Search

In March 2020, when the Government imposed nation-wide lockdown measures to contrast the COVID-19 outbreak, the life of Italians suddenly changed. In order to evaluate the impact of lockdown on lifestyle habits and behavioral risk factors of the general adult population in Italy, we set up the Lost in Italy (LOckdown and lifeSTyles IN ITALY) project. Within this project, the online panel of Doxa was used to conduct a web-based cross-sectional study during the first phase of the lockdown, on a large representative sample of adults aged 18-74 years (N=6003). The self-administered questionnaire included information on lifestyle habits and perceived physical and mental health, through the use of validated scales. As we are working within the Lost in Italy project, we got two additional grants to further research on the medium-term impact of lockdown, a topic of great interest and with anticipated large socio-economic and public health implications. In details: we obtained by the AXA Research Fund support to evaluate the impact of COVID-19 lockdown on physical, mental, and social wellbeing of elderly and fragile populations in the Lombardy region, the area most heavily hit by the pandemic in the country. Moreover, as a fruitful integration, we obtained support by the Directorate General for Welfare of the region to assess health services delivery and access to healthcare in the same study population, combining an analysis of administrative databases with an economic analysis. We are confident that the solid background of our partners, the multi-disciplinary competencies they bring, together with appropriate funding and access to rich data sources will allow us to fulfill our research objectives. (www.actabiomedica.it)

The emergency caused by Covid-19 pandemic raised interest in studying lifestyles and comorbidities as important determinants of poor Covid-19 prognosis. Data on tobacco smoking, alcohol consumption and obesity are still limited, while no data are available on the role of e-cigarettes and heated tobacco products (HTP). To clarify the role of tobacco smoking and other lifestyle habits on COVID-19 severity and progression, we designed a longitudinal observational study titled COvid19 and SMOking in ITaly (COSMO-IT). About 30 Italian hospitals in North, Centre and South of Italy joined the study. Its main aims are: 1) to quantify the role of tobacco smoking and smoking cessation on the severity and progression of COVID-19 in hospitalized patients; 2) to compare smoking prevalence and severity of the disease in relation to smoking in hospitalized COVID-19 patients versus patients treated at home; 3) to quantify the association between other lifestyle factors, such as e-cigarette and HTP use, alcohol and obesity and the risk of unfavourable COVID-19 outcomes. Socio-demographic, lifestyle and medical history information will be gathered for around 3000 hospitalized and 700-1000 home-isolated, laboratory-confirmed, COVID-19 patients. Given the current absence of a vaccine against SARS-COV-2 and the lack of a specific treatment for -COVID-19, prevention strategies are of extreme importance. This project, designed to highly contribute to the international scientific debate on the role of avoidable lifestyle habits on COVID-19 severity, will provide valuable epidemiological data in order to support important recommendations to prevent COVID-19 incidence, progression and mortality.

The Erice 2018 Charter was unanimously approved at the conclusion of the 53rd Residential Course of the International School of Epidemiology and Preventive Medicine “Adapted Physical Activity in Sport, Wellness and Fitness; the role of the Departments of Prevention and of the National Health Service in doping prevention and health promotion”, held on 15-19 May 2018 in Erice, Italy, at the “Ettore Majorana” Foundation and Centre for Scientific Culture, and promoted by the Study Group on “Movement Sciences for Health” of the Italian Society of Hygiene, Preventive Medicine and Public Health. The event was part of a larger project supported by the Ministry of Health aimed at preventing doping in the general population involved in sport and physical activities. After an intense discussion the participants focused on ten statements involving the following critical issues: responsibility, priority, message, alphabetization, networks and alliances, school promoting health, player and opportunities, competences, know-how, programming and acting. These statements provide hints to approach doping within a public health frame and summarize the role of the Departments of Prevention and NHS in promoting and coordinating preventive actions with other institutions and stakeholders. Doping represents a complex phenomenon related to cultural, social, economic and legal issues. In addition to regulatory or repressive actions, education to health and legality is proposed as the fundamental strategy to contrast doping by promoting healthy lifestyles, based on scientific knowledge and respect for legality.

Gambling is widely recognized as an important public health problem. Despite the rising use of stimulant substances among adolescents, there are still very few studies focusing on whether adolescents' use of stimulants is associated with their gambling behaviour. Therefore, the aim of this study was to investigate the association between gambling habits and consumption of stimulants such as coffee, energy drinks, and new psychoactive substances in a sample of Italian adolescents. A survey was conducted in 2017 with a representative sample of Italians between the ages of 14-17 years, comprising 15,833 students attending 201 secondary schools. Logistic regression analyses were run to assess the association between at-risk/problem gambling (O1) and independent predictors: the model included independent variables (coffee, energy drinks and new psychoactive substance consumption) and covariates (demographic variables, social environment variables and risk-taking behaviour variables). A sensitivity analysis was also conducted to examine a second dependent variable regarding any experience of gambling behaviour (O2). Adolescents who were at-risk gamblers or problem gamblers were significantly more likely to consume energy drinks than non-gamblers or not-at-risk gamblers. A similar pattern was seen for consumption of new psychoactive substances. No significant association emerged with coffee consumption. The sensitivity analysis showed that, compared with non gamblers, the group of gamblers had higher odds for frequent coffee consumption, as well as for consumption of energy drinks and/or new psychoactive substances. Screening for gambling and stimulant use may provide important information, as it may be necessary to take action to reduce stimulant substance use as part of efforts to deal with unhealthy gambling habits.El juego es un importante problema de salud pública ampliamente reconocido. A pesar del creciente uso de sustancias estimulantes entre los adolescentes, todavía son escasos los estudios centrados en verificar la existencia de una asociación entre el uso de estimulantes y los comportamientos relacionados con el juego en adolescentes. Por tanto, este estudio tuvo como objetivo investigar la asociación entre los hábitos relacionados con el juego y el consumo de sustancias estimulantes como el café, las bebidas energizantes y las nuevas sustancias psicoactivas en una muestra de adolescentes italianos. En 2017 se realizó una encuesta en una muestra representativa de jóvenes italianos de 14 a 17 años, constituida por 15 833 estudiantes provenientes de 201 escuelas de educación secundaria. Se realizó un análisis de regresión logística para evaluar la asociación entre juego de riesgo/juego problemático (R1) y factores predictivos independientes: el modelo incluyó variables independientes (café, bebida energética y consumo de nuevas sustancias psicoactivas) y otras covariables demográficas, del entorno social y de conductas de riesgo. También se realizó un análisis de sensibilidad para examinar una segunda variable dependiente con respecto a cualquier experiencia de conductas relacionadas con el juego (R2). Los adolescentes clasificados como jugadores de riesgo o jugadores con problemas tenían una probabilidad significativamente mayor de consumir bebidas energizantes que los no jugadores o los jugadores sin riesgo. Se observó un patrón similar en el consumo de nuevas sustancias psicoactivas. No se evidenció ninguna asociación significativa con el consumo de café. El análisis de sensibilidad mostró que, en comparación con los no jugadores, el grupo de jugadores tenía mayores probabilidades de consumo frecuente de café, bebidas energéticas y/o nuevas sustancias psicoactivas. La evaluación del juego y el uso de sustancias estimulantes puede proporcionar información importante. Por consiguiente, podría ser necesario tomar medidas para reducir el uso de sustancias estimulantes como parte de los esfuerzos dirigidos a lidiar con los hábitos de juego poco saludables.

Monitoring pharmacological active compounds in pharmaceutical preparations of medical cannabis and in conventional and non-conventional biological matrices of treated individuals use requires both a wide linear range and sensitive detection. We have developed and validated a fast and sensitive method using ultra-high performance liquid chromatography coupled with tandem mass spectrometry (UHPLC-MS/MS) for analysis of -9-tetrahydrocannabinol (THC), cannabidiol (CBD), their acidic precursors -9-tetrahydrocannabinolic acid A (THCA-A) and cannabidiolic acid (CBDA) and some major metabolites of THC such as 11-nor-9-carboxy-THC (THC-COOH), 11-hydroxy-THC (11-OH-THC), -9-THC-Glucuronide (THC-GLUC) and THC-COOH-Glucuronide (THC-COOH-GLUC) in conventional (whole blood and urine) and non-conventional (oral fluid and sweat) of individual treated with medical cannabis preparation. Specifically, THC, THCA-A, CBD and CBD-A were determined in cannabis decoction and oil prepared to treat individuals. The method used positive electrospray ionization (ESI) mode to reach the sensitivity needed to detect minimal amounts of analytes under investigations exposure with limits of quantification ranging from 0.2 to 0.5 ng per milliliter (ng/mL) or ng per patch in case of collected sweat. The validation results indicated this method was accurate (average inter/intra-day error

Immunotherapy has been changing the scenario of the treatment of non-small cell lung cancer (NSCLC) and is leading to a dramatic improvement in the clinical outcome of patients suffering from this disease. Immunotherapy has a specific toxicity profile and many oncologists are facing a new challenge in the form of clinical management of immune-related adverse events (irAEs). Even though most irAEs remain mild in intensity, around 10% of patients treated with anti-PD1/anti-PDL1 drugs will develop severe, sometimes life-threatening, dysimmune toxicities. Skin toxicity is one of the most common irAEs. The irAEs related to skin toxicity can have many different presentations, which includes maculopapular or papulopustular rash, Sweet’s syndrome, follicular or urticarial dermatitis. It typically occurs within 6 weeks from the beginning of the treatment but, due to the mechanism of action of immunotherapic drugs, delayed toxicities are reported. We present a case study of delayed grade 4 skin toxicity in a 75-year-old male patient with stage IV squamous NSCLC treated with Nivolumab.

Background: Electronic cigarettes (e-cig) known as electronic nicotine devices recently gained popularity among smokers. Despite many studies investigating their safety and toxicity, few examined the delivery of e-cig-derived nicotine and its metabolites in alternative biological fluids. Methods: We performed a randomized, crossover, and controlled clinical trial in nine healthy smokers. Nicotine (NIC), cotinine (COT), and trans-3'-hydroxycotinine (3-HCOT) were measured in plasma and oral fluid by liquid chromatography-tandem mass spectrometry after consumption of two consecutive e-cig administrations or two consecutive tobacco cigarettes. Results: NIC and its metabolites were detected both in oral fluid and plasma following both administration conditions. Concentrations in oral fluid resulted various orders of magnitude higher than those observed in plasma. Oral fluid concentration of tobacco cigarette and e-cig-derived NIC peaked at 15 min after each administration and ranged between 1.0 and 1396 mu g/L and from 0.3 to 860 mu g/L; those of COT between 52.8 and 110 mu g/L and from 33.8 to 94.7 mu g/L; and those of 3-HCOT between 12.4 and 23.5 mu g/L and from 8.5 to 24.4 mu g/L. The oral fluid to plasma concentration ratio of both e-cig- and tobacco cigarette-derived NIC peaked at 15 min after both administrations and correlated with oral fluid NIC concentration. Conclusions: The obtained results support the measurement of NIC and metabolites in oral fluid in the assessment of intake after e-cig use and appear to be a suitable alternative to plasma when monitoring nicotine delivery from e-cig for clinical and toxicological studies.

Skeletal remodelling is a continuous process during life and is still active also in extreme senescence. In the elderly, bone resorption often prevails over bone formation, causing bone loss and fragility. Elderly subjects are exposed to the risk of fractures, and loss of self-sufficiency, if considering that the proximal femur is the most frequently involved site. Bone remodelling can maintain circulating calcium within physiological ranges, at the expense of a substantial loss of this ion from the skeleton, particularly during senescence. Calcium metabolism is regulated at cellular/molecular level by a network of cytokines, growth factors, systemic hormones that act on bone in paracrine/autocrine/systemic fashion. Among the molecules involved in bone metabolism, parathyroid hormone (PTH) and vitamin D present some peculiar aspects during senescence. The osteometabolic features in a consistent group of centenarians have been evaluated. It results that a severe hypovitaminosis D was present in 99 out of 104 centenarians (25-OH vitamin D below 5 nmol/L), and that it plays an important role as a factor inducing a vicious circle involving hypocalcemia, secondary hyperparathyroidism, together with biochemical features indicating a consistent bone loss. Serum C-terminal cross-linking telopeptide, a specific marker of bone resorption was elevated in 92% of these subjects. Moreover, it has been found that several femoral fractures had occurred after 90 years of age. These data offer a rational for the possible prevention of elevated bone turnover, bone loss and consequently the reduction of osteoporotic fractures and fractures-induced disability, in the oldest olds, through the simple supplementation with calcium and vitamin D.

On 25/11/2014 the patient VHG arrives at emergency department of Cardarelli Hospital in Naples following prolonged confusional state and total loss of memory in the last 24 hours. The episode is diagnosed as transient global amnesia (TSA). During the hospitalization the patient receives specialist visits that don't reveal any abnormalities. The patient reports that he assumed, a few hours before the onset of amnesia, a dietary supplement. The product named "Sex Bull", purchased online, it’s indicated for the improvement of sexual performance both in men than in women and, in according to label, it doesn't contain any pharmacological active ingredient. Poison Control Centre of Cardarelli Hospital provides to send a sample of tablets of "Sex Bull" to Superior Institute of Health (Rome) for a qualitative and quantitative determination of components. The analyses show the presence of Paracetamol, vitamin C, sugar and Sildenafil at the dosage of 100 ± 1.5 mg Sildenafil is a drug used in clinical practice for the treatment of erectile dysfunction and the sale of pharmaceutical products containing the active substance "Sildenafil" is subject to medical prescription. In literature, are published several case-reports and a review reporting cases of TGA following a first administration of Sildenafil. In this case report, it’s difficult to establish the causal link between the adverse drug reaction (ADR) and the consumption of the active substance Sildenafil, because "Sex Bull” it is a counterfeit drug. The production and distribution of counterfeit drugs is not done according to Good Manufacturing Practice and Good Distribution Practice so the quality of pharmacological active ingredients isn't guaranteed. Because of these reasons it is not possible establishing any form of interaction between counterfeit products and other pharmaceutical therapies in progress or the ability of these drugs to induce serious ADR or aggravate a pre-existing medical condition.

Altered behavior due to prenatal smoke exposure was examined in 25 neonates born from smoking mothers who consumed at least 5 cigarettes/d during the entire gestation. Data were compared with 25 matched neonates born from nonsmoking mothers. Neonatal behavior was evaluated using the Brazelton Neonatal Behavioral Assessment Scale (BNBAS). Antenatal exposure to tobacco smoke at the end of the pregnancy was determined by measurement of urinary cotinine. Newborns from smoking mothers showed significant lower scores in various BNBAS items compared with neonates from nonsmoking mothers. A strong correlation was observed between infant irritability and urinary cotinine in newborns from smoker and nonsmoking mothers and with number of daily smoked cigarettes and maternal nicotine daily intake of infants exposed to active maternal smoking. Linear regression analysis showed that urinary cotinine was the best predictor of infant irritability (r(2) = 0.727). The latter was also associated to the neonate's low level of attention and poor response to inanimate auditory stimuli. Among infants from nonsmoking mothers, paternal smoking significantly correlated with infant urinary cotinine and infant irritability, being also the best predictor of irritability (r(2) = 0.364). Neonatal behavior can be significantly altered in a dose-dependent manner even after modest prenatal exposure to tobacco smoke.

The difficulty of identifying immature germ cells in unstained, fresh semen has led most laboratories to use the broad definition 'round cells' to indicate cells other than spermatozoa, thus grouping together both leukocytes and immature germ cells. This is also the case in research andrology, where very little attention has been given to immature germ cells in the semen apart from some rare exceptions, such as the attempts to study meiosis. Here we report on the use of a discontinuous Percoll gradient method modified to enable the best separation possible of immature germ cells from the other cells found in the ejaculate, in order to obtain a cellular suspension free of spermatozoa. Our technique (intra-assay variation in duplicates < 10%) demonstrated a high immature germ cell concentration in gradient fractions with 30% to 45% Percoll with a small contamination (1.5-6%) of leukocytes, confirmed by May-Grunwald-Giemsa staining, immunofluorescence and cytofluorimetry. The concentrations of immature germ cells ranged from zero in obstructive azoospermia to 2.0 x 10(6)/ml in oligozoospermia and genital tract infection. The purified immature germ cell suspensions obtained can be useful for diagnostic and research purposes.

1. Mild stress plus mild pain (solvent injection) applied daily to neonatal mice induces hormonal, behavioural and metabolic changes perduring in the adult life. 2. We investigated whether daily mild stress to neonatal mice induces also long-term defined changes of immune response, and whether immune changes are prevented through repeated administration of the opioid antagonist naloxone. 3. Mild stress plus solvent injection administered from birth to the 21st postnatal day causes not only behavioural and metabolic changes, but also long-term (up to 110 days of life) splenocytes modifications, consisting in: increased release of the Th-1 type cytokines interleukin-2 (IL-2) (from an average of 346 to 788 pg ml(-1)), interferon-gamma (from 1770 to 3942) and tumour necrosis factor-alpha (from 760 to 1241); decreased release of the Th-2 type cytokines IL-4 (from 49.1 to 28.4) and IL-10 (from 1508 to 877). Moreover, enhanced natural killer-cell activity; enhanced proliferative splenocytes properties in resting conditions and following phytohemoagglutinin and concanavalin-A stimulation are observed. Immunological, behavioural and metabolic changes are prevented by the opioid antagonist (-)naloxone (1 mg kg(-1) per day s.c., administered instead of solvent) but not by the biologically inactive enantiomorph (+)naloxone. 4. In conclusion, endogenous opioid systems sensitive to naloxone are involved in long-lasting enhancement of the Th-1 type cytokines and cell-mediated immunological response caused by repeated mild stress administered postnatally.

In vivo studies have shown T cells to be central to the mechanism by which estrogen deficiency induces bone loss, but the mechanism involved remains, in part, undefined. In vitro , T cells from ovariectomized mice produce increased amounts of tumor necrosis factor (TNF), which augments receptor activator of NF-κB ligand (RANKL)-induced osteoclastogenesis. However, both the mechanism and the relevance of this phenomenon in vivo remain to be established. In this study, we found that ovariectomy increased the number of bone marrow T cell-producing TNF without altering production of TNF per T cell. Attesting to the essential contribution of TNF, ovariectomy induced rapid bone loss in wild type (wt) mice but failed to do so in TNF-deficient (TNF −/− ) mice. Furthermore, ovariectomy induced bone loss, which was absent in T cell-deficient nude mice, was restored by adoptive transfer of wt T cells, but not by reconstitution with T cells from TNF −/− mice. These findings demonstrate the key causal role of T cell-produced TNF in the bone loss after estrogen withdrawal. Finally, ovariectomy caused bone loss in wt mice and in mice lacking p75 TNF receptor but failed to do so in mice lacking the p55 TNF receptor. These findings demonstrate that enhanced T cell production of TNF resulting from increased bone marrow T cell number is a key mechanism by which estrogen deficiency induces bone loss in vivo . The data also demonstrate that the bone-wasting effect of TNF in vivo is mediated by the p55 TNF receptor.

This document presents a comprehensive overview of biochemistry and physiology of transferrin (Tf) and carbohydrate-deficient transferrin (CDT) and on the role of CDT as alcohol abuse marker. It discusses the characteristics of the available analytical methodologies for CDT determination and finally presents a set of recommendations. CDT measurements should be performed only in accredited laboratories, having a quality system in place and regularly performing IQC and participating in EQAS. Unequivocal patient identification and a documented chain of custody are needed. Non hemolysed serum is the preferred sample and, if it has to be stored for more than 8 h, freezing at -20°C is recommended. Immunological methods are acceptable only as first level testing. A confirmation of positive findings with analytical methods based on different physicochemical principles is recommended. The result should be expressed as percentage of disialo-Tf on total Tf. Each laboratory should establish its own decision limit based on the characteristics of the analytical method used and on the scope for which the measurement is performed. The employed analytical method should be indicated in the final report.