Distribution and abundance of Bluetongue vectors in Sardinia: comparison of field data with prediction maps

Following the spread of Bluetongue virus (BTV) in many Mediterranean countries during the last 5 years, presence of the main BTV vector, Culicoides imicola Kieffer (Diptera: Ceratopogonidae), was recorded in the region, including the island of Sardinia where the first BT epidemic originally started in the year 2000. Several models were also designed based on climate variables and satellite imaging in order to predict the presence and abundance of BTV vectors across Europe. A 3 years entomological survey (2001-2003) was conducted in the southern part of Sardinia confirming the widespread presence of C. imicola. However, substantial differences in terms of relative abundance were observed between field data and prediction maps based on satellite-derived climate variables. Distribution of other potential BT vectors, belonging to Culicoides obsoletus Meigen and Culicoides pulicaris Linnaeus groups was also not congruent with model-based predictions. These results stress the need of taking into account additional environmental factors (such as soil type, land usage, etc.) and local microclimatic conditions, especially related to breeding site requirements of Culicoides species, in order to predict the presence and abundance of BT vectors and to design reliable prediction maps on a local scale.

Mitochondrial genome involvement in ischemia/reperfusion-induced adaptive changes in human myocardial cells

AIM

Following previous studies on the ischemia-induced adaptive changes in human cardiac mitochondria, we examined in the present paper the interaction between nitric oxide-induced (NO) partial inhibition of Cyt. c oxidase (Cyt.OX) and mitochondrial encoded subunit 2 expression. Aim of the study was to investigate specific stages of the biochemical and molecular cascade which takes place in cytoprotective mechanisms of ischemic and reperfused cardiac cell.

METHODS

We examined human left ventricle samples obtained from 20 patients undergoing elective valve surgery before aortic cross-clamping, 20+/-2 min (prolonged ischemia), 58+/-5 min after cross-clamping (intermittent ischemia) and 21+/-4 min after reconstitution of coronary blood flow (reperfusion). Cyt.OX activity was determined by spectrophotometric method and adenosine triphosphate (ATP) content using bioluminescent assay. Malondialdehyde (MDA) assumed as reactive oxygen species (ROS) generation marker was determined by high-performance liquid chromatography method. On the same cardiac samples mitochondrial encoded Cyt.OX subunit 2 expression was examined by immunoblot analysis and blu native gel electrophoresis method. Statistical study of obtained data was performed using repeated measures analysis of variance (ANOVA).

RESULTS

Prolonged as well intermittent ischemia caused reduction of Cyt.OX activity and ATP, a moderate accumulation of ROS and down-regulation of Cyt.OX subunit 2. When reperfused the cardiomyocytes showed a progressive increase of Cyt.OX activity, ATP pools and Cyt.OX subunit 2 expression. ROS generation was significantly increased by the rapid oxygen re-immission in the cardiac cell.

CONCLUSIONS

These data confirm the suggestion that prolonged as well as intermittent ischemia induces activation of cytoprotective mechanisms crucial for cardiac cell survival. Indeed, co-ordinated down-regulation of Cyt.OX activities, ATP pools and mitochondrial encoded Cyt.OX subunit 2 are in favour of an ischemia-activated adaptive mechanism leading to transient and reversible oxidative injury. This observation is confirmed by reduction of apoptosis molecular markers and by complete recovery of mitochondrial oxidative activities in reperfused cardiac tissue.

Mechanisms of cell protection by adaptation to chronic and acute hypoxia: molecular biology and clinical practice

Several experimental and clinical studies have shown that specific biochemical and molecular pathways are involved in the myocardial and skeletal muscle cell tolerance to acute and/or chronic hypoxic injury. A number of different factors were proposed to play a role in the preservation of tissue viability, but to a few of them a pivotal role in the adaptive mechanisms to hypoxic stimuli could be ascribed. Starting from the observation that mitochondrial electron transport chain (ETC) enzymic complexes are the targets of oxygen reduced availability, most of data are compatible with a mechanism of enzymic adaptation in which the nitric oxide (NO) generation plays the major role. If the partial and reversible NO-induced inhibition of ETC enzymic complexes represents the most rapid and prominent adaptive mechanism in counteracting the damaging effects of hypoxia, the sarcolemmal and mitochondrial K+(ATP) channels activation results to be closely involved in cytoprotection. This process is depending on protein kinase C (PKC) isoform activation triggered by reactive oxygen species (ROS) generation, adenosine triphosphate (ATP) depletion and Ca++ overload. It is well known that all these factors are present in hypoxia-induced oxidative damage and mitochondrial Ca++ altered pools represent powerful stimuli in the damaging processes. The activation of mitochondrial K+(ATP) channels leads to a significant reduction of Ca++ influx and attenuation of mitochondrial Ca++ overload. Closely linked to these adaptive changes signal transduction pathways are involved in the nuclear DNA damage and repair mechanisms. On this context, an essential role is played by the hypoxia-induced factor-1alpha (HIF-1alpha) in terms of key transcription factor involved in oxygen-dependent gene regulation. The knowledge of the biochemical and molecular sequences involved in these adaptive processes call for a re-evaluation of the therapeutic approach to hypoxia-induced pathologies. On this light, some specific aspects of the therapeutic management of critically ill patients are taken into consideration and discussed in relation to the cellular biodynamics.

Changing circulation rate of human metapneumovirus strains and types among hospitalized pediatric patients during three consecutive winter-spring seasons. Brief report

From 2001 through 2004, 808 pediatric patients admitted to hospital because of acute respiratory infections were examined for presence of respiratory viruses by either direct fluorescent staining using monoclonal antibodies or RT-PCR during three consecutive winter-spring seasons. On the whole, 336 (42%) patients were detected as positive for one or more respiratory viruses. The most widely circulating virus was human respiratory syncytial virus (hRSV) infecting 50% of positive patients, followed by human metapneumovirus (hMPV) found in 13% of patients, and then by influenza virus type A, human parainfluenzaviruses and coinfections. Significant variations in the circulation rate of hRSV, hMPV and influenzavirus type A were observed during the individual seasons. In addition, the circulation rates of the different types of hMPV changed yearly. In 2001-2002 and 2002-2003 hMPV circulated at a significant lower proportion than hRSV, while in 2003-2004 the circulation rates of the two viruses were closer. In conclusion, the 4 hMPV subtypes circulated yearly in Northern Italy flanking hRSV as major respiratory pathogens in the infantile patient population.

Muscle function and functional ability improves more in community-dwelling older women with a mixed-strength training programme

BACKGROUND

Supervised training can reach a limited number of elderly people.

OBJECTIVE

To determine the impact of a 1-year mixed-strength training programme on muscle function (MF), functional ability (FA) and physical activity (PA).

SETTING

Twice-a-week hospital-based exercise classes and a once-a-week home session.

PARTICIPANTS

twenty-eight healthy community-dwelling men and women on the training programme and 20 controls aged over 75 years.

METHODS

Training with two multi-gym machines for the lower limbs at 60% of the repetition maximum (1RM). At-home subjects used elastic bands.

MEASUREMENTS

Maximum isometric strength of knee extensors (KE), ankle plantar flexors (PF), leg extensor power (LEP), functional reach (FR), chair rise 1 (CR1) and 10 times (CR10), bed rise (BR), six-minute walking test (6MWT), stair climbing (SC), get-up-and-go (GU&G), one-leg standing (1LS). PA was assessed with the Paqap questionnaire.

RESULTS

Women were significantly weaker than men at baseline: -47% for KE and -59% for PF. Training induced significant gains in MF and FA in the training females; males improved significantly only in FA. PA levels increased non-significantly (2%) in all of the training group.

CONCLUSIONS

Long-term mixed-strength programmes can improve MF and FA in elderly females, and FA in elderly males.

Potential vectors of West Nile virus following an equine disease outbreak in Italy

In the late summer of 1998, an outbreak of equine encephalomyelitis due to West Nile virus (WNV) occurred in the Tuscany region of central Italy. The disease was detected in 14 race horses from nine localities in four Provinces: Firenze, Lucca, Pisa and Pistoia. The outbreak area included Fucecchio wetlands (1800 ha), the largest inland marsh in Italy, and the adjacent hilly Cerbaie woodlands with farms breeding horses. To detect potential vectors of WNV, entomological surveys of Fucecchio and Cerbaie were undertaken during 1999-2002 by collecting mosquito larvae from breeding sites and adult mosquitoes by several methods of sampling. Among 6023 mosquitoes (Diptera: Culicidae) collected, 11 species were identified: Aedes albopictus (Skuse), Ae. vexans (Meigen), Anopheles atroparvus Van Thiel, An. maculipennis Meigen s.s., An. plumbeus Stephens, Culex impudicus Ficalbi, Cx. pipiens L., Culiseta longiareolata Macquart), Ochlerotatus caspius (Pallas), Oc. detritus (Haliday) and Oc. geniculatus (Olivier). In Fucecchio marshes, Cx. impudicus predominated with seasonal peak densities in spring and autumn: its greatest abundance during early spring coincides with arrival of migratory birds from Africa. In Cerbaie hills, Cx. pipiens predominated with peak population density in late summer. No viruses were isolated from 665 mosquitoes processed. These findings, plus other data on Italian mosquito bionomics, suggest a possible mode of WNV transmission involving the most abundant Culex in the Fucecchio-Cerbaie areas. Culex impudicus, being partly ornithophilic, might transmit WNV from migratory to non-migratory birds during springtime; Cx. pipiens, having a broader host range, would be more likely to transmit WNV from birds to horses and, perhaps, to humans by late summer.

Deep sedation for magnetic resonance imaging. Personal experience

AIM

Precision in diagnostic procedure and examination of paediatric patients often requires their absolute immobility. Deep sedation has proven to be an excellent method, allowing optimum technical quality of MRI particularly in younger age groups. The aim of study is to demonstrate the possible application of deep sedation through the use of 2 safe and manageable drugs.

METHODS

We carefully evaluated and selected 82 patients (47 males and 35 females; average age 5.4 years): they came from various paediatrics departments. Deep sedation was practiced with: Chloral hydrate (60-80 mg/kg in one oral administration); propofol as intravenous bolus (2-2.5 mg/kg) followed by a maintenance infusion of 75-125 microg/kg/min. This was preceded by midazolam (0.05 mg/kg i.v.) outside the MRI room. Oxygen saturation (SpO2) was monitored in all patients along with heart rate in order to foresee the need for any possible therapeutic intervention.

RESULTS

The sedation levels attained permitted the success of MRI assuring the immobilization required. Manually assisted mask ventilation was required for a period of 2-3 min in 5 patients treated with propofol. All other patients breathed autonomously. Complete reawakening occurred within 2 hours of drug administration. Surveillance was prolonged inside their respective units, however, without registering delayed side effects.

CONCLUSION

The central point of the success of deep sedation is to define the type and dose of optimum drug for individual patients. This requires a qualified, expert group ready to intervene in the presence of adverse results of drugs administered. Propofol and chloral hydrate are the optimum drugs for diagnostic techniques requiring total immobilization and rapid reawakening.

[Percutaneous cervical cordotomy in the therapy of incidence pain]

BACKGROUND

Incident pain does not respond to opioid treatment and it is not easily relieved with other therapeutic strategies (local intrapleural or spinal analgesia, phenol blocks etc.). For this reason cervical percutaneous cordotomy at C(1)-C(2) interspace is the only effective antalgic therapy in patients whose life expectancy is more than three to six months.

METHODS

This study is a rectrospective review of 22 patients with cancer and incident pain from brachial, lumbar-sacral plexus injury and gluteal ulcer.

RESULTS

Cordotomy provided excellent contralateral side pain relief in 21 patients; pain relief was maintained up to death and to the moment of last observation in living patients. In one deaf patient it was impossible to carry out the procedure due to incomplete co-operation and pain returned after 48 hours. Ventilatory depression caused death in one patient. Other complications recorded included ataxia, headache, motor deficit, dysesthesia and orthostatic hypotension.

CONCLUSIONS

The conclusion is drawn that percutaneous cordotomy should, in carefully selected cases, be considered the only technique to relieve incident pain.

[Management of the asthmatic adolescent]

Bronchial asthma is a chronic condition that is on the increase in adolescents as it is among other age groups; often under-diagnosed it prevalently affects males and is 10% sustained by an allergic diathesis. Adolescence, with its peculiarities and characteristic psychological and physical changes affects the clinical expression of asthma and above all requires particular diagnostic and therapeutic attention from the treating paediatrician. The physician should act as a direct, credible interlocutor of the adolescent. Regular sporting activity appropriate to the subject's age and asthmatic condition, and under close medical supervision, must be recommended in the asthmatic adolescent. Bronchial asthma in adolescence often presents as asthma due to physical effort. The onset of asthma must not represent an impediment to regular physical activity; adequate management strategies are however necessary (so as to prevent the symptom occurring after effort). These strategies range from the choice of type of training (environment and work loads) to pharmacological prevention measures. The asthmatic adolescent may also perform physical activity at competitive level although in this case special attention must be paid to the choice of drugs so as to avoid running into problems of disqualification due to doping.

Treatment of Romberg's disease with parascapular free flap and polyethylene porous implants

Romberg's disease is a rare condition characterized by progressive hemifacial atrophy. The atrophic process typically has its onset in the first or second decade of life, it continues for a few years (usually 2, but up to 10), and then it stops spontaneously. The subcutaneous tissue is the first to be involved by the disease, followed by muscles, bones, and, rarely, the skin. The etiology of the disease is unknown. The only available treatment is surgical. Several techniques have been reported in the literature, from fat transplant, to silicon prostheses, to the use of flaps. We present our experience in successfully treating six patients (3 males and 3 females) affected by Romberg's hemifacial atrophy of intermediate or severe degree. A technique including a free parascapular microvascular flap with the adjunct of porous polyethylene implants was used. Further correction was performed with remodeling or resuspension.

Encephalitis without meningitis due to sandfly fever virus serotype toscana

The role of Toscana (TOS) virus in producing encephalitis without meningitis is uncertain. We studied 2 cases of TOS virus encephalitis without meningitis by means of nested polymerase chain reaction assay and DNA sequencing. Findings confirm that TOS virus may directly cause encephalitis and suggest the usefulness of DNA sequencing in investigating relationships between TOS virus molecular patterns and the spectrum of neurological involvement.

Isochromosome (7)(q10) in Shwachman syndrome without MDS/AML and role of chromosome 7 anomalies in myeloproliferative disorders

Shwachman syndrome (SS) is an autosomal recessive disorder in which bone marrow dysfunction is observed, with development of myelodysplastic syndromes (MDS) and acute myeloid leukemias (AML) in up to one third of the cases. Inconclusive data are available as to increased chromosome breakage in SS, while chromosome 7 anomalies, and often an isochromosome (7)(q10), are frequent in cases with MDS/AML. We report on the consistent presence of an i(7)(q10) in the bone marrow and blood lymphocytes in one of two sisters affected with SS without any clinical or cytological signs of MDS/AML. Thus, this patient was either a case of constitutional mosaicism for the i(7)(q10), or this had to be acquired in a nondysplastic and non-neoplastic marrow clone. DNA polymorphism analysis demonstrated the paternal origin of the i(7q). We postulate that the SS mutation acts as a mutator gene, and causes karyotype instability; abnormal clones would thus arise in the marrow, and chromosome 7 anomalies, i(7q) in particular, will in turn lead to MDS/AML. If this interpretation is correct, it would be also an indication to consider chromosome 7 anomalies in general, out of SS, as primary changes in MDS/AML pathogenesis.

Response to long-term hGH therapy in two children with Schwachman-Diamond syndrome associated with GH deficiency

Schwachman-Diamond syndrome is a rare congenital disorder characterized by pancreatic insufficiency, metaphyseal anomalies, recurrent infections, hematologic abnormalities, and growth retardation. Slow growth in these patients has been attributed to nutritional deficits, recurrent infections, and skeletal anomalies. Two cases of Schwachman-Diamond syndrome associated with growth hormone deficiency have been previously reported. We report here on 2 additional cases with this unusual association. Therefore, growth failure in Schwachman-Diamond syndrome should not be assumed to be due to chronic illness or recurrent infections; other etiologies for growth failure should be sought. However, the presence of metaphyseal disorders probably interferes with the long-term efficacy of growth hormone substitutive therapy.

Nijmegen breakage syndrome-associated T-cell-rich B-cell lymphoma: case report

In 1981 Weemaes et al. first described the Nijmegen breakage syndrome (NBS), a rare autosomal recessive disorder characterized by stunted growth, microcephaly, immunodeficiency, spontaneous chromosome instability, and a peculiar predisposition to cancer development. Most NBS-related malignancies are lymphomas, but their pathologic features have rarely been specified. We report here the case of a northern Italian 8-year-old child who, 2 years after the diagnosis of NBS, developed a diffuse large B-cell lymphoma (T cell-rich B-cell lymphoma variant). The histological and immunobiological features of the lymphoma population are analyzed and discussed in detail.

Immunological characterization of Toscana virus proteins

The genome of Toscana virus (Bunyaviridae family, Phlebovirus genus) consists of three single stranded RNA segments (L, M, S), with negative polarity. The L and M segments contain a single ORF in viral complementary sense and the S segment contains two ORFs in "ambisense" orientation. The M segment codes for three proteins in 3'-5' genomic orientation: a 30 kDa non structural protein and two 65 kDa glycoproteins, GN, and GC. In this paper we report the expression in E. coli of the S segment ORFs and of three regions of the L ORF. The expressed proteins were used to produce monospecific polyclonal antibodies in mice. By using these antibodies the N and the NSs proteins were unequivocally assigned to the S viral-complementary and viral-sense ORFs, respectively, and the L protein to the L ORF. We have found that like N and L proteins, NSs protein is associated with the viral nucleocapsids in mature virions, suggesting its possible involvement in early events of viral replication. NSs protein was also found associated with cellular polysomes. In virus-infected cells the anti-L antibodies recognized proteins shorter than the full-length L protein, possibly products of L subgenomic segments. Interestingly these defective products were not found in mature virions, suggesting specific mechanisms in virion assembly.

Ring chromosome 9 with a 9p22.3-p24.3 duplication

A ring chromosome 9 containing an inverted 9p22.3-p24.3 duplication was found in a girl presenting with some of the phenotypic characteristics of ring 9 syndrome such as trigonocephaly, microcephaly, hypotelorism, micrognathia, single palmar crease, and bilateral clinodactyly. The typical facial dysmorphic features of 9p duplication, ascribed to trisomy of the band p22, were not present in this patient. Cytogenetic and molecular studies indicated that the duplicated region of band p22 in the ring is confined to the sub-band 22.3.

CONCLUSION

The chromosome region responsible for the 9p duplication syndrome appears to be restricted to sub-bands p22. 1-22.2.

Synthesis, characterization, and biodistribution of oxo complexes of technetium-99m with biguanide and N1-substituted ligands

We report the synthesis, characterization, and biodistribution of 99mTc-complexes with the bidentate-N,N chelate biguanide (Big) and the N1-substituted ligands dimethyl (DMBig), phenyl (PBig), and phenethyl (PEBig). Dynamic gamma-camera studies with 99mTc-Big and 99mTc-DMSA in rabbits indicated distinct renal and urinary excretion profiles. 99mTc-Big was cleared more quickly than 99mTc-DMSA, and for the same acquisition times, the contrast in whole-body images favored 99mTc-Big. Also, the estimated radiation absorbed doses by kidneys and blood for 99mTc-DMSA were significantly higher than for 99mTc-Big. These preliminary studies show that 99mTc-Big has favourable practical and dosimetric features for renal imaging as an alternative to 99mTc-DMSA.

Characterization of Toscana virus-defective interfering particles generated in vivo

Toscana (TOS) virus stocks strongly interfering with standard virus replication were obtained by sequential passages of virus in suckling mouse brain. Characterization of viral RNAs in these stocks showed the presence of a heterogeneous population of defective RNA molecules derived from the L genomic segment, in both nucleocapsid (NC) and messenger RNAs, suggesting that these molecules could be replicated, assembled, and transcribed. Subgenomic RNAs from the L segment but not from the S or M segments were found in cells infected with these stocks. Defective RNA molecules interfered with virus replication and retained 5' and 3' genomic termini. Nucleotide sequence analysis of some cloned defective interfering (DI) RNAs revealed they contained one or more internal deletions reducing their length to 7-13% of the full-length L segment. An identical sequence motif, of variable length, was found at both terminal sites of the RNA junction on standard L sequences. This motif was retained only in one copy in the subgenomic RNA. These results are consistent with the generation of TOS virus DI particles in vivo and suggest that the defective genomic RNAs could be generated by polymerase jumping from a sequence to an identical one spatially closed because of the RNA structure.