation of the Italian cholera epidemic in 1994.

In the period between 18 October and 4 December 1994, 12 indigenous cases of cholera were registered in the southern Italian region of Puglia, 10 of them were diagnosed in our Departments of Infectious Diseases. All patients were infected by consumption of raw fish or mussels. The patients had an elevated mean age and most were affected with systemic pathologies. The clinical course was mild and rarely complicated, although frequently the characteristic riziform diarrhoea was absent. In all patients V. cholerae serotype Ogawa biotype El Tor, was isolated; one patient was co-infected by Salmonella typhi. All strains showed resistance to cotrimoxazole and tetracycline. Nine of ten patients were treated with oral ciprofloxacin at 1 g/day for 10 days resulting in disappearance of the symptoms within a median of 36 hours and negative fecal cultures within a median of 24 hours. Our data suggest that Italy is at high risk of infection imported from nearby nations. The resistance to commonly used antibiotics for treatment of cholera and the good response to ciprofloxacin suggest including fluoroquinolones among the drugs of first choice geographical areas involved in the circulation of resistant strains of V. cholerae O1.

The relationship between education and risk factors for coronary heart disease. Epidemiological analysis from the nine communities study. The Research Group ATS-OB43 of CNR.

In nine samples of adult populations (2707 males and 2871 females, aged 20-59 years) we studied the relationship between educational level and several lifestyle factors at risk for coronary heart disease (CHD), (i.e., smoking, alcohol consumption, dietary fat intake, sedentary behaviour at work and leisure) and the association between education and certain CHD risk factors (i.e., total cholesterol, HDL-cholesterol, triglycerides, systolic and diastolic blood pressure, body mass index). The data were analyzed separately in samples from North, Central and Southern Italy. The results show that educational level is often associated to the lifestyle factors considered here. This association was positive for both men and women for physical activity at leisure and work stress and only for women with respect to smoking. It was negative for both men and women for alcohol consumption and physical activity at work and for men only for cigarette smoking. The age-adjusted mean levels of the CHD risk factors show some significant differences among subjects with different educational levels, which were not always the same for the three geographical areas. This was with the exception of BMI in females, which appears negatively associated to education in all areas. These differences decreased after adjustments were made for daily cigarette smoking, wine consumption and dietary fat intake. Education seems to play a determining role in lifestyle, however, its direct and indirect effects on some major CHD risk factors are somewhat different in areas at different socio-economic conditions.

Choreoathetosis in acquired immune deficiency syndrome patients with cerebral toxoplasmosis.

The aim of our study was to evaluate both the incidence and the pathologic and clinical features of extrapyramidal disorders in a population of acquired immune deficiency syndrome (AIDS) patients with cerebral toxoplasmosis. Of 240 AIDS patients evaluated in the 1985-1994 period, 50 of them were diagnosed to have cerebral toxoplasmosis on the basis of the following criteria: occurrence of specific antibodies, computed tomography and/or magnetic resonance imaging (MRI), and regression of the symptoms after specific therapy. Three of 50 (6%) had hemichoreoathetosis. In the first case, the disorder began as a dyskinesia of the left hand that subsequently spread to the whole ipsilateral arm and assumed the features of choreic athetotic movements. The other two cases were characterized by left hemisomatic distal choreic movements. Therapy with pyrimethamine and sulfadiazine led to a complete recovery of the extrapyramidal signs in two cases and to improvement in the third. According to our observations, the onset of these movement disorders could not be related to the dimension of the lesion or to the edema, but to a specific localization in subthalamic nucleus, in subthalamic/pallidal, and pallidal/thalamic pathways. MRI seems the elective tool to perform a more accurate study of the anatomic areas involved in this pathway and to verify their integrity. Cerebral toxoplasmosis in AIDS can be considered as a new etiopathogenic cause of choreoathetosis.

Polymerase chain reaction for non-invasive diagnosis of brain mass lesions caused by Mycobacterium tuberculosis: report of five cases in human immunodeficiency virus-positive subjects.

To investigate whether the polymerase chain reaction (PCR) on the IS6110 sequence of Mycobacterium tuberculosis could permit the early and non-invasive diagnosis of tuberculous brain lesions without meningeal involvement in acquired immunodeficiency virus patients, we examined retrospective cerebrospinal fluid (CSF) samples from five patients diagnosed as having cerebral lesions caused by M. tuberculosis. M. tuberculosis deoxyribonucleic acid was detected in CSF samples obtained from each of the patients studied, but in none of the controls. The PCR results coincided with M. tuberculosis isolation from CSF in two patients. In an additional two subjects, culture for M. tuberculosis on CSF was negative, and the diagnosis of central nervous system tuberculosis was achieved by response to specific therapy. In the last patient the PCR result on CSF was confirmed by isolation of M. tuberculosis from brain biopsy. Interestingly, in this patient the CSF did not yield M. tuberculosis isolation when cultured. The data show the value of PCR as a potentially useful approach for the early and rapid diagnosis of cerebral tuberculosis even without meningitis.

Detection of HCV RNA in serum and seminal fluid from HIV-1 co-infected intravenous drug addicts.

The presence of hepatitis C virus (HCV) RNA in serum and seminal fluid was investigated in eleven drug addicts coinfected with HIV-1 and HCV. Serum and seminal fluid were taken from each patient at the same time point. HCV RNA was found in ten of the eleven serum samples tested, but only in one of the semen samples. No relationship was observed between CD4 cell counts, the stage of HIV infection, extent of liver damage and the presence of HCV RNA in serum and semen. The results indicate that HCV is not usually present in the semen and provide further evidence against sexual transmission as an important mode of transmission of HCV infection.

P24 antigen detection, viral isolation, DNA-PCR and in vitro antibody production for the diagnosis of HIV-1 latent infection in heterosexual women at high risk for HIV-1 infection.

INTRODUCTION: The report of the existence of at-risk seronegative subjects, latently infected with HIV-1 and producing "in vitro" HIV-1 specific antibodies, prompted the authors to evaluate extensively twenty-five heterosexual HIV-1 seronegative women at high risk for HIV-1 infection. MATERIAL AND METHODS: The capability of peripheral blood mononuclear cells from such subjects to produce "in vitro" HIV-1 specific antibodies after pokeweed-mitogen stimulation, was studied. Silent HIV-1 infection was investigated by HIV-1 DNA PCR, viral isolation and serum p24 Ag detection at entry and after 6 and 12 months. RESULTS: Three seroconversions took place within 12 months, but no HIV-1 infections were found in the absence of detectable serum anti HIV-1 antibodies, even in subjects who apparently produced such antibodies in vitro. The antibodies produced in vitro by the seronegative women studied appeared of narrow specificity, reacting mainly with gp 160/120 envelope glycoproteins. CONCLUSIONS: A strong concordance was found between the serological status and the other markers for HIV-1 infection, suggesting that the phenomenon of HIV-1 "latent infection" is a very rare event, if it occurs at all. Seronegative women sexually exposed to the virus may produce in vitro anti HIV-1 antibodies of narrow specificity in the absence of other signs of infection and this phenomenon might be related to an anamnestic response to the virus.