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Finocchietti M, Marino ML, Rosa AC, Bellini A, Masiero L, Cardillo M, Massari M, Spila Alegiani S, Pierobon S, Ferroni E, Zanforlini M, Leoni O, Ledda S, Garau D, Davoli M, Addis A, Belleudi V. Immunosuppression with Generics in Liver and Kidney Transplantation: A Real-World Evidence Study. Drug Des Devel Ther 2024; 18:53-69. [PMID: 38229916 PMCID: PMC10790661 DOI: 10.2147/dddt.s431121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 12/22/2023] [Indexed: 01/18/2024] Open
Abstract
Purpose This study evaluates the use, benefit-risk profile, and economic impact of generic immunosuppressants (tacrolimus-TAC, cyclosporine-CsA, and mycophenolate-MYC) in kidney and liver transplant recipients compared to brand-name drugs. Patients and Methods A retrospective multicentre observational study, involving four Italian regions, was conducted based on the national transplant Information system and regional healthcare claims data. The analysis focused on incident patients who received kidney and liver transplants between 2013 and 2019 and evaluated the use of generic of CsA, TAC, and MYC during the 30-day period following discharge. For each type of transplant and immunosuppressive agent, the benefit-risk profile of generic vs branded drugs in a two-year window was estimated by multivariate Cox models (HR; 95% CI). Furthermore, the potential cost savings per person associated with one year of treatment using generics were calculated. Results The utilization of generic drugs showed a significant increase; over the study years, the proportion of users among kidney recipients ranged from 14.2% to 40.5% for TAC, from 36.9% to 56.7% for MYC, and from 18.2% to 94.7% for CsA. A great variability in generic uptake for region was found. A comparable risk-benefit profile between generic and branded formulations was shown for all immunosuppressors considered. Choosing generic immunosuppressants during maintenance could result in yearly savings of around 2000 euros per person for each therapy ingredient. Conclusion The study shows an increasing proportion of patients using generic immunosuppressive drugs over time suggesting a growing acceptance of generics within the transplant community and reveals comparable risk-benefit profiles between the generic and branded formulations of TAC, CsA, and MYC. A significant variability in the use of generics immunosuppressive agents was found both at the regional level and among transplant centers and future research should delve into regional prescribing variations.
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Affiliation(s)
- Marco Finocchietti
- Department of Epidemiology, Lazio Regional Health Service-ASL Roma 1, Rome, Italy
| | - Maria Lucia Marino
- Department of Epidemiology, Lazio Regional Health Service-ASL Roma 1, Rome, Italy
| | - Alessandro C Rosa
- Department of Epidemiology, Lazio Regional Health Service-ASL Roma 1, Rome, Italy
| | - Arianna Bellini
- Department of Epidemiology, Lazio Regional Health Service-ASL Roma 1, Rome, Italy
| | - Lucia Masiero
- Italian National Transplant Center, Istituto Superiore di Sanità, Rome, Italy
| | - Massimo Cardillo
- Italian National Transplant Center, Istituto Superiore di Sanità, Rome, Italy
| | - Marco Massari
- National Center for Drug Research and Evaluation, Istituto Superiore Di Sanità, Rome, Italy
| | | | | | | | - Martina Zanforlini
- The innovation and procurement regional company, A.R.I.A. S.p.A.-Lombardy Region, Milan, Italy
| | - Olivia Leoni
- Regional Epidemiological Observatory, Lombardy Region, Milan, Italy
| | - Stefano Ledda
- General Directorate for Health, Sardinia Region, Cagliari, Italy
| | - Donatella Garau
- General Directorate for Health, Sardinia Region, Cagliari, Italy
| | - Marina Davoli
- Department of Epidemiology, Lazio Regional Health Service-ASL Roma 1, Rome, Italy
| | - Antonio Addis
- Department of Epidemiology, Lazio Regional Health Service-ASL Roma 1, Rome, Italy
| | - Valeria Belleudi
- Department of Epidemiology, Lazio Regional Health Service-ASL Roma 1, Rome, Italy
| | - On behalf of CESIT Study Group
- Department of Epidemiology, Lazio Regional Health Service-ASL Roma 1, Rome, Italy
- Italian National Transplant Center, Istituto Superiore di Sanità, Rome, Italy
- National Center for Drug Research and Evaluation, Istituto Superiore Di Sanità, Rome, Italy
- Azienda Zero, Veneto Region, Padua, Italy
- The innovation and procurement regional company, A.R.I.A. S.p.A.-Lombardy Region, Milan, Italy
- Regional Epidemiological Observatory, Lombardy Region, Milan, Italy
- General Directorate for Health, Sardinia Region, Cagliari, Italy
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Rosa AC, Finocchietti M, Agabiti N, Menè P, Bracaccia ME, Bellini A, Massari M, Spila Alegiani S, Masiero L, Bedeschi G, Cardillo M, Lucenteforte E, Piccolo G, Leoni O, Ferroni E, Pierobon S, Nordio M, Ledda S, Garau D, Davoli M, Addis A, Belleudi V. Determinants of immunosuppressive therapy in renal transplant recipients: an Italian observational study (the CESIT project). BMC Nephrol 2023; 24:320. [PMID: 37891504 PMCID: PMC10604923 DOI: 10.1186/s12882-023-03325-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 09/06/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Very scanty evidence is available on factors influencing the choice of immunosuppressive drug therapy after kidney transplantation. METHODS An Italian multiregional real-world study was conducted integrating national transplant information system and claims data. All patients undergoing kidney transplantation for the first time during 2009-2019 (incident patients) were considered. Multilevel logistic models were used to estimate Odds Ratio (OR) and corresponding 95% Confidence intervals. Factors with statistically significance were identified as characteristics associated with treatment regimens: cyclosporin-CsA vs tacrolimus-Tac and, within the latter group, mTOR inhibitors vs mycophenolate-MMF. RESULTS We identified 3,622 kidney patients undergoing transplantation in 17 hospitals located in 4 Italian regions, 78.3% was treated with TAC-based therapy, of which 78% and 22% in combination with MMF and mTOR, respectively. For both comparison groups, the choice of immunosuppressive regimens was mostly guided by standard hospital practices. Only few recipient and donor characteristics were found associated with specific regimen (donor/receipt age, immunological risk and diabetes). CONCLUSIONS The choice of post-renal transplant immunosuppressive therapy seems to be mostly driven by standard Centre practices, while only partially based on patient's characteristics and recognized international guidelines.
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Affiliation(s)
- Alessandro C Rosa
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Via Cristoforo Colombo, 112, 00147, Rome, Italy
| | - Marco Finocchietti
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Via Cristoforo Colombo, 112, 00147, Rome, Italy
| | - Nera Agabiti
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Via Cristoforo Colombo, 112, 00147, Rome, Italy
| | - Paolo Menè
- Department of Clinical Sciences, Division of Nephrology, University of Rome La Sapienza, Sant'Andrea University Hospital, Rome, Italy
| | - Maria Elena Bracaccia
- Department of Clinical Sciences, Division of Nephrology, University of Rome La Sapienza, Sant'Andrea University Hospital, Rome, Italy
| | - Arianna Bellini
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Via Cristoforo Colombo, 112, 00147, Rome, Italy
| | - Marco Massari
- National Centre for Drug Research and Evaluation, Istituto Superiore Di Sanità, Rome, Italy
| | | | - Lucia Masiero
- Italian National Transplant Centre, Istituto Superiore Di Sanità, Rome, Italy
| | - Gaia Bedeschi
- Italian National Transplant Centre, Istituto Superiore Di Sanità, Rome, Italy
| | - Massimo Cardillo
- Italian National Transplant Centre, Istituto Superiore Di Sanità, Rome, Italy
| | - Ersilia Lucenteforte
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Olivia Leoni
- Department of Health of Lombardy Region, Epidemiology Observatory, Milan, Italy
| | | | | | | | - Stefano Ledda
- General Directorate for Health, Sardinia Region, Cagliari, Italy
| | - Donatella Garau
- General Directorate for Health, Sardinia Region, Cagliari, Italy
| | - Marina Davoli
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Via Cristoforo Colombo, 112, 00147, Rome, Italy
| | - Antonio Addis
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Via Cristoforo Colombo, 112, 00147, Rome, Italy
| | - Valeria Belleudi
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Via Cristoforo Colombo, 112, 00147, Rome, Italy.
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Belleudi V, Rosa AC, Finocchietti M, Poggi FR, Marino ML, Massari M, Spila Alegiani S, Masiero L, Ricci A, Bedeschi G, Puoti F, Cardillo M, Pierobon S, Nordio M, Ferroni E, Zanforlini M, Piccolo G, Leone O, Ledda S, Carta P, Garau D, Lucenteforte E, Davoli M, Addis A. An Italian multicentre distributed data research network to study the use, effectiveness, and safety of immunosuppressive drugs in transplant patients: Framework and perspectives of the CESIT project. Front Pharmacol 2022; 13:959267. [PMID: 36188626 PMCID: PMC9521186 DOI: 10.3389/fphar.2022.959267] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 07/15/2022] [Indexed: 11/30/2022] Open
Abstract
The goal of post-transplant immunosuppressive drug therapy is to prevent organ rejection while minimizing drug toxicities. In clinical practice, a multidrug approach is commonly used and involves drugs with different mechanisms of action, including calcineurin inhibitors (CNI) (tacrolimus or cyclosporine), antimetabolite (antimet) (mycophenolate or azathioprine), inhibitors of mechanistic target of rapamycin (mTOR) (sirolimus or everolimus), and/or steroids. Although evidence based on several randomized clinical trials is available, the optimal immunosuppressive therapy has not been established and may vary among organ transplant settings. To improve the knowledge on this topic, a multiregional research network to Compare the Effectiveness and Safety of Immunosuppressive drugs in Transplant patients (CESIT) has been created with the financial support of the Italian Medicines Agency. In this article, we describe the development of this network, the framework that was designed to perform observational studies, and we also give an overview of the preliminary results that we have obtained. A multi-database transplant cohort was enrolled using a common data model based on healthcare claims data of four Italian regions (Lombardy, Veneto, Lazio, and Sardinia). Analytical datasets were created using an open-source tool for distributed analysis. To link the National Transplant Information System to the regional transplant cohorts, a semi-deterministic record linkage procedure was performed. Overall, 6,914 transplant patients from 2009–19 were identified: 4,029 (58.3%) for kidney, 2,219 (32.1%) for liver, 434 (6.3%) for heart, and 215 (3.1%) for lung. As expected, demographic and clinical characteristics showed considerable variability among organ settings. Although the triple therapy in terms of CNI + antimet/mTOR + steroids was widely dispensed for all settings (63.7% for kidney, 33.5% for liver, 53.3% for heart, and 63.7% for lung), differences in the active agents involved were detected. The CESIT network represents a great opportunity to study several aspects related to the use, safety, and effectiveness of post-transplant maintenance immunosuppressive therapy in real practice.
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Affiliation(s)
- Valeria Belleudi
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
- *Correspondence: Valeria Belleudi,
| | | | | | | | | | - Marco Massari
- National Center for Drug Research and Evaluation, Istituto Superiore Di Sanità, Rome, Italy
| | | | - Lucia Masiero
- Italian National Transplant Center—Istituto Superiore Di Sanità, Rome, Italy
| | - Andrea Ricci
- Italian National Transplant Center—Istituto Superiore Di Sanità, Rome, Italy
| | - Gaia Bedeschi
- Italian National Transplant Center—Istituto Superiore Di Sanità, Rome, Italy
| | - Francesca Puoti
- Italian National Transplant Center—Istituto Superiore Di Sanità, Rome, Italy
| | - Massimo Cardillo
- Italian National Transplant Center—Istituto Superiore Di Sanità, Rome, Italy
| | | | | | | | | | | | | | - Stefano Ledda
- General Directorate for Health, Sardinia Region, Italy
| | - Paolo Carta
- General Directorate for Health, Sardinia Region, Italy
| | | | - Ersilia Lucenteforte
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Marina Davoli
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Antonio Addis
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
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Belleudi V, Poggi FR, Perna S, Naldi L, Bortolus R, Rosa AC, Kirchmayer U, Davoli M, Addis A. Drug discontinuation in pregnant women with psoriasis: The PSO-MOTHER cohort study. Pharmacoepidemiol Drug Saf 2020; 29:904-912. [PMID: 32501653 DOI: 10.1002/pds.5030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 02/06/2020] [Accepted: 04/28/2020] [Indexed: 11/10/2022]
Abstract
PURPOSE To analyse the drug use pattern in women with psoriasis before, during and after pregnancy. METHODS All children born (2009-2016) in a central Italian region (Lazio) to mothers with a diagnosis of psoriasis were identified. Drug use patterns (biologicals, systemic, and topical), and discontinuation and switching of drug therapies before, during, and after pregnancy were studied. Findings were compared with data from a population exposed to similar drug therapies (eg, antirheumatic drugs). RESULTS Among 3499 deliveries by women affected by psoriasis, 1876 (53.6%) were diagnosed with this condition before the Last Menstrual Period (LMP). Of these, 525 (27.9%) had at least one drug prescription for psoriasis therapy during 6 months before LMP. For each class of drugs considered, there was a general decrease in its use during pregnancy. Considering the two trimesters preceding LMP and the three trimesters of pregnancy, the following percentages of prescriptions were observed: from 10.5% to 0% for biologicals, 7.2% to 2.5% for the conventional systemic drugs, and 51.1% to 9.4% for the topical treatments. After delivery, previous treatments were resumed. Similar results were observed for rheumatoid arthritis, a chronic condition. CONCLUSIONS Majority of drugs come with warnings regarding potential embryo-fetotoxicity, which might play a role in the decision to continue treatments during pregnancy. According to our study pregnancy appears to have a significant influence on drug prescriptions of different pharmacological treatments for psoriasis.
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Affiliation(s)
- Valeria Belleudi
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Francesca R Poggi
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Serena Perna
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Luigi Naldi
- Department of Dermatology, AULSS 8 Berica, Ospedale San Bortolo, Vicenza, Italy
| | - Renata Bortolus
- Office for Research Promotion, Department of the Hospital Management, Verona University Hospital, Verona, Italy
| | - Alessandro C Rosa
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Ursula Kirchmayer
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Marina Davoli
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Antonio Addis
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
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Largo R, Lopes MC, Spruyt K, Guilleminault C, Wang YP, Rosa AC. Visual and automatic classification of the cyclic alternating pattern in electroencephalography during sleep. ACTA ACUST UNITED AC 2019; 52:e8059. [PMID: 30810623 PMCID: PMC6393849 DOI: 10.1590/1414-431x20188059] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Accepted: 12/07/2018] [Indexed: 11/30/2022]
Abstract
Cyclic alternating pattern (CAP) is a neurophysiological pattern that can be visually scored by international criteria. The aim of this study was to verify the feasibility of visual CAP scoring using only one channel of sleep electroencephalogram (EEG) to evaluate the inter-scorer agreement in a variety of recordings, and to compare agreement between visual scoring and automatic scoring systems. Sixteen hours of single-channel European data format recordings from four different sleep laboratories with either C4-A1 or C3-A2 channels and with different sampling frequencies were used in this study. Seven independent scorers applied visual scoring according to international criteria. Two automatic blind scorings were also evaluated. Event-based inter-scorer agreement analysis was performed. The pairwise inter-scorer agreement (PWISA) was between 55.5 and 84.3%. The average PWISA was above 60% for all scorers and the global average was 69.9%. Automatic scoring systems showed similar results to those of visual scoring. The study showed that CAP could be scored using only one EEG channel. Therefore, CAP scoring might also be integrated in sleep scoring features and automatic scoring systems having similar performances to visual sleep scoring systems.
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Affiliation(s)
- R Largo
- LaSEEB - Evolutionary Systems and Biomedical Engineering Laboratory, Institute for Systems and Robotics (ISR-Lisboa), Instituto Superior Técnico (IST), University of Lisbon, Lisbon, Portugal.,Escola Superior de Tecnologia de Setúbal, Instituto Politécnico de Setúbal, Setúbal, Portugal
| | - M C Lopes
- LaSEEB - Evolutionary Systems and Biomedical Engineering Laboratory, Institute for Systems and Robotics (ISR-Lisboa), Instituto Superior Técnico (IST), University of Lisbon, Lisbon, Portugal.,Instituto de Psiquiatria (PRATA), Hospital das Cl�nicas (HCFMUSP), Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - K Spruyt
- Lyon Neuroscience Research Center, INSERM U1028-CNRS UMR 5292 Waking Team, School of Medicine, University Claude Bernard, Lyon, France
| | - C Guilleminault
- Sleep Disorders Clinic, Stanford University Medical Center, Stanford, CA, USA
| | - Y P Wang
- Instituto de Psiquiatria (LIM-23), Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - A C Rosa
- LaSEEB - Evolutionary Systems and Biomedical Engineering Laboratory, Institute for Systems and Robotics (ISR-Lisboa), Instituto Superior Técnico (IST), University of Lisbon, Lisbon, Portugal
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Lopes C, Luna SPL, Rosa AC, Quarterone C, Crosignani N, Taylor PM, Pantoja JC, Puoli JNP. Antinociceptive effects of methadone combined with detomidine or acepromazine in horses. Equine Vet J 2015; 48:613-8. [PMID: 26174473 DOI: 10.1111/evj.12483] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 07/07/2015] [Indexed: 11/30/2022]
Abstract
REASONS FOR PERFORMING STUDY To investigate two protocols to provide antinociception in horses. OBJECTIVES To evaluate the antinociceptive effects of intravenous methadone combined with detomidine or acepromazine in adult horses. STUDY DESIGN Randomised, blinded, crossover study. METHODS Mechanical, thermal and electrical stimuli were applied to the dorsal left and right metacarpus and coronary band of the left thoracic limb, respectively. A thermal stimulus was applied caudal to the withers. The horses were treated with saline (C), a combination of methadone (0.2 mg/kg bwt) and detomidine (10 μg/kg bwt) (MD) or methadone (0.2 mg/kg bwt) and acepromazine (0.05 mg/kg bwt) (MA) at 1 week intervals. Nociceptive thresholds were measured before and at 15 min intervals until 150 min after treatment. Wilcoxon rank-sum and Wilcoxon signed rank tests were used to compare data between groups at each time point and over time within each group, followed by the Bonferroni method to adjust the P value. RESULTS The mechanical stimulus was the most sensitive test to differentiate the antinociceptive effects of the treatments. Mechanical thresholds were greater after MD than MA between 15 and 30 min and with both MD and MA these thresholds were greater than C from 15 to 60 min. Electrical and thermal limb thresholds were greater after MD than C at 15 and 45 min and at 15, 30, 45, 75 and 105 min, respectively. Thermal limb thresholds were greater with MA than C at 30 min. Thoracic thermal threshold in MD and MA were higher than C at 45, 75, 90 and 120 min and from 30 to 75 min, respectively. CONCLUSIONS Methadone and acepromazine produced less pronounced mechanical antinociception than MD.
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Affiliation(s)
- C Lopes
- Department of Anaesthesiology, Faculty of Medicine, Universidade Estadual Paulista, UNESP, Botucatu, Brazil
| | - S P L Luna
- Department of Veterinary Surgery and Anaesthesiology, Faculty of Veterinary Medicine and Animal Science, Universidade Estadual Paulista, UNESP, Botucatu, Brazil
| | - A C Rosa
- Department of Anaesthesiology, Faculty of Medicine, Universidade Estadual Paulista, UNESP, Botucatu, Brazil
| | - C Quarterone
- Department of Anaesthesiology, Faculty of Medicine, Universidade Estadual Paulista, UNESP, Botucatu, Brazil
| | - N Crosignani
- Department of Anaesthesiology, Faculty of Medicine, Universidade Estadual Paulista, UNESP, Botucatu, Brazil
| | | | - J C Pantoja
- Department of Veterinary Hygiene and Public Health, Faculty of Veterinary Medicine and Animal Science, Universidade Estadual Paulista, UNESP, Botucatu, Brazil
| | - J N P Puoli
- Department of Animal Production, Faculty of Veterinary Medicine and Animal Science, Universidade Estadual Paulista, UNESP, Botucatu, Brazil
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Rosa AC, Fantozzi R. The role of histamine in neurogenic inflammation. Br J Pharmacol 2014; 170:38-45. [PMID: 23734637 DOI: 10.1111/bph.12266] [Citation(s) in RCA: 117] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Revised: 02/13/2013] [Accepted: 03/28/2013] [Indexed: 12/21/2022] Open
Abstract
The term 'neurogenic inflammation' has been adopted to describe the local release of inflammatory mediators, such as substance P and calcitonin gene-related peptide, from neurons. Once released, these neuropeptides induce the release of histamine from adjacent mast cells. In turn, histamine evokes the release of substance P and calcitonin gene-related peptide; thus, a bidirectional link between histamine and neuropeptides in neurogenic inflammation is established. The aim of this review is to summarize the most recent findings on the role of histamine in neurogenic inflammation, with particular regard to nociceptive pain, as well as neurogenic inflammation in the skin, airways and bladder.
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Affiliation(s)
- A C Rosa
- Dipartimento di Scienza e Tecnologia del Farmaco, University of Turin, Italy.
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Pereira SG, Rosa AC, Ferreira AS, Moreira LM, Proença DN, Morais PV, Cardoso O. Virulence factors and infection ability of Pseudomonas aeruginosa isolates from a hydropathic facility and respiratory infections. J Appl Microbiol 2014; 116:1359-68. [PMID: 24484457 DOI: 10.1111/jam.12463] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 01/17/2014] [Accepted: 01/27/2014] [Indexed: 11/27/2022]
Abstract
AIMS To compare the virulence pool and acute infection ability of Pseudomonas aeruginosa isolates from a hydropathic facility, used to treat respiratory conditions by inhalation of untreated natural mineral water, with clinical isolates from respiratory infections. METHODS AND RESULTS Pseudomonas aeruginosa isolates from a hydropathic facility and from respiratory infections were typed by pulsed-field gel electrophoresis. Nonclonal representatives of each population were selected. 18 virulence-encoding genes were screened by polymerase chain reaction and statistically compared by multiple correspondence analysis. Homogeneous distribution of genes between populations but higher genetic association in aquatic isolates was observed, as well as distinct virulence pool according to location in the water system. Acute infection ability of selected isolates from each population, in Galleria mellonella model, showed lower LD50 of the majority of the hydropathic isolates and significant variations in LD50 of biofilm isolates from different equipments. CONCLUSIONS Hydrotherapy Ps. aeruginosa isolates present similar virulence to isolates from respiratory infections. Hydrotherapy users may be exposed to different microbiological risks when using different treatment equipments. SIGNIFICANCE AND IMPACT OF THE STUDY Twenty-one million people use hydropathic facilities in Europe, and the majority present risk factors to pneumonia. This study demonstrates the health risk associated with this practice. Revision of European regulations should be considered.
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Affiliation(s)
- S G Pereira
- Center for Pharmaceutical Studies, Faculty of Pharmacy, University of Coimbra, Coimbra, Portugal
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9
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Minelli R, Serpe L, Pettazzoni P, Minero V, Barrera G, Gigliotti C, Mesturini R, Rosa AC, Gasco P, Vivenza N, Muntoni E, Fantozzi R, Dianzani U, Zara GP, Dianzani C. Cholesteryl butyrate solid lipid nanoparticles inhibit the adhesion and migration of colon cancer cells. Br J Pharmacol 2012; 166:587-601. [PMID: 22049973 DOI: 10.1111/j.1476-5381.2011.01768.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND AND PURPOSE Cholesteryl butyrate solid lipid nanoparticles (cholbut SLN) provide a delivery system for the anti-cancer drug butyrate. These SLN inhibit the adhesion of polymorphonuclear cells to the endothelium and may act as anti-inflammatory agents. As cancer cell adhesion to endothelium is crucial for metastasis dissemination, here we have evaluated the effect of cholbut SLN on adhesion and migration of cancer cells. EXPERIMENTAL APPROACH Cholbut SLN was incubated with a number of cancer cell lines or human umbilical vein endothelial cells (HUVEC) and adhesion was quantified by a computerized micro-imaging system. Migration was detected by the scratch 'wound-healing' assay and the Boyden chamber invasion assay. Expression of ERK and p38 MAPK was analysed by Western blot. Expression of the mRNA for E-cadherin and claudin-1 was measured by RT-PCR. KEY RESULTS Cholbut SLN inhibited HUVEC adhesiveness to cancer cell lines derived from human colon-rectum, breast, prostate cancers and melanoma. The effect was concentration and time-dependent and exerted on both cancer cells and HUVEC. Moreover, these SLN inhibited migration of cancer cells and substantially down-modulated ERK and p38 phosphorylation. The anti-adhesive effect was additive to that induced by the triggering of B7h, which is another stimulus inhibiting both ERK and p38 phosphorylation, and cell adhesiveness. Furthermore, cholbut SLN induced E-cadherin and inhibited claudin-1 expression in HUVEC. CONCLUSION AND IMPLICATIONS These results suggest that cholbut SLN could act as an anti-metastastic agent and they add a new mechanism to the anti-tumour activity of this multifaceted preparation of butyrate.
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Affiliation(s)
- R Minelli
- Dipartimento di Scienza e Tecnologia del Farmaco, Università di Torino, Torino, Italy
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Gallicchio M, Benetti E, Rosa AC, Fantozzi R. Tachykinin receptor modulation of cyclooxygenase-2 expression in human polymorphonuclear leucocytes. Br J Pharmacol 2009; 156:486-96. [PMID: 19154444 DOI: 10.1111/j.1476-5381.2008.00033.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND PURPOSE We investigated the ability of natural and synthetic selective NK receptors agonists and antagonists to modulate cyclooxygenase-2 (COX-2) expression in human polymorphonuclear leucocytes (PMNs). EXPERIMENTAL APPROACH The presence of all three tachykinin in PMNs was assessed by Western blot and PCR techniques. Natural and synthetic ligands selective for the tachykinin receptors were used to modulate COX-2 protein (measured with Western blotting) and activity [as prostaglandin E(2) (PGE(2)) output]. Effects of substance P (SP) on phosphorylation of mitogen-activated protein kinases (MAPKs) and nuclear factor-kappa B (NF-kappaB) activation were studied to analyse the signalling pathway involved in COX-2 up-regulation mediated by SP. KEY RESULTS Stimulation of NK receptors with the natural ligands SP, neurokinin A (NKA) and neurokinin B, in the pmol.L(-1)-micromol.L(-1) concentration range, modulated COX-2 expression and PGE(2) release in a concentration- and time-dependent manner. Experiments with synthetic selective agonists [Sar(9), Met(O(2))(11)]SP, [beta-Ala(8)] NKA(4-10), senktide or selective antagonists L703,606, SR48,968 or SR142801, confirmed that COX-2 up-regulation was mediated by NK receptors. We found that mainly p38, p42 and p46 MAPKs were phosphorylated by SP and SB202190, PD98059 and SP600125, which are selective inhibitors of these kinases, blocked SP-induced COX-2 expression. SP also induced nuclear translocation of NF-kappaB concentration-dependently, with a maximum effect at 1 nmol.L(-1). CONCLUSIONS AND IMPLICATIONS Human PMNs possess functional NK(1), NK(2) and NK(3) receptors, which mediate the induction of COX-2 expression and NF-kappaB activation by SP.
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Affiliation(s)
- M Gallicchio
- Department of Anatomy, Pharmacology and Forensic Medicine, University of Turin, Italy.
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Jewtuchowicz VM, Mujica MT, Brusca MI, Sordelli N, Malzone MC, Pola SJ, Iovannitti CA, Rosa AC. Phenotypic and genotypic identification of Candida dubliniensis from subgingival sites in immunocompetent subjects in Argentina. ACTA ACUST UNITED AC 2009; 23:505-9. [PMID: 18954358 DOI: 10.1111/j.1399-302x.2008.00465.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
INTRODUCTION It is generally recognized that Candida dubliniensis is commonly found in immunocompromised patients, such as those with advanced human immunodeficiency virus infection, at sites of periodontal disease. Since there are no data available for Argentina, the aim of this study was to determine the prevalence of and to identify C. dubliniensis in periodontal pockets from immunocompetent subjects living in Buenos Aires, Argentina, through a comparison of phenotypic and molecular assays. METHODS Yeasts recovered from subgingival plaque samples were studied for 180 immunocompetent non-smoking patients with periodontal disease. Yeasts were identified by conventional mycological methods and by specific polymerase chain reaction (PCR) assay. Fluconazole and voriconazole susceptibility studies were performed in keeping with the Clinical and Laboratory Standards Institute. RESULTS Among 76 yeasts isolated, C. dubliniensis comprised 10.5% (n = 8; 95% confidence interval 4.7-19.7), which corresponded to 4.4% of patients studied (8/180). C. albicans was the most frequently isolated species of yeast. A great majority of C. dubliniensis isolates was susceptible with only one isolate resistant to both antifungals. CONCLUSION Micromorphology on Staib agar was the phenotypic method that was most concordant with PCR and it was useful for selecting presumptive C. dubliniensis. This is the first report to use PCR to identify C. dubliniensis in subgingival fluid from immunocompetent individuals with periodontal disease in Argentina. On the basis of the findings presented here, we confirm that C. dubliniensis can colonize periodontal pockets of immunocompetent patients with periodontal disease.
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Affiliation(s)
- V M Jewtuchowicz
- Department of Microbiology and Parasitology, School of Dentistry, University of Buenos Aires, Buenos Aires, Argentina.
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Gallicchio M, Rosa AC, Dianzani C, Brucato L, Benetti E, Collino M, Fantozzi R. Celecoxib decreases expression of the adhesion molecules ICAM-1 and VCAM-1 in a colon cancer cell line (HT29). Br J Pharmacol 2007; 153:870-8. [PMID: 18084318 DOI: 10.1038/sj.bjp.0707634] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND AND PURPOSE We investigated the ability of celecoxib, a selective cyclooxygenase-2 (COX-2) inhibitor, to modulate expression of ICAM-1 and VCAM-1 in the colon cancer cell line HT29. EXPERIMENTAL APPROACH We analysed the effect of celecoxib on ICAM-1 and VCAM-1 protein and mRNA expression in HT29 cells. Experiments were performed in the presence of mitogen-activated protein kinases (MAPK) inhibitors to evaluate the involvement of these kinases in this phenomenon. We evaluated adhesion of HT29 cells to FCS-coated plastic wells in the presence of celecoxib or MAPK inhibitors. Furthermore, we studied the effect of celecoxib on apoptosis. KEY RESULTS Celecoxib down-regulated ICAM-1 and VCAM-1 expression in HT29 cells in a time- and dose-dependent way. Celecoxib reduced activation of p38 and p55 c-Jun terminal NH(2) kinase (JNK) MAPKs, but did not affect p46 JNK or p42/44 MAPK phosphorylation. Pretreatment with SB202190 or SP600125, specific inhibitors of p38 and JNK MAPKs, respectively, reduced ICAM-1 and VCAM-1 expression in HT29 cells dose-dependently. Adhesion of HT29 cells to FCS-coated plastic wells was inhibited dose-dependently by celecoxib, and also by SB202190 and SP600125. Celecoxib showed a pro-apoptotic effect, inducing Bax and BID but down-regulating Bcl-2. CONCLUSIONS AND IMPLICATIONS Our findings show that celecoxib caused down-regulation of ICAM-1 and VCAM-1, affecting the adhesive properties of HT29 cells in a COX-2 independent way, inhibiting p38 and p55 MAPKs and activating a pro-apoptotic pathway.
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Affiliation(s)
- M Gallicchio
- Department of Anatomy, Pharmacology and Forensic Medicine, University of Turin, Torino, Italy.
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Brusca MI, Chara O, Sterin-Borda L, Rosa AC. Influence of Different Orthodontic Brackets on Adherence of Microorganisms In Vitro. Angle Orthod 2007; 77:331-6. [PMID: 17319770 DOI: 10.2319/0003-3219(2007)077[0331:iodobo]2.0.co;2] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2006] [Accepted: 05/01/2006] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To define the capacity of different bracket materials to modify the growth and adherence of microorganisms. METHODS Three types of brackets from the right upper central incisor were used: metallic, ceramic, and composite. Streptococcus mutans and Candida albicans were studied. The association of both species was also evaluated. The brackets were placed in flat-bottomed vials containing basal medium with 20% sucrose added; the flasks were inoculated with each of the microbial suspensions. The samples were incubated at 37 degrees C for 48 hours, after which the brackets were removed. The supernatant was removed from the flasks, the cells adhering to the glass were counted, and the brackets were studied with electron microscopy. RESULTS The adherence of Streptococcus mutans was not modified by the different brackets. The adherence of Candida albicans was increased by the composite bracket, whereas the use of metallic brackets decreased the number of colony-forming units (CFUs). By electron microscopy we demonstrated that the adherence of Streptococcus mutans plus Candida albicans together varied according to the bracket materials with composite > ceramic > metallic. CONCLUSIONS Orthodontic appliances serve as different impact zones and modify microbial adherence and colonization, acting as foreign reserves and possible sources of infection.
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Affiliation(s)
- M I Brusca
- Microbiology Unit, School of Dentistry, University of Buenos Aires, Argentina.
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Carvalho C, Pereira HM, Ferreira J, Pina C, Mendonça D, Rosa AC, Carmo-Fonseca M. Chromosomal G-dark bands determine the spatial organization of centromeric heterochromatin in the nucleus. Mol Biol Cell 2001; 12:3563-72. [PMID: 11694589 PMCID: PMC60276 DOI: 10.1091/mbc.12.11.3563] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Gene expression can be silenced by proximity to heterochromatin blocks containing centromeric alpha-satellite DNA. This has been shown experimentally through cis-acting chromosome rearrangements resulting in linear genomic proximity, or through trans-acting changes resulting in intranuclear spatial proximity. Although it has long been been established that centromeres are nonrandomly distributed during interphase, little is known of what determines the three-dimensional organization of these silencing domains in the nucleus. Here, we propose a model that predicts the intranuclear positioning of centromeric heterochromatin for each individual chromosome. With the use of fluorescence in situ hybridization and confocal microscopy, we show that the distribution of centromeric alpha-satellite DNA in human lymphoid cells synchronized at G(0)/G(1) is unique for most individual chromosomes. Regression analysis reveals a tight correlation between nuclear distribution of centromeric alpha-satellite DNA and the presence of G-dark bands in the corresponding chromosome. Centromeres surrounded by G-dark bands are preferentially located at the nuclear periphery, whereas centromeres of chromosomes with a lower content of G-dark bands tend to be localized at the nucleolus. Consistent with the model, a t(11; 14) translocation that removes G-dark bands from chromosome 11 causes a repositioning of the centromere, which becomes less frequently localized at the nuclear periphery and more frequently associated with the nucleolus. The data suggest that "chromosomal environment" plays a key role in the intranuclear organization of centromeric heterochromatin. Our model further predicts that facultative heterochromatinization of distinct genomic regions may contribute to cell-type specific patterns of centromere localization.
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Affiliation(s)
- C Carvalho
- Instituto de Histologia e Embriologia, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
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15
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Rosa AC, Vieira MA, Tibana A, Gomes TA, Andrade JR. Interactions of Escherichia coli strains of non-EPEC serogroups that carry eae and lack the EAF and stx gene sequences with undifferentiated and differentiated intestinal human Caco-2 cells. FEMS Microbiol Lett 2001; 200:117-22. [PMID: 11410359 DOI: 10.1111/j.1574-6968.2001.tb10702.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Escherichia coli strains of non-EPEC serotypes that carry eae and lack the EAF and the Shiga toxin (stx) gene sequences have been found in acute diarrhea. Both the cell association and the cell entry of these strains in human intestinal epithelial cells were studied as a function of cell differentiation and polarization. The eae+/EAF-/stx- non-EPEC E. coli strains invaded undifferentiated Caco-2 cells more efficiently than differentiated cells. In contrast, prototype EPEC strain E2348/69 did not show significative differences from invasion rates of undifferentiated and differentiated cells. The uptake of these strains was greatly enhanced by pretreatment of differentiated Caco-2 cells with EGTA. These results suggest that the eae+/EAF-/stx- non-EPEC E. coli invasion of intestinal cells may be dependent on receptors expressed on the surface of undifferentiated cells and the basolateral pole of differentiated cells.
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Affiliation(s)
- A C Rosa
- Departmento de Microbiologia e Immunologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, RJ, brazil.
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Vieira MA, Andrade JR, Trabulsi LR, Rosa AC, Dias AM, Ramos SR, Frankel G, Gomes TA. Phenotypic and genotypic characteristics of Escherichia coli strains of non-enteropathogenic E. coli (EPEC) serogroups that carry EAE and lack the EPEC adherence factor and Shiga toxin DNA probe sequences. J Infect Dis 2001; 183:762-72. [PMID: 11181153 DOI: 10.1086/318821] [Citation(s) in RCA: 98] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2000] [Revised: 11/27/2000] [Indexed: 11/03/2022] Open
Abstract
This study was conducted to characterize the virulence potential of 59 Escherichia coli strains carrying EAE and lacking the enteropathogenic E. coli adherence factor and Shiga toxin probe sequences. In hybridization studies, all strains carried the locus of enterocyte effacement (LEE)-associated DNA sequences. Of the other 15 virulence DNA sequences tested, HLY was the most frequent (44.1%); 17 combinations of these sequences were found, but strains carrying EAE only (EAE profile) were the most frequent (35.6%). Except for 1 cytodetaching strain, all others adhered to HeLa and Caco-2 cells, most of which (approximately 75.0%) showed variations of the localized adherence pattern. Actin accumulation was detected in 75.9% of the nondetaching strains. Most strains had LEE, probably inserted in pheU (49.2%), and presented a nontypeable intimin (83.1%). Translocated intimin receptor-derived DNA sequences correlated with enteropathogenic and enterohemorrhagic E. coli in 61.0% and 32.0% of the strains, respectively. Thirty-five different serotypes were found. Only strains with the EAE profile were associated with diarrhea (P=.039).
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Affiliation(s)
- M A Vieira
- Departamento de Microbiologia, Imunologia e Parasitologia, Universidade Federal de São Paulo, Escola Paulista de Medicina, Rua Botucatu, 862-3* andar, São Paulo, SP, Brazil, CEP 04023-062
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Rosa AC, Brusca MI, Manto MC, Mosca CO, Nastri N. Effects of handling and storage on sterile dental instruments. Acta Odontol Latinoam 2001; 14:35-9. [PMID: 15208935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
The microbial contamination post-sterilization of dental instruments has been the object of permanent study. The aim of the present study was to evaluate factors affecting long-term sterility of dental instruments sterilized in the dry-oven or autoclave at the Central Sterilizing Service of the School of Dentistry, University of Buenos Aires stored under room temperature and humidity conditions. Half of the 192 samples were placed in standard closed metal containers and sterilized in a dry-oven (D.O), and the remaining half were placed in perforated metal containers and sterilized in an autoclave (A). All the samples were placed in sterilizing paper bags for medical use. Post sterilization, each group (DO and A) was divided into: Group I: minimal handling (control); Group II: wrapping torn mechanically (1 cm); Group III: wrapping torn manually (1 cm). All the samples were stored a closed cabinet. Contamination was evaluated at 30 and 180 days, by seeding under aerobic and anaerobic conditions. Temperature was monitored throughout the experiment, and ranged between 20 degrees C and 31 degrees C (x: 24 degrees C +/- 3.9). Humidity was measured with a digital hygrometer, and ranged between 40% and 60% (x: 54% +/- 10). Group I evidenced no microbial contamination, unlike Groups II and III. Our results evidence that 1) dry oven or autoclave sterilized material that is handled properly during storage remains sterile regardless of variations in temperature and humidity; 2) improper handling affects sterility, and contamination is time-dependent.
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Affiliation(s)
- A C Rosa
- Department of Microbiology, Faculty of Dentistry, University of Buenos Aires
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Abstract
OBJECTIVES The analysis of cyclic alternating pattern (CAP) provides important microstructural information on arousal instability and on EEG synchrony modulation in the sleep process. This work presents a methodology for automatic classification of the micro-organization of human sleep EEG, using the CAP paradigm. METHODS The classification system is composed of 3 parts: feature extraction, detection and classification. The feature extraction part is an EEG generation model-based maximum likelihood estimator. The detector part for the CAP phases A and B is done by a variable length template matched filter, while the classification criteria part is implemented on a state machine ruled-based decision system. RESULTS AND CONCLUSIONS The preliminary results of the automatic classifier on a group of 4 middle-aged adults are presented. The high agreement between the detector and visual scoring is very promising in the achievement of a fully automated scoring system, although a more exhaustive evaluation program is needed.
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Affiliation(s)
- A C Rosa
- Systems and Robotics Institute - IST, Lisbon, Portugal
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Abstract
Candida albicans (Ca), Staphylococcus aureus (Sa), Streptococcus sanguis (Ss), Actinomyces naeslundii (An), Actinomyces odontolyticus (Ao), Porphyromona spp (P spp), Candida glabrata (Cg), Candida krusei (Ck), and Rhodotorula spp (R spp) were tested with equal pieces of biodegradable membranes. Membranes pretreated with saliva or clorhexidine and nontreated control membranes were tested in three different culture media containing 0.1 mL homologous suspension for each strain under study. Incubation was performed at 37 degrees C for 48 hours for aerobiosis and for five days for anaerobiosis. Macroscopy and microscopy were carried out. Membranes were removed, washed, and resuspended. Samples were sonicated, and the supernatant was disseminated on brain heart infusion broth or blood agar. Incubation was repeated, colony-forming unit counts were performed, and statistical analysis was carried out using analysis of variance transforming results to Log10 (x + 1), the highest interaction level was used to calculate standard error. Orthogonal contrast was used to compare the different microorganisms under study. Highest adhesion was found with Ca, Cg, Ck, Sa, and Ss. A sufficient quantity of Actinomyces could not be recovered from the membranes. Results with P spp were poor, confirming lower gram-negative adhesion. Replicate flasks with Ss and Ca were cultivated. Membranes were removed after washing and subjected to scanning electron microscopy, as were untreated control pieces. A cavelike surface was observed. Streptococcus sanguis adhering to the membranes showed extracellular projections. Candida and gram-positive cocci showed great recovery capacity.
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Affiliation(s)
- S L Molgatini
- Microbiology Department, School of Dentistry, University of Buenos Aires, Argentina
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Rosa AC, Mariano AT, Pereira AM, Tibana A, Gomes TA, Andrade JR. Enteropathogenicity markers in Escherichia coli isolated from infants with acute diarrhoea and healthy controls in Rio de Janeiro, Brazil. J Med Microbiol 1998; 47:781-90. [PMID: 9736160 DOI: 10.1099/00222615-47-9-781] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Faeces from urban children < 2 years old with acute diarrhoeal illness and from non-diarrhoeal infants (controls) were examined for Escherichia coli and other enteropathogens. A total of 990 E. coli isolates from 100 patients and 50 controls was tested for enteropathogenic E. coli (EPEC) serotype (O:H), adherence to HEp-2 cells after incubation for 3 and 6 h, fluorescent actin staining (FAS), DNA hybridisation with EAF, eaeA, STh, STp and EAggEC probes and production of heat-labile enterotoxin (LT) and verocytotoxin (VT) with Y1 and Vero cells. EPEC were the most prevalent enteropathogens in patients (32.7%; and 14% in controls). Enteroinvasive E. coli (EIEC) and Vero cytotoxin-producing E. coli (VTEC) were not detected. The rate of isolation of enterotoxigenic E. coli (ETEC) was identical in both groups. Among the EPEC isolates the prevalent serotypes were O111:H2, O55:NM and O119:H6. Localised adherence (LA) was found significantly more frequently in isolates from patients (19.6%) than controls (2.1%). All LA-positive EPEC isolates were FAS+ and eaeA+, but only 75.2% of them hybridised with the EAF probe. Diffusely adhering E. coli (DAEC) and enteroaggregative E. coli (EAggEC) were found with equal frequency in patients and controls. Twenty-seven E. coli isolates were negative for EAF but positive for eaeA and FAS and produced LA in 6-h adherence tests. These EAF-/eaeA+ strains were the only putative enteropathogen identified in seven patients and were not found in controls. The ability of these strains to elicit ultrastructural cell alterations and cell-signalling events was evaluated in Caco-2 cells (human colon carcinoma cell line) by the gentamicin invasion assay and by transmission electron microscopy. The numbers of intracellular bacteria in cell invasion tests varied from 0.4% to 1.6% of the cell-associated bacteria after a 6-h incubation period. Tyrosine phosphorylation of host cell proteins was assessed in HEp-2 cells by immunofluorescence microscopy and all strains gave positive results. EAF-/eaeA+ E. coli strains express most of the virulence properties found among true EPEC strains and can be a relevant cause of infant diarrhoea in developing countries.
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Affiliation(s)
- A C Rosa
- Departamento de Microbiologia e Imunologia, Universidade do Estado do Rio de Janeiro, Brazil
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Lopes JO, Alves SH, Rosa AC, Silva CB, Sarturi JC, Souza CA. Acremonium kiliense peritonitis complicating continuous ambulatory peritoneal dialysis: report of two cases. Mycopathologia 1995; 131:83-5. [PMID: 8532059 DOI: 10.1007/bf01102883] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Two cases of peritonitis caused by Acremonium kiliense in patients receiving a continuous ambulatory peritoneal dialysis treatment are reported. Diagnosis was established by direct examination and cultures of dialysis effluent, secretion of catheter-exit-site and from the tip of the catheter. Management of fungal peritonitis includes catheter removal, since in this infection the result of systemic antifungal therapy is inconsistent.
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Affiliation(s)
- J O Lopes
- University Hospital, Santa Maria, Rio Grande do Sul, Brazil
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Lopes JO, Alves SH, Benevenga JP, Rosa AC. The second case of peritonitis due to Histoplasma capsulatum during continuous ambulatory peritoneal dialysis in Brazil. Mycoses 1994; 37:161-3. [PMID: 7898511 DOI: 10.1111/j.1439-0507.1994.tb00294.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
This paper reports a case of infection due to Histoplasma capsulatum apparently restricted to the peritoneum in a woman submitted to continuous ambulatory peritoneal dialysis (CAPD). Diagnosis was established by direct examination and culture of dialysis effluent. Although the state of Rio Grande do Sul, the southernmost in Brazil, is not considered a region of high endemicity for histoplasmosis, this is the second case of infection occurring in a patient during CAPD.
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Affiliation(s)
- J O Lopes
- Departamento de Microbiologia e Parasitologia, Universidade Federal de Santa Maria, Brazil
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Lopes JO, Alves SH, Benevenga JP, Rosa AC, Gomez VC. Trichosporon beigelii peritonitis associated with continuous ambulatory peritoneal dialysis. Rev Inst Med Trop Sao Paulo 1994; 36:121-3. [PMID: 7997786 DOI: 10.1590/s0036-46651994000200005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
This paper reports a case of peritonitis caused by Trichosporon beigelii in a woman submitted to continuous ambulatory peritoneal dialysis. Diagnosis was established by direct examination and culture of dialysis effluent.
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Affiliation(s)
- J O Lopes
- Serviço de Micologia, Hospital Universitário, Universidade Federal de Santa Maria, RS, Brasil
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Abstract
A simple digital format supporting the technical aspects of exchange and storage of polygraphic signals has been specified. Implementation of the format is simple and independent of hard- or software environments. It allows for any local montages, transducers, prefiltering, sampling frequencies, etc. At present, 7 laboratories in various countries have used the format for exchanging sleep-wake recordings. These exchanges have made it possible to create a common database of sleep records, to compare the analysis algorithms local to the various laboratories to each other by applying these algorithms to identical signals, and to set up a computer-aided interlaboratory evaluation of manual and automatic analysis methods.
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Affiliation(s)
- B Kemp
- Dept. of Clinical Neurophysiology, University Hospital Leiden, The Netherlands
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Rosa AC, Cuba CC, Vexenat A, Barreto AC, Marsden PD. Predominance of Leishmania braziliensis braziliensis in the regions of Três Braços and Corte de Pedra, Bahia, Brazil. Trans R Soc Trop Med Hyg 1988; 82:409-10. [PMID: 3232172 DOI: 10.1016/0035-9203(88)90138-1] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Affiliation(s)
- A C Rosa
- Núcleo de Medicina Tropical e Nutrição, Universidade de Brasília, Brazil
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Costa JM, Marsden PD, Llanos-Cuentas EA, Netto EM, Carvalho EM, Barral A, Rosa AC, Cuba CC, Magalhães AV, Barreto AC. Disseminated cutaneous leishmaniasis in a field clinic in Bahia, Brazil: a report of eight cases. J Trop Med Hyg 1986; 89:319-23. [PMID: 3806749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Eight Bahian patients with cutaneous leishmaniasis who had 20 or more ulcerative lesions of short duration are described. Of five identifications of isolated parasites, four were Leishmania braziliensis braziliensis and one was L. mexicana amazonensis. All but one had positive Montenegro tests initially, and all did after treatment. All had circulating anti-leishmanial antibodies and five responded well to glucantime therapy suggesting a functioning immune response. This is quite different to the anergic hansenoid leishmaniasis seen with L. mexicana amazonensis infections in Brazil. Possible reasons for the occurrence of this type of leishmaniasis are briefly discussed.
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