Epigenetic modifications are among the most important mechanisms by which environmental factors can influence early cellular differentiation and create new phenotypic traits during pregnancy and ...within the neonatal period without altering the deoxyribonucleic acid sequence. A number of antenatal and postnatal factors, such as maternal and neonatal nutrition, pollutant exposure, and the composition of microbiota, contribute to the establishment of epigenetic changes that can not only modulate the individual adaptation to the environment but also have an influence on lifelong health and disease by modifying inflammatory molecular pathways and the immune response. Postnatal intestinal colonization, in turn determined by maternal flora, mode of delivery, early skin-to-skin contact and neonatal diet, leads to specific epigenetic signatures that can affect the barrier properties of gut mucosa and their protective role against later insults, thus potentially predisposing to the development of late-onset inflammatory diseases. The aim of this review is to outline the epigenetic mechanisms of programming and development acting within early-life stages and to examine in detail the role of maternal and neonatal nutrition, microbiota composition, and other environmental factors in determining epigenetic changes and their short- and long-term effects.
Background Fluid challenge may help in the differential diagnosis between pre- and postcapillary pulmonary hypertension (PH). However, the test is still in need of standardization and better defined ...clinical relevance. Methods Two hundred twelve patients referred for PH underwent a right-sided heart catheterization with measurements before and after rapid infusion of 7 mL/kg of saline. PH was defined as mean pulmonary artery pressure ≥ 25 mm Hg, and postcapillary PH was defined as pulmonary artery wedge pressure (PAWP) > 15 mm Hg. An increase in PAWP ≥ 18 mm Hg was considered diagnostic for postcapillary PH. At baseline, 66 patients received a diagnosis of no PH; 22, of postcapillary PH; and 124, of precapillary PH (mostly pulmonary arterial hypertension). Results After fluid challenge, five of 66 patients with no PH (8%) and eight of 124 with precapillary PH (6%) had the diagnosis reclassified as postcapillary PH. Fluid challenge was associated with an increase in PAWP by 7 ± 2 mm Hg in postcapillary PH and 3 ± 1 mm Hg in both precapillary PH and no-PH groups. Between-group differences were significant, but there was overlap. There were no adverse events related to fluid challenge. Prediction bands calculated from quadratic fits of the PAWP responses in pooled control subjects with no PH and patients with precapillary PH helped confirm 18 mm Hg as the cutoff for diagnosing postcapillary PH. Conclusions Fluid challenge with 7 mL/kg saline increases PAWP, more in postcapillary than in precapillary PH or in control subjects with no PH. A cutoff value of 18 mm Hg allows reclassification of 6% to 8% of patients with precapillary PH or normal hemodynamic characteristics at baseline.
What's known on the subject? and What does the study add?
Today, angiogenesis is known to play a key role in cancer growth and development. Emerging cancer treatments are based on the suppression of ...angiogenesis, and modern imaging techniques investigate changes in the microvasculature that are caused by angiogenesis. As for other forms of cancers, angiogenesis is well recognised as a fundamental process in the development of prostate cancer.
The novelty of this extensive report on angiogenesis in cancer, with particular attention on prostate cancer and the imaging techniques able to detect it, is the new prospective to the subject. In contrast with the other available reviews, this report goes from ‘theory’ to ‘practice’, establishing a clear link between angiogenesis development and imaged angiogenesis features. Once the key role of angiogenesis in the development of cancer and in particular prostate cancer has been fully described, attention is turned to the current imaging methods with the potential to assess the angiogenesis process and, as a consequence, to detect and localise prostate cancer.
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As confirmed by all available statistics, cancer represents a major clinical and societal problem in the developed world. The form of cancer with the highest incidence in men is prostate cancer. For prostate cancer, as well as for most forms of cancer, detection of the disease at an early stage is critical to reduce mortality and morbidity.
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Today, it is well known that pathological angiogenesis represents a crucial step in cancer development and progression. Comparable with most forms of cancer, angiogenesis also plays a fundamental role for prostate cancer growth.
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As a consequence, angiogenesis is an ideal target not only for novel anti‐angiogenic therapies, but also for modern imaging techniques that aim at cancer localisation by detection of angiogenic microvascular changes.
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These techniques are mainly based on magnetic resonance, ultrasound, and nuclear imaging.
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This paper provides a comprehensive review of the available studies on angiogenesis in prostate cancer and its use by modern and emerging imaging techniques for prostate cancer localisation.
This article intends to offer a reflection on how reflexive physical activities can support a socio-pedagogical approach to educating about gender diversity through media communication. We use the ...term “reflexive” to refer to all those activities aimed at enhancing the person and his relationships, self-realization, selfknowledge, and self-improvement: in other terms, a circuit of bodily experiences that determine bodily knowledge as a social construction (as described by Connel, 2005). These activities focus mainly on ethical purposes, rather than on performative ones. An example of such disciplines can be considered the practice of yoga which is a currently growing phenomenon both in Europe and in the United States. Yoga is practiced today in the USA by 35.2 million adults, by over 2.5 million people in Italy, and is garnering scientific interest in its contributions to balanced, healthy growth of children and adults. The World Health Organization, in its global action plan on physical activity 2018-2030: More Active People for a Healthier World, calls it a means to improve health. The diffusion of these disciplines responds to a personal and social search for meaning that weighs especially heavily on highly secularized Western culture. This diffusion also portrays a media phenomenon, whose images and messages validate and reinforce capitalist ethics. From this point of view, the “mediated” representation of sports bodies appears to apply to the world of consumers. The images of women practicing yoga, oriented toward alternative values rather than beauty and sexuality, are above all confirmed by the purchase of goods and services that are not related to outward personal appearance. Using the results of an analysis carried out in 2021 of two main international yoga magazines, we are going to discuss the role of yoga as a “reflexive” physical activity and its pedagogical potential oriented to the body as a “primary place of experience”, not just a consumer item, but also a tool for education about gender diversity.
RASopathies are developmental disease caused by mutations in genes encoding for signal transducers of the RAS-MAPK cascade. The aim of the present study was to provide a comprehensive description of ...morbidity and mortality in patients with molecularly confirmed RASopathy.
A multicentric, observational, retrospective study was conducted in seven European cardiac centres participating to the CArdiac Rasopathy NETwork (CARNET). Clinical records of 371 patients with confirmed molecular diagnosis of RASopathy were reviewed. Mortality was described as crude mortality, cumulative survival and restricted estimated mean survival. Multivariable regression analysis was used to assess the impact of mutated genes on number of interventions and overall prognosis.
Cardiac defects occurred in 80.3% of cases, almost half of them underwent at least one intervention. Overall, crude mortality was 0.29/100 patients-year. Cumulative survival was 98.8%, 98.2%, 97.7%, 94.3%, at 1, 5, 10, and 20years, respectively. Restricted estimated mean survival at 20years follow-up was 19.6years. Ten patients died (2.7% of the entire cohort; 3.4% of patients with cardiac defect). Patients with hypertrophic cardiomyopathy (HCM) and age <2years or young adults, as well as subjects with biventricular obstruction and PTPN11 mutations had a higher risk of cardiac death.
The risk of intervention was higher in individuals with Noonan syndrome and pulmonary stenosis carrying PTPN11 mutations. Overall, mortality was relatively low, even though the specific association between HCM, biventricular outflow tract obstructions and PTPN11 mutations appeared to be associated with early mortality, including immediate post-operative events and sudden death.
In recent years the issue of touristification has been progressively discussed in relation to its impact on historic towns. In this regard, physical transformations and gentrification consequences ...are both issues often addressed. In Italy, consciousness on the subject primarily grew in relation to Florence and Venice, both national cases widely discussed also on newspapers. The awareness of a wider range of cases affected by this problem, from big cities to small holiday destinations, is even more recent. The aim of the present paper is to address Capri’s touristification process, which started in the last decades of the nineteenth century and exploded in the second half of the twentieth century, from the point of view of the field of study of history and conservation of cultural heritage and landscape. Therefore, this process and some of its consequences on the island’s cultural landscape and identity are thoroughly analyzed. The paper starts with a brief introduction to the island and its history, which is necessary in order to highlight its rich cultural heritage and the slow pace at which Capri has grown over time as a fishermen island to suddenly transforming into a touristic destination during the last century. Finally, the current touristic vocation and the consequences on Capri’s natural and built environment are discussed, with the aim of individuating if and why there have already been losses and what should be done to prevent this negative process from going on.
The objective of the present article is to highlight the need for attention to Quality of Life of patients with Sickle Cell Disease living in Italy. The transformation of sickle cell disease from a ...severe life-threatening disease of childhood into a chronic, lifelong condition due to the significant improvements in care and treatment options, imposes increasing new challenges to health care providers and patients. Patients now face physical, psychosocial and emotional challenges throughout their lives. They generally have to receive chronic treatments and regular multidisciplinary monitoring which increase social and emotional burden rendering adherence to treatment sometimes complicated. A chronic disease impacts all aspects of patients' lives, not only the physical one, but also the social and emotional aspects as well as the educational and working life. The entire "Quality of Life" is affected and recent evidence demonstrates the importance quality of life has for patients with chronic illness. The results of this review focus on emerging data regarding quality of life across the lifespan of patients with Sickle Cell Disease, and highlight the need for more action in this field in Italy, where recent immigration and improved care determine an increasing population of children with sickle cell disease being taken into long term care.
Abstract Paediatric heart failure (PHF) represents an important cause of morbidity and mortality in childhood. Currently, there are well-established guidelines for the management of heart failure in ...the adult population, but an equivalent consensus in children is lacking. In the clinical setting, ensuring an accurate diagnosis and defining aetiology is essential to optimal treatment. Diuretics and angiotensin-converting enzyme inhibition are the first-line therapies, whereas beta-blockers and device for electric therapy are less used in children than in adults. In the end-stage disease, heart transplantation is the best choice of treatment, while a left ventricular assist device can be used as a bridge to transplantation (due to the difficulties in finding organ donors), recovery (in the case of myocarditis), or destination therapy (for patients with systemic disease).
Fatigue and poor balance are frequent and severe problems in multiple sclerosis (MS) that may interact. Endurance training is known to be effective on fatigue. This study aims to test if balance ...training is more effective against MS fatigue.
A randomised crossover trial was run, recruiting 31 MS people (21 women; median age: 46 years, range: 30-64; median EDSS: 4, range: 2.5-5). Participants received balance and endurance training alternately (15 one-to-one sessions, 5 days/week) and were assessed before (T0), after (T1), and 30 days after treatment ended (T2). The Modified Fatigue Impact Scale (MFIS) with scores linearised through Rasch analysis was the primary outcome (the lower the measure, the better the condition, i.e., the lower the fatigue symptoms). The Equiscale balance scale and posturography (EquiTest) were used to assess balance. Linear mixed-effects models with ANOVA were used for significance testing.
Thirteen participants had no carryover effect and were included in the primary analysis. Fatigue significantly changed across the three time points (
= 16.0;
< 0.001), but no difference across treatments was found. Altogether, both treatments significantly improved the MFIS measure at T1 (95%CI: -1.24 logits; mean: -1.67 to -0.81 logits) and T2 (95%CI: -1.04; mean: -1.49 to -0.60) compared to T0 (95%CI: -0.51; mean: -0.95 to -0.08;
≤ 0.001). Equiscale and posturography highlighted balance improvement after balance training but not after endurance training.
Balance and endurance training could similarly reduce fatigue in MS patients in the short term. However, only balance training also improved balance in MS.
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