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Franzoi IG, Sauta MD, De Luca A, Granieri A. Returning to work after maternity leave: a systematic literature review. Arch Womens Ment Health 2024:10.1007/s00737-024-01464-y. [PMID: 38575816 DOI: 10.1007/s00737-024-01464-y] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/28/2024] [Indexed: 04/06/2024]
Abstract
PURPOSE Working women often experience difficulties associated with balancing family and career, particularly if they choose to have children. This systematic literature review aimed at investigating women's experience in returning to work after maternity leave. METHODS The review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The literature search led to the identification of 52 articles, which underwent data extraction and qualitative analysis. RESULTS Results were organized in 5 categories: (1) Work-life balance; (2) Women's mental and physical health; (3) Job-related wellbeing and working experience; (4) Breastfeeding. Women's both mental and physical health seem connected to a longer maternity leave and a greater coworkers' and supervisors' support. Returning to work seems to constitute one of the most important barriers for exclusive breastfeeding or breastfeeding continuation. A shorter duration of maternity leave, a higher workload and the lack of occupational policies supporting breastfeeding seem to be hindering factors. Partner and family support, and the opportunity for fathers to work under a flextime system after childbirth seem to increase both breastfeeding initiation and duration. Women who continue breastfeeding after returning to work seem to experience more family-to-work conflict and overload. CONCLUSIONS This paper show that there are still many understudied aspects in exploring women's experience of returning to work after maternity leave. This represents an important gap in the literature, since returning to work represents a particularly critical time in women's personal and occupational life, in which challenges and barriers may arise, potentially affecting their experience in the immediate future and years to come.
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Affiliation(s)
| | - Maria Domenica Sauta
- Department of Psychology, University of Turin, Via Verdi 10, Turin, 10124, Italy
| | - Alessandra De Luca
- Department of Psychology, University of Turin, Via Verdi 10, Turin, 10124, Italy
| | - Antonella Granieri
- Department of Psychology, University of Turin, Via Verdi 10, Turin, 10124, Italy
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Birtolo LI, Prosperi S, Monosilio S, Cimino S, Filomena D, Alfarano M, Manzi G, Neccia M, Papa S, Passarelli I, De Persis F, Luca AD, Mei M, Di Iorio M, D’Antoni L, Di Pietro G, Francavilla S, Improta R, Marcon S, Mariani MV, Agnes G, Piro A, Rizzo M, Rachele ES, Straito M, Tocci M, Francone M, Galea N, Severino P, Pasculli P, Colaiacomo MC, Petroianni A, Chimenti C, Lavalle C, Badagliacca R, Palange P, Mastroianni C, Catalano C, Pugliese F, Ciardi M, Maestrini V, Mancone M, Fedele F. 282 Follow-up of hospitalized COVID-19 survivors: assessment of short- and long-term cardiovascular sequelae after SARS-CoV-2 infection. Eur Heart J Suppl 2021. [PMCID: PMC8689752 DOI: 10.1093/eurheartj/suab135.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Aims Cardiovascular sequelae in COVID-19 survivors remain largely unclear and can potentially go unrecognized. Reports on follow-up focused on cardiovascular evaluation after hospital discharge are currently scarce. Aim of this prospective study was to assess cardiovascular sequelae in previously hospitalized COVID-19 survivors. Methods and results The study was conducted at ‘Sapienza’ University of Rome—Policlinico ‘Umberto I’. After 2 months from discharge, n = 230 COVID-19 survivors underwent a follow-up visit at a dedicated ‘post-COVID Outpatient Clinic’. A cardiovascular evaluation including electrocardiogram (ECG), Troponin and echocardiography was performed. Further tests were requested when clinically indicated. Medical history, symptoms, arterial-blood gas, blood tests, chest computed tomography, and treatment of both in-hospital and follow-up evaluation were recorded. A 1-year telephone follow-up was performed. A total of 36 (16%) COVID-19 survivors showed persistence or delayed onset of cardiovascular disease at 2-months follow-up visit. Persistent condition was recorded in 62% of survivors who experienced an in-hospital cardiovascular disease. Delayed cardiovascular involvement included: myocarditis, pericarditis, ventricular disfunction, new onset of systemic hypertension and arrhythmias. At 1-year telephone follow-up, 105 (45%) survivors reported persistent symptoms, with dyspnoea and fatigue being the most frequent. 60% of survivors showed persistent chest CT abnormalities and among those 28% complained of persistent cardiopulmonary symptoms at long term follow-up. Conclusions Our preliminary data showed persistent or delayed onset of cardiovascular involvement (16%) at short-term follow-up and persistent symptoms (45%) at long-term follow-up. These findings suggest the need for monitoring COVID-19 survivors.
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Affiliation(s)
- Lucia Ilaria Birtolo
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, ‘Policlinico Umberto I’ Hospital, Sapienza University of Rome, Rome, Italy
| | - Silvia Prosperi
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, ‘Policlinico Umberto I’ Hospital, Sapienza University of Rome, Rome, Italy
| | - Sara Monosilio
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, ‘Policlinico Umberto I’ Hospital, Sapienza University of Rome, Rome, Italy
| | - Sara Cimino
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, ‘Policlinico Umberto I’ Hospital, Sapienza University of Rome, Rome, Italy
| | - Domenico Filomena
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, ‘Policlinico Umberto I’ Hospital, Sapienza University of Rome, Rome, Italy
| | - Maria Alfarano
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, ‘Policlinico Umberto I’ Hospital, Sapienza University of Rome, Rome, Italy
| | - Giovanna Manzi
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, ‘Policlinico Umberto I’ Hospital, Sapienza University of Rome, Rome, Italy
| | - Matteo Neccia
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, ‘Policlinico Umberto I’ Hospital, Sapienza University of Rome, Rome, Italy
| | - Silvia Papa
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, ‘Policlinico Umberto I’ Hospital, Sapienza University of Rome, Rome, Italy
| | - Ilaria Passarelli
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, ‘Policlinico Umberto I’ Hospital, Sapienza University of Rome, Rome, Italy
| | - Francesca De Persis
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, ‘Policlinico Umberto I’ Hospital, Sapienza University of Rome, Rome, Italy
| | - Alessandra De Luca
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, ‘Policlinico Umberto I’ Hospital, Sapienza University of Rome, Rome, Italy
| | - Mariachiara Mei
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, ‘Policlinico Umberto I’ Hospital, Sapienza University of Rome, Rome, Italy
| | - Martina Di Iorio
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, ‘Policlinico Umberto I’ Hospital, Sapienza University of Rome, Rome, Italy
| | - Letizia D’Antoni
- Department of Public Health and Infectious Diseases, ‘Policlinico Umberto I’ Hospital, Sapienza University of Rome, Rome, Italy
| | - Gianluca Di Pietro
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, ‘Policlinico Umberto I’ Hospital, Sapienza University of Rome, Rome, Italy
| | - Santi Francavilla
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, ‘Policlinico Umberto I’ Hospital, Sapienza University of Rome, Rome, Italy
| | - Riccardo Improta
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, ‘Policlinico Umberto I’ Hospital, Sapienza University of Rome, Rome, Italy
| | - Serena Marcon
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, ‘Policlinico Umberto I’ Hospital, Sapienza University of Rome, Rome, Italy
| | - Marco Valerio Mariani
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, ‘Policlinico Umberto I’ Hospital, Sapienza University of Rome, Rome, Italy
| | - Gianluca Agnes
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, ‘Policlinico Umberto I’ Hospital, Sapienza University of Rome, Rome, Italy
| | - Agostino Piro
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, ‘Policlinico Umberto I’ Hospital, Sapienza University of Rome, Rome, Italy
| | - Massimiliano Rizzo
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, ‘Policlinico Umberto I’ Hospital, Sapienza University of Rome, Rome, Italy
| | - Edoardo Sebastian Rachele
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, ‘Policlinico Umberto I’ Hospital, Sapienza University of Rome, Rome, Italy
| | - Martina Straito
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, ‘Policlinico Umberto I’ Hospital, Sapienza University of Rome, Rome, Italy
| | - Marco Tocci
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, ‘Policlinico Umberto I’ Hospital, Sapienza University of Rome, Rome, Italy
| | - Marco Francone
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Nicola Galea
- Department of Radiological, Oncological and Pathological Sciences, ‘Policlinico Umberto I’ Hospital, Sapienza University of Rome, Rome, Italy
| | - Paolo Severino
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, ‘Policlinico Umberto I’ Hospital, Sapienza University of Rome, Rome, Italy
| | - Patrizia Pasculli
- Department of Public Health and Infectious Diseases, ‘Policlinico Umberto I’ Hospital, Sapienza University of Rome, Rome, Italy
| | - Maria Chiara Colaiacomo
- RadiologyDepartment, ‘Policlinico Umberto I’ Hospital, Sapienza University of Rome, Rome, Italy
| | - Angelo Petroianni
- Department of Public Health and Infectious Diseases, Division of Pulmonary Medicine, ‘Policlinico Umberto I’ Hospital, Sapienza University of Rome, Rome, Italy
| | - Cristina Chimenti
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, ‘Policlinico Umberto I’ Hospital, Sapienza University of Rome, Rome, Italy
| | - Carlo Lavalle
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, ‘Policlinico Umberto I’ Hospital, Sapienza University of Rome, Rome, Italy
| | - Roberto Badagliacca
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, ‘Policlinico Umberto I’ Hospital, Sapienza University of Rome, Rome, Italy
| | - Paolo Palange
- Department of Public Health and Infectious Diseases, Division of Pulmonary Medicine, ‘Policlinico Umberto I’ Hospital, Sapienza University of Rome, Rome, Italy
| | - Claudio Mastroianni
- Department of Public Health and Infectious Diseases, ‘Policlinico Umberto I’ Hospital, Sapienza University of Rome, Rome, Italy
| | - Carlo Catalano
- Department of Radiological, Oncological and Pathological Sciences, ‘Policlinico Umberto I’ Hospital, Sapienza University of Rome, Rome, Italy
| | - Francesco Pugliese
- Department of Anaesthesia and Intensive Care Medicine, ‘Policlinico Umberto I’ Hospital, Sapienza University of Rome, Rome, Italy
| | - Maria Ciardi
- Department of Public Health and Infectious Diseases, ‘Policlinico Umberto I’ Hospital, Sapienza University of Rome, Rome, Italy
| | - Viviana Maestrini
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, ‘Policlinico Umberto I’ Hospital, Sapienza University of Rome, Rome, Italy
| | - Massimo Mancone
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, ‘Policlinico Umberto I’ Hospital, Sapienza University of Rome, Rome, Italy
| | - Francesco Fedele
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, ‘Policlinico Umberto I’ Hospital, Sapienza University of Rome, Rome, Italy
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Prosperi S, Birtolo LI, Revivo MY, Monosilio S, Cimino S, Filomena D, Alfarano M, Manzi G, Neccia M, Papa S, Passarelli I, De Persis F, De Luca A, Tanzilli A, Di Pietro G, Francavilla S, Improta R, Agnes G, Marcon S, Mariani MV, Piro A, Rizzo M, Rachele ES, Straito M, Tocci M, Severino P, Lavalle C, Maestrini V, Mancone M, Fedele F. 288 The effects of cardiovascular diseases and treatment on clinical course of hospitalized COVID-19 patients. Eur Heart J Suppl 2021. [PMCID: PMC8689821 DOI: 10.1093/eurheartj/suab135.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Aims
Significant concern has been raised about the effect of pre-existing cardiovascular diseases (CVD), cardiovascular (CV) risk factors and CV therapies on COVID-19 course. On the other hand, COVID-19 could worse pre-existing CVD or trigger the development of new-onset CVD. The aim of this study was to evaluate the relationship between pre-existing CVD, CV risk factors, and CV therapy with the clinical course of hospitalized COVID-19 patients.
Methods and results
Consecutive hospitalized COVID-19 patients admitted to the Cardiovascular COVID-19 Unit at Policlinico Umberto I of Rome between December 2020 and April 2021 were enrolled. All patients underwent a cardiovascular evaluation including troponin, electrocardiogram (ECG), and echocardiogram. Data on medical history, pre-existing CVD, CV risk factors, and therapy were collected. Admission to the Intensive Care Unit (ICU) or Cardiac Intensive Care Unit (CICU), as well as the development of new-onset CVD, were considered as endpoint of the study. Among n = 229 patients enrolled, 22 (10%) died. Nearly half of patients (112, 49%) were admitted to the ICU/CICU. The presence of prior ischaemic heart disease nearly doubled the probability of hospitalization in the ICU/CICU (HR: 2.09, 95% CI: 1.132–3.866, P 0.018). In regards of therapy, beta blockers reduced the likelihood of admission in the ICU/CICU (HR: −1016, 95% CI: 0.192–10.682, P 0.002). However, neither the use of RAAS blockers, heparin or dexamethasone influenced the risk of ICU/CICU admission (respectively, HR: 0.85, 95% CI: 0.498–1.450, P 0.551; HR: 0.768, 95% CI: 0.435–1.356, P 0.363; HR: 0.861, 95% CI: 0.453–1.635, P 0.647). N = 89 patients (39%) experienced a new onset CVD including arrythmias (18.3%) with nearly half experiencing atrial fibrillation, acute coronary syndrome (10.9%), acute pulmonary embolism (5.3%), heart failure (HF) (3%), and myocarditis and pericarditis (1.3%). A pre-existing diagnosis of HF substantially increased the likelihood of new onset CVD (HR: 2.380, 95% CI: 1.004–5.638, P 0.049). However, treatment with heparin or dexamethasone reduced the risk of new onset CVD (HR: 0.482 95% CI: 0.268–0.867, P 0.015; HR: 0.487, 95% CI: 0.253–0.937, P 0.031, respectively).
Conclusions
Our study found that hospitalized COVID-19 patients who have at least one CV risk factor or pre-existing CVD had a greater likelihood of being admitted to the ICU/CICU and experiencing new onset CVD.
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Affiliation(s)
- Silvia Prosperi
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, ‘Policlinico Umberto I’ Hospital, Rome, Italy
| | - Lucia Ilaria Birtolo
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, ‘Policlinico Umberto I’ Hospital, Rome, Italy
| | - Mia Yarden Revivo
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, ‘Policlinico Umberto I’ Hospital, Rome, Italy
| | - Sara Monosilio
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, ‘Policlinico Umberto I’ Hospital, Rome, Italy
| | - Sara Cimino
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, ‘Policlinico Umberto I’ Hospital, Rome, Italy
| | - Domenico Filomena
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, ‘Policlinico Umberto I’ Hospital, Rome, Italy
| | - Maria Alfarano
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, ‘Policlinico Umberto I’ Hospital, Rome, Italy
| | - Giovanna Manzi
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, ‘Policlinico Umberto I’ Hospital, Rome, Italy
| | - Matteo Neccia
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, ‘Policlinico Umberto I’ Hospital, Rome, Italy
| | - Silvia Papa
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, ‘Policlinico Umberto I’ Hospital, Rome, Italy
| | - Ilaria Passarelli
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, ‘Policlinico Umberto I’ Hospital, Rome, Italy
| | - Francesca De Persis
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, ‘Policlinico Umberto I’ Hospital, Rome, Italy
| | - Alessandra De Luca
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, ‘Policlinico Umberto I’ Hospital, Rome, Italy
| | - Alessandra Tanzilli
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, ‘Policlinico Umberto I’ Hospital, Rome, Italy
| | - Gianluca Di Pietro
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, ‘Policlinico Umberto I’ Hospital, Rome, Italy
| | - Santi Francavilla
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, ‘Policlinico Umberto I’ Hospital, Rome, Italy
| | - Riccardo Improta
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, ‘Policlinico Umberto I’ Hospital, Rome, Italy
| | - Gianluca Agnes
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, ‘Policlinico Umberto I’ Hospital, Rome, Italy
| | - Serena Marcon
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, ‘Policlinico Umberto I’ Hospital, Rome, Italy
| | - Marco Valerio Mariani
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, ‘Policlinico Umberto I’ Hospital, Rome, Italy
| | - Agostino Piro
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, ‘Policlinico Umberto I’ Hospital, Rome, Italy
| | - Massimiliano Rizzo
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, ‘Policlinico Umberto I’ Hospital, Rome, Italy
| | - Edoardo Sebastian Rachele
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, ‘Policlinico Umberto I’ Hospital, Rome, Italy
| | - Martina Straito
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, ‘Policlinico Umberto I’ Hospital, Rome, Italy
| | - Marco Tocci
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, ‘Policlinico Umberto I’ Hospital, Rome, Italy
| | - Paolo Severino
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, ‘Policlinico Umberto I’ Hospital, Rome, Italy
| | - Carlo Lavalle
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, ‘Policlinico Umberto I’ Hospital, Rome, Italy
| | - Viviana Maestrini
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, ‘Policlinico Umberto I’ Hospital, Rome, Italy
| | - Massimo Mancone
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, ‘Policlinico Umberto I’ Hospital, Rome, Italy
| | - Francesco Fedele
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, ‘Policlinico Umberto I’ Hospital, Rome, Italy
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Giugni A, Gamberini L, Carrara G, Antiga L, Brissy O, Buldini V, Calamai I, Csomos A, De Luca A, Ferri E, Fleming JM, Gradisek P, Kaps R, Kyprianou T, Lagomarsino S, Lazar I, Martino C, Mikaszewska-Sokolewicz M, Montis A, Nardai G, Nattino G, Nattino G, Paci G, Portolani L, Xirouchaki N, Chieregato A, Bertolini G. Hospitals with and without neurosurgery: a comparative study evaluating the outcome of patients with traumatic brain injury. Scand J Trauma Resusc Emerg Med 2021; 29:158. [PMID: 34727955 PMCID: PMC8561979 DOI: 10.1186/s13049-021-00959-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 05/24/2021] [Accepted: 09/22/2021] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND We leveraged the data of the international CREACTIVE consortium to investigate whether the outcome of traumatic brain injury (TBI) patients admitted to intensive care units (ICU) in hospitals without on-site neurosurgical capabilities (no-NSH) would differ had the same patients been admitted to ICUs in hospitals with neurosurgical capabilities (NSH). METHODS The CREACTIVE observational study enrolled more than 8000 patients from 83 ICUs. Adult TBI patients admitted to no-NSH ICUs within 48 h of trauma were propensity-score matched 1:3 with patients admitted to NSH ICUs. The primary outcome was the 6-month extended Glasgow Outcome Scale (GOS-E), while secondary outcomes were ICU and hospital mortality. RESULTS A total of 232 patients, less than 5% of the eligible cohort, were admitted to no-NSH ICUs. Each of them was matched to 3 NSH patients, leading to a study sample of 928 TBI patients where the no-NSH and NSH groups were well-balanced with respect to all of the variables included into the propensity score. Patients admitted to no-NSH ICUs experienced significantly higher ICU and in-hospital mortality. Compared to the matched NSH ICU admissions, their 6-month GOS-E scores showed a significantly higher prevalence of upper good recovery for cases with mild TBI and low expected mortality risk at admission, along with a progressively higher incidence of poor outcomes with increased TBI severity and mortality risk. CONCLUSIONS In our study, centralization of TBI patients significantly impacted short- and long-term outcomes. For TBI patients admitted to no-NSH centers, our results suggest that the least critically ill can effectively be managed in centers without neurosurgical capabilities. Conversely, the most complex patients would benefit from being treated in high-volume, neuro-oriented ICUs.
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Affiliation(s)
- Aimone Giugni
- Anesthesia, Intensive Care and Prehospital Emergency, Maggiore Hospital, Bologna, Italy
| | - Lorenzo Gamberini
- Anesthesia, Intensive Care and Prehospital Emergency, Maggiore Hospital, Bologna, Italy
| | - Greta Carrara
- Laboratory of Clinical Epidemiology, Department of Public Health, Istituto Di Ricerche Farmacologiche Mario Negri IRCCS, Villa Camozzi, Via G.B. Camozzi 3, 24020, Ranica, Bergamo, Italy
| | | | - Obou Brissy
- Laboratory of Clinical Epidemiology, Department of Public Health, Istituto Di Ricerche Farmacologiche Mario Negri IRCCS, Villa Camozzi, Via G.B. Camozzi 3, 24020, Ranica, Bergamo, Italy
| | - Virginia Buldini
- Anesthesia, Intensive Care and Prehospital Emergency, Maggiore Hospital, Bologna, Italy
| | - Italo Calamai
- Anesthesia and Intensive Care Unit, AUSL Toscana Centro, San Giuseppe Hospital, Empoli, Florence, Italy
| | - Akos Csomos
- Hungarian Army Medical Center, Budapest, Hungary
| | - Alessandra De Luca
- Neurointensive Care Unit, Department of Anesthesia and Intensive Care Unit, AOU Careggi, Florence, Italy
| | - Enrico Ferri
- Anesthesia, Intensive Care and Prehospital Emergency, Maggiore Hospital, Bologna, Italy
| | - Joanne M Fleming
- Laboratory of Clinical Epidemiology, Department of Public Health, Istituto Di Ricerche Farmacologiche Mario Negri IRCCS, Villa Camozzi, Via G.B. Camozzi 3, 24020, Ranica, Bergamo, Italy
| | - Primoz Gradisek
- Clinical Department of Anaesthesiology and Intensive Therapy, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Rafael Kaps
- General Hospital Novo Mesto, Novo Mesto, Slovenia
| | - Theodoros Kyprianou
- University of Nicosia Medical School, Nicosia, Cyprus
- University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Silvia Lagomarsino
- Neurointensive Care Unit, Department of Anesthesia and Intensive Care Unit, AOU Careggi, Florence, Italy
| | - Isaac Lazar
- Pediatric Intensive Care Unit, Soroka Medical Center and The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Costanza Martino
- Anesthesia and Intensive Care Unit, AUSL Romagna, Maurizio Bufalini Hospital, Cesena, Italy
| | | | - Andrea Montis
- Department of Neurorehabilitation, ASSL Oristano, ATS Sardegna, Oristano, Italy
| | - Gabor Nardai
- Department of Anaesthesiology and Intensive Care, Péterfy Hospital and Trauma Centre, Budapest, Hungary
| | - Giovanni Nattino
- Laboratory of Clinical Epidemiology, Department of Public Health, Istituto Di Ricerche Farmacologiche Mario Negri IRCCS, Villa Camozzi, Via G.B. Camozzi 3, 24020, Ranica, Bergamo, Italy.
| | - Giuseppe Nattino
- Intensive Care Unit, Azienda Socio Sanitaria Territoriale di Lecco, Lecco, Italy
| | - Giulia Paci
- Laboratory of Clinical Epidemiology, Department of Public Health, Istituto Di Ricerche Farmacologiche Mario Negri IRCCS, Villa Camozzi, Via G.B. Camozzi 3, 24020, Ranica, Bergamo, Italy
| | - Laila Portolani
- Anesthesia and Intensive Care Unit, AUSL Romagna, Maurizio Bufalini Hospital, Cesena, Italy
| | | | - Arturo Chieregato
- Neurointensive Care Unit, Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Guido Bertolini
- Laboratory of Clinical Epidemiology, Department of Public Health, Istituto Di Ricerche Farmacologiche Mario Negri IRCCS, Villa Camozzi, Via G.B. Camozzi 3, 24020, Ranica, Bergamo, Italy
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5
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Monini S, Filippi C, De Luca A, Salerno G, Barbara M. On the Effect of Bimodal Rehabilitation in Asymmetric Hearing Loss. J Clin Med 2021; 10:jcm10173927. [PMID: 34501373 PMCID: PMC8432242 DOI: 10.3390/jcm10173927] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 08/18/2021] [Accepted: 08/30/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Bone conductive implants (BCI) have been reported to provide greater beneficial effects for the auditory and perceptual functions of the contralateral ear in patients presenting with asymmetric hearing loss (AHL) compared to those with single-sided deafness (SSD). The aim of the study was to assess the effects of wearing a conventional hearing aid in the contralateral ear on BCI in terms of an improved overall auditory performance. METHODS eleven AHL subjects wearing a BCI in their worse hearing ear underwent an auditory evaluation by pure tone and speech audiometry in free field. This study group was obtained by adding to the AHL patients those SSD subjects that, during the follow-up, showed deterioration of the hearing threshold of the contralateral ear, thus presenting with the features of AHL. Four different conditions were tested and compared: unaided, with BCI only, with contralateral hearing aid (CHA) only and with BCI combined with CHA. RESULTS all of the prosthetic conditions caused a significant improvement with respect to the unaided condition. When a CHA was adopted, its combination with the BCI showed significantly better auditory performances than those achieved with the BCI only. CONCLUSIONS the present study suggests the beneficial role of a CHA in BCI-implanted AHL subjects in terms of overall auditory performance.
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Affiliation(s)
- Simonetta Monini
- ENT Unit, NESMOS Department, Sapienza University, 00189 Rome, Italy; (S.M.); (C.F.); (A.D.L.)
| | - Chiara Filippi
- ENT Unit, NESMOS Department, Sapienza University, 00189 Rome, Italy; (S.M.); (C.F.); (A.D.L.)
| | - Alessandra De Luca
- ENT Unit, NESMOS Department, Sapienza University, 00189 Rome, Italy; (S.M.); (C.F.); (A.D.L.)
| | - Gerardo Salerno
- Laboratory Unit, Sant’Andrea University Hospital, 00189 Rome, Italy;
| | - Maurizio Barbara
- ENT Unit, NESMOS Department, Sapienza University, 00189 Rome, Italy; (S.M.); (C.F.); (A.D.L.)
- Correspondence: ; Tel.: +39-06-3377-5628
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De Luca A, Proietti I, Trani C, Berni A, Sergi SC, Speciale G, Tanzilli G, Tomai F, Di Giosa A, Marchegiani G, Zoccai GB, Versaci F. 342 Impact of temporary traffic bans on the risk of acute coronary syndromes in a large metropolitan area. Eur Heart J Suppl 2020; 22:N81-N82. [PMID: 38626246 PMCID: PMC7799104 DOI: 10.1093/eurheartj/suaa200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Indexed: 11/17/2022]
Abstract
Aims Strong epidemiologic evidence has highlighted the role of pollution, on top of adverse climate features, as a novel cardiovascular risk factor. However, mechanistic proof that reducing pollution may be beneficial to prevent atherothrombotic events is limited. We aimed at appraising the impact of temporary traffic bans in a large metropolitan area on the risk of acute coronary syndromes. Methods and results Aggregate and anonymized data from 15 tertiary cardiac care centers were obtained detailing pre-coronarivus disease 2019 (COVID-19) daily cases of ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI), including those treated with percutaneous coronary intervention (PCI). Data on pollutants and climate were sought for the same days. Mixed level regression was used to compare the week before vs. after the traffic ban (Fortnight analysis), the 3 days before vs. after (Weekly analysis) and the Sunday before vs. after (Sunday analysis). A total of 8 days of temporary traffic bans were included, occurring between 2017 and 2020, totaling 802 STEMI and 1196 NSTEMI in the Fortnight analysis, 382 STEMI and 585 in the Weekly analysis, and 148 STEMI and 210 NSTEMI in the Sunday analysis. Fortnight and Sunday analysis did not disclose a significant impact of traffic ban on STEMI or NSTEMI (all P > 0.05). Conversely, Weekly analysis showed non-significant changes for STEMI but a significant decrease in daily NSTEMI when comparing the 3 days before the traffic ban with the ban day (P = 0.043), as well as the 3 days before vs. the 3 days after the ban (P = 0.025). No statistically significant effect of traffic ban was found at Fortnight, Weekly or Sunday analyses for daily mean concentrations of benzene, carbon monoxide, nitric oxide, nitrogen dioxide, ozone, sulfur dioxide, particulate matter (PM) <2.5 µm or PM < 10 µm (all P > 0.05). However, minimum daily concentrations showed a significant reduction of ozone during the ban in comparison to the week preceding it (P = 0.034), nitric oxide during the ban in comparison to the 3 days preceding it (P = 0.046), and an increase in benzene during the ban in comparison to the Sunday before (P = 0.039). Conclusion Temporary traffic bans may favorably reduce coronary atherothrombotic events, and in particular NSTEMI, even if not globally and immediately impacting on environmental pollution. Further controlled studies are required to confirm and expand this hypothesis-generating results.
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Affiliation(s)
| | | | - Carlo Trani
- Fondazione Policlinico, Universitario Agostino Gemelli
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Pelliccia F, De Luca A, Pasceri V, Tanzilli G, Speciale G, Gaudio C. Safety and Outcome of Rheolytic Thrombectomy for the Treatment of Acute Massive Pulmonary Embolism. J Invasive Cardiol 2020; 32:412-416. [PMID: 33130592] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Percutaneous rheolytic thrombectomy is an attractive alternative to thrombolytic therapy in patients with acute pulmonary embolism (PE), but its use is currently discouraged due to safety concerns. METHODS We studied 33 consecutive patients (age, 43 ± 13 years; 20 men and 13 women) with acute PE and contraindications to thrombolytic therapy who had rheolytic thrombectomy with the AngioJet catheter (Boston Scientific). Acute massive PE was initially diagnosed by computed tomography and then confirmed by pulmonary angiography. Pulmonary thrombus location was evaluated prior to the procedure. Anemia was defined as a decrease in hematocrit level <39% for men and <36% for women. Renal failure was defined as oliguria (urine output <500 mL/24 hours) or an increase in creatinine (>25% over baseline or an overall increase by 1 g/dL). RESULTS Catheter thrombectomy resulted in angiographic improvement in 32 patients (96%), with a rapid amelioration in functional class (from 3.3 ± 0.9 to 2.1 ± 0.7; P<.001) and an increase in oxygen saturation (from 71 ± 15% to 92 ± 17%; P<.001). No patient died. Side effects included transient heart block (n = 1), hypotension (n = 3), and bradycardia (n = 5). Anemia occurred in 4 patients, while renal failure was not detected. Clinical improvement was maintained during follow-up. At 1 year, systolic pulmonary pressure was significantly lower than at baseline (65 ± 31 mm Hg vs 31 ± 19 mm Hg; P<.001). CONCLUSIONS Catheter thrombectomy with AngioJet in patients with acute massive PE and contraindications to thrombolysis is an effective therapeutic alternative that is not associated with relevant and persistent side effects, including the risk of death or developing anemia and renal failure.
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Affiliation(s)
- Francesco Pelliccia
- Department of Cardiovascular Sciences, Sapienza University, Viale del Policlinico 155, 00166 Rome, Italy.
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Abstract
BACKGROUND The bone conductive implants (BCI) are nowadays a reliable alternative for rehabilitation of specific forms of hearing loss, i.e. conductive, mixed or single sided deafness (SSD). Aims/Objective: To analyse the various factors in play when considering an auditory rehabilitation with a bone-conductive device (BCI). MATERIALS AND METHODS The clinical charts of subjects who underwent BCI application at the same Implanting Center from 2005 to 2018 were retrieved analysing also the reason for eventual explantation and the alternative option (transition) for hearing rehabilitation. RESULTS Nine BAHA Compact, 4 BAHA Intenso, 21 BAHA Divino, 3 BAHA BP100, 4 Ponto, 2 Sophono, 5 Bonebridge, 5 BAHA5 Attract; 11 BAHA5 Connect were used in 12 unilateral COM; 16 bilateral COM; 3 unilateral cholesteatoma; 6 bilateral cholesteatoma; 2 unilateral otosclerosis; 5 bilateral otosclerosis; 9 congenital malformations; 6 major otoneurosurgical procedures; 5 sudden deafness. Explantation was necessary for five subjects. CONCLUSIONS Middle ear pathology and sequels from surgery represent the most common reason for BCI implantation, both in unilateral and in bilateral cases. Transition from one implantable device to another one can be predictable, mostly when explantation is necessary. SIGNIFICANCE The role of BCI for rehabilitation in middle ear pathology may be extremely important.
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Affiliation(s)
| | - Edoardo Covelli
- NESMOS Department, ENT Clinic, Sapienza University, Rome, Italy
| | - Chiara Filippi
- NESMOS Department, ENT Clinic, Sapienza University, Rome, Italy
| | - Valerio Margani
- NESMOS Department, ENT Clinic, Sapienza University, Rome, Italy
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Nemery E, Gabriel A, Cassart D, Bayrou C, Piret J, Antoine N, Nilsson M, Steinwall L, Jacobson I, Martins Â, Carvalho C, Viegas I, Marcellin-Little DJ, Harrysson OLA, Crimi CS, Levine D, Calatayud M, Resano M, Mucha M, Virac I, Lang C, Wittek K, Tichy A, Bockstahler B, Randy Walker J, Swogger Ā, Gibson T, Ryan J, Gilligan C, Haulcomb K, Norris LA, Powers M, Pugh T, Purkey S, Pulkkinen H, Lappalainen A, Laitinen-Vapaavuori O, Hyytiäinen H, Essner A, Sjöström R, Zetterberg L, Hellström K, Gustås P, Högberg H, Hielm-Björkman A, Orrfors C, Sundelin G, Gonçalves L, Niza-Ribeiro J, Millis DL, de Matos AJ, Teeling M, Ross K, Geddes V, Carstens A, Kriel T, du Toit K, Pauw J, Martindale G, Mylo K, van den Berg SS, Ogasawara M, Noguchi H, Minami T, Zdeb K, Baumgart U, Ribeiro AM, Palas R, Capelão M, Speciani M, De Luca A, Anzolin E, Pirinen N, Pastell M, Mykkänen A, Jokisalo J, Niinistö K, Hänninen L, McGowan C, Holt A, Subirats M, Perez M, Hernández T, Gutierrez-Cepeda L, Cediel R, Román JLS, Boström AF, Savolainen L, Lappalainen AK, Stadig S, Lundström L, Bergh A, Ley C, Olsén L, Ingvast-Larsson C, Diniz R, Nicolau C, Gamundi A, Akaarir M, Roberts E, McLennan L, Cartildge HC, Evans LKM, Baugh S, Stenfeldt P, Ericson C, Söderberg L, Sjöström L, Colborne R, Byström A, Drum M, de Swarte M, Morandi F, Guevara J, Hickey D, Camp E, Dickson R. Proceedings of the 9th international symposium on veterinary rehabilitation and physical therapy. Acta Vet Scand 2016. [PMCID: PMC5259818 DOI: 10.1186/s13028-016-0259-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
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Cinti C, Claudio PP, Luca AD, Cuccurese M, Howard CM, D'Esposito M, Paggi MG, Sala DL, Azzoni L, Halazonetis TD, Giordano A, Maraldi NM. A serine 37 mutation associated with two missense mutations at highly conserved regions of p53 affect pro-apoptotic genes expression in a T-lymphoblastoid drug resistant cell line. Oncogene 2000; 19:5098-105. [PMID: 11042698 DOI: 10.1038/sj.onc.1203848] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [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: 01/10/2023]
Abstract
The p53 protein accumulates rapidly through post-transcriptional mechanisms following cellular exposure to DNA damaging agents and is also activated as a transcription factor leading to growth arrest or apoptosis. Phosphorylation of p53 occurs after DNA damage thereby modulating its activity and impeding the interaction of p53 with its negative regulator oncogene Mdm2. The serines 15 and 37 present in the amino terminal region of p53 are phosphorylated by the DNA-dependent protein kinase (DNA-PK) in response to DNA damage. In order to verify if specific p53 mutations occur in the multi-drug resistance phenotype, we analysed the p53 gene in two T-lymphoblastoid cell lines, CCRF-CEM and its multi-drug-resistant clone CCRF-CEM VLB100, selected for resistance to vinblastine sulfate and cross-resistant to other cytotoxic drugs. Both cell lines showed two heterozygous mutations in the DNA binding domain at codons 175 and 248. The multi-drug resistant cell line, CCRF-CEM VLB100, showed an additional mutation that involves the serine 37 whose phosphorylation is important to modulate the protein activity in response to DNA damage. The effects of these mutations on p53 transactivation capacity were evaluated. The activity of p53 on pro-apoptotic genes expression in response to DNA damage induced by (-irradiation, was affected in the vinblastine (VLB) resistant cell line but not in CCRF-CEM sensitive cell line resulting in a much reduced apoptotic cell death of the multi-drug resistant cells.
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MESH Headings
- Amino Acid Substitution
- Antibiotics, Antineoplastic/pharmacology
- Antineoplastic Agents, Phytogenic/pharmacology
- Apoptosis/genetics
- Base Sequence
- Cell Survival/radiation effects
- Conserved Sequence
- DNA, Neoplasm/genetics
- DNA, Neoplasm/metabolism
- DNA, Neoplasm/radiation effects
- Dactinomycin/pharmacology
- Doxorubicin/pharmacology
- Drug Resistance, Multiple/genetics
- Drug Resistance, Neoplasm/genetics
- Exons
- Gene Expression Regulation, Leukemic/genetics
- Genes, p53/genetics
- Humans
- Leukemia, T-Cell/genetics
- Leukemia, T-Cell/metabolism
- Leukemia, T-Cell/pathology
- Mutation, Missense
- Polymorphism, Single-Stranded Conformational
- Radiation Tolerance/genetics
- Serine/genetics
- Tumor Cells, Cultured/drug effects
- Tumor Cells, Cultured/radiation effects
- Tumor Suppressor Protein p53/genetics
- Tumor Suppressor Protein p53/metabolism
- Tumor Suppressor Protein p53/physiology
- Vinblastine/pharmacology
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Affiliation(s)
- C Cinti
- Institute of Normal and Pathologic Cytomorphology, CNR, c/o IOR, 40136 Bologna, Italy
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Favaloro B, Tamburro A, Angelucci S, Luca AD, Melino S, di Ilio C, Rotilio D. Molecular cloning, expression and site-directed mutagenesis of glutathione S-transferase from Ochrobactrum anthropi. Biochem J 1998; 335 ( Pt 3):573-9. [PMID: 9794797 PMCID: PMC1219818 DOI: 10.1042/bj3350573] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The gene coding for a novel glutathione S-transferase (GST) has been isolated from the bacterium Ochrobactrum anthropi. A PCR fragment of 230 bp was obtained using oligonucleotide primers deduced from N-terminal and 'internal' sequences of the purified enzyme. The gene was obtained by screening of a genomic DNA partial library from O. anthropi constructed in pBluescript with a PCR fragment probe. The gene encodes a protein (OaGST) of 201 amino acids with a calculated molecular mass of 21738 Da. The product of the gene was expressed and characterized; it showed GST activity with substrates 1-chloro-2, 4-dinitrobenzene (CDNB), p-nitrobenzyl chloride and 4-nitroquinoline 1-oxide, and glutathione-dependent peroxidase activity towards cumene hydroperoxide. The overexpressed product of the gene was also confirmed to have in vivo GST activity towards CDNB. The interaction of the recombinant GST with several antibiotics indicated that the enzyme is involved in the binding of rifamycin and tetracycline. The OaGST amino acid sequence showed the greatest identity (45%) with a GST from Pseudomonas sp. strain LB400. A serine residue in the N-terminal region is conserved in almost all known bacterial GSTs, and it appears to be the counterpart of the catalytic serine residue present in Theta-class GSTs. Substitution of the Ser-11 residue resulted in a mutant OaGST protein lacking CDNB-conjugating activity; moreover the mutant enzyme was not able to bind Sepharose-GSH affinity matrices.
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Affiliation(s)
- B Favaloro
- Istituto di Ricerche Farmacologiche Mario Negri, Consorzio Mario Negri Sud, 'G. Paone' Environmental Health Center, Department of Environmental Sciences, 66030 Santa Maria Imbaro, Italy.
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