bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of Thyroid Gland Function in Children with Obstructive Apnea Hypopnea Syndrome
Authors: Sakellaropoulou A.V. , Hatzistilianou M.N. , Emporiadou M.N. , Aivazis V.TH. , Rousso I. , Athanasiadou-Piperopoulou F.
Published: January 2017

Patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and thyroid function abnormalities, such as hypothyroidism and Hashimoto's thyroiditis, usually have closely resembling clinical features. Differentiation between these disorders is made more difficult because hypothyroid patients are also at risk for secondary sleep-disordered breathing. The aim of our study is to evaluate the prevalence of thyroid function abnormalities in children with OSAHS. Forty-four children (15 females: 29 males), 2.5–14.5 (7.43±2.98) years old were studied with overnight polysomnography. Biochemical screening of thyroid gland function was also carried out. Patients were judged to have OSAHS based mainly on the evaluation of Apnea Hypopnea index per hour of sleep (AHI). 15/44 (34.1%) children had mild OSAHS, 17/44 (38.6%) moderate and 12/44 (27.3%) severe OSAHS. Hypothyroidism was recorded only in 5/44 (11.4%) and Hashimoto's thyroiditis in 3/44 (6.8%) of OSAHS patients. Two patients with hypothyroidism showed mild and three severe OSAHS, while from the 3 children with Hashimoto's thyroiditis one presented mild, one moderate and one severe degree of OSAHS. Although the majority of studies in bibliography worldwide do not consider necessary the systemic evaluation of thyroid gland function in patients with breathing disorders during sleep, it seems that in children this type of screening is required for the differential diagnosis between primary sleep apnea and hypothyroid sleep-disordered breathing in order to differentiate these two conditions. Therefore, the laboratory investigation of thyroid gland function could be considered necessary.
Procalcitonin, C-Reactive Protein, Interleukin-6, and Soluble Intercellular Adhesion Molecule-1 as Markers of Postoperative Orthopaedic Joint Prosthesis Infections
Authors: Drago L. , Vassena C. , Dozio E. , Corsi M.M. , De Vecchi E. , Mattina R. , Romano C.
Published: January 2017

There is a universally recognized need to identify new, reliable markers of inflammation that can aid in the rapid diagnosis of orthopaedic joint prosthesis infections (OJP-Is). Since prompt diagnosis is key to timely intervention in the course of infection, different molecules have been studied. In this study, we examined three groups of patients: those with prosthesis infection, those without infection, and a third group with previous infection in whom the infection had been cleared. Four presumed markers of infection were tested: procalcitonin (PCT); C-reactive protein (CRP); interleukin-6 (IL-6); and soluble intercellular adhesion molecule-1 (sICAM-1). The results showed that PCT cannot be considered as a good marker of periprosthetic infection as no statistically significant difference in serum PCT levels emerged between patients with infection and controls or patients without infection. In contrast, both sICAM-1 and CRP may be considered as good markers of infection, as measurement of their levels allowed us to distinguish between patients with and without infection, and between patients with infection and those with previous infection, since marker levels quickly returned to baseline values after clearance of the infection. IL-6 was found to be a good marker for inflammation, as it distinguished between patients with infection and the other groups. In the patients with previous infection, the IL-6 values remained high versus the controls but lower and with a statistically significant difference versus the patients with infection. Further studies are needed to determine the cut-off value of IL-6 between patients with infection and those with previous infection.
Exhaled Nitric Oxide Levels in Children with Chronic Adenotonsillar Disease
Authors: Torretta S. , Marchisio P. , Esposito S. , Garavello W. , Cappadona M. , Clemente IA. , Pignataro L.
Published: January 2017

Exhaled nitric oxide (eNO) is a highly reactive biological mediator that has recently been associated with chronic tonsillar disease in adults, but there are no published data concerning eNO levels in their pediatric counterparts. The aim of this study is to measure mean eNO levels in children with chronic adenotonsillitis or adenotonsillar hypertrophy, and assess the effects of potential confounding factors. Children aged 3–17 years were divided into three groups (chronic adenotonsillitis, adenotonsillar hypertrophy and controls). Their eNO levels were measured in accordance with the international guidelines, and their other clinical and anamnestic characteristics were recorded. The mean eNO level in the children with chronic adenotonsillitis was slightly higher than that in the other groups, but there was no statistically significant between-group difference. Age (p=0.009), allergy (p=0.05) and body mass index (p=0.03), but not the mean grade of adenoidal or tonsil hypertrophy, were all statistically related to mean eNO levels. These preliminary results indicate the lack of an increase in mean eNO levels in children with chronic adenotonsillar disease, with no substantial difference between children with chronic adenotonsillitis and those with adenotonsillar hypertrophy.
Anti-Laminin-1 Antibodies in Sera and Follicular Fluid of Women with Endometriosis Undergoing in Vitro Fertilization
Authors: Caccavo D. , Pellegrino N.M. , Totaro I. , Vacca M.P. , Selvaggi L. , Depalo R.
Published: January 2017

There is increasing evidence that autoimmune phenomena, including auto-antibody production, may affect fertility in women with endometriosis. The aims of this study are to evaluate anti-laminin-1 antibody (aLN-1) presence in sera and in follicular fluids (FF) of women with endometriosis undergoing IVF and its impact on oocyte maturation and IVF outcome. aLN-1 were measured by a home-made enzyme linked immunosorbent assay in sera and FF obtained from 35 infertile women with endometriosis and in sera from 50 fertile controls and 27 infertile women without endometriosis (IWWE). aLN-1 serum levels were significantly higher in women with endometriosis in comparison with both fertile controls and IWWE (P<0.001 and P <0.05, respectively) and a positive correlation was found between serum-and FF- aLN-1 (r = 0.47, P = 0.004). According to the cut-off (mean+3 SD of fertile controls), 31% of women with endometriosis were aLN-1 positive. Metaphase II oocyte counts showed inverse correlation with FF-aLN-1 levels (r = −0.549, P = 0.0006). Ongoing pregnancy (i.e pregnancy progressing beyond the 12th week of gestation) occurred in 4/11 aLN-1 positive patients and in 7/24 aLN-1 negative with no significant difference (P= 0.7). In conclusion, our results highlight that aLN-1 are increased in women with endometriosis and their presence in FF may affect oocyte maturation leading to a reduced fertility. However, aLN-1 seem to have no effect on IVF outcome.
Friday Asthma Crisis in the Daughter of Two Bakers
Authors: Caimmi S. , Marseglia A. , Caimmi D. , Marseglia G.L.
Published: January 2017

The prevalence of sesame food allergy continues to increase worldwide. The diagnostic tools to confirm such allergy include skin prick tests, specific IgEs and food challenge. We report the case of a 7-year-old girl who presented recurrent episodes of wheezing and dyspnoea. After performing skin tests and evaluating specific IgEs we hypothesised an allergy to sesame. Our patient actually benefitted from avoiding any contact with sesame and sesame seeds. We confirmed our diagnosis through an inhalation food challenge. Further, by reviewing her personal history, we suspect inhalation was the mechanism in which the girl became sensitised to sesame.
Diagnostic Failure of Ciprofloxacin-Induced Spontaneous Bilateral Achilles Tendon Rupture: Case-Report and Medical-Legal Considerations
Authors: Pantalone A. , Abate M. , D'Ovidio C. , Carnevale A. , Salini V.
Published: January 2017

Rare side-effects of fluoroquinolone therapy are tendinitis and tendon rupture. Many reports have demonstrated that the concomitant use of corticosteroids, in patients aged 60 years or older, increase the risk substantially. We present a case of spontaneous bilateral Achilles tendon rupture induced by ciprofloxacin and methylprednisolone. A 61-year-old woman was diagnosed with Bronchiolitis Obliterans with Organizing Pneumonia (BOOP) and was started on oral ciprofloxacin 500 mg twice daily for 3 weeks and on oral methylprednisolone 16 mg twice daily for 2 weeks. The diagnosis was made after doctors, rather than stop drug therapy and advise complete rest, had mistakenly prescribed for the woman to undergo physiotherapy and local NSAIDs, thus favoring the onset of tendon ruptures and resulting in surgical and legal implications. Inspired by this case, we also submit a brief review on professional liability in Orthopaedics.
Platelet Amyloid Precursor Protein Isoform Expression in Alzheimer's Disease: Evidence for Peripheral Marker
Authors: Vignini A. , Sartini D. , Morganti S. , Nanetti L. , Luzzi S. , Provinciali L. , Mazzanti L. , Emanuelli M.
Published: January 2017

Alzheimer's disease (AD) is a chronic neurodegenerative disorder characterized by a progressive cognitive and memory decline. Among peripheral markers of AD, great interest has been focused on the amyloid precursor protein (APP). In this regard, platelets represent an important peripheral source of APP since it has been demonstrated that the three major isoforms, that are constituted of 770, 751 and 695 aa residues, are inserted in the membrane of resting platelets. APP 751 and APP 770 contain a Kunitz-type serine protease inhibitor domain (APP KPI) and APP 695 lacks this domain. To address this issue, we first examined the platelet APP isoform mRNAs prospectively as biomarker for the diagnosis of AD by means of real-time quantitative PCR, and then evaluated the correlation between APP mRNA expression levels and cognitive impairment of enrolled subjects. Differential gene expression measurements in the AD patient group (n=18) revealed a significant up-regulation of APP TOT (1.52-fold), APP KPI (1.32-fold), APP 770 (1.33-fold) and APP 751 (1.26-fold) compared to controls (n=22). Moreover, a statistically significant positive correlation was found between APP mRNA levels (TOT, KPI, 770 and 751) and cognitive impairment. Since AD definitive diagnosis still relies on pathological evaluation at autopsy, the present results are consistent with the hypothesis that platelet APP could be considered a potential reliable peripheral marker for studying AD and could contribute to define a signature for the presence of AD pathology.
Bridging the Gap between the Clinician and the Patient with Cryopyrin-Associated Periodic Syndromes
Authors: Cantarini L. , Lucherini O.M. , Frediani B. , Brizi M.G. , Bartolomei B. , Cimaz R. , Galeazzi M. , Rigante D.
Published: January 2017

Cryopyrin-associated periodic syndromes are categorized as a spectrum of three autoinflammatory diseases, namely familial cold auto-inflammatory syndrome, Muckle-Wells syndrome and chronic infantile neurological cutaneous articular syndrome. All are caused by mutations in the NLRP3 gene coding for cryopyrin and result in active interleukin-1 release: their rarity and shared clinical indicators involving skin, joints, central nervous system and eyes often mean that correct diagnosis is delayed. Onset occurs early in childhood, and life-long therapy with interleukin-1 blocking agents usually leads to tangible clinical remission and inflammatory marker normalization in a large number of patients, justifying the need to facilitate early diagnosis and thus avoid irreversible negative consequences for tissues and organs.
Identification of Differentially-Expressed Proteins between Early Submucosal Non-Invasive and Invasive Colorectal Cancer Using 2D-DIGE and Mass Spectrometry
Authors: Zhang J. , Song M-Q. , Zhu J-S. , Zhou Z. , Xu Z-P. , Chen W-X. , Chen N-W.
Published: January 2017

Early detection and diagnosis of colorectal cancer (CRC) are closely related to a better therapeutic outcome, and the five-year survival rate of early CRC is over 90%. Though endoscopic minimally invasive treatment has become a quick and effective therapy for early CRC, endoscopic biopsies are usually not deep enough to obtain tissues from the submucosal layer and it is difficult to determine whether early CRC has infiltrated into the submucosa. Therefore, in the present study, we constructed tumor models of early submucosal non-invasive CRC (SNICRC) and submucosal invasive CRC (SICRC) in Fischer-344 rats induced by N-methyl-N-nitrosourea (MNU). The differentially-expressed proteins were analyzed and identified in SNICRC, SICRC and normal control (NC) tissues using highly sensitive two-dimensional differential gel electrophoresis (2D-DIGE) coupled with mass spectrometry (MS). Proteomic data revealed 132 protein spots between SNICRC and SICRC, 162 protein spots between SICRC and NC and 154 protein spots between SNICRC and NC which were found differentially expressed. These differential spots were picked, in-gel digested and peptide mass fingerprints were obtained by MALDI-TOF-MS/MS. Finally, five differentially-expressed proteins in SNICRC, SICRC and NC were identified, and increases in Transgelin, peptidylprolyl isomerase A (PPIA) and tropomyosin alpha isoform d were observed, while decreases in carbonic anhydrase 2 (CAII) and an unnamed protein were detected in SICRC compared with SNICRC and NC. Furthermore, Fluorescence-based quantitative polymerase chain reaction (FQ-PCR), Western blotting and immunohistochemistry assays also revealed significant upregulation of Transgelin expression and down-regulation of CAII expression in SICRC tissues. In conclusion, 2D-DIGE is confirmed to be an efficient strategy that enables us to identify differentially-expressed proteins between early SNICRC and SICRC. The potential biomarkers such as Transgelin and CAII may be used for the detection of early SICRC
Lactobacillus Paracasei LP6 Favors Immune Modulation Induced by Allergoid Treatment in Ragweed Sensitized Mice
Authors: Petrarca C. , Lazzarin F. , Lanuti P. , Marchisio M. , Miscia S. , Rossi C. , Braga M. , Mistrello G. , Di Gioacchino M.
Published: January 2017

It has been hypothesized that lactic acid bacteria (LAB) could be used as adjuvant for specific immunotherapy (SIT), as various studies conducted on humans and animals converge to define LAB as anti-Th2 modulators and Treg inducers. In the present study we evaluated the effects of LAB, in particular Lactobacillus paracasei Lp6 (Lp6), in a mouse model of ragweed (RW) allergy. Groups of Balb/c mice, experimentally sensitized towards ragweed, were treated by viable Lp6 or by RW-allergoid with or without co-administration of Lp6. A control group was sham-sensitized with PBS and sham-treated with water and a group was sensitized with RW and treated with water. Serum IgE, RW-induced release of IFN-γ, IL-4 and IL-10 from splenocytes and the frequency of CD4CD25 regulatory T cells (Tregs) expressing Foxp3 or IL-10 were evaluated in various groups. RW-allergoid treatment induced a reduction of serum IgE, with a decrease in RW-induced release of IL-4, and an increase in IL-10 and IFN-γ, along with a significant change in the frequency of Tregs, both CD25+ and -. The joint RW-allergoid+Lp6 treatment induced the highest degree of suppression of allergen-driven IL-4, the greatest reduction of IL-4/IFN-γ and IL-4/IL-10 ratios and the most significant increase of Foxp3 and IL-10 expressing Tregs: The study shows that Lp6 strengthens the immune modulation induced by allergoid-SIT in RW-sensitized mice, essentially characterized by a differential induction of Tregs associated to a reduction of IL-4; data converge to define a role of SIT adjuvant for Lp6.
Kmup-1 Inhibits H441 Lung Epithelial Cell Growth, Migration and Proinflammation VIA Increased NO/CGMP and Inhibited RHO KINASE/VEGF Signaling Pathways
Authors: Wu B.N. , Chen H.Y. , Liu C.P. , Hsu L.Y. , Chen I.J.
Published: January 2017

This study investigates whether KMUP-1 protects soluble guanylate cyclase (sGC) and inhibits vascular endothelial growth factor (VEGF) expression in lung epithelial cells in hypoxia, therapeutically targeting epithelial proinflammation. H441 cells were used as a representative epithelial cell line to examine the role of sGC and VEGF in hypoxia and the anti-proinflammatory activity of KMUP-1 in normoxia. Human H441 cells were grown in hypoxia for 24–72 h. KMUP-1 (1,10,100 μM) arrested cells at the G0/G1 phase of the cell cycle, reduced cell survival and migration, increased p21/p27, restored eNOS, increased soluble guanylate cyclase (sGC) and PKG and inhibited Rho kinase II (ROCK-II). KMUP-1 (0.001−0.1 μM) concentration dependently increased eNOS in normoxia and did not inhibit phosphodiesterase-5A (PDE-5A) in hypoxic cells. Hypoxia-induced factor-1α (HIF-1α) and VEGF were suppressed by KMUP-1 but not by L-NAME (100 μM). The PKG inhibitor Rp-8-CPT-cGMPS (10 μM) blunted the inhibition of ROCK-II by KMUP-1. KMUP-1 inhibited thromboxane A2-mimetic agonist U46619-induced PDE-5A, TNF-α (100 ng/ml)-induced iNOS, and ROCK-II and associated phospho-p38 MAPK, suggesting multiple anti-proinflammatory activities. In addition, increased p21/p27 by KMUP-1 at higher concentrations might contribute to an increased Bax/Bcl-2 and active caspase-3/procaspase-3 ratio, concomitantly causing apoptosis. KMUP-1 inhibited ROCK-II/VEGF in hypoxia, indicating its anti-neoplastic and anti-inflammatory properties. KMUP-1 inhibited TNF-α-induced iNOS and U46619-induced PDE-5A and phospho-p38 MAPK in normoxia, confirming its anti-proinflammatory action. KMUP-1 could be used as an anti-proinflammatory agent to reduce epithelial inflammation.
Expression of IL-23, VEGF and TLR2/TLR4 on Mononuclear Cells after Exposure to Pseudomonas Aeruginosa
Authors: Paolillo R. , Carratelli C. Romano , Sorrentino S. , Mazzola N. , Mita L. , Rizzo A.
Published: January 2017

Pseudomonas aeruginosa is a Gram-negative, aerobic bacillus causing infections of the respiratory and other organ systems in susceptible hosts. Although it does not cause pulmonary infections in immunocompetent individuals, P. aeruginosa causes chronic lung infection in individuals with cystic fibrosis and nosocomial pneumonia resulting in significant morbidity and mortality. Exogenous administration of an important P. aeruginosa virulence factor, lipase, present in P. aeruginosa culture supernatant, induces potent mononuclear cell activation leading to the production of numerous proinflammatory cytokines. In particular, P. aeruginosa culture supernatant stimulated increased proliferation of THP-1 cells and monocytes (MN). The addition of culture supernatant to THP-1 cells and MN also induced Interleukin (IL)-23 and vascular endothelial growth factor (VEGF) release in a time-dependent manner. To investigate whether any compounds present in the supernatant lipase contributed to releasing IL-23 and VEGF, the culture supernatant from P. aeruginosa containing lipase was treated with hexadecylsulfonylfluoride (AMSF). The AMSF-treated culture supernatant (CS) did not show any induction on the IL-23 and VEGF release compared to the cells treated with CS without AMSF. We also showed that Toll-like receptors (TLR)2/TLR4 are expressed in THP-1 cells and MN treated with P. aeruginosa CS in a time-dependent fashion. Flow cytometry analysis revealed a higher TLR4 and a lower TLR2 expression at 48 and 72 h of treatment. The treatment of cells with TLR4 neutralizing antibody, and to a lesser extent with TLR2 neutralizing antibody, resulted in a decrease in P. aeruginosa CS-induced IL-23 and VEGF production.
Hyper-IgM, Neutropenia, Mild Infections and Low Response to Polyclonal Stimulation: Hyper-IgM Syndrome or Common Variable Immunodeficiency?
Authors: Rosado M.M. , Diamanti A. Picchianti , Cascioli S. , Ceccarelli S. , Caporuscio S. , D'Amelio R. , Carsetti R. , Lagana B.
Published: January 2017

A young woman presenting respiratory infections, polyarthritis, severe neutropenia, and increased serum IgM was treated with Intravenous Immunoglobulin (IVIG) with good clinical and laboratory outcome followed by a loss of efficacy. The increased serum IgM associated to recurrent infections and autoimmune manifestations suggested the diagnosis of a hyper–IgM syndrome (HIGMs). The frequency of peripheral T cells, the expression of CD40 on the patients' B cells and CD40L on T cells and the Activation-Induced cytidine Deaminase (AID) and Uracyl-DNA glycosylase (UNG) at mRNA level was comparable to controls. In contrast, the frequency of B cells was one half of the healthy control and all cells showed an atypical phenotype. Although AID and UNG were normal, class-switch recombination was not very efficient because circulating switched memory were reduced and, once stimulated with CpG, generated less antibody-secreting cells than controls. An increase in serum B Lymphocytes stimulator (BLyS) was also found. The patient presented a peculiar clinical and immunological phenotype fitting for many aspects of both HIGM4 and Common Variable Immunodeficiency (CVID). These findings underline the need to better explore the complex link between these two diseases.
Psychophysical Distress and Alexithymic Traits in Chronic Fatigue Syndrome with and without Comorbid Depression
Authors: Sepede G. , Racciatti D. , Gorgoretti V. , Nacci M. , Pizzigallo E. , Onofrj M. , Di Giannantonio M. , Niolu C. , Salerno R.M. , Gambi F.
Published: January 2017

Patients with Chronic Fatigue Syndrome (CFS) often report a comorbid depressive disorder. Comorbid depression may negatively influence the long-term outcome of CFS therefore it must be correctly diagnosed and treated. The aim of the present study is to provide a clinical and psychometric assessment of CFS patients with and without depressive features. A comparative analysis between 57 CFS subjects (CDC, 1994), 17 of whom with a comorbid depression, and 55 matched healthy volunteers was assessed to evaluate the presence of any psychophysical distress and alexithymic traits, by means of Symptom Checklist-90-R (SCL-90R) and Toronto Alexithymia Scale (TAS-20). The severity of fatigue was also assessed in all CFS patients using the Fatigue Impact Scale (FIS). With regard to psychiatric comorbidity, the SCL-90R scores showed higher levels of somatic complaints in CFS patients than in healthy subjects, whereas augmented depressive and obsessive-compulsive symptoms were observed only in the depressed CFS subgroup. When comparing the TAS-20 scores, we observed a selective impairment in the capacity to identify feelings and emotions, as measured by the Difficulty in Identifying Feelings subscale (DIF), non-depressed CFS patients showing an intermediate score between depressed CFS and healthy controls. Finally, in terms of FIS scores, a statistical trend versus a higher fatigue severity in depressed CFS patients, with respect to non-depressed ones, was observed. In conclusion, comorbid depression in CFS significantly increased the level of psychophysical distress and the severity of alexithymic traits. These findings suggest an urgent need to address and treat depressive disorders in the clinical care of CFS cases, to improve social functioning and quality of life in such patients.
Evaluation of Bronchial Hyperreactivity with Mannitol Dry Powder Challenge Test in a Paediatric Population with Intermittent Allergic Asthma or Allergic Rhinitis
Authors: Decimo F. , Capristo C. , Amelio R. , Maiello N. , Capristo A.F. , Del Giudice M. Miraglia
Published: January 2017

We evaluated the bronchial hyperreactivity (BHR) with a new bronchial challenge test, mannitol dry powder, in a paediatric population with intermittent allergic asthma or allergic rhinitis who did not respond to an exercise challenge test. We selected 50 children, aged 9–16 years, with intermittent allergic bronchial asthma (Group 1) or allergic rhinitis without clinical manifestation of asthma for at least 12 months (Group 2). All patients performed the following tests in three different days (> 48 hours apart): Day 1: exhaled nitric oxide (FeNO) determination followed by baseline spirometry and reversibility to inhaled β2-agonists; Day 2: exercise challenge test followed by FeNO determination; Day 3: mannitol challenge test followed by FeNO determination. Forty children completed the study. Eighteen subjects of Group 1 (90%) and 5 subjects of Group 2 (25%) resulted positive to the mannitol test. Positive mannitol challenge subjects showed no statistically significant differences compared to negative subjects as regard baseline spirometry, reversibility to salbutamol and response to the exercise challenge test, but they had significantly higher FeNO values. In conclusion, the mannitol challenge test can be a diagnostic tool more useful than the exercise challenge test to identify BHR in a paediatric population with intermittent allergic asthma or allergic rhinitis because it is better reproducible, quick and easy to perform and well tolerated.
Anetoderma: Evidence of the Relationship with Autoimmune Disease and a Possible Role of Macrophages in the Etiopathogenesis
Authors: Persechino S. , Caperchi C. , Cortesi G. , Persechino F. , Raffa S. , Pucci E. , Tammaro A. , Torrisi M.R.
Published: January 2017

Anetoderma is a benign condition characterized by round or oval macular lesions with focal loss of dermal elastic tissue resulting in localized areas of flaccid or herniated saclike skin. Often, the anetoderma is associated with immuno-mediated pathogenetic mechanism. In this article, we describe the association between anetoderma and autoimmune diseases, by underlining the role and the action of macrophages as a possible etiopathogenesis.
Churg-Strauss and Montelukast
Authors: Carlesimo M. , Mari E. , Palese E. , Pranteda G. , Camplone G.
Published: January 2017

Churg-Strauss syndrome (CSS) is a systemic small vessel vasculitis involving lungs, skin, heart, gastrointestinal tract and peripheral nerves. We report the case of a 36-year-old woman with a necrotic lesion on the left foot of two months duration, associated with hypereosinophilia, patchy lung infiltrates, cardiac damage and a mononeuritis. The personal history was remarkable only for an asthma, treated with Montelukast, a leukotriene receptor antagonist (LRA). Clinical symptoms, laboratory exams and instrumental examinations led us to the diagnosis of CSS. In recent years several studies have reported the possible relationship between use of leukotriene receptor antagonist (LRA) and CSS expression. We report this case to underline the possible relationship between LRA and CSS and its etiopathogenetic mechanism.
Videocapillaroscopic Pattern of Alopecia Areata before and after Diphenylciclopropenone Treatment
Authors: Ganzetti G. , Campanati A. , Simonetti O. , Cataldi I. , Giuliodori K. , Offidani A.M.
Published: January 2017

Alopecia areata (AA) is an inflammatory skin disease the most effective therapy for which is diphenylcyclopropenone (DPCP). Videodermatoscopy and intra-vital capillaroscopy (IVCP) are two non-invasive techniques that help in the differential diagnosis of alopecias. It is known that, after DPCP therapy, there is a histologically proven significant increase of VEGF in hair follicle keratinocites and a consequent increase in capillary vessels in the dermis of the same follicles. The aim of our study is to emphasize any clinical and videodermatoscopic-videocapillaroscopic changes after DPCP treatment in 20 patients affected by alopecia areata. Videodermatoscopic images and an intravital videocapillaroscopic analysis were performed at T0, T12 and T24 to emphasize clinical modifications and microscopic changes in vascular pattern before and after DPCP treatment. At T0, videodermatoscopy showed the presence of “exclamation point” hairs, hair follicles filled with hyperkeratotic plugs (“yellow dots”), hair follicles containing cadaverized hairs (“black dots”) and broken hairs. IVCP highlighted a pale scalp, and vessels were not visible. At 24 weeks (T24), videodermatoscopy revealed the disappearance or a statistically significant reduction of AA hallmarks and an increase of number of vellus hairs. Videocapillaroscopy showed a statistically significant increase of new vessels and, where neoangiogenesis were more marked, a major hair regrowth was evident. Our study emphasizes that, after DPCP therapy, neoangiogenesis is detectable by videocapillaroscopy and these new capillaries could be considered an initial positive attempt to compensate capillary loss of T0 alopecia areata images.
Antiblastic Treatment and Haematological Malignancies during Pregnancy: A Crucial Decision
Authors: Michieli M , Peccatori FA , Lleshi A , Del Pup L , Valente D , Rupolo M , Tirelli U , Berretta M
Published: January 2017

Antiblastic treatment of hematological malignancies during pregnancy poses a number of issues related to the curability of the maternal disease, the need of a prompt treatment and the potential toxicity of chemotherapy for the fetus. Here we report the results of a systematic literature search about the management of the most frequent hematological malignancies that may occur during pregnancy, focusing on specific issues related to gestational age at diagnosis, fetal toxicity and efficacy on the maternal side. The standard approach in non-pregnant women is illustrated as reference.
Is HCMV Vaccine an Unmet Need? The State of Art of Vaccine Development
Authors: Chiurchiù S. , Carducci F.I. Calò , Rocchi F. , Simonetti A. , Bonatti G. , Salmaso S. , Melchiorri D. , Pani L. , Rossi P.
Published: January 2017

Congenital HCMV infection is the most frequent congenital infection, with an incidence of 0.2–2.5% among all live births. About 11% of infected newborns show symptoms at birth, including hepato-splenomegaly, thrombocytopenia, neurologic involvement, hearing impairment and visual deficit. Moreover, 5–25% of the asymptomatic congenital HCMV-infected neonates will develop sequelae over months or even years. The relevant social burden, the economic costs of pre-natal screening, post-natal diagnosis, follow-up and possible therapy, although still limited, are the major factors to be considered. Several types of vaccines have been explored in order to develop an effective and safe HCMV vaccine: live attenuated, subunit, vectored, peptide, DNA, and subviral ones, but none are available for use. This review illustrates the different vaccine types studied to date, focusing on the possible vaccination strategy to be implemented once the HCMV vaccine is available, in terms of target population.
TNF-α, IL-4Rα AND IL-4 Polymorphisms in Mild to Severe Asthma from Italian Caucasians
Authors: Ricciardolo F.L.M. , Sorbello V. , Silvestri M. , Giacomelli M. , Debenedetti V.M.G. , Malerba M. , Ciprandi G. , Rossi G.A. , Rossi A. , Bontempelli M.
Published: January 2017

Asthma is a chronic airway inflammatory disease associated with airway hyperresponsiveness which affects subjects with genetic predisposition. An association has been reported between some polymorphisms in various cytokine genes and asthma. Most of them are single nucleotide polymorphisms (SNPs). These polymorphisms are detected in the protein coding sequence or in the promoter region thus influencing cytokine production. We investigated the involvement of SNP mapping in 5 cytokine genes in mild to severe asthmatics of Italian Caucasians. The frequency of alleles and genotypes, relatively to 10 allelic specificities of the cytokine genes, was defined in 57 asthmatics and in 124 control subjects by a Polymerase Chain Reaction-Sequence Specific Primer method. TNF-α -308A and TNF-α -238A allele frequencies were higher in asthmatics than in controls (p<0.001). Significant differences in the frequency of IL-4 -590T allele and of IL-4Rα + 1902A allele were also detected in asthmatics in comparison with controls (p<0.001 and p=0.005, respectively). Similarly, IL-1α -889C allele was present in 84.1% of asthmatics and in 70.2% of controls (p=0.013). Furthermore, the IL-4Rα + 1902A/A and IL-1α -889C/C homozygous conditions and the TNF-α -308G/A, TNF-α -238G/A, IL-4 -590T/C and IL-10 -1082G/A heterozygous conditions were significantly associated with asthma (p<0.05). ACA haplotype of IL-10 was observed only in asthmatic patients. This study reports, for the first time, the frequency of 10 different single nucleotide polymorphisms in 5 cytokine genes in the Italian Caucasians. Furthermore, we also indicate that in our population some single nucleotide polymorphisms are associated with mild to severe bronchial asthma.
Clinical Significance of Pituitary Tumor Transforming Gene 1 and Transgelin-2 in Pancreatic Cancer
Authors: Lin H. , Chen Q-L. , Wang X-Y. , Han W. , He T-Y. , Yan D. , Chen K. , Su L-D.
Published: January 2017

Human pituitary tumor transforming gene 1 (PTTG1) is an oncogenic transcription factor that is overexpressed in many malignancies, especially cancers with metastatic potential, while transgelin-2 (TAGLN2) is an actin-binding protein shown to be a tumor suppressor. However, the expression and clinical significance of PTTG1 and TAGLN2 in pancreatic cancer remain unclear. The present study aimed to investigate the expression and clinical significance of PTTG1 and TAGLN2 in human primary pancreatic cancer. Seventy-five cases of human pancreatic cancer tissues were collected. The expression of PTTG1 and TAGLN2 protein was assessed using immunohistochemistry (IHC) through tissue microarray procedure. The clinicopathologic characteristics of all patients were analyzed. As a result, the expression of PTTG1 and TAGLN2 in cancerous tissues showed the positive staining mainly in the cytoplasm, and they were found in cancerous tissues with higher strong reactivity rate compared with the adjacent non-cancer tissues (ANCT) (56.0% vs 22.7%, P<0.001; 100% vs 84%, P=0.002), elevating with the ascending order of tumor malignancy. Furthermore, the positive expression of PTTG1 was associated with the gender of pancreatic cancer patients, but did not correlate with their age, pathological styles, tumor size, tumor sites, TNM staging, perineural infiltration and distant metastasis (each P>0.05). In addition, Spearman rank correlation analysis showed the positive correlation of PTTG1 with TAGLN2 (r=0.624, P<0.001). Taken together, PTTG1 and TAGLN2 are highly expressed in human pancreatic cancer, and the positive expression of PTTG1 is associated with the gender of cancer patients, suggesting that it may represent a potential therapeutic target for the treatment of pancreatic cancer.
Short-Term Tolerability of Morniflumate in Patients with Cutaneous Hypersensitivity Reactions to Non-Steroidal Anti-Inflammatory Drugs
Authors: Mero F. , Nettis E. , Aloia A.M. , Di Leo E. , Ferrannini A. , Vacca A.
Published: January 2017

Morniflumate is the morpholinoethyl ester of niflumic acid, a non-steroidal antiinflammatory drug, derived from nicotinic acid. We studied 112 patients who had experienced cutaneous reactions after using non-steroidal anti-inflammatory drugs. Only two of all the patients who underwent an oral challenge with morniflumate had a positive result to the test. By demonstrating the low incidence of reactions to morniflumate through oral challenges, we suggest that patients with non-steroidal anti-inflammatory drug hypersensitivity may tolerate this drug which would therefore be a useful alternative.
Ulcers Caused by Bullous Morphea: Successful Therapy with N-Acetylcysteine and Topical Wound Care
Authors: Rosato E. , Veneziano M.L. , Di Mario A. , Molinaro I. , Pisarri S. , Salsano F.
Published: January 2017

Bullous morphea is an uncommon form of localized scleroderma. The pathogenesis is unknown and treatment of coexistent ulcers is difficult. The pathogenesis of bullae formation in morphea is multifactorial, but reactive oxygen species production appears to play a key role. We report a patient with bullous morphea with long-standing ulcers whom we successfully treated with N-acetylcysteine and topical wound care. N-acetylcysteine, an antioxidant sulfhydryl substance, promotes the healing of ulcers in patients with bullous morphea.
Latex-Fruit Syndrome in Italian Children and Adolescents with Natural Rubber Latex Allergy
Authors: Ricci G. , Piccinno V. , Calamelli E. , Giannetti A. , Pession A.
Published: January 2017

Approximately 30–50% of individuals with natural rubber latex (NRL) allergy show an associated hypersensitivity to particular plant-derived foods, which has been defined “latex-fruit syndrome” (LFS). In our population of 22 patients with IgE-mediated NRL allergy we found a relevant prevalence (36%) of LFS, which resulted significantly higher in the group of patients with more severe clinical manifestations of NRL allergy than in patients with contact symptoms due to NRL (78% vs 8%; p<0.005).
Canadian Psychiatry across 5 Decades: From Clinical Inference to Evidence-Based Practice
Authors: Paris Joel
Published: January 2017

Objective:

To examine the evolution of the epistemological basis of Canadian psychiatry over the last 50 years.

Method:

A comparison of the content of The Canadian Journal of Psychiatry in its early years, then known as the Canadian Psychiatric Association Journal, with publications from recent years, shedding light on broader trends in psychiatric theory and practice.

Results:

A dramatic change has occurred in Journal content, from clinical inference to an evidence-based approach, reflecting stronger biological orientations, as well as empirical psychosocial research.

Conclusions:

Epistemological changes in psychiatry are a positive development. The future should bring an even stronger neuroscience base as well as an evidence-based approach to psychotherapy.
Psychiatry in the New Millennium
Authors: Garfinkel Paul E , Dorian Barbara J
Published: January 2017

The field of psychiatry is experiencing great excitement at this time, much as it was 100 years ago. Current excitement is rooted in the greatly strengthened therapeutics, new models for understanding, and an exponential increase in knowledge of brain function as well as in the opportunity to revise health care delivery. While public expectations of professionals have generally fallen, the role of the healer, which is at the heart of psychiatric practice, has remained high in public regard. Psychiatry has also had to develop new relationships with an active consumer movement. Consumers now appropriately expect to be part of the planning, governance, and evaluation of care. Patients are questioning the research agenda and demand a role in determining the conduct of investigations. This active consumer movement is playing an important role in destigmatizing mental illnesses. Newer, nonmoralistic theories about mental illness and the profession's emphasis on the public trust have also played an important role. The increasing closeness of psychiatry to the rest of medicine has had a greatly beneficial impact, not only on stigma but also on diagnosis and treatment. Care must be taken, however, to see that diagnosis does not become a means to avoiding understanding of people. A welcome recent change has been the reunion between psychiatry and the addictions. This reunion has been facilitated by the development of multifactorial models of care in the mental health field and harm-reduction strategies in the addictions. This bodes well for more integrated treatment in the coming years. The strong psychiatric treatments that are now available and those on the horizon also auger well for an exciting period in our field. The excitement is enhanced by recognizing the multiple approaches to care that have been demonstrated to be effective and the need for great investment in research in this country and by developing new partnerships between the profession and public.
The Epidemiology of Major Depression: Implications of Occurrence, Recurrence, and Stress in a Canadian Community Sample
Authors: De Marco Richard R
Published: January 2017

Objective:

To study the effects of stress process variables on the prevalence of major depressive disorder (MDD) and to explore the factors related to its onset and recurrence, using measures of stress and disorder that are more comprehensive than those in previous studies of depression.

Method:

Data were collected from a randomly selected community sample of 1393 adult respondents in Toronto, Ontario. Depression was measured using the Composite International Diagnostic Interview (CIDI).

Results:

Bivariate and multivariate analyses examine demographic and stress process correlates of MDD to assess their impact on both occurrence and recurrence. The effects of childhood experiences on lifetime MDD are examined as risk factors for the initial onset of depression. With respect to occurrence, the multivariate analyses tended to show agreement with established findings. Results using a subsample of people with lifetime depression to predict recurrence tended to mirror results using the full sample, except with respect to gender, birthplace, and, to a certain degree, stress differences. Finally, traumas experienced in childhood, as well as early childhood experiences involving parental substance abuse and mental health problems, were significant predictors of the onset of major depressive disorder.

Conclusion:

This research currently represents the only Canadian community study to examine the relationship between stress, social support, coping, and depression using outcome measures that approximate Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria. In addition, it is among the few that use a comprehensive measure of life stress encompassing childhood experiences and current operant stress (both events and chronic problems).
Organisation des soins en psychiatrie gériatrique: Un protocole d'accord technique
Authors: de Mendonça Lima Carlos Augusto , Bertolote José Manoel , Camus Vincent , Wertheimer Jean
Published: January 2017

Ce protocole d'accord, publié originalement en anglais par l'Organisation mondiale de la santé (OMS), a été soutenu par la Section de psychiatrie gériatrique de l'Association mondiale de psychiatrie (AMP). La déclaration finale a été préparée par un groupe interdisciplinaire de représentants des principales associations internationales concernées par le thème en question, lors d'une réunion à Lausanne du 14 au 16 avril 1997, présidée par le Professeur Raymond Levy. Le Professeur Cornelius Katona et le Dr Nori Graham ont été les rapporteurs. Ce protocole est la suite d'un premier document de consensus publié par l'OMS et par l'AMP sur la définition de la psychiatrie de la personne âgée (1).
Comparison of Shoplifting Behaviours in Patients with Eating Disorders, Psychiatric Control Subjects, and Undergraduate Control Subjects
Authors: Goldner Elliot M , Geller Josie , Birmingham C Laird , Remick Ronald A
Published: January 2017

Shoplifting behaviours were examined in an eating disorder group (EDG, n = 48), a psychiatric control group (PCG, n = 46), and an undergraduate control group (UCG, n = 82). They were examined in relation to self-esteem, depression, and eating disorder symptomatology. The 3 groups did not differ in overall history of shoplifting, but EDG women were more likely to have shoplifted in the past 6 months (current shoplifting) and to have shoplifted often than were women from the PCG or UCG. Across all 3 groups, current shoplifting was associated with low self-esteem, elevated depression, and purging behaviours at the time of the assessment. The implications of these findings with regard to the relationship between shoplifting and eating disorder symptomatology will be addressed.
Strategies for Managing Depression Refractory to Selective Serotonin Reuptake Inhibitor Treatment: A Survey of Clinicians
Authors: Mischoulon David , Nierenberg Andrew A , Kizilbash Leena , Rosenbaum Jerrold F , Fava Maurizio
Published: January 2017

Objective:

To examine treatment practices in cases where selective serotonin reuptake inhibitors (SSRIs) are ineffective.

Methods:

We surveyed 801 clinicians (including 630 psychiatrists) attending the Massachusetts General Hospital's annual psychopharmacology review course. Clinicians were presented with a vignette about a patient with depression who had responded partially to an SSRI and were asked to choose among various strategies available to manage this patient.

Results:

Of those surveyed, 466 clinicians had been in practice a mean of 16.6 years (SD 10.7). Not all clinicians chose to answer every question. Among 455 respondents, 84% (n = 382) chose to increase the dose of the SSRI, 10% (n = 47) chose augmentation or combination, and 7%(n = 31) opted for switching agents. When asked to switch to another agent, 448 responded, of whom 52% (n = 235) chose a newer antidepressant, 34% (n = 152) chose another SSRI, 10%(n = 44) chose a tricyclic antidepressant (TCA), 2%(n = 8) chose a serotonin norepinephrine reuptake inhibitor (SNRI), 1% (n = 5) chose a monoamine oxidase inhibitor (MAOI), and 1% (n = 4) chose an undefined “other” agent. Among 445 respondents, bupropion was the most widely chosen augmenting agent (30%, n = 134), followed by lithium (22%, n = 98). West coast and Canadian clinicians preferred to switch to another SSRI rather than to a newer antidepressant. Canadian clinicians preferred lithium to bupropion as their first-choice augmenting agent, as did clinicians from academic settings. Clinicians from community, individual practice, or group settings favoured bupropion. More experienced clinicians preferred bupropion as a first-choice augmenter, whereas less experienced ones showed a slight preference for lithium. Canadian clinicians were more likely to use MAOIs as second-line agents.

Conclusions:

Clinicians in this sample often followed strategies different from those recommended in the literature. Bupropion may have an important role in augmentating treatment with SSRIs.
Physical and Sexual Abuse Issues among Youths with Substance Use Problems
Authors: Ballon Bruce C , Courbasson Christine MA , Psych C , Smith Patrick D
Published: January 2017

Objectives:

To evaluate the prevalence of reported physical and sexual abuse among youths with substance use problems, to explore whether youths report relying on substances to cope with the abuse, and to examine whether individual factors related to substance use were associated with the outcome measures of reported physical abuse, sexual abuse, and using substances to cope.

Method:

We assessed 287 male and female youths (age 14 to 24 years) who presented for help for substance use problems, using a semistructured interview that focused on substance use, history of previous sexual and physical abuse, and coping strategies.

Results:

One-half of the female youth substance abusers reported having been sexually abused (50.0%), while male youth substance users reported a significantly lower rate (10.4%). Similarly, one-half of the female youths had a history of physical abuse (50.5%), and males again had a lower rate (26.0%). Of those who endorsed a history of abuse, more females (64.7%) than males (37.9%) reported using substances to cope with the trauma. Specific associations between the outcome measures and substance use variables were found for youths in both sexes.

Conclusion:

These findings underscore the importance of why clinicians should explore abuse issues with substance-using youth of both sexes. Identifying concurrent factors will help provide better intervention strategies. Suggestions for assessing sexual and physical abuse in youths with substance use disorders are provided.