An Approach to Prevent Frailty in Community Dwelling Older Adults: a pilot study performed in Campania region in the framework of the PERSSILAA project.

We developed and tested an innovative physical training method in older adults that embeds the gym program into everyday life in the most conservative way possible. Physical training was included in the activities of local parishes where older women from Southern Italy spend most of their free time and was delivered by trained physical therapists with the support of an ICT tool known as CoCo. 113 older women (aged 72.0 [69.0-75.0] years) noncompliant to conventional exercise programs participated to the study. 57 of them underwent the final anthropometric assessment and 50 the final physical tests. In study completers handgrip strength and physical performance evaluated with the chair-stand, the two minutes step and the chair-sit and -reach tests significantly improved. Quality of life as evaluated with the EuroQol-5dimension (EQ-5D) questionnaire improved as well. In conclusion, a training program designed to minimally impact on life habits of older people is effective in improving fitness in patients noncompliant to other to physical exercise programs.

Innovative Approaches to Active and Healthy Ageing: Campania Experience to Improve the Adoption of Innovative Good Practices.

The demographic projections on the European population predict that people aged over 60 will increase by about two million/year in the next decades. Since 2012, the Campania Reference Site of the European Innovation Partnership on Active and Healthy Ageing supports the innovation of the Regional Health System, to face up demographic changes and sustainability. Campania Reference Site provides the opportunity to connect loco-regional stakeholders in social and health care services (universities, healthcare providers, social services, local communities and municipalities), with international organizations, in order to adopt and scale up innovative solutions and approaches. This paper describes the building process of Campania Reference Site and the main results achieved, that have been allowing it to become a hub for open innovation in the field of active and healthy aging at regional, national and international level.

Multifunctional optofluidic lab-on-chip platform for Raman and fluorescence spectroscopic microfluidic analysis.

A multifunctional lab-on-a-chip platform for spectroscopic analysis of liquid samples based on an optofluidic jet waveguide is reported. The optofluidic detection scheme is achieved through the total internal reflection arising in a liquid jet of only 150 µm diameter, leading to highly efficient signal excitation and collection. This results in an optofluidic chip with an alignment-free spectroscopic detection scheme, which avoids any background from the sample container. This platform has been designed for multiwavelength fluorescence and Raman spectroscopy. The chip integrates a recirculation system that reduces the required sample volume. The evaluation of the device performance has been accomplished by means of fluorescence measurements performed on eosin Y in water solutions, achieving a limit of detection of 33 pM. The sensor has been applied in Raman spectroscopy of water-ethanol solutions, leading to a limit of detection of 0.18%. As additional application, analysis of riboflavin using fluorescence detection demonstrates the possibility of detecting this vitamin at the 560 pM level (0.21 ng l-1). Although measurements have been performed by means of a compact and low-cost spectrometer, in both cases the micro-jet optofluidic chip achieved similar performances if not better than high-end benchtop based laboratory equipment. This approach paves the way towards portable lab-on-a-chip devices for high sensitivity environmental and biochemical sensing, using optical spectroscopy.

Graded-size microlens array by the pyro-electrohydrodynamic continuous printing method.

In the present work, the pyro-electrohydrodynamic technique was used for the realization of tunable-size microlens arrays. Poly(methyl methacrylate) dissolved in different solvent mixtures was used as the polymeric material for the realization of the microstructures. By controlling the experimental parameters and in particular, the volume of the drop reservoir, graded-size square arrays of tens of microlenses with focal length in the range 1.5-3 mm were produced. Moreover, the optical quality and geometrical features were investigated by profilometric and interferometric analysis.

Printing of polymer microlenses by a pyroelectrohydrodynamic dispensing approach.

The investigation of a method for fabricating microlenses by a nozzle-free inkjet printing approach is reported. The new method, based on a pyroelectrohydrodynamic mechanism, is also able to dispense viscous liquids and to draw liquid phase drops directly from the reservoir. Specifically, by dispensing optical grade polymer dissolved in different solvent mixtures, microlenses were printed with a pattern defined directly through this deposition method. The reliability of the microlenses and the tunability of their focal properties were demonstrated through profilometric and inteferometric analyses.

[Usefulness of repetitive transcranial magnetic stimulation in psychiatric disorders]. / Applications thérapeutiques actuelles de la stimulation magnétique transcrânienne répétée en psychiatrie.

Mental disorders represent a concern for the public health because of their prevalence in the general population. Despite progress in psychopharmacology, 20-30 % of the patients suffering of depressive disorders are responding only partially to different pharmacological and psychological therapeutic strategies. Until recently, the therapeutic alternative in refractory depression was the electroconvulsive therapy. New therapeutic approaches should be therefore explored. In October 2008 repetitive transcranial magnetic stimulation was approved as an antidepressive monotherapy by the FDA, opening the way to a routine application of this technique, which will supplement the body of our therapeutic armamentarium for mood disorders. We review this new therapeutic approach, which is rapidly developing for treating depression and schizophrenia.

Anxiety and depression in psychogenic movement disorder and non-epileptic seizures: a prospective comparative study.

OBJECTIVE: This study compared anxiety and depression in patients presenting with psychogenic non-epileptic seizures (PNES) with those suffering from psychogenic movement disorders (PMD) to assess the link between these psychiatric pathologies and neurological symptoms. METHODS: This clinically descriptive, prospective study involved consecutive patients who fulfilled the clinical and video-EEG criteria for PNES and PMD, and who were recruited over an 18-month period. Semi-structured (according to DSM-IV criteria) psychiatric interviews and self-evaluation using the Beck Depression Inventory and Spielberger State-Trait Anxiety Inventory were carried out. Clinical follow-up was conducted 8-12 months after the first evaluation. RESULTS: A total of 17 patients were recruited: nine presented with PNES; and eight had PMD. Both patient groups had similar demographic and clinical data as well as depression and personality disorders. Although not statistically significant, there was a trend towards an increased prevalence of a familial medical history of epilepsy and a higher incidence of anxiety disorders among patients with PNES. CONCLUSION: The data from this prospective study underscore the clinical and psychiatric similarity between PNES and PMD patients. Further studies involving a larger number of subjects should confirm, from a statistical point of view, the differences suggested in the present investigation and, in particular, the greater incidence of anxiety disorders in PNES patients and the presence of an epileptic parent as a risk factor for PNES.

Double-blind multicenter study on the efficacy and tolerability of cetirizine compared with oxatomide in chronic idiopathic urticaria in preschool children.

BACKGROUND: There are no studies on the use of cetirizine in children under the age of 6. OBJECTIVE: We compared the efficacy and tolerability of cetirizine in patients with idiopathic chronic urticaria to the more widely used antihistamine, oxatomide. METHODS: This double-blind study was performed on 62 patients (38 male and 24 female) with idiopathic chronic urticaria, recruited from four different medical centers of the national territory (Ancona, Cagliari, Catania, and Messina). The children's ages ranged from 2 to 6 years (mean 3.85). The patients were randomly assigned to two treatment groups: one group treated 31 children with cetirizine at a dosage of 5 mg q.d., and a second group treated 31 children for the same amount of time with oxatomide, at a dosage of 25 mg q.d. Sixty-two children began the treatment, but five did not finish the study (three in the cetirizine and two in the oxatomide group). Thus, the clinical study and the statistical evaluation were conducted on 57 children (28 cetirizine and 29 oxatomide). The Student's t test was used to compare severity of the illness and changes in the hematochemical tests. RESULTS: Overall, the effectiveness of the two medications in treating erythema, papules, edema, and itching showed comparable therapeutic activity (P < 0.001). Neither medication produced significant side effects. CONCLUSIONS: The results of the present study suggest that cetirizine may represent an effective and safe pharmacologic therapy for chronic urticaria in preschool children. There was no evidence for changes in hematochemical and urinary values, demonstrating the safety and the tolerability of the two antihistamines, even when given to young children.

Cetirizine reduces ICAM-I on epithelial cells during nasal minimal persistent inflammation in asymptomatic children with mite-allergic asthma.

It has been recently demonstrated that individuals who suffer from mite allergy present mucosal inflammation even when asymptomatic. This situation is characterized by infiltration of inflammatory cells (eosinophils and neutrophils) and by ICAM-I expression on epithelial cells. It has been called 'minimal persistent inflammation' (MPI) for its relationship with natural exposure to allergen, which is continuous in the case of mite allergy. ICAM-I (or CD54) expression on epithelial cells is relevant for several reasons: (a) healthy individuals and patients with pollen allergy out of the pollen season do not express this molecule; (b) ICAM-I is the natural ligand of LFA-1 (an integrin expressed on granulocytes), and (c) ICAM-I is also receptor for rhinoviruses. It is well known that viral infections precede asthmatic attacks; consequently, this correlation is more frequent in cases of mite allergy. Cetirizine is an antiallergic drug that can reduce both inflammatory infiltrate and ICAM-I expression induced by allergen-specific conjunctival challenge. The aim of this study was to evaluate the effect of cetirizine on MPI in 20 children (5-14 years old) with mite allergy. All the children suffered from mild asthma and 9 also had rhinitis (they had been asymptomatic, and thus not treated, for 2 months). The study was double-blind, placebo controlled and randomized and children took Cetirizine or placebo for 15 days. At the beginning and end of the study, nasal scrapings were performed to evaluate inflammatory cell infiltration (eosinophils and neutrophils) and ICAM-I expression on epithelial cells. Cetirizine-treated children showed a significant reduction (or even total absence) of ICAM-I expression on epithelial cells (p less than 0.002) and a reduction trend in inflammatory cell counts compared with placebo. In conclusion, Cetirizine might be envisaged as fruitful for the prolonged treatment of allergic children, including during clinical latency, to prevent possible relapse or rhinovirus infections.

[Use of house dust extracts in allergological diagnosis and therapy]. / Considerazioni sull'uso degli estratti di polveri domestiche nella diagnostica e nella terapia allergologica.

In this study (1980-1987) the Authors considered the incidence of sensitization to house dust in patients with respiratory allergic disease. The Authors identified 399 subjects with sensitization to house dust out of 1825 subjects sensitized to at least one of the tested allergens (21.9%). The number of patients exclusively sensitized to house dust resulted very small (13 patients, 0.7%). Most frequently the Authors identified sensitization to house dust and mites (324 patients, 81.2%). Bronchial asthma resulted in 156 patients (39.1%). These results are similar to those recognized in subjects with mites sensitization. The conclusion is drawn that, at the moment, mites are the only house dust allergens with clinical importance.

[Housedust mites: their importance in the pathogenesis of respiratory allergic diseases in Piedmont]. / Acari della polvere domestica: loro importanza nella patogenesi di malattie allergiche respiratorie in Piemonte.

In this study we have considered the importance of house dust mites (Dermatophagoides farinae and pteronyssinus) in the pathogenesis of respiratory allergic diseases in Piedmont. We have identified, from 1980 to 1986, 1530 subjects with sensitization to at least one of the tested allergens; 479 of these (31.3%) were allergic to both or to one of the tested mites. Particularly 97 subjects (6.3%) were sensitized to Dermatophagoides farinae, 73 (4.8%) to Dermatophagoides pteronyssinus and 309 (20.2%) to both of them. This group included 258 males (53.9%) and 221 females (46.1%). Most of the examined subjects had shown the clinical symptoms before the 35th year of age (366 subjects, 76.4%). The mean age of beginning of clinical picture has come out to be of 27.377 +/- 11.527 SD year old. This result shows no significant differences with the mean age come out in allergic subjects to other allergens (26.939 +/- 10.755 SD); 196 subjects (40.9%) presented rhinitis-conjunctivitis, while 102 subjects presented bronchial asthma-rhinitis-conjunctivitis. We have found that bronchial asthma (alone or with other symptoms) was present in 186 subjects (38.8%), while in the allergic subjects sensitized to other allergens was present only in 299 out of 1051 (28.4%); 277 subjects had continuous symptoms (57.8%) while 202 subjects (42.2%) had symptoms only in some periods of the year.

[Statistical study of 428 Piedmont residents suffering from bronchial asthma of allergic etiology]. / Considerazioni statistiche su uno studio di 428 soggetti residenti in Piemonte affetti da asma bronchiale ad etiopatogenesi allergica.

This 6-year (1979-1984) study was conducted on subjects with allergic bronchial asthma diagnosed by scarification skin tests. The skin tests identified 428 subjects with bronchial asthmatic symptoms including 228 females and 220 males (females/males = 1.04). In the 6-15 age range there was a clear predominance of males over females (42 against 24 or males/females = 1.75). At the time of testing, 309 subjects (72.2%) were in the 6-35 age range. In terms of symptoms, 61 subjects (14.2%) presented bronchial asthma alone. The most common combination of symptoms encountered was asthma-rhinitis-conjunctivitis found in 317 subjects (74.1%). Symptoms were seasonal in 305 patients (71.3%) while 123 (28.7%) presented asthmatic symptoms throughout the year. 382 patients (89.25%) presented pollen allergy with grass pollen accounting for the highest percentage (328 subjects or 76.6%). 46 subjects (10.7%) were allergic to tree pollen and 103 (24.1%) to flower pollen. 197 patients (46%) were allergic to permanent inhalants (domestic inhalants, epithelia, mycophytes) with Dermatophagoides Farineae accounting for the largest number (33.4%). 55 subjects (12.9%) were sensitive to at least one of the epithelia tested while mycophyte sensitivity was negligible (10 subjects or 2.3%).

[Statistical study done in Piedmont on 1100 cases of rhinitis caused by hypersensitivity to inhaled allergens]. / Indagine statistica effettuata in Piemonte su 1100 casi di rinite da ipersensibilità ad allergeni inalanti.

In this study conducted from 1979 to 1984 we have examined 2315 subjects with rhinitis. All the subjects lived in Piedmont. The skin tests identified 1100 subjects (47.5%) allergic to at least one of the tested allergens. This group included 575 (52.3%) males and 525 (47.7%) females (males/females = 1.1). In the 6-15 age range we have found a clear predominance of males over females (112 against 57 or males/females = 2). At the time of testing, 854 patients (77.7%) were in the 6-35 age range. Only 75 subjects (6.8%) had rhinitis alone; the most common combination of symptoms encountered was rhinitis-conjunctivitis, found in 580 patients (52.7%). Symptoms were seasonal in 909 subjects (82.6%), while 191 (17.4%) were symptomatic throughout the year. Among the subjects with pollen allergy, the grass pollen accounted for the highest percentage (883 subjects or 80.3%). Among the subjects allergic to permanent inhalants Dermatophagoides Farinae (252 subjects or 22.9%) and Dermatophagoides Pteronyssinus (240 subjects or 21.8%) accounted for the largest number. Mycophyte sensitivity was negligible (36 subjects or 3.3%). In the end we have seen that grass pollen and Dermatophagoides sensitivity prefer males, while Parietaria sensitivity prefers females.