The Growth Differentiation Factor 11 (GDF11) has been controversially involved in the aging/rejuvenation process. To clarify whether GDF11 is differently expressed during aging, we have evaluated GDF11 levels in skeletal muscles and hippocampi of young and old mice, sedentary or subjected to a 12-weeks triweekly training protocol. The results of real-time PCR and Western blot analyses indicate that skeletal muscles of sedentary old mice express higher levels of GDF11 compared to young animals (p < 0.05). Conversely, in hippocampi no significant differences of GDF11 expression are detected. Analysis of long-term potentiation, a synaptic plasticity phenomenon, reveals that population spikes in response to a tetanic stimulus are significantly higher in sedentary young mice than in old animals (p < 0.01). Training induces a significant improvement of long-term potentiation in both young and old animals (p < 0.05), an increase (p < 0.05) of skeletal muscle GDF11 levels in young mice and a reduction of GDF11 expression in hippocampi of old mice (p < 0.05). Overall, data suggest that GDF11 can be considered an aging biomarker for skeletal muscles. Moreover, physical exercise has a positive impact on long-term potentiation in both young and old mice, while it has variable effects on GDF11 expression depending on age and on the tissue analyzed.

The effects of training on muscle structure are dependent on adaptive changes induced by different intensities of physical exercise. Evidence has shown that aerobic training is able to induce adaptive changes to muscle structure based on intensity. The aim of the present study was to investigate the effects of different methods of continuous aerobic training in mice using functional, morphological and biomolecular approaches. The continuous aerobic training methods used in the present study were uniform continuous training (UC), varying continuous training (VC) and progressive continuous training (PC). Mice were made to run 3 times a week for 12 weeks on a motorized RotaRod, following one of the three different training methods at different speeds. The results of the present study demonstrated that the various training methods had different effects on sarcomere length. Ultrastructural analysis demonstrated that UC training resulted in a shortening of sarcomere length, PC training resulted in an elongation of sarcomere length and VC training showed similar sarcomere length when compared with the control sedentary group. Additionally, succinate dehydrogenase complex flavoprotein subunit A levels in muscle tissue following VC training were higher compared with UC and PC training. Overall, the present study showed that varying exercise methods resulted in different types of muscle plasticity, and that the VC protocol resulted in increased coordination and strength endurance in the functional tests, in agreement with the ultrastructural and biochemical profile. These observations support the view that VC training may be more efficient in increasing performance and may thus form the basis of training regimens when an improvement of motor efficiency is required.

The positive effects of physical activity on cognitive functions are widely known. Aerobic training is known to promote the expression of neurotrophins, thus inducing an increase in the development and survival of neurons, as well as enhancing synaptic plasticity. Based on this evidence, in the present study, we analyze the effects of two different types of aerobic training, progressive continuous (PC) and varying continuous (VC), on synaptic and muscular plasticity in heterozygous mice carrying the genetic mutation for Niemann-Pick type C disease. We also analyze the effects on synaptic plasticity by extracellular recordings in vitro in mouse hippocampal slices, while the morphological structure of muscle tissue was studied by transmission electron microscopy. Our results show a modulation of synaptic plasticity that varies according to the type of training protocol used, and only the VC protocol administered twice a week, has a significantly positive effect on long-term potentiation. On the contrary, ultrastructural analysis of muscle tissue shows an improvement in cellular conditions in all trained mice. These results confirm the beneficial effects of exercise on quality of life, supporting the hypothesis that physical activity could represent an alternative therapeutic strategy for patients with Niemann-Pick type C disease.

Background Acute pharyngitis is a frequent reason for primary care or emergency unit visits in children. Most available data on pharyngitis management come from primary care studies that demonstrate an underuse of microbiological tests, a tendency to over-prescribe antibiotics and a risk of antimicrobial resistance increase. However, a comprehensive understanding of acute pharyngitis management in emergency units is lacking. This study aimed to investigate the frequency of rapid antigen test use to diagnose acute pharyngitis, as well as other diagnostic approaches, the therapeutic attitude, and follow-up of children with this condition in the emergency units. Methods A multicentric national study was conducted in Italian emergency departments between April and June 2022. Results A total of 107 out of 131 invited units (response rate 82%), participated in the survey. The results showed that half of the units use a scoring system to diagnose pharyngitis, with the McIsaac score being the most commonly used. Most emergency units (56%) were not provided with a rapid antigen diagnostic test by their hospital, but the test was more frequently available in units visiting more than 10,000 children yearly (57% vs 33%, respectively, p = 0.02). Almost half (47%) of the units prescribe antibiotics in children with pharyngitis despite the lack of microbiologically confirmed cases of Group A β-hemolytic streptococcus. Finally, about 25% of units prescribe amoxicillin-clavulanic acid to treat Group A β-hemolytic streptococcus pharyngitis. Conclusions The study sheds light on the approach to pharyngitis in emergency units, providing valuable information to improve the appropriate management of acute pharyngitis in this setting. The routinary provision of rapid antigen tests in the hospitals could enhance the diagnostic and therapeutic approach to pharyngitis.

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Deficiency of vitamin A (retinol) has been suggested as an important contributing cause in the pathogenesis of bronchopulmonary dysplasia (BPD) in premature newborns with severe lung disease. Although the efficacy of vitamin A supple- mentation has yet to be clearly confirmed, it is widely employed, at different dosages and schedules, in neonatal intensive care units (NICU). Since in Italy today no suitable formulation of vitamin A is available, the present observational study was designed to define the profile of plasma vitamin A and retinol-binding protein (RBP) concentrations in supplemented infants at risk for BPD admitted to seven Italian NICU. Twelve babies (average 27 weeks of gestation, birth weight 1,008 g), supplemented with vitamin A, were observed with sequential measurements of retinol and RBP up to 28 days of age. At birth retinol and RBP plasma concentrations were both adequate in the infants and half their mothers’ levels. During supplementation the levels rose with wide variability according to the differences in dosing and timing in the different units. Plasma levels of retinol and RBP were the same in infants who had BPD and those who did not. A routine standardized therapeutic approach using vitamin A supplementation in Italian NICU will be more than welcome.