RESUMO
BACKGROUND: The term hypomineralisation of molars and incisors (MIH), introduced in 2001 by Weerheijm et al., describes a clinical state of hypomineralisation of permanent molars with frequent involvement of the incisors. MIH is considered a global dental problem with a prevalence ranging from 2.4% to 40.2% in the entire world paediatric population. The continuous increase in the prevalence of enamel anomalies, including MIH, indicates the need to define new intervention protocols based on the technological advances that are revolutionising paediatric dentistry. The use of ozone associated with the selective and minimally invasive excavation of the dental tissue combines the antibacterial properties of the gas with an ultra-conservative approach aimed at the maximum conservation of the dental tissue. The operative protocol described can be an important tool in the prevention and treatment of MIH. The aim of this work is to illustrate an operative clinical protocol based on the combined use of selective excavation and ozone for the treatment of carious lesions in paediatric patients with MIH.
Assuntos
Cárie Dentária , Hipoplasia do Esmalte Dentário , Humanos , Criança , Hipoplasia do Esmalte Dentário/epidemiologia , Suscetibilidade à Cárie Dentária , Cárie Dentária/epidemiologia , Dente Molar/patologia , Incisivo/anormalidades , PrevalênciaRESUMO
BACKGROUND: Angiosarcoma (AS) of the breast is very rare, accounting for 1% of all soft tissue breast tumors. AS may present as primary tumors of the breast or as secondary lesions usually associated with previous radiotherapy. Commonly, secondary AS affects older women (median age 67-71 years) with a clinical history of breast cancer. The preferred site of onset of RIAS is the edge of radiation fields, where radiation doses and tumor necrosis may be heterogeneous, resulting in a DNA damage and instability. Radical surgery is the treatment of choice, but no clear consensus exists on surgical management of breast AS. CASE REPORT: We describe an atypical case of relapsed RIAS after radical mastectomy, treated with new surgery and, considering the higher risk of recurrence, subsequent adjuvant chemotherapy with weekly paclitaxel. CONCLUSIONS: The frequency of radiation-induced angiosarcomas (RIAS) after breast-conserving surgery and radiotherapy has been increased to 0.14-0.5% among long survivors. Nevertheless, even if RIAS continues to be prognostically an extremely unfavorable cancer due to a high rate of recurrence, distant spread, and median overall survival (OS) of about 60 months, the benefits of loco-regional breast radiotherapy are clearly higher than the risk in developing angiosarcoma.
Assuntos
Neoplasias da Mama , Hemangiossarcoma , Neoplasias Induzidas por Radiação , Feminino , Humanos , Idoso , Neoplasias da Mama/patologia , Hemangiossarcoma/etiologia , Hemangiossarcoma/terapia , Hemangiossarcoma/patologia , Mastectomia/efeitos adversos , Terapia Combinada , Neoplasias Induzidas por Radiação/diagnóstico , Neoplasias Induzidas por Radiação/terapia , Neoplasias Induzidas por Radiação/complicações , Radioterapia Adjuvante/efeitos adversosRESUMO
BACKGROUND: Glioblastoma (GBM) is a highly lethal disease despite integrated treatment comprising radiotherapy plus concomitant and adjuvant temozolomide, with a median overall survival of less than 15 months. For recurrent glioblastoma, there is yet no standard therapy, considering that Bevacizumab have failed to improve overall survival (OS) while regorafenib had a little benefit over standard chemotherapy. In addition, the disease control rate is almost exclusively stability, with a poor objective response rate. CASE REPORT: Here we present a case of rapid response to regorafenib in early glioblastoma progression at the end of adjuvant radiotherapy: after a single cycle of regorafenib the patient observed an impressive improvement in clinical condition, disappearance of headaches and a clear reduction of neoplastic tissue in MRI. A brief review about new radiological patterns in Magnetic Resonance Imaging (MRI) related to the introduction in clinical practice of antiangiogenic drugs and tyrosine kinase inhibitors has also been carried out. CONCLUSIONS: Regorafenib was certainly a first turning point in the second-line treatment of GBM, showing longer response rates and mostly disease stability than bevacizumab. A switch-maintenance strategy with tyrosine kinase inhibitors may represent a valid second-line therapeutic option.
Assuntos
Neoplasias Encefálicas , Glioblastoma , Bevacizumab/uso terapêutico , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/tratamento farmacológico , Glioblastoma/diagnóstico por imagem , Glioblastoma/tratamento farmacológico , Humanos , Recidiva Local de Neoplasia/tratamento farmacológico , Compostos de Fenilureia , Inibidores de Proteínas Quinases/uso terapêutico , PiridinasRESUMO
Results: The results highlighted that 40 laboratories fall into the "low risk" and the remaining 2 into the "moderate risk" category. Conclusions: Labs with risk factors are a minority. These were properly identified using the proposed methodology. Background and aim: Biomedical research in academic settings is an important issue for Public Health and Environment protection. As workplaces, the facilities for research expose their personnel to different hazards and health risks. The University of L'Aquila (Italy) carried out a field study aimed at creating and applying a checklist intended for laboratory staff. Methods: The proposed checklist was derived from the procedure illustrated in the Appendix (procedure followed for the identification of a numerical index of biological risk for university facilities) and consists of 9 items. The study was conducted in 42 laboratories.
Assuntos
Lista de Checagem , Laboratórios , Humanos , Medição de Risco , Universidades , Local de TrabalhoRESUMO
DNAJC17 is a heat shock protein (HSP40) family member, identified in mouse as susceptibility gene for congenital hypothyroidism. DNAJC17 knockout mouse embryos die prior to implantation. In humans, germline homozygous mutations in DNAJC17 have been found in syndromic retinal dystrophy patients, while heterozygous mutations represent candidate pathogenic events for myeloproliferative disorders. Despite widespread expression and involvement in human diseases, DNAJC17 function is still poorly understood. Herein, we have investigated its function through high-throughput transcriptomic and proteomic approaches. DNAJC17-depleted cells transcriptome highlighted genes involved in general functional categories, mainly related to gene expression. Conversely, DNAJC17 interactome can be classified in very specific functional networks, with the most enriched one including proteins involved in splicing. Furthermore, several splicing-related interactors, were independently validated by co-immunoprecipitation and in vivo co-localization. Accordingly, co-localization of DNAJC17 with SC35, a marker of nuclear speckles, further supported its interaction with spliceosomal components. Lastly, DNAJC17 up-regulation enhanced splicing efficiency of minigene reporter in live cells, while its knockdown induced perturbations of splicing efficiency at whole genome level, as demonstrated by specific analysis of RNAseq data. In conclusion, our study strongly suggests a role of DNAJC17 in splicing-related processes and provides support to its recognized essential function in early development.
Assuntos
Proteínas de Choque Térmico HSP40/metabolismo , Processamento Alternativo , Núcleo Celular/metabolismo , Proteínas de Choque Térmico HSP40/análise , Proteínas de Choque Térmico HSP40/genética , Células HeLa , Humanos , Mapeamento de Interação de Proteínas , Proteômica , Spliceossomos/metabolismoRESUMO
Epidemiologic and experimental studies have associated changes of blood glucose homeostasis to Bisphenol A (BPA) exposure. We took a toxicogenomic approach to investigate the mechanisms of low-dose (1 × 10(-9 )M) BPA toxicity in ex vivo cultures of primary murine pancreatic islets and hepatocytes. Twenty-nine inhibited genes were identified in islets and none in exposed hepatocytes. Although their expression was slightly altered, their impaired cellular level, as a whole, resulted in specific phenotypic changes. Damage of mitochondrial function and metabolism, as predicted by bioinformatics analyses, was observed: BPA exposure led to a time-dependent decrease in mitochondrial membrane potential, to an increase of ROS cellular levels and, finally, to an induction of apoptosis, attributable to the bigger Bax/Bcl-2 ratio owing to activation of NF-κB pathway. Our data suggest a multifactorial mechanism for BPA toxicity in pancreatic islets with emphasis to mitochondria dysfunction and NF-κB activation. Finally, we assessed in vitro the viability of BPA-treated islets in stressing condition, as exposure to high glucose, evidencing a reduced ability of the exposed islets to respond to further damages. The result was confirmed in vivo evaluating the reduction of glycemia in hyperglycemic mice transplanted with control and BPA-treated pancreatic islets. The reported findings identify the pancreatic islet as the main target of BPA toxicity in impairing the glycemia. They suggest that the BPA exposure can weaken the response of the pancreatic islets to damages. The last observation could represent a broader concept whose consideration should lead to the development of experimental plans better reproducing the multiple exposure conditions.
Assuntos
Compostos Benzidrílicos/toxicidade , Glicemia/metabolismo , Ilhotas Pancreáticas/efeitos dos fármacos , Fenóis/toxicidade , Animais , Relação Dose-Resposta a Droga , Hepatócitos/efeitos dos fármacos , Homeostase/efeitos dos fármacos , Ilhotas Pancreáticas/citologia , Ilhotas Pancreáticas/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Toxicogenética/métodosRESUMO
INTRODUCTION: Obesity is a risk factor for chronic diseases and premature mortality, but the extent of these associations among the elderly is under debate. The aim of this systematic literature review (SR) is to collate and critically assess the available information of the impact of obesity on mortality in the elderly. METHODS: In PubMed, there are three-hundred twelve papers on the relationship between obesity and mortality among older adults. These papers were analysed on the basis of their abstracts, and sixteen studies were considered suitable for the purpose of the study. It was possible to perform a pooled estimate for aggregated data in three different studies. CONCLUSION: The results of this SR document that an increased mortality in obese older adults. The limitation of BMI to index obesity and the noted protective action of a moderate increase in BMI on mortality are highlighted. Waist circumference is an indicator of central adiposity and potentially as good a risk factor for mortality as BMI in obese elderly adults.
Assuntos
Índice de Massa Corporal , Causas de Morte , Obesidade/mortalidade , Idoso , Humanos , Obesidade Abdominal/mortalidade , Fatores de Risco , Circunferência da CinturaRESUMO
BACKGROUND AND PURPOSE: The amphibian peptide Bv8 induces potent nociceptive sensitization in rodents. Its mammalian homologue, prokineticin 2 (PROK2), is strongly up-regulated in inflamed tissues and is a major determinant in triggering inflammatory pain. Bv8 and PROK2 activate two closely related GPCRs, PK(1) and PK(2) , in a relatively non-selective fashion. To characterize better the roles of the two receptors in hyperalgesia and to obtain ligands whose binding affinity and efficacy differed for the two receptors, we modified the Bv8 molecule in regions essential for receptor recognition and activation. EXPERIMENTAL APPROACH: We modified the Bv8 molecule by substituting Trp in position 24 with Ala (A-24) and compared it with Bv8 for binding and activating PK(1) and PK(2) receptors in cell preparations and in affecting nociceptive thresholds in rodents. KEY RESULTS: A-24 preferentially bound to PK(2) receptors and activated them with a lower potency (5-fold) than Bv8. When systemically injected, A-24 induced Bv8-like hyperalgesia in rats and in mice, at doses 100 times higher than Bv8. Locally and systemically injected at inactive doses, A-24 antagonized Bv8-induced hyperalgesia. In rat and mouse models of inflammatory and post-surgical pain, A-24 showed potent and long-lasting anti-hyperalgesic activity. Unlike Bv8, A-24 increased ß-endorphin levels in mouse brain. CONCLUSIONS AND IMPLICATIONS: A-24 induced its anti-hyperalgesic effect in rodents by directly blocking nociceptor PK(1) receptors and by activating the central opioid system and the descending pain control pathway through brain PK(2) receptors.
Assuntos
Proteínas de Anfíbios/química , Proteínas de Anfíbios/farmacologia , Analgésicos/química , Analgésicos/farmacologia , Neuropeptídeos/química , Neuropeptídeos/farmacologia , Receptores Acoplados a Proteínas G/metabolismo , Receptores de Peptídeos/metabolismo , Alanina/química , Substituição de Aminoácidos , Proteínas de Anfíbios/uso terapêutico , Analgésicos/uso terapêutico , Animais , Células CHO , Quimiotaxia/efeitos dos fármacos , Cricetinae , Modelos Animais de Doenças , Relação Dose-Resposta a Droga , Edema/tratamento farmacológico , Hiperalgesia/tratamento farmacológico , Hiperalgesia/metabolismo , Ligantes , Macrófagos/citologia , Macrófagos/efeitos dos fármacos , Masculino , Camundongos , Neuropeptídeos/uso terapêutico , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/metabolismo , Ligação Proteica , Ratos , Ratos Sprague-Dawley , Relação Estrutura-Atividade , Transfecção , Triptofano/químicaRESUMO
Sexually transmitted human papillomaviruses (HPVs) are responsible for anogenital infections and tumours. Types 16 and 18 cause 70% of cervical carcinomas, the incidence of which is higher among young women. The aim of this study was to evaluate the propensity of mothers to have their 12-year-old daughters vaccinated against HPV and identify the variables that may influence their agreement, such as their kowledge of HPV and its relationship with cervical cancer. A 17-item questionnaire was anonymously administered to 312 mothers of girls born in 1997 who were invited to undergo vaccination by their local health authority. The results were analysed using the chi-squared test and STATA 9 statistical software. The analysis showed that 69% of the mothers had had their daughters vaccinated, that most of them know about HPV but only 20% clearly understood the relationship between HPV and cancer Acceptance of the vaccination seems to be associated more with a general predisposition to vaccinate than with a knowledge of HPV and its causal relationship with cervical carcinoma. This indicates a need for educational/ information programmes before and during the vaccination cycle.
Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Mães , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus , Neoplasias do Colo do Útero/prevenção & controle , Adulto , Criança , Feminino , Humanos , Cooperação do Paciente , Inquéritos e QuestionáriosRESUMO
UNLABELLED: In elderly subjects, past researches have already underlined the role of nutritional status as a basic factor able to influence the prognosis either in acute wards or in rehabilitation and long-term care settings. Aim of the study is that of retrospectively verify, through a multivariate analysis, the factors able to condition mortality in long-term care, paying particular attention to the nutritional status. METHODS: The survey included 513 patients aged more than 65 years admitted to a long-term care unit during a three years period. Exitus within the first three months of hospitalization was considered the outcome variable, while baseline functional, cognitive, clinical and nutritional status were considered the independent variables eventually related to mortality. RESULTS: The univariate analysis found that some variables were significantly correlated with the outcome: comorbidity, ADL, cognitive status, pressure sores, albumin, transferrin, CRP, mucoprotein, cholesterol, cholinesterase, MAMC and MNA. The predictive value of the block model of the logistic regression analysis was 77.9% (specificity = 85.3%, sensitivity = 63.9%). With the forward stepwise analysis only MNA, cholinesterase, CRP and mucoprotein were considered in the final model. In this case the predictive value of the model was 79.3% (specificity = 84.6%, sensitivity = 69.46%).
Assuntos
Avaliação Geriátrica , Hospitalização , Assistência de Longa Duração , Desnutrição/mortalidade , Avaliação Nutricional , Estado Nutricional , Atividades Cotidianas , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Proteína C-Reativa/metabolismo , Colinesterases/sangue , Cognição , Comorbidade , Feminino , Glicoproteínas/sangue , Pesquisas sobre Atenção à Saúde , Habitação para Idosos , Humanos , Modelos Logísticos , Masculino , Análise Multivariada , Valor Preditivo dos Testes , Prognóstico , Estudos Retrospectivos , Fatores de RiscoRESUMO
Obesity is a prevalent health disease among the elderly as it contributes to the early onset of chronic morbidity and functional impairment and is also related to premature mortality. The prevalence of sarcopenic-obesity increases too with age in each sex leading to a significantly higher prevalence of physical impairment and disability, as well as higher prevalence of metabolic syndrome. We observe a natural phenomenon (ageing) and a complex world-wide illness (obesity) that should not be merely treated as the sum of the treatments for the elderly and for the obese. The balance between the potential benefits of treatment interventions, reducing premature morbidity and mortality, and the impact on quality of life in old age may be different from young and adult age in case of obesity and need to be seriously considered.
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Envelhecimento , Síndrome Metabólica/etiologia , Obesidade , Qualidade de Vida , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Feminino , Humanos , Comunicação Interdisciplinar , Itália/epidemiologia , Masculino , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/prevenção & controle , Obesidade/complicações , Obesidade/epidemiologia , Obesidade/etiologia , Obesidade/fisiopatologia , Obesidade/terapia , Prevalência , Fatores de Risco , Sarcopenia/etiologiaRESUMO
Medication overuse headache (MOH) is a challenging, debilitating disorder that develops from the frequent use of medications taken for the treatment of migraine headache pain. MOH affects an estimated 3-5% of the general population. The mechanisms underlying the development of MOH remain unknown. Opiates are one of the major classes of medications used for the treatment of migraine at least in some countries, including the USA. Although the effects of repeated opiate use for headache are unknown, it is possible that opiate use may contribute to increased frequency and occurrence of such headaches. Recent preclinical studies exploring the neuroadaptive changes following sustained exposure to morphine may give some insights into possible causes of MOH. Peripherally, these changes include increased expression of calcitonin gene-related peptide (CGRP) in trigeminal primary afferent neurons. Centrally, they include increased excitatory neurotransmission at the level of the dorsal horn and nucleus caudalis. Critically, these neuroadaptive changes persist for long periods of time and the evoked release of CGRP is enhanced following morphine pretreatment. Stimuli known to elicit migraine, such as nitric oxide donors or stress, produce hyperalgesia in morphine- but not in saline-pretreated rats even long after the discontinuation of the opiate. CGRP plays a prominent role in initiating vasodilation of the intracranial blood vessels and subsequent headache. Furthermore, studies have demonstrated increased excitability of the nociceptive pathway in migraine sufferers, and CGRP receptor antagonists have been shown to be efficacious in migraine pain. Thus, such persistent neuroadaptive changes may be relevant to the processes that promote MOH.
Assuntos
Analgésicos Opioides/efeitos adversos , Transtornos da Cefaleia Secundários/fisiopatologia , Transtornos de Enxaqueca/tratamento farmacológico , Morfina/efeitos adversos , Nociceptores/efeitos dos fármacos , Nervo Trigêmeo/efeitos dos fármacos , Adaptação Fisiológica/efeitos dos fármacos , Animais , Peptídeo Relacionado com Gene de Calcitonina/fisiologia , Humanos , Hiperalgesia/induzido quimicamente , Hiperalgesia/fisiopatologia , Nociceptores/fisiologia , Ratos , Nervo Trigêmeo/fisiologiaRESUMO
UNLABELLED: Obesity, associated with morbidity and mortality, is a complex disorder, characterised by an increase in fat mass (FM). Most authors agree in considering essential an integrated treatment made up of nutritional intervention, physical reconditioning programme and cognitive-behavioural psychotherapy. However, the feasibility is problematic and data in literature confirming the validity of this approach are poor. AIM: To verify the efficacy of a multidimensional approach (Nutritional Psycho-Physical Reconditioning - NPPR) in obesity treatment. METHODS: All patients admitted from June 2002 to June 2004 (464 subjects) ranged from 18 to 65 years old, with a body mass index (BMI) >30 kg/m2 were included in the programme. After the nutritional status evaluation a standard dietetic treatment (group N) or an integrated and multidisciplinary obesity treatment (group NPPR) was proposed. RESULTS: In group NPPR treatment duration was significantly higher (142.6+/-26 vs 48.6+/-55 days - p=0.000), while the drop-out amount was definitely lower (5.5 vs 54.4%; p=0.000). Weight loss compared to the initial weight and the difference between initial and final FM resulted significantly higher in group NNPR. Subjects in NPPR obtained a higher increase in the distance covered in a 6-minute walk test (59.9+/-19 vs 40.5+/-17 m; p=0.04) and in muscular strength. State and trait anxiety, mood and quality of life scores improved in NPPR subjects while remained substantially stable in group N. CONCLUSIONS: An integrated approach to obesity is the way to be pursued in order to obtain important and at least short-term results.
Assuntos
Fármacos Antiobesidade/uso terapêutico , Terapia Cognitivo-Comportamental , Dieta Redutora , Comunicação Interdisciplinar , Obesidade/terapia , Equipe de Assistência ao Paciente , Adulto , Idoso , Índice de Massa Corporal , Prestação Integrada de Cuidados de Saúde , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Necessidades Nutricionais , Estado Nutricional , Valor Nutritivo , Obesidade/dietoterapia , Obesidade/tratamento farmacológico , Obesidade/psicologia , Resultado do Tratamento , Redução de Peso , Adulto JovemRESUMO
With the aim of identifying intervention programmes within the framework of basic and permanent nursing training, we evaluated the knowledge of 187 nurses and nursing students concerning biological emergencies. A questionnaire was used to identify their knowledge of the pathogens that may be used in a terrorist attack and measures for containing them, and their perception of the danger to public health. Analysis of the responses showed that the undergraduates studying for the Triennial Degree were the best informed, and those studying for the specialist degree were the least informed. The question relating to the precautions adopted against transmission of Bacillus anthracis was the most predictive of the total score because it was the only one with a substantial number of correct answers (79/187). It seems that the information derived more from the generalist media than from academic training. We conclude that there is a need to train qualified personnel capable of responding to a possible emergency in terms of both preventive and interventional medicine.
Assuntos
Bioterrorismo/prevenção & controle , Enfermagem em Emergência , Recursos Humanos de Enfermagem/educação , Estudantes de Enfermagem , Adulto , Análise de Variância , Atitude do Pessoal de Saúde , Competência Clínica , Currículo , Bacharelado em Enfermagem , Educação Continuada em Enfermagem , Programas de Graduação em Enfermagem , Educação de Pós-Graduação em Enfermagem , Avaliação Educacional , Enfermagem em Emergência/educação , Enfermagem em Emergência/métodos , Conhecimentos, Atitudes e Prática em Saúde , Necessidades e Demandas de Serviços de Saúde , Humanos , Controle de Infecções , Itália , Meios de Comunicação de Massa , Pesquisa em Educação em Enfermagem , Recursos Humanos de Enfermagem/psicologia , Estudantes de Enfermagem/psicologia , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Malnutrition due to undernutrition or overnutrition is highly prevalent in hospital in-patients and it decisively conditions patients clinical outcome. One of the most influencing factors of malnutrition in hospitalized patients is--at least in part--the Catering Service Quality. AIM: Is to verify, over a 5 year period, the course of the quality of the institutional Catering Service, verifying the effectiveness of the quality improvement process used. METHODS: Quality control was performed by objective (meal order accuracy, proper distribution of food in trolleys, route time from the kitchen to the ward and time of food distribution, food weight and temperature, waste assessment) and subjective assessment (quality was measured by giving the patients a questionnaire after meals). RESULTS: The survey included: 572 meals and 591 interviews. A significant amount of "qualitative" errors (lack of respect for patient preferences or at the moment of supplying the food trolley) have been found. Over the time and the amount of patients that wasted a considerable amount of the portion served was considerably reduced food temperature have been improved. Also patient satisfaction with menu variability, portion size, temperature and cooking quality improved over time. The overall ratings of meals under observation improved too in fact, positive opinions ranged from 18% in 2002 to 48.3% in 2006. CONCLUSION: Ongoing research and quality verification, which include all catering service workers, yields a constant improvement in quality. Patients in healthcare settings should receive a service they appreciates, but it should be--at the same time--correct from a nutritional point of view. For this reason, it is necessary a continuous mediation between customers satisfaction and nutritionists work, dieticians and nursing staff. From this point of view the educational approach becomes essential to feed patient compliance to dietetic treatment that will continue after discharge.
Assuntos
Manipulação de Alimentos/métodos , Manipulação de Alimentos/normas , Serviço Hospitalar de Nutrição/normas , Alimentos/normas , Satisfação do Paciente , Controle de Qualidade , Idoso , Feminino , Humanos , Tempo de Internação , Masculino , Planejamento de Cardápio , Pessoa de Meia-Idade , Paladar , TemperaturaRESUMO
AIMS: To isolate and characterize spore-former bacteria able to colonize the human gastrointestinal tract (GIT). METHODS AND RESULTS: A total of 25 spore-formers was isolated from faeces and ileal biopsies of healthy human volunteers and identified at the species level. Physiological analysis was performed to evaluate the ability of the various isolates to form biofilms, to swarm, to produce surfactants and molecules that have antimicrobial activity against selected pathogens. To assess the potential probiotic activity of the isolates, we tested the resistance of cells and spores to simulated gastric conditions, the ability to grow and sporulate in anaerobic conditions and the presence of toxin-encoding genes in their genome. CONCLUSIONS: Spore-formers belonging to various bacterial species have been isolated from the gut of healthy human volunteers. These strains appear to be well adapted to the intestinal environment and we propose them as potential probiotic strains for human use and as oral vaccine vehicles. SIGNIFICANCE AND IMPACT OF THE STUDY: To our knowledge this is the first detailed characterization of spore-forming Bacilli from the human GIT. Our data suggest that the isolated species do not transit, but rather colonize this specific habitat and propose them as probiotic strains for human use.
Assuntos
Bacillus/fisiologia , Trato Gastrointestinal/microbiologia , Esporos Bacterianos/crescimento & desenvolvimento , Adulto , Anaerobiose , Animais , Bacillus/patogenicidade , Biofilmes/crescimento & desenvolvimento , Eletroforese em Gel de Ágar , Enterotoxinas/biossíntese , Fezes/microbiologia , Feminino , Humanos , Ílio/microbiologia , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Esporos Bacterianos/isolamento & purificação , Fatores de Virulência/análiseRESUMO
It is possible to identify risks or protective factors against dementia. Increased levels of homocysteine (HCY) and vitamin B deficiency, obesity and central adiposity in midlife are independent risk factors for the development of dementia. High dietary intake of antioxidants and omega-3 fatty acids lower the risk of Alzheimer disease (AD). The supplementation with single nutrients, like vitamin B, omega-3-polyunsaturated fatty acids (PUFA) or antioxidants is generally not effective in lowering the risk of dementia or in slowing the progression of the disease. It is probably necessary that these nutrients are part of a healthy diet (with at least five portions of fruit and vegetables per day and one portion of fish per week) during the lite where other factors interact with them as it happens in the Mediterranean diet. Nutritional strategies for modifying the clinical course of cognitive failure should consider the use of nutritional screening tools in the multidimensional geriatric evaluation. Moreover, the diet, oral supplementation, caregiver education could be important factors to prevent or treat weight loss and its consequences in AD while the use of artificial nutrition in demented patients may have questionable benefits.
Assuntos
Antioxidantes/uso terapêutico , Transtornos Cognitivos/epidemiologia , Transtornos Cognitivos/prevenção & controle , Estado Nutricional , Idoso , Idoso de 80 Anos ou mais , Deficiência de Vitaminas/epidemiologia , Deficiência de Vitaminas/prevenção & controle , Transtornos Cognitivos/diagnóstico , Comorbidade , Humanos , Hiper-Homocisteinemia/epidemiologia , Hiper-Homocisteinemia/prevenção & controle , Programas de Rastreamento/métodos , Obesidade/epidemiologia , Obesidade/prevenção & controle , Prevalência , Redução de Peso , Talassemia betaRESUMO
A study was undertaken at the biggest dental hospital in Italy, the "George Eastman Dental Hospital", in order to assess the dentistry environment as it stands with current equipment and dental practice in use. In order to gain information on the possible presence of chemical pollutants from dentistry activity, a simultaneous consecutive 7-day sampling of volatile organic compounds (VOCs) at the dental chair (dentistry indoor) and at the related vicinity outdoor window (dentistry outdoor) was performed. Volatile organic compounds were identified; cyclohexane, benzene, n-eptane, methylcyclohexane, toluene, ethylbenzene, xylenes, trimethylbenzene and methylhexane were quantitatively determined. As a preliminary result, the dentistry indoor (I(D)) and outdoor (O(D)) volatile organic compounds concentrations ratios are always higher than 1 (I(D)/O(D) > 1), pointing to higher VOCs concentrations in dentistry indoor than in outdoor. It should be noted homes indoor/outdoor concentrations ratios (I(D)/O(H) > 1) are usually higher than 1 as well. For an in-depth study, aimed at assessing the level of VOCs in dentistry setting, instantaneous, hourly, daily, and weekly samplings and a greater number of samples are needed.
Assuntos
Poluição do Ar em Ambientes Fechados/análise , Odontologia , Monitoramento Ambiental/normas , Compostos Orgânicos/análise , Exposição Ambiental/efeitos adversos , Humanos , ItáliaRESUMO
UNLABELLED: The prevalence of pressure sores (PS) ranges from 1 to 18% of in-patients and from 3 to 28% of those admitted to long-term settings. The aim of our study was to verify, a posteriori, how nutritional status influenced the evolution of PS in a population of elderly subjects hospitalised in a long-term care setting. MATERIALS AND METHODS: The charts of 125 patients with ulcerative or necrotic pressure ulcers were evaluated retrospectively. For each subject we took note of: PS characteristics (stage, ulcer surface, evolution), clinical characteristics (comorbidity, adverse clinical events, cognitive, functional and nutritional status). RESULTS: In 58 patients (46.4%) there was overall healing of the lesions while in 39 patients (31.2%) we had however an "improvement" of PS. The course of PS was not significantly influenced by the patient's physiological characteristics, by cognitive status or by initial characteristics of PS. Instead, we noticed a significant difference in the course of PS as a function of the level of autonomy and clinical status. The course of PS, and in particular the Healing Index, were influenced by the Nutritional Status and, above all, by its course during the treatment period. CONCLUSIONS: The development of PS is multifactorial. Whereas, it is clear that factors other than nutrition influence the risk of developing PS, an important role for nutrition in the development and resolution of PS is suggested. Our data certainly confirm the "Quality indicators for prevention and management of pressure ulcers in vulnerable elders", especially were they say "if a vulnerable elder is identified as at risk for pressure ulcer development and has malnutrition, then nutritional intervention or dietary consultation should be instituted because poor diet, particularly low dietary protein intake, is an independent predictor of pressure ulcer development".
Assuntos
Proteínas Alimentares/administração & dosagem , Enfermagem Geriátrica/normas , Assistência de Longa Duração , Estado Nutricional , Úlcera por Pressão/epidemiologia , Úlcera por Pressão/etiologia , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Feminino , Humanos , Itália/epidemiologia , Assistência de Longa Duração/normas , Masculino , Pessoa de Meia-Idade , Qualidade da Assistência à Saúde , Estudos Retrospectivos , Fatores de RiscoRESUMO
The health care staff is potentially more exposed to contract infectious diseases at work. This risk becomes true if the DPI are not utilized and the operators don't work according to the standard protocol, and, with regard to the health care students, they begin their clinical training without the right knowledges. To verify the adequacy of knowledges and the consequent behaviours we effected a study among the students at first year of the D. U. for nurses in the University of L'Aquila, through a questionnaire. It came out many gaps of knowledges about the standard practice and about the Universal Precautions in about 20% of the interviewed.