The effects of superoxide dismutase-rich melon pulp concentrate on inflammation, antioxidant status and growth performance of challenged post-weaning piglets.

Piglets can often suffer impaired antioxidant status and poor immune response during post-weaning, especially when chronic inflammation takes place, leading to lower growth rates than expected. Oral administration of dietary antioxidant compounds during this period could be a feasible way to balance oxidation processes and increase health and growth performance. The aim of the trial was to study the effects of an antioxidant feed supplement (melon pulp concentrate) that contains high concentration of the antioxidant superoxide dismutase (SOD) on inflammation, antioxidant status and growth performance of lipopolysaccharide (LPS) challenged weaned piglets. In total, 48 weaned piglets were individually allocated to four experimental groups in a 2×2 factorial design for 29 days. Two different dietary treatments were adopted: (a) control (CTR), fed a basal diet, (b) treatment (MPC), fed the basal diet plus 30 g/ton of melon pulp concentrate. On days 19, 21, 23 and 25 half of the animals within CTR and MPC groups were subjected to a challenge with intramuscular injections of an increasing dosage of LPS from Escherichia coli (serotype 0.55:B5) (+) or were injected with an equal amount of PBS solution (-). Blood samples were collected at the beginning of the trial and under the challenge period for interleukin 1ß, interleukin 6, tumour necrosis factor α, haptoglobin, plasma SOD activity, total antioxidant capacity, reactive oxygen species, red blood cells and plasma resistance to haemolysis, and 8-oxo-7, 8-dihydro-2'-deoxyguanosine. Growth performance was evaluated weekly. A positive effect of melon pulp concentrate was evidenced on total antioxidant capacity, half-haemolysis time of red blood cells, average daily gain (ADG) and feed intake, while LPS challenge increased pro-inflammatory cytokines and haptoglobin serum concentrations, with a reduced feed intake and gain : feed (G : F). The obtained results show that oral SOD supplementation with melon pulp concentrate ameliorates the total antioxidant capacity and the half-haemolysis time in red blood cell of post-weaning piglets, with positive results on growing performance.

Short communication: Associations between blood fatty acids, ß-hydroxybutyrate, and α-tocopherol in the periparturient period in dairy cows: An observational study.

The objective of the present study was to examine the relationships between blood concentrations of fatty acids, ß-hydroxybutyrate (BHB), and α-tocopherol during the periparturient period in dairy cows. Blood samples were collected from 131 cows belonging to 4 different commercial dairy farms in southeastern Europe (Greece and Italy). We determined blood concentrations of fatty acids, BHB, and α-tocopherol at dry-off, at calving, and 30d postpartum. Results indicated that fatty acid concentrations were low at dry-off, reached maximum value at calving, and then declined at 30d postpartum. In fact, fatty acid concentrations at 30d postpartum were 50% lower than at calving. In contrast, BHB concentrations were low at dry-off, increased by 27% at calving, and continued to increase by another 20% at 30d postpartum. Overall, we found a weak correlation between fatty acids and BHB throughout the periparturient period. Concentrations of α-tocopherol were lowest at calving, and we detected no differences in α-tocopherol concentrations at dry-off or 30d postpartum. Negative correlations between fatty acids and α-tocopherol were highly significant at 30d postpartum and approached the level of significance at dry-off. However, both correlations became nonsignificant following the adjustment of α-tocopherol with cholesterol, indicating that the correlations were a reflection of changes in lipid transport. We found significant negative correlations (strong at dry-off and weak at 30d postpartum) between BHB and α-tocopherol after adjustment with cholesterol. The physiological basis for the negative correlations between BHB and α-tocopherol, especially that at dry-off, is not known and should not be taken to imply a cause-effect relationship. However, it opens the door to investigating the effects of vitamin E on liver function in dairy cows.

UCP1 and UCP2 expression in different subcutaneous and visceral adipose tissue deposits in 30 days old goat kids and effect of fatty acid enriched diets.

Beside its importance in the first hours of life, brown adipose tissue has also significant roles in the following stages of growth and in adults by regulating energy metabolism, but its identification in adult ruminants is still controversial. Quantitative PCR, followed by histological confirmation, was used to investigate UCP expression and brown and white adipocytes' distribution in 30-day-old goat kids. The influence of maternal diet enriched with either fish oil or stearic acid was investigated as well. Results showed the differential expression of both UCP1 and UCP2 genes between subcutaneous and visceral adipose tissues, suggesting a different thermogenic activity between the two macro areas. The maternal diet influenced neither UCP1 nor UCP2 gene expression. The presence of multilocular adipocytes in 1-month goat kids is remarkable, as suggests thermogenic activity in non-newborn animals. Further insights into characteristics and functions of adipose tissue in young and adult goats are worth exploring.

Short communication: Endoplasmic reticulum stress gene network expression in bovine mammary tissue during the lactation cycle.

The endoplasmic reticulum (ER) has a crucial role in cellular metabolism. Recent studies in nonruminants discovered that components of the ER stress pathway, induced during the unfolded protein response, play critical roles in regulating lipogenesis. The bovine mammary gland faces extreme metabolic stress at the onset of lactation due primarily to the increase in flux through pathways associated with milk fat and protein synthesis. Our objective was to study, via quantitative real-time PCR, the expression of the ER stress pathway components P58IPK, PERK, XBP1, ATF4, ATF3, ATF6, CHOP, MBTPS1, GRP94, and BiP in mammary tissue (n=7 cows × 5 time points) collected at -15, 1, 15, 60, and 240 d relative to parturition. Expression of P58IPK and ATF4 increased to a peak at d 60, followed by a decrease by d 240 postpartum. Despite the decrease in expression by 240 d, P58IPK remained higher than prepartal levels (d -15). Expression patterns of ATF3 and CHOP were similar and peaked at d 15, followed by a decrease through d 240, at which point CHOP expression was still greater than prepartal levels. The sharp increase in milk production postpartum (d 15) as well as apoptosis during late lactation (240 d) may have induced a pseudo unfolded protein response state. This is supported by the similar expression patterns of P58IPK and PERK. In the context of lactation, however, transcriptional changes in the ER stress pathway at different stages of the lactation cycle are a normal aspect of the tissue's adaptation to the changing physiological state.

The Gap between Tobacco Treatment Guidelines, Health Service Organization, and Clinical Practice in Comprehensive Cancer Centres.

Smoking cessation is necessary to reach a higher quality of life, and, for a cancer patient, it represents an important step in improving the outcome of both prognosis and therapy. Being a cancer patient addicted to nicotine may be a critical situation. We conducted a survey to monitor how many comprehensive cancer centres in Italy have an outpatient smoker clinic and which kinds of resources are available. We also inquired about inpatient services offering psychological and pharmacological support for smoking cessation, reduction, or care of acute nicotine withdrawal symptoms. What we have witnessed is a significant gap between guidelines and services. Oncologists and cancer nurses are overscheduled, with insufficient time to engage in discussion on a problem that they do not consider directly related to cancer treatment. Furthermore, smoking habits and limited training in tobacco dependence and treatment act as an important barrier and lead to the undervaluation of smokers' needs.

Taking care of smoker cancer patients: a review and some recommendations.

A cancer patient who smokes is a very fragile person and we identify in scientific literature three main areas of clinical practice and research to develop the care of smokers with cancer. (i) Telling facts: smoking impacts on the survival and on the outcomes of surgery, chemo-, radio- and biological therapies. The aim of our intervention was to enable patients to make informed choices about smoking. (ii) Offering sensitive and effective smoking cessation like an instrument of patient empowerment to motivate change in smoker patient lifestyle. (iii) Assisting smoker patients if they develop acute nicotine withdrawal symptoms. Smoking care and nicotine replacement therapy can support temporary abstinence during the inpatient stay and providing patients with an opportunity for smoking cessation can prompt a future permanent quit attempt. Comprehensive cancer centers must act like a promoter of a better smokers' care, applying guidelines to their reality and try to do more research on smokers' needs and on the resources to assist them. Only the alliance between victims of smoking addiction and health personnel can give a chance against the tobacco epidemic.

Effects of protected fish oil in the diet of periparturient dairy goats on phenotypic variation in blood and milk leukocytes.

The goal of this study was to evaluate the effects of dietary protected fish oil (FO) on phenotypic variation in blood, milk leukocytes, and some productive and metabolic parameters in periparturient dairy goats. About 12 Alpine goats, selected from a larger group of second-parity animals, were fed from 15 days before kidding until the 15th day of lactation with the same basal diet that had been supplemented with either 47 g/head per day of FO or 47 g/head per day hydrogenated palm oil (PO). Dry matter intake, live body weight (LBW), body condition score (BCS), and productive performance were evaluated in 2 weeks after kidding. On days 15, 7, and 2 before kidding and days 2, 7, and 15 after kidding, plasma samples were collected for evaluation of alanine aminotransferase, aspartate aminotransferase, non-esterified fatty acids, glucose, beta-hydroxybutyrate, cholesterol, and urea levels. White blood cell and blood leukocyte subsets were counted in whole blood samples on the kidding day, as well as at 1, 4, and 15 days after kidding. In addition, milk somatic cell count, intramammary infection (IMI), and milk leukocyte subsets were evaluated on days 4 and 15 after kidding. No differences were observed in dry matter intake and BCS, while LBW was higher in FO-fed animals. Milk production and composition, plasma metabolites, and liver enzymes were similar in both experimental groups. Blood CD4 positive cells increased constantly (P = 0.05) in FO-fed group, while CD8 and CD14 cell counts significantly increased 4 days after kidding (P < 0.01). Milk leukocyte subsets showed a significant (P < 0.01) decrease in PO-fed group and a non-significant increase (P = 0.34) in FO-fed group, despite the presence of coagulase negative staphylococci IMI. The results of the productive performance evaluation agreed with those of many other studies, which did not find any significant differences between dairy goats fed diets enriched with FO or PO supplements. The administration of FO to dairy goats in transition appeared to affect the variation in blood leukocytes with a constant increase in CD4- and CD8-positive cells in comparison with a PO fat-supplemented diet.

Second-hand smoke exposure in a sample of European hospitals.

Smoking in hospitals is banned in many European countries; nevertheless, the level of compliance is diverse, and, in some cases, smoking areas remain. The present study describes the levels of second-hand smoke, as derived from respirable suspended particle measurements, in a sample of European hospitals during the year 2007. The present study was a multicentric descriptive cross-sectional study carried out in 30 hospitals in seven European countries (Austria, Belgium, France, Germany, Greece, Romania and Spain). Particulate matter with a 50% cut-off aerodynamic diameter of 2.5 microm (PM(2.5)) concentration was measured by means of a hand-held laser-operated monitor of particle size and mass concentration in six selected indoor locations. Medians and interquartile ranges of PM(2.5) concentration were computed in order to describe the data by country and location of measurement. The median PM(2.5) concentration in all countries and locations was 3.0 microg x m(-3), with half of the measurements ranging 2.0-7.0 microg. x m(-3). PM(2.5) levels were similar across countries. Eleven (5.5%) measurements were >25.0 microg x m(-3), which is the 24-h mean limit recommended by the World Health Organization outdoor air quality guideline. The present results show that exposure to second-hand smoke in this sample of European hospitals is very low, and can be easily monitored in order to ensure smoke-free legislation compliance.

Haemato-oncology and burnout: an Italian survey.

This cross-sectional survey aimed to evaluate the prevalence of burnout and estimated psychiatric disorders among haemato-oncology healthcare professionals in Italy. The aspects of work that respondents perceive as stressful and satisfying have also been examined. The assessments were made using the Maslach Burnout Inventory (MBI), General Health Questionnaire and a study-specific questionnaire. Logistic regression models were applied to show associations between different sources of work-related stress and burnout. Three hundred and eighty-seven out of 440 (87.95%) returned their questionnaires. The scores on MBI subscales indicate a high level of emotional exhaustion in 32.2% of the physicians and 31.9% of the nurses; a high level of Depersonalisation in 29.8 and 23.6%, respectively; and a low level of personal accomplishment in 12.4 and 15.3% respectively. The estimated prevalence of psychiatric disorders was 36.4% in physicians and 28.8% in nurses. Statistical analysis confirmed age, sex, personal dissatisfaction, physical tiredness and working with demanding patients to be associated with burnout. In conclusion, haemato-oncology healthcare professionals report a level of burnout and estimated psychiatric morbidity comparable to other oncological areas. Knowledge of the mechanisms of burnout and preventing and dealing with them is therefore a fundamental requirement for the improvement of quality in health services and job satisfaction.

Protein-protein and protein-ligand interactions studied by electrospray-ionization mass spectrometry.

Preservation of non-covalent interactions in biopolymer mass spectrometry offers new approaches to binding analysis. Recent work from our laboratory is reviewed here and discussed with reference to recent literature in the field. Three issues are considered in particular: hydrophobically stabilized complexes, pH-dependent transitions, and linked protein-ligand and protein-protein binding equilibria.

Degree of control of physician-diagnosed asthma and COPD in Italy.

BACKGROUND: It is important for the Italian National Health Service to obtain data on the degree of control of asthma and chronic obstructive pulmonary disease (COPD) in the general population in Italy in order for balanced planning of future investments in these diseases to be made. Currently, precise estimates of these parameters are not available in literature. OBJECTIVES: In collaboration with the Italian Academy of General Practitioners (SIMG; www.simg.it) we have investigated the degree of control of physician-diagnosed asthma and COPD in Italy. METHODS: A standardised questionnaire on asthma and COPD has been self-administered to a sample of 1937 Italian family physicians (representing around 5% of all the Italian doctors involved in general practice) chosen to cover all the Italian counties. RESULTS: We have collected questionnaire data from 19,917 patients with asthma and COPD followed in their practice and 12,438 (62.4%) were correctly filled in enabling evaluation. We selected the number of emergency room visits, hospitalisations and intensive care unit admissions for asthma and COPD in the last 12 months as objective measures of the degree of asthma and COPD morbidity in these patients. The figures were respectively 12.4% (emergency room visits), 17.3% (hospitalisations) and 1.2% (intensive care unit admissions) of all patients with physician-diagnosed asthma and COPD. CONCLUSIONS: This data suggests that in Italy the morbidity of asthma and COPD remains high; representing a significant burden for the Italian National Health Service. There is a clear necessity for further studies to investigate the causes of this incomplete control.

Real-time measurement of particulate matter deposition in the lung.

Air pollution and cigarette smoke are recognized health risks. A method was developed for the measurement of the deposition fraction (DF) of polydisperse particulate matter (PM) in human airways. Ten normal volunteers [three females, age range 18-67 years, mean age (SD) 43.9 (14)] made single breath exhalations after inhalation to total lung capacity. The exhaled breath was diverted to a multichannel laser diffraction chamber where the particulate profiler measured 0.3 - 1.0-microm particles. DF was inversely related to expiration flow-rate, 0.69 (0.02) at 4 l min-1 and 0.5 (0.01) at 13 l min-1, respectively (p<0.05), and was influenced by the inhalation flow-rate [0.70 (0.02) at 3 l min-1 and 0.59 (0.02) at 13 l min-1, respectively (p<0.05)], while no differences were found between nasal and oral inhalation (0.68 (0.05) versus 0.67 (0.06), p>0.05). Higher breath holding times were associated with elevated DF [0.74 (0.02) at 20 s, and 0.62 (0.05) without breath holding (p<0.01)]. When the expiratory flow was controlled and the breath hold time standardized, DF was reproducible (CV = 4.85%). PM can be measured in the exhaled breath and its DF can be quantified using a portable device. These methods may be useful in studies investigating the health effects of air pollution and tobacco smoke.

Underuse of spirometry by general practitioners for the diagnosis of COPD in Italy.

BACKGROUND: The Global Initiative for Chronic Obstructive Lung Disease (GOLD) underlines that spirometry is the gold standard as the most reproducible, standardised, and objective way of measuring airflow limitation in the diagnosis and assessment of Chronic Obstructive Pulmonary Disease (COPD). However, studies undertaken in different countries have suggested a widespread underuse of spirometry by general practitioners to establish the diagnosis of COPD. Precise estimates of the prevalence of physician-diagnosed COPD in Italy are not currently available. In collaboration with the Italian Academy of General practitioners (SIMG) we have investigated the degree of use of spirometry to establish the diagnosis of COPD in Italy. METHODS: A standardised questionnaire has been self-administered to a sample of 2425 Italian general practitioners (representing 5% of all the Italian doctors involved in general practice). They have been chosen to cover each of the Italian counties. RESULTS: The prevalence of physician-diagnosed COPD was found to be approximately 4%. However, 30% of general practitioners do not use spirometry to establish the diagnosis of COPD. The main reasons given for the failure to use spirometry are (i) that spirometry is not necessary for the diagnosis of COPD or (ii) there are logistical limitations to the access of the patients to lung function laboratories. CONCLUSIONS: This data suggests that contrary to GOLD Guidelines, in Italy, as with other countries, spirometry is not always used in the diagnosis of COPD. There is a clear necessity for further education initiatives targeted to this group of physicians.

Particulate matter from tobacco versus diesel car exhaust: an educational perspective.

BACKGROUND: Air pollution is a common alibi used by adolescents taking up smoking and by smokers uncertain about quitting. However, environmental tobacco smoke (ETS) causes fine particulate matter (PM) indoor pollution exceeding outdoor limits, while new engines and fuels have reduced particulate emissions by cars. Data comparing PM emission from ETS and a recently released diesel car are presented. METHODS: A 60 m3 garage was chosen to assess PM emission from three smouldering cigarettes (lit sequentially for 30 minutes) and from a TDCi 2000cc, idling for 30 minutes. RESULTS: Particulate was measured with a portable analyser with readings every two minutes. Background PM10, PM2.5, and PM1 levels (mean (SD)) were 15 (1), 13 (0.7), and 7 (0.6) microg/m3 in the car experiment and 36 (2), 28 (1), and 14 (0.8) microg/m3 in the ETS experiment, respectively. Mean (SD) PM recorded in the first hour after starting the engine were 44 (9), 31 (5), and 13 (1) microg/m3, while mean PM in the first hour after lighting cigarettes were 343 (192), 319 (178), and 168 (92) microg/m3 for PM(10), PM2.5, and PM1, respectively (p < 0.001, background corrected). CONCLUSIONS: ETS is a major source of PM pollution, contributing to indoor PM concentrations up to 10-fold those emitted from an idling ecodiesel engine. Besides its educational usefulness, this knowledge should also be considered from an ecological perspective.

Indoor particulate matter measurement as a tool in the process of the implementation of smoke-free hospitals.

AIM OF THE STUDY: There are International and National standards that requires hospitals and health premises to be smoke-free. According to recent data from Italy and other European Countries, smoking is a widespread habit in hospitals. To get smoke-free hospitals in an Italian region, we have adopted the European Code for smoke-free hospitals, which sets standards and provides instruments for its implementation. According to the Code, whenever possible, each step towards a smoke-free hospital, should be shared by all staff. As a mean for achieving this goal, in our region the certification of single units as smoke-free units has been chosen. For getting the certification, besides implementing the Code, we planned to use ETS (Environmental Tobacco Smoke) monitoring, as ETS should not be present in hospitals. As a marker of ETS we have chosen Particulate Matter (PM), as it can easily be measured in real-time with a portable instrument and, when other even outdoor--sources of combustion can be ruled out, it is an accurate detector of cigarette smoke. Here the first experience of measuring PM in hospitals for monitoring ETS and certificating smoke-free health premises, is described. MATERIALS AND METHODS: PM measurements were carried out without any previous notification in different areas of two Network hospitals of the Veneto Region, during a single working day. A real time laser-operated aerosol mass analyser was used. Several classes of PM (PM1, PM2.5, PM7, PM10, TSP Total Suspended Particles) were measured. RESULTS: Outdoor PM levels were found to be repeatedly lower than the annual official limits of 65 mcg/m3 and around the 24 hour official limits of 15 mcg/m3 [15 to 20 mcg/m3, with an overall mean (+/-SD) of 17.8 (1.9)] throughout the whole day. Very good indoor air quality was found in the operating theaters and isolation department, where PM2.5 concentrations were much lower than outdoor levels [1.6 (0.9) and 5.9 (0.6) mcg/m3, respectively]. No increase in PM pollution was found in the surveyed medical offices, halls and waiting rooms where smoking was positively forbidden [PM2.5 concentrations of 14.8 (2.2) and 12.9 (1.1) mcg/m3] except in a medical office and in two coffee rooms for staff only where high PM levels were recorded [PM2.5 58.7 (29.1), 27.0 (10.6) and 107.1 (47.8) mcg/m3] and an offence of smoking restrictions could be proved. CONCLUSIONS: The measurement of PM in hospital for monitoring ETS proved to be both feasible and sensible. PM measurements with a portable instrument can be used both for controlling the compliance with rules or chosen standards and for educating staff about smoking related hazards, thus gaining consensus for the implementation of the tobacco control policy. In our experience, PM measurement can be used as an aid inside all actions designed by the European Code for smoke-free hospitals.