Francesco De Caro

Utilization of chemically oxidized polystyrene as co-substrate by filamentous fungi.

Atactic polystyrene, one of the most widely used chemical products, was subjected to novel chemically oxidative treatments able to trigger a great variety of physical and chemical changes in the polymers chains. The oxidized polystyrene samples, when analyzed with Fourier transform infrared spectroscopy (FTIR) clearly showed the formation of carbonyl groups and hydroxyl groups, which increased with the increase in the strength of chemically oxidative treatments. In fungal degradation tests deploying Curvularia species, the fungus colonized the oxidized samples within 9 weeks. Colonization was confirmed by microscopic examination, which showed that the hyphae had adhered to and penetrated the polymers structure in all the treated samples. Such colonization and adhesion by microorganisms are a fundamental prerequisite for biodegradation of polymers.

Network analysis of drug prescriptions.

Networks exist in many different aspects of the world, at social, economical, biological, and molecular levels. Network science studies their parameters, or quantitative indicators; its instruments make it possible to draw and analyze networks from a mathematical perspective.

Sepsis and septic shock: New definitions, new diagnostic and therapeutic approaches

Sepsis and septic shock are common life-threatening pathologies associated with high mortality and substantial costs for healthcare system. Clinical guidelines and bundles for the management of patients with sepsis have recently been updated. Herein, we review the history of sepsis and related conditions definitions from the first consensus conference in 1991 to nowadays, the epidemiologic data resulting from worldwide studies on incidence and mortality, the diagnostic approaches including the microbiological assessment of infection and the use of several prognostic and diagnostic biomarkers and finally we review the main therapeutic measures as the intravenous immunoglobulin therapy and the administration of appropriate antibiotic treatment to provide patients with sepsis a favourable outcome in the antibiotic-resistance era.

New FTIR methodology for the evaluation of 13C/12C isotope ratio in Helicobacter pylori infection diagnosis

OBJECTIVES The objective of this work was to assess the reliability of a newly developed FTIR (Fourier Transform Infrared spectroscopy) technique for (13)C-urea breath test in the non-invasive diagnosis of Helicobacter pylori infection, in comparison to those currently used, isotope ratio mass spectrometry (IRMS) and non-dispersive isotope-selective infrared spectrometry (NDIRS). This new methodology is based on the use of a very less expensive and sophisticated FTIR than IRMS and NDIRS. MATERIALS AND METHODS Sixty patients (male and female, aged between 15-70 years) with dyspeptic symptoms, like the epigastric pain, were tested for H. pylori infection using (13)C-urea breath test. Triplicate breath samples were collected before and 30 min after drinking the test solution (75 mg (13)C-urea dissolved in 200 ml 0.1M citric acid). Analysis of delta(13)C were conducted in parallel by means of IRMS, NDIRS and FTIR in order to compare the results. RESULTS Delta-over-baseline values were over 5 per thousand in 18 patients, ranging from 8.81 to 60.88 per thousand for IRMS measurements, from 7.2 to 61.2 per thousand for NDIRS and from 7.7 to 61.2 per thousand for FTIR measurements. The remaining 42 subjects had values well below the 5 per thousand cut-off. The results of the baseline-corrected (13)CO(2) exhalation values between FTIR and IRMS/NDIRS were in good agreement. CONCLUSIONS The newly developed FTIR methodology has been demonstrated to be a reliable and accurate analytical tool, low cost and easy-to-operate, which permits a highly specific measurement of (13)C enrichment in breath samples. As IRMS and NDIRS it allows to adequately discriminate between infected and non-infected subjects.

Deep tissue biopsy vs. superficial swab culture, including microbial loading determination, in the microbiological assessment of Skin and Soft Tissue Infections (SSTIs)

Thirty-two patients affected by SSTIs including DFIs were enrolled between 2013 and 2014. Superficial swab was obtained before and after cleansing with sterile saline, and after ultrasonic debridement; deep tissue biopsy was obtained from ulcer base. Samples were diluted with 1 mL of saline, serial 10-fold dilutions to 10−6 were made and 50 μL of each dilution was plated onto appropriate media. Bacteria were identified by Vitek II system. Microbial load was expressed as CFU/mL. Statistical analysis was performed by χ2. Incidence of Gram positives was higher than Gram negatives (S. aureus and P. aeruginosa being the most frequent); concordance (same bacteria isolated before and after debridement) never exceeded 60%. Ultrasonic debridement significantly reduced bacterial load or even suppressed bacterial growth. While reliability of superficial swab is poor for microbiological diagnosis of SSTIs, swabbing after ultrasonic debridement and biopsy of the ulcer base may be equally reliable.

The Impact of Aging on Cardio and Cerebrovascular Diseases

A growing number of evidences report that aging represents the major risk factor for the development of cardio and cerebrovascular diseases. Understanding Aging from a genetic, biochemical and physiological point of view could be helpful to design a better medical approach and to elaborate the best therapeutic strategy to adopt, without neglecting all the risk factors associated with advanced age. Of course, the better way should always be understanding risk-to-benefit ratio, maintenance of independence and reduction of symptoms. Although improvements in treatment of cardiovascular diseases in the elderly population have increased the survival rate, several studies are needed to understand the best management option to improve therapeutic outcomes. The aim of this review is to give a 360° panorama on what goes on in the fragile ecosystem of elderly, why it happens and what we can do, right now, with the tools at our disposal to slow down aging, until new discoveries on aging, cardio and cerebrovascular diseases are at hand.

Internet Addiction: a prevention action-research intervention

The aim of this paper was to present an action-research intervention for the prevention of Internet addiction (IA) in schools. Applying a pre-experimental research design model, a total of 90 young subjects (45 males and 45 females) were treated using a peer education programme. The Internet Addiction Test was used as a screening tool pre- and post-treatment and analysed using a paired t-test. The results showed a significant positive difference in the post-treatment values for both males and females. This research highlights the link between IA and cultural and social aspects of the disease in addition to discussing the difficulties of IA prevention.

A multicenter study on the appropriateness of hospitalization in obstetric wards:application of Obstetric Appropriateness Evaluation Protocol (Obstetric AEP)

Abstract The cross-sectional study has been based on the implementation of the Obstetric Appropriateness Evaluation Protocol (OAEP) in seven hospitals to determine inappropriate hospital admissions and days of stay. The outcomes were: inappropriateness of admission and “percentage of inappropriateness” for one hospitalization. A total number of 2196 clinical records were reviewed. The mean percentage of inappropriateness for hospitalization was 22%. The percentage of inappropriateness for the first 10 d of hospitalization peaked in correspondence of the fourth (42%). The logistic regression model on inappropriated admission reported that emergency admission was a protective factor (OR = 0.4) and to be hospitalized in wards with ≥30 beds risk factor (OR = 5.12). The second linear model on “percentage of inappropriateness” showed that inappropriated admission and wards with ≥30 beds increased the percentage (p < 0.001); whereas the admission in Teaching Hospitals was inversely associated (p < 0.001). The present study suggests that the percentage of inappropriate admission depends especially on the inappropriate admission and the large number of beds in obstetric wards. This probably indicates that management of big hospitals, which is very complex, needs improving the processes of support and coordination of health professionals. The OAEP tool seems to be an useful instrument for the decision-makers to monitor and manage the obstetric wards.

Diagnostic and therapeutic appropriateness in bone and joint infections: results of a national survey

The impact of infectious diseases (ID) specialist consultation in the management of many types of bacterial infections has been fully demonstrated but not for bone and joint infections (BJIs). Nineteen ID Italian centres collected of data from June 2009 to May 2012. Italian guidelines (2009) were used to determine the appropriateness of the diagnostic and therapeutic process of BJIs before and after consulting an ID specialist. Data on 311 patients were collected: 111 cases of prosthetic joint infection, 99 osteomyelitis, 64 spondylodiscitis and 37 fixation device infection. A significant increase of microbiological investigations, imaging techniques and blood inflammation markers were noted after consulting the ID specialist. Moreover, inappropriateness of treatment duration, dosage, and number of administrations significantly decreased after consultation. Infectious disease specialist intervention in the management of BJIs significantly increases the appropriateness both in performing instrumental and laboratory analysis, but especially in determining the correct therapy.

The Main Determinants of Diabetes Mellitus Vascular Complications: Endothelial Dysfunction and Platelet Hyperaggregation

Diabetes mellitus is a common disease that affects 3–5% of the general population in Italy. In some countries of northern Europe or in North America, it can even affect 6–8% of the population. Of great concern is that the number of cases of diabetes is constantly increasing, probably due to the increase in obesity and the sedentary nature of the population. According to the World Health Organization, in the year 2030 there will be 360 million people with diabetes, compared to 170 million in 2000. This has important repercussions on the lives of patients and their families, and on health systems that offer assistance to patients. In this review, we try to describe in an organized way the pathophysiological continuity between diabetes mellitus, endothelial dysfunction, and platelet hyperaggregation, highlighting the main molecular mechanisms involved and the interconnections.