An interdisciplinary intervention for health prevention and promotion in a Roman neighborhood

 

Influencing behavioral patterns through primary prevention, possibly addressing more risk factors at a time, is the most effective means to tackle cardiovascular diseases. Many interdisciplinary prevention activities have been coordinated by community nurses outside of specialist centers, resulting in a more effective control of risk factors. Our study aims at describing the impact of an 18-month prevention and promotion, interdisciplinary intervention on lifestyle habits and cardiovascular risk. From December 2018 to May 2020, patients were recruited by 4 General Practitioners (GPs) in the Roman neighborhood of Torresina and received nutritional, physical and psychological counselling to learn healthy lifestyles. Until May 2020 patients had to self-manage their new healthy habits, but during this phase the SARS-CoV-2 pandemic broke out. Patients were assessed at baseline, 6, 12 and 18 months by a nutritionist, a physiotherapist, a psychologist, the 4 GPs and community nurses, and the cardiovascular risk score (CRS) was estimated at every examination. 76 patients were included, with a mean age of 54,6 years. Mean CRS showed a significant reduction between baseline and 12 months (from 4.9 to 3.8, p < 0.001), but this trend was not maintained at 18 months. As for variables included in the calculation of the cardiovascular risk score, both total cholesterol and systolic blood pressure significantly decreased at 6 months of follow up (respectively, from 211.1 to 192 (p < 0.001) and from 133.1 to 123.1(p < 0.001)). Nontheless, the reduction was maintained in the remaining points in time only for systolic blood pressure. Our interdisciplinary educational intervention in a primary care setting resulted in a CRS improvement at 12 months, but this changes where not maintained at 18 months. Community nurses were facilitators in improving health outcomes and patient's satisfaction in the described primary care setting.

Key messages

Coping Styles in the SARS-CoV-2 national lockdown: impact on behaviors for cardiovascular prevention

Background

Coping styles are the ways in which people deal with different stressor situations. Coping strategies can be categorized into three types: task-oriented, emotion-oriented, and avoidance-oriented. Several studies showed a strong relationship between coping styles and cardiovascular diseases. The aim of the study was to evaluate how much the SARS-CoV-2 national lockdown has impacted the coping strategies on behaviors for cardiovascular prevention.

Methods

62 participants from Rome were recruited to assess the impact of prevention and promotion of health on Individual Cardiovascular Risk. The Coping Inventory to Stressful Situations (CISS, Endler & Parker, 1990) is a self-report questionnaire that measures the three strategies of coping. Behaviors dealing with cardiovascular prevention were evaluated at the beginning of the observation period, and after 6, 12, and 18 months. During 12 (February 2020) and 18 months (July 2020) the SARS-CoV-2 national lockdown enabled us to inquire into coping strategies in stressful situations and cardiovascular risk factors.

Results

The Pearson correlation analysis was used to assess the existence of a correlation between coping strategies and the variation of cardiovascular risk factors and alcohol consumption at 12 and 18 months. Interestingly, results showed relations between Emotional-oriented (r = 0.26 p &lt; 0.05) and Task-oriented (r = -0.33 p &lt; 0.01) coping styles and Differential Cardiovascular Risk Reduction (DCRR). Furthermore, a positive relation between Task-oriented (r = 0.34 p &lt; 0.01) coping style and Differential Alcohol Consumption (DAC) was observed.

Conclusions

We found that the DCRR relates to the Emotional- and Task-oriented coping styles, while DAC is associated with the Task-oriented coping style. The strength of our study consists in the territorial and multidisciplinary dimension of the project, the main critical issue is represented by the small size of the patient sample.

Key messages

A relationship can be described between Differential Cardiovascular Risk Reduction and Emotional- and Task-oriented coping styles. There is a relationship between Differential Alcohol Consumption and the Task-oriented coping style.

Occurrence of Parasites of the Genus Eustrongylides spp. (Nematoda: Dioctophymatidae) in Fish Caught in Trasimeno Lake, Italy

Eustrongylides spp. is considered a freshwater fish zoonotic nematode. In the present study, the prevalence of Eustrongylides spp. in six edible fish (European perch - Perca fluviatilis, goldfish - Carassius auratus, largemouth black bass - Micropterus salmoides, tench- Tinca tinca, carp - Cyprinus carpio and sand smelt - Atherina boyeri) of Trasimeno lake was surveyed. The investigations were conducted from October 2014 to September 2015 and 384 specimens per species for each season were caught in Trasimeno lake and examined for the presence of larvae in the abdominal cavity and muscle. The presence of nematodes in the abdominal cavity and musculature was revealed in three fish species. The prevalence of Eustrongylides spp. infection was 6.84, 1.89 and 0.13% in perch, largemouth black bass and sand smelt, respectively. The number of parasites per fish was only one in largemouth black bass and sand smelt and ranged from one up to three in perch. This study states that the European perch, largemouth black bass and sand smelt of Trasimeno lake are infected with zoonotic parasites; therefore, food business operators have to take appropriate measures to guarantee the health of consumers.

Thermal Inactivation and Growth Potential of Listeria Monocytogenes in Smoked Tench

An experimental study for the evaluation of Listeria monocytogenes inactivation during a hot smoking process in tench was performed using Listeria innocua strains. Furthermore, the survival of L. monocytogenes in smoked tench was determined after post-processing in contaminated samples, evaluating the growth potential during storage. L innocua was not detected after the smoking process. In the challenge test, the growth potential of L. monocytogenes was 5.68 log colony forming unit g-1. The results showed that hot smoking at an inner temperature around 72°C is able to eliminate the microorganism. Nevertheless, the product is able to support the growth of the pathogen if post-process contamination occurs, as the food is suitable for Listeria multiplication. Product recontamination should be prevented by means of appropriate application of hygiene measures.

Vomer aplasia in a patient carrying a de novo mutation of the TP63 gene (3q27)

The congenital vomer defect (CVD) is a rare and still partially unknown condition. Only few cases have been reported in the international literature and the large majority of them appeared to be isolated. We report a case of CVD detected in a 7-year-old girl affected by ectodermal dysplasia clefting syndrome caused by a mutation of the TP63 gene.

[Italian Program for Surveillance of Acute Pesticide-Related Illnesses: cases identified in 2005]

In 2005, the Italian System for Surveillance of Acute Pesticide-Related Illnesses (SIAF) identified 625 cases, among which 520 unintentionally exposed. The majority of these subjects were men (75%) and aged 26-65 years (65%). About 63% of all exposures occurred at work. Severity for these illnesses was low for 94% and moderate for 5%. Four cases were classified as illnesses of high severity. Some 70% of all the reported exposures occurred between May and September. The active ingredients responsible for the largest number of cases were: glyphosate (n. 56), copper sulphate (n. 55), methomyl (n. = 52), metam-sodium (n. 24). Three episodes of collective environmental exposure to soil fumigants involving 23 subjects were also detected.

[Long-term effects on male gonadal function of antitumoral drugs used during childhood]

The survival rate of children and adolescents with cancer has improved dramatically in the last decades so that the prospect of survival in adulthood is today a realistic expectation for about 70% of the treated patients. However, the deleterious impact that chemotherapy and radiotherapy have on the reproductive function and future fertility could compromise the quality of life of the survivors in adulthood. The interest of the scientific community on this topic is increasing and focused on a more accurate evaluation of the reproductive risk among cancer treated children and on the development of less aggressive therapies. In the present review, some information about the long-term effects on the male reproductive function, particularly vulnerable to the cancer therapies, are reported from clinical and experimental studies. Furthermore, the concern about the development of pharmacological treatments and assisted reproductive techniques that might preserve or restore the fertility potential in children being treated with gonadotoxic cancer therapy, is discussed. These new strategies are still under experimentation and deeper knowledges on the functional development of the gonads during infancy, both in human and animals models are required. On the other hand, the future clinical application of these strategies in children rise important ethical and legal problems.

Innate immunity against hematological malignancies

BACKGROUND

Allogeneic hematopoietic transplantation relies on T-cell alloreactions for engraftment and the GvL effect. In HLA haplotype-mismatched transplants, extensive T-cell depletion of the graft is essential to prevent GvHD. This raises the question of whether mismatched transplants exert any GvL effect, and whether it will ever be possible to reduce the intensity of preparative regimens. Natural killer (NK) cells are negatively regulated by MHC Class I-specific inhibitory receptors. Mismatched transplants may therefore trigger NK-cell alloreactivity.

METHODS

The effects of NK-cell alloreactivity were evaluated in clinical transplantation and in murine transplant models.

RESULTS

In clinical hematopoietic stem-cell transplants, HLA Class I disparities driving NK-cell alloreactions in the GvH direction eliminate AML relapse and graft rejection, while protecting patients from GvHD. In murine MHC mismatched transplant models, the pre-transplant infusion of donor-versus-recipient alloreactive NK cells conditioned the recipients to BMT, and reduced GvHD.

DISCUSSION

NK-cell alloreactivity may thus provide a novel, powerful tool for enhancing the efficacy and safety of allogeneic hematopoietic transplantation.

Occupational exposures to metals, solvents and pesticides: recent evidence on male reproductive effects and biological markers

This review is based primarily on the recent epidemiological studies conducted in occupational settings in order to explore the relationship between exposures to chemical agents and the possible effects on male reproductive function. The paper examines evidence of the effects of metals, solvents, pesticides and dioxin. The effects considered are primarily the possible alterations of sperm quality and reduction of fertility. Many studies have identified small groups of workers with exposures to these agents, presenting some alteration in the spermatological or fertility profile, but the results are difficult to replicate in other settings with different individuals and different levels of exposure. From examination of the concentrations of environmental and occupational pollutants in the blood and in the seminal fluid of exposed individuals, it appears that, in general, the concentrations are much lower in the seminal fluid and in sperm cells, making this a less useful marker of exposure.

Role of natural killer cell alloreactivity in HLA-mismatched hematopoietic stem cell transplantation

Because of the expression of inhibitory receptors (KIR) for major histocompatibility complex (MHC) class I allotypes, a person's natural killer (NK) cells will not recognize and will, therefore, kill cells from individuals lacking his/her KIR epitopes. This study investigated the role of NK cell alloreactivity in human HLA haplotype-mismatched hematopoietic stem cell transplantation and, specifically, the role of the three major NK specificities, ie, those for HLA-C group 1, HLA-C group 2, and HLA-Bw4 alleles. In 20 of 60 donor-recipient pairs, KIR epitope incompatibility and functional analyses of donor NK cell clones predicted donor NK cells could cause graft-versus-host (GVH)/graft-versus-leukemia (GVL) reactions. NK cell clones of donor origin were obtained from transplanted recipients and tested for lysis of recipient's cryopreserved pretransplant lymphocytes. Despite the absence of GVH disease, we detected high frequencies of NK clones which killed recipient's target cells. Lysis followed the rules of NK cell alloreactivity, being blocked only by the MHC class I KIR epitope which was missing in the recipient. The alloreactive NK clones also killed the allogeneic leukemia. Transplants from these KIR epitope incompatible donors had higher engraftment rates. Therefore, a GVL effector and engraftment facilitating mechanism, which is independent of T-cell-mediated GVH reactions, may be operational in HLA mismatched hematopoietic cell transplants.

Natural killer cell-mediated lysis of autologous cells modified by gene therapy

This study investigated the role of natural killer (NK) cells as effectors of an immune response against autologous cells modified by gene therapy. T lymphocytes were transduced with LXSN, a retroviral vector adopted for human gene therapy that carries the selectable marker gene neo, and the autologous NK response was evaluated. We found that (i) infection with LXSN makes cells susceptible to autologous NK cell-mediated lysis; (ii) expression of the neo gene is responsible for conferring susceptibility to lysis; (iii) lysis of neo-expressing cells is clonally distributed and mediated only by NK clones that exhibit human histocompatibility leukocyte antigen (HLA)-Bw4 specificity and bear KIR3DL1, a Bw4-specific NK inhibitory receptor; and (iv) the targets are cells from HLA-Bw4(+) individuals. Finally, neo peptides anchoring to the Bw4 allele HLA-B27 interfered with KIR3DL1-mediated recognition of HLA-B27, i.e., they triggered NK lysis. Moreover, neo gene mutations preventing translation of two of the four potentially nonprotective peptides reduced KIR3DL1(+) NK clone-mediated autologous lysis. Thus, individuals expressing Bw4 alleles possess an NK repertoire with the potential to eliminate autologous cells modified by gene therapy. By demonstrating that NK cells can selectively detect the expression of heterologous genes, these observations provide a general model of the NK cell-mediated control of viral infections.

In vivo studies on possible adverse effects on reproduction of the fungicide methyl thiophanate

The fungicide methyl thiophanate (MT), widely used to control some of the most common fungal diseases in crops, is metabolized in animals into benzimidazole compounds, including the well-known reproductive toxicant carbendazim. However, standard toxicological tests did not indicate that MT may cause testicular toxicity and/or embryotoxicity, which are typical effects of many benzimidazoles. In the present study some aspects of the MT potential for reproductive toxicity have been assayed by means of two non-conventional models. Following the oral administration of 700 and 1000 mg kg(-1) body wt. for five consecutive days, short-term testicular toxicity was examined in the B6C3F1 mouse through specific parameters (sperm head count, specific enzyme activities, histopathology on days 3-35 post-dosing). In spite of the high doses administered, none of the testicular parameters examined, including histopathology, showed significant alterations as compared to controls at any time post-dosing. Pregnant CD rat dams were administered orally the limit dose of 650 mg kg(-1) body wt. day(-1) during preimplantation (gestational day or GD 2-5) or peri-implantation (GD 6-9) phases; embryos and adnexa were evaluated morphologically on GD 12 as a window for the early observation of embryotoxicity. Evident maternal toxicity was present in both treated groups, whereas only marginal reductions of the growth of embryos and adnexa were observed. A full understanding of MT toxicology will need more quantitative data on metabolism, including plasma kinetics and dosimetry of carbendazim at the relevant targets. Nevertheless, the absence of any clear-cut effect on a number of specific endpoints may provide reassurance that no further testing of MT is needed with regard to testicular toxicity or embryotoxicity.

No evidence of effect on male mice germ cells after acute treatment with thiram

Thiram is a dithiocarbamate compound widely used for industrial processes and agriculture. Animal studies reveal that this compound may affect the male reproductive system. Aim of this study was to test, using sensitive testicular parameters, whether thiram directly affects germinal cells. For this purpose, B6C3F1 mice were intraperitoneally injected with thiram in oil (single dose: 75 mg/kg; repeated five daily doses: 25 mg/kg). Although both treatments were toxic, none of the parameters examined, i.e., testis weight, spermatid head number, specific enzyme levels at different times after treatment (14, 28, 35, 56 days) showed significant variations from the controls. On the contrary, in the positive controls (treated with chlorambucil), a marked reduction of sperm head number as well as a decrease of lactate dehydrogenasex and sorbitol dehydrogenase activity levels were evidenced at day 28, with a tendency to recover at day 35. Under these conditions thiram did not cause cytotoxicity on differentiating spermatogonia and on late spermatocyte stages of mice gonads.

Communications intercellulaires dans les ovarioles de Dytiscus marginalis L

L'un des aspects intéressants de l'oogénèse de Dytiscus marginalis est la formation, à partir d'une même oogonie, et au cours de quatre mitoses différentielles, d'un oocyte et de quinze cellules nourricières. Dès la première mitose diffèrentielle, le noyau de l'oocyte se caractérise par la présence d'une masse de chromatine qui lui est propre et ne se retrouve done pas dans les cellules nourricières (Giardina, 1901). Cette masse Feulgen positive de la vésicule germinative se désagrège assez vite et se fragmente de plus en plus au cours de la période d'accroissement de l'oocyte tandis qu'augmente parallèlement la quantité de RNA présente dans son noyau (Urbani, 1950; Urbani & Russo-Caia, 1964; Bier & Ribbert, 1966; Kaori Kato, 1968).

Dans l'oogénèse d'autres Insectes aussi, on observe des corpuscules extrachromosomiaux dont le comportement ressemble à celui du dytique. Une analyse soigneuse de ces formations au niveau cytochimique et ultrastructural a été réalisée par Lima-De-Faria (1962), Lima-De-Faria & Moses (1966), Bier, Kunz & Ribbert (1967), Lima-De-Faria et al. (1968).