Radon risk mapping: A new geostatistical method based on Lorenz Curve and Gini index.

In confined spaces such as living environments and workplaces, the concentration levels of radon (Rn222) can be very high as compared to the external environment. Since Rn has been classified as the second leading cause of lung cancer after cigarette smoking, to apply efficient locally based risk reduction actions, dense maps of indoor radon concentration are needed. These maps would provide information about the areas prone to high radon concentrations and therefore more dangerous to human health. The soil is the primary source of the Rn, hence the risk assessment and reduction for the radon exposure cannot disregard the identification of the local geology. In this regard, we propose an innovative method, based on the Gini index computation, for the realization of interpolated maps (kriging) to describe the distribution of concentration of Rn. To validate the method, a tool that simulates sets of radon concentrations is used, whose variability is, to the first order, controlled by a priori imposed different lithologies. A systematic comparison is made between the results achieved by means of a classically used geostatistical method and the proposed Gini-based tool. We show how, by using this latter tool, the kriging solutions appear to be more robust to resolve the different geogenic radon sources independently from the number of the available measurements.

HIV awareness: a kap study among students in Italy reveals that preventive campaigns still represent a public health priority.

BACKGROUND: Improving knowledge about HIV/AIDS among young people is crucial for preventing new infections. The aim of the study was to investigate knowledge, attitudes and practices regarding HIV infection among students attending university courses related to the healthcare professions, in order to better target future preventive and informative HIV campaigns tailored for young people. STUDY DESIGN: A knowledge, attitude and practices study was conducted among university students attending the following university courses in Bari (Southern Italy): Medicine and Surgery (MS), Dentistry and Dental Prostheses, Health Assistance, Motor Activities and Sports Sciences, Sciences and Technology of Herbal and Health Products, Nursing, Biomedical Laboratory Techniques, and Dietetics. METHODS: Students completed a self-administered questionnaire designed to assess their knowledge/attitudes re/ HIV and their own sexual practices. The general part of the questionnaire requested information about age, gender, nationality, religion and marital status. The second part included questions asking about knowledge, attitude and practices with respect to HIV, which required true/false answers or graduated answers (reported as agree, quite agree, quite disagree, and disagree). RESULTS: Four hundred students were invited to fill in the questionnaire. The response rate was 91.2% (n=365). Almost all students were aware that HIV is transmitted through sexual intercourse and blood, but only 34% knew that breastfeeding is a route of transmission. Of the respondents, 86.8% referred to previous sexual intercourse (25.8% reported using a condom in all cases of sexual intercourse, 43.5% in most cases, 18.6% rarely and 12.1 never). Sexual intercourse with casual partners was reported by 37.5% of these students and 63.9% of them did not always use a condom. CONCLUSIONS: The results of the study show that knowledge about some aspects of HIV is insufficient even though the students participating in the present study are students attending university courses related to the healthcare professions. Moreover, high-risk behaviors as the lack of the use of condom during sexual intercourse with casual partners are also common among interviewed students. Programs aimed at providing information that can prevent/reduce transmission of HIV in young people and new strategies to improve knowledge should be stressed as a public health priority.

Leaf anatomy and photochemical behaviour of Solanum lycopersicum L. plants from seeds irradiated with low-LET ionising radiation.

Plants can be exposed to ionising radiation not only in Space but also on Earth, due to specific technological applications or after nuclear disasters. The response of plants to ionising radiation depends on radiation quality/quantity and/or plant characteristics. In this paper, we analyse some growth traits, leaf anatomy, and ecophysiological features of plants of Solanum lycopersicum L. "Microtom" grown from seeds irradiated with increasing doses of X-rays (0.3, 10, 20, 50, and 100 Gy). Both juvenile and compound leaves from plants developed from irradiated and control seeds were analysed through light and epifluorescence microscopy. Digital image analysis allowed quantifying anatomical parameters to detect the occurrence of signs of structural damage. Fluorescence parameters and total photosynthetic pigment content were analysed to evaluate the functioning of the photosynthetic machinery. Radiation did not affect percentage and rate of seed germination. Plants from irradiated seeds accomplished the crop cycle and showed a more compact habitus. Dose-depended tendencies of variations occurred in phenolic content, while other leaf anatomical parameters did not show distinct trends after irradiation. The sporadic perturbations of leaf structure, observed during the vegetative phase, after high levels of radiation were not so severe as to induce any significant alterations in photosynthetic efficiency.

Radon measurements and effective dose from radon inhalation estimation in the Neapolitan catacombs.

In this study, the indoor radon activity concentrations have been measured in the Neapolitan catacombs using LR115 detectors. The detectors were exposed for two quarters, one in the warm season and the other in the cold. This has allowed one to evaluate the seasonal variations of concentrations, while the diurnal variations were evaluated performing continuous measurements by a Radim 5 monitor. The authors found that radon concentrations were lower in winter than in summer. Based on their values, taking into consideration the working hours in the catacombs and the equilibrium factor of 0.4, the effective dose to workers was estimated.

Cervical cancer prevention and health inequalities: an ad-hoc survey in Italian women.

OBJECTIVE: To assess knowledge and attitudes towards cervical cancer prevention in a sample of 2400 Italian women. STUDY DESIGN: Cross-sectional study. METHODS: The study was conducted through a standardized questionnaire administered in the workplace. RESULTS: Regular Pap testing was reported by 65.6% of the sample, and 86.9% were aware of the human papillomavirus (HPV) vaccine. Just over half of the women (51.8%) stated that they would pay for the vaccine for themselves or family members. Significant differences in responses were associated with monthly income and educational level. CONCLUSION: Introduction of payment for the HPV vaccine may increase health inequalities significantly. For overall improvement in the quality of life, effective prevention and treatment services should be made available to all.

Communication skills in HPV prevention: an audit among Italian healthcare workers.

This study aims to investigate the knowledge, the attitudes and practices on HPV vaccination of health professionals of Mother and Child Service of Puglia Region (Italy). The study was conducted through a standardized questionnaire. Of 455 respondents, 74.2% judged HPV vaccine very important for immunization calendar. 88.9% did not believe that the administration of HPV vaccine implies consent to the initiation of sexual activity but 34.2% sustained that vaccine can give a false sense of protection against sexually transmitted diseases. 62.2% believed that boys should also be vaccinated. Skills necessary in the implementation of strategies in the promotion of health are partially inadequate and appropriate ongoing education should be carried out for health care workers.

A nosocomial outbreak of 2009 pandemic influenza A(H1N1) in a paediatric oncology ward in Italy, October-November 2009.

A nosocomial outbreak of 2009 pandemic influenza A(H1N1), with eight confirmed cases, occurred in a paediatric oncology ward in Italy, in October/November 2009. The fact that one case was infected despite being isolated and without contact to a symptomatic patient, hints towards potential transmission through a health care worker (HCW) and underlines the importance of vaccination of HCW who are involved in the care of critically ill patients.

Frequency of human papillomavirus infection and genotype distribution among women with known cytological diagnosis in a Southern Italian region.

INTRODUCTION: In the Puglia region (South Italy) about 200 new hospitalizations for cervical cancer are registered every year. The study investigated the frequency of Human Papillomavirus (HPV) infection and the genotype distribution of HPV in a sample of women with known cytology attending the outpatient clinics of four Gynecological Departments of the University of Bari over a four-year period (2005-2008). METHODS: Cervical samples from 1,168 women were analyzed for the presence of HPV-DNA through Polymerase Chain Reaction (PCR) in L1 region and reverse hybridization. The cytological results were associated with HPV positivity and type-specific prevalence. RESULTS: Overall, HPV infection was found in 355 (30.4%) women. HPV-DNA was found in 34.4% of women with a cytological diagnosis of ASCUS, in 46.8% of women with Low-grade Squamous Intraepithelial Lesion (LSIL) and in 87.0% of women with High-grade Squamous Intraepithelial Lesion (HSIL)/carcinoma. Also 16.0% of women with normal Pap smear were found to be HPV-DNA positive. The most common HPVgenotype was type 16 found in 27.3% of positives, followed by type 53 (11.5%), type 66 (9.2%) and type 31 (9.0%). HPV genotype 18 was found in 6.4% of positives. Types 16 or 18 were detected in about 34% (120/355) of all infected women, in about 33% of LSIL and in 60% of HSIL/ carcinoma HPV-positive women. Among low risk (LR) genotypes, type 61 was found in 10.7% of HPV positive women, type 62 in 8.4%, type 42 in 8.1% and type CP6108 in 7.8%. DISCUSSION AND CONCLUSIONS: The findings of the study give evidence that HPV infection is frequent in the studied cohort of women. The most widespread genotypes found were 16 and 53. These data may represent a benchmark for future evaluation after the recent introduction of vaccination against HPV in 12-year-old girls.

Alterations of ubiquitin ligases in human cancer and their association with the natural history of the tumor.

Protein ubiquitination is critical for many cellular processes, through its ability to regulate protein degradation and various signaling mechanisms. In the ubiquitin (Ub) system, substrate specificity is achieved through the E3 family of Ub ligases. Because alterations of the ubiquitination machinery have been reported in human cancers, the selective interference with Ub ligases might represent a powerful therapeutic tool. Here, we report the first wide survey of misregulation of Ub ligases in cancer. We analysed 82 Ub ligases in nine types of cancer by in situ hybridization on tissue microarrays. We found 27 instances in which an Ub ligase was altered in a given type of tumor, when compared with normal tissues: 21 cases of overexpression and 6 cases of underexpression. We further analysed selected Ub ligases in large cohorts of breast and non-small-cell lung carcinomas. In five, of six, of these extended analyses (HUWE1, CCNB1IP1, SIAH1 and SIAH2 in breast cancer and CCNB1IP1 in lung cancer), we found that the levels of Ub ligases correlated significantly with relevant prognostic factors, and with clinical outcome. Our findings show that the alteration of Ub ligases is a frequent event in cancer and identify candidate targets for molecular therapies.

Malignant cancer mortality in Province of Taranto (Italy). Geographic analysis in an area of high environmental risk.

BACKGROUND: A geographic analysis of the causes of death is an important tool for assessing the effectiveness of Public Health initiatives. The aim of this study is to analyse the causes of death between 2000 and 2004, to discover any excess mortality from cancer in Province of Taranto, an area at high environmental risk. METHODS: Mortality data from cancer were selected from the Puglia Regional Nominative Causes of Death Registry. Crude and standardized rates and Standardized Mortality Ratios (SMR) were calculated for the five Provinces of the Puglia Region, their capital cities and in four concentric rings around the industrial area located in Province of Taranto. RESULTS: . Even if the highest death rate for all tumours resulted in the Province of Lecce (24.9 x 10,000), in the cities of Lecce and Bari (29 x 10,000), the distribution of the SMRs in Province of Taranto showed an excess of mortality (+10%) in the ring next to industrial area. For lung cancer the highest rate was reported in city of Taranto (6 x 10,000) and the highest risk (+24%) in the ring next to industrial area. Moreover, in this area 9 (70%) of the 13 considered malignant tumours types presented an excess of mortality. CONCLUSION: The results uphold the data reported in the published literature. It is fundamental to intensify research into other risk factors (exposure at work and aberrant lifestyles). Moreover, there is an increasing need for a Regional Cancer Register.

Gene expression analysis of early and advanced gastric cancers.

Gastric carcinoma is one of the major causes of cancer mortality worldwide. Early detection results in excellent prognosis for patients with early cancer (EGC), whereas the prognosis of advanced cancer (AGC) patients remains poor. It is not clear whether EGC and AGC are molecularly distinct, and whether they represent progressive stages of the same tumor or different entities ab initio. Gene expression profiles of EGC and AGC were determined by Affymetrix technology and quantitative polymerase chain reaction. Representative regulated genes were further analysed by in situ hybridization (ISH) on tissue microarrays. Expression analysis allowed the identification of a signature that differentiates AGC from EGC. In addition, comparison with normal gastric mucosa indicated that the majority of alterations associated with EGC are retained in AGC, and that further expression changes mark the transition from EGC to AGC. Finally, ISH analysis showed that representative genes, differentially expressed in the invasive areas of EGC and AGC, are not differentially expressed in the non-invasive areas of the same tumors. Our data are more directly compatible with a progression model of gastric carcinogenesis, whereby EGC and AGC may represent different molecular stages of the same tumor. Finally, the identification of an AGC-specific signature might help devising novel therapeutic strategies for advanced gastric cancer.

Lack of changes in the PI3K/AKT survival pathway in the spinal cord motor neurons of a mouse model of familial amyotrophic lateral sclerosis.

The vulnerability of motor neurons in transgenic SOD1G93A mice, a model of familial amyotrophic lateral sclerosis (ALS), may depend on the failure of these cells to activate survival mechanisms in response to the toxic mutant SOD1. To test this we investigated whether defects in the PI3K/Akt pathway, a survival signal, and of its neuron-specific activator, Rai, were important for motor neuron degeneration in these mice. No substantial changes were found in the levels of Rai, PI3K(p85) or phosphorylated Akt (P-Akt) in the ventral horn of spinal cord of SOD1G93A mice during disease progression. P-Akt immunoreactivity was the same in degenerating and healthy motor neurons. Rai ablation in SOD1G93A mice slightly accelerated the motor dysfunction without affecting their life span. Thus, motor neurons in SOD1G93A mice do not lose the pro-survival PI3K/Akt signal nor increase it in order to suppress the cell death mechanisms.

Radon survey in the high natural radiation region of Niska Banja, Serbia.

A radon survey has been carried out around the town of Niska Banja (Serbia) in a region partly located over travertine formations, showing an enhanced level of natural radioactivity. Outdoor and indoor radon concentrations were measured seasonally over the whole year, using CR-39 diffusion type radon detectors. Outdoor measurements were performed at 56 points distributed over both travertine and alluvium sediment formations. Indoor radon concentrations were measured in 102 living rooms and bedrooms of 65 family houses. In about 50% of all measurement sites, radon concentration was measured over each season separately, making it possible to estimate seasonal variations, which were then used to correct values measured over different periods, and to estimate annual values. The average annual indoor radon concentration was estimated at over 1500 Bq/m3 and at about 650 Bq/m3 in parts of Niska Banja located over travertine and alluvium sediment formations, respectively, with maximum values exceeding 6000 Bq/m3. The average value of outdoor annual radon concentration was 57 Bq/m3, with a maximum value of 168 Bq/m3. The high values of indoor and outdoor radon concentrations found at Niska Banja make this region a high natural background radiation area. Statistical analysis of our data confirms that the level of indoor radon concentration depends primarily on the underlying soil and building characteristics.

[Epidemiology of HPV infections and cervical cancer in Apulia: a survey study and current data analysis]. / Epidemiologia delle infezioni da HPV e del cervicocarcinoma in Puglia: studi ad hoc e analisi dei dati correnti.

HPV infection is common in sexually active women and is an important risk factor for cervical cancer. The aim of this article is to describe the prevalence of HPV infection, the incidence and the mortality rates for cervical cancer and adherence to screening programs in Apulia in the light of recent introduction of anti-HPV vaccines. The prevalence of HPV was evaluated testing biological samples from 1082 women. The 33% resulted positive for HPV (80% for high-risk genotypes and 20% for low-risk genotypes). The 59% of positive samples showed only a single viral type while 37% multiple genotypes. In Apulia, from 1998 to 2005, a total of 1849 women were hospitalized for cervical cancer with a decreasing trend; the 46% had exo cervical cancer; the 22% endocervical cancer, 29% cancer of cervix without specification and 3% infiltrating cervical cancer. The mortality rate was 1,5 x 100.000. Data from PASSI study regarding cervical cancer screening showed that 62% of Apulian women 25-64 years aged had a Pap smear and 54.7% get it every three years. The viral genotypes circulating in Apulia region are present in anti-HPV vaccines; this item could give information on their introduction together with actions to implement the adherence to screening program that results lower than international standard.

High natural radiation exposure in radon spa areas: a detailed field investigation in Niska Banja (Balkan region).

The measurement campaigns have been done in the rural community of Niska Banja, a spa town located in southern Serbia, to evaluate population exposure to natural radioactivity. After a screening survey in 200 houses, annual radon and thoron concentrations were measured in 34 houses, and in 2004 a detailed investigation was carried out at six houses with elevated indoor radon concentrations. The paper presents the results of these detailed measurements. The complementary techniques were applied to determine radon and thoron concentrations in indoor air, in soil gas, radon exhalation from soil, soil permeability, and indoor and outdoor gamma doses. Soil and water samples were collected and analysed in the laboratory. Indoor radon and thoron concentrations were found to be more than 1kBqm(-3) and 200Bqm(-3), respectively. Extremely high concentrations of soil-gas radon (>2000kBqm(-3)) and radon exhalation rates (1.5mBqm(-2)s(-1)) were observed. These results will be utilised to set up the methodology for a more systematic investigation.

Photo-activation of hypericin with low doses of light promotes apparent photo-resistance in human histiocytic lymphoma U937 cells.

We have observed that exposure of U937 cells, pre-incubated for 18 h with 0.2 microM hypericin, to 599 nm laser radiation with a fluence of 2.5 J/cm(2) renders them insensitive to higher light doses. In fact, pre-sensitized cells appear to be fully resistant to light doses that normally determine massive cellular apoptosis in experimental photo-dynamic therapy. The appearance of the photo-resistance, as measured by evaluating the changes in levels of expression of pro and anti apoptotic proteins, PARP fragmentation and cell viability is exclusively observed with exposure to light doses not exceeding 5-6 J/cm(2). Above this energy, necrosis replaces apoptosis upon photo-stimulation of U937 cells. Here, we describe the appearance of photo-resistance in hypericin-loaded U937 cells, but could not fully unravel the molecular mechanism underlying this process. However, the observed stimulation of the expression of the HSP-70 protein upon photo-induced stress may suggest its involvement in this process.

Anti-Fas (CD95/Apo-I) autoantibodies and soluble Fas levels concur in T cell depletion in HIV type 1 infection.

Deregulation of the Fas/FasL pathway in activated T cells is suspected to contribute to the abnormal apoptosis that drives their progressive depletion during HIV-1 infection. However, the role of serum soluble Fas (sFas) is unclear. Here we investigated both sFas and anti-Fas IgG levels in a cohort of 227 HIV-1-infected patients with respect to their T cell apoptosis. By using optimized ELISAs, we found that serum titers of sFas and anti-Fas were linearly correlated in 17 severely lymphopenic subjects as compared with other patients grouped in relation to their single expression of anti-Fas and sFas, or with double-negative control patients. Cytofluorimetric measurement of the subdiploid DNA-containing cell population by both PI and TUNEL revealed an increased occurrence of cell death in vitro, in particular in patients with elevations of sFas. We also found that fresh CD4(+) cells from these patients showed high levels of both caspase 3 (CPP32) and its molecular targets, namely PARP and CK18. In addition, their in vitro proliferative rate was inhibited by sFas, in particular in patients with undetectable levels of the soluble receptor in vivo as well as in normal donors. In these subjects the Fas-related caspase 8 (FLICE) was significantly increased in cells treated with the recombinant Fas. These results support the contention that functionally exhausted T cells may undergo apoptosis in response to the persistent in vivo stimulation by sFas. This may elucidate the described occurrence of enhanced cell death in advanced HIV-1 infection in association with serum elevations of the soluble receptor.

Hypericin photosensitization of tumor and metastatic cell lines of human prostate.

We have investigated the photoactivating effect of hypericin on two cancer cell lines: PC-3, a prostatic adenocarcinoma non-responsive to androgen therapy and LNCaP, a lymphonodal metastasis of prostate carcinoma responsive to androgen therapy. The two cell lines are incubated for 24 h with hypericin at concentrations ranging from 0.001 to 0.3 microg/ml in cell culture medium. The cells are irradiated at 599 nm (fluence = 11 J/cm2) using a dye laser pumped by an argon laser. Hypericin exerts phototoxic effects on both cell lines, while it does not produce toxic effects in the absence of irradiation. These results suggest that photodynamic therapy (PDT) with hypericin could be an alternative approach to the treatment of prostatic tumors, and could be beneficial in tumors that are non-responsive to androgen therapy.

MS-2 fibrosarcoma characterization by laser induced autofluorescence.

BACKGROUND AND OBJECTIVE: MS-2 fibrosarcoma implanted in BALB-CDF1 mice was investigated by frequency and time domain measurements of the autofluorescence (AF) radiation emitted upon excitation by a N(2) laser beam (337.1 nm). STUDY DESIGN/MATERIALS AND METHODS: AF spectra were obtained by using a spectrograph, a multichannel plate and an optical multichannel analyzer for the steady state detection. Time-resolved spectra were performed by means of a monochromator, a photomultiplier, and a digital signal analyzer. RESULTS: Spectral measurements show that the autofluorescence intensity of pathologic tissue is lower than that of healthy one in the 400- to 500- spectral region. In the same spectral range, we found the fluorescence decay to be the sum of a fast and a slow component. The lifetime of the fast component of tumoral tissue is significantly lower than that of healthy samples. CONCLUSION: Frequency and time domain measurements used in combination show that MS2-fibrosarcoma is characterized by the probable presence of the free form of NADH.

Effect of antiretroviral therapy on cryptosporidiosis and microsporidiosis in patients infected with human immunodeficiency virus type 1.

To better understand whether potent antiretroviral therapies can modify the natural history of HIV-1-associated microsporidiosis and cryptosporidiosis, the response to antimicrobial treatment of these opportunistic infections was evaluated in patients with or without antiretroviral treatment. Fifty patients with diarrhoea, all positive for Cryptosporidium parvum or Enterocytozoon bieneusi, were included in the study. Retrospective data were collected concerning demographics, clinical and microbiological characteristics of the parasitic infection, antiretroviral therapy and prophylaxis against opportunistic infections. Faecal samples were prepared using the Richie formalin-ethyl acetate method and stained using the modified Ziehl-Neelsen method for detection of Cryptosporidium parvum and Isospora belli, the modified trichrome and calcofluor white technique for detection of Enterocytozoon spp., and iodine for detection of ova, cysts or vegetative forms. Diarrhoea was defined as an abnormal increase in stool liquidity, an abnormal increase in stool frequency and a daily stool weight of more than 250 g for a period of at least 4 days. Patients treated with double antiretroviral therapy or protease inhibitors demonstrated an excellent response and a sustained therapeutic effect after follow-up (range, 5-36 months). The relapse of cryptosporidiosis in two patients who discontinued antiretroviral therapy suggests that the infection might remain in a latent stage. The resolution of the diarrhoea seems to be related to an increased CD4+ cell count rather than to the viral load. In conclusion, these data strongly support the hypothesis that combination antiretroviral therapy is able to greatly modify the course of cryptosporidiosis and microsporidiosis in patients infected with HIV-1.