The potential role of local pharmacies to assess asthma control: an Italian cross-sectional study.

BACKGROUND: Asthma control and monitoring still represents a challenge worldwide. Although the international guidelines suggest the interplay between secondary and primary care services as an effective strategy to control the disease, community pharmacies' are seldom involved in asthma control assessment. The present cross-sectional study aimed at providing a picture of the relationship between asthma severity and control in community pharmacies within the health district of the city of Verona (Veneto Region, North-Eastern Italy). METHODS: A call for participation was launched through the Pharmacists' Association of Verona. Patients referring to the participating pharmacies with an anti-asthmatic drug medical prescription and an asthma exemption code were asked to complete the Asthma Control Test (ACT) and a brief questionnaire collecting information on their age, sex, smoking status, aerobic physical exercise and usual asthma therapy, which also defined asthma severity. A multinomial logistic regression model was fitted to investigate the risk of uncontrolled as well as poorly controlled vs. controlled asthma (base). Results were expressed as relative risk ratios (RRR) with 95% confidence interval (95%CI). RESULTS: Fifty-seven community pharmacies accepted to participate and 584 asthmatic patients (54% females; mean-age: 51 ± 19 years) were consecutively recruited from 1st January to 30th June 2018 (6 months). Based upon ACT score 50.5% patients had a controlled asthma, 22.3% a poorly controlled and 27.2% uncontrolled. A variable proportion of patients with uncontrolled asthma were observed for every level of severity, although more frequently with mild persistent form of asthma. Most patients (92%) self-reported regular compliance with therapy. At multinomial regression analysis, patients under regular asthma treatment course (RRR = 0.33; 95%CI: 0.15; 0.77) were less likely to have an ACT< 16 compared to those not taking medications regularly. CONCLUSIONS: Overall, our findings highlighted an unsatisfactory asthma control in the general population, independently of the severity level of the disease. Community pharmacies could be a useful frontline interface between patients and the health care services, supporting an effective asthma management plan, from disease assessment and monitoring treatment compliance to referral of patients to specialist medical consultancies.

Social support network characteristics and sexual risk taking among a racially/ethnically diverse sample of young, urban men who have sex with men.

Associations between social support network characteristics and sexual risk among racially/ethnically diverse young men who have sex with men (YMSM) were examined using egocentric network data from a prospective cohort study of YMSM (n = 501) recruited in New York City. Bivariate and multivariable logistic regression analyses examined associations between social support network characteristics and sexual risk taking behaviors in Black, Hispanic/Latino, and White YMSM. Bivariate analyses indicated key differences in network size, composition, communication frequency and average relationship duration by race/ethnicity. In multivariable analyses, controlling for individual level sociodemographic, psychosocial and relationship factors, having a sexual partner in one's social support network was associated with unprotected sexual behavior for both Hispanic/Latino (AOR = 3.90) and White YMSM (AOR = 4.93). Further examination of key network characteristics across racial/ethnic groups are warranted in order to better understand the extant mechanisms for provision of HIV prevention programming to racially/ethnically diverse YMSM at risk for HIV.

Ferromagnetic Mn-doped Si0.3Ge0.7 nanodots self-assembled on Si(100).

Densely packed epitaxial Mn-doped Si(0.3)Ge(0.7) nanodots self-assembled on Si(100) have been obtained. Their structural properties were studied using reflection high-energy electron diffraction, energy dispersive x-ray diffraction, atomic force microscopy, extended x-ray absorption fine structure measurements and high-resolution transmission electron microscopy. Mn(5)Ge(1)Si(2) crystallites embedded in Si(0.3)Ge(0.7) were found. They exhibit a ferromagnetic behaviour with a Curie temperature of about 225 K.

Intravenous immunoglobulin increases survival time in the acute phase of experimental Chagas disease.

Chagas disease induced by Trypanosoma cruzi (Tc) infection is an important cause of mortality and morbidity affecting the cardiovascular system for which presently available therapies are insufficient and largely inadequate. Intravenous immunoglobulin (IVIg) is a therapeutic preparation containing normal polyspecific IgG obtained from plasma pools of several thousand healthy donors and is used in several autoimmune, inflammatory and infectious diseases. In the study of heart from mice chronically infected with Tc, we observed that IVIg restores type 1 atrioventricular block or bradycardia. In the present study, we investigated the effects of IVIg in acute Tc infection. Intravenous immunoglobulin administration after the first week of infection was associated with an increase in survival time. Taken together, results observed in the chronic and in the acute phase associate IVIg treatment with a favourable outcome in T. cruzi infection.

Benznidazole therapy in Trypanosoma cruzi-infected mice blocks thymic involution and apoptosis of CD4+CD8+ double-positive thymocytes.

Several alterations involving peripheral lymphoid organs have been extensively described after experimental Trypanosoma cruzi infection. Thymic involution occurs as well in infected mice, with both structural and functional alterations in the organ. Despite these abnormalities, specific immune response proceeds to control parasitemia and the participation of T lymphocytes is essential. However, there are relatively few studies on the impact of benznidazole (N-benzyl-2-nitroimidazole acetamide) upon this response. In this present work, we decided to evaluate the impact of benznidazole treatment upon the thymus involution following acute T. cruzi infection in mice. We have provided evidence that benznidazole treatment controls the severe abnormalities seen in the thymus due to T. cruzi infection. The thymocyte loss related to the depletion of double-positive CD4(+)CD8(+) thymocytes was clearly prevented, corroborating the idea that the mechanism responsible for the prevention of thymus involution is related to the decrease of apoptosis rate in this subset after benznidazole treatment. Furthermore, we demonstrated the prevention of enhanced extracellular matrix deposition in the thymus. In conclusion, the preservation of thymus homeostasis, even though partial, was accomplished after benznidazole treatment. Our data are consistent with the notion that different outcomes of T. cruzi infection may be linked to differences in the parasite load concomitant to fine tuning of the host immune response.

Enzymatic markers of heart lesion in mice infected with Trypanosoma cruzi and submitted to benznidazole chemotherapy.

Creatine kinase (CK total and CK-MB) were studied as markers of lesion progression induced by Trypanosoma cruzi infection. After 3 weeks mice infected with 10(4) parasites showed an increase in both enzyme levels and in their frequency distribution. A trend to increase was already detected in the 2nd week. A short duration per os treatment with benznidazole (Bz) prevented the occurrence of tissue lesions, since no changes were observed in enzymes. However, in the 4th week, about 40% of Bz-treated mice showed an increase in CK-MB, as did those that survived until the 8th week. Long-term treatment with Bz in drinking water of mice infected with 10(2) parasites showed, after 32 weeks, a partial reversion of the occurrence of high CK-MB levels from 85.7% to 50%. We found a positive correlation between inflammatory infiltrates and CK-MB levels, indicating that this marker could be useful to monitor the occurrence of experimental chagasic myocarditis.

Calibration and data elaboration procedure for sky irradiance measurements.

The problems encountered in the elaboration of measurements of direct and sky diffuse solar irradiance are the following: (1) to carry out the calibration for the direct irradiance, which consists in determining the direct irradiance at the upper limit of the atmosphere; (2) to carry out the calibration for the diffuse irradiance, which consists in determining the solid viewing angle of the sky radiometer; (3) to determine the input parameters, namely, ground albedo, real and imaginary parts of the aerosol refractive index, and aerosol radius range; and (4) to determine from the optical data the columnar aerosol optical depth and volume radius distribution. With experimental data and numerical simulations a procedure is shown that enables one to carry out the two calibrations needed for the sky radiometer, to determine a best estimate of the input parameters, and, finally, to obtain the average features of the atmospheric aerosols. An interesting finding is that inversion of only data of diffuse irradiance yields the same accuracy of result as data of both diffuse and direct irradiance; in this case, only calibration of the solid viewing angle of the sky radiometer is needed, thus shortening the elaboration procedure. Measurements were carried out in the Western Mediterranean Sea (Italy), in Tokyo (Japan), and in Ushuaia (Tierra del Fuego, Argentina); data were elaborated with a new software package, the Skyrad code, based on an efficient radiative transfer scheme.