Interleukin-18 modulation in autism spectrum disorders.

BACKGROUND: Autism spectrum disorder (ASD) is a neurodevelopmental disease which affects 1 in 88 children. Its etiology remains basically unknown, but it is apparent that neuroinflammation is involved in disease development. Great attention has been focused on pro-inflammatory cytokines, and several studies have reported their dysfunction unbalance in serum as well as in the brain. The present work aimed at evaluating putative dysregulation of interleukin-18 (IL-18), a pro-inflammatory cytokine of the IL-1 family in the sera of patients with ASD of different grades, compared to healthy controls, as well as in postmortem brain samples obtained from patients with tuberous sclerosis as well as acute inflammatory diseases. Moreover, quantitative analysis of IL-18 was performed in the sera and brain obtained from Reeler mice, an experimental model of autism. METHODS: Serum IL-18 levels were measured by ELISA. IL-18 was localized by immunohistochemical analysis in brain sections obtained from tuberous sclerosis and encephalitis patients, as well as from gender- and age-matched controls, and in the brain sections of both Reeler and wild-type mice. IL-18 was also quantified by Western blots in homogenates of Reeler and wild-type mice brains. IL-18 binding protein (IL-18BP) was evaluated in Reeler and wild-type mice plasma as well as in their brains (sections and homogenates). RESULTS: IL-18 content decreased in the sera of patients with autism compared to healthy subjects and in Reeler sera compared to wild-type controls. IL-18 was detected within glial cells and neurons in the brain of subjects affected by tuberous sclerosis and encephalitis whereas in healthy subjects, only a weak IL-18 positivity was detected at the level of glial cells. Western blot identified higher amounts of IL-18 in Reeler brain homogenates compared to wild-type littermates. IL-18BP was expressed in higher amounts in Reeler brain compared to the brain of wild-type mice, whereas no significant difference was detected comparing IL-18BP plasma levels. CONCLUSIONS: IL-18 is dysregulated in ASD patients. Further studies seemed necessary to clarify the molecular details behind IL-18 increase in the brain and IL-18 decrease in the sera of patients. An increase in the size of the patient cohort seems necessary to ascertain whether decreased IL-18 content in the sera can become a predictive biomarker of ASD and whether its measure, in combination with other markers (e.g., increased levels of brain-derived neurotrophic factor (BDNF)), may be included in a diagnostic panel.

Pregnancy in autistic women and social medical considerations: scoping review and meta- synthesis.

Introduction: This article addresses a topic that has been largely overlooked by scientific literature, namely pregnancy in autistic women. Generally, the issue of sexuality in disability, particularly in disabled women, autistic or otherwise, has been underexplored. However, it is necessary to scientifically investigate this topic to propose adequate social and health policies. Therefore, we chose to conduct a scoping review to answer three main questions: "What does it mean for an autistic woman to be pregnant?"; "How do these two conditions coexist?"; "Are health services prepared to receive this population adequately or does autism become a stigma for pregnant women?" Methods: We conducted a systematic review and qualitative thematic synthesis following the Preferred Reporting Guidelines for Systematic Reviews and Meta-Analyses on autistic women and pregnancy in the last 10 years. Results: The studies included in our review are 7, extremely diverse in terms of methodologies and sample sizes. Despite the heterogeneity of samples and methodologies, all research tends to highlight the following results. For autistic women during pregnancy, three areas seem to be the most difficult: sensory issues, mood disorders, and relationships with specialists. Discussion: Our study found that women with ASD face unique challenges during childbirth that differ from those of neurotypical women. Participants often felt belittled, ignored, and uninformed about the care they received, and being placed at the centre of attention was often seen as negative and hindering rather than positive. However, the research shows us how some "expected" results, such as difficulties in breastfeeding, have been disproven.

Staphylococcus aureus in a northern Italian region: phenotypic and molecular characterization.

BACKGROUND: Staphylococcus aureus is a leading cause of community-acquired infections and healthcare-associated infections. Epidemiological data are useful for understanding the dynamics of the diffusion of this pathogen, and to plan control activities and monitor their efficacy. METHODS: S. aureus isolates were collected in 13 public hospital laboratories of Emilia-Romagna (northern Italy region) during February-March 2009; phenotypic and molecular characterizations of these isolates were performed. RESULTS: The study sample included 267 isolates, 57 from blood, 81 from respiratory tract, and 129 from wounds; 106 (40%) were methicillin-resistant S. aureus (MRSA). MRSA showed a limited number of circulating clones with 2 predominant spa types--t008 and t041--accounting for 36% and 27% of MRSA isolates, respectively. The t041 type had a higher prevalence of antimicrobial resistance compared to other spa types and accounted for most of the retrieved hetero-vancomycin-intermediate S. aureus (h-VISA), while t008 was more frequently detected in non-hospital isolates. A higher degree of genetic diversity was observed in methicillin-susceptible S. aureus (MSSA), with no predominant clones and low prevalence of antimicrobial resistance. The occurrence of community-acquired MRSA infection appears to be rare in Emilia-Romagna. CONCLUSIONS: In contrast to previous studies reporting Italian data, t008 was the most frequent spa type among MRSA isolates in Emilia-Romagna. The prevalence of antimicrobial resistance of different MRSA spa types could influence their ability to cause infections with hospital onset. The presence of only 2 major MRSA clones circulating in Emilia-Romagna increases the chances that a regional strategy aimed at MRSA prevention will be effective.

No Correlation between Blood Benzene Levels and Luteinizing Hormone Plasma Values in Outdoor Workers.

OBJECTIVE: The purpose of the study is to evaluate whether low-dose exposure to benzene, an environmental pollutant to which male and female traffic policemen are daily exposed to could cause alterations in plasma luteinizing hormone (LH) levels. METHODS: From an initial sample of 1594 workers, we only selected 95 workers of whom study we knew the values of late-shift benzene and LH hormone. All subjects underwent biological monitoring (final blood benzene evaluation) and luteinizing hormone dosing. Excluding subjects with the main confounding factors, the final sample included 76 workers. The normal distribution of the variables was evaluated using the Kolmogorov - Smirnov test, followed by the logarithmic transformation of the LH and benzene values. The comparison among means was performed by using the t-test for the independent samples. The ANOVA test was performed for variables with more than 2 modes (ages and seniority) and Pearson correlation index between variables in the total sample and after subdivision as to sex, job, sports activity and smoking. The results were considered significant when p values were less than 0.05. RESULTS/CONCLUSION: The study did not show a correlation between benzene levels and LH plasma levels in outdoor workers.

Quality of Life in Dementia Sufferers: The Role of Diet and Exercise.

BACKGROUND: Among the myriad of factors modulating quality of life assessments estimated in patients presenting a variety of cognitive impairments, the distinctive and critical influence of diet and exercise cannot be overestimated. OBJECTIVE: The objective of this study was to review the evidence to confirm the association between these health-endowering agents and cognitive performance in People With Dementia as well as providing a correlation between Mini Mental State Examination scores and available anthropometric data. METHODS: The authors tested the hypothesized correlation on a sample of subjects with instrumentally confirmed cognitive impairment using parameters as Body Mass Index and calf circumference. RESULTS: The results confirm the hypothesis and suggesting the possible use of anthropometric data in the process of objective evaluation of the patient with cognitive impairment that could also be used for forensic medicine.

The Portal Hypertensive Gastropathy: A Case and Review of Literature.

Upper gastrointestinal bleeding is a cause of high risk for morbidity and mortality. It has been debated in alcoholic cirrhosis, if alcohol exerts an exclusive and causal role upon gastropathy or whether it is linked to cirrhotic portal hypertension. The authors describe an autopsy report regarding mortality caused by gastric bleeding in a 53-year-old patient who suffered from cirrhosis. Literature has evidence of direct, marked damage of alcohol upon the gastric mucosa and there is noteworthy statistical data implying the revaluation of the pathogenesis of the bleeding.

Imported and autochthonous histoplasmosis in Italy: new cases and old problems.

In the past the Italian soil was considered as a low-endemic pabulum for H. capsulatum var. capsulatum and only few autochthonous cases of histoplasmosis were reported in Italy, especially in the Po valley. The aim of the paper was to evaluate this possibility by reviewing the literature and providing our own personal data. Four additional cases of histoplasmosis were observed during 1999-2003 in AIDS immigrant or in Italian citizens, and in travellers to endemic areas. One of the AIDS patients was an autochthonous case of histoplasmosis. The Italian literature was reviewed. Recent cases and literature data confirm the possible autochthonous presence of histoplasmosis in Italy, especially in the Northern regions.

[Aetiology of intestinal parasites in a sample of students from Mozambique]. / Eziologia delle parassitosi intestinali in un campione di studenti mozambicani: breve indagine conoscitiva.

The purpose of this survey is to assess the prevalence of intestinal parasites in a population of Mozambican students. Ninety five faecal samples were collected at the three schools in Marrere, Mozambique, for a period of about one week. Observations of fresh and Giemsa-stained samples were performed at the laboratory of the Geral de Marrere Hospital; observation after concentration (FEA) was performed later at the Microbiology Laboratory of the S. Maria Nuova Hospital (Reggio Emilia, Italy). The results show a high rate of intestinal parasites among the subjects examined, supported mainly by helminths (Strongyloides stercoralis and Ancylostoma/Necator americanus), and protozoa (Dientamoeba fragilis and Giardia intestinalis). Analysis of data shows that the search for pathogenic parasites with the formalin-ethyl acetate (FEA) stool concentration technique shows higher sensitivity than the observation of fresh samples (60% vs 30%) and in some cases allows the presence of a second or third parasite to be detected. The high rate of parasitosis in endemic areas underlines the importance of lending greater attention to immigrant patients in Italy, due also to the fact that parasitosis is often found in asymptomatic forms.

[Prevalence of intestinal parasitosis in Reggio Emilia (Italy) during 2009]. / Prevalenza delle parassitosi intestinali a Reggio Emilia e provincia nel corso del 2009.

The purpose of this survey is to assess the prevalence of intestinal parasites in Reggio Emilia during 2009. We analyzed 1961 samples from 1503 subjects: a copro-parasitological standard examination was performed in 1416 of the subjects and the scotch-test in the remaining 87. Of the 1503 subjects examined, 111 (7.4%) were positive for one or more parasites. Pathogenic parasites were found in 44 subjects (39.6% of all positive subjects) and non-pathogenic protozoa were found in 67 subjects (60.4% of all positive subjects). The most commonly found species were, of the protozoa, Blastocystis hominis, Dientamoeba fragilis and Giardia intestinalis and, of the helminths, Enterobius vermicularis and Taenia Spp. This epidemiological survey shows the need to pay more attention to immigrants and travellers to endemic areas as potential carriers of major parasitic infections in the community.