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Plasma cortisol (C) in adult horse is influenced by several environmental factors, such as temperature and lighting conditions but to date it is not clear if also hair cortisol is subjected to the same factors. The aim of this study was to investigate the influence of these environmental factors on foal hair cortisol levels at 30 days of age during the breeding season. Hair samples were collected from 69 foals at 30 days of age from March to July and analyzed for C by RIA. For each sample were considered the averages of environmental factors (lighting conditions and temperature) during the 30 days preceding the sampling. Hair cortisol levels were 37.32±8.87 pg/mg (mean value ±SD). None of the climate variables was related to cortisol hair concentrations. In conclusion these data suggest that hair cortisol in 30 days old foals is not affected by the influence of temperature and lighting conditions and cortisol variations are due to an individual HPA axis activation and not to environmental factors.

Knowledge about fetal fluids composition could be useful for fetal well being assessment also in small animals, but few studies focused on this topic. In the present study IGF-I, NEFA and Cortisol (C) levels were evaluated in amniotic and allantoic fluids collected from dogs and cats at mid pregnancy (MP) and from dogs at term pregnancy (TP). A total of 11 canine amniotic and 8 allantoic MP samples, 24 canine amniotic and 26 allantoic TP samples, and 18 feline amniotic and 4 allantoic MP samples were collected and analyzed for IGF-I and C by RIA and for NEFA by enzymatic-colorimetric methods. The results showed significant differences between the two fluids within the canine specie only in C levels at TP, with higher levels in the amniotic fluid. When the different stages of pregnancy were considered in the dog, IGFI levels declined, while C levels increased significantly at TP in the amniotic fluid. The comparison between the two species evidenced that, at MP, IGF-I levels were lower in the cat in both amniotic and allantoic fluids. NEFA seems to show no significant differences between the two fluids, between the two stages of pregnancy and also between dogs and cats.

Since cortisol (C) plays an important role in foetal multi-organs final maturation, the study evaluated the reliability for hair and nails C measurement in newborn puppies and kittens as a retrospective picture of foetal C accumulation during the last stage of gestation. The results obtained from 32 born dead normal puppies and 8 born dead normal kittens showed that C is higher in the hair of kittens compared to puppies, while no differences were found between nails C levels in dogs compared to cats, between hair and nails C concentrations within each species, between sex of the newborns and, in the dog between the fair and dark color of the coat. This experiment provides a new interesting tool for C non invasive measurement in newborn puppies and kittens, useful for the study of both last intrauterine development foetal stage and for newborn adaptational monitoring.

Hair cortisol levels were determined in 85 multiparous lactating Italian Friesian dairy cows. The animals were clinically healthy and had not undergone social group changes within the past 3 months. Hair cortisol data were stratified into 14 frequency classes. Data showed a strongly positive asymmetric distribution. In 50% of the animals, cortisol levels were below 3.29 pg/mg while in 33% hair cortisol levels were concentrated in the hair cortisol class 2-2.99 pg/mg. This range of values was suggested as the representative class of hair cortisol levels in healthy animals. Hair cortisol analysis could be a valid, interesting and useful tool for monitoring HPA activity in healthy dairy cows.

In different species the insulin-like growth factor I (IGF-I) is an important regulatory factor in fetal and neonatal growth, especially in skeletal and gut development. This study was carried out to assess plasma IGF-I profile in newborn healthy donkey and horse foals during the first two weeks of age. The study was conducted on 32 horse and 19 donkey foals, born at term, after spontaneous parturition, mature and viable. Blood samples were collected from the jugular vein at 10, 20 and 30 minutes, 3 and 12 hours and at day 3, 7, 10, 14 of life. IGF-I levels were evaluated by RIA. IGF-I showed an increasing profile in both species, with lower levels (P

In patients with ischemic stroke, endovascular treatment results in a higher rate of recanalization of the affected cerebral artery than systemic intravenous thrombolytic therapy. However, comparison of the clinical efficacy of the two approaches is needed.We randomly assigned 362 patients with acute ischemic stroke, within 4.5 hours after onset, to endovascular therapy (intraarterial thrombolysis with recombinant tissue plasminogen activator [t-PA], mechanical clot disruption or retrieval, or a combination of these approaches) or intravenous t-PA. Treatments were to be given as soon as possible after randomization. The primary outcome was survival free of disability (defined as a modified Rankin score of 0 or 1 on a scale of 0 to 6, with 0 indicating no symptoms, 1 no clinically significant disability despite symptoms, and 6 death) at 3 months.A total of 181 patients were assigned to receive endovascular therapy, and 181 intravenous t-PA. The median time from stroke onset to the start of treatment was 3.75 hours for endovascular therapy and 2.75 hours for intravenous t-PA (P0.001). At 3 months, 55 patients in the endovascular-therapy group (30.4%) and 63 in the intravenous t-PA group (34.8%) were alive without disability (odds ratio adjusted for age, sex, stroke severity, and atrial fibrillation status at baseline, 0.71; 95% confidence interval, 0.44 to 1.14; P=0.16). Fatal or nonfatal symptomatic intracranial hemorrhage within 7 days occurred in 6% of the patients in each group, and there were no significant differences between groups in the rates of other serious adverse events or the case fatality rate.The results of this trial in patients with acute ischemic stroke indicate that endovascular therapy is not superior to standard treatment with intravenous t-PA. (Funded by the Italian Medicines Agency, ClinicalTrials.gov number, NCT00640367.).

Aims and background The TomoTherapy Hi-Art II system is able to deliver dynamic intensity-modulated radiation therapy within a helical geometry providing robust conformality and modulation, abrupt dose falloff, and reliable accuracy. A new upgrade named TomoDirect was introduced recently, allowing delivery of radiation at discrete angles with a fixed gantry. We present our preliminary clinical experience with TomoDirect. Methods Three specific clinical contexts were chosen for the implementation of TomoDirect, namely palliation of bone metastasis pain (BP), whole brain radiation therapy for intracranial secondary lesions (WBRT), and adjuvant whole breast radiation therapy after conservative surgery for early stage breast cancer (AWBRT). After appropriate positioning, planning CT, contouring, and plan generation, all patients were treated with the TomoDirect upgrade of the TomoTherapy Hi-Art II system with different doses and fractionation according to clinical decision-making. Results Between May and December 2010, 41 patients were treated with TomoDirect. Eighteen patients were treated for BP (mainly vertebral metastases) with a predominant posterior field arrangement. Seven patients were treated for WBRT (multiple brain lesions) with a parallel-opposed latero-lateral approach and 16 patients were treated for conventionally fractionated AWBRT mainly with a 2-field tangential approach. Radiation treatments were generally well tolerated and the acute toxicity was mild. Conclusions While helical tomotherapy allows the delivery of very sophisticated treatment plans, in certain anatomical sites and clinical contexts where the number of beam directions is constrained and supposed not to affect plan quality, TomoDirect might be an efficient means to deliver radiation at static angles with consistent dosimetric and clinical results.

OBJECTIVES: To assess risk factors for nasopharyngeal carriage of Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis in a large sample of healthy children. METHODS: In this point prevalence survey nasopharyngeal specimens were obtained from 1723 healthy children, ages 1 to 7 years, attending day-care centers or schools in 18 Italian cities. Written questionnaires for obtaining information about the demographics and medical history of the children were completed by the parents in the presence of a pediatrician. RESULTS: The overall carrier rate of respiratory pathogens was 17.9% (S. pneumoniae, 3.5%; H. influenzae, 11.9%; M. catarrhalis, 4.1%). Only 5% of S. pneumoniae strains were penicillin-resistant whereas approximately 40% were erythromycin-resistant. Beta-lactamase production was found in 5.8% of H. influenzae and 88.7% of M. catarrhalis isolates. By multivariate analysis age (< or = 3 years), having older siblings, a history of prolonged full-time day-care attendance and living in a rural area significantly influenced the odds of carrying nasopharyngeal respiratory pathogens, particularly in children ages 1 to 5 years. Sex, breastfeeding, passive smoking and recent upper respiratory tract infections were not significant variables. Antibiotic treatment in the previous 3 months did not affect nasopharyngeal carriage, whereas repeated treatments with a macrolide were associated with carriage of S. pneumoniae. CONCLUSIONS: Our results suggest that there is a strong and long term relationship between exposure to large numbers of children in the first years of life and nasopharyngeal carriage of all respiratory pathogens. In addition antimicrobial restrictive guidelines should be tailored to local microbiologic sceneries.

Objective: To evaluate the safety and the immunogenicity of a booster dose of recombinant acellular pertussis vaccine combined with diphtheria and tetanus toxoids (DTaP, Biocine SpA) in 15- to 21-month-old children primed in infancy with either whole-cell diphtheria-tetanus-pertussis (DTwP) vaccine or DTaP vaccine. Design: Open-label second phase of a double-masked, controlled trail, with masked analysis of serum samples. Participants and setting: Three hundred fifty children, 15 to 21 months of age, who had been primed at 2, 4, and 6 months of age with either three doses of DTaP vaccine (n = 173) or DTwP vaccine (n = 177). The children were enrolled in eight vaccination centers in Italy. Interventions: All children received a booster dose of the DTaP vaccine and were examined for safety at 48 hours and at 7 days after vaccination. Serum samples for evaluation of immunogenicity were obtained from 196 (55%) of the 350 children. Main outcome measures: IgG antibodies to pertussis toxin (Ptox), filamentous hemagglutinin, 69-kilodalton protein, and tetanus toxoid were measured by enzyme-linked immunosorbent assay. Pertussis toxin-neutralizing antibodies were measured by the Chinese hamster ovary cell toxin neutralization assay. Main results: Adverse reactions to DTaP were infrequent, and there was no difference in the incidence of local or systemic reactions in children given DTaP as a fourth dose in comparison with a first dose. One month after the DTaP booster vaccination, both groups had 6- to 40-fold increases in serum antibody concentrations to all antigens tested; the concentrations against the three pertussis antigens were higher in the DTaP-primed children (p

The safety and immunogenicity of an acellular pertussis vaccine containing the genetically detoxified pertussis toxin PT-9K/129C, filamentous hemagglutinin, and pertactin, together with diphtheria and tetanus toxoids, were compared with those of a whole-cell pertussis component-diphtheria-tetanus vaccine. Four hundred eighty infants were enrolled into this prospective, multicenter, double-blind study. Each infant was randomly given three doses of one of the two vaccines at 2, 4, and 6 months of age. Both local and systemic adverse reactions, reported within 48 hours and 7 days of each injection, were less frequent after the acellular vaccine than after the whole-cell vaccine. The enzyme-linked immunosorbent assay titers to pertussis toxin, filamentous hemagglutinin, and pertactin, as well as the pertussis toxin-neutralizing titer measured by the Chinese hamster ovary cell assay, were significantly higher after the acellular vaccine was given. Both vaccines induced adequate levels of anti-diphtheria and anti-tetanus antibodies. We conclude that the recombinant acellular pertussis vaccine produces fewer reactions than the whole-cell vaccine and provides a high antibody response against the antigens of Bordetella pertussis involved in bacterial adhesion and systemic toxic effects.