We describe plant communities occurring in an abandoned area in the northern Apennines using a phytosociological approach. We evaluate the biodiversity in and between the identified plant communities ...using the following indices: species richness, diversity, dominance and equitability. Ten vegetation types were identified in the study area. Because of the still active dynamics only three types were classified at the association level, while the other seven types were classified at alliance level. The α-diversity is generally high in all the identified plant communities. Two main secondary successions characterize the study area: a high hilly mesophilous succession (> 800 m above sea level where precipitation is more abundant) with Knautio drymeiae-Ostryetum carpinifoliae as final stage and a low hilly thermophilous succession (< 800 m above sea level where precipitation is less abundant) with Quercus pubescens woods as final stage. Trochiscantho-Fagetum represents the final stage of a third succession that develops above 1000 m above sea level. The study area is evolving towards the final stages of the three secondary successions. This will soon cause a loss of biodiversity at different levels: landscape, vegetation communities, flora and fauna. Grasslands and low shrub communities are the most threatened communities, occupying low percentages of the study area.
Guillain-Barré syndrome (GBS) is a peripheral nervous system disease caused by an immune-mediated inflammatory mechanism, usually triggered by a previous infectious process or vaccine; its typical ...presentation is a rapid and progressive bilateral limb hyposthenia, associated with sensory deficits and reduction or absence of osteotendinous reflexes. However, also autonomic nervous system can be involved with heart rate fluctuations, blood pressure instability, pupillary dysfunction, and urinary retention. Since the beginning of COVID-19 pandemic, GBS has been reported among neurological complications of SARS-CoV-2 infection, although etiopathological mechanisms still have to be clearly defined. We report the case of a 79-year-old man with multiple comorbidities, including diabetes, who was affected by SARS-CoV-2 interstitial pneumonia and developed dysautonomic symptoms after 10 days of hospitalization. A neurological evaluation was performed, and GBS was considered as a possible cause of the clinical manifestations. This hypothesis was confirmed by electrophysiological study and further supported,
ex-juvantibus
, by the satisfactory response to immunoglobulin treatment. In our opinion, this case of pure dysautonomic presentation of GBS in a SARS-CoV-2 positive patient is relevant because it suggests to consider GBS upon SARS-CoV-2 infection even if the symptoms have uncommon characteristics (e.g., pure vegetative manifestations) and if there are confounding factors which could lead to a misdiagnosis (e.g., old age, SARS-CoV-2 infection consequences and diabetes).
Hereditary spastic paraplegia (HSP) is a group of genetically heterogenous neurodegenerative disorders characterized by progressive spasticity and weakness of lower limbs. We report a novel splicing ...variant (c.1617-2A>C) of the SPAST gene in a heterozygous carrier from an Italian family with autosomal dominant HSP. The case study describes a pure form of spastic paraparesis with the cardinal clinical features of SPG4. The novel variant affects a canonical splice site and is likely to disrupt RNA splicing. We conclude that the c.1617-2A>C substitution is a null variant, which could be classified as pathogenic; its penetrance should be further investigated.
•Hereditary spastic paraplegia (HSP) denotes a group of clinically and genetically heterogeneous neurodegenerative disorders; the identification of the underlying pathogenic variant is crucial.•The case study presents a 59-years-old woman with progressive spasticity and weakness of lower limbs; family history was suggestive for HSP.•Genetic analysis demonstrated a novel heterozygous variant (c.1617-2A>C) of the SPAST gene, which was predicted to disrupt RNA splicing.•Based on clinical and molecular findings, the c.1617-2A>C substitution could be classified as a pathogenic null variant associated with SPG4.
Introduction
Guillain–Barré syndrome associated with Coronavirus-2-related severe acute respiratory syndrome (COV-GBS) occurs as para- or post-infectious forms, depending on the timing of disease ...onset. In these two forms, we aimed to compare the cerebrospinal fluid (CSF) and serum proinflammatory cytokine profiles to evaluate differences that could possibly have co-pathogenic relevance.
Materials and methods
We studied a retrospective cohort of 26 patients with either post-COV-GBS (
n
= 15), with disease onset occurring > 7 days after SARS-CoV-2 infection, or para-COV-GBS (
n
= 11), with disease onset 7 days or less. TNF-α, IL-6, and IL-8 were measured in the serum with SimplePlex™ Ella™ immunoassay. In addition to the para-/post-COV-GBS patients, serum levels of these cytokines were determined in those with non-COVID-associated-GBS (NC-GBS;
n
= 43), paucisymptomatic SARS-CoV-2 infection without GBS (COVID,
n
= 20), and in healthy volunteers (HV;
n
= 12). CSF cytokine levels were measured in patients with para-/post-COV-GBS, in those with NC-GBS (
n
= 29), or with Alzheimer’s disease (AD;
n
= 24).
Results
Serum/CSF cytokine levels did not differ in para- vs post-COV-GBS. We found that SARS-CoV-2 infection raises the serum levels of TNF-α, IL-6, and IL-8, as well as an increase of IL-6 (in serum and CSF) and IL-8 (in CSF) in either NC-GBS or COV-GBS than controls. CSF and serum cytokine levels resulted independent one with another.
Conclusions
The change of cytokines linked to SARS-CoV-2 in COV-GBS appears to be driven by viral infection, although it has unique characteristics in GBS as such and does not account for cases with para- or post-infectious onset.
In an Italian long-term-care facility (LTCF), we observed a 17.5% adherence to hand hygiene (HH), as well as 47.5% rate of glove use. Performing a procedure at high risk for cross-transmission of ...germs was the factor most strongly associated with noncompliance (odds ratio = 13.3; 95% confidence interval = 6.2 to 28.8; P < .0001). No significant differences in compliance related to health care worker category were found. Adherence to HH in the LTCF was similar to that found in a rehabilitation medicine unit of an acute care hospital (15.8%) but significantly lower than that reported in an infectious disease unit (53.7%; P < .0001). Our findings indicate that compliance with HH is a similar problem in LTCFs as in acute care facilities.
Cerebral autosomal dominant angiopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is an autosomal dominant hereditary disease whose clinical expression is a stepwise subcortical ...vascular dementia. Initial presentation of the disease involves transient or stabilized focal neurological deficits, migraine and mood changes. Recently, a high prevalence of right-to-left shunt (RLS) due to patent foramen ovale has been reported in subjects with migraine. The aim of our study was to determine the prevalence of RLS in CADASIL with and without migraine.
We performed transcranial Doppler with gaseous contrast in 5 members of an Italian family with CADASIL, diagnosed by means of genetic and skin biopsy criteria. We then compared the prevalence of RLS in 40 consecutive subjects with juvenile stroke, 80 asymptomatic subjects affected by migraine with aura and 50 normal controls.
A very high prevalence of RLS was found in CADASIL patients (4/5, 80%), as opposed to young subjects with ischemic stroke (15/40, 37%), asymptomatic subjects with migraine (32/80, 40%) and normal controls (8/50, 16%). All the subjects with CADASIL and migraine (4/4) showed RLS. The difference between CADASIL patients and controls was highly significant (p = 0.006).
We suggest an association between CADASIL and RLS, possibly due to the abnormal development of the endocardial cushion influenced by Notch 3 mutation. Our hypothesis needs to be tested in larger samples.
PDF
