De novo assembly and sex-specific transcriptome profiling in the sand fly Phlebotomus perniciosus (Diptera, Phlebotominae), a major Old World vector of Leishmania infantum.

BACKGROUND: The phlebotomine sand fly Phlebotomus perniciosus (Diptera: Psychodidae, Phlebotominae) is a major Old World vector of the protozoan Leishmania infantum, the etiological agent of visceral and cutaneous leishmaniases in humans and dogs, a worldwide re-emerging diseases of great public health concern, affecting 101 countries. Despite the growing interest in the study of this sand fly species in the last years, the development of genomic resources has been limited so far. To increase the available sequence data for P. perniciosus and to start studying the molecular basis of the sexual differentiation in sand flies, we performed whole transcriptome Illumina RNA sequencing (RNA-seq) of adult males and females and de novo transcriptome assembly. RESULTS: We assembled 55,393 high quality transcripts, of which 29,292 were unique, starting from adult whole body male and female pools. 11,736 transcripts had at least one functional annotation, including full-length low abundance salivary transcripts, 981 transcripts were classified as putative long non-coding RNAs and 244 transcripts encoded for putative novel proteins specific of the Phlebotominae sub-family. Differential expression analysis identified 8590 transcripts significantly biased between sexes. Among them, some show relaxation of selective constraints when compared to their orthologs of the New World sand fly species Lutzomyia longipalpis. CONCLUSIONS: In this paper, we present a comprehensive transcriptome resource for the sand fly species P. perniciosus built from short-read RNA-seq and we provide insights into sex-specific gene expression at adult stage. Our analysis represents a first step towards the identification of sex-specific genes and pathways and a foundation for forthcoming investigations into this important vector species, including the study of the evolution of sex-biased genes and of the sexual differentiation in phlebotomine sand flies.

Effects of the time of day of walking on dietary behaviour, body composition and aerobic fitness in post-menopausal women.

AIM: Post-menopause is linked to an increased risk of death from cardiovascular disease. Physical exercise and healthy dietary habits are normally suggested to enhance health. The aim of this study was to verify whether the time of day of walking had different effects on both spontaneous dietary intake and body composition modification in overweight and sedentary post-menopausal women. METHODS: Forty-two sedentary post-menopausal women (53.46+/-3.32 yrs) were recruited. Thirty-three completed the study: 29 were suitable for statistical analysis. Of those, 14 walked in the morning (MG) and 15 in the early evening (EG). Body composition, dietary habits and predicted VO2max were investigated. Food intake was analysed for energy, macronutrients and daily distribution. RESULTS: The Mann-Whitney test showed that according to the time of day of walking there were different fat mass (FM) reductions and dietary behaviour responses. EG reduced FM greater than MG and showed a major increase in morning energy intake (EI). Sub-samples did not differ in total EI, daily macronutrient portioning and daily meals variations. The variation of FM was correlated with that of proteins (r=-0.352), morning EI (r=-0.367) and aerobic performance (r=0.369). Both MG and EG improved their aerobic performance. CONCLUSION: The positive effects of walking on health could be optimised by its evening execution because it could also be linked to spontaneous dietary habit modification.

A new palliative prognostic score: a first step for the staging of terminally ill cancer patients. Italian Multicenter and Study Group on Palliative Care.

In recent years, extensive research has been performed to identify prognostic factors that predict survival in terminally ill cancer patients. This study describes the construction of a simple prognostic score based on factors identified in a prospective multicenter study of 519 patients with a median survival of 32 days. An exponential multiple regression model was adopted to evaluate the joint effect of some clinico-biological variables on survival. From an initial model containing 36 variables, a final parsimonious model was obtained by means of a backward selection procedure. The Palliative Prognostic Score (PaP Score) is based on the final model and includes the following variables: Clinical Prediction of Survival (CPS), Karnofsky Performance Status (KPS), anorexia, dyspnea, total white blood count (WBC) and lymphocyte percentage. A numerical score was given to each variable, based on the relative weight of the independent prognostic significance shown by each single category in the multivariate analysis. The sum of the single scores gives the overall PaP Score for each patient and was used to subdivide the study population into three groups, each with a different probability of survival at 30 days: (1) group A: probability of survival at 30 days > 70%, with patient score < or = 5.5; (2) group B: probability of survival at 30 days 30-70%, with patient score 5.6-11.0; and (3) group C: probability of survival at 30 days < 30%, with patient score > 11.0. Using this method, 178/519 (34.3%) patients were classified in risk group A, 205 (39.5%) patients were in risk group B, and 136 (26.2%) patients were in risk group C. The patients classified in the three risk groups had a very different survival experience (logrank = 294.8, P < 0.001), with a median survival of 64 days for group A, 32 days for group B, and 11 days for group C. The PaP Score based on simple clinical and biohumoral variables proved to be statistically significant in a multivariate analysis. The score is valid in this population (training set). An independent validation on another patient series (testing set) is required and is the object of a companion paper.

Mask continuous positive airway pressure in AIDS.

FMCPAP and NCPAP therapy is an effective modality for treating patients with PCP, hypoxia, and respiratory insufficiency. The therapy decreases intrapulmonary shunting and improves oxygenation. It is safe and, in some cases, can be provided outside of an intensive care unit. The major benefit of MCPAP is that it postpones (and sometimes obviates) the need for intubation and mechanical ventilation. This may provide adequate time for a trial of therapy, education, ethical discussions, and completion of personal matters by patients. It is conceivable that failure to respond to MCPAP may provide prognostic information to help guide further therapy. Further outcome studies are needed to clarify this issue. Adding MCPAP to mechanical ventilation and conventional mask oxygen therapy increases the options that practitioners can use to provide the best titrated care for their patients.

[Bamifylline in the therapy of asthmatic syndromes. Efficacy and side effects vs delayed-action theophylline anhydride]. / La bamifillina nella terapia delle sindromi asmatiche. Efficacia ed effetti collaterali vs teofillina anidra ad azione prolungata.

Two homogeneous groups of 8 patients suffering from bronchial asthma or chronic obstructive bronchial pneumonia were treated with slow release theophylline anhydride or bamiphylline respectively, both products being given orally twice a day. The results showed that both drugs possess a powerful bronchodilatory action and therefore have a beneficial effect on subjective symptoms. Statistical analysis confirmed the absence of any significant difference between the two xanthine derivatives, both of which were well-tolerated though bamiphylline offered a slight advantage in this respect. In fact there were no side effects at all in the bamiphylline group whereas there was one case of moderate gastric intolerance in the group given theophylline anhydride, though it was not severe enough to warrant suspension of the treatment or reduction of the dose.

[Antiblastic agent-induced vomiting: possibilities of its prevention and alizapride therapy]. / Vomito indotto da antiblastici: possibilità di prevenzione e terapia con alizapride.

The spread of cytostatics has made the search for safe drugs for the prevention and treatment of induced vomiting important. In the present study, the protective (prophylactic and therapeutic) effect of Alizapride has been examined. Ten oncological patients of average age 60 were treated with a total of 30 cycles according to the commonest protocols of drugs with varying emetic potential (from bland bleomycin type to high cisplatin type). The patients were subdivided into two groups: a) prophylaxis before and after chemotherapy; b) treatment only as needed. Analysis of the data showed excellent tolerance and significant effectiveness in both groups.

[High-frequency atrial arrhythmia induced by a cisplatin-etoposide combination]. / Aritmia atriale ad alta frequenza indotta dalla combinazione cisplatino-etoposide.

The cardiotoxicity of cytostatic drugs reported in the literature is marked for some (adriamycin), rather rare for others. Cases of angina, infarction, and atrial arrhythmia have been reported during treatment with cisplatin. The case is reported of a 65-year-old patient with no risk factors for cardiovascular disease who had two attacks of high-frequency atrial arrhythmia during combined treatment with cisplatin and etoposide. The first attack came after the first cycle and disappeared spontaneously; the second, after the second cycle, required antiarrhythmic treatment. The potential myocardial toxicity of cisplatin, especially when combined with other potentially cardiotoxic drugs or administered after cycles of adriamycin is discussed.

[Reactions caused by Hymenoptera: a first aid problem]. / Reazioni da imenotteri: un problema di pronto soccorso.

The incidence of reactions to insect bites both local (erythema, pemphigus, oedema, itching) and systemic (urticaria, angioedema, anaphylactic shock) in Borgomanero (NO) National Health Clinic 54 was assessed. The high incidence of medical treatments for this pathology encountered reflects the fact that in the summer and in a rural area a great many people are exposed to this type of emergency. The importance of careful diagnosis (anamnesis, skin allergy tests, RAST is emphasised as a means of identifying cases at allergic risk and providing the appropriate immunotherapy.

[Evaluation of several parameters of coagulation in liver cirrhosis: disseminated intravascular coagulation or pseudo-disseminated intravascular coagulation?]. / Valutazione di alcuni parametri di coagulazione in corso di cirrosi epatica: CID o pseudo-CID?

Reports in the literature on the difficulty of differential diagnosis between Disseminated Intravascular Coagulation (DIC) Pseudo-DIC and Primary Fibrinolysis (PF) in patients with liver disease, stimulated a study of various coagulation parameters (PT, PTT, Platelets, Fibrinogen, FDP) in 28 cirrhotic patients. The study confirmed reports in the literature on the high incidence of circulating FDP among liver disease patients. The vital role these play in maintaining alterations in haemostasis means that cirrhosis cases must be approached with extreme caution, avoiding any therapeutic or instrumental procedure liable to worsen the already disturbed coagulation pattern in such patients.

[Determination of fibrinogen-fibrin degradation factors in neoplasms]. / Determinazione dei fattori di degradazione fibrinogeno-fibrina (FDP) in corso di neoplasie.

Disseminated intravascular coagulation (DIC) and Primary Fibrinolysis (PF) are frequently reported in the literature as occurring in a wide variety of tumours whether subjected to chemotherapy or not and triggering a thrombohemorrhagic mechanism that is often fatal. It was therefore decided to assess the extent of the Fibrinogen-Fibrin Degradation Products (FDP) in a group of cancer patients in order to identify the primary, asymptomatic clinical expressions of these syndromes with a view to ascertaining the possibility of preventing more severe forms. The data confirm the presence of circulating FDP in a small percentage of the patients (26.9%) especially those with solid tumours metastasising to the liver. The involvement of that organ is therefore considered decisive for the onset of DIC and PF.

[Contact sensitization in eczema of the hands]. / La sensibilizzazione da contatto nell'eczema delle mani.

A personal series of patients with eczema on the hands arising in non-occupational conditions was examined (students, housewives, clerical workers, teachers, farm labourers). The data obtained indicate the presence of allergic sensitisation in 70% of the cases and especially among females (3 : 1). The most frequently encountered allergens were difenylguanadine (used in rubber manufacture) and nickel. It is therefore suggested that patch tests should be performed immediately on these patients so that contact with allergen can be prevented in addition to the usual topical treatment.

[Thrombopenia and cirrhosis. Study of 56 cases]. / Piastrinopenia e cirrosi. Studio di 56 casi.

Blood platelets were assayed in 56 cirrhosis patients divided into two groups: alcoholic cirrhosis (20 cases) and non-alcoholic cirrhosis (36 cases). Each group was also divided into two sub-groups: with and without clinical signs of portal hypertension. Low platelet counts were found in both groups (greater than 70%), the incidence being high in the sub-group with clinical signs of portal hypertension. Alcohol appeared to have no influence on the development of platelet insufficiency which was rather correlated with the severity of the hepatopathy, the presence of splenomegaly (splenic sequestration), immunological factors, (presence of circulating antiplatelet antibodies) and "consumption" phenomena (significant incidence of circulating FDP, and indicator of chronic Disseminated Intravascular Coagulation).

[Primary extra-lymph node localization of non-Hodgkin's lymphoma. Considerations on a clinical case]. / Localizzazioni primitive extralinfonodali del linfoma non Hodgkin. Considerazioni su di un caso clinico.

The location on first diagnosis of a non-Hodgkin lymphoma (NH lymphoma) in the respiratory structures (bronchi, pleura, pulmonary parenchyma) is rather rare (2-4%) in the absence of mediastinic and/or hilar adenopathy. In any event diagnosis is extremely difficult, often impossible even with the aid of a properly conducted biopsy since the biopsy does not provide suitable material. The case is presented of a 72 year old woman with intermittent hyperpyrexia and multiple alveolar masses, the aetiology of which was only identified 8 months after the onset of the symptoms with the appearance of latero-cervical lymphadenopathy where biopsy revealed the presence of an N.H. lymphoma that was highly malignant but otherwise unspecificable.

[Hepatic cirrhosis caused by alcohol: normalization of the functional parameters after prolonged abstinence]. / Cirrosi epatica da alcool: normalizzazione dei parametri di funzionalità dopo prolungata astensione.

It has often been noted that total abstention from alcohol will lead to the normalisation of modest liver lesions. For this reason the possibility of regression of more severe lesions was studied. To this end five patients with clinically diagnosed cirrhosis of the liver (bioptically confirmed in 2 cases) were followed up for a minimum of 1 and a maximum of 5 years, demonstrating the total reversibility of clinical and laboratory signs after total abstention for an average 15 months.

[Angioimmunoblastic lymphoadenopathy with dysproteinemia. A doubtful clinical case]. / Linfoadenopatia angioimmunoblastica con disproteinemia. Un caso clinico dubbio.

After a brief description of the clinical and laboratory picture of angioimmunoblastic lymphadenopathy with Dysproteinaemia (AILD), the case of a 49 year old woman is described. The woman died of haematemesis and with a clinical picture that originated 14 years earlier with Sjogren's syndrome that developed with modest systemic lymphadenopathy, splenohepatomegaly, autoimmune anaemia (Coombs direct positive). Histological examination of the parotid, certain lymph glands, the liver and the spleen suggested a diagnosis of proliferative lymphopathy that might have been either AIDL or low malignity NH lymphoma. The rarity of the syndrome and the clinical difficulties of accurate diagnosis are discussed.

[Occupational exposure to hepatitis B virus in personnel of the S.S. Trinità Hospital in Borgomanero]. / Esposizione professionale al virus dell'epatite B (H.B.V.) del personale ospedaliero "S.S. Trinità" di Borgomanero.

369 workers at the S.S. Trinità Hospital, Borgomanero - Health Unit 54 were screened for H.B.V. H.B.V. markers were found in 49.9% of whom 28% presented a profile of immunization, 1.9% were found to be chronic carriers of HBsAg, 18.1% were only positive for anti-HBc and 1.9% presented a doubtful serum profile that will require further study. Women and senior staff (in terms of both age and seniority of service) were most often affected. In view of the high rate of H.B.V. infection, preventive vaccination is though necessary to protect the workers' health.

[Essential thrombocythemia. Clinical case report]. / La trombocitemia essenziale. Contributo clinico-pratico.

Essential thrombocythemia is a rare form of proliferative myelopathy and should not be confused with secondary thrombocythemia. In view of the frequency with which an increased platelet count is recorded with the automatic hemochromogen recorder, the fundamental parameters necessary for an accurate diagnosis are summarised on the basis of a typical clinical case observed for two years.

[Proposal for a program in the early diagnosis of breast cancer]. / Proposta per un programma di diagnosi precoce del carcinoma della mammella.

Systematic examination of the breasts of women admitted to a medical ward for apparently non-breast-related pathologies revealed 22 cases of isolated nodules (2.06%) of which 9 (40.9%) were carcinomatous. It is pointed out that while mass screenings are impossibly expensive careful periodic clinical examination by the G.P. is sufficient to identify a good percentage of potentially curable neoplasias.