The cerebellum monitors errors and entrains executive networks.

Frontal midline θ (Fmθ) activity occurs in medial prefrontal cortices (mPFC), when expected and actual outcomes conflict. Cerebellar forward models could inform the mPFC about this mismatch. To verify this hypothesis we correlated the mPFC activation during a visuomotor tracking task (VM) with performance accuracy, in control and cerebellum-lesioned participants. Additionally, purely visual (V), motor (M) and a motor plus visual tasks (V + M) were performed. An Independent Component, with a mid-frontal topography scalp map and equivalent dipole location in the dorsal anterior cingulate cortex accounted for Fmθ. In control participants Fmθ power increased during VM, when the error level crossed a threshold, but not during V + M, M and V. This increase scaled with tracking error. Fmθ power failed to increase during VM in cerebellar participants, even at highest tracking errors. Thus, in control participants, activation of mPFC is induced when a continuous monitoring effort for online error detection is required. The presence of a threshold error for enhancing Fmθ, suggests the switch from an automatic to an executive tracking control, which recruits the mPFC. Given that the cerebellum stores forward models, the absence of Fmθ increases during tracking errors in cerebellar participants indicates that cerebellum is necessary for supplying the mPFC with prediction error-related information. This occurs when automatic control falters, and a deliberate correction mechanism needs to be triggered. Further studies are needed to verify if this alerting function also occurs in the context of the other cognitive and non-cognitive functions in which the cerebellum is involved.

Bluetongue serotype 2 and 9 modified live vaccine viruses as causative agents of abortion in livestock: a retrospective analysis in Italy.

The recent outbreak caused by Schmallenberg virus, which affected sheep, goats and cattle in Europe, highlighted the importance of having a robust surveillance plan capable of monitoring abortions and malformations in the livestock offspring. In this context, bluetongue viruses (BTVs) represented and represent one of the major threats to the European livestock industry. Aiming to improve the understanding on BTV cross placental transmission and serotype involvement, in this retrospective study foetal spleens and/or brains of 663 ovines, 429 bovines, 155 goats and 17 buffaloes were tested for the presence of BTV by virus isolation. BTV vaccine strains were isolated from 31 foetuses (2.4%; 95% CI: 1.7-3.4%): 24 (3.6%; 95% CI: 2.4-5.3%) from ovine foetal tissues; 6 (1.4%; 95% CI: 0.6-3.0%) from bovine foetal tissues and 1 (0.6%; 95% CI: 0.2-3.5%) from the spleen of a caprine foetus. All foetuses were from animals vaccinated with either BTV-2 or BTV-2, and BTV-9 modified live vaccines (MLVs) produced by Onderstepoort Biological Products (OBP), South Africa. Among the 31 isolated vaccine strains, serotype 9 (n = 28) was more frequently isolated (P < 0.05) than serotype 2 (n = 3). In two cases infectious vaccine strains were found in the foetal tissues 2 months after the vaccine administration. Other pathogens known to be causative agents of abortion in ruminants were not detected nor isolated. This study demonstrates, for the first time, that BTV-2 and BTV-9 vaccine strains are able to cross the placental barrier of sheep, cattle and goats. BTV-2 and BTV-9 vaccine strains are able to infect foetuses and cause abortions or malformations depending on the period of pregnancy at the time of vaccination.

The length of BTV-8 viraemia in cattle according to infection doses and diagnostic techniques.

Four groups of BTV free Frisian and cross bred calves were used to determine the length of viraemia following infection with different doses of BTV-8 Italian isolate. The first group of five animals was infected with 10 TCID(50) of BTV-8, the second group of four animals with 10(3) TCID(50) and the third group, which also included four animals, was infected with 10(6) TCID(50). A placebo containing uninfected tissue culture medium was given to the four animals of the fourth group. The viraemia was evaluated by real time RT-PCR and virus isolation. In all infected groups, virus isolation was able to detect infectious virus up to 39 days post infection (dpi) while RT-PCR was positive up to 151-157dpi. Infectious dose did influence neither the length nor the pattern of BTV-8 viraemia and confirmed that real time RT-PCR remains positive although no circulating virus is detectable in the peripheral circulation.

[Obesity and Eating Disorders. Indications for the different levels of care. An Italian Expert Consensus Document]. / Documento di Consensus. Obesità e Disturbi dell'Alimentazione Indicazioni per i diversi livelli di trattamento.

This paper is an Italian Expert Consensus Document on multidimensional treatment of obesity and eating disorders. The Document is based on a wide survey of expert opinion. It presents, in particular, considerations regarding how clinicians go about choosing the most appropriate site of treatment for a given patient suffering from obesity and/or eating disorders: outpatient, partial hospitalization, residential rehabilitation centre, inpatient hospitalization. In a majority of instances obesity and eating disorders are long-term diseases and require a multiprofessional team-approach. In determining an initial level of care or a change to a different level of care, it is essential to consider together the overall physical condition, medical complications, disabilities, psychiatric comorbidity, psychology, behaviour, family, social resources, environment, and available services. We first created a review manuscript, a skeleton algorithm and two rating scales, based on the published guidelines and the existing research literature. As the second point we highlighted a number of clinical questions that had to be addressed in the specific context of our National Health Service and available specialized care units. Then we submitted eleven progressive revisions of the Document to the experts up to the final synthesis that was approved by the group. Of course, from point to point, some of the individual experts would differ with the consensus view. The document can be viewed as an expert consultation and the clinical judgement must always be tailored to the particular needs of each clinical situation. We will continue to revise the Document periodically based on new research information and on reassessment of expert opinion to keep it up-to-date. The Document was not financially sponsored.

Assessment of efficacy of a bivalent BTV-2 and BTV-4 inactivated vaccine by vaccination and challenge in cattle.

The efficacy of a bivalent inactivated vaccine against bluetongue virus (BTV) serotypes 2 (BTV-2) and 4 (BTV-4) was evaluated in cattle by general and local examination, serological follow-up, and challenge. Thirty-two 4-month-old calves were randomly allocated into 2 groups of 16 animals each. One group was vaccinated subcutaneously (s/c) with two injections of bivalent inactivated vaccine at a 28-day interval, and the second group was left unvaccinated and used as control. Sixty-five days after first vaccination, 8 vaccinated and 8 unvaccinated calves were s/c challenged with 1 mL of 6.2 Log10 TCID50/mL of an Italian field isolate of BTV serotype 2, while the remaining 8 vaccinated and 8 unvaccinated animals were challenged by 1 mL of 6.2 Log10 TCID50/mL of an Italian field isolate of BTV serotype 4. Three additional calves were included in the study and used as sentinels to confirm that no BTV was circulating locally. At the time of the challenge, only one vaccinated animal did not have neutralizing antibodies against BTV-4, while the remaining 15 showed titres of at least 1:10 for either BTV-2 or BTV-4. However, the BTV-2 component of the inactivated vaccine elicited a stronger immune response in terms of both the number of virus neutralization (VN) positive animals and antibody titres. After challenge, no animal showed signs of disease. Similarly, none of the vaccinated animals developed detectable viraemia while bluetongue virus serotype 2 and 4 titres were detected in the circulating blood of all unvaccinated animals, commencing on day 3 post-challenge and lasting 16 days. It is concluded that administration of the bivalent BTV-2 and BTV-4 inactivated vaccine resulted in a complete prevention of detectable viraemia in all calves when challenged with high doses of BTV-2 or BTV-4.

An inactivated vaccine for the control of bluetongue virus serotype 16 infection in sheep in Italy.

Because no suitable products are at the moment available to safely control the spread of BTV-16 in Europe, an inactivated vaccine was produced from the reference field isolate of bluetongue virus serotype 16. One group of six sheep was vaccinated subcutaneously with the inactivated vaccine twice, on days 0 and 28, whereas a second group of eight sheep was inoculated with saline solution and used as mock-vaccinated control animals. Seventy-eight days after the first vaccination, all sheep were inoculated subcutaneously with a suspension containing 10(6.3) TCID(50) of a virulent reference BTV-16 isolate. Apart from a transient inflammatory reaction at the injection site, no adverse effects were reported following vaccination. All vaccinated animals developed high titres (7.3-9.3log(2)(ED50%/50 microl)) of virus-specific neutralising antibodies and were resistant to challenge with BTV-16. Conversely, following challenge, control animals developed hyperthermia and long lasting high-titre viraemia.

Virological and serological response of sheep following field vaccination with bivalent modified-live vaccine against bluetongue virus serotypes 2 and 9.

A group of 44 sheep was vaccinated with the bivalent modified-live vaccine against bluetongue virus (BTV) serotype 2 (BTV-2) and BTV-9 to evaluate viraemia and antibody kinetics. Blood samples were taken from the sheep three times a week for two months and screened for the presence of BTV and for antibody using the competitive enzyme-linked immunosorbent assay (c-ELISA) and the virus neutralisation (VN) test. Intravenous egg inoculation, followed by two blind passages in Vero cells, was used to isolate BTV-2 and BTV-9 from the ethylene-diaminetetra-acetic acid (EDTA) blood samples; virus titres were also determined in the viraemic animals. BTV was detected in the blood of 39 sheep between day 3 and day 24 post vaccination (pv). Viraemia peaked on day 7 pv with average titres of 10(5.3)TCID50/ml. Antibodies were first detected in the c-ELISA on day 6 pv and by day 16, all sheep were seropositive. Only 36 of the 44 inoculated sheep developed virus-neutralising antibodies against both BTV-2 and BTV-9 while 4 were positive to BTV-2 only; neutralising antibodies were not detected in the 4 remaining animals. Antibody titres were very low and unstable and often bordered on the negative/positive threshold.

Plasma antiviral activity and interferon-gamma production by superantigen-stimulated lymphocytes during normal human pregnancy.

PROBLEM: Plasma interferon (IFN)-beta levels, lymphocyte responsiveness, and evaluation of the relationship between circulating antiviral activity (AA) and IFN-gamma production were studied in pregnant women and nonpregnant age-matched controls with the objective of elucidating the downregulation of IFN-gamma production in successful pregnancy. METHOD OF STUDY: In plasma and supernatants of peripheral blood mononuclear cell (PBMC) cultures, stimulated with staphylococcal enterotoxin A (SEA) superantigen, from 43 pregnant women with a history of normal pregnancy and 30 healthy nonpregnant age-matched controls, levels of AA were measured in a micromethod by inhibition of the cytopathic effect (CPE) caused by vesicular stomatitis virus (VSV) in the human amnionic cell line (WISH). RESULTS: Significantly higher plasma AA (60% was IFN-gamma and residual activity was acid-labile IFN-like) was present in pregnant women than controls. On the other hand, SEA-activated PBMCs from pregnant women produced significantly lower IFN-gamma levels than those of nonpregnant women. Furthermore, maternal plasma AA levels correlated negatively with IFN-gamma production by SEA-stimulated PBMCs. CONCLUSION: The hypothesis that successful pregnancy requires downregulation of IFN-gamma is only partially sustained, suggesting that the immunology of pregnancy is more complex and that murine and human pregnancy have different cytokine profiles.

[Occult child abuse (opinions, considerations, personal observations)]. / Il maltrattamento occulto del bambino (opinioni, considerazioni, osservazioni personali).

At the beginning of the statement the authors point out some lesser aspects of child's ill-treatment (previously suggested by them in other occasions) as expressions of very strict educational systems which strongly limit childrens' freedom or impose them several extrascholastic activities (such as: athletics, music with participation in competitive examination, studies of foreign languages, Latin and so on) where the child must excel in (composex of the "leader-child"). Then these authors suggest using the term "abuse" to mean lexically every excessive, undue, arbitrary use and not only "sexual". They point out the seriousness of abuse as far as juvenile exploitation is concerned both in case of manual labour and prostitution. But the pay particularly attention to the problem of sport when it is gone in for too intensively (as athletics). These authors infact sum up the harms that sport can cause when it is gone in for during the age under the stabilized puberty. Physical harms may occur especially during the practice of risky sports such as: Alpine skiing, cycling on the road, swimming combined with diving, fencing, boxing) and during tiring condition, while psychic harms can entail a fall in scholastic performances, irritability, insomnia, anxiety. The authors depreciate the behaviour of those parents who stimulate their children' aggressiveness during competitions and scold them when their performances are insufficient, or give them forbidden stimulants of hormonal anabolic drugs instead of taking care of their children in order to keep away from the arms mentioned above. However, after all these observations and considerations about competitive sports in juvenile age, these authors can firmly state that all this could be meant as an important aspects of the juvenile exploitation that must be taken in great consideration.

[Interactions between drugs and food in pediatric age]. / Interazioni tra farmaci e nutrienti in età pediatrica.

Interactions between food and drugs represent a very interesting chapter even in paediatric field, although this subject has not been very treated so far. We have tried to locate common points between pharmacology and elementary metabolism, in order to divide drug-food interactions into five great categories, according to the scheme suggested by Vannucci and Capriati. This scheme is based on the phases in which the interactions take place: 1) before gastroenteric absorption; 2) during gastroenteric absorption; 3) during distribution and storage in tissues; 4) during process of bio-transformation; 5) during excretion. If we want rationally to give a drug, we must exactly know its pharmacokinetic, particularly in paediatrics. In fact, we can avoid detrimental interactions drug-food merely adjusting the pharmacologic dosage to the particular diet of the considered child and vice versa.

[Correlations of the response to the prick test and blood levels of specific IgE in children]. / Correlazione tra risposte del prick test e livelli ematici di IgE specifiche in età pediatrica.

A good correlation between intensity of prick test result and haematic levels of specific IgE is a fundamental presupposition to affirm that both diagnostic methods are equivalent to demonstrate a condition of IgE-mediate hypersensitivity. Using a retrospective analysis of our data, we intended to examine the degree of this correlation for the most common food and inhalant allergens. The comparison between prick test results and specific IgE haematic levels for all considered allergens-shows a good concordance of F.A.S.T. for prick negative results and a sharp discordance of F.A.S.T. for prick positive results. Both food and inhalant allergens are equally involved in the discordance between the tests. Therefore, we cannot exclude the possibility of clashing results between prick test reaction and specific IgE haematic levels, even in further analysis would be necessary to obtain more reliable verifications.

[Catering services in schools for children (critique and operative proposals)]. / A proposito di refezione collettiva nelle scuole per bambini (critiche e proposte operative).

Several protests by pupils' parents against bad-quality of food given in school-meal--widely and minutely reported by local press--advised Autors to give due emphasis on some deficiencies in school-meal administration, rightly denounced by relatives. To cut down health troubles, Authors suggest to commit school-meal's management to catering firms for their great experience in field of collective meal. In fact they have implements and competence to check properly: -education and skill of staff attached to school-meal and distribution; -places, structures, tools used to get meals; -victualling, carriage, storage and condition of food maintenance; -the fancy diets, appropriately diversified by age. Authors think that each school should have places, structures and tools to prepare and take meals and should engage a sole firm both for cooking and serving school-meal.

[Lung infections in children. IV. Pneumonia due to Chlamydia pneumoniae]. / Infezioni polmonari emergenti nel bambino. IV. Polmoniti da Chlamydia pneumoniae.

Chlamydia pneumoniae is the third strain of Chlamydia and transmission is presumed to be by droplet spread from symptomatic patients. The authors show a literature scientific review on subject-matter emphasizing several sporadic and epidemic case of illness in every age, first months excepted. The described cases are few and therefore clinical characteristics are shadowy. Certain clinical features are suggesting of severe pneumonia with fever and pharyngitis without exudate. In the childhood and in the adolescence the clinical evolution is favourable. Tetracyclines or erythromycin is recommended for therapy.

[Pulmonary infections in children. III. Pneumonia due to Chlamydia trachomatis]. / Infezioni polmonari emergenti nel bambino. III--Polmoniti da Chlamydia trachomatis.

The authors show a scientific literary review on Ch. trachomatis pneumonia. A distinctive syndrome pneumonia has been reported in infants infected by Chlamydia (at 2-3 months of age) in genital-urinary infected mothers. The infection may be preceded by conjunctivitis, in apyrexia followed by attacks of coughing pertussis-like. Blood eosinophilia is present. Although favorable prognosis in infancy, erythromycin is the drug of choice shortening the clinical course erythromycin is also recommended in woman infected prevention.

[Sensitization to house dust mites and juvenile atopic dermatitis]. / Sensibilizzazione agli acari della polvere domestica e dermatite atopica infantile.

The etiopathogenetic bases of atopic dermatitis are still much discussed and controversial. Nevertheless most of the Authors agree upon the pathogenetic role of an IgE mediated hypersensitivity mechanisms with respect to many alimentary and/or environmental allergens. We have looked for the IgE mediated sensitization to the house dust mites by means of skin tests (prick) and/or haematic dosage of specific IgE (F.A.S.T.) in a group of 40 children aged less than 6 with atopic dermatitis. We have divided the examined children into three groups according to their age and found out a high percentage of dust mites sensitization in the children of the oldest age group. This datum could give credit to the hypothesis of a pathogenetic role developed by the allergy to dust mites in the keeping of eczematous lesions. From the anamnestic search emerge both the leading role developed by dust mites on the development of allergic breathing pathology in the subjects with atopic dermatitis and the finding out of a settled exordium of breathing manifestations due to dust mites at an older age in comparison with the age in which the cutaneous disease manifests itself. These observations lead us to recommend a very accurate environmental cleaning since the first manifestations of atopic dermatitis prescinding from the checking of a demonstrated IgE mediated house dust mites hypersensitivity.

[Pulmonary infections in children. II - Mycoplasma pneumonia]. / Infezioni polmonari emergenti nel bambino. II--Polmoniti da micoplasmi.

The authors show a literary review on Mycoplasma pneumonia which represents a fifth of human pneumonia. M. pneumoniae is the major cause of illness in school-age children (5-9 years) and young adults and the peak incidence of illness occurs in this age. The infection appears mainly as an interstitial pneumonitis and the onset of illness is gradual, influence-like with few clinical symptoms and typical roentgenographic and bronchoscopic findings. Cold hemagglutinins appear in approximately 50% of patients. A severe prognosis can be associated with extrarespiratory symptoms; Erythromycin (as others macrolides) is the drug of choice.

[Pulmonary infections in children. I -- pneumonia due to Legionella pneumophila]. / Infezioni polmonari emergenti nel bambino. I--Polmoniti da Legionelle.

Pneumonia due to L. pneumophila occurs frequently in children even though "legionnaires' disease" in adults in usual. The authors show a literary scientific review of almost one hundred cases, sporadic generally, in childhood. In children legionnaires' disease remembers the adults infection, beginning with bronchiolitis. The extrarespiratory symptoms appears more frequently in adults. Chest roentgenograms obtained early reveal patchy infiltrates that become nodular areas of consolidation bilateral also, with pleural effusion. In children prognosis is poor (exitus in 15 about 97 described cases). The infection responds to erythromycin; it is administered intravenously, but oral treatment may also be used.

[Food allergy in children. Diagnostic difficulties, doubts and digressions]. / Allergia alimentare nel bambino. Difficoltà diagnostiche, dubbi, divagazioni.

It is very difficult to diagnose an alimentary allergy especially because of: the difference among individuals in their physical, psychic and humoral reactions to the environment; weakness and variability of these reactions during the puberty; limited reliability in the results of certain kind of research (i.e. false positiveness and negativeness, discordance between laboratory results and the results of the challenge, neutralization of diagnostic antigenic extracts and/or the presence in these extracts of lectin, etc.); the bad compliance of some therapies and their restricted efficaciousness, particularly in the little children. Moreover: the superimposition of the clinical manifestations of alimentary allergy and pseudoallergy with those of allergy, the possibility of an association between the alimentary and the respiratory allergy, the acquisition on behalf of the allergic child of other kinds of allergy, false polyallergy, the allergy might change its seats and in consequence also its manifestations. The authors, apart a short account of the different diagnostic methods, lay stress on the challenge as the most reliable. They discuss upon the dose of a nourishment that can be given to the patient without risk, besides they suggest to take into account the type and the seriousness of the clinical manifestations in fixing this dose.