Study on hydrophilicity and degradability of chitosan/polylactide-co-polycaprolactone nanofibre blend electrospun membrane.

Electrospinning is an interesting technique to produce polymer membranes made of entangled nanofibres. The technique is raising interest in pharmaceutical and biomedical areas. Either electrospun membranes are studied for tissue regeneration purposes, or incorporation of nanoparticles in electrospun membranes can be an opportunity to control the delivery of drug or to obtain dual drug delivery system. In this work suspensions of hydrochloride chitosan salt in copolymer polylactide-co-polycaprolactone (PLA-PCL) solution were electrospun in order to assess an advanced study for developing polymer nanofibre blend membrane loaded with chitosan polymer. The aim of the work was to investigate the properties and stability of chitosan/PLA-PCL electrospun membranes considering their application for tissue regeneration and drug delivery. The electrospun membranes were characterized for their physico-chemical (FT-IR) morphology (SEM) and in vitro biological properties (cytocompatibility and cells engraftment). Results show that homogeneous electrospun PLA-PCL/chitosan blend nanofibres in the range size 800 nm were obtained. Chitosan was loaded inside the nanofibres up to 27.2% (w/w) without modifying nanofibre shape, and only 6% of the loaded chitosan resulted to be on the nanofibre surface. The presence of chitosan in the nanofibres has shown to accelerate the electrospun membranes degradation in vitro.

Emerging and re-emerging infectious disease in otorhinolaryngology.

SUMMARY: Emerging and re-emerging infectious disease in otorhinolaryngology (ENT) are an area of growing epidemiological and clinical interest. The aim of this section is to comprehensively report on the epidemiology of key infectious disease in otorhinolaryngology, reporting on their burden at the national and international level, expanding of the need of promoting and implementing preventive interventions, and the rationale of applying evidence-based, effective and cost- effective diagnostic, curative and preventive approaches. In particular, we focus on i) ENT viral infections (HIV, Epstein-Barr virus, Human Papilloma virus), retrieving the available evidence on their oncogenic potential; ii) typical and atypical mycobacteria infections; iii) non-specific granulomatous lymphadenopathy; iv) emerging paediatric ENT infectious diseases and the prevention of their complications; v) the growing burden of antimicrobial resistance in ENT and the strategies for its control in different clinical settings. We conclude by outlining knowledge gaps and action needed in ENT infectious diseases research and clinical practice and we make references to economic analysis in the field of ENT infectious diseases prevention and care.

Effect of HSV-2 infection on the expression of HPV 16 genes in CaSki cells.

Human papillomaviruses (HPVs) have been proposed to be the most important etiological factors for cervical cancer although different agents may act in conjunction. Herpes simplex virus type 2 (HSV-2) infection is considered as a possible cofactor to malignant transformation. To examine the influence of HSV-2 infection on the HPV genes expression, CaSki cells bearing 60 to 600 copies of HPV-16 DNA per cell were used as a model system. Twenty hours post HSV-2 infection the mRNA transcripts for HPV-16 early (E1, E2 and E6) and late (L1) genes were analysed by RT-PCR assay. Results indicated that the level of transcription of E1, E2 and E6 genes was up to 3-fold enhanced in HSV-2 infected CaSki cells suggesting that HSV-2 infection could increase the risk of cervical cancer by overexpression of both HPV regulatory and oncogenic genes.

Involvement of herpes simplex type 2 in modulation of gene expression of human papillomavirus type 18.

Human papillomaviruses (HPVs) and herpes simplex virus type 2 (HSV-2) can establish latent or persistent infections in the host, and are involved in the aetiology of benign and/or malignant lesions of the urogenital tract. To investigate the putative interaction between these DNA viruses when a double infection occurs, we have studied the effect of HSV-2 infection in HeLa 229 cells containing 10-50 copies of HPV type 18 genomic DNA. Twenty hours post HSV-2 infection, the analysis of mRNA transcripts from E1, E2, E6 early and L1 late HPV18 genes was performed in HeLa cells by a semi-quantitative RT-PCR assay. A modulation of HPV18 E1 and E6 early genes was observed, resulting in a 9-fold and 3-fold increased transcription respectively.

Herpes simplex virus type 2 modulates the susceptibility of human bladder cells to uropathogenic bacteria.

The present study analyses the susceptibility of human bladder-derived cells (HT-1376) to the infection by herpes simplex virus type 2 (HSV-2) and Chlamydia trachomatis, as well as to the adhesiveness of uropathogenic bacteria. HT-1376 cells were efficiently infected by HSV-2 strain 333, as demonstrated by immunofluorescence staining of viral antigens, titration of cytopathic effect, and visualisation by transmission electron microscopy. This cell model was also prone to C. trachomatis (serovar E, Bour strain) replication and to the adherence of clinical uropathogenic isolates of Escherichia coli, Pseudomonas aeruginosa, Proteus vulgaris and Enterococcus faecalis. The pre-infection of HT-1376 cells with HSV-2 caused a tenfold increased adherence of an E. coli strain (U1), isolated from a patient affected by severe haemorrhagic cystitis, whereas in HSV-2 pre-infected cells the number of C. trachomatis inclusion bodies was significantly reduced. Our findings indicate that these cells are a suitable in vitro model for studying infection and super-infection of the lower urinary tract by viruses and bacteria.

[Suicidal behavior in the North Varese province: a epidemiological analysis]. / La condotta suicidaria nel nord della provincia di Varese: un'indagine epidemiologica.

OBJECTIVE: Analysis of figures and characteristics of suicide behaviour in the area of Varese and the neighbouring northern towns (Valceresio, the valleys around Luino and northern Verbano), with the purpose of finding out preventing measures. DESIGN: Epidemiological-descriptive survey. The 1995-1997 ISTAT death cards, included in the death files of the former USSL of Varese have been taken into consideration. Only those people who were resident at the suicide moment have been included in the survey. Afterwards the psychiatric service archives were consulted, to find any possible contact between the subjects in the ISTAT files and the psychiatric services themselves. With regard to these patients, some information such as suicide attempts, psychiatric pathology and first contact with the psychiatric services have been pointed out. SETTING: Arcisate, Cittiglio, Luino and Varese districts, where the Community Mental Health Services 1 and 2 of "Azienda Ospedaliera Universitaria Macchi" of Varese operate. MAIN OUTCOME MEASURES: The suicide rates in the studied area have been reckoned and, through direct standardization, the rates of the single districts have been compared. RESULTS: There were 78 suicides (24 females and 54 males): rate of 8.2 per 100,000. In accordance with the national trend, there is evidence of a general reduction of the suicide phenomenon, except among the youngest. Districts of Luino and Arcisate are geographic areas to examine in the time, because a wider sample could reveal a higher risk. Young and elderly people are the most affected among the males and, 55/64-year-old people, both males and females, are at higher risk. Suicide methods vary with the age. A high percentage of subjects are not married and with low education. Less than one third of the subjects had come into contact with the psychiatric service. CONCLUSIONS: These data allow a comparison with the national survey and an analysis of the suicide features in the study area. The purpose is to elaborate preventing strategies with multi-dimensional approach whose efficacy may be proved in the future by setting up a provincial observatory.

Detection of viral and bacterial infections in women with normal and abnormal colposcopy.

Signs and symptoms of sexually-transmitted diseases (STD) do not allow any etiological diagnosis in women. Colposcopic findings are seldom pathognomic. Consequently, the microbiology laboratory with the recent availability of molecular diagnostic tools is required to detect the infectious bacterial and/or viral agents involved in STD. In cervical samples of women submitted to gynaecological screening for past or present signs and symptoms of inflammation and with different colposcopic findings, we searched by molecular approaches Chlamydia trachomatis, Mycoplasma genitalium, herpes simplex virus type 1 and 2, adenovirus and 45 genotypes of papillomaviruses and, by cultural methods Mycoplasma hominis and Ureaplasma urealyticum. Colposcopy permitted us to divide the studied population into three groups: 48 women had negative colposcopic findings, 50 presented signs of flogosis and 100 resulted positive for an abnormal transformation zone (ANTZ) and/or for HPV colposcopic findings. Results obtained by microbiological assays indicated that the prevalence of infectious agents did not always correlate with colposcopy. Double and triple infections were found in groups 2 and 3, with mycoplasmas being the most common microrganisms present in association and quite almost copresent with papillomaviruses.

Metal complexes of bovine lactoferrin inhibit in vitro replication of herpes simplex virus type 1 and 2.

The inhibitory effect of bovine lactoferrin (BLf) saturated with ferric, manganese or zinc ions, on the infection of Vero cells by human herpes simplex virus type 1 (HSV1) and 2 (HSV2) was investigated. Viral infectivity determined by intracellular antigen synthesis and plaque formation was efficiently inhibited by metal saturated lactoferrins in a dose-dependent manner. Effective BLf concentrations which reduced the infection by 50% ranged from 5.2 to 31 micrograms ml-1 and were far below the cytotoxicity threshold. Fe3+BLf and Mn2+BLf exhibited selectivity indexes higher than Zn2+BLf and apoBLf for both viruses and the effect was mainly directed towards the early steps of infection. The slight viral inhibition shown by the citrate complexes of the different metals could indicate that the antiviral effect was not significantly influenced by Fe3+, Mn2+ or Zn2+ ions delivered by BLf into the cells.

Simultaneous detection of HPV and other sexually transmitted agents in chronic urethritis.

BACKGROUND: Many pathogens may be responsible of Non Gonococcal Urethritis (NGU) with the possible occurrence of symptomatic and asymptomatic mixed viral and bacterial infections. In particular, genital papillomaviruses (HPVs) have been searched since they are linked to both benign and malignant lesions of the penis and urethra and the presence of a potential male carried state has received limited scrutiny while the screening of sexually active females has received substantial attention. METHODS: In male patients affected by chronic NGU, the presence of DNA of Chlamydia trachomatis, herpes simplex virus (HSV) type 1 and 2 and human papillomaviruses by PCR and the occurrence of Gram positive and Gram negative micro-organisms, of Mycoplasma hominis and Ureaplasma urealyticum, by conventional cultural methods have been investigated. RESULTS: Results obtained indicated a high percentage of mixed infections, up to 36%. Genital HPV DNA was detected in 31% of specimens positive for two or more agents, and HSV DNA was detected in 10% of studied population. CONCLUSIONS: The concomitant presence of different infectious agents could determine latent, sub-clinical or chronic infections with periodic reactivation. In particular results suggest that HPV and HSV may stimulate cytokine production which can up regulate the expression of other infectious agents and may be responsible for latent chlamydial infections characterised by the persistence of this micro-organism in an altered form, viable but in a culture negative state. Therefore an increased awareness of mixed infections is relevant to define the management and treatment of chronic urethritis.

In vitro effect of natural and semi-synthetic carbohydrate polymers on Chlamydia trachomatis infection.

The effect of different natural and semi-synthetic polysaccharides on Chlamydia trachomatis multiplication in Hela 229 cells was evaluated. Some neutral, negatively and positively charged carbohydrates were able, in a dose-dependent fashion, to inhibit chlamydial infection by interfering mainly with the adsorption process. The inhibiting compounds, whose effect was shown within the concentration range of 8-200 micrograms/ml, were in order of action: dextran sulphate > glyloid sulphate 4327 > glycogen sulphate 4427 > arabic gum = glyloid > chitosan > glycogen. Data obtained suggested that antichlamydial activity was not only related to the electric charge of these molecules but could also be attributed to other features of their polymeric backbone. Since carbohydrate polymers have also been shown to inhibit the early stages of infection by viral agents causing sexually transmitted diseases, the employment of these molecules for prevention or treatment of mixed viral-C. trachomatis infections can be hypothesized.

Age-Specific Anti-Hepatitis A Virus Seroepidemiology in Italian Travelers: Indications for Anti-Hepatitis A Vaccination.

Background: Hepatitis A virus (HAV) circulation in the environment is decreasing in most industrialized Western countries. This decrease has lead to low seroprevalence rates in adults. As a consequence, many nonimmune unprotected travelers from areas of low prevalence are considered at risk of acquiring HAV infection when traveling to high HAV endemic areas in developing countries. The recent HAV inactivated vaccine has proved safe and effective, and its use in different geographic areas should be guided by local age-specific HAV seroprevalence rates. The aim of this paper is to describe the age-specific sero-epidemiology of HAV infection in travelers from a highly industrialized region in Northern Italy (Lombardy). Methods: Seven hundred and forty-four consecutive travelers aged from 20 to 59 years, subdivided in 10-year age groups, gave blood samples in the collaborative Health Centers in the Lombardy region and sera were tested for HAV IgG antibodies. A questionnaire was given to travelers that investigated alimentary habits and a history of previous travel. Results: Anti-HAV seroprevalence was 18.0%, 58.0%, 75.8%, and 89.5% in the 20-29, 30-39, 40-49, and 50-59 age groups, respectively. Age was the single most important determinant of anti-HAV seroprevalence. The influence of previous travels, eating shellfish, or ingestion of self-cultivated vegetables was ruled out by multivariate analysis. Conclusions: In the Lombardy region (Northern Italy), age specific anti-HAV seroprevalence rates are much higher than those reported in other Western European countries. The cost-benefit analysis suggested that travelers born after 1960 do not need serologic screening before vaccination. Whenever possible, however, HAV serologic screening is advisable for travelers born before 1960. However, the severity of the disease in older subjects, and the proved safety of HAV vaccination in immune subjects, may advise d'emblée HAV vaccination without prior screening, when serologic investigation is unfeasible because of lack of time or the unavailability of testing facilities.

Superinfection by Listeria monocytogenes of cultured human enterocyte-like cells infected with poliovirus or rotavirus.

A mixed infection with either rotavirus or poliovirus and Listeria monocytogenes was analysed in Caco-2 cells, a tumour-derived cell line, highly susceptible to these pathogens. The multiplication of these pathogens, whose usual site of entry and/or replication is the intestine, was also followed by electron microscopy. Results obtained showed an increase of L. monocytogenes internalisation in cells infected with rotavirus, whereas the preinfection with poliovirus had only a slight interfering effect on bacterial entry. Analysis of L. monocytogenes multiplication in virus-infected cells revealed that rotavirus also promoted bacterial replication, which poliovirus hampered replication. Concerning the effect of Caco-2 cell invasion by L. monocytogenes on viral replication, we observed an increase in rotavirus antigen synthesis but no significant effect on poliovirus yield under our experimental conditions.

Antiviral effect of a polysaccharide from Sclerotium glucanicum towards herpes simplex virus type 1 infection.

Among different neutral polysaccharides from natural sources, scleroglucan from Sclerotium glucanicum significantly inhibits the replication of herpes simplex virus type 1 on Vero cells. Scleroglucan belongs to a class of exopolymers, expressed by members of genus Sclerotium and consists of a linear beta-1,3-linked glucopyranose with side chains of single glucopyranose residues linked through beta-1,6 glycosidic bonds. The effective antiviral concentration of this polysaccharide is far from the cytotoxicity threshold and consequently this natural product possesses a good selectivity index. Results obtained in experiments carried out in order to clarify the mechanism of action of this carbohydrate indicate that the block of infection occurs during the very early phases of the viral mutliplication cycle since the highest inhibitory effect took place when it was added during the attachment step. The antiviral effect of scleroglucan seems to be related to its binding with membrane glycoproteins of HSV-1 particles which impedes the complex interactions of the virus with the cell plasma membrane.

In vitro study of a double infection by herpes simplex virus type 2 and Chlamydia trachomatis.

Sexually transmitted diseases (STDs) may recognize multiple etiological agents. Among them, Chlamydia trachomatis (Ct) and herpes simplex virus type 2 (HSV-2) cause symptomatic, subclinical and asymptomatic infections of the urogenital tract which can lead to serious sequelae. In the present study the coinfection and superinfection by Ct and HSV-2 in epithelial cultured cells from human cervix (HeLa 229) are described. A double infection, followed by the intracellular synthesis of chlamydial and viral antigens, was established. Both synergistic and interfering phenomena were recorded: viral antigen synthesis resulted increased whereas Ct inclusion bodies were produced to a lower extent.

Lactoferrin inhibits herpes simplex virus type 1 adsorption to Vero cells.

This paper describes the ability of human and bovine lactoferrins (HLf; BLf), iron-binding proteins belonging to the non-immune defense system, to interfere with herpes simplex virus type 1 (HSV-1) infection. Since lactoferrins are known to bind to heparan sulphate proteoglycans and to low density lipoprotein receptor, which in turn act as binding sites for the initial interaction of HSV-1 with host cells, we tested the effect of these proteins on HSV-1 multiplication in Vero cells. Both HLf and BLf are found to be potent inhibitors of HSV-1 infection, the concentrations required to inhibit the vital cytopathic effect in Vero cells by 50% being 1.41 microM and 0.12 microM, respectively. HLf and BLf exerted their activity through the inhibition of adsorption of virions to the cells independently of their iron withholding property showing similar activity in the apo- and iron-saturated form. The binding of [35S]methionine-labelled HSV-1 particles to Vero cells was strongly inhibited when BLf was added during the attachment step. BLf interacts with both Vero cell surfaces and HSV-1 particles, suggesting that the hindrance of cellular receptors and/or of viral attachment proteins may be involved in its antiviral mechanism.

Inhibition of herpes simplex virus infection by negatively charged and neutral carbohydrate polymers.

Different natural and semisynthetic polysaccharides were evaluated for their inhibitory effect on in vitro replication of herpes simplex virus (HSV) types 1 and 2. Some neutral and negatively charged carbohydrates were able to inhibit viral infection by interfering mainly with the adsorption process showing a dose-dependent relationship. Their effect was shown within the concentration range of 200-0.8 micrograms/ml, and the inhibiting compounds were in order of action: dextran sulfate = scleroglucan = lambda carrageenan > glyloid sulfate 4324 > locust beam gum towards HSV-1 and dextran sulfate = glyloid sulfate 4324 = lambda carrageenan > scleroglucan > glycogen sulfate 4435 towards HSV-2. The data obtained indicate that the antiviral activity of polysaccharides was not only related to their electric charge. Other characteristics of the molecules such as the polymeric backbone, the carbohydrate moieties and the degree of polymerization could play a role in influencing their antiviral properties.

Skin necrosis due to intravenous heparin.

A patient on intravenous heparin is described who developed an acute hemorrhagic necrosis of her legs. Thrombi without vasculitis were seen in the dermal blood vessels. This appears to be the 4th reported case of skin necrosis after intravenous heparin at sites unrelated to injections. Skin necrosis after intravenous heparin should warn the dermatologist of a possible fatal outcome from myocardial or cerebral infarction.

A solid phase immunoradiometric assay for gastric parietal cell antibodies.

We recently described a solid phase immunoradiometric assay (IRMA) for anti-thyroglobulin and anti-thyroid microsomal antibodies. In the present study a similar IRMA for gastric parietal cell antibodies (PCA) has been developed. Samples to be tested are incubated within wells of polyvinyl microtitre plates coated with solubilized gastric microsomal antigen. After removal of unbound material, PCA is detected by adding purified 125I-anti-human IgG antibody. A good correlation was found with the results of PCA assays obtained by indirect immunofluorescence. In contrast, negative PCA by IRMA were consistently obtained in sera containing high titres of several other organ specific and non-organ specific autoantibodies. PCA determinations by IRMA were than carried out in a series of normal controls and patients with autoimmune or non-autoimmune thyroid disorders. Positive results were obtained in three of 70 (4.3%) apparently normal subjects, in 16 of 87 (18.4%) patients with Hashimoto's thyroiditis, in 10 of 48 (20.8%) with idiopathic myxoedema, in 25 of 95 (25.6%) with Graves' disease and in five of 64 (7.8%) with other non-autoimmune thyroid disorders. Preliminary results showed that quantitative measurements of PCA by IRMA could be performed using a serum containing high levels of PCA as standard reference. In conclusion, PCA may be easily and specifically detected using the same IRMA procedure previously developed for anti-thyroid antibodies. We therefore suggest that the present IRMA may be proposed as a general technique for the detection of different organ specific autoantibodies.