Implementing carrier screening for cystic fibrosis outside the clinic: ethical analysis in the light of the personalist view.

BACKGROUND: Cystic Fibrosis (CF) is an autosomal recessive genetic disease. Two models for screening CF are normally used: newborn screening and population-based CF carrier screening. In turn, there are three main models of population-based CF carrier screening: prenatal carrier screening, preconception carrier screening, and carrier screening outside clinical settings. AIM: To evaluate, in the light of the personalist view, the use of carrier screenings for CF outside the clinic, i.e. in non-clinical settings, such as school and workplaces. METHODS: Analysis has been carried out according to the "Personalist approach" (also called "Triangular model"), an ethical method for performing ethical analysis within HTA process. It includes factual, anthropological and ethical data in a ''triangular'' normative reflection process. FINDINGS: Implementing carrier screening for cystic fibrosis outside the clinical settings allows acquisition of knowledge for informing reproductive choices, that can be considered as valuable; benefit-risk ratio seems to be not much favorable; autonomous and responsible decisions can be taken only under certain conditions; economic advantage is difficult to determine; therefore, from a personalist view, implementing carrier screenings outside the clinic seems not to be ethically justified. CONCLUSIONS: In accordance with the personalist perspective, public health programs providing carrier screenings outside the clinic should not be implemented.

Effect of mechanical extraction parameters on the yield and quality of tobacco (Nicotiana tabacum L.) seed oil.

The aim of this study was to investigate how the combination of extraction parameters, such as extraction temperature seeds preheating and screw rotation speed, influenced the yield and chemical quality of tobacco seed oil (TSO). For its peculiar properties, TSO can be used for several purposes, as raw material in the manufacturing of soap, paints, resins, lubricants, biofuels and also as edible oil. TSO was obtained using a mechanical screw press and the quality of the oil was evaluated by monitoring the free fatty acids (FFA), the peroxide value (PV), the spectroscopic indices K232, K270 and ΔK and the fatty acid composition. The maximum extraction yield, expressed as percent of oil mechanically extracted respect to the oil content in the seeds, determined by solvent extraction, was obtained with the combination of the highest extraction temperature, the slowest screw rotation speed and seeds preheating. Under these conditions yield was 80.28 ± 0.33% (w/w), 25% higher than the lowest yield obtained among investigated conditions. The extraction temperature and seed preheating showed a significant effect on FFA, on spectroscopic indices K232, K270 and ΔK values. The average values of these parameters slightly increased rising the temperature and in presence of preheating, the screw rotation speed did not affect the chemical characteristic tested. In the extraction conditions investigated no significant changes in PV and fatty acids composition of oil were observed.

[Genetic test for cancer and intra-family communication: freedom vs. responsibility]. / Test genetici in oncologia e comunicazione intrafamiliare: autonomia vs responsabilità.

Genetic tests affect not only single patients but also their genetic relatives. In some cases, they in fact allow to acquire information not only about a single patient, but also about those who are genetically linked (genetic relatives). By appealing to the principle of autonomy, the patient can refuse to be informed of the test result, or to inform their relatives on the risk of a pathology. How might the relatives' right to know be reconciled with the will of a patient who refuses to know or to inform? Among the large number of moral dilemmas that this field can raise, the article aims to reply to the above mentioned question and to analyse in depth some aspects of intra-family communication within the field of genetic tests for cancer.

Prevención farmacológica de la otitis media aguda recurrente / Pharmacological prevention of the recurrent acute otitis media

El presente trabajo se de sarrolló en dos fases: en la primera los pdiatras respondieron a preguntas de un cuestionario, para poner en evidencia los tratamientos personales practicados en caso de Otitis Media Aguda (OMA) así como otitis media concaracter recurrente (ver cuadro 1). La segunda fase del trabajo consiste en evaluar críticamente cada uno de los estudios clínicos publicados sobre prevención farmacológica de OMAR y discutirlos en encuentros formales, de caracter colegial

Antibiotic administration and oral bacterial therapy in infants.

Feces samples of 35 children, aged between 3 and 24 months (mean age 12 months), were analyzed. Sixteen children who had no therapy were considered as "control samples"; an antibiotic therapy was administered to 8 subjects for at least 5 days for extraintestinal pathology (ampicillin, orally, at a dose of 100 mg/kg/die in three doses). Finally, the same antibiotic therapy with the addition, from the beginning over 5 days, of the oral preparation of Bacillus subtilis spores (4 X 10(9) die) was administered to 11 patients. During antibiotic therapy, the number of stools per day increased, but not for those patients taking B. subtilis spores. Regarding the bacterial flora, the subjects treated with antibiotic therapy alone showed a significant decrease of all aerobic species, except for fungi, anaerobic total count and aerobic cocci. After oral bacteriotherapy together with ampicillin, we observed an increase of saccharolytic flora, aerobic and anaerobic, while proteolytic flora did not show any changes.