Inflammatory and Immunological parameters in adults with Down syndrome

<p>Abstract</p> <p>Background</p> <p>The increase in life expectancy within the general population has resulted in an increasing number of elderly adults, including patients with Down syndrome (DS), with a current life expectancy of about 50 years. We evaluate the parameters of humoral and cellular immune response, the quantitative expression of the regulator of calcineurin1 gene (RCAN1) and the production of cytokines. The study group consisted of adults DS (n = 24) and a control group with intellectual disability without Down syndrome (ID) (n = 21) and living in a similar environmental background. It was evaluated serology, immunophenotyping, the quantitative gene expression of RCAN1 and the production of cytokines.</p> <p>Results</p> <p>In the DS group, the results showed an increase in NK cells, CD8, decreased CD19 (p < 0.05) and an increase spontaneous production of IFNgamma, TNFalpha and IL-10 (p < 0.05). There was not any difference in RCAN1 gene expression between the groups.</p> <p>Conclusions</p> <p>These data suggest a similar humoral response in the two groups. The immunophenotyping suggests sign of premature aging of the immune system and the cytokine production show a proinflammatory profile.</p

Endogenous and exogenous sex steroid hormones in asthma and allergy in females:protocol for a systematic review and meta-analysis

Before puberty, asthma and allergy are more common in males than in females, but these conditions become more common in females than in males during adulthood until around the time of menopause.(1-7) The disease severity, healthcare utilisation and impact on health-related quality of life (HRQoL) are also considerably higher in post-pubertal females than in males.(1-7) Although the specific mechanisms for these differences are unclear, it has been suggested that female sex steroid hormones may have a role.(1,2) Higher disease risk in females appears to follow key hormonal transitional time points in a female's reproductive life cycle, such as puberty, menarche, menstruation and menopause.(1,2) These hormonal transitional points may increase the risk of asthma and poor asthma outcomes in females.(8-10) In contrast, external suppression of endogenous sex hormone production with hormonal contraceptives may improve asthma outcomes,(9-14) but the evidence is inconsistent,(13,14) with evidence suggesting that hormone replacement therapy (HRT) may increase the risk of poor outcomes.(15-22) A clearer understanding of the role of sex steroid hormones in the development of asthma and allergy in females and their impact on asthma exacerbation, use of healthcare, and HRQoL will help to provide new insights into disease mechanisms and essential preliminary data to inform the development of primary prevention interventions and hormonal-based management strategies. We plan to undertake a systematic synthesis of the evidence to provide a comprehensive, unbiased estimate of the actual effects of sex steroid hormones on the development and clinical expression of asthma and allergy in females. The only relevant previous systematic review on this topic was confined to investigating the role of menopausal transition; this review focussed on asthma incidence as the sole outcome of interest.(23) Consequently, that study does not allow a thorough appraisal of this evidence base, given that key endogenous and exogenous hormonal factors, as well as other essential asthma and allergy outcomes, were not considered. There is therefore the need to undertake a more comprehensive synthesis of the effect of the various endogenous and exogenous hormonal factors on the full spectrum of asthma outcomes in females.</p

Stress echocardiography in Italian echocardiographic laboratories: A survey of the Italian society of echocardiography and cardiovascular imaging

Background: The Italian Society of Echography and Cardiovascular Imaging (SIECVI) conducted a national survey to understand the volumes of activity, modalities and stressors used during stress echocardiography (SE) in Italy. Methods: We analyzed echocardiography laboratory activities over a month (November 2022). Data were retrieved through an electronic survey based on a structured questionnaire, uploaded on the SIECVI website. Results: Data were obtained from 228 echocardiographic laboratories, and SE examinations were performed in 179 centers (80.6%): 87 centers (47.5%) were in the northern regions of Italy, 33 centers (18.4%) were in the central regions, and 61 (34.1%) in the southern regions. We annotated a total of 4057 SE. We divided the SE centers into three groups, according to the numbers of SE performed: &lt;10 SE (low-volume activity, 40 centers), between 10 and 39 SE (moderate volume activity, 102 centers) and &gt;= 40 SE (high volume activity, 37 centers). Dipyridamole was used in 139 centers (77.6%); exercise in 120 centers (67.0%); dobutamine in 153 centers (85.4%); pacing in 37 centers (21.1%); and adenosine in 7 centers (4.0%). We found a significant difference between the stressors used and volume of activity of the centers, with a progressive increase in the prevalence of number of stressors from low to high volume activity (P = 0.033). The traditional evaluation of regional wall motion of the left ventricle was performed in all centers, with combined assessment of coronary flow velocity reserve (CFVR) in 90 centers (50.3%): there was a significant difference in the centers with different volume of SE activity: the incidence of analysis of CFVR was significantly higher in high volume centers compared to low - moderate - volume (32.5%, 41.0% and 73.0%, respectively, P &lt; 0.001). The lung ultrasound (LUS) was assessed in 67 centers (37.4%). Furthermore for LUS, we found a significant difference in the centers with different volume of SE activity: significantly higher in high volume centers compared to low - moderate - volume (25.0%, 35.3% and 56.8%, respectively, P &lt; 0.001). Conclusions: This nationwide survey demonstrated that SE was significantly widespread and practiced throughout Italy. In addition to the traditional indication to coronary artery disease based on regional wall motion analysis, other indications are emerging with an increase in the use of LUS and CFVR, especially in high-volume centers

The evolution of primate short-term memory

Short-term memory is implicated in a range of cognitive abilities and is critical for understanding primate cognitive evolution. To investigate the effects of phylogeny, ecology and sociality on short-term memory, we tested the largest and most diverse primate sample to date (421 non-human primates across 41 species) in an experimental delayed-response task. Our results confirm previous findings that longer delays decrease memory performance across species and taxa. Our analyses demonstrate a considerable contribution of phylogeny over ecological and social factors on the distribution of short-term memory performance in primates; closely related species had more similar short-term memory abilities. Overall, individuals in the branch of Hominoidea performed better compared to Cercopithecoidea, who in turn performed above Platyrrhini and Strepsirrhini. Interdependencies between phylogeny and socioecology of a given species presented an obstacle to disentangling the effects of each of these factors on the evolution of shortterm memory capacity. However, this study offers an important step forward in understanding the interspecies and individual variation in short-term memory ability by providing the first phylogenetic reconstruction of this trait’s evolutionary history. The dataset constitutes a unique resource for studying the evolution of primate cognition and the role of short-term memory in other cognitive abilities

Liver transplantation in Jehovah's witnesses

For religious reasons, Jehovah's witnesses refuse transfusion of blood products (red cells, platelets, plasma), but may accept organ transplantation. The authors developed a multidisciplinary protocol for liver transplantation in Jehovah's witnesses. In a 6-year period, nine Jehovah's witness patients were listed for liver transplantation. They received preoperative erythropoietin therapy, with iron and folic acid that allowed significant haematocrit increase. Two patients underwent partial spleen embolization to increase platelet count. Seven patients underwent cadaveric whole liver transplantation, and two right lobe living-related liver transplantation, using continuous circuit cell saving system and high dose aprotinin. No patient received any blood product during the surgical procedure. One patient suffering from deep anaemia after living-related liver transplantation was transfused as required by his family, but died from aspergillus infection. One 6-year-old child was transfused against her parent's will. The authors demonstrated that it is possible to increase haematocrit and platelet levels in cirrhotic patients awaiting liver transplantation. They were able to reduce intraoperative need for blood products, allowing liver transplantation in prepared Jehovah's witness patients. This experience may be beneficial for non-Jehovah's witness liver transplant recipients