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Espíndola R, Vella V, Benito N, Mur I, Tedeschi S, Zamparini E, Hendriks JGE, Sorlí L, Murillo O, Soldevila L, Scarborough M, Scarborough C, Kluytmans J, Ferrari MC, Pletz MW, McNamara I, Escudero-Sanchez R, Arvieux C, Batailler C, Dauchy FA, Liu WY, Lora-Tamayo J, Praena J, Ustianowski A, Cinconze E, Pellegrini M, Bagnoli F, Rodríguez-Baño J, Del-Toro-López MD. Incidence, associated disease burden and healthcare utilization due to Staphylococcus aureus prosthetic joint infection in European hospitals: the COMBACTE-NET ARTHR-IS multi-centre study. J Hosp Infect 2023; 142:9-17. [PMID: 37797656 DOI: 10.1016/j.jhin.2023.09.012] [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: 07/14/2023] [Revised: 09/14/2023] [Accepted: 09/17/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND The aim of this study was to estimate the incidence, associated disease burden and healthcare utilization due to Staphylococcus aureus prosthetic joint infections (SA-PJI) after primary hip and knee arthroplasty in European centres. METHODS This study was conducted in patients who underwent primary hip and knee arthroplasty in 19 European hospitals between 2014 and 2016. The global incidence of PJI and SA-PJI was calculated. The associated disease burden was measured indirectly as infection-related mortality plus loss of function. For healthcare utilization, number and duration of hospitalizations, number and type of surgical procedures, duration of antibiotic treatments, and number of outpatient visits were collected. Subgroup and regression analyses were used to evaluate the impact of SA-PJI on healthcare utilization, controlling for confounding variables. RESULTS The incidence of PJI caused by any micro-organism was 1.41%, and 0.40% for SA-PJI. Among SA-PJI, 20.7% were due to MRSA with substantial regional differences, and were more frequent in partial hip arthroplasty (PHA). Related deaths and loss of function occurred in 7.0% and 10.2% of SA-PJI cases, respectively, and were higher in patients with PHA. Compared with patients without PJI, patients with SA-PJI had a mean of 1.4 more readmissions, 25.1 more days of hospitalization, underwent 1.8 more surgical procedures, and had 5.4 more outpatient visits, controlling for confounding variables. Healthcare utilization was higher in patients who failed surgical treatment of SA-PJI. CONCLUSIONS This study confirmed that the SA-PJI burden is high, especially in PHA, and provided a solid basis for planning interventions to prevent SA-PJI.
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Affiliation(s)
- R Espíndola
- Infectious Diseases and Microbiology Clinical Unit, Hospital Universitario Virgen Macarena, Seville, Spain; Biomedicine Institute of Sevilla (IBiS)/CSIC, Seville, Spain
| | - V Vella
- GlaxoSmithKline (GSK), Siena, Italy
| | - N Benito
- Infectious Diseases Unit, Hospital de la Santa Creu i Sant Pau/Sant Pau Institute for Biomedical Research, Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain; University of Queensland, UQ Centre for Clinical Research, Brisbane, Australia
| | - I Mur
- Infectious Diseases Unit, Hospital de la Santa Creu i Sant Pau/Sant Pau Institute for Biomedical Research, Barcelona, Spain
| | - S Tedeschi
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy; Infectious Diseases Unit, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
| | - E Zamparini
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - J G E Hendriks
- Department of Orthopaedic Surgery & Trauma, Máxima MC, Eindhoven, The Netherlands
| | - L Sorlí
- Department of Infectious Diseases, Hospital del Mar, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain
| | - O Murillo
- Department of Infectious Diseases, Hospital Universitari Bellvitge, IDIBELL, Barcelona, Spain
| | - L Soldevila
- Department of Infectious Diseases, Hospital Universitari Bellvitge, IDIBELL, Barcelona, Spain
| | - M Scarborough
- Bone Infection Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - C Scarborough
- Bone Infection Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - J Kluytmans
- Department of Infection Control, Amphia Hospital, Breda, The Netherlands; Department of Medical Microbiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - M C Ferrari
- Prosthetic-Joint Replacement Unit, Humanitas Research Hospital, Milano, Italy
| | - M W Pletz
- Center for Infectious Diseases and Infection Control, Jena University Hospital, Jena, Germany
| | - I McNamara
- Department of Orthopaedics, Norfolk and Norwich University Hospital, Norwich, UK
| | - R Escudero-Sanchez
- Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain; Department of Infectious Diseases, Instituto Ramón y Cajal de Investigación Sanitaria, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - C Arvieux
- Department of Infectious Diseases, Centre Hospitalier Universitaire de Rennes, Rennes, France
| | - C Batailler
- Orthopedic Surgery Department, Croix Rousse Hospital, Lyon, France
| | - F-A Dauchy
- Department of Infectious and Tropical Diseases, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - W-Y Liu
- Department of Orthopaedic Surgery & Trauma, Máxima MC, Eindhoven, The Netherlands; Department of Orthopaedic Surgery & Trauma, Catharina Hospital, Eindhoven, The Netherlands
| | - J Lora-Tamayo
- Department of Internal Medicine (CIBERINFEC-CIBER de Enfermedades Infecciosas), Hospital Universitario 12 de Octubre, Madrid, Spain
| | - J Praena
- Clinical Unit of Infectious Diseases and Microbiology, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - A Ustianowski
- Infectious Diseases Unit, North Manchester General Hospital, Manchester, UK
| | | | | | | | - J Rodríguez-Baño
- Infectious Diseases and Microbiology Clinical Unit, Hospital Universitario Virgen Macarena, Seville, Spain; Biomedicine Institute of Sevilla (IBiS)/CSIC, Seville, Spain; Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain; Department of Medicine, University of Sevilla, Spain
| | - M-D Del-Toro-López
- Infectious Diseases and Microbiology Clinical Unit, Hospital Universitario Virgen Macarena, Seville, Spain; Biomedicine Institute of Sevilla (IBiS)/CSIC, Seville, Spain; Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain; Department of Medicine, University of Sevilla, Spain.
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Cassanello G, Serpenti F, Bagnoli F, Saporiti G, Goldaniga M, Cavallaro F, Barbullushi K, Bellani V, Galassi G, Onida F. Treosulfan, thiotepa and fludarabine conditioning regimen prior to first allogeneic stem cell transplantation in acute myeloid leukemia and high-risk myelodysplastic syndromes: a single center experience. Bone Marrow Transplant 2023; 58:1059-1061. [PMID: 37355712 DOI: 10.1038/s41409-023-02023-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 05/30/2023] [Accepted: 06/15/2023] [Indexed: 06/26/2023]
Affiliation(s)
- G Cassanello
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.
| | - F Serpenti
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - F Bagnoli
- IRCCS Humanitas Research Hospital - Humanitas Cancer Center, Milan, Italy
| | - G Saporiti
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - M Goldaniga
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - F Cavallaro
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - K Barbullushi
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - V Bellani
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - G Galassi
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - F Onida
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Bastos MCS, de Almeida AP, Bagnoli F, de Oliveira VM. Early breast cancer: concept and therapeutic review. Rev Assoc Med Bras (1992) 2023; 69:e2023S114. [PMID: 37556633 PMCID: PMC10411694 DOI: 10.1590/1806-9282.2023s114] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 03/23/2023] [Indexed: 08/11/2023]
Abstract
OBJECTIVE Breast cancer treatment has evolved significantly over the years, both in terms of local and systemic approaches. Halsted's radical mastectomy gave way to modified mastectomies and to conservative surgeries, along with breast reconstruction and repair. Although the use of new drugs has directly increased the survival of patients submitted to adjuvant or neoadjuvant systemic therapies, the de-escalation of drugs may also be beneficial in numerous cases. Therefore, breast cancer treatment must be increasingly customized and assessed using a multidisciplinary approach. This study aimed to review the concept and therapy of early breast cancer. METHODS A narrative review of the literature was carried out in the PubMed database in December 2022, where the keywords for the searches were as follows: early breast cancer, surgical treatment of breast cancer, systemic treatment of breast cancer, neoadjuvant chemotherapy in breast cancer, adjuvant treatment of luminal breast cancer, early triple negative tumor, and early positive Her-2 tumor. Articles that were historically important in the treatment of breast cancer and articles that impacted management with scientific relevance were selected for this review. DISCUSSION As new evidence continues to update existing knowledge, breast cancer treatment is becoming increasingly personalized and must now take into account the different tumor variants and their clinical stages, the age of patients and relevant comorbidities, as well as personal expectations and desires. CONCLUSION This literature review of current studies shows that the primary therapy for patients with early breast cancer continues to be surgery, although a customized and multidisciplinary approach is now required.
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Affiliation(s)
| | | | - Fábio Bagnoli
- Santa Casa de Misericórdia de São Paulo – São Paulo (SP), Brazil
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Businaro Fernandes João T, de Oliveira VM, Bagnoli F, Bastos MCS, Rinaldi JF, Brenelli FP, Mateus EF. How well are Brazilian mastologists (breast surgeons) trained in breast reconstruction and oncoplastic surgery? A study of the impact of a breast reconstruction and oncoplastic surgery improvement course. Front Oncol 2023; 13:1139461. [PMID: 37287926 PMCID: PMC10242663 DOI: 10.3389/fonc.2023.1139461] [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] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 04/24/2023] [Indexed: 06/09/2023] Open
Abstract
Introduction The breasts are a female symbol, impacts self-image and self-esteem. Breast reconstructive and oncoplastic surgeries have an important role in minimizing injuries. In Brazil less than a third of public health system (SUS) users have access to immediate reconstructive surgery. The low rate of breast reconstructions has multiple causes and the deficiency in availability and surgeons' technical qualification play a role. In 2010, the Breast Reconstruction and Oncoplastic Surgery Improvement Course was created by professors of the Mastology Department of Santa Casa de São Paulo and State University of Campinas (UNICAMP). The objectives of this study were to evaluate the impact of the techniques learned on patients' management by the surgeons enrolled in the Course, as well as to characterize their profile. Methods All students enrolled in the Improvement Course between 2010 and 2018 were invited to answer an online questionnaire. Students who did not agree to answer the questionnaire or answered them incompletely were excluded. Results Total students included: 59. The mean age: 48.9 years, male (72%) with more than 5 years of Mastology practice (82.2%), from all regions of Brazil, 1.7% from the North, 33.9% from the Northeast, 44.1% from the Southeast, and 12% from the South. Most of the students considered they had little or no knowledge of breast reconstruction (74.6%) and 91,5% did not consider they had enough aptitude to perform breast reconstructions after finishing residency. After the Course, 96.6% considered themselves apt to perform such surgeries. Over 90% of the students considered the Course had impacted their practice and changed their surgical strategy view. Before the Course, 84.8% of the students stated that less than half of their patients who were operated on for breast cancer had breast reconstruction, compared to 30.5% after the Course. Conclusion The Breast Reconstruction and Oncoplastic Surgery Improvement Course studied here positively impacted the mastologists' management of patients. New training centers worldwide can help a lot of women with breast cancer.
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Affiliation(s)
- Thais Businaro Fernandes João
- Irmandade da Santa Casa de Misericórdia de São Paulo (ISCMSP); Faculty of Medical Sciences of Santa Casa de São Paulo (FCMSCSP), São Paulo, Brazil
| | - Vilmar Marques de Oliveira
- Irmandade da Santa Casa de Misericórdia de São Paulo (ISCMSP); Faculty of Medical Sciences of Santa Casa de São Paulo (FCMSCSP), São Paulo, Brazil
| | - Fábio Bagnoli
- Irmandade da Santa Casa de Misericórdia de São Paulo (ISCMSP); Faculty of Medical Sciences of Santa Casa de São Paulo (FCMSCSP), São Paulo, Brazil
| | - Maria Carolina Soliani Bastos
- Irmandade da Santa Casa de Misericórdia de São Paulo (ISCMSP); Faculty of Medical Sciences of Santa Casa de São Paulo (FCMSCSP), São Paulo, Brazil
| | - José Francisco Rinaldi
- Irmandade da Santa Casa de Misericórdia de São Paulo (ISCMSP); Faculty of Medical Sciences of Santa Casa de São Paulo (FCMSCSP), São Paulo, Brazil
| | - Fabrício Palermo Brenelli
- State University of Campinas (UNICAMP), Campinas, Brazil
- Beneficiência Portuguesa de São Paulo, São Paulo, Brazil
| | - Evandro Fallaci Mateus
- Irmandade da Santa Casa de Misericórdia de São Paulo (ISCMSP); Faculty of Medical Sciences of Santa Casa de São Paulo (FCMSCSP), São Paulo, Brazil
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Soliani Bastos MC, Bagnoli F, Rinaldi JF, João TBF, de Oliveira VM. Dermoglandular advancement-rotation flap for conservative treatment of breast cancer - description of technique, objective and subjective assessments. Front Oncol 2023; 13:1137924. [PMID: 37207164 PMCID: PMC10189110 DOI: 10.3389/fonc.2023.1137924] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 04/17/2023] [Indexed: 05/21/2023] Open
Abstract
Objective to describe and evaluate the dermoglandular advancement-rotation flap with no contralateral surgery as a technique for the conservative treatment of breast cancer when skin or a large proportion of gland requires resection. Patients/Methods 14 patients with breast tumors with a mean size of 4.2 cm and need for skin resection. The resection area is included within an isosceles triangle, with its apex located on the areola, which is the pivot for rotation of a dermoglandular flap released through a lateral extension along that triangle base. Symmetry before and after radiotherapy was objectively assessed by authors using the BCCT.core software, as well as subjectively by three experts and patients themselves using the Harvard scale. Results Experts considered the breast symmetry results to be excellent/good for 85.7% of patients in the early post-operative period and 78.6% in the late post-operative period. Excellent/good ratings provided by BCCT.core software amounted to 78.6% of cases in the early post-operative period and 92.9% in the late post-operative period. Symmetry was rated as excellent/good by 100% of patients. Conclusion Dermoglandular advancement-rotation flap technique with no contralateral surgery provides good symmetry when a large proportion of skin or gland requires resection on breast conservative cancer treatment.
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Freitas-Junior R, de Oliveira VM, Frasson AL, Cavalcante FP, Mansani FP, Mattar A, Zerwes FP, de Oliveira Freitas AM, de Souza ABA, Damin AP, dos Santos AMR, Ruiz CA, de Lucena CÊM, Millen EC, Bagnoli F, Andrade F, Rodrigues FLB, Facina G, Novita G, Pedrini JL, Guará JP, Soares LR, de Nigro Corpa MV, Passos M, de Lucena Ferreira NCF, Freitas NMA, Machado RHS, da Cunha Amaral RK, Reinert T, Budel VM. Management of early-stage triple-negative breast cancer: recommendations of a panel of experts from the Brazilian Society of Mastology. BMC Cancer 2022; 22:1201. [PMID: 36419031 PMCID: PMC9682792 DOI: 10.1186/s12885-022-10250-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 10/31/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Triple-negative breast cancer (TNBC) is a heterogenous subtype involving different patterns of behavior and clinical course, demanding a complex, individualized sequence of treatment. The knowledge and attitudes of the affiliated members of the Brazilian Society of Mastology regarding TNBC were evaluated and a consensus regarding management and treatment was reached. METHODS Affiliates completed a survey involving 44 objective questions. In addition, a specialist meeting was held with 27 experts and 3 ad hoc consultants. The panelists completed the survey before and after brainstorming. Answers achieving 70% of agreement were considered consensual. The chi-square test was used to compare answers between panelists and affiliates and the Kappa coefficient to calculate agreement. RESULTS Consensus among the panelists increased from 26 (59.1%) to 32 questions (72.7%) following brainstorming (p = 0.17), including 7/10 questions on systemic treatment. Among the affiliates, consensus was achieved for 24 questions (54.5%), resulting in moderate agreement (κ = 0.445). Neoadjuvant chemotherapy should be indicated for almost all cases (except cT1a-b N0) and should include platinum agents. When indicated, immunotherapy is part of the standard of care. The panel reaffirmed the concept of no ink on tumor as indicative of adequate margins and the possibility of sentinel lymph node biopsy for cN1 patients who become cN0 following neoadjuvant therapy. Controversies remain on combining immunotherapy with capecitabine/olaparib in pertinent cases. CONCLUSION Expert consensus was achieved for > 70% of the questions, with moderate agreement between panelists and affiliates. Educational interventions on systemic breast cancer treatment affected decision-making in 60% of the questions.
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Affiliation(s)
- Ruffo Freitas-Junior
- grid.411195.90000 0001 2192 5801Advanced Center for Breast Diagnosis (CORA), Federal University of Goiás and the Araújo Jorge Hospital, Goiás Association for the Combat of Cancer, 1ª Avenida, s/n, Setor Universitário, Goiânia, GO 74605-050 Brazil
| | - Vilmar Marques de Oliveira
- grid.419432.90000 0000 8872 5006School of Medical Sciences, Santa Casa de Misericórdia de São Paulo, São Paulo, SP Brazil
| | - Antonio Luiz Frasson
- grid.413562.70000 0001 0385 1941Pontifical Catholic University of Rio Grande do Sul, Porto Alegre (RS), Brazil and the Hospital Israelita Albert Einstein, São Paulo, SP Brazil
| | | | - Fabio Postiglione Mansani
- grid.412323.50000 0001 2218 3838Department of Medicine, State University of Ponta Grossa, Ponta Grossa, PR Brazil
| | - André Mattar
- grid.459930.2Reference Center in Women’s Health Care, Pérola Byington Hospital, São Paulo, SP Brazil
| | - Felipe Pereira Zerwes
- grid.412519.a0000 0001 2166 9094Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS Brazil
| | | | | | - Andrea P. Damin
- grid.8532.c0000 0001 2200 7498Federal University of Rio Grande do Sul, Porto Alegre, RS Brazil
| | | | - Carlos Alberto Ruiz
- grid.11899.380000 0004 1937 0722Teaching Hospital, School of Medicine, University of São Paulo, São Paulo, SP Brazil
| | | | | | - Fábio Bagnoli
- grid.419432.90000 0000 8872 5006School of Medical Sciences, Santa Casa de Misericórdia de São Paulo and the Hospital Israelita Albert Einstein, São Paulo, SP Brazil
| | - Felipe Andrade
- grid.413471.40000 0000 9080 8521Department of Breast Surgery, Hospital Sírio-Libanês, São Paulo, SP Brazil
| | | | - Gil Facina
- grid.411249.b0000 0001 0514 7202Department of Gynecology, Federal University of São Paulo, São Paulo, SP Brazil
| | - Guilherme Novita
- grid.413562.70000 0001 0385 1941Hospital Israelita Albert Einstein, São Paulo, SP Brazil
| | | | - José Pereira Guará
- grid.411204.20000 0001 2165 7632Teaching Hospital of the Federal University of Maranhão, São Luís, MA Brazil
| | - Leonardo Ribeiro Soares
- grid.411195.90000 0001 2192 5801Advanced Center for Breast Diagnosis (CORA), Federal University of Goiás and the Dona Iris Women’s and Maternity Hospital, Goiânia, GO Brazil
| | | | - Mauro Passos
- grid.414433.5Hospital de Base, Federal District, Brasília, DF Brazil
| | | | - Nilceana Maya Aires Freitas
- Radiotherapy Unit, Araújo Jorge Cancer Hospital, Goiás Association for the Combat of Cancer, and Brazilian Center for Radiotherapy, Oncology and Mastology (CEBROM), Goiânia, GO Brazil
| | | | | | - Tomás Reinert
- Oncoclínicas Porto Alegre, Porto Alegre (RS) and the Serra Gaúcha Research Center, Caxias do Sul, RS Brazil
| | - Vinicius Milani Budel
- grid.20736.300000 0001 1941 472XTeaching Hospital of the Federal University of Paraná, Curitiba, PR Brazil
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Postolache D, Oddou-Muratorio S, Vajana E, Bagnoli F, Guichoux E, Hampe A, Le Provost G, Lesur I, Popescu F, Scotti I, Piotti A, Vendramin GG. Genetic signatures of divergent selection in European beech (Fagus sylvatica L.) are associated with the variation in temperature and precipitation across its distribution range. Mol Ecol 2021; 30:5029-5047. [PMID: 34383353 DOI: 10.1111/mec.16115] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 07/28/2021] [Accepted: 07/29/2021] [Indexed: 11/29/2022]
Abstract
High genetic variation and extensive gene flow may help forest trees with adapting to ongoing climate change, yet the genetic bases underlying their adaptive potential remain largely unknown. We investigated range-wide patterns of potentially adaptive genetic variation in 64 populations of European beech (Fagus sylvatica L.) using 270 SNPs from 139 candidate genes involved either in phenology or in stress responses. We inferred neutral genetic structure and processes (drift and gene flow) and performed differentiation outlier analyses and gene-environment association (GEA) analyses to detect signatures of divergent selection. Beech range-wide genetic structure was consistent with the species' previously identified postglacial expansion scenario and recolonization routes. Populations showed high diversity and low differentiation along the major expansion routes. A total of 52 loci were found to be putatively under selection and 15 of them turned up in multiple GEA analyses. Temperature and precipitation related variables were equally represented in significant genotype-climate associations. Signatures of divergent selection were detected in the same proportion for stress response and phenology-related genes. The range-wide adaptive genetic structure of beech appears highly integrated, suggesting a balanced contribution of phenology and stress-related genes to local adaptation, and of temperature and precipitation regimes to genetic clines. Our results imply a best-case scenario for the maintenance of high genetic diversity during range shifts in beech (and putatively other forest trees) with a combination of gene flow maintaining within-population neutral diversity and selection maintaining between-population adaptive differentiation.
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Affiliation(s)
- D Postolache
- National Institute for Research and Development in Forestry "Marin Drăcea", Romania
| | - S Oddou-Muratorio
- INRAE, URFM, Avignon, France.,ECOBIOP Université de Pau et des Pays de l'Adour, INRAE, ECOBIOP, E2S UPPA, Saint-Pée-sur-Nivelle, France
| | - E Vajana
- Laboratory of Geographic Information Systems (LASIG), School of Architecture, Civil and Environmental Engineering (ENAC), École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - F Bagnoli
- Institute of Biosciences and Bioresources, National Research Council, Sesto Fiorentino (Firenze), Italy
| | - E Guichoux
- Université de Bordeaux, INRAE, BIOGECO, Cestas, France
| | - A Hampe
- Université de Bordeaux, INRAE, BIOGECO, Cestas, France
| | - G Le Provost
- Université de Bordeaux, INRAE, BIOGECO, Cestas, France
| | - I Lesur
- Université de Bordeaux, INRAE, BIOGECO, Cestas, France.,HelixVenture, Mérignac, France
| | - F Popescu
- National Institute for Research and Development in Forestry "Marin Drăcea", Romania
| | | | - A Piotti
- Institute of Biosciences and Bioresources, National Research Council, Sesto Fiorentino (Firenze), Italy
| | - G G Vendramin
- Institute of Biosciences and Bioresources, National Research Council, Sesto Fiorentino (Firenze), Italy
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Resende Paulinelli R, Oliveira VM, Bagnoli F, Letzkus Berríos J, Cézar Chade M, Bragatto Picoli L, Dias Santos T, Bastos de Carvalho AP, Jubé Ribeiro LF, Freitas‐Junior R. Oncoplastic mammaplasty with geometric compensation: Evolution of the technique, outcomes and follow‐up in a multicentre retrospective cohort. J Surg Oncol 2020; 121:967-974. [DOI: 10.1002/jso.25860] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Accepted: 01/20/2020] [Indexed: 11/09/2022]
Affiliation(s)
- Régis Resende Paulinelli
- Breast Program, Department of Gynaecology and ObstetricsFederal University of GoiásGoiânia Goiás Brazil
- Gynaecology and Breast UnitAraújo Jorge Hospital, ACCGGoiânia Goiás Brazil
| | | | - Fábio Bagnoli
- School of Medical SciencesSanta Casa de Misericórdia de São PauloSão Paulo SP Brazil
| | - Jaime Letzkus Berríos
- Breast Surgical Unit at San Borja ArriaránClinical HospitalSantiago Chile
- Medical SchoolUniversity of ChileSantiago Chile
| | - Milca Cézar Chade
- School of Medical SciencesSanta Casa de Misericórdia de São PauloSão Paulo SP Brazil
| | | | | | | | | | - Ruffo Freitas‐Junior
- Breast Program, Department of Gynaecology and ObstetricsFederal University of GoiásGoiânia Goiás Brazil
- Gynaecology and Breast UnitAraújo Jorge Hospital, ACCGGoiânia Goiás Brazil
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Resende Paulinelli R, Oliveira VM, Bagnoli F, Letzkus Berríos J, Cézar Chade M, Bragatto Picoli L, Dias Santos T, Bastos de Carvalho AP, Jubé Ribeiro LF, Freitas‐Junior R. Back Cover Image, Volume 121, Number 6, May 1, 2020. J Surg Oncol 2020. [DOI: 10.1002/jso.25935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Régis Resende Paulinelli
- Breast Program, Department of Gynaecology and ObstetricsFederal University of GoiásGoiânia Goiás Brazil
- Gynaecology and Breast UnitAraújo Jorge Hospital, ACCGGoiânia Goiás Brazil
| | | | - Fábio Bagnoli
- School of Medical SciencesSanta Casa de Misericórdia de São PauloSão Paulo SP Brazil
| | - Jaime Letzkus Berríos
- Breast Surgical Unit at San Borja ArriaránClinical HospitalSantiago Chile
- Medical SchoolUniversity of ChileSantiago Chile
| | - Milca Cézar Chade
- School of Medical SciencesSanta Casa de Misericórdia de São PauloSão Paulo SP Brazil
| | | | | | | | | | - Ruffo Freitas‐Junior
- Breast Program, Department of Gynaecology and ObstetricsFederal University of GoiásGoiânia Goiás Brazil
- Gynaecology and Breast UnitAraújo Jorge Hospital, ACCGGoiânia Goiás Brazil
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10
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Bonometti A, Sacco G, De Juli E, Invernizzi R, Venegoni L, Bagnoli F, Moltrasio C, Passoni E, Bellistri F, Bianchi P, Alaibac M, Paulli M, Berti E. Multisystem non‐arthropathic reticulohistiocytosis: problems and pitfalls in the differential diagnosis of multisystem non‐Langerhans‐cell histiocytoses. J Eur Acad Dermatol Venereol 2019; 33:e195-e198. [DOI: 10.1111/jdv.15461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- A. Bonometti
- Unit of Anatomic Pathology Department of Molecular Medicine IRCCS San Matteo Foundation University of Pavia Via Forlanini 14 27100 Pavia Italy
| | - G. Sacco
- Unit of Dermatology University of Padua Via Gallucci, 4 35121 Padua Italy
| | - E. De Juli
- Division of Pneumology ASST Grande Ospedale Metropolitano Niguarda Piazza Ospedale Maggiore, 3 20162 Milan Italy
| | - R. Invernizzi
- Department of Internal Medicine IRCCS Policlinico San Matteo Foundation University of Pavia Viale Golgi 16 27100 Pavia Italy
| | - L. Venegoni
- Department of Pathophysiology and Transplantation Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico Via Pace, 9 20122 Milan Italy
| | - F. Bagnoli
- Department of Oncology and Hematology University of Milan Via Festa del Perdono, 7 20122 Milan Italy
| | - C. Moltrasio
- Unit of Dermatology IRCCS Ca’ Granda ‐ Maggiore Policlinico Hospital Foundation Milan University of Milan Via Pace, 9 20122 Milan Italy
| | - E. Passoni
- Unit of Dermatology IRCCS Ca’ Granda ‐ Maggiore Policlinico Hospital Foundation Milan University of Milan Via Pace, 9 20122 Milan Italy
| | - F. Bellistri
- Department of Internal Medicine IRCCS Policlinico San Matteo Foundation University of Pavia Viale Golgi 16 27100 Pavia Italy
| | - P. Bianchi
- Department of Oncohematology Anemia Pathophysiology Section Fondazione IRCCS Ca’ Granda Ospedale Maggiore di Milano Via Mangiagalli 32 Milan Italy
| | - M. Alaibac
- Unit of Dermatology University of Padua Via Gallucci, 4 35121 Padua Italy
| | - M. Paulli
- Unit of Anatomic Pathology Department of Molecular Medicine IRCCS San Matteo Foundation University of Pavia Via Forlanini 14 27100 Pavia Italy
| | - E. Berti
- Department of Pathophysiology and Transplantation Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico Via Pace, 9 20122 Milan Italy
- Department of Oncology and Hematology University of Milan Via Festa del Perdono, 7 20122 Milan Italy
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11
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Brondi R, Bagnoli F, Coelho F, Rinaldi J, Oliveira V. Does oncoplastic breast surgery cause a delay in the onset of adjuvant treatment? Breast 2019. [DOI: 10.1016/s0960-9776(19)30387-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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12
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Nocadello S, Minasov G, Shuvalova L, Dubrovska I, Sabini E, Bagnoli F, Grandi G, Anderson WF. Crystal structures of the components of the Staphylococcus aureus leukotoxin ED. Acta Crystallogr D Struct Biol 2016; 72:113-20. [PMID: 26894539 PMCID: PMC4756620 DOI: 10.1107/s2059798315023207] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [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: 08/20/2015] [Accepted: 12/02/2015] [Indexed: 12/31/2022] Open
Abstract
Staphylococcal leukotoxins are a family of β-barrel, bicomponent, pore-forming toxins with membrane-damaging functions. These bacterial exotoxins share sequence and structural homology and target several host-cell types. Leukotoxin ED (LukED) is one of these bicomponent pore-forming toxins that Staphylococcus aureus produces in order to suppress the ability of the host to contain the infection. The recent delineation of the important role that LukED plays in S. aureus pathogenesis and the identification of its protein receptors, combined with its presence in S. aureus methicillin-resistant epidemic strains, establish this leukocidin as a possible target for the development of novel therapeutics. Here, the crystal structures of the water-soluble LukE and LukD components of LukED have been determined. The two structures illustrate the tertiary-structural variability with respect to the other leukotoxins while retaining the conservation of the residues involved in the interaction of the protomers in the bipartite leukotoxin in the pore complex.
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Affiliation(s)
- S. Nocadello
- Center for Structural Genomics of Infectious Diseases, Department of Biochemistry and Molecular Genetics, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - G. Minasov
- Center for Structural Genomics of Infectious Diseases, Department of Biochemistry and Molecular Genetics, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - L. Shuvalova
- Center for Structural Genomics of Infectious Diseases, Department of Biochemistry and Molecular Genetics, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - I. Dubrovska
- Center for Structural Genomics of Infectious Diseases, Department of Biochemistry and Molecular Genetics, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - E. Sabini
- Center for Structural Genomics of Infectious Diseases, Department of Biochemistry and Molecular Genetics, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - F. Bagnoli
- Novartis Vaccines and Diagnostics, Research Centre, Siena, Italy
| | - G. Grandi
- Novartis Vaccines and Diagnostics, Research Centre, Siena, Italy
| | - W. F. Anderson
- Center for Structural Genomics of Infectious Diseases, Department of Biochemistry and Molecular Genetics, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
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13
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Plomion C, Bartholomé J, Lesur I, Boury C, Rodríguez-Quilón I, Lagraulet H, Ehrenmann F, Bouffier L, Gion JM, Grivet D, de Miguel M, de María N, Cervera MT, Bagnoli F, Isik F, Vendramin GG, González-Martínez SC. High-density SNP assay development for genetic analysis in maritime pine (Pinus pinaster). Mol Ecol Resour 2015; 16:574-87. [PMID: 26358548 DOI: 10.1111/1755-0998.12464] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [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: 02/26/2015] [Revised: 08/28/2015] [Accepted: 09/03/2015] [Indexed: 12/18/2022]
Abstract
Maritime pine provides essential ecosystem services in the south-western Mediterranean basin, where it covers around 4 million ha. Its scattered distribution over a range of environmental conditions makes it an ideal forest tree species for studies of local adaptation and evolutionary responses to climatic change. Highly multiplexed single nucleotide polymorphism (SNP) genotyping arrays are increasingly used to study genetic variation in living organisms and for practical applications in plant and animal breeding and genetic resource conservation. We developed a 9k Illumina Infinium SNP array and genotyped maritime pine trees from (i) a three-generation inbred (F2) pedigree, (ii) the French breeding population and (iii) natural populations from Portugal and the French Atlantic coast. A large proportion of the exploitable SNPs (2052/8410, i.e. 24.4%) segregated in the mapping population and could be mapped, providing the densest ever gene-based linkage map for this species. Based on 5016 SNPs, natural and breeding populations from the French gene pool exhibited similar level of genetic diversity. Population genetics and structure analyses based on 3981 SNP markers common to the Portuguese and French gene pools revealed high levels of differentiation, leading to the identification of a set of highly differentiated SNPs that could be used for seed provenance certification. Finally, we discuss how the validated SNPs could facilitate the identification of ecologically and economically relevant genes in this species, improving our understanding of the demography and selective forces shaping its natural genetic diversity, and providing support for new breeding strategies.
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Affiliation(s)
- C Plomion
- BIOGECO, UMR 1202, INRA, F-33610, Cestas, France.,BIOGECO, UMR 1202, University of Bordeaux, F-33400, Talence, France
| | - J Bartholomé
- BIOGECO, UMR 1202, INRA, F-33610, Cestas, France.,BIOGECO, UMR 1202, University of Bordeaux, F-33400, Talence, France
| | - I Lesur
- BIOGECO, UMR 1202, INRA, F-33610, Cestas, France.,HelixVenture, F-33700, Mérignac, France
| | - C Boury
- BIOGECO, UMR 1202, INRA, F-33610, Cestas, France.,BIOGECO, UMR 1202, University of Bordeaux, F-33400, Talence, France
| | | | - H Lagraulet
- BIOGECO, UMR 1202, INRA, F-33610, Cestas, France.,BIOGECO, UMR 1202, University of Bordeaux, F-33400, Talence, France
| | - F Ehrenmann
- BIOGECO, UMR 1202, INRA, F-33610, Cestas, France.,BIOGECO, UMR 1202, University of Bordeaux, F-33400, Talence, France
| | - L Bouffier
- BIOGECO, UMR 1202, INRA, F-33610, Cestas, France.,BIOGECO, UMR 1202, University of Bordeaux, F-33400, Talence, France
| | - J M Gion
- BIOGECO, UMR 1202, INRA, F-33610, Cestas, France.,UMR AGAP, CIRAD, F-33612, Cestas, France
| | - D Grivet
- Forest Research Centre, INIA, E-28040, Madrid, Spain
| | - M de Miguel
- BIOGECO, UMR 1202, INRA, F-33610, Cestas, France.,BIOGECO, UMR 1202, University of Bordeaux, F-33400, Talence, France
| | - N de María
- Forest Research Centre, INIA, E-28040, Madrid, Spain
| | - M T Cervera
- Forest Research Centre, INIA, E-28040, Madrid, Spain
| | - F Bagnoli
- Institute of Biosciences and Bioresources, National Research Council, Sesto Fiorentino (FI), Italy
| | - F Isik
- Department of Forestry and Environmental Resources, North Carolina State University, Raleigh, NC, USA
| | - G G Vendramin
- Institute of Biosciences and Bioresources, National Research Council, Sesto Fiorentino (FI), Italy
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14
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Pinosio S, González-Martínez SC, Bagnoli F, Cattonaro F, Grivet D, Marroni F, Lorenzo Z, Pausas JG, Verdú M, Vendramin GG. First insights into the transcriptome and development of new genomic tools of a widespread circum-Mediterranean tree species, Pinus halepensis Mill. Mol Ecol Resour 2014; 14:846-56. [PMID: 24450970 DOI: 10.1111/1755-0998.12232] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [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: 11/12/2013] [Revised: 01/15/2014] [Accepted: 01/17/2014] [Indexed: 11/30/2022]
Abstract
Aleppo pine (Pinus halepensis Mill.) is a relevant conifer species for studying adaptive responses to drought and fire regimes in the Mediterranean region. In this study, we performed Illumina next-generation sequencing of two phenotypically divergent Aleppo pine accessions with the aims of (i) characterizing the transcriptome through Illumina RNA-Seq on trees phenotypically divergent for adaptive traits linked to fire adaptation and drought, (ii) performing a functional annotation of the assembled transcriptome, (iii) identifying genes with accelerated evolutionary rates, (iv) studying the expression levels of the annotated genes and (v) developing gene-based markers for population genomic and association genetic studies. The assembled transcriptome consisted of 48,629 contigs and covered about 54.6 Mbp. The comparison of Aleppo pine transcripts to Picea sitchensis protein-coding sequences resulted in the detection of 34,014 SNPs across species, with a Ka /Ks average value of 0.216, suggesting that the majority of the assembled genes are under negative selection. Several genes were differentially expressed across the two pine accessions with contrasted phenotypes, including a glutathione-s-transferase, a cellulose synthase and a cobra-like protein. A large number of new markers (3334 amplifiable SSRs and 28,236 SNPs) have been identified which should facilitate future population genomics and association genetics in this species. A 384-SNP Oligo Pool Assay for genotyping with the Illumina VeraCode technology has been designed which showed an high overall SNP conversion rate (76.6%). Our results showed that Illumina next-generation sequencing is a valuable technology to obtain an extensive overview on whole transcriptomes of nonmodel species with large genomes.
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Affiliation(s)
- S Pinosio
- Institute of Biosciences and Bioresources, National Research Council, Via Madonna del Piano 10, 50019, Sesto Fiorentino, Firenze, Italy; IGA Technology Services s.r.l., Via J. Linussio, 51, 33100, Udine, Italy
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15
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Bagnoli F, Casucci M, Toti S, Cecchi S, Iurato C, Coriolani G, Tiezzi M, Vispi L. Is vitamin D supplementation necessary in healthy full-term breastfed infants? A follow-up study of bone mineralization in healthy full-term infants with and without supplemental vitamin D. Minerva Pediatr 2013; 65:253-260. [PMID: 23685376] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
AIM The aim of the study is to establish whether healthy full-term breastfed infants require supplemental vitamin D for proper bone mineralization. METHODS Bone mineralization was studied by performing ultrasound scans of 73 healthy full-term subjects at the age of 3 months. The infants were divided into three groups. Group A: breastfed without supplemental vitamin D (BF); group B: breastfed with supplement of 400 IU/day of vitamin D (BFD); group C: fed with formula (with and without supplemental vitamin D 400 IU/day) (FF). The values of mcSOS (m/sec) and mcBTT (µsec) were assessed in all subjects. RESULTS A statistically significant difference has been found between group A vs group B both in mcSOS (P=0.03) and in mcBTT (P=0.01) values and also between group A vs group C both in mcSOS (P=0.012) and in mcBTT (P=0.003) values. Significant differences between group B vs group C were not found. In 75% of subjects of group A mcSOS and mcBTT values were ≤ the 10th percentile, while in group B they were between the 10th and 50th percentile. In FF infants given supplemental vitamin D mcSOS and mcBTT values were between the 25th and 75th percentile. CONCLUSION Human breast milk is an appropriate source of nutrition for the growth of healthy full-term newborns, but is poor in vitamin D as demonstrated by the impaired bone mineralization in the breastfed infants without supplemental vitamin D. The results presented demonstrate that exclusively breastfed infants require at least 400 IU/day of supplemental vitamin D.
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Affiliation(s)
- F Bagnoli
- Department of Pediatrics, Obstetrics and Reproductive Medicine, University of Siena, Siena, Italy.
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Abstract
Vaccine research has experienced a quantum leap after the beginning of the genomics era. High-throughput sequencing techniques, unlimited computing resources, as well as new bioinformatic algorithms are now changing the way we perform genomic studies. Whole genome sequencing will soon become the gold standard for phylogenetic and epidemiology studies and is already shedding new light on the dynamics of bacterial evolution. We believe that deep sequencing projects, together with structural studies on vaccine candidates, will allow targeting constant epitopes and avoid vaccine failure due to antigenic variability. Systems biology, which is expected to revolutionize vaccine research and clinical studies, greatly relies on high-throughput technologies such as RNA-seq. Furthermore, genomics is a key element to develop safer vaccines, and the accuracy of deep sequencing will allow monitoring vaccine coverage after their introduction on the market.
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Affiliation(s)
- P Prachi
- Novartis Vaccines, Research Center, Siena, Italy
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Bellieni CV, Bagnoli F, Tei M, De Filippo M, Perrone S, Buonocore G. Increased risk of brain injury in IVF babies. Minerva Pediatr 2011; 63:445-448. [PMID: 22075798] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
AIM The aim of this paper was to assess brain injury occurrence among in vitro fertilization (IVF) babies. METHODS We examined all babies born in our hospital in the triennium 2004-2006, comparing the presence of brain injuries between IVF babies and the rest of the population. RESULTS In IVF group (180 babies), brain injury was present in 4 babies, while in the rest of population (n=3602) it was present in 23 babies (P=0.042, RR: 3.18). IVF babies have a higher risk of being born with a birthweight less than 2 500 grams (P<0.0001; RR: 5.133). When we considered only babies born with a birth weight less than 2 500 grams, the difference of brain injury between the two groups was not significant. CONCLUSION In IVF babies, brain injury occurred more frequently than in the rest of population. This is probably due to a higher rate of premature births and low birth weight in IVF population. Anyway, this data should be disclosed to future parents to make an informed decision.
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Affiliation(s)
- C V Bellieni
- Department of Pediatrics Obstetrics and Reproduction Medicine, University of Siena, Siena, Italy.
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Bagnoli F, Badii S, Conte ML, Toti MS, De Felice C, Bellieni CV, Borlini G, Tomasini B, Zani S. [Influence of prolonged treatment with octreotide on GH, IGF I, insulin, ACTH, cortisol, T3, T4 and TSH secretion in a case of congenital chylothorax]. Minerva Pediatr 2010; 62:411-417. [PMID: 20940674] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Congenital chylothorax is a rare condition characterized by the accumulation of lymph fluid in the pleural space that causes respiratory and circulatory dysfunctions, immune deficiencies, hypoalbuminemia, electrolyte imbalance and alterations of the coagulation. Mortality rates are elevated and can rise to 50%. Therapy consists in conservative treatment based on thoracic drainage combined with total parenteral nutrition or use of low-fat high-protein diet supplemented with medium chain triglycerides. In case of failure surgical intervention may be considered. During the last years some authors have experienced the use of octreotide with doubtful results. In no case the drug impact on insulin, GH and cortisol secretion in neonatal age has been investigated and only in one case the effect on thyroid hormones has been assessed. We report the case of a 36-week baby with congenital chylothorax treated with octreotide for 42 days. The drug was well tolerated but hormonal level measurements showed a deep depression of insulin secretion unaccompanied by alterations of glucose levels. Levels of GH and TSH showed only a transitory decrease. ACTH and cortisol remained normal. At 5 months, the measurements of hormonal levels did not show significant alterations. It is not possible to determine if such a drug played an essential role in the solution of the pleural effusion, but it is important to emphasize that a prolonged treatment with octreotide has not caused, in our case, persistent hormonal alterations.
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Affiliation(s)
- F Bagnoli
- Unità Operativa Complessa di Terapia Intensiva Neonatale, Dipartimento di Pediatria, Ostetricia e Medicina della Riproduzione, Azienda Ospedaliera Universitaria Senese, Siena, Italia.
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19
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Bagnoli F, Rossetti A, Casucci M, Mori A. Aminoterminal B-type natriuretic peptide (NT-proBNP) in the therapy of patent ductus arteriosus. Minerva Pediatr 2010; 62:67-70. [PMID: 21089722] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND NT-proBNP is a reliable index in case of cardiac diseases. OBJECTIVE To evaluate the diagnostic usefulness of NT-proBNP as index of the closure of patent ductus arteriosus (PDA) in ELBW. METHODS Considered 73 ELBW (mGA 26+3 weeks; mBW 789 g) with echocardiographical diagnosis of PDA. The closure of the duct was spontaneous in 22%, pharmacological in 49.3% and by surgical ligation in 28.7%. Plasma NT-proBNP levels were measured on day 3 in 35 preterm infants; in 20 of them concentrations of the peptide were assayed on day 3 and on closure of the duct. RESULTS On day 3 the median of NT-proBNP levels was 13718 pg/ml (range 1918-70000). Peptide concentrations did not differ between pharmacological treatment and surgical ligation (respectively 13718 and 12342 pg/ml; p = 0.33). Concentrations of NT-proBNP were significantly lower on the closure of the duct (p < 0.0001) compared to concentrations on day 3 (median 12666 at day 3 versus 2443.5 pg/ml at closure), with a decrease of 80.71%. CONCLUSIONS ELBW showed high variability of NT-proBNP concentrations both on day 3 and on closure of PDA. Although NT-proBNP high levels were indicative of the presence of hsPDA, due to the extreme heterogeneity of the values it was not possible to determine an absolute cut-off concentration of NT-proBNP below which closure of the duct occurred, while a decrease of NT-proBNP > or =80% was a reliable index of PDA closure.
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MESH Headings
- Biomarkers
- Ductus Arteriosus, Patent/blood
- Ductus Arteriosus, Patent/complications
- Ductus Arteriosus, Patent/drug therapy
- Ductus Arteriosus, Patent/surgery
- Female
- Gestational Age
- Humans
- Ibuprofen/therapeutic use
- Infant, Extremely Low Birth Weight
- Infant, Newborn
- Infant, Premature, Diseases/blood
- Infant, Premature, Diseases/drug therapy
- Infant, Premature, Diseases/surgery
- Ligation
- Male
- Natriuretic Peptide, Brain/blood
- Peptide Fragments/blood
- Prognosis
- Remission, Spontaneous
- Renal Insufficiency/complications
- Retrospective Studies
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Affiliation(s)
- F Bagnoli
- Department of Pediatrics, Obstetrics and Reproduction Medicine, Neonatal Intensive Care, University of Siena, Italy
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20
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Bagnoli F, Toti MS, Conte ML, Badii S, Mori A, Tomasini B, Zani S. [Quantitative ultrasound for the assessment of bone in the preterm infant]. Minerva Pediatr 2010; 62:125-132. [PMID: 20440231] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
AIM Preterm infants are at risk of osteopathy of prematurity (OP). The present study aims to assess quantitative ultrasound as a safe and non-invasive method in evaluating bone mineral status in the critically ill preterm infant. METHODS Sixty preterm infants (27 females) have been evaluated in the Neonatal Intensive Care Unit of the University Hospital of Siena. Gestational age was between 22 and 36 weeks and birth weight ranged between 610 and 3240 g. A single operator did all the measurements on the second metacarpus by the DBM Sonic BP (IGEA). Ultrasound parameters were bone transmission time (BTT, micros) and speed of sound (SOS, m/s). RESULTS BTT positively increased with birth gestational age (r=0.72, P<0.001, F-Ratio=62.4428), birth weight (r=0.7827, P<0.001, F-Ratio=91.7274) and birth length (r=0.7729, P<0.001, F-Ratio=86.0748). SOS was also related with gestational age (r=0.2937, P<0.023, F-Ratio=5.4768), birth weight (r=0.2634, P<0.042, F-Ratio=4.3250) and birth length (r=0.3252, P<0.011, F-Ratio=6.8596). Small infants for gestational age showed BTT values lower then infants with appropriate size for gestational age (P<0.03). There was no difference between male and female infants. CONCLUSION Quantitative ultrasound is a non-invasive method, which is easy to perform in a Neonatal Intensive Unit, safe, harmless and gentle. This method detects subtle differences in bone mineral status, according to gestational age, weight and length. Quantitative ultrasound is a useful screening tool for early detection of bone status in newborns and a valid method for the longitudinal assessment of bone in growing children.
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Affiliation(s)
- F Bagnoli
- Unità Operativa Complessa di Terapia Intensiva Neonatale, Dipartimento di Pediatria, Ostetricia e Medicina della RiproduzioneAzienda Ospedaliera Universitaria di Siena, Siena, Italia.
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21
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Oliveira VMD, Ribeiro LDS, Rossi LM, Silva MALG, Aldrighi JM, Bagnoli F, Rinaldi JF, Aoki T. [Aromatase expression in invasive and in situ ductal carcinoma present in the same breast]. Rev Assoc Med Bras (1992) 2010; 55:651-5. [PMID: 20191218 DOI: 10.1590/s0104-42302009000600008] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2008] [Accepted: 07/21/2009] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to evaluate the expression of aromatase in simultaneously invasive ductal carcinoma (IDC) and ductal carcinoma in situ (DCIS). METHODS forty-five surgical samples were obtained from mastectomy and quadrantectomy with simultaneous IDC and DCIS of stage I and II patients. Aromatase was evaluated using antibodies anti-aromatase and the samples classified in accordance with the number and intensity of stained cells. RESULTS Aromatase was expressed positively in 32(71%) and negatively in 13(29%) of the cases in the IDC. The same results were obtained in the DCIS showing a perfect positive correlation. In the normal epithelium,aromatase was positive in 19(42.2%) and negative in 26 (57.8%) and a positive correlation, statistically significant was obtained when compared with IDC and DCIS(p<0.01). Concerning the normal stroma, positivity was only 7 (15.5%) showing no correlation with aromatase expression. Aromatase was positive in 36(80%) of the tumor stroma and this result was statistically significant as in the IDC and DCIS. Comparing results of aromatase expression with nuclear grade, histological grade, tumor size and age no difference was found. CONCLUSION our results demonstrated high correlation between aromatase expression in IDC, DCIS, normal epithelium and tumor stroma showing a possible autocrine and paracrine mechanism of this enzyme in breast cancer.
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Bagnoli F, Conte ML, Tomasini B, Bellieni CV, Borlini G, De Felice C, Perrone S, Zani S, Gatti MG. [Survival rates in a single neonatal intensive care unit (period 2002-2007). Neuro-developmental outcome and survival for infants born at 23-25 weeks of gestation]. Minerva Pediatr 2010; 62:29-41. [PMID: 20212396] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
AIM The aim of this study was to evaluate survival rates in a single Neonatal Intensive Care Unit (NICU) (period 2002-2007), with a special focus on the survival data and outcome at one-year of corrected age for infants born at 23-25 weeks of gestation. METHODS All infants who had evidence of heart activity at birth were actively resuscitated, regardless of birth weight or gestational age. Survival rate was calculated as a function of the following variables: birth weight and gestational category; gender in infants of birth weight < or = 1000 g ; appropriate (AGA) or small (SGA) weight for gestational age; inborn or outborn. Twenty-eight newborns (23-25 weeks of gestation) completed follow-up at one-year of corrected age. RESULTS During the examined period, no infants died in the delivery room; 833 newborns were admitted to the NICU. Overall survival rates were as following: <500 g (37%), 501-750 g (59%), 751-1,000 g (82%), 1,001-1,250 g (96%), 1251-1,500 g (97%), 1,501-2,000 g (100%), 2,001-2,500 g (98%), >2,500 g (99%); 23-25 weeks of gestation (50%); 26-27 weeks (77%), 28-32 weeks (90%); males < or = 1,000 g (68%), females < or = 1,000 g (68%); AGA < or = 1,000 g (63%), SGA < or = 1,000 g (79%), AGA < or =28 weeks (63%), SGA < or = 28 weeks (67%); inborn (54%), outborn (25%). A fraction of 64% (infants of 23-25 weeks of gestation) did not show handicap at one-year of corrected age, while 25% presented severe, 7% moderate, and 4% mild handicaps. CONCLUSION High rate of survival without handicap at one-year of corrected age at extremely low gestational age and the chance of improvements in neonatal care for newborn < or = 24 weeks, indicate the appropriateness for our strategy of resuscitating all newborns with evidence of heart activity in the delivery room.
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Affiliation(s)
- F Bagnoli
- Unità Operativa Complessa, Terapia Intensiva Neonatale, Dipartimento di Pediatria, Ostetricia e Medicina della Riproduzione, Azienda Ospedaliera Universitaria Senese, Siena, Italia.
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Bagnoli F, Oliveira VMD, Silva MALGD, Taromaru GCM, Rinaldi JF, Aoki T. The interaction between aromatase, metalloproteinase 2,9 and cd44 in breast cancer. Rev Assoc Med Bras (1992) 2010; 56:472-7. [DOI: 10.1590/s0104-42302010000400023] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2010] [Accepted: 05/23/2010] [Indexed: 11/22/2022] Open
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Bagnoli F, Conte ML, Magaldi R, Rinaldi M, De Felice C, Perrone S, Vezzosi P, Paffetti P, Borgogni P, Toti MS, Badii S. [Insulin and glucagon plasma levels in very low birth weight preterm infants of appropriate weight for gestational age]. Minerva Pediatr 2009; 61:469-475. [PMID: 19794372] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVES Prematurity is a known risk factor for hypoglycaemia, hyperglycemia, neonatal sepsis and other common neonatal complications, possibly associated with glucoregolatory hormone (insulin and glucagon) alterations. Insulin and glucagon levels change also in relation to gender, mode of delivery and postnatal clinical severity. Because of the lack of reference range in literature, the aim of this study is to assess plasma insulin and glucagon levels in preterm appropriate for gestational age (AGA) infants of birth weight <1500 g (very low birth weight, VLBW) as a function of gestation, birth weight, gender and mode delivery. METHODS The authors examined 48 preterm AGA infants (mean birth weight 1 163+/-286 g, mean gestational age 28.2+/-2.4 weeks). The infant population was subdivided in relation to gestational age, weight, gender, mode of delivery and assisted ventilation at 5-7(th) days. Plasma glucose, insulin and glucagon levels were assessed in all newborns at birth and at 5-7(th) days of life. Data were analyzed using t-test. RESULTS A negative correlation between insulin and gestational age was observed (P<0.05). At birth, no significant differences regarding plasma glucose, insulin and glucagon levels were observed as a function of the examined category variables. At the 5-7(th) days of life, insulin levels were significantly higher in newborns with gestational age =or<27 weeks (P<0.02), in the female gender (P<0.02) and in the infants born to emergency Cesarean delivery (P<0.05). CONCLUSIONS These findings indicate potentially useful reference range values for plasma insulin and glucagon in the VLBW population.
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Affiliation(s)
- F Bagnoli
- Operative Unito f Neonatal Intensive Therapy, Department of Pediatrics, Obstetrics and Reproductive Medicine, Senese University Hospital, Siena, Italy.
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de Felice C, Toti P, Musarò M, Peruzzi L, Paffetti P, Pasqui L, Magaldi R, Bagnoli F, Rinaldi M, Rinaldi G, Grilli G, Tonni G, Latini G. Early activation of the hypothalamic-pituitary-adrenal-axis in very-low-birth-weight infants with small thymus at birth. J Matern Fetal Neonatal Med 2009; 21:251-4. [DOI: 10.1080/14767050801927871] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Bagnoli F, Vendramin GG, Buonamici A, Doulis AG, González-Martínez SC, La Porta N, Magri D, Raddi P, Sebastiani F, Fineschi S. Is Cupressus sempervirens native in Italy? An answer from genetic and palaeobotanical data. Mol Ecol 2009; 18:2276-86. [PMID: 19389173 DOI: 10.1111/j.1365-294x.2009.04182.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [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
This study represents the first large-scale analysis using nuclear molecular markers to assess genetic diversity and structure of Cupressus sempervirens L.. Genetic and fossil data were combined to infer the possible role of human activity and evolutionary history in shaping the diversity of cypress populations. We analysed 30 populations with six polymorphic nuclear microsatellite markers. Dramatic reductions in heterozygosity and allelic richness were observed from east to west across the species range. Structure analysis assigned individuals to two main groups separating central Mediterranean and eastern populations. The two main groups could be further divided into five subgroups which showed the following geographical distributions: Turkey with the Greek islands Rhodes and Samos, Greece (Crete), Southern Italy, Northern Italy, Tunisia with Central Italy. This pattern of genetic structure is also supported by SAMOVA and Barrier analyses. Palaeobotanical data indicated that Cupressus was present in Italy in the Pliocene, Pleistocene and Holocene. Furthermore, our molecular survey showed that Italian cypress populations experienced bottlenecks that resulted in reduced genetic diversity and allelic richness and greater genetic differentiation. Recent colonization or introduction may also have influenced levels of diversity detected in the Italian populations, as most individuals found in this range today have multilocus genotypes that are also present in the eastern range of the species. The data reveal a new interpretation of the history of cypress distribution characterized by ancient eastern populations (Turkey and Greek islands) and a mosaic of recently introduced trees and remnants of ancient, depauperate populations in the central Mediterranean range.
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Affiliation(s)
- F Bagnoli
- CNR Istituto per la Protezione delle Piante, Sesto Fiorentino, Firenze, Italy
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Nelson AL, Ries J, Bagnoli F, Dahlberg S, Fälker S, Rounioja S, Tschöp J, Morfeldt E, Ferlenghi I, Hilleringmann M, Holden DW, Rappuoli R, Normark S, Barocchi MA, Henriques-Normark B. RrgA is a pilus-associated adhesin in Streptococcus pneumoniae. Mol Microbiol 2007; 66:329-40. [PMID: 17850254 PMCID: PMC2170534 DOI: 10.1111/j.1365-2958.2007.05908.x] [Citation(s) in RCA: 131] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Adherence to host cells is important in microbial colonization of a mucosal surface, and Streptococcus pneumoniae adherence was significantly enhanced by expression of an extracellular pilus composed of three subunits, RrgA, RrgB and RrgC. We sought to determine which subunit(s) confers adherence. Bacteria deficient in RrgA are significantly less adherent than wild-type organisms, while overexpression of RrgA enhances adherence. Recombinant monomeric RrgA binds to respiratory cells, as does RrgC with less affinity, and pre-incubation of epithelial cells with RrgA reduces adherence of wild-type piliated pneumococci. Non-adherent RrgA-negative, RrgB- and RrgC-positive organisms produce pili, suggesting that pilus-mediated adherence is due to expression of RrgA, rather than the pilus backbone itself. In contrast, RrgA-positive strains with disrupted rrgB and rrgC genes exhibit wild-type adherence despite failure to produce pili by Western blot or immunoelectron microscopy. The density of bacteria colonizing the upper respiratory tract of mice inoculated with piliated RrgA-negative pneumococci was significantly less compared with wild-type; in contrast, non-piliated pneumococci expressing non-polymeric RrgA had similar numbers of bacteria in the nasopharynx as piliated wild-type bacteria. These data suggest that RrgA is central in pilus-mediated adherence and disease, even in the absence of polymeric pilus production.
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Affiliation(s)
- A L Nelson
- Swedish Institute for Infectious Disease Control and Department of Microbiology, Tumor and Cell Biology, Karolinska InstitutetStockholm, Sweden
| | - J Ries
- Swedish Institute for Infectious Disease Control and Department of Microbiology, Tumor and Cell Biology, Karolinska InstitutetStockholm, Sweden
| | | | - S Dahlberg
- Swedish Institute for Infectious Disease Control and Department of Microbiology, Tumor and Cell Biology, Karolinska InstitutetStockholm, Sweden
| | - S Fälker
- Swedish Institute for Infectious Disease Control and Department of Microbiology, Tumor and Cell Biology, Karolinska InstitutetStockholm, Sweden
| | - S Rounioja
- Swedish Institute for Infectious Disease Control and Department of Microbiology, Tumor and Cell Biology, Karolinska InstitutetStockholm, Sweden
| | - J Tschöp
- Swedish Institute for Infectious Disease Control and Department of Microbiology, Tumor and Cell Biology, Karolinska InstitutetStockholm, Sweden
| | - E Morfeldt
- Swedish Institute for Infectious Disease Control and Department of Microbiology, Tumor and Cell Biology, Karolinska InstitutetStockholm, Sweden
| | | | | | - D W Holden
- Centre for Molecular Microbiology and Infection, Imperial CollegeLondon, UK
| | | | - S Normark
- Swedish Institute for Infectious Disease Control and Department of Microbiology, Tumor and Cell Biology, Karolinska InstitutetStockholm, Sweden
| | | | - B Henriques-Normark
- Swedish Institute for Infectious Disease Control and Department of Microbiology, Tumor and Cell Biology, Karolinska InstitutetStockholm, Sweden
- E-mail ; Tel. (+46) 8 457 24 13; Fax (+46) 8 30 25 66
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Florio P, Reis FM, Severi FM, Luisi S, Imperatore A, Palumbo MA, Bagnoli F, Gioffre W, Petraglia F. Umbilical Cord Serum Activin A Levels are Increased in Pre-eclampsia with Impaired Blood Flow in the Uteroplacental and Fetal Circulation. Placenta 2006; 27:432-7. [PMID: 16051348 DOI: 10.1016/j.placenta.2005.04.008] [Citation(s) in RCA: 8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2004] [Revised: 04/21/2005] [Accepted: 04/23/2005] [Indexed: 10/25/2022]
Abstract
The aims of the present study were to evaluate the umbilical cord serum activin A concentrations in complicated pregnancies and also to explore the relationship between activin A levels and blood flow velocity in fetal arteries. Umbilical cord blood samples were obtained postpartum after a full term uneventful gestation (control group, n=40), and from pregnancies complicated by gestational diabetes (n=13), preterm labour (n=18), or pre-eclampsia (n=19). Cord serum activin A levels were three-fold higher in pregnancies complicated by pre-eclampsia (1.17+/-0.14 ng/ml, p<0.01) than in the control group (0.43+/-0.03 ng/ml), but were unaltered in the diabetes and preterm labour groups. The pre-eclampsia group had a marked increase of umbilical artery pulsatility index (PI) and also a decrease of middle cerebral artery PI (p<0.01). Furthermore, activin A concentration correlated directly with the umbilical artery PI (r=0.540, p=0.021), with the length of stay in the Neonatal Intensive Care Unit (r=0.857, p<0.001) and also with cord blood pH (r=-0.886, p<0.001). In conclusion, umbilical cord serum activin A levels are increased in the presence of pre-eclampsia and provide an indirect marker of impaired blood flow in the uteroplacental and fetal circulation.
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Affiliation(s)
- P Florio
- Department of Pediatrics, Obstetrics and Reproductive Medicine, University of Siena, Policlinico Le Scotte, Viale Bracci, 53100 Siena, Italy
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Bellieni CV, Buonocore G, Bagnoli F, Cordelli DM, Gasparre O, Calonaci F, Filardi G, Merola A, Petraglia F. Is an excessive number of prenatal echographies a risk for fetal growth? Early Hum Dev 2005; 81:689-93. [PMID: 16005167 DOI: 10.1016/j.earlhumdev.2005.05.004] [Citation(s) in RCA: 11] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2004] [Revised: 05/09/2005] [Accepted: 05/16/2005] [Indexed: 11/30/2022]
Abstract
AIM To assess whether a very high number of prenatal ultrasonographies affects birthweight. POPULATION AND METHODS We studied 1203 consecutive women who delivered in Siena Hospital. Exclusion criteria were the following: twin pregnancy, maternal smoke or alcohol ingestion in pregnancy, gestational diabetes, placenta or umbilical cord defects, gestational age at birth <37 weeks, and major malformations. We analysed birthweights in relation to the number of ultrasound examinations. 120 women had undergone a minimum number (three or less-base group) and 167 a maximum number (nine or more-intensive group) of fetal US scans. We compared the birthweight of the children born in these two groups and the correlation between number of US scans and birthweight in the whole population. RESULTS Mean birthweights of the base and the intensive groups were 3389.5+/-434 g and 3268+/-438 g, respectively (p=0.0206). Nevertheless, the regression study did not show a significant correlation between birthweight and number of US scans. The mean age of the base group was 30.1+/-5.3 years and that of the intensive group was 32.09+/-4.99 years (p=0.0018). Eighteen women of base group underwent amniocenteses vs. 71 in the intensive group (p<0.001). In the base group 57.5% of the mothers had low school level vs. 24.4% in the intensive group (p<0.01). CONCLUSION More studies are needed to confirm or exclude any relationship between an intensive use of prenatal ultrasounds and birthweight, and to exclude other effects of ultrasounds on children's health. Moreover, our study shows an excess of prenatal diagnostic procedures, the causes of which should be investigated.
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Affiliation(s)
- C V Bellieni
- Department of Pediatrics, Obstetrics and Reproductive Medicine, University of Siena, Italy.
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Bellieni CV, Odent M, Cordelli FM, Cordelli DM, Bagnoli F, Perrone S, Buonocore G. Ante partum bed rest and unexplained infantile crying. Minerva Pediatr 2005; 57:163-6. [PMID: 16172594] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
AIM The aim of this study was to assess whether bed rest during pregnancy is a risk factor for infantile colics. METHODS In a previous paper a questionnaire was administered to 86 women (43 of whom had stayed in bed during pregnancy for a mean of 3.4+/-1.2 months, and 43 were controls) about the clinical history and the present state of their 11-15 year old babies. In the present paper we traced these women and assessed the presence/absence of unexplained infant crying (UIC, infantile colic), diagnosed by a physician in the first year of life of these children. Forty mothers answered the inquiry, and we compared their answers with 40 control mothers. RESULTS Babies born after maternal bed rest during pregnancy had a higher incidence of UIC than the control group (26/40 vs 11/40; P=0.0015). No significant correlation was found between UIC and allergies or between UIC and maternal or artificial breast feeding. CONCLUSIONS Our retrospective study shows a possible association between bed rest and UIC: further studies, including other important variables (stress, drugs, smoking) are needed.
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Affiliation(s)
- C V Bellieni
- Department of Pediatrics, Obstetrics and Reproductive Medicine, University of Siena, Siena, Italy.
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Bagnoli F, Bianchi A, Ceccarini A, Fuoco R, Giannarelli S. Trace metals and organic pollutants in treated and untreated residues from urban solid waste incinerators. Microchem J 2005. [DOI: 10.1016/j.microc.2004.10.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Bellieni CV, Bagnoli F, Pinto I, Stacchini N, Buonocore G. Reduction of exposure of newborns and caregivers to very high electromagnetic fields produced by incubators. Med Phys 2004; 32:149-52. [PMID: 15719965 DOI: 10.1118/1.1829404] [Citation(s) in RCA: 13] [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: 11/07/2022] Open
Abstract
The aims of this paper is to measure whether ferromagnetic panels sufficiently reduce the high electromagnetic fields (EMF) to which newborns are exposed in incubators and to which caregivers are exposed when working near the incubators. We measured EMF at mattress level in three neonatal incubators with and without ferromagnetic panels between the electric motor and the mattress. We then measured the EMF at the level of the maximum emission point for caregivers, i.e., near the display panel. The ferromagnetic panels were (a) 5 mm thick iron, (b), (c), (d) respectively, one, two, and three sheets of 0.3 mm thick mu-metal. The weight of iron sheet was 4 g/cm2, and mu-metal 0.2 g/cm2. The use of the ferromagnetic panels significantly reduced the EMF. No significant difference in attenuation was recorded using one, two, or, three sheets of mu-metal, or a single sheet of iron. One, two, and three sheets of mu-metal reduced EMFs by 77%, 82%, and 84.3%, respectively; the reduction with iron was 80%. EMF values measured in incubators were higher than those to which the general population is exposed. The use of ferromagnetic panels significantly reduces the level of EMFs to which neonates and caregivers are exposed.
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Affiliation(s)
- C V Bellieni
- Department of Pediatrics, Obstetrics and Reproduction Medicine, NICU, University of Siena, Viale Bracci, Siena 53100, Italy.
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Bellieni CV, Pinto I, Stacchini N, Cordelli DM, Bagnoli F. [Vibration risk during neonatal transport]. Minerva Pediatr 2004; 56:207-12. [PMID: 15249905] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
AIM The aim of this paper is to assess the entity of the mechanical vibrations which newborn and medical staff are exposed to and to evaluate the possible risks connected with excessive exposure. METHODS Vibrations during a simulated emergency ambulance transport were studied. Vibration values with an accelerometer at the level of the incubator's mattress and at passengers' and pilot's seat level were measured. Mean accelerations (awz) and peak accelerations (awpeak), measured using a ponderation filter, according with ISO standard 2631, were considered. RESULTS Inside the incubator an acceleration mean value of 1.33 (+/-0.13) m/s(2) and peak values of 11.8 (+/-0.1) m/s(2) were found. On passengers' seats the awz findings were 0.55 m/s(2) (+/-0.13) and 0.56 m/s(2) (+/-0.08) while awpeak respectively 4.8 m/s(2) (+/-0.1) and 10.2 m/s(2) (+/-0.1). On pilot's seat a mean acceleration of 0.48 m/s(2) (+/-0.08) and an awpeak value of 4.5 m/s(2) (+/-0.1) were found. CONCLUSION Peak vibration values which newborns are exposed to (11.8 m/s(2)) are high, when compared with acceleration of gravity (9.8 m/s(2)); this can provoke repeated jerks. Environmental stress can easily alter the stability of an ill newborn and interfere with care manoeuvres. Decreasing vibrations in neonatal transport unit could increase the safety of newborns, reducing the risks which newborns are actually exposed to.
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Affiliation(s)
- C V Bellieni
- Dipartimento di Pediatria, Ostetricia e Medicina della Riproduzione, Università degli Studi di Siena, Siena, Italy.
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De Capua B, De Felice C, Costantini D, Bagnoli F, Passali D. Newborn hearing screening by transient evoked otoacoustic emissions: analysis of response as a function of risk factors. Acta Otorhinolaryngol Ital 2003; 23:16-20. [PMID: 12812130] [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: 03/03/2023]
Abstract
Hearing loss can be considered as the most common birth defect. Early detection of hearing loss by screening at, or shortly after, birth and appropriate intervention are critical to speech, language and cognitive development. In the present study, the characteristics of Transient Evoked Otoacoustic Emissions have been evaluated as a function of known pre- and perinatal risk factors for hearing loss. All newborns were screened for hearing loss using a physiologic test of hearing function, the Transient Evoked Otoacoustic Emissions. A total of 532 consecutive newborn infants received binaural Transient Evoked Otoacoustic Emission testing (262 males, 270 females; mean gestational age 39.2 +/- 2.1 weeks, range 26-43; birth weight: 3,240 +/- 550 g, range 910-4,780). The population examined comprised 448 control infants and 84 high-risk for hearing loss infants (Joint Committee on Infant Hearing 1994 criteria). All Transient Evoked Otoacoustic Emission recordings were performed at comparable postconceptional ages. Audiological screening by Transient Evoked Otoacoustic Emission recording showed an overall 100% sensitivity, 99.02% specificity, with negative and positive predictive values of 100% and 62.5%, respectively. As compared to controls, high-risk infants showed: 1. increased rates of Fail-1 (Transient Evoked Otoacoustic Emissions absent at first examination, 21.4% vs 9.8%, p = 0.004), Fail-2 (Transient Evoked Otoacoustic Emissions absent on retesting: 8.64% vs 1.37%, p = 0.0014), false positives (Transient Evoked Otoacoustic Emissions absent/V wave present: 3.7% vs 0.46%, p = 0.029) and true positives (Transient Evoked Otoacoustic Emissions absent, V wave absent: 2.47% or 24.5 per 1,000 live births vs 0.22% or 2.2 per 1,000 live births, p = 0.013); 2. significantly reduced Transient Evoked Otoacoustic Emission intensity in the 0.7-1 kHz (right side) and 1-2 kHz (left side) frequency ranges. Multivariate logistic regression analysis showed a significant positive correlation between congenital hearing loss and the following risk factors: assisted ventilation lasting > 10 days (Odds ratio 14.8; 95% confidence interval, 4.5-48.8, p < 0.000001), severe birth asphyxia (Odds ratio 5.8; 95% confidence interval; 2.1-16.1; p = 0.0006) and administration of ototoxic drugs (Odds ratio 4.5; 95% confidence interval; 1.4-13.9; p = 0.009). Results of this study confirm the feasibility and accuracy of universal neonatal hearing screening based on recording Transient Evoked Otoacoustic Emissions. These data stress the importance of the risk factors for hearing loss, including prolonged assisted ventilation, ototoxic drugs, and severe birth asphyxia.
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Affiliation(s)
- B De Capua
- Department of Otorhinolaryngology, University of Siena, Italy.
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Bellieni CV, Bagnoli F, Buonocore G. Alone no more: pain in premature children. Ethics Med 2003; 19:5-9. [PMID: 14700042] [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: 04/27/2023]
Abstract
It is only recently that newborns have been recognised to feel pain. To avoid the drawbacks of common analgesics, alternative analgesic methods (e.g. sucking and/or oral sugar) have been proposed. We showed that these methods are of little effect without the relaxing, distracting, comforting presence of a person at the cribside who talks to and massages the baby. This is a further demonstration that newborns, including premature babies, look for a reassuring presence when experiencing pain. This is surprising as premature babies are relatively unreactive, often completely isolated in an incubator and considered incapable of social behavior. To the attentive observer, however, they reveal an unsuspected emotional world. Not only do they feel pain, but they are also capable of suffering, distress, anxiety and fear. This needs to be considered in neonatal analgesic treatment, even for extremely premature children. It is mandatory for caregivers to be a reassuring presence during painful procedures: premature babies are exacting patients. They not only feel pain, they even suffer; they request not only drugs, but a human presence nearby.
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Affiliation(s)
- C V Bellieni
- Neonatal Intensive Care Unit, Department of Pediatrics, Obstetrics and Reproduction Medicine, University of Siena, Italy
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Bagnoli F, Giannino D, Caparrini S, Camussi A, Mariotti D, Racchi ML. Molecular cloning, characterisation and expression of a manganese superoxide dismutase gene from peach (Prunus persica [L.] Batsch). Mol Genet Genomics 2002; 267:321-8. [PMID: 12073034 DOI: 10.1007/s00438-002-0664-7] [Citation(s) in RCA: 25] [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] [Received: 12/01/2001] [Accepted: 02/20/2002] [Indexed: 10/27/2022]
Abstract
Two cDNA clones encoding mitochondrial manganese superoxide dismutases (MnSODs) from peach ( Prunus persica [L.] Batsch) were identified, which show homologies to several plant MnSODs. The amino acid sequence predicted from one full-length clone ( MnSOD1) showed the highest homology to an MnSOD from Nicotiana plumbaginifolia (94%) and included a 24-amino acid transit peptide typical of those used to target proteins to the mitochondria. A second, partial clone ( MnSOD2) showed divergence from MnSOD1 in the 3' untranslated region. It could therefore derive from a second gene or from an allele of MnSOD1. Southern hybridisation analysis suggests the existence of two MnSOD genes in peach. SOD isoenzyme profiles, MnSOD1 expression and protein levels were studied in aerial vegetative tissues derived from plants of different ages and in adult plants during the seasonal cycle. Zymograms revealed at least two isoforms of MnSODs in pre-shooting vegetative buds and in developing fruits. Levels of MnSODs were lower in leaves derived from apical shoots of adult plants than in leaves derived from seedlings, basal shoots or in vitro propagated juvenile plants, which are considered as juvenile-like structures. The MnSOD1 transcript and protein followed the same pattern. The results suggest that the steady-state levels of MnSOD1 mRNA in leaves vary with both the ontogenetic stage and the growth rate of the tissues examined.
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Affiliation(s)
- F Bagnoli
- Sezione di Genetica, Dipartimento di Biotecnologie Agrarie, Università degli Studi di Firenze, Piazzale delle Cascine 24, 50144 Florence, Italy
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Bagnoli F, Bezzi M. Is the "small world" effect relevant to evolution? Riv Biol 2001; 94:487-97. [PMID: 11913102] [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: 04/18/2023]
Abstract
Mutations and selection are the driving forces of biological evolution. We model here the simplest case: an evolving population of asexual organisms. We consider two kinds of mutations: point mutations, corresponding to local displacements in the genotypic space, and all the other genotypic rearrangements, equivalent to long-range jumps. We show that a small-world effect is present in evolution: even a small fraction of quenched long-range jumps makes the results indistinguishable from those obtained by assuming all mutations equiprobable. We apply this result to the evolution of a population on a smooth fitness landscape, showing that the equilibrium distribution is a Boltzmann one, in which the fitness plays the role of an energy, and mutations that of a temperature.
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Affiliation(s)
- F Bagnoli
- Dipartimento di Matematica Applicata, Università di Firenze, Via S. Marta 3, I-50139 Firenze, Italy.
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Abstract
For asexual organisms point mutations correspond to local displacements in the genotypic space, while other genotypic rearrangements represent long-range jumps. We investigate the spreading properties of an initially homogeneous population in a flat fitness landscape, and the equilibrium properties on a smooth fitness landscape. We show that a small-world effect is present: even a small fraction of quenched long-range jumps makes the results indistinguishable from those obtained by assuming all mutations equiprobable. Moreover, we find that the equilibrium distribution is a Boltzmann one, in which the fitness plays the role of an energy, and mutations that of a temperature.
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Affiliation(s)
- F Bagnoli
- Dipartimento di Matematica Applicata, Università di Firenze, Via S. Marta, 3 I-50139 Firenze, Italy.
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Bellieni CV, Buonocore G, Nenci A, Franci N, Cordelli DM, Bagnoli F. Sensorial saturation: an effective analgesic tool for heel-prick in preterm infants: a prospective randomized trial. Biol Neonate 2001; 80:15-8. [PMID: 11474143 DOI: 10.1159/000047113] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Pain is traumatic for preterm infants and can damage their CNS. We wanted to assess whether multisensorial stimulation can be analgesic and whether this effect is only due to oral glucose or sucking. We performed a randomized prospective study, using a validated acute pain rating scale to assess pain during heel-prick combined with five different procedures: (A) control, (B) 10% oral glucose plus sucking, (C) sensorial saturation (SS), (D) oral water, and (E) 10% oral glucose. SS is a multisensorial stimulation consisting of delicate tactile, vestibular, gustative, olfactory, auditory and visual stimuli. Controls did not receive any analgesia. We studied 85 heel-pricks (5 per baby) performed for routine blood samples in 17 preterm infants (28-35 weeks of gestational age). We applied in random order in each patient the five procedures described above and scored pain. SS and sucking plus oral glucose have the greater analgesic effect with respect to no intervention (p < 0.001). The effect of SS is statistically better than that of glucose plus sucking (p < 0.01). SS promotes interaction between nurse and infant and is a simple effective form of analgesia for the NICU.
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Affiliation(s)
- C V Bellieni
- Department of Pediatrics, Obstetrics and Reproduction Medicine, University of Siena, Italy.
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Abstract
The diagnosis of Ehlers-Danlos syndrome is based on distinctive phenotypical characteristics such as hyperelastic skin and hypermobile joints. To date, no congenital physical markers exist for identifying patients with Ehlers-Danlos syndrome. Absence of the inferior labial (100% sensitivity; 99.4% specificity) and lingual frenulum (71.4% sensitivity; 100% specificity) was found to be associated with classical and hypermobility types of Ehlers-Danlos syndrome.
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41
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Bagnoli F, Boccara N, Rechtman R. Nature of phase transitions in a probabilistic cellular automaton with two absorbing states. Phys Rev E Stat Nonlin Soft Matter Phys 2001; 63:046116. [PMID: 11308921 DOI: 10.1103/physreve.63.046116] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2000] [Revised: 12/12/2000] [Indexed: 05/23/2023]
Abstract
We present a probabilistic cellular automaton with two absorbing states, which can be considered a natural extension of the Domany-Kinzel model. Despite its simplicity, it shows a very rich phase diagram, with two second-order and one first-order transition lines that meet at a bicritical point. We study the phase transitions and the critical behavior of the model using mean field approximations, direct numerical simulations and field theory. The second-order critical curves and the kink critical dynamics are found to be in the directed percolation and parity conservation universality classes, respectively. The first-order phase transition is put in evidence by examining the hysteresis cycle. We also study the "chaotic" phase, in which two replicas evolving with the same noise diverge, using mean field and numerical techniques. Finally, we show how the shape of the potential of the field-theoretic formulation of the problem can be obtained by direct numerical simulations.
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Affiliation(s)
- F Bagnoli
- Dipartimento di Matematica Applicata, Università di Firenze, via Santa Marta 3, I-50139 Florence, Italy.
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42
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Abstract
A significant association with asymptomatic joint hypermobility was observed in 37 children with a history of infantile hypertrophic pyloric stenosis (P =.0016) and their parents (mothers, P <.0001; fathers, P <.05). The subjects with articular hypermobility showed an increased frequency of absent mandibular frenulum, thereby suggesting the presence of a previously unrecognized, systemic abnormality of the extracellular matrix.
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Affiliation(s)
- C De Felice
- Department of Preventive Pediatrics and Neonatology, Institute of General Surgery and Surgical Specialties, University of Siena, Siena, Italy
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Racchi ML, Bagnoli F, Balla I, Danti S. Differential activity of catalase and superoxide dismutase in seedlings and in vitro micropropagated oak (Quercus robur L.). Plant Cell Rep 2001; 20:169-174. [PMID: 30759905 DOI: 10.1007/s002990000300] [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] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Catalase (CAT) and superoxide dismutase (SOD) activity profiles were examined by native polyacrylamide gel electrophoresis in different tissues of seedlings and microcuttings of oak (Quercus robur L.) initiated from crown material (NL100A) and from basal epicormic shoots (NL100R), which differ in rooting ability. Two CAT isoforms were differentially active in seedlings and microcuttings; in particular, CAT-2 was activated in the basal callus of rooted microshoots. SOD isoenzymes, Mn-SOD and at least four Cu/Zn-SODs were found to be present, with Mn-SODs particularly active in microcuttings. No differences were found between the electrophoretic profiles of the two lines despite their different ontogenetic origin. The strong activity of CAT-2 in rooted microshoots indicates that this isoform is a protein specifically related to rooting.
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Affiliation(s)
- M L Racchi
- Sezione di Genetica, Dipartimento Biotecnologie Agrarie, Università degli Studi di Firenze, p.le delle Cascine 4, 50144 Florence, Italy e-mail: Fax: +39-055-5002336, , , , , , IT
| | - F Bagnoli
- Sezione di Genetica, Dipartimento Biotecnologie Agrarie, Università degli Studi di Firenze, p.le delle Cascine 4, 50144 Florence, Italy e-mail: Fax: +39-055-5002336, , , , , , IT
| | - I Balla
- Research Institute of Fruit Growing and Ornamentals, Budapest, Hungary, , , , , , HU
| | - S Danti
- Sezione di Genetica, Dipartimento Biotecnologie Agrarie, Università degli Studi di Firenze, p.le delle Cascine 4, 50144 Florence, Italy e-mail: Fax: +39-055-5002336, , , , , , IT
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Bellieni CV, Ferrari F, De Felice C, Bagnoli F, Cioni M, Farnetani M, Gatti MG, Buonocore G. EEG in assessing hydroxycobalamin therapy in neonatal methylmalonic aciduria with homocystinuria. Biol Neonate 2000; 78:327-30. [PMID: 11093015 DOI: 10.1159/000014288] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
We performed serial electroencephalograms (EEG) in a newborn with methylmalonic aciduria and homocystinuria to assess the effects of hydroxycobalamin (OHcbl) therapy on the CNS. Diagnosis was made at 22 days of age: she had torpor, failure to thrive and hypotonia of the limbs, and intermittent opisthotonus. The first EEG, performed on the first day of therapy, showed abnormal and immature transients, low voltage and very long flat periods in the discontinuous part of the tracing. These features quickly improved during therapy. After 13 days of OHcbl therapy, the EEG tracing became normal for conceptional age and showed normal sleep phases with only minor anomalies; only mild hypotonia still remained and biochemical parameters normalized. The decrease in blood homocysteine (index of blood detoxification) was statistically correlated to the reduction of the length of flat periods in EEG (p < 0.01). In conclusion, changes in neonatal EEG, particularly the length of interburst periods in the intermittent part of the tracing, appeared to be a reliable index for evaluating drug effectiveness in methylmalonic aciduria and homocystinuria.
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Affiliation(s)
- C V Bellieni
- Istituto di Pediatria Preventiva e Neonatologia, Università di Siena, Italia
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De Felice C, Di Maggio G, Zagordo L, Parrini S, Toti P, Tota G, Bagnoli F. Hypoplastic or absent mandibular frenulum: a new predictive sign of infantile hypertrophic pyloric stenosis. J Pediatr 2000; 136:408-10. [PMID: 10700703 DOI: 10.1067/mpd.2000.103506] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Among 25 patients with hypertrophic pyloric stenosis, a hypoplastic or absent mandibular frenulum was noted in 92%, compared with 1.6% of 319 control infants (P <.001). This previously unrecognized sign may prove helpful in identifying newborns at risk of developing the disorder.
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Affiliation(s)
- C De Felice
- Neonatal Intensive Care Unit, Institute of Preventive Pediatrics and Neonatology, University of Siena, Italy
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Abstract
Chorioamnionitis, a major cause of preterm birth with significant neonatal morbidity and mortality, frequently occurs in mothers who are free of symptoms. A combined clinical, radiologic, and pathologic study of 129 very low birth weight infants indicated a significant association between a markedly decreased thymic size at birth and subclinical chorioamnionitis.
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Affiliation(s)
- C De Felice
- Department of Preventive Pediatrics and Neonatology, the Institute of Pathology, University of Siena, Italy
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Abstract
The relationship between physiological variations in female sex and androgenic hormones and calciotropic hormones was investigated during the menstrual cycle. Estradiol, progesterone, total and free testosterone, androstenedione, immunoreactive PTH, calcitonin, osteocalcin (OC), and ionized calcium serum levels were determined throughout the menstrual cycle in a population of healthy eumenorrhoic women (n = 12; age range: 20-29 yr; mean: 24.2 yr). The women were studied from the first day of a menstrual phase until the first day of the following menstrual phase. Cycle length was standardized on the preovulatory estradiol peak (day 0), and values were given for the first day of a menstrual phase, and days -12, -10, -8, -6, -4, -2, 0, 2, 4, 6, 8, 10, 12, and 14 of the menstrual cycle. All subjects had a regular ovulatory cycle, as indicated by the hormonal profile. No significant cycle phase-dependent changes in calciotropic hormones were present. Significant positive correlations between total testosterone (r = 0.32, P < 0.001), free testosterone (r = 0.26, P < 0.001), androstenedione (r = 0.35, P < 0.0001), and OC were observed. The significant relations between these variables were confirmed by a time series analysis. For the first time, these findings indicate a relationship between androgens and OC serum levels during the menstrual cycle. An important regulatory role of endogenous androgens in OC secretion, bone formation, and maintenance of normal bone mineral content in the healthy eumenorrhoic woman is hence suggested.
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Affiliation(s)
- C Massafra
- Department of Obstetrics and Gynecology, University of Siena, Italy.
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De Felice C, Di Maggio G, Messina M, Toti P, Bagnoli F, Bracci R, Tota G. Congenital cystic adenomatoid malformation of the lung associated with esophageal atresia and tracheoesophageal fistula. Pediatr Surg Int 1999; 15:260-3. [PMID: 10370039 DOI: 10.1007/s003830050571] [Citation(s) in RCA: 13] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Bronchopulmonary malformations associated with esophageal atresia (EA) and tracheoesophageal fistula (TEF) are extremely rare. The authors describe a case of type II congenital cystic adenomatoid malformation (CCAM) of the right lower lobe associated with EA and TEF (Vogt-Gross type C) in a full-term female infant. The CCAM presented as an incidental radiologic finding, and a contralateral tension pneumothorax developed shortly after surgical repair of the EA. Early recognition of this rare association is essential for correct operative management.
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Affiliation(s)
- C De Felice
- Institute of Preventive Pediatrics and Neonatology, University of Siena, Italy
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Abstract
Juvenile Rheumatoid Arthritis (JRA) is frequently associated with osteoporosis. In order to determine if JRA osteoporosis is related to reduced formation or to increased bone resorption or both, serum levels of calcium (Ca), phosphorus (PO4), magnesium (Mg), alkaline phosphatase (ALP), parathormone (PTHi), 25-hydroxyvitamin D3 (25-OHD) and 1,25-dihydroxyvitamin D3 (1,25-(OH)2D), osteocalcin (OT), carboxyterminal propeptide (P-coll-1-c), and carboxyterminal telopeptide of type I collagen (ICTP) were evaluated in 47 JRA children, 33 with active disease and 14 in remission. The therapy consisted of nonsteroidal antiinflammatory (NSAIDs) drugs in pauciarticular subset, NSAIDs and Methotrexate (MTX) in polyarticular, NSAIDs and steroids in systemic onset. OT reflects bone formation, P-coll-1-c reflects collagen production and bone formation, ICTP, marker of collagen degradation in bone, indicates bone destruction. Serum levels of Ca, PO4, Mg, ALP, PTHi 25-OHD and 1,25-(OH)2D were comparable in JRA children and in controls. OT (8.7 +/- 3.7 ng/ml vs 9.6 +/- 5.1), P-coll-1-c (301.2 +/- 118.4 ng/ml vs 264.1 +/- 100.1) and ICTP (15.7 +/- 5.7 ng/ml vs 16.1 +/- 6.1) did not differ statistically in the whole group of JRA children vs controls. OT (8.0 +/- 3.5 vs 10.4 +/- 3.8) and ICTP (14.4 +/- 5.4 vs 18.8 +/- 5.4) were significantly lower in active than inactive group. In polyarticular and systemic onset OT and ICTP were significantly lower than in pauciarticular. No difference was found in active patients treated with steroids vs active patients treated with NSAIDS and NSAIDs plus MTX. The lower serum levels of OT and ICTP in active disease support the hypothesis that both bone formation and resorption are reduced in JRA bone turnover.
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Affiliation(s)
- F Falcini
- Dipartimento di Pediatria, Sezione di Reumatologia, University of Firenze, Italy
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Bagnoli F, De Felice C, Massafra C, Pecciarini L, Bencini S, Gioia D. Decreased parathyroid hormone serum levels in pregnant women with first-trimester vaginal bleeding. Acta Obstet Gynecol Scand 1997; 76:807-8. [PMID: 9348266 DOI: 10.3109/00016349709024355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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