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Objective. Vulvodynia is a chronic clinical condition characterized by provoked or non-provoked vulvar pain for at least 3 months of unknown etiology. The onset of vulvodynia involves a complex interplay of peripheral and central pain mechanisms, such as pelvic floor muscle and autonomic dysfunction, and interpersonal factors. A stepwise approach of pelvic floor physical therapy as medical management is suggested. In this scenario, by this meta-analysis of randomized controlled trials, we aimed to evaluate the efficacy of rehabilitation interventions in patients with vulvodynia. Methods. On October 13, 2022, PubMed, Scopus, and Web of Science were systematically searched for randomized controlled trials that assessed the efficacy of the rehabilitative approach to pain during intercourse in patients with vulvodynia. The quality assessment was performed with the Cochrane risk-of-bias tool for randomized trials. The trial registration number is CRD42021257449. At the end of the search, 9 studies were included for a total of 332 patients. A pairwise meta-analysis was performed to highlight the efficacy of rehabilitative approaches for reducing pain during intercourse, as measured with a visual analog scale or a numerical rating scale. Results. Meta-analysis showed that all these rehabilitative approaches had an overall effect size of -1.43 (95% CI = -2.69 to -0.17) in decreasing vulvodynia pain in terms of the visual analog scale. In the subgroup analysis, a significant effect size in acupuncture (effect size = -2.36; 95% CI = -3.83 to -0.89) and extracorporeal shockwave therapy (effect size = -2.94; 95% CI = -4.31 to -1.57; [I.sup.2] = 58%) was observed. According to the Cochrane risk-of-bias tool, a low risk of bias for outcome selection in 89% of studies. Conclusion. Findings from this meta-analysis suggested that the physical agent modalities and complementary medicine techniques in people with vulvodynia appear to be more effective than placebo, sham, or waiting list. Further evidence on physical agent modalities and complementary therapies are warranted in the future. Impact. This was the first systematic review and meta-analysis of randomized controlled trials to provide evidence on the efficacy of rehabilitation interventions in patients with vulvodynia. Keywords: Pain, Pelvic Floor Pain, Physical Agent Modalities, Physical Therapy, Vulvodynia, Introduction Vulvodynia is a chronic clinical condition of unknown etiology characterized by vulvar pain for at least 3 months without other dermatological or gynecological disorders according to the International Society [...]

Let Rbe a prime ring of characteristic different from 2, Qrits right Martindale quotient ring, Cits extended centroid, La non-central Lie ideal of R, n≥1a fixed integer, Fand Gtwo generalized derivations of R. If (F(xy)-G(x)G(y))n=0, for any x,y∈L, then there exists λ∈Csuch that F(x)=λ2xand G(x)=λx, for any x∈R. Moreover, we analyze the semiprime case.

As the global plastics crisis grows, numerous technologies have been invented and implemented to recover plastic pollution from the environment. Although laudable, unregulated clean-up technologies may be inefficient and have unintended negative consequences on ecosystems, for example, through bycatch or removal of organic matter important for ecosystem functions. Despite these concerns, plastic clean-up technologies can play an important role in reducing litter in the environment. As the United Nations Environment Assembly is moving toward an international, legally binding treaty to address plastic pollution by 2024, the implementation of plastic clean-up technologies should be regulated to secure their net benefits and avoid unintended damages. Regulation can require environmental impact assessments and life cycle analysis to be conducted predeployment on a case-by-case basis to determine their effectiveness and impact and secure environmentally sound management. During operations catch-efficiency and bycatch of nonlitter items, as well as waste management of recovered litter, should be documented. Data collection for monitoring, research, and outreach to mitigate plastic pollution is recommended as added value of implementation of clean-up technologies.

Background: Previous evidence showed that cellular aging is a multifactorial process that is associated with decline in mitochondrial function. Physical exercise has been proposed as an effective and safe therapeutical intervention to improve the mitochondria network in the adult myocytes. Aims: The aim of this systematic review of randomized controlled trials (RCTs) was to assess the exercise-induced muscle mitochondria modifications in older adults, underlining the differences related to different exercise modalities. Methods: On November 28th, 2021, five databases (PubMed, Scopus, Web of Science, Cochrane, and PEDro) were systematically searched for RCTs to include articles with: healthy older people as participants; physical exercise (endurance training (ET), resistance training (RT), and combined training (CT)) as intervention; other different exercise modalities or physical inactivity as comparator; mitochondrial modifications (quality, density and dynamics, oxidative, and antioxidant capacity) as outcomes. The quality assessment was performed according to the PEDro scale; the bias risk was evaluated by Cochrane risk-of-bias assessment tool. Results: Out of 2940 records, 6 studies were included (2 assessing ET, 2 RT, 1 CT, and 1 both ET and RT). Taken together, 164 elderly subjects were included in the present systematic review. Significant positive effects were reported in terms of mitochondrial quality, density, dynamics, oxidative and antioxidant capacity, even though with different degrees according to the exercise type. The quality assessment reported one good-quality study, whereas the other five studies had a fair quality. Discussion: The overall low quality of the studies on this topic indicate that further research is needed. Conclusion: RT seems to be the most studied physical exercise modality improving mitochondrial density and dynamics, while ET have been related to mitochondrial antioxidant capacity improvements. However, these exercise-induced specific effects should be better explored in older people.

The COVID-19 pandemic led to a sudden global increase in the production, consumption, and mismanagement of personal protective equipment (PPE). As plastic-based PPE such as disposable face masks and gloves have become widely used, human exposure to PPE-derived pollutants may occur through indirect and direct pathways. This review explores the potential health impacts related to plastic-based PPE through these pathways. Face masks release microplastics, which are directly inhaled during use or transported through the environment. The latter can adsorb chemical contaminants and harbor pathogenic microbiota, and once consumed by organisms, they can translocate to multiple organs upon intake, potentially causing detrimental and cytotoxic effects. However, more research is required to have a comprehensive overview of the human health effects.

Lumbar spinal stenosis (LSS) causing neurogenic claudication (NC) is increasingly common with an aging population and can be associated with significant symptoms and functional limitations. We developed this guideline to present the evidence and provide clinical recommendations on nonsurgical management of patients with LSS causing NC. Using the GRADE approach, a multidisciplinary guidelines panel based recommendations on evidence from a systematic review of randomized controlled trials and systematic reviews published through June 2019, or expert consensus. The literature monitored up to October 2020. Clinical outcomes evaluated included pain, disability, quality of life, and walking capacity. The target audience for this guideline includes all clinicians, and the target patient population includes adults with LSS (congenital and/or acquired, lateral recess or central canal, with or without low back pain, with or without spondylolisthesis) causing NC. The guidelines panel developed 6 recommendations based on randomized controlled trials and 5 others based on professional consensus, summarized in 3 overarching recommendations: (Grade: statements are all conditional/weak recommendations) Recommendation 1. For patients with LSS causing NC, clinicians and patients may initially select multimodal care nonpharmacological therapies with education, advice and lifestyle changes, behavioral change techniques in conjunction with home exercise, manual therapy, and/or rehabilitation (moderate-quality evidence), traditional acupuncture on a trial basis (very low-quality evidence), and postoperative rehabilitation (supervised program of exercises and/or educational materials encouraging activity) with cognitive-behavioral therapy 12 weeks postsurgery (low-quality evidence). Recommendation 2. In patients LSS causing NC, clinicians and patients may consider a trial of serotonin–norepinephrine reuptake inhibitors or tricyclic antidepressants. (very low-quality evidence). Recommendation 3. For patients LSS causing NC, we recommend against the use of the following pharmacological therapies: nonsteroidal anti-inflammatory drugs, methylcobalamin, calcitonin, paracetamol, opioids, muscle relaxants, pregabalin (consensus-based), gabapentin (very low-quality), and epidural steroidal injections (high-quality evidence).

Purpose: This study aims to evaluate the relevance of telerehabilitation during the spread of the COVID-19 pandemic based on the prevalence of participation and activity International Classification of Functioning, Disability and Health (ICF) domains in a population with disabilities. Design/methodology/approach: We perfomed an observational study of ICF files of people with disabilities pre- and post-three-months lockdown imposed by the government to stop the spread of the COVID-19 pandemic. Findings: ICF qualifiers such as performing the daily routine (d230), using communication devices and techniques (d360) and doing housework (d640) showed a significant decrease of the disabilities (p < 0.05). Instead, a significant increase (p < 0.05) in disability was evident in relating with strangers (d730); informal social relationships (d750); acquiring, keeping and terminating a job (d845); complex economic transactions (d865); community life (d910); and recreation and leisure (d920). Practical implications: Telerehabilitation should not be regarded as home-based rehabilitation delivered through technology. The results show how telerehabilitation should be a functional diagnostic tool and monitoring of patients’ rehabilitation needs. Originality/value: Through a comprehensive classification scale of disability, it is possible to redefine the term telerehabilitation.

AbstractIn this paper, a live hectocotylus, found inside a stranded female Argonauta argoshell, allowed us to describe the behaviour of this copulatory arm and add new information on its morphology. The hectocotyluspenile filament is contained in a special membranous pocket or sac, almost completely transparent, extending from the apex of the basal part to about one-third of the central section. The hectocotylus assumes a folded position to protect the penile filament in the membranous sac. This is probably extracted only when copulation occurs. Our observations seem to suggest that the shell may have the secondary function of storing and protecting the hectocotylireceived by males until the copulation. The observations confirmed the high vitality and endurance of the hectocotylus after detachment from the A. argomale.

PHOTO (COLOR): This handful of trash is made up of plastic. PHOTO (COLOR): My team works hard to collect plastic trash from beaches. PHOTO (COLOR): We look at plastic trash under a microscope. [Extracted from the article]

Background/AimsThe person in this case study was a man with prostatic cancer and diastasis rectus abdominis. Perineal rehabilitation was needed to prevent urinary incontinence, before and after a radical prostatectomy. This study reports on an original application of kinesio tape to reduce the diastasis rectus abdominis so that he could carry out the rehabilitation programme.MethodsThree green-coloured Y-type tapes (width 5 cm and length 15 cm) were positioned to form an X, orthogonally at the linea alba, separating the tape half in width and two-thirds of a grid in length into 2 ends, under 75% pulling force (above and below the navel), and two green-coloured I-type tapes (width 5 cm and length 30 cm) positioned in parallel at the rectus abdominis, from the external face of the 5th, 6thand 7thcostal cartilage and by the xiphoid process to the upper part of the pubis tubercle and pubic symphysis under 50% pulling force. Kinesio tapes were applied daily before every session of the perineum rehabilitation.FindingsA significant reduction of the diastasis was observed by ultrasound, after the kinesio tape was applied.ConclusionsThis case demonstrates that it was possible to perform a pre- and post-operative perineal rehabilitation programme after the application of kinesio tape, which efficiently reduced the diastasis rectus while performing exercises, with the aim to prevent urinary incontinence.

Brain drug delivery is hampered by the presence of the blood brain barrier and nanocarriers, administered by intranasal route, could represent an alternative and efficient strategy to improve drug localization in the Central Nervous System (CNS). The aim of this work is to design and characterize non-ionic surfactant vesicles (NSVs) and perfluorocarbon gas non-ionic surfactant based nanobubbles (VNBs) suitable for Nose to Brain Delivery (N2B). In particular, Pluronic F127, Span 85 and cholesterol have been employed to prepare NSVs and VNBs. Both systems have been characterized in terms of (a) hydrodynamic diameter, ζ-potential and morphology (b) vesicle bilayer feature (anisotropy), (c) physical-chemical stability and (d) fluorescent model probe release capability. VNBs have been also studied in terms of gas entrapment and acoustic efficiency. In addition, in order to understand optimal ultrasound (US) parameters to obtain in vitrostable cavitation, the acoustic pressure effect on VNBs fluorescent probes release kinetics was evaluated. The obtained results suggest that NSVs and VNBs show a hydrodynamic diameter suitable for N2B delivery. Moreover, in this study, we develop a new kind of protocol to evaluate an in vitroUS characterization of VNBs and our data suggest a stable and controlled probe release, encouraging the possibility to deliver VNBs in mixture with NSVs loaded neuroprotective drugs for brain delivery coupled to US obtaining stable cavitation. In this context, extracellular field recordings in specific area of hippocampus (CA1-CA3) have been carried out in order to assure that empty NSVs do not affect synaptic plasticity in the form of long-term potentiation, a molecular mechanism which underlies learning and memory.

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Musculoskeletal disorders (MSD) are a crucial issue in current literature due to their impact on physical function, social, and economic costs. Rehabilitation plays a pivotal role in the therapeutic management of these disabling conditions with growing evidence underlining positive effects in improving functional outcomes. However, to date, several questions are still open about the mechanisms underpinning functional improvements while recent research is now focusing on a deeper understanding of the biophysical processes underpinning the macroscopical effects of these treatments. Thus, this narrative review aims at providing a comprehensive overview about the state of the art of biophysical dimensions of currently available treatments for MSD. PubMed, Scopus, CENTRAL, PEDro, and Web of Science were searched between March 2022 and October 2022 for in vitroand in vivostudies, clinical trials, systematic reviews, and meta-analysis addressing the issue of biophysics-based approach in rehabilitation of MSD. Our findings showed that a biophysical approach might be integrated into regenerative rehabilitation, aiming at enhancing regenerative processes by mechanical and biophysical stimuli. In addition, a biophysical-based approach has been proposed to improve knowledge about several instrumental physical therapies, including shock wave therapies, low-level laser therapy, ultrasound, short-wave diathermy, electrical stimulation, pulsed electromagnetic field, and vibration therapy. In accordance, emerging research is now focusing on the biophysical properties of several medical procedures to improve pain management in patients with MSD. Taken together, our results showed promising results of the integration of a biophysical-based approach in rehabilitation, albeit several limitations currently limit its implementation in routine clinical setting. Unfortunately, the state of the art is still inconclusive, and the low quality of clinical studies based on the biophysical approach did not provide clear treatment protocols. Further studies are needed to promote a precise rehabilitation approach targeting biological modification and enhancing the functional improvement of patients with MSDs.

Lumbar spinal stenosis (LSS) is a growing health problem and a leading cause of disability and loss of independence in older adults. It is usually caused by age-related degenerative narrowing of the spinal canals leading to compression and ischemia of the spinal nerves and symptoms of neurogenic claudication. Limited walking ability is the dominant functional impairment caused by LSS. Animal studies suggest increased blood flow to the spinal nerves and spinal cord with superficial paraspinal electrical stimulation. The purpose of this study is to assess the effectiveness of paraspinal transcutaneous electrical nerve stimulation (TENS) applied while walking on walking ability in patients with LSS.

People with knee or hip osteoarthritis (OA) can experience comorbid lumbar spinal stenosis (LSS), but the impact on treatment outcomes is unknown. The aim of this study was to investigate associations between comorbid LSS symptoms and changes in pain, function, and quality of life following a patient education and exercise therapy program.

Letter to the Editor

The aim was to examine the physiological responses and activity patterns of a Beach soccer friendly match, involving varsity ten male players (age: 23.6±4.4 yrs; height: 177±0.05 cm; body mass: 71.8±3.8 kg). The match was arranged to evaluate heart rates, blood lactate, lower limbs power performance and time motion analysis (TMA), considering: standing, walking, jogging, running and sprinting, and technical and tactical aspects. The match imposed a mean HR of 166±16 beat·min-1, corresponding to an overall mean of 85.3±8% of the maximum heart rate (HRmax). The mean value of blood lactate (La) was 6.20 mM. The TMA results showed that for 51% of the match the players performed very low intensity activities. The notational analysis (NA) showed that during the 60.8% of the offensive actions 2 players were involved and the 54.1% of the offensive actions was performed by one pass. The beach soccer is an intermittent high intensity sport with a significant involvement of anaerobic metabolism. The results of TMA and NA underscored that the sand does not support the movements of players overall the high intensity running. Team work is difficult to implement due to irregular rebounds doesn’t consent precise passes.

Striving for enhancing athletic performance, many sportsmen undergo rigid dietary habits, which could lead to eating disorders (EDs) or Orthorexia Nervosa (ON), a psychopathological condition characterized by the obsession for high quality food. The aim of the study was to examine the occurrence of ON in athletes and to verify the relationship between ON and EDs. Five-hundred-seventy-seven athletes and 217 matched controls were administered the following tests: ORTO-15, Eating Attitude Test 26 (EAT-26), Body Uneasiness Test (BUT) and Yale-Brown-Cornell Eating Disorder Scale (YBC-EDS). High positivity to ORTO-15 (28%) and EAT-26 (14%) emerged in athletes, whereas a high rate of BUT positivity was evident among controls (21%). Multivariate logistic regression analysis revealed that independent predictors of ON are previous dieting, age, positivity to YBC-EDS, positivity to EAT-26, competition level, and number of YBC-EDS preoccupations and rituals. Sharing many features with both EDs and Obsessive-Compulsive Spectrum, ON represents a crossroad between these pathologic conditions and might compromise the health state of an athlete. Therefore, coaches should consider important to detect symptoms of EDs and ON in their athletes.

This study aimed to show the intensity of efforts, swimming patterns, and technical and tactical aspects of waterbasket. In particular, during a friendly waterbasket match, ten male water polo players (age: 17±1 yrs; height: 179±9 cm; body mass: 74±15 kg) were analyzed in terms of heart rate, blood lactate, grip strength, swimming patterns (horizontal and vertical swimming with and without ball possession), and technical and tactical aspects (actions, passes, players involved, lost possessions, fouls, and occurrence, successful, and origin area of shots). Results showed differences for heart rate intensities (p<0.05), highlighting the 81-90% of maximal heart rate as the most frequent category. After the 2nd (4.2±1.6 mM) and 4th (4.6±2.2 mM) period, the lactate concentrations was higher than before the match (p<0.05). No differences has been reported for grip strength. Vertical swimming was the most frequent activity (74%) and the others did not show patterns longer than 10 s. Waterbasket match has been mainly characterized by Even actions (68%) and shots performed outside the 1.5m area, even though the reverse picture emerged for Primary Counterattack. In conclusion, this study provides a good reference for waterbasket and adjacent sports, even showing a useful model to gather information in linked competitive situations.!

ObjectiveThe prevalence of sacroiliac SI joint abnormalities in a primary low back pain population remains unresolved. The aims of our study were to define the prevalence of SI joint disease in this cohort, and to identify clinical features that might accurately predict radiographic changes in the SI joint and spine.MethodsLumbar spine and anteroposterior pelvis radiographs taken over a 3year period for the evaluation of back pain at a major chiropractic college were scored for the presence of inflammatory or degenerative features. Data were subsequently extracted by means of a predetermined template from the clinical notes. The outcomes were correlated using Spearmans correlation coefficients.ResultsWe identified 315 patients 173 men, 142 women, ages 18–60 years. Of these, 100 patients 31.7 demonstrated SI joint abnormalities: 75 23.8 degenerative, 25 7.9 inflammatory. Sex was strongly associated with type of SI joint pathology; degenerative disease was predominantly found in women 68, whereas inflammatory disease was predominantly found in men 63. In women there was no correlation between degenerative SI joint abnormalities and degenerative changes in the lumbar spine. Of the clinical descriptors evaluated, none were associated with the radiographic findings with the exception of buttock pain, which was associated with inflammatory sacroiliitis. Neither being overweight nor pregnancy history was associated with degenerative changes in the SI joint.ConclusionIn a primary back pain cohort, degenerative SI joint disease may be an underrecognized clinical entity. It is strongly influenced by sex but is unrelated to degenerative changes in the lumbar spine. Currently proposed clinical discriminators performed poorly in correlating with radiographic changes in the SI joint.

Listeria monocytogenescan cause a placental-foetal infection that results in spontaneous abortion, premature labour, stillbirth, or neonatal sepsis and meningitis. Bacteria cross the maternofoetal barrier at the villous syncytiotrophoblast level and subsequently spread from the placenta to the fetus. L. monocytogenesis able to induce different kinds of death in a variety of cells. Murine hepatocytes, murine T and human B lymphocytes, and murine dendritic cells die by apoptosis, whereas bacterial infection of murine and human macrophages leads mainly to necrotic cell death. As we previously described the efficient infection and growth of L. monocytogenesin a human amniotic cell line, we investigated the fate of these cells in order to analyse the mode of cell death. Our results provide biochemical and morphological evidence of necrotic death induced by L. monocytogenesinfection.

Primary effusion lymphomas (PELs) are invariably infected by the human herpesvirus 8 (HHV8) that is present in most PEL cells as latent virus but replicates in a subset of permissive cells to produce infectious progeny. Here we show that productively infected PEL cells release C-type retrovirus-like particles encoding an Mn++-dependent RT activity, which is typical of endogenous retroviruses. Strikingly, C-type particles are produced only in cells showing advanced HHV8 morphogenesis. Phorbol esters, which induce productive HHV8 replication and morphogenesis in PEL cells, increase RLP production. Phosphonoacetic acid, a blocker of HHV8 late gene expression, inhibits the production of C-type particles, whereas neutralizing anti-αIFN antibodies, which are known to increase HHV8 assembly, increases C-type particle production. These data suggest that factors expressed in advanced stages of HHV8 reactivation support endogenous C-type particle morphogenesis in PEL cells.

Treatment of human herpes simplex virus (HSV) diseases represents an important goal, as herpetic infections are not controlled by vaccination. Many therapeutic agents have been developed and used for HSV infections and several alternative natural compounds are under investigation. Most of the drugs clinically employed against HSV types 1 and 2 are represented by guanosine nucleoside analogues, such as aciclovir and aciclovir-like drugs. The emergence of aciclovir-resistant virus strains provided a stimulus for increased search of new effective agents. Alternative drugs are other nucleoside analogues, such as the vidarabine, brivudin, and cidofovir, or pyrophosphate analogues such as foscarnet, that showed efficacy for HSV infections refractory to aciclovir. However, the risk of adverse effects reported for available anti-herpetic compounds and the frequent development of drug-resistant strains of HSV following therapeutic treatment generate the need for new antiviral agents. In the last years, several studies have been carried out on the anti- HSV activity of different components of innate host defences such as cationic antimicrobial peptides. The antiviral activity of these peptides often appears to be related to the viral adsorption and entry process or is a result of a direct effect on the viral envelope. Other natural compounds, extracts from medicinal plants employed in ethnomedicine and displaying marked anti-herpetic activity, are at present under investigation to determine the scientific evidence and rationale for their clinical use. This review discusses the anti-HSV activity of compounds licensed for clinical use and promising natural molecules.

Pseudomonas aeruginosaand Burkholderia cenocepaciaare two important opportunistic respiratory pathogens of cystic fibrosis (CF) patients. Infections caused by these microorganisms are particularly difficult to eradicate because they are usually highly resistant to several currently available broad-spectrum antibiotics. Lactoferrin (Lf), a glycoprotein found in physiological fluids of mammals and present at high concentrations in infected and inflamed tissues, plays an important role in the natural defence mechanism against pathogens and in immune regulation. In the present study, we evaluate the ability of bovine lactoferrin (bLf) to influence P. aeruginosaPAO1 and B. cenocepaciaPV1 adhesiveness and invasiveness, using the A549 human bronchial cell line. Three different iron-induced morphological forms of bacteria (free-living, aggregates and biofilm) were assayed. The addition of bLf to cells just before infection had little influence on adhesion efficiency for all three of the morphological forms of B. cenocepaciaPV1, while a slight increase in adhesion efficiency by P. aeruginosaPAO1 was noticed. Conversely, invasion of all three morphological forms of both P. aeruginosaand B. cenocepaciawas strongly inhibited by the presence of bLf, independently of its degree of iron-binding activity. This is the first report demonstrating an anti-invasive property of bLf for strains of P. aeruginosaand B. cenocepacia.

Stenotrophomonas maltophiliais an emerging nosocomial bacterial pathogen which is currently isolated with increasing frequency from the airways of cystic fibrosis (CF) patients. In this study 13 S. maltophiliastrains (11 isolated from the airways of independent CF patients, and two non-CF respiratory reference strains) have been characterized for the expression of several virulence-associated factors. In particular, the ability to form biofilm on abiotic surfaces has been determined and correlated with different features, such as motility, adherence and the ability to invade A549 respiratory epithelial cells. Moreover, the presence of a flagellum-associated gene as well as that of the StmPr1gene, which encodes an extra-cellular protease, have been determined by Southern blot hybridization. Our data indicate that the different degree of biofilm formation exhibited by the 11 CF isolates does not correlate with motility, ability to adhere to and invade A549 cells, or with the presence of flagella. On the other hand, among the CF isolates the StmPr1gene was found only in two strains, both able to establish chronic lung infections in CF patients. Moreover, only four of the strains analyzed show a temperature-independent antibiotic-resistance profile, suggesting either a different origin of these strains or an intervening adaptation to host tissues.

Among Listeriagenus, only two species, Listeria ivanoviiand Listeria monocytogenes, are pathogenic. L. ivanoviiis almost only associated with infections in animals, mainly sheep and cattle, and has rarely been associated with human infections, whereas L. monocytogenescauses severe illnesses in both humans and animals. To further investigate the pathogenetic features of L. ivanoviiin humans, we undertook a study in which the intracellular behaviour of this pathogen was analysed in WISH cells, a cell line derived from human amniotic tissue, and compared to that of L. monocytogenes. Using microbiological, biochemical, and ultrastructural approaches, we demonstrate that L. ivanoviican adhere to and invade human amniotic cells, lyse the phagosomal membrane, polymerize host cell actin, and spread from cell to cell more efficiently than L. monocytogenes. However, although L. ivanoviiis capable of specifically infecting and replicating in human amnion cells, its survival in cytoplasm is limited compared to that of L. monocytogenes.

Pseudomonas aeruginosaand Burkholderia cenocepaciaare predominant opportunistic pathogens in cystic fibrosis (CF) patients. In healthy humans the lower respiratory tract as well as all mucosa, contains a very low free iron concentration (10-18M), while in CF patients' sputum iron concentration is very high, showing a median value of 63×10-6M. Accumulation of catalytic reactive iron heavily contributes to subsequent clinical complications in the lung disorders by the production of reactive oxygen species and increases bacterial growth and virulence. The data reported in this study indicate that low iron concentration (Fe3+1 µM) induced free-living forms and motility both in P. aeruginosaand B. cenocepacia, while high iron concentrations (Fe3+10 and 100 µM) stimulated aggregation and biofilm formation already in the fluid phases, so demonstrating that aggregation and biofilm formation are positively iron-modulated in these bacteria. Moreover, the different morphological forms (free-living, aggregates and biofilm) showed different capabilities of adhering and invading the bronchial cell line A549. P. aeruginosaPAO1 aggregates, and mostly biofilm, exerted the highest adhesion efficiency, while B. cenocepaciaPV1 aggregates or biofilm the lowest. A significant reduction in invasion efficiency by P. aeruginosabiofilm and a significant increase in cell internalization by B. cenocepaciabiofilm has been reported. Therefore, the iron availability is an important signal to which P. aeruginosaand B. cenocepaciacounteract by leaving the motile free-living forms and entering into a new lifestyle, i.e. biofilm. These data could contribute to explain that the iron-overload of the sputum of CF patients, inducing nonmotile forms, aggregates and biofilm, may facilitate penetration of host epithelial barriers contributing to the establishment of infection, colonization, persistence and systemic spread of these opportunistic pathogens.

Abstract. We examined the in vitro ability of Enterococcus faecalis clinical isolates to adhere to and to invade HeLa cells, suggested to be a valuable model system to study bacteria-directed endocytosis. Using a variety of compounds that act on eukaryotic cell structures, both microtubules and microfilaments were found to be involved in enterococcal entry into cells. Two distinct modes of interaction were observed: in one, a close proximity of bacteria with the cell membrane was observed, possibly leading to direct engulfment of the bacterial cell. In the other mode, cellular pseudopodal formation seemed to be stimulated by vicinity of bacterial cells; in some cases, such associations involved formation of clathrin-coated-like vesicles before internalizing enterococci. The above-mentioned experimental data together with the use of monodansylcadaverine, amiloride and NH₄Cl, all involved in cytosol acidification and inhibition of receptor-mediated endocytosis (RME), led us to conclude that E. faecalis is internalized within HeLa cells by more than one invasion pathway. One, sensitive to amiloride, is most likely a macropinocytic, actin-dependent uptake mechanism, which determines the production of large smooth-membrane vacuoles engulfing enterococci. The other is RME, in which entry is dependent on both microfilament and microtubule structural integrity.

Clinical and food Listeria monocytogenesisolates, pre-exposed to mild acidic conditions, were able to readily develop acid tolerance, irrespective of their origin. We attempted to investigate the influence of acid tolerance mechanisms, either constitutive or induced, on the invasive behaviour of this facultative food-borne pathogen. Entry efficiency and intracellular growth of acid-tolerant strains were evaluated in in vitrocell models capable to mimic in vivotarget cells, such as enterocytes and macrophages. An acid-adapted L. monocytogeneswild-type strain and a constitutively acid-tolerant mutant were able to enter enterocyte-like (Caco-2) cells as well as to survive and proliferate intracellularly in lipopolysaccharide-treated macrophage-like (J774.A1) cells, at a significant increased extent by respect of the non acid-adapted wild-type strain. These findings add new information about the influence of the acid tolerance response on L. monocytogenesvirulence, suggesting that in acid-adapted bacteria the early events of pathogenesis which allow the colonization and the spread of bacteria in the host may be highly promoted.

We have studied the influence of periplasmic Cu,Zn superoxide dismutase on the intracellular survival of Escherichia coli strains able to invade epithelial cells by the expression of the inv gene from Yersinia pseudotuberculosis but unable to multiply intracellularly. Intracellular viability assays, confirmed by electron microscopy observations, showed that invasive strains of E. coli engineered to increase Cu,Zn superoxide dismutase production are much more resistant to intracellular killing than strains containing only the chromosomal sodC copy. However, we have found only a slight difference in survival within HeLa cells between a sodC-null mutant and its isogenic wild-type strain. Such a small difference in survival correlates with the very low expression of this enzyme in the wild-type strain. We have also observed that acid- and oxidative stress-sensitive E. coli HB101(pRI203) is more rapidly killed in epithelial cells than E. coli GC4468(pRI203). The high mortality of E. coli HB101(pRI203), independent of the acidification of the endosome, is abolished by the overexpression of sodC. Our data suggest that oxyradicals are involved in the mechanisms of bacterial killing within epithelial cells and that high-level production of periplasmic Cu,Zn superoxide dismutase provides bacteria with an effective protection against oxidative damage. We propose that Cu,Zn superoxide dismutase could offer an important selective advantage in survival within host cells to bacteria expressing high levels of this enzyme.

ABSTRACTWe have studied the influence of periplasmic Cu,Zn superoxide dismutase on the intracellular survival of Escherichia colistrains able to invade epithelial cells by the expression of theinvgene from Yersinia pseudotuberculosisbut unable to multiply intracellularly. Intracellular viability assays, confirmed by electron microscopy observations, showed that invasive strains of E. coliengineered to increase Cu,Zn superoxide dismutase production are much more resistant to intracellular killing than strains containing only the chromosomalsodCcopy. However, we have found only a slight difference in survival within HeLa cells between a sodC-null mutant and its isogenic wild-type strain. Such a small difference in survival correlates with the very low expression of this enzyme in the wild-type strain. We have also observed that acid- and oxidative stress-sensitiveE. coliHB101(pRI203) is more rapidly killed in epithelial cells than E. coliGC4468(pRI203). The high mortality ofE. coliHB101(pRI203), independent of the acidification of the endosome, is abolished by the overexpression of sodC. Our data suggest that oxyradicals are involved in the mechanisms of bacterial killing within epithelial cells and that high-level production of periplasmic Cu,Zn superoxide dismutase provides bacteria with an effective protection against oxidative damage. We propose that Cu,Zn superoxide dismutase could offer an important selective advantage in survival within host cells to bacteria expressing high levels of this enzyme.

ABSTRACTThe ability to produce slime and to express a slime-associated antigen was examined in a collection of staphylococcal clinical isolates. Slime-producing strains were found among coagulase-negative staphylococci in percentages comparable to those reported in other studies; surprisingly, a high percentage of Staphylococcus aureusstrains also were able to produce this extracellular material. In the latter case, this ability was strongly dependent on the presence of an additional carbohydrate source in the growth medium. Expression of the slime-associated antigen appeared to be species specific and confined to the Staphylococcus epidermidissensu stricto isolates; its strong association with the ability of these strains to produce thicker biofilms indicated slime-associated antigen as a possible virulence marker for S. epidermidis.

The effects of poliovirus infection in CaCo‐2 cells, a human enterocyte‐like cell line are described. Infected cells were examined by a combination of techniques, including optical and electron microscopy, cytofluorimetric analysis of DNA content, and DNA agarose gel electrophoresis. Results obtained by the different experimental approaches demonstrate that poliovirus infection in enterocyte‐like cells can result in an apoptotic process. J. Med. Virol. 59:122–129, 1999. © 1999 Wiley‐Liss, Inc.

Abstract: In this study we investigated the inhibitory activity of different milk proteins on poliovirus infection in Vero cells. Proteins analyzed were mucin, α-lactalbumin, β-lactoglobulin, and bovine and human lactoferrin. Viral cytopathic effect was not prevented by mucin, α-lactalbumin or β-lactoglobulin, whereas the lactoferrins tested were able to inhibit the replication of poliovirus in a dose-dependent manner. Further experiments were carried out in which apo- and native lactoferrin or lactoferrin fully saturated with ferric, manganese or zinc ions were added to the cells during different phases of viral infection. Results obtained demonstrated that all lactoferrins were able to prevent viral replication when present during the entire cycle of poliovirus infection or during the viral adsorption step. Only zinc lactoferrin strongly inhibited viral infection when incubated with the cells after the viral attachment, being the inhibition directly correlated with the degree of zinc saturation. Our results demonstrated that all lactoferrins interfered with an early phase of poliovirus infection; zinc lactoferrin was the sole compound capable of inhibiting a phase of infection subsequent to virus internalization into the host cells.

Aims and background Although initial treatment of Hodgkin's disease induces a complete remission in most patients, approximately 50% of patients with advanced disease will not achieve a complete remission or will relapse following the first complete remission.Patients and methods Twenty-three patients with relapsed/resistant Hodgkin's disease, observed between January 1991 and October 1993, underwent CEP combination chemotherapy (CCNU, etoposide, prednimustine). All patients had previously received MOPP and ABVD regimens, in combination at diagnosis or sequentially (at diagnosis and at the first relapse).Results Thirteen (56%) patients achieved complete responses and 4 (18%) had partial responses. Two partial responders obtained a complete remission after a successive autologous bone marrow transplantation. The complete remission was not influenced by the timing of MOPP and ABVD treatments, presence of extranodal involvement or presence of bulky disease, but was affected by the presence of a primary disease refractory to the first standard programs. All the complete responders but 2 were alive and relapse-free at a median follow-up of 15 months; no major toxic effects were recorded.Conclusions These data suggest, as did those of other studies, that CEP is an effective regimen in patients with Hodgkin's disease in first or second relapse, also to reduce the tumor burden and to determine chemosensitivity before contingent bone marrow or peripheral blood stem cell support.

An electron microscopic study addressed morphological changes induced by rotavirus in the enterocyte-like cell line HT-29. Tubuloreticular structures were found in the latest stages of viral infection when cells, undergoing a cytopathic effect, detached from the substrate. Tubuloreticular structures were localized, together with viral particles, within highly dilated perinuclear cisternae. The results suggest that tubuloreticular structures evolve during interaction of rotavirus with the rough endoplasmic reticulum membranes.

1Anaesthetized rats subjected to total occlusion of the superior mesenteric artery and the coeliac trunk for 45 min developed a severe shock state (splanchnic artery occlusion, SAO shock) resulting in death within 70–90 min after release of the occlusion. Sham‐operated animals were used as controls.2Survival rate, survival time, serum tumour necrosis factor (TNF‐α), white blood cell (WBC) count, mean arterial blood pressure (MAP), plasma malonylaldehyde (MAL), myeloperoxidase activity (MPO) and the responsiveness to acetylcholine (ACh 10 nM‐10 μM) of aortic rings were investigated.3SAO shocked rats had a decreased survival rate and survival time (74 ± 10 min, while sham‐shocked rats survived more than 4 h), reduced mean arterial blood pressure, increased serum levels of TNF‐α (267 ± 13 u ml−1) and plasma levels of MAL (57 ± 7 nmol ml−1), enhanced MPO activity in the ileum (0.23 ± 0.04 u × 10−3g−1tissue) and in the lung (2.2 ± 0.8 u × 10−3g−1tissue), leukopenia and reduced responsiveness to ACh of aortic rings.4The 21‐aminosteroid U‐74389G (30 mg kg−1, i.v.) increased survival (survival time = 232 ± 15 min), lowered the serum levels of TNF‐α and the plasma levels of MAL, reduced leukopenia and MPO activity both in the ileum (0.021 ± 0.004 u × 10−3g−1tissue) and in the lung (0.23 ± 0.03 u × 10−3g−1tissue), improved MAP and restored the responsiveness to ACh of aortic rings.5Our data suggest that U‐74389G is a potent lipid peroxidation inhibitor and that it has antishock and endothelial protective actions. Anaesthetized rats subjected to total occlusion of the superior mesenteric artery and the coeliac trunk for 45 min developed a severe shock state (splanchnic artery occlusion, SAO shock) resulting in death within 70–90 min after release of the occlusion. Sham‐operated animals were used as controls. Survival rate, survival time, serum tumour necrosis factor (TNF‐α), white blood cell (WBC) count, mean arterial blood pressure (MAP), plasma malonylaldehyde (MAL), myeloperoxidase activity (MPO) and the responsiveness to acetylcholine (ACh 10 nM‐10 μM) of aortic rings were investigated. SAO shocked rats had a decreased survival rate and survival time (74 ± 10 min, while sham‐shocked rats survived more than 4 h), reduced mean arterial blood pressure, increased serum levels of TNF‐α (267 ± 13 u ml−1) and plasma levels of MAL (57 ± 7 nmol ml−1), enhanced MPO activity in the ileum (0.23 ± 0.04 u × 10−3g−1tissue) and in the lung (2.2 ± 0.8 u × 10−3g−1tissue), leukopenia and reduced responsiveness to ACh of aortic rings. The 21‐aminosteroid U‐74389G (30 mg kg−1, i.v.) increased survival (survival time = 232 ± 15 min), lowered the serum levels of TNF‐α and the plasma levels of MAL, reduced leukopenia and MPO activity both in the ileum (0.021 ± 0.004 u × 10−3g−1tissue) and in the lung (0.23 ± 0.03 u × 10−3g−1tissue), improved MAP and restored the responsiveness to ACh of aortic rings. Our data suggest that U‐74389G is a potent lipid peroxidation inhibitor and that it has antishock and endothelial protective actions.

The effects of 12 fatty acids, naturally occurring in milk from several mammalian species, on the survival and invasion ability of Listeria monocytogenes, a food‐borne pathogen, were determined. The survival was tested in the presence of 200 μg ml−1fatty acids suspended in brain hearth infusion broth or in storage conditioning solution (NaCl 1%) of Mozzarella cheese, an Italian soft unripened cheese, at pH 7·0 or 5·0. Lauric (C12:0), linoleic (C18:2) and linolenic (C18:3) acids exerted the strongest bactericidal activity. The invasive efficiency of L. monocytogenes, determined in the Caco‐2 enterocyte‐like cell line, was strongly decreased in the presence of the fatty acids tested (from about 20 to 500‐fold). This research suggests that naturally occurring fatty acids of milk, supplemented in milk derivatives, could affect both bacterial growth and invasiveness and consequently, could serve as barriers towards L. monocytogenesinfection.

Abstract: Different milk proteins were analyzed for their inhibitory effect on either rotavirus-mediated agglutination of human erythrocytes or rotavirus infection of the human enterocyte-like cell line HT-29. Proteins investigated were α-lactalbumin, β-lactoglobulin, apo-lactoferrin, and Fe3+-lactoferrin, and their antiviral action was compared with the activity of mucin, a milk glycoprotein known to affect rotavirus infection. Results obtained demonstrated that β-lactoglobulin, apo- and Fe3+-lactoferrin are able to inhibit the replication of rotavirus in a dose-dependent manner, apo-lactoferrin being the most active. It was shown that apo-lactoferrin hinders virus attachment to cell receptors since it is able to bind the viral particles and to prevent both rotavirus haemagglutination and viral binding to susceptible cells. Moreover, this protein markedly inhibited rotavirus antigen synthesis and yield in HT-29 cells when added during the viral adsorption step or when it was present in the first hours of infection, suggesting that this protein interferes with the early phases of rotavirus infection.

Abstract: A mixed infection with either rotavirus or poliovirus and Listeria monocytogenes was analysed in Caco-2 cells, a tumour-derived cell line, highly susceptible to these pathogens. The multiplication of these pathogens, whose usual site of entry and/or replication is the intestine, was also followed by electron microscopy. Results obtained showed an increase of L. monocytogenes internalisation in cells infected with rotavirus, whereas the preinfection with poliovirus had only a slight interfering effect on bacterial entry. Analysis of L. monocytogenes multiplication in virus-infected cells revealed that rotavirus also promoted bacterial replication, which poliovirus hampered replication. Concerning the effect of Caco-2 cell invasion by L. monocytogenes on viral replication, we observed an increase in rotavirus antigen synthesis but no significant effect on poliovirus yield under our experimental conditions.

We investigated the role played by monocytes and lymphocytes in the pathogenesis of experimental shock. Splanchnic artery occlusion (SAO) shock was induced in anaesthetized rats by clamping splanchnic arteries for 45 min followed by reperfusion. Sham operated animals were used as controls. SAO shocked rats had a decreased survival time (80±11 min, while sham shocked rats survived more than 4 h), increased serum (248±21 U/ml) and macrophage (145±15 U/ml) levels of TNF-α, enhanced myeloperoxidase (MPO) activity in the ileum (3.38±0.2 U×10−3/g tissue), decreased number of monocytes, lymphocytes and neutrophils and a profound hypotension. In addition we found an increased expression of vascular cell adhesion molecule-1 (VCAM-1) on aortic endothelium and a reduced percentage of VLA-4 positive monocytes and lymphocytes. Inhibition of TNF-α synthesis, reversed the increased endothelial expression of VCAM-1, increased the percentage of integrin VLA-4 positive leukocytes and improved monocyte, lymphocyte and neutrophil count. Furthermore a passive immunization with specific antibodies raised against VCAM-1 (2 mg/kg, i.v. 3 h before SAO) increased survival, reduced MPO activity in the ileum (0.034±0.04 U×10−3/g tissue) and improved mean arterial blood pressure. Our data suggest that monocytes and lymphocytes participate in the pathogenesis of splanchnic ischaemia-reperfusion injury and may amplify the adhesion of neutrophils to peripheral tissues.

Rehabilitation is important for patients with coronavirus disease 2019 (COVID-19) infection. Given the lack of guidelines in English on the rehabilitation of these patients, we conducted a review of the most recent reports. We performed this literature review using the principal research databases and included randomized trials, recommendations, quasi-randomized or prospective controlled clinical trials, reports, guidelines, field updates, and letters to the editor. We identified 107 studies in the database search, among which 85 were excluded after screening the full text or abstract. In total, 22 studies were finally included. The complexity of the clinical setting and the speed of spread of the severe acute respiratory syndrome coronavirus 2, which leads to rapid occupation of beds in the intensive care unit, make it necessary to discharge patients with COVID-19 who have mild symptoms as soon as possible. For these reasons, it is necessary to formulate rehabilitation programs for these patients, to help them restore physical and respiratory function and to reduce anxiety and depression, particularly patients with comorbidities and those who live alone or in rural settings, to restore a good quality of life.

ABSTRACTListeria monocytogenesis a facultative intracellular bacterial pathogen that is frequently associated with food-borne infection. Of particular concern is the ability of L. monocytogenesto breach the blood-brain barrier, leading to life-threatening meningitis and encephalitis. The mechanisms used by bacterial pathogens to infect the brain are not fully understood. Here we show that L. monocytogenesis able to utilize vimentin for invasion of host cells. Vimentin is a type III intermediate filament protein within the cytosol but is also expressed on the host cell surface. We found that L. monocytogenesinteraction with surface-localized vimentin promoted bacterial uptake. Furthermore, in the absence of vimentin, L. monocytogenescolonization of the brain was severely compromised in mice. The L. monocytogenesvirulence factor InlF was found to bind vimentin and was necessary for optimal bacterial colonization of the brain. These studies reveal a novel receptor-ligand interaction that enhances infection of the brain by L. monocytogenesand highlights the importance of surface vimentin in host-pathogen interactions.IMPORTANCEListeria monocytogenesis an intracellular bacterial pathogen that is capable of invading numerous host cells during infection. L. monocytogenescan cross the blood-brain barrier, leading to life-threatening meningitis. Here we show that an L. monocytogenessurface protein, InlF, is necessary for optimal colonization of the brain in mice. Furthermore, in the absence of vimentin, a cytosolic intermediate filament protein that is also present on the surface of brain endothelial cells, colonization of the brain was significantly impaired. We further show that InlF binds vimentin to mediate invasion of host cells. This work identifies InlF as a bacterial surface protein with specific relevance for infection of the brain and underscores the significance of host cell surface vimentin interactions in microbial pathogenesis.

Coriander (Coriandrum sativumL., Apiaceae) is known for its antimicrobial activity and the aim of this study was to investigate the effect of its essential oil (CDO) against multidrug resistant uropathogenic Escherichia coli(UPEC). CDO was able to inhibit the growth of UPEC strains and propidium iodide uptake, and electron microscopy examination suggested that bacterial structural modifications occurred. The presence of CDO reduced the MIC of gentamicin. E.coliadhesion efficiency on cell monolayers and abiotic surfaces was not affected by subMIC oil concentrations; furthermore, CDO showed cytotoxic activity towards the HEp-2 tumor cell line. These findings contribute to the knowledge about essential oils as sources of potential antimicrobial agents against uropathogenic E. coliand encourage further investigations.

The article focuses on the challenges, the instructors can face in online education. According to the author, the students who are extremely new to online education can be a real challenge for the instructors in communication. In case of online education, the classroom materials, such as readings and assignments, should be designed in a broad clarity and be viewed from a perspective of the least-skilled user, because there are all type of students in the classes, typically containing students of varying degrees of computer experience, technical expertise, and personal stamina.