Natural Deep Eutectic Solvents as Rust Removal Agents from Lithic and Cellulosic Substrates

The peculiar physicochemical features of deep eutectic solvents (DESs), in particular their tunability, make them ideal media for various applications. Despite their ability to solubilize metal oxides, their use as rust removers from valuable substrates has not yet been thoroughly investigated. In this study, we chose three known DESs, consisting of choline chloride and acetic, oxalic or citric acid for evaluating their ability to remove corrosion products from a cellulose-based material as linen fabric and two different lithotypes, as travertine and granite. The artificial staining was achieved by placing a rusty iron grid on their surfaces. The DESs were applied by means of cellulose poultice on the linen fabrics, while on the rusted stone surfaces with a cotton swab. Macro- and microscopic observations, colorimetry and SEM/EDS analysis were employed to ascertain the cleaning effectiveness and the absence of side effects on the samples after treatment. Oxalic acid-based DES was capable of removing rust stains from both stone and cellulose-based samples, while choline chloride/citric acid DES was effective only on stone specimens. The results suggest a new practical application of DESs for the elimination of rust from lithic and cellulosic substrates of precious and artistic value.

Pyoderma gangrenosum in ulcerative colitis patient treated with vedolizumab: adsorptive granulocyte/monocyte apheresis as a new therapeutic option refractory cases - a case report and literature review

Extraintestinal manifestations occur rather frequently in ulcerative colitis (UC) and Crohn's disease patients and are usually related to an exacerbation of the underlying intestinal bowel disease but sometimes may run a course independent of the inflammatory bowel diseases (IBD). About one-third of patients with IBD develop extraintestinal manifestations, such as pyoderma gangrenosum (PG). PG is an uncommon inflammatory skin disorder of unknown pathogenesis. There are no specific serological or histological markers, and diagnosis is predominantly clinical. Topical and systemic therapies are both vital aspects of treatment and immune modulators have been used with increasing success in recent years, although immunosuppressive drugs raise some concerns due to an increased risk of serious and opportunistic infections and cancer, particularly in elderly and comorbid patients, underlining the unmet need for safer alternative therapies. Thus, in this case report, we highlighted an adsorptive granulocyte/monocyte apheresis (GMA) as a new therapeutic possibility in IBD patients with extraintestinal manifestations. We report a case of a 60-year woman with a history of UC with a Mayo grade 3 score which was associated with a PG. Given that the patients maintained clinical remission with vedolizumab, we preferred not to perform a combined treatment with other antitumor necrosis factor-alpha or ciclosporin, thus avoiding an increased risk of serious infections in the patient. Therefore, we performed the extracorporeal leukocyte apheresis. The patient progressed favorably, with progressive improvement of skin and bowel disease. Therefore, adsorptive GMA has a very favorable safety profile and has been confirmed in numerous studies. In this study, we underlined that an intensive regimen of GMA paves the way to an ideal option for patients with severe and refractory PG complicated with UC.

Prevention of Swelling Phenomenon of Alginate Beads To Improve the Stability and Recyclability of Encapsulated Horse Liver Alcohol Dehydrogenase

Horse Liver Alcohol Dehydrogenase (HLADH) has been immobilized on calcium-alginate beads and used for both oxidation and reduction reactions. To avoid swelling of the beads and their subsequent breakage, calcium ions were added to both reaction and storage solutions, allowing the beads to maintain the initial structural features. The techniques used for this purpose revealed that 2 mM Ca2+ is the optimal concentration, which does not significantly change the weight of the beads, the amount of water in them, and their external and internal structure. The optimized experimental procedure has been used to verify the properties of the enzyme in terms of reusability, storage, and thermal stability. The addition of calcium ions allows the enzyme to retain more than 80 % of its initial activity for fourteen cycles and approximately 50 % at the twentieth cycle. Moreover, when the biocatalyst has been stored in a buffer solution containing 2 mM Ca2+ , the retention of enzyme activity after 30 days was 100 %, compared to that measured before incubation. The encapsulated enzyme exhibits greater thermal stability than free HLADH up to at least 60 °C, preventing dimer dissociation into the two subunits.

Biodeterioration of stone monuments: Studies on the influence of bioreceptivity on cyanobacterial biofilm growth and on the biocidal efficacy of essential oils in natural hydrogel

An important field of research is devoted to the development of innovative, sustainable, and safe methodologies to counteract biodeterioration of stone monuments due to the growth of microbial communities. However, besides the biocide's efficacy, it is crucial to consider the features of substrates on which biocides must be applied, to define the so-called bioreceptivity of the lithic faces. In this research five different lithotypes, namely Lecce stone, Travertine, Peperino, Serena stone, and Granite, have been used as substrates for the growth of cyanobacterial biofilms. Open porosity, hygroscopic properties, and roughness parameters have been investigated for each lithotype and correlated to the photosynthetic yields of the biofilms colonizing the different stones to propose an easy method to estimate stone bioreceptivity. Different levels of coverage of the stone surfaces have been accomplished in relation to the typology of lithotypes. To develop innovative restoration methodologies against biodeterioration of stone monuments, a hydrogel-biocide system has been optimized by using a polysaccharide dispersion as a matrix where to embed T. vulgaris essential oil (at 0.25 % or 0.1 %) or its main component thymol (at 0.18 % or 0.07 %). The efficacy and the effect of the innovative biocide have been evaluated combining microscopy, photosynthetic measurements, and colorimetric analyses and both the biocides (with T. vulgaris EO or thymol) showed to be highly effective against the cyanobacterial biofilms for at least six months from the treatment without inducing any significant alteration to the lithic surfaces. The efficacy of thymol alone allows to treat colonized surfaces with a single active ingredient, or at least a mixture thereof, much cheaper and reproducible. The results obtained in this work pave the way to develop a sustainable cleaning protocol to counteract the biodeterioration of stone monuments or historic buildings induced by the presence of phototrophic biofilms that endangered their conservation.

Search for Dark-Matter-Nucleon Interactions via Migdal Effect with DarkSide-50

Dark matter elastic scattering off nuclei can result in the excitation and ionization of the recoiling atom through the so-called Migdal effect. The energy deposition from the ionization electron adds to the energy deposited by the recoiling nuclear system and allows for the detection of interactions of sub-GeV/c^{2} mass dark matter. We present new constraints for sub-GeV/c^{2} dark matter using the dual-phase liquid argon time projection chamber of the DarkSide-50 experiment with an exposure of (12 306±184)  kg d. The analysis is based on the ionization signal alone and significantly enhances the sensitivity of DarkSide-50, enabling sensitivity to dark matter with masses down to 40  MeV/c^{2}. Furthermore, it sets the most stringent upper limit on the spin independent dark matter nucleon cross section for masses below 3.6  GeV/c^{2}.

Search for Dark Matter Particle Interactions with Electron Final States with DarkSide-50

We present a search for dark matter particles with sub-GeV/c^{2} masses whose interactions have final state electrons using the DarkSide-50 experiment's (12 306±184)  kg d low-radioactivity liquid argon exposure. By analyzing the ionization signals, we exclude new parameter space for the dark matter-electron cross section σ[over ¯]_{e}, the axioelectric coupling constant g_{Ae}, and the dark photon kinetic mixing parameter κ. We also set the first dark matter direct-detection constraints on the mixing angle |U_{e4}|^{2} for keV/c^{2} sterile neutrinos.

Characterization of lipase from Candida rugosa entrapped in alginate beads to enhance its thermal stability and recyclability

Development of a simple method to efficiently immobilize lipase ensuring its stability and activity in water even at high temperatures.

Emotional status and fear in patients scheduled for elective surgery during COVID-19 pandemic: a nationwide cross-sectional survey (COVID-SURGERY)

Background

Fragmented data exist on the emotional and psychological distress generated by hospital admission during the pandemic in specific populations of patients, and no data exists on patients scheduled for surgery. The aim of this multicentre nationwide prospective cross-sectional survey was to evaluate the impact of pandemic on emotional status and fear of SARS-CoV-2 contagion in a cohort of elective surgical patients in Italy, scheduled for surgery during the COVID-19 pandemic.

Results

Twenty-nine Italian centres were involved in the study, for a total of 2376 patients surveyed (mean age of 58 years ± 16.61; 49.6% males). The survey consisted of 28 total closed questions, including four study outcome questions. More than half of patients had at least one chronic disease (54%), among which cardiovascular diseases were the commonest (58%). The most frequent type of surgery was abdominal (20%), under general anaesthesia (64%). Almost half of the patients (46%) declared to be frightened of going to the hospital for routine checkups; 55% to be afraid of getting SARS-CoV-2 infection during hospitalization and 62% were feared of being hospitalised without seeing family members. Having an oncological disease and other patient-related, centre-related or perioperative factors were independently associated with an increased risk of fear of SARS-CoV-2 infection during hospitalization and of being hospitalised without seeing family members. A previous infection due to SARS-COV-2 was associated with a reduced risk of worse emotional outcomes and fear of SARS-CoV-2 infection during hospitalization. Patients who showed the most emotionally vulnerable profile (e.g. use of sleep-inducing drugs, higher fear of surgery or anaesthesia) were at higher risk of worse emotional status towards the hospitalization during COVID-19 pandemic. Being operated in hospitals with lower surgical volume and with COVID-19 wards was associated with worse emotional status and fear of contagion.

Conclusions

Additional fear and worse emotional status may be frequent in patients scheduled for elective surgery during COVID-19 pandemic. More than half of the participants to the survey were worried about not being able to receive family visits. Psychological support may be considered for patients at higher risk of psychological distress to improve perioperative wellbeing during the pandemic.

Support-Activity Relationship in Heterogeneous Catalysis for Biomass Valorization and Fine-Chemicals Production

Heterogeneous catalysts are progressively expanding their field of application, from high-throughput reactions for traditional industrial chemistry with production volumes reaching millions of tons per year, a sector in which they are key players, to more niche applications for the production of fine chemicals. These novel applications require a progressive utilization reduction of fossil feedstocks, in favor of renewable ones. Biomasses are the most accessible source of organic precursors, having as advantage their low cost and even distribution across the globe. Unfortunately, they are intrinsically inhomogeneous in nature and their efficient exploitation requires novel catalysts. In this process, an accurate design of the active phase performing the reaction is important; nevertheless, we are often neglecting the importance of the support in guaranteeing stable performances and improving catalytic activity. This review has the goal of gathering and highlighting the cases in which the supports (either derived or not from biomass wastes) share the worth of performing the catalysis with the active phase, for those reactions involving the synthesis of fine chemicals starting from biomasses as feedstocks.

The novel Mechanical Ventilator Milano for the COVID-19 pandemic

This paper presents the Mechanical Ventilator Milano (MVM), a novel intensive therapy mechanical ventilator designed for rapid, large-scale, low-cost production for the COVID-19 pandemic. Free of moving mechanical parts and requiring only a source of compressed oxygen and medical air to operate, the MVM is designed to support the long-term invasive ventilation often required for COVID-19 patients and operates in pressure-regulated ventilation modes, which minimize the risk of furthering lung trauma. The MVM was extensively tested against ISO standards in the laboratory using a breathing simulator, with good agreement between input and measured breathing parameters and performing correctly in response to fault conditions and stability tests. The MVM has obtained Emergency Use Authorization by U.S. Food and Drug Administration (FDA) for use in healthcare settings during the COVID-19 pandemic and Health Canada Medical Device Authorization for Importation or Sale, under Interim Order for Use in Relation to COVID-19. Following these certifications, mass production is ongoing and distribution is under way in several countries. The MVM was designed, tested, prepared for certification, and mass produced in the space of a few months by a unique collaboration of respiratory healthcare professionals and experimental physicists, working with industrial partners, and is an excellent ventilator candidate for this pandemic anywhere in the world.

Non-linear Terahertz driving of plasma waves in layered cuprates

The hallmark of superconductivity is the rigidity of the quantum-mechanical phase of electrons, responsible for superfluid behavior and Meissner effect. The strength of the phase stiffness is set by the Josephson coupling, which is strongly anisotropic in layered cuprates. So far, THz light pulses have been used to achieve non-linear control of the out-of-plane Josephson plasma mode, whose frequency lies in the THz range. However, the high-energy in-plane plasma mode has been considered insensitive to THz pumping. Here, we show that THz driving of both low-frequency and high-frequency plasma waves is possible via a general two-plasmon excitation mechanism. The anisotropy of the Josephson couplings leads to markedly different thermal effects for the out-of-plane and in-plane response, linking in both cases the emergence of non-linear photonics across T_c to the superfluid stiffness. Our results show that THz light pulses represent a preferential knob to selectively drive phase excitations in unconventional superconductors.

Josephson coupling determines the superconducting phase stiffness and sets the energy scale of plasma waves. Here, the authors show that THz light can induce two-plasmon excitations of both out-of-plane and in-plane phase modes, leading however to markedly different resonant and thermal effects due to the strong anisotropy of the Josephson couplings.

Table Olives Fermented in Iodized Sea Salt Brines: Nutraceutical/Sensory Properties and Microbial Biodiversity

This research aimed to study the influence of different brining processes with iodized and noniodized salt on mineral content, microbial biodiversity, sensory evaluation and color change of natural fermented table olives. Fresh olives of Olea europaea Carolea and Leucocarpa cvs. were immersed in different brines prepared with two different types of salt: the PGI "Sale marino di Trapani", a typical sea salt, well known for its taste and specific microelement content, and the same salt enriched with 0.006% of KIO₃. PGI sea salt significantly enriches the olive flesh in macroelements as Na, K and Mg, and microelements such as Fe, Mn, Cu and Zn. Instead, Ca decreases, P remains constant, while iodine is present in trace amounts. In the olives fermented in iodized-PGI sea salt brine, the iodine content reached values of 109 μg/100 g (Carolea cv.) and 38 μg/100 g (Leucocarpa cv.). The relationships between the two varieties and the mineral composition were explained by principal component analysis (PCA) and cluster analysis (CA). Furthermore, analyzing the fermenting brines, iodine significantly reduces the microbial load, represented only by yeasts, both in Carolea cv. and in Leucocarpa cv. Candida is the most representative genus. The sensory and color properties weren't significantly influenced by iodized brining. Only Carolea cv. showed significative difference for b* parameter and, consequently, for C value. Knowledge of the effects of iodized and noniodized brining on table olives will be useful for developing new functional foods, positively influencing the composition of food products.

Refining the model to design α-chymotrypsin superactivators: the role of the binding mode of quaternary ammonium salts

Modelling, synthesis and kinetic studies were combined to investigate the interactions responsible for the superactivation of α-chymotrypsin by ammonium-based additives.

Effect of Surfactant Structure on the Superactivity of Candida rugosa Lipase

In this work, we present the effects of ionic and zwitterionic surfactants on the hydrolytic activity of Candida rugosa lipase (CRL), one of the most important and widely used microbial lipases. A series of amine N-oxide surfactants was studied to explore the relationship between their molecular structures and their effect on catalytic properties of CRL. These zwitterionic amphiphiles are known for their ability to form aggregates that can increase their size, thanks to a sphere-rod transition, without any additive. Enzyme activity seemed to be improved by morphological changes of micelles from spherical to rod-like, and the structure of the monomers played a crucial role in this transition. In fact, all the amine oxides investigated provoked superactivation, but the CRL activity increased by lengthening the alkyl chain of N-oxide surfactants, whereas it decreased in the presence of bulky head groups. Superactivity was mainly because of an increase in k_cat (0.57 s^-1 in buffer, 0.80-1.99 s^-1 in surfactant solutions) and, in some cases, a decrease in K_M (2 × 10^-3 M in buffer, 1.08-4.28 × 10^-3 M in surfactant solutions). Micelles seemed to play a dual role: superactivity occurred at surfactant concentrations higher than their critical micelle concentration, but, on the other hand, micelles subtracted the substrate from the bulk, making it unavailable for the catalysis.

Constraints on Sub-GeV Dark-Matter-Electron Scattering from the DarkSide-50 Experiment

We present new constraints on sub-GeV dark-matter particles scattering off electrons based on 6780.0 kg d of data collected with the DarkSide-50 dual-phase argon time projection chamber. This analysis uses electroluminescence signals due to ionized electrons extracted from the liquid argon target. The detector has a very high trigger probability for these signals, allowing for an analysis threshold of three extracted electrons, or approximately 0.05 keVee. We calculate the expected recoil spectra for dark matter-electron scattering in argon and, under the assumption of momentum-independent scattering, improve upon existing limits from XENON10 for dark-matter particles with masses between 30 and 100  MeV/c^{2}.

Low-Mass Dark Matter Search with the DarkSide-50 Experiment

We present the results of a search for dark matter weakly interacting massive particles (WIMPs) in the mass range below 20  GeV/c^{2} using a target of low-radioactivity argon with a 6786.0 kg d exposure. The data were obtained using the DarkSide-50 apparatus at Laboratori Nazionali del Gran Sasso. The analysis is based on the ionization signal, for which the DarkSide-50 time projection chamber is fully efficient at 0.1  keVee. The observed rate in the detector at 0.5  keVee is about 1.5  event/keVee/kg/d and is almost entirely accounted for by known background sources. We obtain a 90% C.L. exclusion limit above 1.8  GeV/c^{2} for the spin-independent cross section of dark matter WIMPs on nucleons, extending the exclusion region for dark matter below previous limits in the range 1.8-6  GeV/c^{2}.

Recent Borexino results and perspectives of the SOX measurement

Borexino is a liquid scintillator detector sited underground in the Laboratori Nazionali del Gran Sasso (Italy). Its physics program, until the end of this year, is focussed on the study of solar neutrinos, in particular from the Beryllium, pp, pep and CNO fusion reactions. Knowing the reaction chains in the sun provides insights towards physics disciplines such as astrophysics (star physics, star formation, etc.), astroparticle and particle physics. Phase II started in 2011 and its aim is to improve the phase I results, in particular the measurements of the neutrino fluxes from the pep and CNO processes. By the end of this year, data taking from the sun will be over and a new project is scheduled to launch: Short distance Oscillation with boreXino (SOX), which uses a Cerium source for neutrinos (100÷150 kCi of activity) and aims to confirm or rule out the presence of sterile neutrinos. This particle is hypothesised to justify the reactor, Gallium and LSND anomalies found and can reject extensions to the standard model. The work presented is a summary of the solar neutrino results achieved so far, which lead not only to a precise study of the processes in the sun, but also to more Standard Model oriented measurements (such as the stability of the charge, i.e. the life time of the electron). Furthermore, the perspectives of the SOX program are discussed showing the experiment sensitivity to a fourth neutrino state covering almost entirely 3σ of the preferred region of the anomalous neutrino experiments, and additional applications of the detector such as the study of geo-neutrinos.

Test of Electric Charge Conservation with Borexino

Borexino is a liquid scintillation detector located deep underground at the Laboratori Nazionali del Gran Sasso (LNGS, Italy). Thanks to the unmatched radio purity of the scintillator, and to the well understood detector response at low energy, a new limit on the stability of the electron for decay into a neutrino and a single monoenergetic photon was obtained. This new bound, τ≥6.6×10^{28}  yr at 90% C.L., is 2 orders of magnitude better than the previous limit.

Natural history of cystic echinococcosis in humans

This study provides a contribution to understanding of the natural history of the hydatid cyst during its evolution in the human liver examining the high morphostructural variability of larval forms of Echinococcus granulosus. A detailed study of a large sample of intact cysts removed from patients surgically treated by means of total pericystectomy, has enabled to outline the different developmental stages of the parasite over time, up to its death and complete degeneration.

Human cystic echinococcosis in Sardinia during the 20th century

At the beginning of the 20th century in Sardinia human Cystic Echinococcosis was considered a highly endemic disease by all the health operators. In the early twenties the number of reported cases was 429, but incidence appeared rising due to increase in availability of data and to improvements in diagnosis. The fall of personal and public hygienic conditions together with the drift from urban to rural areas during the second world war, had in fact facilitated the possibilities of infection, causing a strong growth of surgical cases during the post war years, so that incidence rate remains high and almost unvaried until the end of the eighties. Comparative analysis of young and probably old cysts indicates that this high rate of surgical cases was attributable to treated hepatic cysts in elderly. On the contrary the continuous reduction in the number of young cysts clearly shows a slow but constant decrease of the infection rate.

[Human cystic hydatidosis in Italy: a public health emergency? Past to present]

Starting from 1991 the Central Office of Statistics ISTAT, according to changed regulations on notification of infective diseases, stopped reporting official national data on human hydatidosis. On the other hand until then notified data, concerning only about a hundred cases per year in mean during the last decades and just 36 in 1991, appeared unreliable, suggesting a diffusion far from the actual. Owing to specific studies on different research groups it is possible to try to describe a not exhaustive but indicative pattern of trend of human hydatidosis in Italy. More recent publications regarding different regions report an annual mean incidence rate of surgical cases of 9.77/100,000 inhabitants in Sardinia, of 1.57 in Emilia Romagna, of 2.30 in Sicily and of 2.33 in Apulia, the latter encompassing only hepatic cysts treated in the region, irrespective of residence of subjects. A comparison with previous studies regarding the period between 1948-1952 and 1980-84 respectively, indicates an increase in the more recent surveys. However, as even underlined by Authors, former surveys were not all-embracing (for example not including patients from private Clinics etc). On the other hand during time, improvements in surgical as well in anaesthesiological skills have made surgery possible in patients previously inoperable, and particularly in old subjects. Conversely, at present, availability of alternative therapies such as chemotherapy, PAIR or modified PAIR-based techniques may allow cases to avoide surgical surveys. However, actual parasite burden in humans may be estimated by assessing the trend of likely young cysts, as due to recent infections. Rate of pulmonary cysts, that are sure to be young, was of 48.6%/100,000 inhab. in 1952 in Italy, then falling to 18.2 in 1980-84 in the 9 considered regions, to 12.7 in Sicily (1989-91), 6.5 in Emilia-Romagna (1989-93) and 15.7 in Sardinia (1990-95). Another "class" of surely young cysts regards all cysts in young age group that necessarily have been recently infected. Ratio of infection rates in the old/young people was around 1 in 1941-52 but was exceeding 3 in 1980-84. In addition available data from more recent surveys indicate that ratio is at present still relatively low in Sardinia (3.9), where sheep-breeding is widespread, and dog-livestock-man interaction is most likely to exist, and conversely is very high in Emilia-Romagna (5.75) where pastoral economy is not prevalent (just 92,000 sheep). Actual trend both parasitological and in terms of public health would ameliorate if studies were provided with long temporary series. In Sardinia all hydatid cases surgically treated from 1969 to 1995 have been registered and analysed with a standardized methodology. During the considered period incidence appears nearly unvaried (16.9 in 1969 vs 15.8 in 1985), with a fall only for the last 5 years (9.1 in 1995), and with an increase regarding 1984-88 period. Analysis according to cyst localization strongly suggests that fall in the last period is only weakly related to hepatic cysts, that conversely are near completely responsible of rise in 1984-88. On the contrary for pulmonary cysts, i.e. young cysts, a slow but continuous and significant decrease (from 6.5 in 1969 to 1.4 in 1995) is evident. In the same way the above- mentioned old/young ratio rises from 1.7 (1969-79) to 3.9 (1990-95). On the whole analysed data suggest that although parasitic burden, strong in central-south Italy for decades, is now slow lowering due to structural changes and improvements in general conditions of life rather to specific preventive actions, human hydatidosis still represents a public health problem that will continue in the future as, because of latency, incidence rates will stay long relevant.

Causality or coincidence: may the slow disappearance of helminths be responsible for the imbalances in immune control mechanisms?

Intestinal infection continues to be a problem worldwide and helminths, which currently infect billions of individuals, are primary culprits. The major burden of disease falls on the populations of developing countries, given that over the last four to five decades helminth infections are disappearing in industrialized societies. In developing countries, a major source of immunomodulatory signals in post-natal life are parasites, particularly helminths, which, unlike most bacteria and viruses, selectively stimulate Th2 function. Helminths and their eggs are probably the most potent stimulators of mucosal Th2 responses. Responses elicited by worms can modulate immune reactions to other parasites, bacterial, viral infections and several unrelated diseases. Bacterial and protozoal infections may also protect against atopy and asthma, through the induction of the Th1 regulatory responses. Today, people in developed countries often live in ultra-hygienic environments, avoiding exposure to viruses, bacteria, ectoparasites and endoparasites, particularly helminths. Perhaps failure to acquire worms and experience mucosal Th2 conditioning predisposes to unrelated diseases. In contrast to this hypothesis it has also been suggested that Th2 responses can make the host more susceptible to other important diseases and to contribute to the spread of them.

Morphological variability and degenerative evolution of human hepatic hydatid cysts

The findings are presented of a macro and microscopic investigation of 89 hydatid hepatic cysts removed intact from 59 patients by total pericystectomy. Detailed analysis revealed significant morphostructural variability and cysts grouped into 10 types were characterized, providing useful clinical indications. Only 30 cysts resulted fertile (33.7%), probably due to mean age of sample; 7 of these were "classic" cysts, 1 "septated" and 22 "multivesicular" packed with daughter cysts (DC), of varying turgidity or collapsed. Among the remaining 59 sterile cysts, 52 were degenerated and classified as "hyperlaminated" cysts due to the presence of large convoluted sheets of laminar tissue (SLT) surrounded by varying amounts of caseous (40 specimens), granular (6) or gelatinous (6) matrix. Moreover, "multivesicular", "acephalocyst", "caseous" and "serous" cysts were also recovered among the sterile specimens. Some "multivesicular" cysts (14) appeared as "transitional forms" towards the various types of "hyperlaminated" cysts containing all different forms of DC and large SLT intermingled with a variously degenerated matrix. The comprehensive study allows to hypothesize the train of events leading, over the years, to the gradual transformation and degeneration of the larval form Echinococcus granulosus in the human liver.

Study on immunobiology in endoparasites of public health interest: echinococcosis-hydatidosis

Cystic echinococcosis caused by Echinococcus granulosus is one of the most widespread zoonoses in the Mediterranean, endemic in some regions such as Sardinia. Some aspects of the research conducted in this area are briefly reviewed for an integrated analysis of both epidemiological and immunobiological knowledge, gained from field observations and experimental studies. Data on epidemiology in intermediate hosts, immunological assessment of exposure in humans, immune response and Th1/Th2 polarization in secondary experimental hydatidosis, kinetics of response in definitive host and cytokine production in experimental models are briefly reported. They confirm the usefulness of an immunobiological approach both in intermediate and definitive hosts and their potential in prevention, monitoring and control of E/H.

Study on immunobiology in ectoparasites of public health interest: Rhipicephalus sanguineus

The recently defined range of Mediterranean Spotted Fever (MSF) in Sardinia coincides with that of the widely studied Rickettsia conorii vector, the brown dog tick Rhipicephalus sanguineus. This tick is major vector of disease in humans, domestic and wild animals. Characteristic features of the vector with respect to their seasonal activity, abundance as well as incidence of human-tick contact and how these factors influence the incidence of MSF were studied. This paper also looks at host, pathogen and tick vector interactions, re-examining some of the immunobiological parameters involved. However, the primary objective of this research is to develop a strategy that will allow better and safer tick control.

Hydatidosis: a comprehensive view of the Sardinian case

In Sardinia the close association of sheep, dogs and humans still exists in some parts of the region, so that ideal conditions persist for the perpetuation of the parasite's life cycle. Two factors contribute to the spread of the disease: the practice of slaughtering sheep at home and the proliferation of dogs, mainly strays. This paper reviews the epidemiological picture and the economic consequences of the disease in man and livestock, strongly suggesting that this endemic disease is a major public health problem.

Cytokine production during infection with Hymenolepis diminuta in BALB/c mice

Levels of the cytokines IFN-gamma, IL-2, IL-3, IL-4 and IL-5 were monitored in cells from the mesenteric lymph nodes (MLN) of BALB/c mice infected with Hymenolepis diminuta after stimulation in vitro with Con-A. Infection was associated with an increased production of IL-3, IL-4 and IL-5 and a low production of IFN-gamma, indicating the preferential activation of a Th2 response. It is suggested that this reflects the purely lumenal development of this worm. The results are discussed in relation to effector mechanisms known to be involved in immunity to intestinal helminths.

A clinical and urodynamic study of patients with varying degrees of cystocele

OBJECTIVE

To assess urodynamic alterations in patients with varying degrees of cystocele but without prolapse of the uterus, rectocele and/or enterocele.

PATIENTS AND METHODS

Between September 1993 and June 1995 we examined 83 patients with varying degrees of isolated cystocele. All subjects were questioned about their medical history and underwent urogynaecological examination and urodynamic tests.

RESULTS AND CONCLUSIONS

In our study there were no cases of pure urge incontinence nor were there any normal urodynamic situations; genuine stress incontinence was the most frequent urinary disorder. Moreover patients with grade 3-4 cystocele on the Baden-Walker scale had more difficulty in voiding than subjects with milder forms of cystocele. In fact the maximum and average flow rates of the former tended to decrease, flow and voiding times were longer and acceleration of flow rate were significantly lower. The maximum urethral closure pressure tended to diminish with an increase in the duration of menopause, whereas the pressure transmission ratio tended to decline significantly with an increase in cystocele severity. In conclusion, even when cystocele is the only alteration in pelvic statics, it determines significant urodynamic changes that must be carefully assessed so as to optimize the choice, mode and time of surgical, rehabilitative or pharmacological intervention.

Epidemiology of hydatid disease in the Mediterranean basin with special reference to Italy

Hydatidosis, caused by dog tapeworms of the genus Echinococcus, is one of the most important cestode infections in man. Of the four species of the genus Echinococcus, only Echinococcus granulosus is widespread in the Mediterranean basin which is still, unfortunately, a major endemic focus. This article critically reviews its diffusion in humans and sheep over the past twenty years. Although most of the available data are scarce, fragmentary, and not homogeneous, they represent the only possibility at present of evaluating the parasitic pressure.

Immune response to the cestode Hymenolepis nana: cytokine production during infection with eggs or cysts

Analysis of cytokine production (IFN-gamma, IL-2, IL-3, IL-4, IL-5) by in vitro Con A-stimulated mesenteric lymph node cells measured daily after egg or cyst infection of mice with Hymenolepis nana showed that cytokine production varies during parasite development and between different host strains (BALB/c and C3H/He mice). Egg infection stimulates a rapid increase in IFN-gamma, independent of mouse strain. In addition, in BALB/c mice a Th2-like response (IL-4, IL-5 secretion) was stimulated 4-5 days p.i., when the parasites are thought to begin their lumenal phase. After infection with cysts significant increases in IFN-gamma, IL-2, IL-4 and IL-5 were observed at the time when autoinfection with eggs is thought to occur. The level of IFN-gamma paralleled that seen after a primary egg infection. This suggests that there is a predominantly Th1-type response during the tissue phase of H. nana development and that, in BALB/c mice, a Th2 polarization occurs during the first few days of the lumenal phase. The cytokine patterns observed are discussed in relation to host responses during chronic helminth infection.

[Volume increase of the left leg and dyspnea as clinical manifestation of ruptured abdominal aorta aneurysm: problems of diagnostic assessment]

The case of a 74-year-old man who presented with abdominal pain, worsening dyspnea and swelling of the left lower limb is described. Careful history taking and clinical examination enabled diagnosis of the rupture of an abdominal aortic aneurysm.

Effect of an intraperitoneal injection with activated Hymenolepis nana and H. diminuta cysticercoids on homologous challenge

The intraperitoneal injection of excysted-activated cysticercoids of Hymenolepis nana and H. diminuta stimulates a protective immunity in mice and rats against an oral homologous challenge with different levels of effectiveness. The immunizing dose reduced only worm growth in the natural host (i.e. H. nana/mouse and H. diminuta/rat models), while in the unnatural host (i.e. H. diminuta/mouse model) expulsion of the worms from the intestine was accelerated. In mice infected with H. nana the effect appeared about 20 days after injection, but a greater effect was found in both models 40 days later even at low dose (1 cysticercoid). In rats the effect appeared 40 days after injection when a large inoculum (50 or 100 cysticercoids) was used. The induced immunity was slow in developing and only partially effective: this was probably related to host difficulties in processing somatic worm antigens, or to the slow production of metabolites by the worms in the peritoneal cavity.

Onset of resistance to light Hymenolepis nana infection in mice of different strains

Rapidity in onset of resistance against Hymenolepis nana egg infection after a light primary infection was studied in low and high responder mice challenged at different time intervals. A very rapid acquisition of protection was observed in C57 and a delayed response in C3H mice. In both cases the effect of resistance on weight or worm number was related to the time of challenge infection, suggesting a "race against time" involving host response and parasite development, the outcome varying according to host genetic background.

Immune stimulation and Hymenolepis nana cysticercoid expulsion in C3H/He and BALB/c mice

Adoptive transfer of immunity with heterologous and homologous immune serum, and drug-abbreviated immunizations were used in C3H and BALB/c mice to determine the strain-characteristic time of expulsion of H. nana cysts. Transfer of immune serum did not accelerate worm expulsion in C3H, while elimination of worms was virtually complete by day 8 in BALB/c mice. Loss of worms was also obtained when BALB/c mice were stimulated with abbreviated infections using 20 or 1000 H. nana eggs. The immunizing infection terminated immediately after the tissue phase. After similar immunizations C3H mice again appeared slow responders but were able to affect the intestinal worms population after the higher immunizing infection. The data obtained suggest that the time of worm expulsion was related to the genetically-determined ability of the mice to respond and was independent of the stimulations used for immunization. A quantitative difference in response is proposed to explain the slow responder status of C3H.

Specific cross-immunity between Hymenolepis nana and H. diminuta: effects of transfer of immunity with homologous and heterologous immune mesenteric lymph node cells in BALB/c mice

In BALB/c mice, Hymenolepis nana and H. diminuta stimulate a strong response. Accelerated expulsion of adult worms, as well as protection against larvae, occurred anamnestically when homologous or heterologous mesenteric lymph node cells from immune mice were transferred before challenge. The results further support the hypothesis that worm expulsion is a thymus dependent phenomenon. The extensive cross reactivity found is discussed in relation to the distinctive characteristics of the two worms. These results strongly suggest that there are antigenic similarities between the two parasites and that the accelerated expulsion of heterologous challenge infections is the result of a specific response to shared antigens.

Failure to demonstrate suppressor T cell activity in the lamina propria of Hymenolepis diminuta-infected rats

The aim of this study was to examine whether there was an increase of suppressor T cells, relative to helper T cells, in the intestinal lamina propria of Hymenolepis diminuta-infected rats, a condition which might allow the parasite to survive for the life-span of the host. Lamina propria cells were isolated by enzymatic procedure. All lymphocytes were passed over nylon wool columns in order to remove B cells; then the T cells were purified by a panning technique using monoclonal anti-T cell antibodies. Changes in the mitogen-stimulated synthesis of IgM, IgG and IgA by normal peripheral blood indicator lymphocytes, as measured by sandwich ELISA, was used as an index of help and/or suppression. No significant suppressor T cell activity was observed in the cultures, either from control or infected intestine.

Mechanisms of protective immunity in Hymenolepis nana/mouse model

Some immunological and parasitological aspects related to the infection of Hymenolepsis nana in mice are summarized in this review, focusing on the immune effector mechanisms involved in this host/parasite relationship. H. nana is a small cestode tapeworm of man and mice. A primary egg-infection determines within few days a strong immunity. Immunity elicited by low-level primary infection is effective as a high-level infection. The protective role of both humoral and cell-mediated immunity is summarized. The histological findings demonstrate that eosinophils and mast-cells are implicated as effector cells. This review is an attempt to re-examine, at low-level infection, the immune mechanisms in H. nana/mouse model.

Epidemiology of hydatid disease in Sardinia: a study of fertility of cysts in sheep

Hydatidosis, caused by Echinococcus granulosus, is a cyclozoonotic disease of economic significance in Sardinia. The life-cycle involves stray and sheep dogs as definitive hosts and sheep, pigs, goats and cattle as intermediate hosts. The most important intermediate host is sheep, due to home slaughtering with ready access of the viscera to dogs. This survey was undertaken in 1987 to ascertain the epidemiological significance of sheep in maintaining the life-cycle. A total of 700 (91.3%) of 767 sheep harboured hydatid cysts. The frequency distribution of the number of hydatid cysts was over-dispersed. Of 497 infected sheep, 7.6% had fertile cysts, 75.7% sterile cysts and 16.7% fertile + sterile cysts.

[Distribution of ovine hydatidosis in Sardinia, 1987-1988]

The prevalence of Echinococcus granulosus in sheep was examined in Sardinia between June and September 1987-1988. Of the examined sheep 243 were being pastured in fenced fields while 1084 were being pastured in open fields. An infection rate of 1.6% was recorded in the first group of sheep, and 86.7% in the second. The prevalence rate differed in various parts of the region, ranging from 79.4% (Oristano province) to 95% (Nuoro province). Of the parasitized sheep 7.9% harboured only fertile cysts, and 74.1% only sterile cysts. The latest figure is surprising compared to data previously reported in the literature. Most of the sheep examined were infected in both organs (67.4%) but only 27.4% of these showed a massive infection with over 10 hydatid cysts. The variation in prevalence rate and epidemiological implications are discussed.

Kinetics of mast cells, eosinophils and phospholipase B activity in the spontaneous-cure response of two strains of mice (rapid and slow responder) to the cestode Hymenolepis nana

Primary egg-derived infection of Hymenolepis nana (100 eggs) in BALB/c (rapid responder) and C3H (slow responder) mice resulted in increased levels of mucosal mast cells (MMCs), eosinophilia (bone marrow, peripheral, tissue) and phospholipase B activity. The response appeared to be similar in both strains used, with a slight difference in cellular accumulation but a significantly earlier response in BALB/c than in C3H mice. These findings suggest that the prolongation of H. nana infection in C3H mice may be related to the delayed appearance of MMCs and eosinophils, which triggers a slower generation of the intestinal inflammation response. The rapidity with which phospholipase B activity increased was strictly correlated with eosinophil tissue number; this further supports the hypothesis for a direct parallel between eosinophils and phospholipase B activity in infected tissue.

Specific cross-immunity between Hymenolepis nana and H. diminuta: immunization with heterologous and homologous light infections

The consequences of previous and concurrent infection with two related species of cestodes, Hymenolepis nana and H. diminuta, were studied in CD1 mice. A H. diminuta infection strongly affected the establishment and the survival of a secondary H. nana egg or cyst infection administered 30 days later. An infection of 20 H. nana eggs strongly protected against a 5-cyst H. diminuta challenge, whereas an infection of 10 H. nana cysts was ineffective; 20 H. nana eggs also protected against a challenge with 5 cysts of H. diminuta administered 5 days later. No effects were observed in either parasite during a concurrent infection established by administration of cysts. An H. nana egg-infection was unable to affect the establishment of a secondary H. nana cyst-infection given 1 month later; however a significant decrease in growth was found. Similar results were found when a primary H. nana egg-infection was followed 5 days later by the homologous cyst-infection. But an infection with 5 H. nana cysts was unable to protect against a homologous challenge of 5 cysts or 200 eggs. The reciprocal cross immunity between the heterologous parasites and the failure of protection of homologous challenges are discussed in relation to light infections.