Chlamydophila psittaci is viable and infectious in the conjunctiva and peripheral blood of patients with ocular adnexal lymphoma: results of a single-center prospective case-control study

Ocular adnexal MALT lymphoma (OAML) is linked to Chlamydophila psittaci (Cp) infection. Viability and infectivity of Cp, demonstrated by growth in culture, has not been yet investigated in these patients. We conducted a single-center prospective case-control study to assess the prevalence, viability and infectivity of Cp in 20 OAML patients and 42 blood donors registered in a 6-month period. The presence of Cp in conjunctival swabs and peripheral blood mononuclear cells (PBMC) of patients and donors was assessed by TETR-PCR and in vitro cultures. From an epidemiological point of view, OAML patients often resided in rural areas, and reported a history of chronic conjunctivitis and prolonged contact with household animals (85% vs. 38% of donors; p = 0.00001). Cp was detected in lymphoma tissue in 15 (75%) patients. Cp DNA was detected in conjunctival swabs and/or PBMC from 10 (50%) patients and in PBMC from 1 (2%) donor (p = 0.01). Viability and infectivity of Cp, demonstrated by growth in culture, were confirmed in conjunctival swabs and/or PBMC from 5 (25%) patients, but not in donors (p = 0.002). This prospective study demonstrates, for the first time, that Cp present in the conjunctiva and PBMC of OAML patients is capable to grow and be isolated in cell cultures. Cp infection is common in OAML patients and exceptional in blood donors. Epidemiological data of OAML patients (prolonged contact with household animals and chronic conjunctivitis) are consistent with Cp exposure risk.     

Pulmonary function,smoking habits,and high resolution computed tomography (HRCT) early abnormalities of lung and pleural fibrosis in shipyard workers exposed to asbestos

To evaluate the presence of asbestos-related pleural and parenchymal abnormalities and their correlation with pulmonary function and smoking habits, 119 asbestos-exposed asymptomatic workers (mean age, 46.2 years; mean duration of asbestos exposure, 8.6 years; mean latency time, 21.6 years) with normal standard P-A chest radiographs were submitted to HRCT, CO-diffusing capacity, and pulmonary function tests. HRCT scans were normal only in 31 (26%) examined workers; 31 (26%) subjects showed both pleural and parenchymal involvement, and 50 (42%) and seven (6%) had exclusively pleural and parenchymal abnormalities, respectively. Based on CO-diffusing capacity and pulmonary function tests, no significant difference was demonstrated between workers with pleural lesions and subjects with normal pleura; however, lower values of FVC were observed in the nonsmoking workers with parenchymal abnormalities in comparison with nonsmoking subjects with normal parenchyma (78.2 vs. 89.7% of predicted values; p = 0.03 by student's two-tailedttest), and lower values of FEV₁/FVC in the smokers with parenchymal lesions with respect to smokers with normal parenchyma (93.7 vs. 100.2% of predicted values; p = 0.005 by student's two-tailedttest). In conclusion, our results demonstrate that HRCT may detect early parenchymal abnormalities which correlate with exposure to asbestos and respiratory function impairment, including a reduction in obstructive indices in smokers occupationally exposed to asbestos, without any clinically evident disease. © 1996 Wiley-Liss, Inc.     

CONTEXTUALIZING THE LIVED EXPERIENCES OF PATIENTS WITH LOW BACK PAIN FROM DIFFERENT COUNTRIES ACCORDING TO THE ICF FRAMEWORK

ObjectiveTo explore perspectives, including social and psychological aspects, of patients seeking manual care for low back pain, in order to understand constructs of functioning that are important across different cultural contexts. The International Classification of Functioning, Disability and Health (ICF) emphasizes the importance of these aspects to describe health-related functioning.DesignFocus group interviews.PatientsPatients from Botswana, Canada and Norway seeking manual care for their low back pain. Methods: Interviews were conducted in the 3 countries, transcribed verbatim, translated into English, and linked to the ICF according to established rules.ResultsSeven focus groups yielded 1,863 meaningful concepts that were linked to ICF categories. The largest proportion of responses linked to the Activities and Participation domain. The most frequently mentioned chapters related to pain and its mental aspects, suggesting that the psychological impact of living with low back pain is important to patients.ConclusionDespite cultural differences, patients seeking manual care for low back pain in Botswana, Canada and Norway reported similar experiences of disability across ICF domains. The relatively high ranking of psychosocial factors highlights their importance for patients, in addition to factors of biological origin, and indicates that the contextual nature of the lived experience of low back pain may not be covered in standard examinations used in manual medicine.LAY ABSTRACTThe aim of this study was to understand the experiences of people living with low back pain in 3 countries. The study explored perspectives of patients seeking manual care for low back pain, in order to understand aspects of functioning across different cultural contexts. Seven focus groups with 31 patients seeking manual care for their low back pain in Botswana, Canada and Norway were recorded, transcribed, and coded using the International Classification of Functioning, Disability and Health linking rules to categories. More than 1,800 meaningful concepts were linked to categories, with the largest proportion linked to Activities and Participation. Participants from all 3 countries most frequently mentioned issues related to the pain and mental aspects of health-related functioning, suggesting the psychological impact of living with low back pain is important to patients, regardless of cultural context. While patients seeking manual care are commonly assessed for pain and function, it is also important to capture the lived experiences associated with low back pain.Key words: low back pain, International Classification of Functioning Disability and Health, disability, health manual therapy

Low back pain (LBP) is the leading cause of disability globally (1), and is expected to increase further in the coming decades due to population growth and ageing (2). LBP affects physical wellbeing, but also personal, societal and psychological aspects of life (3). For people living with pain and disability, these aspects significantly influence their lived experiences, mental health, social interaction, quest for diagnosis and expectations of clinical care (4–6).In caring for patients with LBP, patient-reported outcomes, such as pain intensity and disability, are commonly assessed (7). However, these assessments do not capture the biopsychosocial (8) and environmental (9) nature of LBP-related disability, which may influence its management and outcomes.To capture the multifaceted nature and varying patient experiences of disability, the World Health Organization (WHO) developed the International Classification of Functioning, Disability and Health (ICF) framework to collect, document and communicate information about health-related functioning (10). Rather than consider disability a consequence of disease, the ICF operationalizes an integrative model of health and presents related outcomes from the interaction between a person’s health condition and their contextual factors (11) (Fig. 1). The ICF framework applies to all people regardless of sex, age, culture or health condition, and provides a common language to describe functioning across health professions.Open in a separate windowFig. 1Components of the International Classification of Function, Disability and Health (ICF) model.Furthermore, the WHO delineated a system of concepts and a hierarchical classification system based on components, chapters and categories (12). Functional depictions include: Body Functions and Structure according to body regions or systems; Activities and Participation from both individual and societal perspectives; from specific to general Environmental Factors (12). Personal Factors, although considered important to the ICF (13), are not classified because of their wide social and cultural variance (12).The ICF comprises more than 1,400 human functioning categories and serves as a framework to organize information (12). To increase applicability for clinical assessments and research, ICF Core Sets were developed, based on literature reviews, expert surveys and quantitative and qualitative clinical studies (14). Core Sets include category selections that describe the typical spectrum of functioning problems for patients with specific conditions (15).In manual medicine, little is known about the core components of LBP-related disability relevant to patients. Most clinical tools used in manual medicine measure functioning and disability related to Body Functions and Activities and Participation (9). In general, patients’ main reasons for seeking care for LBP are pain (16) and, especially, higher levels of disability (17), but also fear of future job impairment, limited social functioning and engagement in sports (17). However, patients seeking manual medicine may differ from patients seeking traditional medical care (18).The aim of this study was to explore the perspectives of patients seeking manual care for LBP in 3 countries, in order to understand what constructs of functioning are important to them. The ICF framework was used to guide the analysis of lived experiences of persons with LBP and disability. This study is part of an international, collaborative project between Ontario Tech University (Ontario Tech) and the University of Oslo, to identify the aspects of functioning that are most important to patients, and, subsequently, to develop an ICF assessment schedule for manual medicine with standardized measurement and reporting of functioning.     

Italians Do It … Less. COVID-19 Lockdown Impact on Sexual Activity: Evidence From a Large Representative Sample of Italian Adults

BackgroundTo explore how sexual activity was impacted by coronavirus disease 2019 (COVID-19) lockdown measures in the general adult population.MethodsA cross-sectional survey was conducted among 6,003 Italian adults aged 18–74 years who were representative of the Italian general population. Study subjects were recruited at the time of the nationwide stay-at-home order (from April 27 to May 3, 2020). We identified characteristics associated with decreased frequency of sex during lockdown, differentiating between cohabiting and non-cohabiting subjects.ResultsOver one-third (35.3%) of Italians reported to have changed their sexual activity during lockdown (8.4% increased and 26.9% decreased). When focusing on cohabitants (N = 3,949, 65.8%), decreased sexual activity (20.7%) was more frequently reported by men (22.3%; compared to women, multivariable odds ratio 1.23; 95% confidence interval, 1.05–1.44), younger subjects (P for trend <0.001), more educated subjects (P for trend = 0.004), subjects living in smaller houses (P for trend = 0.003), and those reporting longer time spent outdoors before the lockdown (P for trend <0.001).ConclusionsCOVID-19 lockdown drastically altered people’s day-to-day life and is likely to have impacted lifestyle habits and behavioral risk factors, including sexual attitudes and practice. This is the first national population-level study exploring changes in sexual life in this COVID-19 era. As we report sexual practice to have been affected by lockdown restrictions, we suggest that the mental health, social, and other determinants of these changes are to be explored beyond imposed social distancing.Key words: COVID-19, lockdown restrictions, sexual activity     

Soluble tumor necrosis factor receptors in human inflammatory synovial fluids

Objective. To test synovial fluid (SF) for the presence of soluble fragments originating from distinct tumor necrosis factor receptors (TNF-sR55 and TNF-sR75) which bind to TNF and inhibit its biologic activity. Methods. TNF-sR55 and TNF-sR75 were measured in 62 SF samples by specific immunoassays using monoclonal antibodies. Results. Both TNF-sR were present in all of the SF tested. Their concentrations were higher in SF from patients with seropositive rheumatoid arthritis than in patients with other inflammatory arthritides. The relative amount of TNF-sR75, as compared with TNF-sR55, was higher in seropositive RA SF than in other SF. Conclusion. The balance between TNF and its specific inhibitors may be critical to the biologic outcome mediated by this cytokine.     

Electronic Nose Technology in Respiratory Diseases

Electronic noses (e-noses) are based on arrays of different sensor types that respond to specific features of an odorant molecule, mostly volatile organic compounds (VOCs). Differently from gas chromatography and mass spectrometry, e-noses can distinguish VOCs spectrum by pattern recognition. E-nose technology has successfully been used in commercial applications, including military, environmental, and food industry. Human-exhaled breath contains a mixture of over 3000 VOCs, which offers the postulate that e-nose technology can have medical applications. Based on the above hypothesis, an increasing number of studies have shown that breath profiling by e-nose could play a role in the diagnosis and/or screening of various respiratory and systemic diseases. The aim of the present study was to review the principal literature on the application of e-nose technology in respiratory diseases.     

Cervical and hysteroscopic injection for identification of sentinel lymph node in endometrial cancer

ObjectivesThe aims of our study were to evaluate the possibility of identifying the sentinel lymph node (SLN) in patients with endometrial cancer (EC) and to directly compare two injection techniques, cervical and hysteroscopic injection.MethodsFifty-four patients with endometrial carcinoma, clinical stages I and II, were submitted to complete surgical staging through laparoscopy, as recommended by FIGO in 1988. For the mapping procedure the patients were divided into two groups of injection: the cervical injection group and hysteroscopic injection group. Technetium (Tc) 99m radiocolloid was used as tracer.ResultsIntraoperative detection rate of SLN was 70% in cervical group and 65% in the hysteroscopic group (p = n.s.). In the cervical group, all patients had SLN in the pelvis only and the mean SLN removed was 18 (range 2–26). In the hysteroscopic group, all patients had SNLs in the pelvis and two patients had SLN both in the pelvis and above the bifurcation of the aorta. Mean pelvic SLN removed was 20 (range 8–42).ConclusionsOur data shows that it is possible to identify the SLN in tumours of the endometrium. Both cervical and hysteroscopic techniques are feasible but the hysteroscopic procedure might represent the only method able to highlight the complete lymphatic drainage of the uterus as suggested by the presence of paraaortic positive SLN only in this group.     

Prevalence and Correlates of Overweight,Obesity and Physical Activity in Italian Children and Adolescents from Lombardy,Italy

Investigating pediatric overweight and physical activity correlates is essential to design effective preventive programs. We used regional data (Lombardy, northern Italy) from the 2019 survey “OKKio alla Salute” (3093 children aged 8–9 years with measured anthropometric data), and from the 2018 wave of the “Health Behaviour in School-aged Children” survey (2916 adolescents aged 11–15 years with self-reported anthropometric data). In both the surveys, a cluster sampling methodology was used. Unconditional multiple logistic regression models were applied to estimate the odds ratios (OR) and corresponding 95% confidence intervals (CI) of overweight, obesity and poor physical activity. The prevalence of overweight (including obesity) was 22.4% for children aged 8–9 years and 14.4% for adolescents aged 11–15 years. A higher prevalence of overweight was observed among males, children with greater birth weight and those with obese parents. Scant physical activity was higher among females and older adolescents. There was a direct relationship between obesity and increased psychological distress (OR = 2.44; 95% CI: 1.12–5.27) or being victims of bullying (OR = 2.25; 95% CI: 1.17–4.34). Increasing physical activity significantly decreased the frequency of mental health outcomes. Prevention campaigns should be promoted to safeguard childhood physical and psychological wellbeing.