Azienda Usl 8 Arezzo

Background/Objectives: Breastfeeding represents a critical developmental window during which maternal biology, environmental exposures, and nutrition converge to influence infant gastrointestinal health and long-term developmental trajectories. From a One Health perspective, breastfeeding can be conceptualized not as a static nutritional act, but as a dynamic and modifiable biological system in which maternal factors shape early-life microbiota assembly and immune programming. This narrative review explores how microbiota-oriented strategies during breastfeeding may foster a favorable trajectory of infant health, potentially extending to transgenerational outcomes. Methods: This narrative review is structured around a ten-point decalogue addressing interconnected domains relevant to the maternal-milk-infant microbiota axis, including maternal diet, microbial diversity, environmental exposures, psychological stress and probiotic use. Current mechanistic and clinical evidence was examined to evaluate how these domains may modulate microbiota composition and function during breastfeeding. Attention was given to probiotic supplementation, including strain specificity, timing of administration, and clinical context, as well as to the broader implications of a One Health framework. Results: Available evidence suggests that maternal nutritional patterns, environmental and psychosocial exposures, and targeted microbiota-modulation strategies may influence the composition and functional properties of human milk and the developing infant microbiota. Probiotic use during breastfeeding appears to have strain-specific and context-dependent effects, with potential benefits in selected clinical scenarios. However, findings remain heterogeneous, and uncertainties persist regarding optimal strains, timing, and long-term outcomes. Conclusions: Breastfeeding can be understood as a dynamic biological interface shaped by maternal and environmental factors. Integrating microbiota-oriented strategies within a One Health framework may support infant gastrointestinal health and possibly contribute to longer-term developmental trajectories. Nevertheless, careful interpretation of the current evidence is warranted to avoid reductionist, supplement-centered approaches and to prevent maternal overmedicalization or blame.

In the HOMAGE (Heart Omics in AGEing) trial, spironolactone reduced serum concentrations of procollagen Type I C-terminal propeptide (PICP), a fibrosis biomarker, in patients at risk of heart failure. To elucidate the underlying mechanisms, multidimensional analyses including proteomics were conducted. Olink cardiovascular and inflammation panels (n=276 proteins) were measured in plasma from 488 HOMAGE participants at baseline, 1 month, and 9 months after randomization. Proteins associated with PICP changes were identified using machine learning algorithms (MLAs). Selected candidates were further analyzed in patients with heart failure and preserved ejection fraction (Aldo-DHF trial). Linear regression and mediation analyses assessed which MLA-selected proteins mediated spironolactone's effects on PICP. MLAs consistently linked PICP reduction to changes in biomarkers of collagen (e.g., decreased COL1A1), fatty acid metabolism (e.g., increased FABP4), immune function (e.g., increased CCL24 and IL6RA, and decreased FLT3L), neurological function (e.g., increased DNER), cell-matrix interactions (e.g., increased galectin-9 [GAL9] and decreased thrombospondin-2 [THBS2]), and reduced NT-proBNP. Mediation analysis suggested that changes in GAL9 and THBS2 were associated with spironolactone-induced PICP reduction, which was confirmed in Aldo-DHF patients. This study raises the hypothesis that spironolactone inhibits collagen synthesis via inflammatory, metabolic, and extracellular matrix pathways, and particularly through modulation of GAL9 and THBS2.

IntroductionAging in dogs is a complex phenomenon characterized by metabolic, immunological and neurological alterations that may result in chronic inflammation, oxidative stress, and intestinal microbiota changing that can compromise dogs’ overall health. Phytotherapeutics represents a promising approach to improve the quality of life in elderly dogs. In this study we have tested a mix of phytoextracts on seven old breed dogs to evaluate their synergistic beneficial effects.MethodsThe mix was constituted by Passiflora incarnata (4% vitexin), Withania somnifera (2.5% withanolides), and Taraxacum officinale (20% inulin) administered per os for 40 days in addition to their diet. The whole blood and serum have been collected at the beginning of the experimental phase (T0), after 20 days (T1) and at the end point of the experiment, i.e., 40 days (T2), and used for biochemical analysis, detection of interleukins by ELISA, and for malondialdehyde (MDA) and Total antioxidant capacity (TAC) assay. Fresh feces have been collected at the same time points and immediately frozen to evaluate gut microbiota modification by 16S rRNA sequencing.ResultsResults revealed a significant reduction of C-reactive protein (CRP) for T1 and T2 respect to the basal condition (T0) (p < 0.05). Moreover, a statistical decrease in IL-6 and IL-10 cytokines at both T1 and T2 was observed, probably due to mitigation of chronic inflammation in the treated old dogs. The addition of the abovementioned extracts into the diet was associated with TAC increase and reduced lipid peroxidation in the sera of aged dogs, especially at T2 (p < 0.01). After treatment, an interesting modulation of the microbiota was observed with a trend from T0 to T2 toward higher relative abundances of SCFA-producing taxa, although alpha and beta diversity metrics did not reach statistical significance.DiscussionThis study supports the hypothesis that the integration of these herbal medicines into dietary or therapeutic regimens could represent a natural and synergistic strategy to improve the quality of life, promoting the general well-being of old dogs.

IntroductionThe gut microbiota is a central player in canine health, influencing digestion, immune modulation, and metabolic homeostasis. Microbiota imbalance fuels interest in dietary interventions such as prebiotics, probiotics, and synbiotics (a combination of prebiotics and probiotics).MethodsThis pilot feasibility study employed the SCIME™, a novel in vitro fermentation model simulating the canine colonic environment, to evaluate the metabolic effects of three dietary supplements using fecal inoculum from a single healthy canine donor. Products tested were Microbiotal (product M), a probiotic (product P, Lactobacilli reuteri), and a synbiotic (product M + P: Microbiotal +L. reuteri). Over a 2-week treatment period, fermentation parameters, including short-chain fatty acid (SCFA) production, acidification trends, and proteolytic activity, were measured using a high-resolution metabolomic profiling via the Laser-Assisted Rapid Evaporative Ionization Mass Spectrometry (LA-REIMS).ResultsDescriptive observations revealed distinct and complementary metabolic patterns. Microbiotal supplementation enhanced acidification in both the proximal and distal colon, with stimulation of acetate production in the proximal colon. Treatment with L. reuteri stimulated lactate production while reducing acetate and propionate levels. The synbiotic treatment showed combined effects, increasing acetate in the distal colon and producing metabolic shifts, as determined by LA-REIMS analysis. All treatments showed trends toward increased proteolytic markers in the distal colon.ConclusionThis pilot in vitro feasibility study demonstrates that prebiotics, probiotics, and synbiotics produce distinct metabolic fingerprints in vitro, warranting future validation through studies with multiple donors, independent SCIME™ runs, and in vivo trials to assess generalizability and explore potential applications in canine gastrointestinal research.

Hair can be significantly damaged following exposure to environmental agents and physical and chemical treatments. The aim of this study concerned the evaluation of the protective and restructuring efficacy of a hair mask containing two rice derivatives: rice germ oil GX-N and ferulic acid. This evaluation was performed on hair damaged by bleaching, UV irradiation, and heat treatment by applying the following techniques: FT-IR (Fourier Transform Infrared Spectroscopy), SEM (Scanning Electron Microscopy), a stress–strain test, polarized light microscopy analysis, and protein loss determination. The application of the masks highlighted an improvement in the characteristics of the hair. Rice germ oil GX-N showed very interesting and protective properties in all the treatments; however, the inclusion of a low concentration of ferulic acid did not provide additional benefits.

The term "dyslipidemia", commonly used in a broad sense, refers to a clinical condition characterized by alterations in the lipid profile across all its components: total cholesterol (TOT-C), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG). An imbalance in one or more of these parameters contributes to increased cardiovascular risk, primarily driven by the acceleration of atherosclerotic processes. Currently, numerous therapeutic options are available for the management of dyslipidemia, ranging from more conventional treatments - such as 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors and selective cholesterol absorption inhibitors - to more recently introduced therapies, including proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i), bile acid sequestrants, monoclonal antibodies, dietary supplements, cholesterol synthesis and absorption inhibitors, and LDL-C excretion promoters. The aim of this review is to provide a systematic overview of the various therapeutic approaches currently available, in light of two key factors: the broad spectrum of pharmacological options, and the recent regulatory updates regarding prescriptive authority, which now allows nephrologists to prescribe newly introduced lipid lowering agents.

Compared to passive reflectors for radar calibration, active reflectors offer electronic flexibility as well as better integration capability into air vehicles. Based upon classical microwave components, the design of such devices to fulfill radar cross section specifications is explained, and further potential applications are presented.

Nephrolithiasis (NL) is frequently associated with metabolic disorders such as type 2 diabetes mellitus (T2DM),obesity, and chronic kidney disease (CKD), all of which alter urinary composition and increase the risk of calciumoxalate and uric acid stone formation. Sodium-glucose cotransporter-2 inhibitors (SGLT2i), originally developedfor glycemic control in T2DM, have emerged as promising agents with both renoprotective and anti-lithogeniceffects. These effects are mediated through mechanisms such as osmotic diuresis, increased urinary citrate excretion (citraturia), and modulation of urinary pH, all contributing to reduced supersaturation and stone risk. Thisreview provides a comprehensive overview of the mechanisms by which SGLT2i may prevent stone formation,alongside a critical analysis of the current clinical evidence.

ABSTRACT Background Multi-canal benign paroxysmal positional vertigo (MC-BPPV) is a rare form of BPPV characterized by the simultaneous involvement of multiple semicircular canals, often resulting in complex diagnostic and therapeutic challenges. While MC-BPPV most commonly affects the posterior and horizontal semicircular canals, tri-canal involvement – especially with bilateral asymmetry – is exceedingly rare. Purpose To describe a unique case of tri-canal BPPV involving right posterior and horizontal semicircular cupulolithiasis and left horizontal semicircular canalolithiasis, successfully managed with a structured, sequential protocol of repositioning maneuvers including a novel Bascule maneuver. Case Description A 43-year-old woman presented with vertigo triggered by positional changes. Detailed positional testing identified cupulolithiasis in the right posterior and horizontal canals and canalolithiasis in the left horizontal canal. Sequential diagnostic maneuvers, including half Dix-Hallpike, inversion, and supine roll tests, revealed complex nystagmus patterns indicating multicanal involvement. Treatment began with mastoid oscillations and the Bascule maneuver targeting the right posterior canal, followed by the Zuma and Gufoni maneuvers for horizontal canal involvement. Outcomes Right posterior canal cupulolithiasis resolved within 24 hours. On day 2, transformation of horizontal nystagmus patterns enabled identification and successful treatment of right horizontal canal cupulolithiasis. On day 3, the left horizontal canalolithiasis was confirmed and treated. Complete symptom resolution and negative positional testing were achieved within 72 hours. Conclusion This case highlights the importance of comprehensive positional testing and a sequential, canal-specific therapeutic approach in managing complex MC-BPPV. The Bascule maneuver, combined with tailored repositioning techniques, proved highly effective in resolving tri-canal involvement rapidly and completely.