Factors associated with circulating concentrations of irisin in the general population cohort of the ABCD study.

OBJECTIVE: Animal studies have shown that irisin is a myokine secreted following physical exercise, and that it induces the remodeling of white adipose tissue toward brown adipose tissue. Therefore, a protective role of irisin against obesity, diabetes, and other metabolic and cardiovascular conditions has been hypothesized. However, data in humans are contradictory and few data are available concerning the general population. DESIGN: We aimed to evaluate the association between serum irisin concentrations and habitual physical activity, as well as other metabolic and cardiovascular factors in a general population in a Mediterranean area. METHODS: We considered 858 consecutive individuals included in the ABCD (Alimentazione, Benessere Cardiovascolare e Diabete) study (ISRCTN15840340), a longitudinal observational single-center study of a cohort representative of the general population of Palermo, Sicily. Irisin serum concentrations (Phoenix Europe, Germany), habitual physical activity (HPA) level, and other blood and clinical variables were measured. RESULTS: The irisin serum concentrations were not normally distributed in the cohort (Shapiro-Wilk test=0.94; P<0.001). A significant association between irisin concentrations and HPA was observed (P<0.001). Irisin concentrations were higher in women than in men (P<0.01), and significantly correlated with serum concentrations of HDL-cholesterol (P<0.05) and hs-C-reactive protein (hs-CRP; P<0.05). Binary logistic regression analysis demonstrated that high (⩾ median value) irisin serum concentrations were significantly associated with female gender (OR=1.63; 95% CI=1.16-2.28), high serum hs-CRP concentrations (OR=1.61; 95% CI=1.02-2.54) and the HPA level (OR=1.42; 95% CI=1.02-1.96). CONCLUSIONS: Our study confirms, in a cohort of a general population, that irisin concentrations gradually increase with the usual level of habitual physical activity.

[Prevalence of monoclonal gammopathies: an experience in Western Sicily]. / Prevalenza delle gammopatie monoclonali: un'esperienza nella Sicilia Occidentale.

Monoclonal gammopathies (GM) are divided into clinically manifest and asymptomatic syndromes. In the last 20 years, the prevalence of GM in industrialized Countries is more than doubled. In order to verify the prevalence of these forms in Western Sicily, at University General Hospital of Palermo an epidemiologic inquiry was made to check the presence of GM as fortuitous event during routine analyses; from March 2000 to March 2001 it was found a prevalence of 0.89% (196 cases on 22100 analysed). Average age was 67.5, with 58.2% men and 41.8% women from different Departments of University General Hospital. The finding of a monoclonal component must be considered an important laboratory datum to observe with time by not invasive laboratory examinations (high-resolution serum-protein electrophoresis and immunofixation).

Role of color flow Doppler sonography in pre-operative diagnostics of the thyroid pathology.

BACKGROUND: The aim of this work is to demonstrate the high effectiveness of preoperative diagnosis by echotomographic study of thyroid nodules through color-Doppler sonography integrated by B-mode. The authors performed both B-mode ultrasonography and color-Doppler sonography on 125 patients expecting total thyroidectomy surgical intervention, without a previous evaluation of a number of other already performed clinical and instrumental tests. After the intervention, we compared the histologic test with the data drawn from the ultrasound scan, in order to demonstrate that color-Doppler sonography is able to provide for additional diagnostic information in the preoperative period. METHODS: One hundred and twenty five patients with thyroid pathologies were examined by both B-mode and color-Doppler sonography. Two diagnoses were made for each clinical case: the first supported by B-mode data, the second based on vascularity. Our aim was to check color-Doppler's ability to provide new information in the ultrasound diagnosis. All patients underwent a total thyroidectomy surgical intervention. The data were examined by K concordance test. RESULTS: Ultrasound data were compared with the histologic test, which showed 118 (97.4%) benign and 7 (5.6%) malignant lesions. B-mode ultrasound test gave a correct diagnosis in 115 (97%) out of 118 benign lesions and in 4 (57%) out of 7 malignant lesions, while 3 (2.5%) out of 118 cases were false positive and 3 (42.8%) out of 7 were false negative. In those cases showing a wrong conventional ultrasound diagnosis, after the integration of B-mode with color-Doppler results, a decrease was recorded in both false negative and false positive. CONCLUSIONS: Even if no correspondence was found between the different aspects of blood flow and the histologic types of lesions, this experience proves that the color-Doppler test has a high predictive value of benignity in cases with pattern I II and IV, while lesions with pattern III should be more carefully examined, since both malignant and benign lesions belong to this group. From the data drawn from this study, we are able to infer that color-Doppler sonography is undoubtedly an advantage not only in terms of cutting the false negatives, but also in the aim of obtaining a higher effectiveness in the screening of goitrogenic pathology.

Epidemiological aspects of hepatitis B in Palermo: changes in HBV spread.

Prevalence of HBV infection in Palermo was investigated in 1989, in comparison with similar data observed in 1982. Between September 1988 and April 1989, 1001 serum samples taken from healthy individuals or from patients with pathology unrelated to liver diseases, in the age groups 0 to 59 years, were collected. Prevalence of HBsAg and anti-HBc was, respectively, 2.7% and 24.3% in males, 2.3% and 19% in females. Prevalence was inversely related to socioeconomic level as defined by occupation, educational level and area of residence. Prevalence of HBV markers in 1989 was compared with that of a sample of sera taken in 1982 and stored at -20 degrees C. Prevalence was lower in 1989 for age groups under 20, while no difference was seen in older age groups.

Salmonella serovars identified at the Centre for Enterobacteriaceae of Palermo over the 5-year period 1983-87.

Salmonellosis is become an increasing public health problem in many countries. Serotyping and assessment of antibiotic resistance are useful tools, which assist in understanding the epidemiology of Salmonella infections. In this respect, the Centre of Enterobacteriaceae of Southern Italy provides helpful information on the changing pattern of Salmonella serovars in this geographic area. This paper reports the distribution of serovars and their antibiotic susceptibility in the years 1983-1987. In particular, because of their peculiar trends during this 5-year period, epidemiological features of Mbandaka, Corvallis, Dublin, Infantis and Wien serovars are described.

Multiple typing of strains of Salmonella enterica subsp. bongori ser. 48:Z35:- isolated in southern Italy.

In 1984-87, 10 isolates of Salmonella enterica subsp. bongori ser. 48:Z35:-, 9 of human source, were identified at the Southern Italy Centre of Enterobacteriaceae. This serotype had never been identified in Southern Italy before 1984. The combined use of different typing methods, with particular reference to restriction enzyme fingerprinting of plasmid and chromosomal DNA, supports the hypothesis that all Bongor serovars derive from a single strain.

Multiple typing of Salmonella typhimurium isolates: an epidemiological study.

An epidemiological study was carried out on sixty-four Salmonella typhimurium strains isolated in Palermo during the period January-July 1987 and identified at the Southern Italy Center of Enterobacteriaceae. These included 5 isolates from a small food-poisoning outbreak, which resulted antibiotic susceptible, not colicinogenic and untypable by the phage-type scheme of Anderson. Plasmid profile analysis was not a reliable method to differentiate them from non epidemic strains. The 5 epidemic isolates, belonging to biotype 25a, were assigned into NT 2 phage-type by an accessory set of phages developed in this laboratory. Such biotype/phage-type association was never detected in the remaining Salmonella typhimurium strains isolated during the first 7 months of 1987. Chromosomal DNA analysis provided additional information on the relationships among Salmonella typhimurium isolates.

Molecular study on Salmonella enteritidis strains from a nosocomial gastroenteritis outbreak.

A molecular epidemiological analysis was carried out on S. enteritidis isolates identified at the Central Italy Enterobacteriaceae Center during 1986. 26 of these were from a diarrhoeal disease outbreak, which occurred in the period April-June at the "S. Chiara" Hospital, Pisa. All S. enteritidis strains harboured a virulence-encoding 39 MDa plasmid. The nosocomial isolates made in June 1986 carried an additional non-conjugative plasmid of 75 MDa, associated with the streptomycin-resistance. In contrast, the nosocomial S. enteritidis strains isolated during the period April-May and 16 isolates from the same geographic area were susceptible to antibiotics and showed a different plasmid pattern. According to the plasmid profile and antibiotic resistance pattern analysis, it could be argued that the hospital cases of S. enteritidis infection occurring after May 1986 are attributable to a strain having different origin from the strain circulating in April-May 1986.

Molecular relationship among Salmonella dublin isolates identified at the Center for Enterobacteriaceae of Palermo during the years 1971-85.

A molecular epidemiological study was carried out on 60 Salmonella dublin isolates identified at the Southern Italy Enterobacteriaceae Center between 1971 and 1985. These included 23 isolates from children with diarrhoea in Palermo obtained during 1984. All isolates from the outbreak of gastroenteritis in children were resistant to chloramphenicol and streptomycin and harboured two plasmids of 50 MDa and 3 MDa molecular weight, whereas the majority of the isolates identified before 1984 were susceptible to these antibiotics and carried only a 50 MDa molecular weight plasmid. Four S. dublin strains successively identified from cattle (Palermo, Foggia, Portici) and from a child (Palermo) were shown to possess similar antibiotic resistance patterns and plasmid profiles to S. dublin isolates from the outbreak of gastroenteritis in children. The 50 MDa plasmid was shown to be associated with virulence in mice, while it was not possible to assign any genetic function to the 3 MDa plasmid.

A molecular study of Salmonella strains identified from two food-poisoning outbreaks.

A molecular epidemiology study was carried out on Salmonella mbandaka and Salmonella corvallis strains identified from two food-poisoning outbreaks which occurred in August 1985 in Pistoia and in October 1985 in Sant'Ilario d'Enza (RE). All the Salmonella mbandaka strains were plasmid-free; all the epidemic Salmonella corvallis strains, in contrast to the non epidemic isolates, carried a small plasmid of approximately 2 MDa molecular weight. Restriction enzyme cleavage pattern analysis revealed that the plasmids of the epidemic strains were closely related.

A new chromogenic test for the detection of urokinase in the genus Shigella.

A simple test for detection of urokinase in Shigella is described. The test is performed by suspending a loopful of bacteria in 100 microliters of a buffered 1mM solution of benzoyl-beta-alanyl glycyl-arginyl-4-nitroanilide acetate (Chromozym U). Enzymatic activity is revealed by formation of a yellow colour after 24 h of incubation at 37 degrees C. The test is able to differentiate serotypes of Shigella dysenteriae, Shigella flexneri, Shigella boydii. The results suggest the possibility of including this chromogenic test in the biochemical assay of Shigella genus.

A study on oral rehydration therapy of diarrheal disease in western Sicily.

A longitudinal study to ascertain the most common therapeutic approach to diarrheal disease by general practitioners and pediatricians was carried out in Western Sicily. Data obtained showed that of 902 home-managed cases of diarrhea observed by 58 physicians during one year, 65.3% were treated with antibiotics, 8.0% with antimotility agents and 26.7% were not treated with any pharmacological agent (rehydration or diet). Although oral rehydration therapy was widely known by physicians in Western Sicily, only a few of them were willing to use it routinely as the principal and exclusive treatment.

Salmonella and Yersinia enterocolitica in soil and dog faeces.

Dog faeces and soil samples, collected for one year from public gardens in densely inhabited areas of Palermo (Italy), were investigated for the presence of Salmonella spp. and Ye.enterocolitica, to verify the hypothesis that mechanism of spread of Ye.enterocolitica may be comparable to that of Salmonella spp. Five Salmonella and one Ye.enterocolitica were isolated from 212 dog faeces; one Salmonella and four Ye.enterocolitica from 240 soil samples. O-serotypes of Ye.enterocolitica were not belonging to human pathogenic groups. The same Salmonella spp. were present both in humans and in the environment.

Epidemiological value of the gamma-glutamyltransferase test in Salmonella typhimurium.

The simple and rapid method of Giammanco et al. (1980) has been used for the detection of the gamma-glutamyltransferase (gamma-GT) by means of a chromogenic substrate in 803 endemic and epidemic strains of Salmonella typhimurium from Southern Italy. About 20% of the strains have been proved gamma-GT negative. Both in endemic and epidemic isolates, negative and positive strains were respectively belonging to different phage types. The reported data suggest that the presence or absence of the gamma-GT in S. typhimurium is an epidemiological marker quickly and easily detectable by the described chromogenic test.

Isolation of Mycobacteria from drinking water in Palermo.

Mycobacteria other than tuberculosis (MOTT) were isolated from 20 of 54 samples (37%) of tap water collected in Palermo in the period April-July 1984. The 55 isolates were M. gordonae (40), M. scrofulaceum (9), MAIS organisms (3), M. fortuitum (2), M. non photochromogenic (1). M. gordonae was isolated from 16 of the 20 positive samples and in five of them in association to other MOTT. A study of MOTT spread in other levels of piping system, showed, as already reported in similar studies, that some places, like taps and tanks, are probably favourable to more or less persistent MOTT colonization.

Beta-glucuronidase activity in Enterobacteriaceae.

Beta-glucuronidase activity has been investigated in 1,221 Enterobacteriaceae strains. The test, using p-nitrophenyl-beta-D-glucuronide (pNPGlcU) agar culture, can be included easily in the routine Enterobacteriaceae biochemical assays. The test is discriminating for Enterobacteriaceae genera and species and useful for identification of some monophasic serotypes of Salmonella.