Assessment of children in the autistic spectrum disorder that carry the Thr92Ala-DIO2 polymorphism.

INTRODUCTION: A polymorphism in the type 2 deiodinase (Thr92Ala-DIO2) gene has been associated with behavioral and cognitive dysfunction as well as neurodegeneration and oxidative stress in the central nervous system. OBJECTIVE: To test whether the minor allele (Ala92) frequency (MAF) is increased in children in the autism spectrum disorder (ASD), and whether carriers of the minor allele exhibit more severe symptoms and/or worse adaptive behavior. STUDY DESIGN: ASD children were evaluated at baseline and yearly throughout the study by psychologists using the following tools: autism behavior checklist, Vineland Adaptative Behaviour Scales II, non-verbal intelligence test SON-R 21/2-7, SON-R 6-40, Weschler scale for intelligence, and autism treatment evaluation checklist. SETTINGS: Academic outpatient mental health facility in Sao Paulo, Brazil. PARTICIPANTS: ASD boys and girls younger than 18 years of age. 132 consecutive ASD children, mostly boys (~ 80%); ~ 50% was classified as verbal. Exclusion criteria were coexistence of sensory and/or physical impairment, or any associated genetic syndromes. RESULTS: Median follow-up was for an uninterrupted period of 937 days (139-1375 days), which did not vary significantly among the genotypes. The MAF was 47% in ASD patients vs. 51% in a local reference population with similar ethnic background; the clinical severity and progression were not affected by the minor allele. Carriers of the minor allele exhibited higher adaptive behavior in the domains "daily living skills" and "communication", which correlated positively with the dose of the minor allele. CONCLUSION: The MAF is not different in ASD children, but carriers of the Thr92Ala-DIO2 polymorphism exhibited higher adaptive behavior.

Building the Human Vaccines Project: strategic management recommendations and summary report of the 15-16 July 2014 business workshop.

The Human Vaccines Project is a bold new initiative, with the goal of solving the principal scientific problem impeding vaccine development for infectious diseases and cancers: the generation of specific, broad, potent and durable immune responses in humans. In the July 2014 workshop, 20 leaders from the public and private sectors came together to give input on strategic business issues for the creation of the Human Vaccines Project. Participants recommended the Project to be established as a nonprofit public-private partnership, structured as a global R&D consortium closely engaged with industrial partners, and located/affiliated with one or more major academic centers conducting vaccine R&D. If successful, participants concluded that the Project could greatly accelerate the development of new and improved vaccines, with the potential to transform disease prevention in the 21st century.

In vivo and in vitro assessment of pathways involved in contrast media-induced renal cells apoptosis.

Contrast-induced nephropathy accounts for >10% of all causes of hospital-acquired renal failure, causes a prolonged in-hospital stay and represents a powerful predictor of poor early and late outcome. Mechanisms of contrast-induced nephropathy are not completely understood. In vitro data suggests that contrast media (CM) induces a direct toxic effect on renal tubular cells through the activation of the intrinsic apoptotic pathway. It is unclear whether this effect has a role in the clinical setting. In this work, we evaluated the effects of CM both in vivo and in vitro. By analyzing urine samples obtained from patients who experienced contrast-induced acute kidney injury (CI-AKI), we verified, by western blot and immunohistochemistry, that CM induces tubular renal cells apoptosis. Furthermore, in cultured cells, CM caused a dose-response increase in reactive oxygen species (ROS) production, which triggered Jun N-terminal kinases (JNK1/2) and p38 stress kinases marked activation and thus apoptosis. Inhibition of JNK1/2 and p38 by different approaches (i.e. pharmacological antagonists and transfection of kinase-death mutants of the upstream p38 and JNK kinases) prevented CM-induced apoptosis. Interestingly, N-acetylcysteine inhibited ROS production, and thus stress kinases and apoptosis activation. Therefore, we conclude that CM-induced tubular renal cells apoptosis represents a key mechanism of CI-AKI.

The assessment of IFN-gamma and its regulatory cytokines in the plasma and bronchoalveolar lavage fluid of patients with active pulmonary tuberculosis.

OBJECTIVES: To assess the role of IFN-gamma and its regulatory cytokines in active pulmonary tuberculosis (TB). DESIGN: Cytokines were measured in the plasma of TB patients and healthy subjects with different risk for TB exposure. In addition, cytokine profile was assessed in the bronchoalveolar lavage fluid (BALf) of six TB patients and nine normal controls. RESULTS: Circulating IFN-gamma, IL-10 and IL-18 were higher in TB patients than in control groups. Plasma IL-12 levels were extremely variable, and no difference was observed among study groups. An inverse correlation between plasma IFN-gamma and IL-10 levels was found in TB patients. Furthermore, circulating IL-18 correlated with IL-10 but not with IFN-gamma levels. Finally, IFN-gamma, IL-18 and IL-12 were increased in the BALf of TB patients, whereas no difference was observed in IL-10 levels. CONCLUSIONS: In human TB, at least at certain disease stages, there is a differential compartmentalization of the IFN-gamma-regulatory factors IL-12 and IL-10, the former being concentrated in the lungs and the latter being present in peripheral circulation. In addition, our findings address more critically the role of IL-18 in the host response to tuberculosis infection in humans.

Appropriate and inappropriate use of day-hospital care in Italy.

This study describes the extent of inappropriate day-hospital assistance and the effect of different variables on such inappropriateness. A random sample of patients admitted to pediatric and adult day-hospital care during the period Janurary--December 2000 in three hospitals located in the area of Catanzaro, Italy were reviewed. Assessment of appropriateness was made for the first access and for each of the following accesses in day-hospital. A total of 826 patients were reviewed. Overall, 23.8% of the first access in day-hospital care was judged to be inappropriate and 49.7% of the sample showed at least one inappropriate access for day-hospital care with a mean of 1.4 inappropriate accesses. Multiple logistic regression analysis indicated that the inappropriateness of the first access significantly increased with relation to lower distance from hospital to patient's home; admission to general medicine wards; first access from Monday to Thursday; lower number of patient's diagnostic procedures and medical examinations in the first access. Stepwise multiple linear regression analysis showed that the number of inappropriate accesses was significantly higher for general medicine and surgery and trauma/orthopedics wards; in patients who the first access was inappropriate; in those who received a lower number of diagnostic procedures and medical examinations; in patients who showed a higher length of care in day-hospital. The findings suggest the need for standardized diagnostic and therapeutic guidelines for day-hospital care.

Appropriateness of hospital utilisation in Italy.

The purpose of this study was to determine the extent of inappropriate hospital admission and inappropriate days of stay and the effect of variables on such inappropriateness on an adult population in Italy. A review was made of medical records of patients admitted to any one of the following specialities: medicine, surgery, gynaecology or traumatology/orthopaedics at one of five hospitals located respectively in Siena, Frosinone, Rome and Catanzaro, and who were in-patients during one of four pre-selected index days. To determine the appropriateness of hospital admission and length of hospitalisation, a retrospective application was made using the Italian version of Appropriateness Evaluation Protocol (AEP). A total of 1299 patient days were reviewed. 14.2% of the hospital admissions and 37.3% of the number of hospitalisation days were judged to be inappropriate. Multiple logistic regression analysis showed that inappropriate admission was significantly increased with relation to: greater distance from hospital to patient's home; admission to a medical ward; planned admissions; and admission over a weekend. Multiple logistic regression analysis indicated that the inappropriate number of days of hospitalisation was significantly higher for medicine and for patients who were inappropriately admitted. The main reason for categorising an admission as inappropriate was that the patient's problems could be treated on an out-patient basis, and, for inappropriate days of care, the physician was overtly cautious in the management of a patient. Changing the physicians' behaviour and the organisation of hospital activities may be effective in improving the quality and efficiency of hospital care.

[Epidemiological studies of the dental-periodontal health conditions in 2 samples of the school-age population of the city of Turin]. / Indagine epidemiologica sulle condizioni di salute dento-parodontali di 2 campioni di popolazione scolastica della città di Torino.

The paper reports the results of a study of the prevalence of teeth-parodontal diseases found in two groups from the school population, aged between 13 and 19, resident in Turin. The structure of the survey, the clinical methods of collecting data and the statistical processing of data were carried out according to OMS directives regarding the study of oral pathologies.

Nutritional needs assessment of rural agricultural migrants of southern Brazil: designing, implementing and evaluating a nutrition education program.

A nutritional needs assessment was conducted among rural agricultural migrant women (target group) and children (less than 5 years). The study was conducted in Vila Diogo, a slum located on the periphery of Nuporanga, a village in Sao Paulo state, Brazil. A nutrition education program was designed on the basis of evidence obtained from demographic/socioeconomic information of the study population and a nutritional needs assessment of women (target group) and children less than 5 years of age. The nutritional needs assessment consisted of anthropometry, dietary assessment, and nutrition knowledge, attitudes, and beliefs questionnaires. Formative and summative evaluation of the nutrition education program, using appropriately selected criteria and comparisons of nutrition knowledge scores before and after the program, were used to determine program effectiveness. Major findings of the study were: Diets of Vila Diogo residents were generally simplistic, consisting primarily of rice, beans, and coffee with sugar. Vila Diogo women appeared to be at a relatively high risk for vitamin A, iron, calcium, ascorbic, and riboflavin deficiencies, based on comparisons of 24-hour dietary intake data with FAO recommendations. Children (2-5 years) appeared at high risk for vitamin A, iron, and ascorbic acid deficiencies, based on comparisons of 24-hour dietary intake data with FAO recommendations. All children less than 5 years of age had been breast-fed at birth, but more than one half of children had been weaned by the third month. Infant feeding practices during fever and diarrhea were nutritionally detrimental. Women generally recognized a relationship between dietary intake during pregnancy and fetal nourishment. Using weight-for-height index, a significant number of women were probably undernourished; a small percentage of women, however, were overweight or obese. Although children less than 5 years of age did not generally appear malnourished, a relatively large number were stunted in growth. Although Vila Diogo women reported many food taboos during various physiological states (menstruation, pregnancy, immediately post partum, lactation), relatively few food taboos had potentially negative nutritional consequences. For women who participated in the nutrition education program, nutrition knowledge scores after the program showed improvement which was statistically significant at alpha = 0.05, using Wilcoxon signed rank test.

Inhalation of a radioactively labeled monodisperse aerosol in rats for the assessment of regional deposition and clearance.

Unanesthesized male Sprague-Dawley rats, averaging 261 g of weight (s.d. = 9 g), were exposed to a radioactively (198Au) labeled monodisperse carnauba wax aerosol, whose AMMD was 0.54 micrometers with a sigma g of 1.1, to determined the alveolar deposition and clearance of particles. Results indicate that 74% of the initial lung burden is cleared in phase one with a T/2 of 11 hours. The remaining 26%, conventionally considered to be the alveolar deposit, is cleared with a T22 of 320 hours. Excised lungs from serial sacrifices have also been measured. The retention curve resulting form the pooled lung data per each day compared well with the curve of the whole animals counted in vivo.