Eight Italian Regions have begun offering vaccination against varicella to children aged 13-15 months, with a second dose at 5-6 years of age. A serosurvey was conducted to evaluate the impact of extensive vaccination in these "pilot" Regions.

Background: Metabolic syndrome (MS) represents a cluster of cardiovascular risk factors that has become a serious problem for HIV-1-infected patients. It has been proposed that disturbance of phosphate metabolism may represent a key feature of MS. Thus, we undertook the present study to investigate the relationship between phosphate levels and the presence of the characteristics of MS. Methods: One hundred and twenty-one HIV-1-infected patients were consecutively enrolled in a prospective, cross-sectional, single-centre study. Kidney tubular function was examined using tubular resorption of phosphate and normalized renal threshold phosphate concentration. Results: Univariate analysis showed that serum phosphate levels correlated negatively with systolic and diastolic blood pressure, glucose values, waist circumference, insulin, and triglycerides. Moreover, there was a positive relationship between phosphate and high-density lipoprotein (HDL) cholesterol. Multivariate analysis showed that insulin levels were correlated with serum phosphate concentration (r = − 0.24, p = 0.01). Conclusions: Our data show that HIV-1-infected patients with MS have lower phosphate levels.

The Mediterranean diet (MD) is considered one of the healthiest dietary models, as it decreases the risk of chronic diseases and may modulate the organism's early response to environmental pollution. In recent decades, Mediterranean countries have been replacing their traditional diet with other less healthy eating habits, especially among children and teenagers.

Dietary habits of university students were analyzed in order to investigate any differences between students living at and away from home. Two hundred and fifty-eight undergraduate students attending University of Ferrara completed a self-administered questionnaire on demographic characteristics, food frequency consumption habits and body weight perception.

Introduction. This study aimed to estimate the most recent cae- sarean section rates in the world and examine the association between these rates and old and new indicators of health care. Methods. Authors analyzed the CS rates, also in geo-economic and economic groups, and correlated them to maternal and neo- natal mortality, to births attended by skilled health personnel and to births among adolescents. Analysis of covariance and piece- wise regressions were used for the statistical analysis. Results. In 47.2% of the countries, the CS rate exceeded 15%. Countries of Latin America and the Caribbean along with Europe, North America and Oceania had the highest values. The analysis showed an inverse association between CS rates and MMR and NMR for all geographical areas except for Europe. The great- est association was observed in lower-middle-income countries. In developing countries only 50% of cases, occur in medical facilities and only half of these are seen by medical, nursing and obstetrical staff. Age of the mother appears to influence the out- come and choice of delivery type. Countries where an high ABR rate is present have low CS use. Conclusions. To best evaluate the consequences of the increas- ing rate of CS, it would be useful to identify the most sensitive outcome indicators.

BACKGROUND: Human immunodeficiency virus (HIV) infection and antiretroviral treatment are associated with metabolic and cardiovascular complications that potentially increase the risk of atherosclerosis and cardiovascular disease in this population. Measurement of arterial wall thickness has been used as a surrogate of extent, severity and progression of atherosclerosis. A cross-sectional cohort study was performed to compare the validity of two non-invasive arterial measures: carotid intima-media thickness (IMT), a parameter of atherosclerosis, and ophthalmic artery resistance index (OARI), an index of occlusive carotid artery disease. METHODS: A total of 95 patients receiving highly active antiretroviral therapy (HAART) for more than 12 months were consecutively enrolled. IMT and OARI were measured by 7.5 MHz linear probe. RESULTS: There was a significant linear increase in IMT and OARI values as the grade of cardiovascular risk (0.70 and 0.69 for very low risk, 0.86 and 0.72 for low risk and 0.98 and 0.74 for medium/high risk, p < 0.001). A IMT > 0.83 and an OARI > 0.72 were the most discriminatory values for predicting a cardiovascular risk ≥ 10% (sensibility 89.6% and 75.8%; sensitivity 70.5% and 68.4%; p < 0.001). CONCLUSIONS: Our data indicate that OARI may have a potential as a new precocious marker of subclinical atherosclerosis in HIV-1-infected patients.

Rotaviruses are one of the most important causes of gastroenteritis in children under 5 years old. Analysis of G and P rotavirus genotypes in circulation is crucial in evaluating the appropriacy of mass vaccination of children worldwide. Overall, 592 stool samples were collected in Tirana (Albania), the Salento peninsula (South Italy), and three different hospitals in Rome (Central Italy). Of the total samples, 31.3% were rotavirus positive in Albania, 78.3% in the Salento, and 40.3% in Rome. The samples collected in Tirana and Rome were G-P typed, whereas the samples collected in the Salento were only G typed. Overall, in Italy the most frequent combinations were G4 P[8] (54.5%), G1 P[8] (27.3%), and G2 P[4] (18.2%); in Albania they were G9 P[8] (72.1%), G4 P[8] (8.8%), G1 P[8] (5.9%), and G2 P[4] (2.9%). The prevalence in Albania of atypical combinations was 7.4% for G4 P[4] and 2.9% for G9 P[4]. Phylogenetic analysis was also performed to assess the genetic relatedness of the strains.

The purpose of this study was to demonstrate that shellfish can be used to detect enteric viruses in marine waters where they are present at very low concentrations. Aqua-cultured mussels were placed in the sea just off the mouth of a drainage channel affected by human and animal faecal contamination. Samples were taken from the channel, the sea and the mussels at intervals over two 4-week periods. The samples were tested to verify the presence of both rotaviruses and E. coli. Rotaviruses were detected by Real Time-PCR, typed by multiplex PCR and subsequently sequenced. E. coli was enumerated in water matrices by a filtering method and in mussels by the MPN method. The presence of E. coli in the examined matrices demonstrates contamination of faecal origin throughout the studied environments. Rotaviruses were recorded in channel waters, but not in sea water. In both experiments, rotaviruses were detected in mussels 21 and 28 days after being placed in the sea water off the channel mouth. The use of mussels thus enabled the detection of rotaviruses in waters where the high dilution rendered direct investigation impossible. This study indicates that mussels can be used in marine virological surveillance programs. © 2012 Springer Science + Business Media, LLC.

The aim of this study was to assess the eating habits of a group of university students, to highlight any differences between students living at and away from home and to examine aspects of their health and nutritional status. One hundred and ninety-three undergraduate students at the University of Salento (Lecce, Italy) completed a self-administered food habits questionnaire divided into three major sections: demographic, social and cultural characteristics, eating habits, health information. Students living at home got more physical exercise and consumed higher quantities of cooked vegetables, fish, meat products, chips, bread/cereals, pulses, cooked meals and sandwiches. In contrast, students living away from home were characterized by higher consumption of raw vegetables, beer and alcoholic drinks, raw/cold meals, frozen meals and ready meals. Moreover, students living alone reported a greater number of episodes of gastroenteritis and perceived that they had a larger body mass. Student lifestyles and living arrangements were associated with a shift away from the Mediterranean diet and would appear to expose students to the risk of food-borne illness. This appeared more evident among students living away from home, for whom the assumption of primary responsibility for food shopping and preparation can lead to unhealthy dietary habits.

Selective immune adsorption (SIA) is an emerging method for treating immune-mediated neurological diseases, given its superior safety profile compared to plasma exchange (PEX). However, the available literature concerning Multiple Sclerosis includes no cases of SIA applied to steroid-refractory rebound after Fingolimod discontinuation.

In order to elucidate the distribution of Cryptococcus neoformans and C. gattii in the Mediterranean basin, an extensive environmental survey was carried out during 2012-2015. A total of 302 sites located in 12 countries were sampled, 6436 samples from 3765 trees were collected and 5% of trees were found to be colonized by cryptococcal yeasts. Cryptococcus neoformans was isolated from 177 trees and C. gattii from 13. Cryptococcus neoformans colonized 27% of Ceratonia, 10% of Olea, Platanus and Prunus trees and a lower percentage of other tree genera. The 13 C. gattii isolates were collected from five Eucalyptus, four Ceratonia, two Pinus and two Olea trees. Cryptococcus neoformans was distributed all around the Mediterranean basin, whereas C. gattii was isolated in Greece, Southern Italy and Spain, in agreement with previous findings from both clinical and environmental sources. Among C. neoformans isolates, VNI was the prevalent molecular type but VNII, VNIV and VNIII hybrid strains were also isolated. With the exception of a single VGIV isolate, all C. gattii isolates were VGI. The results confirmed the presence of both Cryptococcus species in the Mediterranean environment, and showed that both carob and olive trees represent an important niche for these yeasts.

Background: The aim of our pilot study is to investigate different components of the immune response to influenza vaccination in a group of healthy volunteers. We evaluated the cellular immune response (CD4+ T lymphocytes) by flow cytometry. The humoral immune response was assessed by measuring the serum haemagglutination inhibition antibody response. Methods: Healthy adult donors (n = 18), were vaccinated with a commercially influenza virus vaccine (FLUARIX® GlaxoSmithKline S.p.a. Verona, Italy), peripheral blood was drawn the same day as influenza virus vaccination and one month later in order to enumerate the antigen-specific CD4+ T lymphocytes. Hemagglutination inhibition assay was performed to enumerate the titer of neutralizing antibodies. Samples of nasal-pharyngeal secretions were taken by swabbing, from ILI (Influenza like Illness) subjects among the studied group, in order to verify influenza infections and eventually identify viruses using Real Time PCR. Results and Conclusions: Parenteral influenza vaccination results in significant increase in the CD4+ Th cell population after vaccination. The number of pre-vaccination CD4+ T cells was 0.018 [the results are presented as number of percent fluorescent cells per 10 000 lymphocytes (fixed cells)], while there was a significantly higher number of CD4+ Th cells one month after vaccination (statistical significance was set at the level of α = 0.01). Twenty-two percent of patients demonstrated protective antibody levels to influenza A H1/N1 serotype. None was diagnosed with influenza type A or B.

The prevalence of Rotavirus (RV)-related gastroenteritis in Cameroon was monitored in this study, identifying the circulating G-P types, and the presence of co-infection with intestinal parasites. The stool samples were examined for rotaviruses using chromatographic and molecular techniques, and parasites were identified by macroscopic and microscopic examination. 38% of samples were RV positive. Data revealed the presence of three different G-genotypes (G1, G2 and G8) and three Pgenotypes (P [8], P[6] and P[4]). The main G-P combination was G1+G2P[8]. Entamoeba histolytica was identified in 44.4% of stool samples. The G2P[8] genotype identified is an unusual strain with the G1P[8] or G2P[4] more common. Genotype G8 strains, also associated with animals, have been sporadically recovered from humans and have been considered for inclusion in bovine-human reassortant vaccine. Epidemiological RV strain surveillance should be continued in order to support RV vaccination campaigns. The results also show a high prevalence of intestinal parasite infections.

The MAPEC-Life project aims to study the biological effects of early exposure to air pollutants on the oral mucosa cells of school-age children in five Italian cities. A questionnaire was created to evaluate the association between outdoor and indoor airborne pollutants, lifestyle, diet and biomarker effects. The feasibility and reliability of the questionnaire were evaluated.

Artemisia annua tea has been proven to be a very effective treatment for malaria in various clinical trials, but to date its efficacy has not been investigated in vitro. A study was therefore performed to evaluate the effects of A. annua tea on Plasmodium falciparum cultures in vitro. The concentration of artemisinin in the herbal tea preparation was also determined. The herbal tea extract was tested against chloroquine (CQ)-sensitive D10 and CQ-resistant W2 strains of P. falciparum using the parasite lactate dehydrogenase assay. Quantification of artemisinin in the extract of leaves of A. annua was performed using proton nuclear magnetic resonance (1H-NMR). Results of the in vitro tests were consistent with the clinical efficacy of A. annua tea [50% inhibitory concentration (IC50) for strain D10=1.11±0.21μg/ml; IC50 for strain W2=0.88±0.35μg/ml]. The concentration of artemisinin in A. annua tea (0.18±0.02% of dry weight) was far too low to be responsible for the antimalarial activity. The artemisinin present in the tea is probably co-solubilised with other ingredients, some of which also have antimalarial activity and act synergistically with it. These compounds also merit further research to determine whether their presence hinders the development of parasite resistance compared with pure artemisinin.

The aim of the study was to evaluate if and how varicella prevalence has changed in Italy. In particular a seroprevalence study was performed, comparing it to similar surveys conducted in pre-immunization era. During 2013-2014, sera obtained from blood samples taken for diagnostic purposes or routine investigations were collected in collaboration with at least one laboratory/center for each region, following the approval of the Ethics Committee. Data were stratified by sex and age. All samples were processed in a national reference laboratory by an immunoassay with high sensitivity and specificity. Statutory notifications, national hospital discharge database and mortality data related to VZV infection were analyzed as well. A total of 3707 sera were collected and tested. In the studied period both incidence and hospitalization rates decreased and about 5 deaths per year have been registered. The seroprevalence decreased in the first year of life in subjects passively protected by their mother, followed by an increase in the following age classes. The overall antibody prevalence was 84%. The comparison with surveys conducted with the same methodology in 1996-1997 and 2003-2004 showed significant differences in age groups 1-19 y. The study confirms that in Italy VZV infection typically occurs in children. The impact of varicella on Italian population is changing. The comparison between studies performed in different periods shows a significant increase of seropositivity in age class 1 - 4 years, expression of vaccine interventions already adopted in some regions.

The aim of the present study was to determine the epidemiology of jellyfish stings in the Province of Lecce (Italy) in the bathing seasons of years 2007-2011, in order to estimate the presence of these organisms along the coast of the Salento and assess its socio-health implications. The study involved the gathering and processing of data on patients seeking medical treatment at summer first aid centres and hospitals along the coast of the Salento following contact with jellyfish. The analysis of reports showed that in the period 2007-2011 1733 stung bathers sought medical assistance, accounting for 3% of all medical services provided at first aid centres. In addition, jellyfish stings were observed to be the main cause of human pathologies arising from contact with marine organisms. 25.7% of total cases were reported in summer 2007, 22.5% in 2008, 24.7% in 2009, 17.6% in 2010 and 9.5% in 2011. The spatial distribution indicates a greater frequency of stings sustained along the Adriatic coast (65%); this trend is related to wind direction. Most of the injuries were seen in persons aged between 1 and 10. In the majority of cases the symptoms were not severe, being confined to local and cutaneous reactions. In 8.7% of cases however, there were complications, mainly allergic reactions (6.2%). The main drugs used are corticosteroids, locally applied and systemic (46% and 43%, respectively), while non-pharmacological treatments mainly consisted of rinsing with ammonia (74%). In the five-year period under study, an average of 8.1 cases/km of coastline was recorded, ranging from a maximum of 18.4 cases/km along the Adriatic coast to a minimum of 2.6 cases/km on the Lower Ionian, with an estimated cost of the health services provided of about 391,658 Euros. Overall, a slightly decreasing trend of jellyfish stings was observed from 2007 to 2011 along the coasts of Salento. Nevertheless, in the light of the significant economic costs and the socio-health impact reported in this study and given the importance of the bathing tourism in the Salento, there is a need to identify suitable strategies that will guarantee the best response in terms of both prevention and treatment.

Human bocavirus (HBoV) is a parvovirus isolated about a decade ago and found worldwide in both respiratory samples, mainly from early life and children of 6-24 mo of age with acute respiratory infection, and in stool samples, from patients with gastroenteritis. Since then, other viruses related to the first HBoV isolate (HBoV1), namely HBoV2, HBoV3 and HBoV4, have been detected principally in human faeces. HBoVs are small non-enveloped single-stranded DNA viruses of about 5300 nucleotides, consisting of three open reading frames encoding the first two the non-structural protein 1 (NS1) and nuclear phosphoprotein (NP1) and the third the viral capsid proteins 1 and 2 (VP1 and VP2). HBoV pathogenicity remains to be fully clarified mainly due to the lack of animal models for the difficulties in replicating the virus in in vitro cell cultures, and the fact that HBoV infection is frequently accompanied by at least another viral and/or bacterial respiratory and/or gastroenteric pathogen infection. Current diagnostic methods to support HBoV detection include polymerase chain reaction, real-time PCR, enzyme-linked immunosorbent assay and enzyme immunoassay using recombinant VP2 or virus-like particle capsid proteins, although sequence-independent amplification techniques combined with next-generation sequencing platforms promise rapid and simultaneous detection of the pathogens in the future. This review presents the current knowledge on HBoV genotypes with emphasis on taxonomy, phylogenetic relationship and genomic analysis, biology, epidemiology, pathogenesis and diagnostic methods. The emerging discussion on HBoVs as true pathogen or innocent bystander is also emphasized.

We have studied the occurrence of hBoV, hMPV and InfA-B in an Apulian population with respiratory tract infections. During influenza season 2008-2009, 116 oropharingeal swabs were collected from patients affected by Influenza-Like Illness (ILI). The PCR products of hMPV M and HBoV NP-1 genes were sequenced. 78 out of 116 samples were positive for at least one respiratory virus; hBoV was detected in 53, hMPV in 22 and InfA-B in 41 out of 116 swabs. A high rate of hBoV infection in adult (18.9%) and elderly (26.4%) subjects was found. The co-infection rate was higher for hMPV (18/22 cases, 81.8%) compared to hBoV (26/53 cases, 49.1%), and InfA-B (25/41 cases, 61.0%). Co-infections were common in children. hBoV positive samples shared a high level of genetic similarity with the hBoV1 genotype, and hMPV positive samples clustered with A2 subgroup. Our results suggest that hBoV and hMPV play a role in ILI.

SUMMARY. Hepatitis E virus (HEV) is considered an emerging pathogen in industrialized countries. The occurrence of HEV genotypes in samples of faeces from asymptomatic migrants arriving on the coasts of South Italy and environmental samples was investigated. Analyses of sequences were used to compare human and environmental genotypes. A total of 40 stool specimens, 12 samples of untreated urban sewage, 12 samples of treated urban sewage and 12 samples of surface water were analysed. Viruses were concentrated from water samples by the tangential flow ultrafiltration technique. The presence of HEV RNA was detected by nested RT-PCR. Viral isolates were sequenced and phylogenetically characterized. Two (5%) of the 40 faecal samples tested were found to be positive for HEV RNA (G1 and G3 genotypes). The virus was detected in 25% (3/12) of the untreated sewage samples and 25% (3/12) of the surface water samples: all isolates belonged to G3 genotype. None of the treated sewage samples were found to be HEV RNA positive. The virus was detected in the faeces of two asymptomatic subjects, suggesting a potential role for symptom-free HEV carriers as a human reservoir. G3 HEV strains were detected in the untreated sewage, as observed in similar studies conducted in other European countries but differing from another study conducted in Italy recently. Moreover, our results show the first case of HEV isolated from fresh surface waters.

Stinging jellyfish outbreaks represent a health hazard, causing contact dermatitis and systemic reactions. This study investigated the epidemiology, severity, and treatment protocols of jellyfish stings in a coastal area with high tourist development and frequent stinging jellyfish outbreaks of the central Mediterranean (Salento, Southern Italy), and the associated costs for the Italian National Health Service. In 2007–2011, 1,733 bathers (mostly children and females) sought medical assistance following jellyfish stings, the main cause of human pathologies due to contact with marine organisms. The majority of events were reported in the years 2007–2009, whereas the occurrence of cnidarian jellyfish outbreaks has been increasingly reported in the same area since summer 2010. Most symptoms were limited to local and cutaneous reactions; conversely, 8.7% of cases evoked complications, mainly due to allergic reactions. The main drugs used were corticosteroids, locally applied and systemic (46% and 43%, respectively), and with ammonia (74%) as the main non-pharmacological treatment. The estimated cost of jellyfish-related first-aid services along the Salento coastline over the 5-year period was approximately 400,000 Euros. Therefore the management of jellyfish outbreak phenomena need coordinated research efforts towards a better understanding of underlying ecological mechanisms, together with the adoption of effective prevention policy, mitigation strategies, and appropriate planning of health services at tourist hot spots.

Background: General and visceral adiposity are metabolic conditions associated with a state of chronic inflammation. In HIV1+ patients, visceral adiposity (VO) is a serious complication that predisposes to an increased risk of cardiovascular diseases. IL-17 has been associated with induction of tissue inflammation by up-regulation of IL-23. The aim of this study was to evaluate the role of IL-17 in visceral tissue in HIV1+ patients. Methods: eighty-two HIV1+ patients (41 with VO, Group-A; 41 without VO, Group-B) and 32 HIV1- controls (22 with VO, Group-C; 10 without VO, Group-D) receiving Highly-Active-Antiretroviral-Therapy (HAART) for more 12 months, were enrolled. Sonographically measured Perirenal Fat Diameter/Body Mass INdex was used to assess thickness of visceral adipose tissue using 3.75MHz convex probe. A value >0.22 was considered an index of central obesity. Metabolic parameters as well as IL-17 and IL-23 levels were measured. The association of IL-17 with PRFD/BMI and IL-23 was analyzed. Results: IL-17 serum levels in HIV1+ patients were significantly greater than those in control (837.86±260.06 pg/mL vs 377.36±144.76 pg/mL, p<0.001). IL-17 serum levels in Group A and C were lower than those in Groups B and D (756.98±282.98 and 344.44±138.94 vs 918.74±208.47 and 449.77±136.62 respectively; p<0.001) (Figure 1). For all subjects a statically significant positive correlation between IL-17 and IL-23 was found (r=0.7504; p< 0.0001). Conclusions: Our preliminary data could confirm a pro-inflammatory role of IL-17 in immune and adaptive response to host defense. The findings suggest a potential implication for IL-17 in obesity and describe emerging data regarding the role of IL-17 in adipogenesis.

Con questo corposo volume, il Liceo Classico Statale “Francesca Capece” di Maglie (LE) dimostra la propria vivacità culturale, grazie ai contributi di personale e contatti esterni, per una scuola che sia aggiornata e promotrice della crescita degli alunni e del territorio.

Lifestyles profoundly determine the quality of an individual's health and life since his childhood. Many diseases in adulthood are avoidable if health-risk behaviors are identified and improved at an early stage of life. The aim of the present research was to characterize a cohort of children aged 6-8 years selected in order to perform an epidemiological molecular study (the MAPEC_LIFE study), investigate lifestyles of the children that could have effect on their health status, and assess possible association between lifestyles and socio-cultural factors.

To assess the burden of regional environmental factors influencing the incidence of Melanoma in the Italian population and overcome the problem of partial population coverage by local cancer registries and thematic archives.

Aquaculture is an enterprise in constant development, in particular relating to its effect on the environment and also the quality of its products. It represents a valid alternative to traditional fishing, facing the increasing demand for fish products. To guarantee to the consumer a product of high nutritional, organoleptic and hygienic quality, it is fundamental to monitor every phase of the fish farming industry, isolating the potential risk points. For this reason there has been a rapid evolution of productive technique, particularly in the technology, artificial reproduction and feed sectors. The aim of this research has been the monitoring of the evolution of certain microbial and nutritional quality indexes (total microbial counts and lipid analysis on suspensions of Rotifers and Artemia, used as live feed) in the larval phase of the productive cycle of the farm raised fish, in an intensive system. The study has shown an increment in the total microbial counts in the fish farming industry within the production of Rotifers and Artemia, more evident in the suspensions of Rotifers. In addition the study has demonstrated that the maintenance phase, in the enrichment protocol, can reduce the EPA and DHA content. The results confirm the importance of microbial and nutritional control of the live feeds before they get supplied to fish larvae.

Introduction. Sepsis is a major cause of significant morbidity and mortality in neutropenic patients. Blood culture remains the gold standard in the microbiological diagnosis of bacterial or fungal bloodstream infections, but it has clear limits of rapid- ity and sensitivity. The objective of the study was to compare the real-time polymerase chain reaction (RT-PCR) with auto- mated blood cultures (BC) method in detection in whole blood of pathogens in febrile neutropenic patients with hematological malignancies. Methods. A total of 166 consecutive febrile neutropenic patients were enrolled. Blood samples for cultures and SeptiFast testing were obtained at the onset of fever, before the implementation of empirical antibiotic therapy.

Genotoxic biomarkers have been studied largely in adult population, but few studies so far have investigated them in children exposed to air pollution. Children are a high-risk group as regards the health effects of air pollution and some studies suggest that early exposure during childhood can play an important role in the development of chronic diseases in adulthood. The objective of the project is to evaluate the associations between the concentration of urban air pollutants and biomarkers of early biological effect in children, and to propose a model for estimating the global risk of early biological effects due to air pollutants and other factors in children.

Introduzione L'inquinamento atmosferico rappresenta una delle più rilevanti cause di malattia in tutto il mondo. Diversi studi hanno trovato un'associazione consistente tra l'esposizione all'inquinamento atmosferico, soprattutto al particolato, e l'incidenza di diverse malattie croniche come il cancro al polmone, le malattie cardiovascolari e il diabete. Tra i meccanismi responsabili di questi effetti negativi, il danno genotossico è particolarmente importante. Anche se l'intera popolazione è esposta all'inquinamento atmosferico, alcune categorie, in particolare i bambini, hanno un rischio maggiore di subire le conseguenze delle sostanze tossiche disperse nell'aria. Dati recenti suggeriscono che le alterazioni genetiche che si verificano nei primi anni di vita possono aumentare il rischio di cancerogenesi in età adulta. I biomarcatori di danno genetico sono stati studiati in gran parte della popolazione adulta, ma solo pochi studi finora sono stati condotti sui bambini esposti all'inquinamento atmosferico. L'obiettivo dello studio MAPEC_LIFE (Monitoring Air Pollution Effects on Children for Supporting Public Health Policy) [1] è di valutare l'associazione tra la concentrazione di alcuni inquinanti atmosferici e gli effetti biologici precoci in bambini residenti in cinque città italiane (Brescia, Torino, Lecce, Perugia and Pisa) caratterizzate da differenti livelli di inquinamento atmosferico. Gli autori presentano i risultati del test dei micronuclei (MN) condotto sulle cellula della mucosa orale dei soggetti residenti a Lecce in relazione agli stili di vita e a fattori associati all'esposizione indoor/outdoor comprendenti il livello di PM10 e PM0,5, il contesto familiare e residenziale, l'attività fisica e lo stato ponderale.

To determine the abundance and species composition of luminous bacteria in the coastal waters of the southern Adriatic Sea (Otranto, Italy), samples were collected from three sites affected by different degrees of anthropogenic pollution. A total of 116 strains of marine luminous bacteria were isolated and subjected to phenotypic characterization, which included 36 biochemical tests. Numerical analysis of the data revealed five clusters with > 86% similarity, which were readily identified as Photobacterium leiognathi, Vibrio fischeri, Vibrio harveyi, Vibrio splendidus biovar I, and Shewanella hanedai. The relative abundance of each species shows that culturable luminous bacteria in the monitored waters are composed mainly of V. harveyi (69.0%), followed by V. fischeri (13.8%) and P. leiognathi (12.1%). In addition, human activity appears to affect the total abundance of luminous bacteria but not the selection of individual species, since the frequencies of the bacteria were similar at all examined sites.

Abstract: Persistent infection of High Risk (HR) Human papillomavirus (HPV) infection can lead to cervical cancer. The HPV genotypes are found worldwide, but important regional variations have been found. For a population-based HPV type prevalence study to assess the effect of existing and new prevention methods, frequently updated information on thè burden of cervical cancer is essential. We evaluated thè prevalence of HPV genotypes in a volunteer population screened for cervical cancer at the Local Health Unit (LHU) of Lecce. A total of 9,720 women were studied. The tests were performed by INNO-Lipa HPV genotyping and LINEAR ARRAY HPV Genotyping Test. The overall HPV prevalence was 29.7% (95% CI, 28.8-30.6) for any HPV DNA. The prevalent type for ali age groups was HPV 16 (7.4%; CI, 6.9-7.9) followed by HPV 31 (3.4%; CI, 3.0-3.7), 51 (3.0%; CI, 2.6-3.3), 52 (2.7%; CI, 2.3-3.0) and 58 (2.4%; CI, 2.1-2.7). HPV 53 was thè most common low-risk HPV type with prevalence rate of 3.5 (CI, 3.1-3.8), followed by HPV 66 (3.0; CI, 2.6-3.3), 6 (2.9; CI, 2.6-3.2) and 42 (2.5; CI, 2.2-2.8). Multiple infections were present in 13.6% of HPV-tested women (CI, 12.9-14.3). Among these, thè most common combination was of HPV 16 and HPV 52 genotypes. This study reports high prevalence of HPV infection and may serve as a valuable reference for assessing thè impaci of HPV vaccination programs. Furthermore, it supports the need for new vaccines that contain the most common HPV genotypes present in the population.

A. annua was usually used to prepare a tea and if it contains effective amounts of artemisinin, it might be used today as a self-reliant treatment of malaria [1]. Artemisia annua tea has proven itself to be a very effective treatment for malaria in various clinical trials, but to date, his efficacy has not been investigated in vitro. Therefore, we have carried out a study for the evaluation of effects of A. annua tea on Plasmodium falciparum cultures in vitro. We also determined the concentration of artemisinin in herbal tea preparation. The compound was tested against chloroquine-sensitive D10 and chloroquine-resistant W2 strains of P. falciparum using the parasite lactate dehydrogenase assay [2]. The quantification of artemisinin in the extract of leaves of A. annua was obtained using an 1H NMR method. The in vitro tests conducted in this study confirm the clinical efficacy demonstrated by the tea of A. annua in vivo on both chloroquine-sensitive D10 and chloroquine-resistant W2 strains. The concentration of artemisinin in A. annua tea is lower with respect to that of pure artemisinin responsible for the same antimalarial activity. The artemisinin present in the tea is probably co-solubilised with other ingredients, some of which may also have antimalarial activity and act synergistically with it. The presence of other active ingredients suggests that A. annua is a natural artemisinin combination therapy. These compounds also merit further research, to see whether their presence hinders the development of parasite resistance compared to pure artemisinin [3]. [1] C.H.Blanke, G.B.Naisabha, M.B.Balema, G.M.Mbaruku, L.Heide and M.S.Muller, Trop. Doct., 38, 2008, 113–6. [2] M.T.Makler, J.M.Ries, J.A.Williams, J.E.Bamcroft, R.C.Piper, B.L.Gibbins, et al, Am.J.Trop.Med.Hyg., 48(6), 1993, 739-41. [3] Work supported by Regione Puglia Progetto Strategico PS70.

Environmental monitoring was conducted in Otranto (Italy), from January 2006 to April 2007, to monitor the circulation of rotaviruses in various water matrices (raw and treated sewage, surface waters and seawater) and to identify any correlation with the traditional bacteriological indices (faecal coliforms). The viruses were detected using tangential flow ultrafiltration and reverse transcriptase-nested polymerase chain reaction, whilst detection of feaecal coliform was performed according to standard methods. The results showed widespread viral contamination, particularly in spring, of the matrices tested, with the exception of seawater, which at all times tested negative for the presence of rotaviruses. The typing of the rotavirus strains identified the circulation in the studied area of only two genotypes: G1 (22%) and G2 (78%). The bacterial recoveries confirmed the presence of faecal pollution indicators in all examined samples, sometimes with high values. A very weak correlation was found between the presence of faecal coliforms and the circulation of rotaviruses in the environment. The presence of rotaviruses in the environmental water samples may constitute a potential health risk for the local population

The purpose of this study was to evaluate ‘‘in field’’ the accumulation of virus in shellfish and compare it with the concentration of bacterial indicators. Individuals of Mytilus galloprovincialis were placed in two sampling station located in a contaminated coastal bay and in one control station located one kilometer offshore. The presence of Rotavirus and E. coli was assessed weekly both in seawater and in shellfish samples. The Rotavirus genome was detected in water, preliminarily concentrated by tangential flow ultrafiltration method, and in hepatopancreas of mussels by Real-Time PCR. E. coli was enumerated in water matrices by a filtering method and in mussels by the MPN method. Rotaviruses were not recorded in seawater, while in mussels they were detected since third week after placement. E. coli in mussels were always below the limits set in the Regulation (EC) 854/2004. This study suggests the need for a viral indicator to insure the safety for consumption of shellfish.

Problems affecting the vaginal tract in diabetic women are very often neglected. The efficacy and safety of three gynecological treatments in diabetic women have been assessed. Materials and Methods: A single-blind randomized progressive trial on 48 diabetic women affected by vaginal dryness, dyspareunia, and recurrent Candida infections was carried out. The ICIQ Vaginal Symptoms (ICIQ-VS) questionnaire was administered. Results: The analysis of the parameters of ICIQ-VS questionnaire among the three groups showed significant difference only for "dragging pain" (p = 0.019) and "soreness" (p = 0.028). In all groups and for all parameters of the questionnaire, improvement of symptoms was observed. In particular, in Group 1 for all symptoms a highly significant difference was observed, to support the already known benefits of the products and of the proposed combination. Significant improvement was also observed in Group 2. Conclusions: The proposed treatment with DermoXEN® Ultracalming Special for diabetics and DermoXEN® Vitexyl vaginal gel exert effective moisturizing and soothing action. Indeed, the aforementioned products have been proven effective for the main gynecological problems of diabetic women.

The surveillance and monitoring of rotavirus (RV)-related diseases, preferably through the establishment of sentinel surveillance sites, are essential for assessing the need for vaccination and the projected results of the vaccine in terms of reducing the burden of disease. The objective of the present study was to compare RV strains isolated in Northern (Ferrara) and Southern (Galatina-LE) Italy. During 2007–2008, 115 RV-positive stool samples were collected from children with diarrhea admitted to the hospitals of Ferrara and Galatina. The specimens were genotyped for VP7 (G-type) and VP4 (P-type) gene by reverse transcription (RT) and multiplex polymerase chain reaction (PCR). A subset of 21 RV strains was randomly selected and characterized by sequence analysis of the VP7 genes. In total, seven G/P combinations (G1P[8], G2P[4], G4P[8], G9P[8], G2P[8], G1P[9], and G2P[10]) were identified. Phylogenetic comparison of the VP7 encoding gene of selected strains showed that there was similarity among RV strains circulating in Northern and Southern Italy. The observation of nucleotide sequence diversity contributes to a better understanding of RV spreading and helps to characterize the various antigenic shifts that could have an impact on vaccine effectiveness.

A serological survey was performed to determine the prevalence of antibodies against human bocavirus in Apulian population. Anti-hBoV IgG antibodies were analyzed in 1,206 inhabitants (Age range: 1 month-84 years) using a standardized ELISA test based on the use of recombinant hBoV VP2 virus-like particles. In total, 1,075 (89.1%) of 1,206 participants (mean age 32±24.8 yrs) displayed anti-hBoV-IgG. The seroprevalence increased significantly (p<0.0001) in children from 2-4 yrs (64.2%) to 5-9 yrs (96.4%). A similar trend was observed in both males and females. In conclusion, our results show that hBoV infection is common in population, especially in children.

The prevalence of obesity among Italian children has reached such alarming levels as to require detailed studies of the causes of the phenomenon. A cross-sectional study was carried out in order to assess the weight status of 1164 Italian children aged 6-8 years (the Monitoring Air Pollution Effects on Children for Supporting Public Health Policy (MAPEC_LIFE) cohort) and to identify any associations between selected socio-economic and environmental factors and overweight/obesity. The data were obtained by means of a questionnaire given to parents, and any associations were examined by binomial logistic regression analyses. Overweight was found to be positively associated with male gender, parents of non-Italian origin, and parents who smoke, and negatively associated with the parents' level of education and employment. In addition, the frequency of overweight varied in relation to the geographical area of residence, with a greater prevalence of overweight children in the cities of central-southern Italy. This study highlights the need to implement appropriate obesity prevention programs in Italy, which should include educational measures concerning lifestyle for parents from the earliest stages of their child's life.

Assessment of protozoan populations is an important tool in evaluating the efficiency of activated sludge in the treatment of wastewater. In this process, protozoa play a significant role by grazing on dispersed bacteria, supporting a healthy food web in activated sludge artificial ecosystems. The objective of this study was to verify how the success of the purification process in activated sludge plants, mainly in terms of TSS, BOD, and COD, is related to ciliate protozoa communities and the presence of filamentous bacteria. Samples were collected from five water treatment plants in the Puglia region, in the period May 2007 - April 2008. Microfauna and filamentous bacteria were identified and quantified, and the sludge biotic index calculated. The data show a correlation between the biological components of activated sludge and traditional chemical parameters. Our results indicate that biological analyses represent a valid alternative to traditional chemical testing in assessing the performance of activated sludge systems.

The aim of this study was to evaluate the presence of influenza virus co-infections in humans and changes in the genetic variability of A(H3N2) virus strains in southern Italy from 1999 to 2009. A partial sequence of the haemagglutinin (HA) gene by human influenza H3N2 strains identified in oropharyngeal swabs from patients with influenza-like illness was analysed by DNA sequencing and a phylogenetic analysis was performed. During the seasons 1999–2000, 2002–2003, 2004–2005 and 2008–2009, the influenza viruses circulating belonged to subtype H3N2. However, A(H1N1) subtype virus and B type were respectively prevalent during the 2000–2001, 2006–2007, 2007–2008 and 2001–2002, 2003–2004, 2005–2006 seasons. The HA sequences appeared to be closely related to the sequence of the influenza A vaccine strain. Only the 2002–2003 season was characterized by co-circulation of two viral lineages: A/New York/55/ 01(H3N2)-like virus of the previous season and A/Fujian/411/02(H3N2)-like virus, a new H3 variant. In this study, over the decade analysed, no significant change was seen in the sequences of the HA gene of H3 viruses isolated.

Background: Varicella is predominantly a childhood disease, considered a mild self-limiting disease that can have serious complications for a pregnant woman and her developing fetus. Objectives: We investigated the susceptibility to varicella-zoster Virus (VZV) among pregnant women in the province of Lecce. Study design: A cross-sectional study was carried out in Departments of Gynecology and Obstetrics of the Province of Lecce, where 539 pregnant women were recruited, and face-to-face interviews were conducted. Varicella IgG tests were performed. Results: The prevalence of varicella susceptibility among pregnant mothers was 10.6%. The prevalence of IgG antibodies increases significantly with increasing age, from 62.5% in the age group 15–19 years to 94.4% in the age group 40–49 years. Discussion: In the Italian National Vaccination Plan 2005–2007, varicella vaccine is only recommended for childbearing women. A safe and effective vaccine is available and no abnormalities have been observed among infants born to susceptible women who received varicella vaccines during pregnancy. Such a high number of susceptible women indicates that preventive and informative programs should be introduced, even among those who do not plan to become pregnant. Routine counselling, varicella IgG antibody screening and varicella vaccination should be considered if they have no history of the infection, to reduce the risk of fetal complications and the cost of healthcare associated with the infection.

Some quinoline-based compounds bearing a ferrocenyl unit in the 2-position of the heterocyclic system were synthesized from ferrocenyl-o-nitrochalcones through a simple hydrogenation/intramolecular cyclization sequence and fully characterized. The obtained ferrocenyl derivatives were evaluated in vitro as antimalarial agents against chloroquine-susceptible D10 and chloroquine-resistant W2 strains of Plasmodium falciparum and a beneficial effect of the organometallic moiety was evidenced in comparison with the phenyl-substituted analogues. All the ferrocenyl heterocycles inhibited the parasite growth in mM range and the lowest values of IC50 were determined for derivatives containing a dimethylamino group as additional substituent.

Clinical and epidemiological surveillance of influenza and other Acute Respiratory Infections (ARI) are currently amajor objective of PublicHealth. The aim was to describe the epidemiology of influenza using the Italian surveillance system. Vaccination Coverage (VC) rates were calculated during 1999-2009 influenza seasons. Molecular studies of influenza virus isolated, from patients with ILI, living in Apulia, are described. 1269 nasal-pharyngeal swabs were taken from patients with ILI and ARI in order to isolate and identify viruses using PCR. Influenza isolates are typed as being types A and B and influenza A isolates are A/H1 and A/H3. The progression of the ILI cases registered in Apulia was similar to the data recorded on a national level. The VC data recorded in Apulia showed a progressive increase in the vaccine doses administered to subjects over 65 years old. The virological surveillance showed a major circulation of the type A/H3N2 influenza virus during the peak incidence of the illness in seasons 1999-2000, 2002-2003, 2004-2005 and 2008-2009. During the same period, the lowest incidence was registered when the type A/H1N1 and B viruses were in circulation. In contrast, during the other seasons the lowest incidence was reported with A/H3N2 and B viruses

Background: The aetiology of multiple sclerosis (MS) remains unknown. This hampers molecular diagnosis and the discovery of bio-molecular markers. Consequently, MS diagnostic procedures are complex and criteria for assessing therapeutic efficacy are controversial, suggesting that a pathophysiological rather than an aetiological approach to the disease would be more appropriate. In this regard, blood-proteomics represents a still-unexplored tool. We investigated the potential of proteomics as applied to peripheral blood mononuclear cells (PBMCs) for differentiating treatment-naive RR-MS patients from healthy controls and from IFN-treated RR-MS patients. Methods: A comparative analysis of PBMC proteins isolated from 13 unselected IFN-treated RR-MS patients, 6 IFN-untreated RR-MS patients and 14 matched healthy controls was performed using two-dimensional gel electrophoresis and MALDI-TOF mass spectrometry. We considered the volume of each spot, expressed as a percentage of the total volume of all spots in the gel. Heuristic clustering was applied to a composite population made up of a random sequence of gels from the different groups in comparison. For the differentially expressed proteins, we applied the Student's t-test to identify only those down- or up-regulated at least 2.5-fold [Ratio(R) ≥ 2.5] with respect to the homologous spots of the compared groups. Results: Rho-GDI2, Rab2 and Cofilin1 were found to be associated with down-regulated and naïve group phenotypes; Cortactin and Fibrinogen beta-Chain Precursor were found to be associated with down-regulated and group-related IFN-treated RR-MS phenotypes. Thus, by means of similarity analysis, the proteomes were homogeneously segregated into three distinct groups corresponding to naive, IFN-treated and healthy control subjects. Interestingly, no separation was found between IFN-treated and healthy controls. Moreover, the molecular phenotypes were consistent with disease pathogenesis. Conclusions: We demonstrated for the first time, albeit only with preliminary data, the aprioristic possibility of distinguishing naive and IFN-treated MS groups from controls, and naive from IFN-treated MS patients using a blood sample-based methodology (i.e. proteomics) alone. The functional profile of the identified molecules provides new pathophysiological insight into MS. Future development of these techniques could open up novel applications in terms of molecular diagnosis and therapy monitoring in MS patients.

Universal varicella vaccination in Sicily was introduced in infant population since 2003, with a rapidly increasing coverage. Aim of the present study was to analyze changes in the epidemiology of varicella since the introduction of universal vaccination.

Optic nerve sheath diameter quantification by transbulbar B-mode sonography is a recently validated technique, but its clinical relevance in relapse-free multiple sclerosis patients remains unexplored. In an open-label, comparative, cross-sectional study, we aimed to assess possible differences between patients and healthy controls in terms of optic nerve sheath diameter and its correlation with clinical/paraclinical parameters in this disease. Sixty unselected relapse-free patients and 35 matched healthy controls underwent transbulbar B-mode sonography. Patients underwent routine neurologic examination, brain magnetic resonance imaging and visual evoked potential tests. The mean optic nerve sheath diameter 3 and 5 mm from the eyeball was 22-25% lower in patients than controls and correlated with the Expanded Disability Status Scale (r = -0.34, p = 0.048, and r = -0.32, p = 0.042, respectively). We suggest that optic nerve sheath diameter quantified by transbulbar B-mode sonography should be included in routine assessment of the disease as an extension of the neurologic examination.

OBIETTIVI: Le scarse precipitazioni e l’assenza di riserve idriche superficiali, parallelamente alla crescente richiesta idrica nel settore civile e produttivo, hanno determinato, nelle aree centrali del Salento ed in particolare nella Grecia Salentina, l’incremento dello sfruttamento della falda profonda. Contemporaneamente si sono registrati fenomeni di antropizzazione del territorio individuabili nell’urbanizzazione delle zone rurali, nell’introduzione di tecnologie di produzione agricola sempre più intensiva e nell’industrializzazione, che sommati alla vulnerabilità intrinseca degli acquiferi profondi, hanno determinato un potenziale impatto negativo sulla qualità delle acque con possibili conseguenze sanitarie ed economiche. L’obiettivo dello studio è stato quello valutare lo stato microbiologico delle risorse idriche profonde nella Grecia Salentina e identificare eventuali criticità determinate da fattori di rischio presenti sul territorio. METODI: Il metodo di riferimento adottato in questo studio è stato il modello concettuale DPSIR secondo cui i fattori antropici (D) esercitano pressioni (P) sull’ambiente tali da modificarne lo stato di qualità (S) e produrre impatti negativi (I) sulla salute umana e sugli ecosistemi, per cui vengono richieste delle risposte (R) di tutela ambientale. Pertanto, oltre alla valutazione dello stato microbiologico delle risorse idriche profonde, sono stati presi in considerazione indicatori ambientali relativi a caratteristiche idrogeologiche, aspetti demografici, sociali ed economici, consumo idrico, produzione di fattori inquinanti, aspetti sanitari dell’ambiente e della popolazione, strategie di tutela dell’ambiente. RISULTATI E CONCLUSIONI: I risultati hanno evidenziato uno stato microbiologico eterogeneo riconducibile ad una contaminazione di origine fecale, elevata e diffusa in gran parte del territorio, durante l’estate e modesta e puntiforme nel corso delle altre stagioni. In alcune aree i fenomeni di degrado sono particolarmente evidenti a causa della presenza di fattori antropici che, in associazione alla vulnerabilità del territorio, determinano condizioni di pericolo tali da compromettere la salubrità delle risorse idriche: insediamenti abitativi extraurbani ad uso prevalentemente estivo, non serviti dalla rete fognaria; aree urbane con basso numero di allacci fognari; depuratori sottodimensionati; aree industriali. Lo stato sanitario delle acque profonde ne condiziona la loro fruibilità sia per scopi potabili che per quelli irrigui. Tali circostanze impongono la tempestiva realizzazione di interventi finalizzati al recupero della situazione di degrado e ripristino degli standards minimi di qualità ambientale.