Estimated excess mortality figures in the year 2020-2021 in casentino municipalities (Italy)

Background

In 2020, the total deaths from all causes were the highest ever recorded in Italy since World War II (15.6% excess), with peaks during Sars-Cov2 waves and reductions in periods of national lockdown. On the contrary, in 2021, the total number of deaths from all causes reduced compared to the previous year. Analysing local mortality data, our study aims to assess whether, in the Casentino Valley (Arezzo, Tuscany), an excess of deaths from all causes occurred between January 2020 and December 2021 compared to the five years 2015-2019.

Methods

We used the official mortality data from the Italian Institute of Statistics (ISTAT), and that are published in the Table of deaths by the municipality on March 2, 2022. From this database, we extrapolated all deaths from all causes between January 1, 2020, and December 31, 2021, in the 10 municipalities of Casentino. The data collected were processed using Microsoft Excel 2016 software. We then distinguished by total per month, gender, and age group and then compared these data with the previous five years’ average by calculating the percentage change.

Results

Overall, both the years 2020 and 2021, it is shown an increase in the deaths percentages compared to the previous five-year period, respectively 5.66% and 8.07%. In particular, there is an excess of mortality in November and December 2020. The increase in mortality is more remarkable for males (13% in 2020 and 20% in 2021). The highest percentage increase was recorded in 2021 for the 75-84 age group (+15%) and in 2020 for males over 85 (+29%).

Conclusions

The data analysed confirms the excess mortality in 2020-2021 compared to the average of the previous 5 years in Casentino. There are peaks in November and December 2020, corresponding with the second wave of Sars Cov2 infection. The results obtained establish the basis for subsequent analyses that will verify the correlation of mortality peaks with the incidence of Sars-Cov2 cases in the territory studied.

Key messages

• Between January 1, 2020, and December 31, 2021 there was an excess of all-cause mortality in our area.

• This excess mortality appears to be related to peaks in Sars-Cov2 infection.

Flu and Covid-19: is there adherence to vaccination in target groups?

Background

In Italy, the flu vaccine is recommended and free for target groups (adults≥60 years old, fragile people, healthcare workers, pregnant women). During the 2020/2021 flu season, an increased vaccination coverage (+6,9%) was observed compared to the previous season, also due to the Covid-19 pandemic. We aimed to investigate how strong the adherence to the flu vaccine was by the vulnerable groups and assess if the Covid-19 vaccination campaign may have influenced the rate of flu vaccines.

Methods

At the beginning of autumn 2021 we conducted an online survey among the population of Tuscany. We collected data on demographics, health status (pregnancy, vulnerable), flu and COVID-19 vaccinations coverage and health information sources. In addition, we performed a descriptive and a risk factors analysis to assess correlation between our variables with R v 4.0.0. Significance level was set at p < 0.05.

Results

Among 408 participants, 248 (61%) belong to a vulnerable group and are recommended to receive the flu vaccine, 229 (56%) usually get the flu vaccine, 386 (95%) got the Covid-19 vaccine, 267 (65%) choose and trust the general practitioner (GP) as their health information source. There is a statistically significant association between being part of a vulnerable group and getting the seasonal flu vaccine (OR 6.63 95% CI 4.26-10.3 p < 0.001). In addition, getting the Covid-19 vaccine increases the likelihood of receiving the flu vaccine (2.90 95% CI 1.16-7.28 p = 0.018). Moreover, participants who trust their GP as their health information source (OR 1.63 CI 1.08-2.46 p = 0.019) are more likely to receive the flu vaccine; other information sources (TV, newspaper, social media) are not associated with the flu vaccine.

Conclusions

Our research shows that vulnerable groups get vaccinated against the flu. The increase in flu vaccine coverage may be due to the COVID-19 vaccines campaign. GPs play a crucial role in the health promotion, prevention and health literacy of patients.

Key messages

The Conjoint Family Drawing: A Tool to Explore About Family Relationships

In this article we will present the Conjoint Family Drawing, a graphic-interactive tool developed to evaluate family relationships. This tool allows an analytical and clinical evaluation of families and their relationships while facilitating the understanding of the overall family functioning through a synthetic coding system which distinguishes families from each other. First of all, a presentation of the analytical coding system is provided; such system consists of a grid, formed by two distinct levels of observation: the analysis of the product, which, in turn focuses on two levels, the global-familiar one (given by the overall drawing) and the individual one (given the individual members' drawings), and the analysis of the drawing process (what happens during the realization of the drawing), which is made up of the observations of family interactions at the individual and group level. Consistently with our objectives and the theoretical and methodological literature on family drawing in its various forms and ways of implementation, 10 indicators for product analysis and 9 indicators for process analysis have been identified. A sample of 117 Conjoint Family Drawings was analyzed in order to verify the coding system's applicability and effectiveness. The sample was constituted according to a convenience (not probabilistic) criterion. Following, a computing system was developed to allow the investigation of the overall family functioning through three steps: (1) the analysis of the frequency distribution of each indicator, in order to verify the non-determinability rates and the distribution of the different answer options; (2) a two-step cluster analysis, to determine homogeneous groups of Conjoint Family Drawings and identify, within each cluster (and comparatively between the clusters), the indicators and answer modalities that mostly affect the clusters' aggregation itself; (3) the development of a synthetic system to code the Conjoint Family Drawing, beginning with the indicators that define the typological profiles of the clusters obtained. The synthetic system was developed through a summative and logical-combinatorial method, merging the most discriminating and clinically significant coding items, that is, those that are best associable to specific ways of family functioning. Seven family types emerged from these analyses: families characterized by optimal functioning, families characterized by adequate functioning, families characterized by chaotic functioning, families characterized by fragile paternity, families characterized by separate functioning, families with multiproblematic functioning and residual families. The characteristics of these family types will be outlined in this article.

Psycho-social characteristics in patients with discopathy: Quality of Life, coping strategy and mood state

The pathologies of the musculoskeletal apparatus are the most common cause of chronic diseases, with a huge impact on people and society. Scientific literature has discovered how experiencing chronic pain directly affects peoples' well-being, lifestyle, social relationships and can also cause psychological distress. The present study aims to investigate pain experience in patients with hernias or protrusions of the cervical and lumbosacral tract on a sample of 120 patients, recruited from patients of Poliambulatorio Oberdan, medical centre in Brescia (Italy) specialized in physical rehabilitation and CT-guided oxygen ozone therapy. In a bio-psychosocial perspective, the research aimed to investigate how the perception of pain, the mood state associated with it, the coping strategies adopted and the quality of life differ according to each patient's gender and to the more or less prolonged use of pain medication. The data were collected by means of medical and psychological anamnestic interviews and self-report tests (WHOQOL-BREF, COPE-NVI, POMS). The quantitative analysis, carried out through SPSS 25 (2017) software, showed how functional impairment of one's autonomy (walking, driving) affects mood states. In particular, the female sample expressed a more deflected mood, despite the greater use of relational and/or transcendent support (coping strategies) compared to men. The study suggests that the greater impairment of the moods of women can be attributed both to the caregiving role they play, which often results in a greater fatigue and difficulties in redefining this role following the algic condition, and more general differences in the expression of suffering, which, on a cultural level, sees men emotionally coerced. The analysis also shows how taking pain medication for a long period of time has a negative impact on the quality of life. The results suggest that the patients treated with analgesic therapy tend to adopt avoidant coping styles, which usually escalate into postponement of the time when dealing with a stressful situation and, if used in the long run, may lead to worsening health condition.

May car washing represent a risk for Legionella infection?

BACKGROUND

Legionella is a ubiquitous Gram-negative bacterium naturally found in aquatic environments. It can pose a health problem when it grows and spreads in man-made water systems. Legionella pneumophila is the most common cause of Legionnaires' disease nowadays, a community-acquired pneumonia with pulmonary symptoms and chest radiography no different from any other form of infectious pneumonia. Legionella monitoring is important for public health reasons, including the identification of unusual environmental sources of Legionella.

METHODS

We report two cases of Legionnaires' disease associated with two different car wash installations in the province of Vicenza, in the Veneto region, northeastern Italy. Patients were not employees of the car wash installations, but users of the service. In both cases, Legionella antigen was detected in urine using the Alere BinaxNOW® Legionella Urinary Antigen, and Legionella antibodies were detected in serum using SERION ELISA classic Legionella pneumophila 1-7 IgG and IgM. Water samples were also analyzed as part of the surveillance program for Legionella prevention and control in compliance with the Italian guidelines.

RESULTS

Both patients had clinical symptoms and chest radiography compatible with pneumonia, and only one of them had diabetes as a risk factor. Legionella urinary antigen and serological test on serum samples were positive for Legionella in both patients, even if much slighter in the case A due to the retrospective serological investigation performed a year later the episode and after the second clinical case occurred in the same district. The environmental investigations highlighted two different car wash plants as potential source of infection. A certified company using shock hyperchlorination was asked to disinfect the two plants and, subsequently, control samples resulted negative for Legionella pneumophila.

CONCLUSION

Any water source producing aerosols should be considered at risk for the transmission of Legionella bacteria, including car wash installations frequently used by a large number of customers and where poor maintenance probably creates favorable conditions for Legionella overgrowth and spreading. Additional research is needed to ascertain optimal strategies for Legionella monitoring and control, but environmental surveillance, paying careful attention to possible unconventional sources, should remain an important component of any Legionnaires' disease prevention program. Additionally, all available diagnostic methods would be recommended for the confirmation of all cases even in the event of non-serogroup 1 Legionella pneumophila infection, probably underestimated at this time.

Intimate Partner Violence and Child Custody Evaluation: A Model for Preliminary Clinical Intervention

Intimate partner violence is defined by the World Health Organization as “any behavior within an intimate relationship that causes physical, psychological, or sexual harm to those in the relationship” and it refers to a specific relationship dynamic. In recent decades, an increasing number of studies have focused on this phenomenon, considering its exponential growth over time. Many studies have focused on risk factors for violence within the couple relationship. This paper specifically analyses the association between violence and separation or divorce. Although many interventions have been developed over the years, the effectiveness of extant interventions on violent behaviors is not yet empirically supported. Since clinical experience allows to affirm that both partners can be involved in treatment for intimate partner violence especially during mandated proceedings, the present study focuses on domestic violence in separated couples involved in a child custody evaluation process. In this case, literature supports the need for individualized assessment in order to promote the best intervention according to the specific conditions of each partner, whether the battered one or the perpetrator. However, little research has been done on child custody evaluation in the presence of violent couples. The aim of the present study is to present a model of couple clinical intervention with a separated violent couple in the context of a child custody evaluation. This model can be defined as relational-intergenerational and its main aim is to understand the exchange between familial generations and to search for factors that safeguard and care for family relations. Furthermore, according also to the therapeutic assessment approach, there is an intrinsic connection between assessment and “family transformative potential.” This paper presents the specific working methodology underlying this model, through the description of a single clinical case. In particular, the proposed model provides a multi-dimensional assessment comprising three levels: individual, evaluating parents' history through representations, thoughts, and feelings; interpersonal, investigating the different relations; discussion and dialogue with the parental couple about findings.

Muslim Immigrant Men's and Women's Attitudes Towards Intimate Partner Violence

This study aims to study the attitudes towards Intimate Partner Violence (IPV) in a group of Muslim immigrants. To this end, six focus-groups were conducted involving 42 first-generation Muslim immigrants (21 males and 21 females) from Pakistan, Egypt and Morocco. Focus groups transcripts were then analyzed using the software ATLAS.ti. Irrespectively of nationality, couples replicate relational models learnt in their country of origin, implying a rigid gender-based role division. Women are considered less socially competent if compared to men and therefore in need of protection. Divorce is possible only in case of severe danger: women have to stand beside their husbands and maintain family unity. Even though they are not directly related to IPV, these factors may be key in determining its onset and perpetration. With regards to ethnic background, Pakistani interviewees not only seem to acknowledge the possible occurrence of violence within couple relationships, they also accept it as a mean to regulate socially dysfunctional behaviors. Both Moroccan males and females denounce the impact of post migration stressors as potential triggers of IPV. The distance from one's family of origin in migration is perceived as problematic by both men and women, however, while males' distance from their kin might make them feel overwhelmed with family responsibilities and give way to deviant behaviors, women suffer from the lack of support and protection by their extended family. Implications for practice are also discussed.

Till the ocean do us part: Italian and American therapists' representations of stepfamilies in treatment

Research often focuses on the characteristics of stepfamilies and their differences with first-union families; however, few studies take into account the therapist's perspective with regards to the treatment of such families. Also, cross-cultural research on the topic is limited. To fill these gaps, a content analysis of responses from 125 Italian and 45 American therapists regarding their representations of stepfamilies and stepfamily therapy was undertaken. Results show that American therapists emphasized specific stepfamily characteristics (e.g., the lack of a shared family history, the occurrence of conflict between former spouses, the presence of unrealistic expectations towards treatment) to a greater extent if compared to Italian therapists. By contrast, besides being more general in their definition of stepfamilies, Italian therapists focused more on themselves, their theoretical models, and their professional and personal skills. The study provides insights on both the differences in the clinical cultures of the two countries and implications for stepfamily therapy and training.

High incidence of antibiotic multi-resistant bacteria in coastal areas dedicated to fish farming

Marine bacteria exposed to antibiotics in fish farms can acquire antimicrobial resistance by mobile genetic elements and horizontal gene transfer. A total of 872 autochthonous marine bacterial strains was isolated from samples collected from four different fish farms located at northern and southern Italian Adriatic Sea. Resistance to only tetracycline (17%) and to trimethoprim-sulfadiazine (7%) were the most frequent patterns obtained, while flumequine resistance has recorded in only 0.3% of the strains. Comparing strains isolated from coastal areas and fish farms, a significant higher incidence (4% versus 10%) of multi-resistant strains in aquaculture centers was found. Significant differences in antibiotic resistance incidence were also detected among the four fish farms due probably to different approaches in farm management and the more or less frequent use of antibiotics. Antibiotic-resistant and multi-resistant strains isolated constitute an environmental reservoir directly involved in the seafood chain and might represent a public health concern.

Insulin resistance is a risk factor for high blood pressure regardless of body size and fat distribution in obese children

BACKGROUND AND AIM

The prevalence of children with hypertension is increasing, especially in obese children. This study was to assess the relationship between blood pressure, indexes of adiposity, body fat distribution and insulin resistance.

SAMPLE

1044 children (M/F: 484/560; aged 6-11 years). Anthropometry and blood pressure were measured and fasting blood samples were tested for triacylglycerol, total cholesterol, HDL cholesterol, glucose, insulin and ALT. The prevalence of high blood pressure in overweight males and females was 14.3 and 6.4%, respectively (chi(2)=16.73, p<0.001) and in obese it was 40.4 and 32.8%, respectively (chi(2)=5.56, p<0.001). High blood pressure increased progressively with BMI z-score categories (chi(2)=67.99, p<0.001) as well as with waist/height ratio (W/Hr) categories (chi(2)=23.51, p<0.001). Hypertensive subject had significantly higher insulin (15.6+/-9.8 vs 11.9+/-7.2, p<0.001 and 20.63+/-14.7 vs 15.26+/-9.8, p<0.001 in males and females respectively) and HOMA(IR) (3.23+/-2.1 vs 2.42+/-1.49, p<0.001 and 4.12+/-2.87 vs 3.07+/-1.98, p<0.001 in males and in females, respectively) than non-hypertensive ones. Among metabolic and cardiovascular risk factors, HOMA(IR) was the only variable able to predict high blood pressure in obese boys and girls, in addition to BMI or body fat distribution (waist, W/Hr). The highest HOMA(IR) category was the most important predicting factor of high blood pressure in overweight and obese children in addition to body size or body fat distribution.

CONCLUSIONS

Blood pressure is associated with the degree of overweight and the indices of body fat distribution. Insulin resistance is an independent additional risk factor for hypertension.

17beta-Hydroxysteroid dehydrogenase-3 deficiency: from pregnancy to adolescence

OBJECTIVE

Aim of this study is to report on basal clinical phenotype and follow up after diagnosis, of patients with 17beta-hydroxysteroid-dehydrogenase type 3 (17beta-HSD3) deficiency in Italy.

SETTING

Pediatric Endocrine Departments, University Hospitals.

PATIENTS

The cases of 5 Italian subjects affected by 17beta-HSD3 deficiency are presented in this study.

INTERVENTIONS

Laboratory and genetic assessment. Gonadectomy and female sex assignment (4 patients) or GnRH analog therapy to regress puberty and gender identity disorder (1 patient).

RESULTS

Presentation lasted from pregnancy (pre-natal diagnosis of a 46,XY fetus with female external genitalia) to infancy (inguinal hernia containing testes/clitoromegaly) and adolescence (virilisation). All subjects but one (subject 1, Central-Northern Italy) were from small areas of Southern Italy. Endocrine data (baseline and/or stimulated testosterone/ Delta4-androstenedione ratio) were informative. Two girls were homozygous for 17beta-HSD3 gene mutations (G289S/G289S; R80W/R80W), while the others were compound heterozygous (IVS325+4 A>T/A203V; L212Q/M235V; R80W/A235E). Four patients were confirmed as females and were well-adjusted with assigned sex; gender identity disorder improved during treatment with GnRH analog in the last subject.

CONCLUSIONS

17betaHSD3 deficiency may present from pregnancy to puberty for different clinical issues. Albeit testosterone/Delta4-androstenedione ratio represents the most accurate endocrine marker to diagnose the disorder, hCGstimulation is mandatory in pre-puberty. Molecular analysis of 17beta-HSD3 gene should be performed to confirm the diagnosis. Temporary GnRH analog treatment may regress gender identity disorder and provide time to confirm or change the birth sex assignment. Female individuals seems to be compliant with their sex, providing that virilisation does not occur. In Italy, the disorder seems to be more prevalent in the Southern regions and shows genetic heterogeneity.

Isolation of a Vibrio parahaemolyticus pandemic strain from a marine water sample obtained in the northern Adriatic

Binary file ES_Abstracts_Final_ECDC.txt matches

Degradation of pyrimethanil in soil: influence of light, oxygen, and microbial activity

The research was carried out in order to verify the influence that light, oxygen, and microbial activity have on the degradability of pyrimethanil (PYR) in soil. The products of degradation were also identified and their evolution in time evaluated. The results indicate that the molecule is more persistent in the absence of light, oxygen, and microbial activity. The order of importance of these three factors is as follows: light < microbial activity < oxygen. The following products of degradation were identified: (1) benzoic acid, (2) cis,cis-muconic acid, (3) hydroxyl-4,6-dimethyl-2-pirimidinamine, (4) N'-ethyl-N-hydroxyformamidine, and (5) 4,6-dimethyl-2-piridinamine, which appeared different from those reported in literature for the degradation of PYR in abiotic conditions. This result suggests that the degradation in soil is mainly biotic.

Inhibition of Trypanosoma cruzi by plant extracts used in Chinese medicine

In this work, we assessed the effect of extracts obtained from 17 plants used in traditional Chinese medicine. These extracts were tested in vitro with the epimastigote form of Trypanosoma cruzi, clone Bra C(15) C(2), at 27 degrees C in F-29 medium at a concentration of 100 microg/ml in axenic cultures. Allopurinol was used as reference drug. Seven plant extracts showed inhibitory activities lower than 25%. Pueraria lobata, Mahonia beaei, Dictamus dasycarpus, Kochia scoparia, Sophora flavescens and Ligustrum lucidum showed effects with inhibition values between 25% and 60%, whereas Lithospermum erythrorhizon, Saussurea lappa, Melia toosendan and Cinnamomum cassia showed the greatest inhibitory activity of 100%. The IC(50) of these extracts were: 0.4, 2.4, 1.8 and 3.9 microg/ml, respectively. The MTT assay was made and did not show cytotoxic activity. These results allowed us to suggest that L. erythrorhizon, S. lappa, M. toosendan and C. cassia could be a source of new compounds against T. cruzi.

[The hemodiafiltration with infusion of acetate-free dialysis fluid can modify the inflammatory response in patients "high responders" to inflammatory stimuli?]

PURPOSE

This study aimed to verify the effects of paired hemodiafiltration on-line (PHF-AF) on inflammation in patients who were "high responders" to inflammatory stimuli: elevated C-reactive protein (CRP), genetic polymorphisms influencing a low transcription for interleukin-10 (IL-10) and a high transcription for IFN-gamma.

METHODS

Ten patients selected as high responders for IFN-gamma and low responders for IL-10 were included in a crossover study to compare PHF-AF and standard bicarbonate hemodialysis (BHD). At study entry and before the start of each dialysis session the following examinations were performed: CRP, albumin, fibrinogen, ferritin, transferrin, prealbumin and serum levels of IL-6, IL-10, IFN-gamma, tumor necrosis factor-alpha (TNF-alpha). After the 1st and 3rd week of the study, the blood samples were also collected after the dialysis session.

RESULTS

. There was a significant reduction in albumin and prealbumin in PHF-AF patients during the study; none of the other parameters were changed in both patient groups. CRP tended to be elevated after dialysis in both PHF-AF and BHD. While IL-6, IL-10 and IFN-gamma were unchanged during the dialysis session, there was a significant variation in TNF-alpha levels, which were increased in BHD (from 10.9 +/- 3.1 to 14.7 +/- 4.1 pg/mL; p=0.004) and reduced in PHF-AF (from 11.9 +/-2.8 to 6.3 +/- 2.2 pg/mL; p=0.0004).

CONCLUSION

Although the cytokine levels were unchanged during the study in both BHD and PHF-AF, the modification of TNF-alpha during the dialysis session was considered as inflammatory significance.

Adsorption of imidazolinone herbicides on smectite-humic acid and smectite-ferrihydrite associations

Adsorption of imazapyr (IMZ), imazethapyr (IMZT), and imazaquin (IMZQ) was studied on two smectite-humic acid and two smectite-ferrihydrite binary systems prepared by treating a Wyoming smectite with a humic acid extracted from soil (4 and 8% w/w of the smectite) and with just-precipitated synthetic ferrihydrite (8 and 16% w/w of the smectite). Adsorption of the three herbicides on the smectite was not measurable at pH >4.5, presumably because of negative charges on the surface of the smectite. Adsorption on the smectite-humic acid systems was also not measurable, presumably because of negative charges on the surface, despite the high affinity of the three herbicides for humic acid, the adsorption order of which was IMZ < IMZT << IMZQ. Adsorption decreased in the order IMZ < IMZT < IMZQ on the smectite-ferrihydrite systems and IMZQ < IMZT < IMZ on ferrihydrite, although here the differences were small. These results show that even though pure smectite cannot adsorb herbicides, it modifies the adsorption capacity of ferrihydrite. The mutual interaction of active phases such as humic acid, ferrihydrite, and smectite alters the characteristics of the resulting surface and hence the adsorption process. Investigations of herbicide adsorption have been seen to produce more reliable results if conducted on polyphasic systems rather than on single soil components.

Interaction of imidazolinone herbicides with soil humic acids. Experimental results and molecular modeling

Adsorption and desorption isotherms of the herbicides imazapyr, imazethapyr and imazaquin on a soil humic acid have been performed at pH 2.8 and 4.0 (below and above the pKa of the herbicides). At both pH, adsorption increased according to the lipophilic character of the molecules (imazapyr < imazethapyr << imazaquin). The extent of adsorption was higher at pH 2.8 than at pH 4.0 because of the partial ionization of the carboxylic groups of both herbicides and humic acids at increasing pH. Desorption of imazapyr and imazethapyr was nearly complete at pH 4 and higher than 60% at pH 2.8 while desorption of imazaquin was 45 and 8% at pH 4 and 2.8, respectively. No differences between adsorption isotherms at 10 degrees C and 25 degrees C were observed a pH 4.0 indicating that adsorption involved very weak bonds while at pH 2.8, adsorption was higher at 10 degrees C than at 25 degrees C indicating an exothermic process. The isosteric enthalpy of adsorption of each herbicide was low (about -1 kJoule mole(-1)) suggesting that low energetic bonds were involved. Adsorption on different humic acids has indicated that for each herbicide, the extent of adsorption expressed as Kd was correlated with the amount of carboxylic and aromatic groups of humic acids suggesting that hydrogen bonding and/or charge-transfer complexes formation could take place. Molecular modeling and geometry optimization of humic acid and soil organic matter (SOM) herbicide complexes were also performed. The results obtained with this theoretical approach gave a consistent chemical interpretation of the experimental results. To the best of our knowledge this is the first report to contribute to a better understanding of site-specific bonding of herbicides in SOM complexes by nanochemical modeling and distinct energy descriptors.

Role of ferrihydrite in adsorption of three imidazolinone herbicides

Adsorption of the imidazolinone herbicides imazapyr, imazethapyr, and imazaquin on synthetic ferrihydrites, either freeze-dried or not-freeze-dried, has been studied. The synthetic ferrihydrites were characterized by X-ray diffraction, scanning electron micrographs, and specific area determination. On each ferrihydrite, adsorption was found to be strongly dependent on pH. The highest extent of adsorption took place at pH values close to the pK(a) of the carboxylic group of the herbicides. No adsorption was observed at pH > 8. The freeze-drying process reduced the adsorptive capacity of the ferrihydrite by formation of larger aggregates provoking a decrease of the surface area. The chemical differences between the herbicides did not strongly affect the adsorption process of the herbicides. However, imazaquin was more adsorbed than the other two herbicides, in particular at pH close to its pK(a).

Adsorption of imidazolinone herbicides on ferrihydrite-humic acid associations

Adsorption of the imidazolinone herbicides imazapyr, imazethapyr and imazaquin was studied on two binary systems (ferrihydrite-humic acid) prepared by treating ferrihydrite (Fh) immediately after its precipitation with a soil humic acid (HA) at different loadings (4% and 8% HA content), and on a blank ferrihydrite sample prepared in the same way, but without HA addition. Imidazolinone adsorption on pure Fh and on the 4% Fh-HA decreased with increasing of the herbicide hydrophobicity (imazaquin<imazethapyr<imazapyr), whereas on the 8% Fh-HA system the order of adsorption was nearly the same, indicating that higher amounts of HA on Fh increase the hydrophobicity of the surface and thus increases its affinity for the herbicides, specially for imazaquin. Adsorption was also enhanced by low pH values and slight changes in pH enhanced the contribution of each component in adsorption. Both the nature of the surface exposed and its ability to interact with herbicides are greatly altered by the mutual interaction of Fh and HA. The results show that albeit artificial polyphasic associations are more representative of the real situation than single model components and are thus better indicators of the behaviour of a given herbicide in the soil.

Behavior of cinosulfuron in paddy surface waters, sediments, and ground water

Cinosulfuron (3-(4,6-dimethoxy-1,3,5-triazin-2-yl)-1-[2-(2-methoxyethoxy)-phenylsulfonyl]-urea) is a sulfonylurea herbicide used to control a wide range of broadleaf weeds in rice (Oryza sativa L.). A 2-yr field study was conducted in northwest Italy to determine the effect of cinosulfuron on surface and subsoil waters in rice paddies. Cinosulfuron was applied at 70 g a.i. ha(-1) on 35 ha of flooded rice. After the treatment, the change in herbicide concentration over time was studied by analyzing water and sediment samples in a test paddy field (2.16 ha, located in the treated area), water in a spring and a pond (both located near the test paddy), two wells (up- and downhill to the treated area), and two piezometers (along the test paddy levee). To better understand some of the field study results, cinosulfuron degradation was also evaluated in the laboratory in solutions buffered to different pH values. Two weeks after the treatment, the cinosulfuron concentration in the paddy water decreased by about 60%. No cinosulfuron was detected at about 2.5 mo after the treatment. The concentration in the sediment gradually increased after the treatment, reaching the highest value (13.53 microg kg(-1)) 3 wk later. The maximum cinosulfuron content in the spring and pond were 0.91 and 0.29 microg L(-1), respectively, and these were detected 60 to 90 days after treatment (DAT). The water collected in the piezometers reached the highest concentration (0.99 microg L(-1)) 29 DAT. Cinosulfuron was never detected in the wells. In the degradation study at different pH values, cinosulfuron degraded rapidly at low pH values.

Liquid chromatographic determination of triasulfuron in soil

Two extraction methods were developed for the determination of triasulfuron in soil. Method I included extraction with methanol-phosphate buffer at pH 7 (2 + 1, v/v), liquid-liquid partition with dichloromethane, and cleanup on a liquid chromatographic Si adsorption solid-phase extraction tube. In Method II, Extrelut was added and the sample was then extracted with acetonitrile. In both cases, the extracts were analyzed by liquid chromatography (LC) with UV detection and the LC peak was confirmed by LC/mass spectrometry (MS). The 2 methods were tested on 3 soils having different physicochemical characteristics. Method I gave 83% average recovery and a determination limit of 0.4 microg/kg soil. Method II gave 67% average recovery and a determination limit of 2 microg/kg soil. Examples of application of Method I to field samples are reported.

Insulin-like growth factor-I (IGF-I) and IGF-binding protein-3 (IGFBP-3) concentrations compared to stimulated growth hormone (GH) in the evaluation of children treated for malignancy

OBJECTIVE

The aim of this investigation was to evaluate the utility of IGF-I and IGFBP-3 determinations in screening for GH deficiency (GHD) in children previously submitted to treatment for childhood malignancy.

PATIENTS AND METHODS

We compared the GH responses to two pharmacological tests (arginine and levo-dopa) with the IGF-I and IGFBP-3 levels in 48 patients (29 boys) who had undergone bone marrow transplantation (BMT) (36 patients) or treatment for a solid cranial tumor (12 patients).

RESULTS

22 patients (45.8%) showed GHD (i.e. GH peak < 8 ng/ml in both tests), and only three (13.6%) of the GHD patients had concomitant low IGF-I levels (i.e. -2 SD below the normal mean) and only one (4.5%) an abnormal IGFBP-3 value (i.e. -2 SD below the normal mean). Among the 26 children with normal GH secretion, 21 (80.8%) also showed normal IGF-I and IGFBP-3 levels, three (11.5%) had a concomitant low IGF-I value and two (7.7%) a concomitant low IGFBP-3 value. A significant correlation was found between GH secretion and age at diagnosis (r = 0.26, P < 0.05), and between IGF-I and IGFBP-3 (r = 0.52, P < 0.0001), but not between GH and IGF-I or IGFBP-3. Comparing the growth pattern of these patients from diagnosis to the first year after therapy or BMT, we found that while individual height changes did not correlate with the GH peak, a significant correlation was found between height SDS decrease and IGF-I (r = 0.31, P < 0.05) or IGFBP-3 SDS (r = 0.37, P < 0.01).

CONCLUSION

Our results indicate that the cut-off of -2 SD for IGF-I and IGFBP-3 was insensitive in screening for GHD. A normal value did not exclude a subnormal GH response to provocative tests and therefore although IGF-I and IGFBP-3 levels may be indicators of the growth pattern, they cannot be used alone as a tool for identifying GHD children after treatment for childhood malignancy.

An interlaboratory study to find an alternative to the MPN technique for enumerating Escherichia coli in shellfish

Nine laboratories in eight countries tested 16 batches of common mussels (Mytilus edulis) over a 32 week period in order to find an alternative to the Most Probable Number (MPN) technique to enumerate E. coli. The alternatives investigated included the 3M Petrifilm system, the Merck Chromocult agar method and a Malthus conductance technique. The Petrifilm was found to be unsuitable and was subsequently dropped from the trial. After 669 analyses, a correlation of 0.83 was observed for log E. coli counts between the MPN and Chromocult methods and there was no significant evidence that either method tended to give higher readings than the other. The MPN was slightly better than the Chromocult method for repeatability but the Chromocult was slightly better for reproducibility. However, the observed differences are probably too small to be of practical importance. On the basis of these data therefore, the two methods appear equally suitable for E. coli enumeration in shellfish. There were poor correlations between these methods and the Malthus technique. A small but significant number of samples tested positive on the Malthus instrument but were recorded negative on the MPN and Chromocult tests. Subsequent analysis positively identified E. coli from these Malthus assays. After statistical analysis, errors were noted in both the MPN and Chromocult methods but it was found that there would be no statistical differences if the Chromocult agar were used as an alternative to the MPN technique.

Cartilage associated protein (CASP) is a novel developmentally regulated chick embryo protein

A subtracted cDNA library was generated to identify cDNAs specific for chondrocyte mRNAs preferentially expressed at the hypertrophic stage with respect to early differentiation stages. The characterization of a cDNA isolated from this library that hybridizes with a 1.8 kb mRNA is described here. This mRNA is expressed at extremely low levels in dedifferentiated chondrocytes cultured in adherent conditions, at very low levels in differentiating chondrocytes and at very high levels in hypertrophic chondrocytes cultured in suspension conditions. In the developing chick embryo this mRNA is detectable in RNAs extracted from several other tissues besides cartilage. The described cDNA contains a complete open reading frame coding for a polypeptide of about 33 kDa. Homology searches with known cDNA and protein sequences have revealed that the chicken protein is related to the amino-terminal half of two mammalian nuclear antigens. By immunohistochemistry with specific rabbit antisera a strong signal was detected in the cartilage extracellular matrix of selected regions of the developing skeleton. Because of this localization of the antigen we named this protein cartilage associated protein (hereafter referred to as CASP).

Expression of runtB is modulated during chondrocyte differentiation

The runt locus in Drosophila encodes a nuclear protein involved in embryo segmentation, sex determination/X dosage compensation, and neurogenesis. runt homologues have been identified in higher vertebrates. The encoded proteins share a domain of 128 amino acids called the runt domain. It has been reported that this domain mediates DNA binding and heterodimerization. Here, we analyze runtB expression during chondrocyte differentiation "in vitro" and "in vivo." We have first isolated, from a chondrocyte library, a cDNA clone coding for a runtB chicken homologue and containing a complete open reading frame. The predicted protein product is 84% identical to the mouse PEBP2alphaB2 isoform. By RT-PCR analysis we have also cloned the chicken cDNA fragment coding for delta alphaB2, the exon sequence included in the B1 isoform mRNA. On Northern blot analysis of cultured chondrocytes, runtB mRNA levels increase dramatically with the transition from stage 0 (dedifferentiated) to stages I and II (hypertrophic chondrocytes). Moreover, runt polypeptides were demonstrated in chondrocytes both in vivo and in vitro. These results suggest that runt plays a role in chondrogenic differentiation.

Cometabolic degradation of acifluorfen by a mixed microbial culture

Laboratory experiments were conducted to study the degradation of acifluorfen 5-[2-chloro-4-(trifluoromethyl)-phenoxyl]-2-nitrobenzoic acid by a mixed microbial population. Concentrations of acifluorfen up to 100 mg/l had no inhibitory effect on the growth of microbial culture. The microorganisms degraded acifluorfen through a cometabolic process in presence of 2-nitrobenzoate. The degradation rate of acifluorfen, determined by liquid chromatography analysis in batch cultures incubated under oxygen-limited conditions were compared. The degradation was slower under oxygen than oxygen-limited conditions. Aminoacifluorfen was produced in both conditions.

Trauma care in Italy: evidence of in-hospital preventable deaths

The quality of a trauma system can be assessed by the rate of preventable deaths. A random selected sample of 110 trauma patients was examined using both clinical and autopsy data. The assessors were asked the following question: If this patient had sustained the accident in front of the hospital in a normal working day, might death have been prevented? Death was found to be unavoidable in 61 cases, in 25 cases death was classified potentially preventable; 11 cases were classified as clearly preventable death. The main failures of treatment were identified as errors and delays during the first phases of in-hospital assessment and care. An improvement in the pre-hospital phase will be almost useless if the quality of the definitive in-hospital management is not addressed.

Comparative characterization of Acinetobacter strains isolated from different foods and clinical sources

Eighty-three Acinetobacter strains from clinical sources, and 170 from various foods (including fresh and spoiled meat and fish, vegetables, raw milk and cheese) were identified according to recently improved taxonomy, using a computer-assisted probabilistic method based on phenotyping tests. Apart from some atypical characters, most of the strains (94%) were identified to belong to the genospecies or groups of genospecies described in the literature. Among our strains from hospitals, the A. calcoaceticus- A. baumannii complex predominated, whereas the strains isolated from food were predominated by genospecies 7 (A. johnsonii), followed by genospecies 8/9 (A. lwoffii). The isolates from clinical environments showed a major incidence of antibiotic resistance, haemolytic strains and strains producing polysaccharidic material.

Modulation of tensin and vimentin expression in chick embryo developing cartilage and cultured differentiating chondrocytes

It has been proposed that tensin, in association with several other proteins, mediates the micro-filament-integrin link. Here we describe the isolation of clones spanning about 5 kb from the 3' end of tensin mRNA from cultured chick embryo chondrocyte and embryonic heart cDNA libraries. Tensin expression was investigated in cultured chick embryo cells. It was observed that tensin expression is dependent upon substrate adhesion and it is turned off after 7 days of suspension culture. This process is reversible. Tensin expression is also regulated during cartilage cell differentiation in vivo; at Hamburger and Hamilton stage 39-40, non-hypertrophic tibial chondrocytes express both RNA and protein while hypertrophic chondrocytes do not. In the culture system the expression of vimentin, a major component of intermediate filaments, showed an opposite behaviour since the suspension culture enhances the accumulation of both vimentin and its mRNAs. Therefore in chick embryo cultured chondrocytes and in vivo, during cartilage development, cell shape changes and/or integrin-extracellular matrix protein interactions may be involved in the regulation of these two genes coding for cytoskeletal proteins.

Microbial metabolism of fluazifop-butyl

A microbial mixed culture able to grow on fluazifop-butyl and fluazifop was isolated. Fluazifop degradation by this microbial population was studied either when the herbicide was applied as the sole carbon source or in the presence of a second carbon source (sodium acetate or sodium propionate). The degradation rate was enhanced by sodium propionate. The degradation was found to be stereoselective. The S-enantiomer of fluazifop was degraded at a much higher rate than the R-enantiomer. Fluazifop disappearance was accompanied by formation of three metabolites which were identified by UV, IR, MS and NMR analyses. The metabolites were shown to be: 4-(5-trifluoromethyl-2-pyridyl)oxyphenol, 5-trifluoromethyl-2- hydroxypyridine and 2-(5-trifluoro-methyl pyridyl)hydroxy acetate.

Type XIV collagen is encoded by alternative transcripts with distinct 5' regions and is a multidomain protein with homologies to von Willebrand's factor, fibronectin, and other matrix proteins

The combined nucleotide sequences of several overlapping cDNAs provide the first complete amino acid sequence of type XIV collagen. Independent confirmation of the deduced sequence is provided by amino acid sequencing of several tryptic peptides isolated from purified chicken skin type XIV collagen. Comparative analyses show that the amino-terminal non-triple-helical region of alpha 1(XIV) chains contains sequence motifs that are similar to alpha 1(IX) collagen, fibronectin type III repeats, and von Willebrand's factor A-domains. The results also strongly suggest that the alpha 1(XIV) collagen gene is identical to the gene encoding the matrix component previously named undulin. cDNAs covering the 5' region of alpha 1(XIV) mRNA fall into two classes with distinct sequences in their 5'-untranslated regions. We believe the two alternative sequences result from differential splicing of the primary transcript. Interestingly, one of the untranslated sequences shows a high degree of identity with the cis-regulatory translational control sequence in the 5'-untranslated region of a Drosophila ribosomal protein mRNA. We hypothesize therefore that the sequence in alpha 1(XIV) collagen may play a role in the control of alpha 1(XIV) protein synthesis.

A study of the incidence of different fluorescent Pseudomonas species and biovars in the microflora of fresh and spoiled meat and fish, raw milk, cheese, soil and water

Of 182 various foodstuffs and environmental samples examined, 86% had microflora containing fluorescent Pseudomonas in differing proportions. A computer-aided technique was used to identify most of the 445 fluorescent strains. Pseudomonas fluorescens biovar V-1 was most frequently isolated (24%); it either predominated or was present in all types of samples. Other strains, belonging to the other subgroups of biovar V (V-2, V-4, V-5, V-6 and V-7), together represented 14.3%. We also identified Ps. fluorescens biovars I-1 and I-2 (13.9%), II-1 and II-3 (3.6%), III-1 and III-2 (8.7%), IV-2 (0.7%); Ps. putida A and B (11%); Ps. lundensis (10.3%); group B3 (2%) and Ps. aeruginosa (0.7%). Unidentified strains accounted for 10.6% of the flora, many resembling Ps. fluorescens biovar V. Although the presence of Ps. fluorescens V-1 was often marked, other taxa predominated or were present in large quantities in some particular samples, such as Ps. fluorescens I-1 in raw milk and cheese, Ps. lundensis in spoiled meat and Ps. fluorescens III-1 in spoiled fish. Pseudomonas putida A and B were evident in environmental rather than in food samples.

Glutathione is the antioxidant responsible for resistance to oxidative stress in V79 Chinese hamster fibroblasts rendered resistant to cadmium

By manipulation of Cd and Zn concentrations in the medium, several phenotypes, differing in the contents of glutathione (GSH) and metallothionein (Mt), were derived from a parental clone of V79 Chinese hamster fibroblast. In some of these phenotypes, resistance to Cd and cross-resistance to oxidative stress was developed. The highest levels of GSH and Mt were found in cells which were rendered resistant to Cd by stepwise increases of Cd and Zn in the cell medium for over 50 passages. Upon removal of Cd/Zn from the medium of these cells or addition of Cd/Zn to the parental cell medium, changes of cellular GSH and Mt levels occurred to different extents. At the same time, changes in the resistance to Cd and H2O2 were observed. Good linear correlations were observed for Mt levels x resistance to Cd and for GSH levels x resistance to H2O2. Poor linear correlations were found for Mt levels x resistance to H2O2 or for GSH levels x resistance to Cd. Moreover, addition of Zn to the medium produced an increase in Mt content without affecting the GSH content. In this case no cross-resistance to oxidative stress was developed. Therefore, Mt which has been shown to be an excellent antioxidant in in vitro experiments, does not seem to play any major role against oxidative stress in Zn and Cd challenged cells. Most of the cross-resistance to oxidative stress in Cd challenged cells seems to be accounted for by the parallel increase in GSH.

Isolation and characterization by conventional methods and genetic transformation of Psychrobacter and Acinetobacter from fresh and spoiled meat, milk and cheese

Of 126 samples of fresh and spoiled meat and dairy products, 40% were positive for the presence of Moraxella-like bacteria and 64% of Acinetobacter; 279 and 466 strains, respectively, were isolated and a part of these were tested by biochemical methods and DNA transformation assays. In some cases, the Moraxellaceae in the samples examined reached considerable quantitative levels, but their percentage in the microflora was generally low. Moraxella-like bacteria were predominant in fresh meat, Acinetobacter in spoiled meat and milk. Most acinetobacters belonged to biotype lwoffii (sensu lato) and all 90 strains tested were positive for DNA transformation with an auxotrophic Acinetobacter. Moraxella-like bacteria were identified as Psychrobacter immobilis in 96% of 103 transformation assays. Moraxellaceae show lipolytic activity but they are considered of low incidence in food spoilage. Only 3.7% of acinetobacters from dairy sources was able to produce ropy milk. Unlike strains from clinical isolates, psychrobacters and acinetobacters isolated from food often do not grow at 37 degrees C.

cDNA cloning and gene expression of chicken osteopontin. Expression of osteopontin mRNA in chondrocytes is enhanced by trypsin treatment of cells

A cDNA clone, pCP15, specific for the chicken 66-kDa major bone phosphoprotein (osteopontin), was isolated from a subtracted library enriched in DNAs coding for mRNAs expressed in chicken differentiating chondrocytes. Northern blot analysis of RNAs extracted from several chick embryo tissues and organs, confirm and extend the observation that osteopontin mRNA expression is not restricted to tissues involved in phosphate metabolism. Osteopontin mRNA was detected in sternal resting chondrocytes at higher levels than in hypertrophic chondrocytes; therefore osteopontin gene transcription occurs in chondrocytes at many stages of differentiation. The steady state level of osteopontin mRNA was enhanced by trypsin treatment of cultured cells. An increased level of osteopontin mRNA in quail chondrocytes constitutively expressing v-myc oncogene is also shown.

[The aging of the heart: weight and structural changes in the left ventricle with age]

Structural alterations of the cardiovascular system with aging are difficult to differentiate from superimposed pathologic processes. To determine whether aging "per se" affects the dimension of the heart, the weight of the heart, and the left ventricle and their rations to body weight, left ventricle wall thickness, the number of myocyte nuclei in the ventricle and the myocyte cell volume per nucleus were measured in 67 autopsies of subjects, 45 males and 22 females, who died from causes independent of cardiovascular diseases, from 17 to 90 years old. With aging, total heart weight increased slightly, while left ventricular and interventricular septum weights after dissection of the subepicardial fat decreased significantly (r = 0.44; p less than 0.001). Although left ventricular wall thickness remained constant with time, left ventricular weight to body weight ratio decreased progressively. At the structural level the number of myocyte nuclei within the left ventricle decreased (r = 0.45; p less than 0.001), whereas myocyte cell volume per nucleus increased (r = 0.30; p greater than 0.05) with age. Thus, the aging process of the heart is associated with a reduction in volume of the myocardial mass resulting from myocyte cell loss and reactive hypertrophy of the spared myocytes.

Liquid chromatographic determination of acifluorfen in soil and water

An analytical method based on the use of a liquid chromatograph equipped with a UV detector was developed for the determination of acifluorfen in soil and water. Acifluorfen was extracted from soil in methanol-0.10N NaOH (80 + 20 v/v) and from water by partition with dichloromethane. Solvent partitioning and solid-phase extraction were used to separate acifluorfen from major interfering sample components. Average recoveries from soil at 1, 0.1, and 0.01 ppm fortification levels were 95.1 +/- 3.4, 92.6 +/- 2.9, and 73.9 +/- 3.0%, respectively. Recoveries from water spiked at levels from 0.01 to 1 ppm averaged 96.5 +/- 5.4%. Method limits of detection were 0.006 ppm in soil and 0.003 ppm in water.

Prevention of non-hemolytic transfusion reactions with leucocyte-poor blood: a prospective study

Twenty-five patients with homozygous beta-thalassemia, who complained of occasional nonhemolytic transfusion reactions (NHTR), were alternately transfused eight times with normal packed red cells (PRC) and leucocyte-poor blood prepared by three methods: cotton wool filtration (CWF), buffy coat removal after dilution with saline and upright spin (BCR), and microaggregate filtration (MAF). On overall, CWF-treated RBC concentrates (CWF-RBC) contained 0.02 x 10(9) leucocytes; BCR-RBC contained 0.4 x 10(9), MAF-RBC 1.3 x 10(9) and PRC 1.7 x 10(9). The frequencies of NHTR were: CWF, 0.02; BCR, 0.04; MAF, 0.20; PRC, 0.28. Compared to PRC, both CWF and BCR significantly reduced the frequency of NHTR (p less than 0.01), whilst MAF did not (p greater than 0.1). On the other hand, in one patient CWF caused the two most severe NHTR recorded in this study, both of which were characterized by anaphylaxis.

Multiple splanchnic artery aneurysms. Report of a case

It is reported the case of a patient with multiple visceral aneurysms (seven). These aneurysms are more common than usually appreciated but their multiplicity is rarely reported in the literature. Angiography should always follow surgery when a splanchnic aneurysm is recognized by chance only at operation and when the surgeon is already aware of the multiple aneurysms. It is indicated a contemporary treatment of all of them to avoid the subsequent risk of rupture which has been suggested to increase after laparotomy.