Online Questionnaire with Fibromyalgia Patients Shows Negative Correlations between Disease Severity and Adherence to Mediterranean Diet.

Fibromyalgia (FM) is a multidimensional disorder in which intense chronic pain is accompanied by a variety of psychophysical symptoms that impose a burden on the patients' quality of life. Despite the efforts and the recent advancement in research, FM pathogenesis and effective treatment remain unknown. Recently, the possible role of dietary patterns and/or components has been gaining attention. The current study aimed to investigate a potential correlation between adherence to the Mediterranean diet (MedDiet) and FM severity in a sample of Italian FM patients. An online survey was designed, composed of customized questions and validated questionnaires with the aim of investigating the intensity and type of pain, the presence of other psychophysical symptoms, the overall impact of FM, general food and lifestyle habits, and adherence to the MedDiet. The collected responses were analyzed for descriptive statistics, linear regression, and propensity score analyses. The results show that, despite considerable use of pharmaceuticals and supplements, FM participants suffered from a high-severity grade disease. However, those with good adherence to the MedDiet experienced a lower pain intensity and overall FM impact. A propensity score analysis indicates a positive influence of the MedDiet against FM severity, thus unveiling the need for well-designed intervention studies to evaluate the therapeutic potential of different dietary patterns.

Silent myocardial infarction fatty scars detected by coronary calcium score CT scan in diabetic patients without history of coronary heart disease.

OBJECTIVES: To evaluate the prevalence of intra-myocardial fatty scars (IMFS) most likely indicating previous silent myocardial infarction (SMI), as detected on coronary artery calcium (CAC) computed tomography (CT) scans in diabetic patients without history of coronary heart disease (CHD). METHODS: Diabetic patients screened for silent coronary insufficiency in a tertiary-care, university hospital between Jan-2015 and Dec-2016 were categorized according to their CAC score in two groups comprising 242 patients with CACS = 0 and 145 patients with CACS ≥ 300. CAC-CT scans were retrospectively evaluated for subendorcardial and transmural IMFS of the left ventricle. Adipose remodeling, patients' characteristics, cardiovascular risk factors and metabolic profile were compared between groups. RESULTS: Eighty-three (21%) patients with IMFS were identified, 55 (37.9%) in the group CACS ≥ 300 and 28 (11.6%) in the CACS = 0 (OR = 4.67; 95% CI = 2.78-7.84; p < 0.001). Total and average surface of IMFS and their number per patient were similar in both groups (p = 0.55; p = 0.29; p = 0.61, respectively). In the group CACS ≥ 300, patients with IMFS were older (p = 0.03) and had longer-lasting diabetes (p = 0.04). Patients with IMFS were older and had longer history of diabetes, reduced glomerular filtration rate, more coronary calcifications (all p < 0.05), and higher prevalence of carotid plaques (OR = 3.03; 95% CI = 1.43-6.39, p = 0.004). After correction for other variables, only a CACS ≥ 300 (OR = 5.12; 95% CI = 2.66-9.85; p < 0.001) was associated with an increased risk of having IMFS. CONCLUSIONS: In diabetic patients without known CHD, IMFSs were found in patients without coronary calcifications, although not as frequently as in patients with heavily calcified coronary arteries. It remains to be established if this marker translates in an upwards cardiovascular risk restratification especially in diabetic patients with CACS = 0. CLINICAL RELEVANCE STATEMENT: In diabetic patients without history of coronary heart disease, intramyocardial fatty scars, presumably of post-infarction origin, can be detected on coronary artery calcium CT scans more frequently, but not exclusively, if the coronary arteries are heavily calcified as compared to those without calcifications. KEY POINTS: • Intramyocardial fatty scars (IMFS), presumably of post-infarction origin, can be detected on coronary artery calcium (CAC) CT scans more frequently, but not exclusively, in diabetic patients with CACS ≥ 300 as compared to patients CACS = 0. • Patients with IMFS were older and had longer history of diabetes, reduced glomerular filtration rate, and more coronary calcifications. • Carotid plaques and CACS ≥ 300 were associated with an increased risk of having IMFS, about three and five folds respectively.

Generation of all randomizations using circuits.

After a rich history in medicine, randomized control trials (RCTs), both simple and complex, are in increasing use in other areas, such as web-based A/B testing and planning and design of decisions. A main objective of RCTs is to be able to measure parameters, and contrasts in particular, while guarding against biases from hidden confounders. After careful definitions of classical entities such as contrasts, an algebraic method based on circuits is introduced which gives a wide choice of randomization schemes.

Online Questionnaire with Fibromyalgia Patients Reveals Correlations among Type of Pain, Psychological Alterations, and Effectiveness of Non-Pharmacological Therapies.

Fibromyalgia (FM) is a chronic pain syndrome with an unclear etiology. In addition to pain, FM patients suffer from a diverse array of symptoms and comorbidities, encompassing fatigue, cognitive dysfunction, mood disorders, sleep deprivation, and dizziness. Due to the complexity of FM, the diagnosis and treatment of it are highly challenging. The aim of the present work was to investigate some clinical and psychological characteristics of FM patients, and to uncover possible correlations with pharmacological and non-pharmacological therapies. We conducted a cross-sectional, questionnaire-based study aimed at evaluating pain, psychological traits, and the self-perceived effectiveness of pharmacological and non-pharmacological treatments in an Italian population of FM patients. Descriptive statistics, correlation, and inference analyses were performed. We found a prevalence of a neuropathic/nociplastic type of pain, which correlated with psychological traits such as anxiety, low mood, psychophysical discomfort, and the inability to relax. The pain type and psychological traits proved to play a role in determining the self-perceived effectiveness of therapeutic interventions. Patients revealed a better response to non-pharmacological therapies, particularly dietary interventions, relaxation techniques, and psychotherapy rather than pharmacological interventions. The sum of our data indicates that for better outcomes, the type of pain and psychological traits should be considered for tailor-made treatments considering non-pharmacological protocols as a complement to the use of drugs.

Vestibular Disability/Handicap in Fibromyalgia: A Questionnaire Study.

Fibromyalgia (FM) is a poorly understood, central pain processing disorder characterized by a broad range of symptoms, such as chronic pain, sleep disruption, chronic fatigue, and psychosomatic symptoms. In addition, recent studies have shown that FM patients also experience dizziness. We aimed to establish a prevalence rate of vestibular symptoms in a population of FM patients through a battery of questionnaires investigating socio-demographic, clinical and psychological characteristics, combined with the Dizziness Handicap Inventory (DHI) and the Situational Vertigo Questionnaire (SVQ). A total of 277 respondents, officially diagnosed with FM, completed the full study, while 80 controls were also included for DHI and SVQ questionnaires. We found that FM participants were significantly affected by vestibular symptoms, which correlated with FM-associated pain and non-pain symptoms. The dizziness reported by FM participants showed peculiar features suggesting an FM-intrinsic mechanism of vestibular dysfunction, possibly linked to migraine and dysautonomia conditions. Correlations between dizziness and depressive mood (or neuroticism), revealed an impact of dizziness on psychological status, leading to depressive reactions and interpersonal difficulties, and possibly involving a noxious, self-sustained stress condition. In conclusion, data showed a manifesting dizziness condition in FM patients that warrants careful clinical attention due to its possible inherent role in the syndrome.

Analysis of the Weighted Kappa and Its Maximum with Markov Moves.

In this paper, the notion of Markov move from algebraic statistics is used to analyze the weighted kappa indices in rater agreement problems. In particular, the problem of the maximum kappa and its dependence on the choice of the weighting schemes are discussed. The Markov moves are also used in a simulated annealing algorithm to actually find the configuration of maximum agreement.

Performance of a new combination of blood culture vials in sepsis detection: a 2-year retrospective comparison.

The diagnosis of bloodstream infection requires the optimum combination of media in an automated blood culture system for maximum recovery of pathogens with the earliest time to detection. In a previous work, we showed that for patients admitted to the Emergency Department of our hospital, the combination of BACTEC lytic anaerobic and BACTEC aerobic vials was more efficient than BACTEC anaerobic and BACTEC aerobic vial. In this study, we extended the work including a broader patient population, representative of all hospital. A total of 8629 cultures were collected during the pre-lytic phase, from 01 July 2013 to 30 June 2014 and 7940 cultures during the post-lytic phase, ranged from 01 July 2015 to 30 June 2016. The number of positive blood cultures was higher during the post-lytic phase (19.74%) than in the pre-lytic phase (17.52%), particularly for Escherichia coli, Staphylococcus spp., Enterococcus spp., and anaerobes. We also observed a significant decreased of the time to detection, with the mean and median in the post-lytic phase of 17.68 and 13.05 h compared with 19.49 and 14.47 h in the pre-lytic phase. Whereas the time to detection was the same for organisms recovered in the aerobic Plus bottles for both time periods, time to detection for the anaerobic lytic bottles was significantly faster than with the anaerobic Plus bottles. This study carried out on a long time observation reported that a simple modification of composition of blood culture set could lead to better results in bloodstream infection detection.

Toxic effects of mercury on the cell nucleus of Dictyostelium discoideum.

Governmental agencies (www.epa.gov/mercury) and the scientific community have reported on the high toxicity due to mercury. Indeed, exposure to mercury can cause severe injury to the central nervous system and kidney in humans. Beyond its recognized toxicity, little is known regarding the molecular mechanisms involved in the actions of this heavy metal. Mercury has been also observed to form insoluble fibrous protein aggregates in the cell nucleus. We used D. discoideum to evaluate micronuclei formation and, since mercury is able to induce oxidative stress that could bring to protein aggregation, we assessed nuclear protein carbonylation by Western Blot. We observed a significant increase in micronuclei formation and 14 carbonylated proteins were identified. Moreover, we used isotope-coded protein label (ICPL) and mass spectrometry analysis of proteins obtained by lysis of purified nuclei, before of tryptic digestion to quantify nuclear proteins affected by mercury. In particular, we examined the effects of mercury that associate a classical genotoxic assay to proteomic effects into the nucleus. The data present direct evidences for mercury genotoxicity, nuclear protein carbonylation, quantitative change in core histones, and the involvement of pseudouridine synthase in mercury toxicity. © 2016 Wiley Periodicals, Inc. Environ Toxicol 32: 417-425, 2017.

Plants used in artisanal fisheries on the Western Mediterranean coasts of Italy.

BACKGROUND: Artisanal fisheries in the Mediterranean, especially in Italy, have been poorly investigated. There is a long history of fishing in this region, and it remains an important economic activity in many localities. Our research entails both a comprehensive review of the relevant literature and 58 field interviews with practitioners on plants used in fishing activities along the Western Mediterranean Italian coastal regions. The aims were to record traditional knowledge on plants used in fishery in these regions and to define selection criteria for plant species used in artisanal fisheries, considering ecology and intrinsic properties of plants, and to discuss the pattern of diffusion of shared uses in these areas. METHODS: Information was gathered both from a general review of ethnobotanical literature and from original data. A total of 58 semi-structured interviews were carried out in Liguria, Latium, Campania and Sicily (Italy). Information on plant uses related to fisheries were collected and analyzed through a chi-square residual analysis and the correspondence analysis in relation to habitat, life form and chorology. RESULTS: A total of 60 plants were discussed as being utilized in the fisheries of the Western Italian Mediterranean coastal regions, with 141 different uses mentioned. Of these 141 different uses, 32 are shared among different localities. A multivariate statistical analysis was performed on the entire dataset, resulting in details about specific selection criteria for the different usage categories (plants have different uses that can be classified into 11 main categories). In some uses, species are selected for their features (e.g., woody), or habitat (e.g., riverine), etc. The majority of uses were found to be obsolete (42%) and interviews show that traditional fishery knowledge is in decline. There are several reasons for this, such as climatic change, costs, reduction of fish stocks, etc. CONCLUSIONS: Our research correlates functional characteristics of the plants used in artisanal fishery and habitats, and discusses the distribution of these uses. This research is the first comprehensive outline of plant role in artisanal fisheries and traditional fishery knowledge in the Mediterranean, specifically in Italy.

Semi-Markov graph dynamics.

In this paper, we outline a model of graph (or network) dynamics based on two ingredients. The first ingredient is a Markov chain on the space of possible graphs. The second ingredient is a semi-Markov counting process of renewal type. The model consists in subordinating the Markov chain to the semi-Markov counting process. In simple words, this means that the chain transitions occur at random time instants called epochs. The model is quite rich and its possible connections with algebraic geometry are briefly discussed. Moreover, for the sake of simplicity, we focus on the space of undirected graphs with a fixed number of nodes. However, in an example, we present an interbank market model where it is meaningful to use directed graphs or even weighted graphs.

Expression analysis of the molluscan p53 protein family mRNA in mussels (Mytilus spp.) exposed to organic contaminants.

In this study, we report the tissue expression analysis of the p53 protein family mRNA in mussels (Mytilus spp.) by means of quantitative RT-PCR. The tissue specific response was evaluated after 24 h exposure to a sublethal benzo[a]pyrene (B[a]P) concentration (75 nM), showing a 2.6 fold induction in digestive gland cells and a dramatic gene down regulation in circulating hemocytes. The comet assay and DNA gel diffusion tests showed significant effects in hemocytes and negligible differences in the digestive gland nuclei, implicating p53 in DNA damage of molluscan hemocytes. Finally, the kinetics of p53 protein family mRNA expression in the digestive gland of animals exposed to B[a]P and crude oil (0.5 ppm) showed partially overlapping trends, characterised by a common down regulation after 1 week exposure. These data should be carefully considered in view of the biological effects of organic pollutants and particularly following spills.