1
|
Latham L, Gianazza S, Garbarino S, Coriele SG, Fontana F, Timb Timb F, Facchini A, Marcelli Graziosi B, Rossini G, Ballabio A, Palillo A, Costa J, Inversini D, Ietto G, Carcano G. P-091 IMPROVEMENT OF RESPIRATORY PHYSIOLOGY AFTER POSTERIOR COMPONENT SEPARATION TAR: A PILOT STUDY. Br J Surg 2022. [DOI: 10.1093/bjs/znac308.189] [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] [Indexed: 11/14/2022]
Abstract
Abstract
Aim
Patients with incisional hernia with a width greater than 9 centimeters, submitted to Posterior Component Separation Trasversus Abdominis Release, by Department of Emergency and Transplantation Surgery in Varese Hospital, were analyzed to define the modifications in respiratory physiology after surgery.
Material and Methods
Patients that underwent Posterior Component Separation were prospectively analyzed by evaluating: volume of laparocele, volume of abdominal cavity and their ratio. Furthermore Pulmonary Peak pressures and Pulmonary Plateau pressures were measured in three different times: at the induction of the anaesthesia, when the mesh was placed and at the closure of the anterior muscular layer. All patients were submitted to a pre-operative simple spirometry, and re-examinated three months after the surgical procedure with the same procedure to check if modifications in their respiratory function were present.
Results
Primary results of the study will be shown to define how this surgical procedure impacts on the respiratory function of the patients. The expectation is that an improvement of the respiratory physiology happens independently from a pulmonary pressure elevation which is determinated by the re-allocation of the herniated viscera in the abdomen when the anterior muscular fascia is closed.
Conclusions
the aim of this study is to show how, the reconstitution of a functional abdominal wall with an efficient respiratory accessory musculature guaranteed by the laparocele correction with Posterior Component Separation, ensures an improvement of respiratory physiology visible with spirometry, independently from the development of a superior intrathoracic pressure.
Collapse
Affiliation(s)
- L Latham
- Emergency and Transplantation Surgery , Ospedale di Circolo, Varese , Italy
| | - S Gianazza
- Emergency and Transplantation Surgery, University of Insubria , Varese , Italy
| | - S Garbarino
- Emergency and Transplantation Surgery , Ospedale di Circolo, Varese , Italy
| | - S G Coriele
- General Surgery, University of Insubria , Cittiglio , Italy
| | - F Fontana
- Radiology , Ospedale di Circolo, Varese , Italy
| | - F Timb Timb
- Radiology, University of Insubria , Varese , Italy
| | - A Facchini
- Pneumology , Ospedale di Circolo, Varese , Italy
| | | | - G Rossini
- Anestesiology , Ospedale di Circolo, Varese , Italy
| | - A Ballabio
- Emergency and Transplantation Surgery, University of Insubria , Varese , Italy
| | - A Palillo
- Emergency and Transplantation Surgery, University of Insubria , Varese , Italy
| | - J Costa
- Emergency and Transplantation Surgery, University of Insubria , Varese , Italy
| | - D Inversini
- Emergency and Transplantation Surgery, University of Insubria , Varese , Italy
| | - G Ietto
- Emergency and Transplantation Surgery, University of Insubria , Varese , Italy
| | - G Carcano
- Emergency and Transplantation Surgery, University of Insubria , Varese , Italy
| |
Collapse
|
2
|
Bikbov B, Ruggenenti P, Perna A, Perico N, Gotti E, Plati A, Gaspari F, Carrara F, Gambara V, Peracchi T, Rossini G, Rota G, Lacanna F, Amaduzzi A, Colledan M, Remuzzi G. Long-Term Outcomes of Kidney Transplants from Older/Marginal Donors: A Cohort Study. Nephron Clin Pract 2021; 145:642-652. [PMID: 34130292 DOI: 10.1159/000516534] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 04/07/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION To safely expand the donor pool, we introduced a strategy of biopsy-guided selection and allocation to single or dual transplantation of kidneys from donors >60 years old or with hypertension, diabetes, and/or proteinuria (older/marginal donors). Here, we evaluated the long-term performance of this approach in everyday clinical practice. METHODS In this single-center cohort study, we compared outcomes of 98 patients who received one or two biopsy-evaluated grafts from older/marginal donors ("recipients") and 198 patients who received nonhistologically assessed single graft from ideal donors ("reference-recipients") from October 2004 to December 2015 at the Bergamo Transplant Center (Italy). RESULTS Older/marginal donors and their recipients were 27.9 and 19.3 years older than ideal donors and their reference-recipients, respectively. KDPI/KDRI and donor serum creatinine were higher and cold ischemia time longer in the recipient group. During a median follow-up of 51.9 (interquartile range 23.1-88.6) months, 11.2% of recipients died, 7.1% lost their graft, and 16.3% had biopsy-proven acute rejection (BPAR) versus 3.5, 7.6, and 17.7%, respectively, of reference-recipients. Overall death-censored graft failure (rate ratio 0.78 [95% CI 0.33-2.08]), 5-year death-censored graft survival (94.3% [87.8-100.0] vs. 94.2% [90.5-98.0]), BPAR incidence (rate ratio 0.87 [0.49-1.62]), and yearly measured glomerular filtration rate decline (1.18 ± 3.27 vs. 0.68 ± 2.42 mL/min/1.73 m2, p = 0.37) were similar between recipients and reference-recipients, respectively. CONCLUSIONS Biopsy-guided selection and allocation of kidneys from older/marginal donors can safely increase transplant activity in clinical practice without affecting long-term outcomes. This may help manage the growing gap between organ demand and supply without affecting long-term recipient and graft outcomes.
Collapse
Affiliation(s)
- Boris Bikbov
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy
| | - Piero Ruggenenti
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy.,Nephrology Dialysis and Transplantation Unit, ASST-Papa Giovanni XXIII, Bergamo, Italy
| | - Annalisa Perna
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy
| | - Norberto Perico
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy
| | - Eliana Gotti
- Nephrology Dialysis and Transplantation Unit, ASST-Papa Giovanni XXIII, Bergamo, Italy
| | - AnnaRita Plati
- Nephrology Dialysis and Transplantation Unit, ASST-Papa Giovanni XXIII, Bergamo, Italy
| | - Flavio Gaspari
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy
| | - Fabiola Carrara
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy
| | - Vincenzo Gambara
- Nephrology Dialysis and Transplantation Unit, ASST-Papa Giovanni XXIII, Bergamo, Italy
| | - Tobia Peracchi
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy
| | - Giuseppe Rossini
- Organ and Tissue Transplant Immunology Unit, Foundation IRCCS "Ca' Granda Ospedale Maggiore Policlinico", Milan, Italy
| | - Giovanni Rota
- Pediatric Surgery Unit, ASST-Papa Giovanni XXIII, Bergamo, Italy
| | | | - Annalisa Amaduzzi
- General Surgery and Abdominal Transplantation Unit, ASST-Papa Giovanni XXIII, Bergamo, Italy
| | - Michele Colledan
- General Surgery and Abdominal Transplantation Unit, ASST-Papa Giovanni XXIII, Bergamo, Italy
| | - Giuseppe Remuzzi
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy
| |
Collapse
|
3
|
Eccher A, Carraro A, Girolami I, Villanova M, Borin A, Violi P, Paro B, Mescoli C, Malvi D, Novelli L, D'Errico A, Rossini G, Ungari M. Diffuse Micro-Nodules on Peritoneal Surfaces at Donor Organ Procurement: Highlights on the Diagnostic Challenge and Transplant Management. Am J Case Rep 2021; 22:e929348. [PMID: 33579891 PMCID: PMC7888240 DOI: 10.12659/ajcr.929348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Patient: Female, 41-year-old Final Diagnosis: Diffuse leiomyomatosis Symptoms: None Medication:— Clinical Procedure: — Specialty: Pathology
Collapse
Affiliation(s)
- Albino Eccher
- Department of Pathology and Diagnostics, University and Hospital Trust of Verona, Verona, Italy
| | - Amedeo Carraro
- General Surgery and Liver Transplant Unit, University and Hospital Trust of Verona, Verona, Italy
| | - Ilaria Girolami
- Department of Pathology and Diagnostics, University and Hospital Trust of Verona, Verona, Italy
| | - Manuela Villanova
- Department of Pathology and Diagnostics, University and Hospital Trust of Verona, Verona, Italy
| | - Alex Borin
- General Surgery and Liver Transplant Unit, University and Hospital Trust of Verona, Verona, Italy
| | - Paola Violi
- Department of Vascular Surgery, ASST Hospital Trust of Brescia, Brescia, Italy
| | - Barbara Paro
- Department of Vascular Surgery, ASST Hospital Trust of Brescia, Brescia, Italy
| | - Claudia Mescoli
- Pathology Unit, Department of Medicine, University and Hospital Trust of Padua, Padua, Italy
| | - Deborah Malvi
- Department of Experimental Diagnostic and Specialty Medicine, University of Bologna, Policlinico St. Orsola-Malpighi Hospital, Bologna, Italy
| | - Luca Novelli
- Institute of Histopathology and Molecular Diagnosis, Careggi University Hospital, Florence, Italy
| | - Antonietta D'Errico
- Department of Experimental Diagnostic and Specialty Medicine, University of Bologna, Policlinico St. Orsola-Malpighi Hospital, Bologna, Italy
| | - Giuseppe Rossini
- North Italy Transplant Program, Fondazione IRCCS "Ca' Granda Ospedale Maggiore Policlinico", Milan, Italy
| | - Marco Ungari
- Department of Pathology, ASST Hospital Trust of Cremona, Cremona, Italy
| |
Collapse
|
4
|
Pappalardo O, Pasquali M, Maltagliati A, Rossini G, Italiano G, Fusini L, Penso M, Tamborini G, Andreini D, Redaelli A, Pepi M. A platform for real-3d visualization and planning of left atrial appendage occlusion through mixed reality. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.247] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
In left atrial appendage occlusion (LAAO), pre-procedural computed tomography (CT) is pivotal to describe the complex and highly variable LAA anatomy and to guide the operator in accurate planning of the intervention. Multiplanar reconstruction and 3D rendering are used for the navigation and analysis of the 3D datasets but they share some limitations that are due to the use of 2D screens; Mixed Reality (MxR) technology aims at overcoming such limitations by allowing for real-3D visualizations with holographic replicas of anatomical models while preserving a sense of presence within the true physical environment by the operator.
Purpose
To develop and test a MxR platform that provides a more intuitive and informative tool for the morphological analysis during the planning phase of LAAO.
Methods
Patients (n = 4) were randomly selected among those referred for a CT scan prior to transcatheter aortic valve replacement, each one characterized by a specific LAA morphology (cauliflower, bilobular, chicken wing, wind-sock). CT scans were performed in diastole at 75% of the R-R interval on a 64-slice scanner, with in-plane resolution 0.38-0.64 mm and slice thickness 0.62 mm. Firstly, the acquisition was cropped to contain the left atrium, the circumflex artery, the left upper pulmonary ridge. Subsequently, an isosurface with high coincidence between the blood cavity border and the endocardium was identified by the user and processed using a marching cube algorithm to obtain the 3D model. Finally, the 3D model was optimized for a MxR platform that allows for moving, zooming and cutting the model, measuring the main LAA linear dimensions and simulating the implant of a virtual replica of a transcatheter occluder.
Results
The workflow was successfully applied for all the patients independently from the morphology. All the models were successfully uploaded in the MxR platform (Fig 1.a) and for all the patients the morphological analysis was performed (Fig 1.b) in less than 10 minutes.
The four different morphologies of the LAA were correctly identified allowing a very detailed holographic modeling of the structure, including the neck, the landing zone, the curvature and the position and size of lobes.
For both the identified ostium and landing planes, using a dedicated measuring tool (Fig. 1.c), the operator measured the minimum and maximum diameters, which were later used to define the size of the occluder device to be used in the virtual implant simulation (Fig. 1.d).
Conclusions
The tested MxR platform suggested the potential to overcome the limits of the standard technologies in planning of LAAO thanks to the real-3D perception, potentially leading to a more accurate and faster planning phase. Furthermore, the use of MxR technology may enhance the ability to predict the optimal device size and position within the anatomy to obtain LAA complete sealing.
Abstract Figure.
Collapse
Affiliation(s)
| | | | | | | | - G Italiano
- IRCCS Centro Cardiologico Monzino, Milan, Italy
| | - L Fusini
- IRCCS Centro Cardiologico Monzino, Milan, Italy
| | - M Penso
- IRCCS Centro Cardiologico Monzino, Milan, Italy
| | - G Tamborini
- IRCCS Centro Cardiologico Monzino, Milan, Italy
| | - D Andreini
- IRCCS Centro Cardiologico Monzino, Milan, Italy
| | - A Redaelli
- Politecnico di Milano, Dipartimento di Elettronica, Informazione e Bioingegneria, Milano, Italy
| | - M Pepi
- IRCCS Centro Cardiologico Monzino, Milan, Italy
| |
Collapse
|
5
|
Carrara C, Cravedi P, Perna A, Peraro F, Villa A, Carrara F, Cortinovis M, Gotti E, Plati AR, Amaduzzi A, Rota G, Lacanna F, Rossini G, Abelli M, Remuzzi G, Ruggenenti P. Preimplantation Histological Score Associates with 6-Month GFR in Recipients of Perfused, Older Kidney Grafts: Results from a Pilot Study. Nephron Clin Pract 2021; 145:137-149. [PMID: 33486477 DOI: 10.1159/000512341] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 10/14/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Biopsy-guided selection of older kidneys safely expands the organ pool, and pretransplant perfusion improves the preservation of these fragile organs. Herein, we studied morphofunctional variables associated with graft outcomes in perfused, histologically evaluated older kidneys. METHODS This single-center prospective cohort pilot study evaluated the relationships between preimplantation histologic scores and renal perfusion parameters during hypothermic, pulsatile, machine perfusion (MP) and assessed whether these morphofunctional parameters associated with GFR (iohexol plasma clearance) at 6 months after transplantation in 20 consecutive consenting recipients of a biopsy-guided single or dual kidney transplant from >60-year-old deceased donors. RESULTS The donor and recipient age was 70.4 ± 6.5 and 63.6 ± 7.9 years (p = 0.005), respectively. The kidney donor profile index (KDPI) was 93.3 ± 8.4% (>80% in 19 cases), histologic score 4.4 ± 1.4, and median (IQR) cold ischemia time 19.8 (17.8-22.8 h; >24 h in 5 cases). The 6-month GFR was 41.2 (34.9-55.7) mL/min. Vascular resistances positively correlated with global histologic score (p = 0.018) at MP start and then decreased from 0.88 ± 0.43 to 0.36 ± 0.13 mm Hg/mL/min (p < 0.001) in parallel with a three-fold renal flow increase from 24.0 ± 14.7 to 74.7 ± 31.8 mL/min (p < 0.001). Consistently, vascular resistance reductions positively correlated with global histologic score (p = 0.009, r = -0.429). Unlike KDPI or vascular resistances, histologic score was independently associated with 6-month GFR (beta standardized coefficient: -0.894, p = 0.005). CONCLUSIONS MP safely improves graft perfusion, particularly in kidneys with severe histologic changes that would not be considered for transplantation because of high KDPI. The preimplantation histologic score associates with the functional recovery of older kidneys even in the context of a standardized program of pulsatile perfusion.
Collapse
Affiliation(s)
- Camillo Carrara
- Department of Renal Medicine, Clinical Research Centre for Rare Diseases "Aldo e Cele Daccò": Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy.,Unit of Nephrology and Dialysis, Azienda Socio-Sanitaria Territoriale (ASST) Papa Giovanni XXIII, Bergamo, Italy
| | - Paolo Cravedi
- Department of Medicine, Icahn School of Medicine at Mount Sinai, Translational Transplant Research Center, New York, New York, USA
| | - Annalisa Perna
- Department of Renal Medicine, Clinical Research Centre for Rare Diseases "Aldo e Cele Daccò": Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy
| | - Francesco Peraro
- Department of Renal Medicine, Clinical Research Centre for Rare Diseases "Aldo e Cele Daccò": Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy
| | - Alessandro Villa
- Department of Renal Medicine, Clinical Research Centre for Rare Diseases "Aldo e Cele Daccò": Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy
| | - Fabiola Carrara
- Department of Renal Medicine, Clinical Research Centre for Rare Diseases "Aldo e Cele Daccò": Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy
| | - Monica Cortinovis
- Department of Renal Medicine, Clinical Research Centre for Rare Diseases "Aldo e Cele Daccò": Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy
| | - Eliana Gotti
- Unit of Nephrology and Dialysis, Azienda Socio-Sanitaria Territoriale (ASST) Papa Giovanni XXIII, Bergamo, Italy
| | - Anna Rita Plati
- Unit of Nephrology and Dialysis, Azienda Socio-Sanitaria Territoriale (ASST) Papa Giovanni XXIII, Bergamo, Italy
| | - Annalisa Amaduzzi
- Department of Organ Failure and Transplantation, Azienda Socio-Sanitaria Territoriale (ASST) Papa Giovanni XXIII, Bergamo, Italy
| | - Giovanni Rota
- Department of Organ Failure and Transplantation, Azienda Socio-Sanitaria Territoriale (ASST) Papa Giovanni XXIII, Bergamo, Italy
| | - Francesco Lacanna
- Department of Organ Failure and Transplantation, Azienda Socio-Sanitaria Territoriale (ASST) Papa Giovanni XXIII, Bergamo, Italy
| | - Giuseppe Rossini
- Organ and Tissue Transplant Immunology Unit, Foundation IRCCS "Ca' Granda Ospedale Maggiore Policlinico", Milan, Italy
| | - Massimo Abelli
- Kidney Transplant Unit, Foundation IRCCS Policlinico San Matteo, Pavia, Italy
| | - Giuseppe Remuzzi
- Department of Renal Medicine, Clinical Research Centre for Rare Diseases "Aldo e Cele Daccò": Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy,
| | - Piero Ruggenenti
- Department of Renal Medicine, Clinical Research Centre for Rare Diseases "Aldo e Cele Daccò": Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy.,Unit of Nephrology and Dialysis, Azienda Socio-Sanitaria Territoriale (ASST) Papa Giovanni XXIII, Bergamo, Italy
| |
Collapse
|
6
|
Picozzi M, Nicoli F, Biffa G, De Feo TM, Pegoraro R, Piccolo G, Piga MA, Rossini G, Vesconi S, Limido A. [Waiting time on dialysis for active access to renal transplantation: a multicenter cross-sectional study in Lombardy]. G Ital Nefrol 2019; 36:36-2-2019-13. [PMID: 30983180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND The amount of time spent in dialysis waiting for a renal transplantation significantly affects its outcome. Hence, the timely planning of patients' transplant evaluation is crucial. According to data from the Nord Italia Transplant program (NITp), the average waiting time between the beginning of dialysis and the admission to the regional transplant waiting list in Lombardy is 20.2 months. METHODS A multicenter cross-sectional study was conducted in order to identify the causes of these delays and find solutions. Two questionnaires were administered to the directors of 47 Nephrology Units and to 106 patients undergoing dialysis in Lombardy respectively, during their first visit for admission to the transplant waiting list. RESULTS The comparative analysis of the results revealed that both patients (52%) and directors (75%) consider the time required for registering to the waiting list too long. Patients judge information about the transplant to be insufficient, especially regarding the pre-emptive option (63% of patients declare that they had not been informed about this opportunity). Patients report a significantly longer time for the completion of pre-transplantation tests (more than 1 year in 23% of the cases) compared to that indicated by the directors. CONCLUSIONS The study confirmed the necessity of providing better and more timely information to patients regarding the different kidney transplantation options and highlighted the importance of creating target-oriented and dedicated pathways in all hospitals.
Collapse
Affiliation(s)
- Mario Picozzi
- MD, PhD, Professore Associato di Medicina Legale, Direttore del Centro di Ricerca in Etica Clinica, Dipartimento di Biotecnologie e Scienze della Vita, Università degli Studi dell'Insubria, Varese, Italia
| | - Federico Nicoli
- PhD, membro del Centro di Ricerca in Etica Clinica, Dipartimento di Biotecnologie e Scienze della Vita, Università degli Studi dell'Insubria, Varese, Italia; referente del Servizio di Etica Clinica, Casa di cura Domus Salutis, Fondazione Teresa Camplani, Brescia, Italia
| | - Gabriella Biffa
- U.O. di Psicologia Clinica e Psicoterapia, Ospedale Universitario San Martino, Genova, Italia
| | - Tullia Maria De Feo
- MD, PhD, North Italy Transplant program, Fondazione IRCCS "Ca' Granda Ospedale Maggiore Policlinico", Milano, Italia
| | - Renzo Pegoraro
- MD, Cancelliere presso la Pontificia Accademia per la Vita, Città del Vaticano
| | - Giuseppe Piccolo
- MD, Coordinatore regionale trapianti, North Italy Transplant program, Fondazione IRCCS "Ca' Granda Ospedale Maggiore Policlinico", Milano, Italia
| | - Maria Antonella Piga
- MD, Ricercatrice in Medicina Legale e del Lavoro, Università degli Studi di Milano, Italia
| | - Giuseppe Rossini
- North Italy Transplant program, Fondazione IRCCS "Ca' Granda Ospedale Maggiore Policlinico", Milano, Italia
| | - Sergio Vesconi
- MD, membro del Comitato Esecutivo del Sistema Trapianti di Regione Lombardia, Milano, Italia
| | - Aurelio Limido
- MD, UO Nefrologia e Dialisi, ASST Fatebenefratelli e Oftalmico, Milano, Italia
| |
Collapse
|
7
|
Ruggenenti P, Silvestre C, Boschiero L, Rota G, Furian L, Perna A, Rossini G, Remuzzi G, Rigotti P. Long-term outcome of renal transplantation from octogenarian donors: A multicenter controlled study. Am J Transplant 2017; 17:3159-3171. [PMID: 28792681 DOI: 10.1111/ajt.14459] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 07/11/2017] [Accepted: 08/01/2017] [Indexed: 02/06/2023]
Abstract
To assess whether biopsy-guided selection of kidneys from very old brain-dead donors enables more successful transplantations, the authors of this multicenter, observational study compared graft survival between 37 recipients of 1 or 2 histologically evaluated kidneys from donors older than 80 years and 198 reference-recipients of non-histologically evaluated single grafts from donors aged 60 years and younger (transplantation period: 2006-2013 at 3 Italian centers). During a median (interquartile range) of 25 (13-42) months, 2 recipients (5.4%) and 10 reference-recipients (5.1%) required dialysis (crude and donor age- and sex-adjusted hazard ratio [95% confidence interval] 1.55 [0.34-7.12], P = .576 and 1.41 [0.10-19.54], P = .798, respectively). Shared frailty analyses confirmed similar outcomes in a 1:2 propensity score study comparing recipients with 74 reference-recipients matched by center, year, donor, and recipient sex and age. Serum creatinine was similar across groups during 84-month follow-up. Recipients had remarkably shorter waiting times than did reference-recipients and matched reference-recipients (7.5 [4.0-19.5] vs 36 [19-56] and 40 [24-56] months, respectively, P < .0001 for both comparisons). Mean (± SD) kidney donor risk index was 2.57 ± 0.32 in recipients vs 1.09 ± 0.24 and 1.14 ± 0.24 in reference-recipients and matched reference-recipients (P < .0001 for both comparisons). Adverse events were similar across groups. Biopsy-guided allocation of kidneys from octogenarian donors permits further expansion of the donor organ pool and faster access to a kidney transplant, without increasing the risk of premature graft failure.
Collapse
Affiliation(s)
- Piero Ruggenenti
- IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Clinical Research Center for Rare Diseases Aldo e Cele Daccò, Bergamo, Italy.,Nephrology and Dialysis Unit, Azienda Socio Sanitaria Territoriale (ASST) Papa Giovanni XXIII, Bergamo, Italy
| | - Cristina Silvestre
- Kidney and Pancreas Transplant Unit, University Hospital of Padua, Padua, Italy
| | - Luigino Boschiero
- Kidney Transplantation Unit, Department of Surgery, Azienda Ospedaliero-Universitaria (AOUI) di Verona, Verona, Italy
| | - Giovanni Rota
- Kidney Transplantation Center, Unit of Pediatric Surgery, Azienda Socio Sanitaria Territoriale (ASST) Papa Giovanni XXIII, Bergamo, Italy
| | - Lucrezia Furian
- Kidney and Pancreas Transplant Unit, University Hospital of Padua, Padua, Italy
| | - Annalisa Perna
- Nephrology and Dialysis Unit, Azienda Socio Sanitaria Territoriale (ASST) Papa Giovanni XXIII, Bergamo, Italy
| | - Giuseppe Rossini
- Organ and Tissue Transplant Immunology Unit, Foundation IRCCS "Ca' Granda Ospedale Maggiore Policlinico", Milan, Italy
| | - Giuseppe Remuzzi
- IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Clinical Research Center for Rare Diseases Aldo e Cele Daccò, Bergamo, Italy.,Nephrology and Dialysis Unit, Azienda Socio Sanitaria Territoriale (ASST) Papa Giovanni XXIII, Bergamo, Italy.,Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Paolo Rigotti
- Kidney and Pancreas Transplant Unit, University Hospital of Padua, Padua, Italy
| |
Collapse
|
8
|
Specchia ML, Cacciatore P, Rossini G, Calabrò GE, Ferriero AM, Petitti T, Rosolia A, Ricciardi W, Damiani G. Do Public-Private Partnerships add value to healthcare delivery? Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx187.269] [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: 11/12/2022] Open
Affiliation(s)
- ML Specchia
- Department of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - P Cacciatore
- Department of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - G Rossini
- Department of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - GE Calabrò
- Department of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - AM Ferriero
- Department of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - T Petitti
- Public Health Research and Statistics Unit, Università Campus Bio-Medico, Rome, Italy
| | - A Rosolia
- Public Health Research and Statistics Unit, Università Campus Bio-Medico, Rome, Italy
| | - W Ricciardi
- Department of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - G Damiani
- Department of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| |
Collapse
|
9
|
Gaspari V, Ortalli M, Foschini M, Baldovini C, Lanzoni A, Cagarelli R, Gaibani P, Rossini G, Vocale C, Tigani R, Gentilomi G, Misciali C, Pesci S, Patrizi A, Landini M, Varani S. New evidence of cutaneous leishmaniasis in north-eastern Italy. J Eur Acad Dermatol Venereol 2017; 31:1534-1540. [DOI: 10.1111/jdv.14309] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 04/12/2017] [Indexed: 12/13/2022]
Affiliation(s)
- V. Gaspari
- Unit of Dermatology; Department of Experimental, Diagnostic and Specialty Medicine; University of Bologna; St. Orsola Malpighi University Hospital; Bologna Italy
| | - M. Ortalli
- Unit of Microbiology; Department of Experimental, Diagnostic and Specialty Medicine; University of Bologna; Bologna Italy
| | - M.P. Foschini
- Department of Biomedical and Neuro Motor Sciences; Anatomic Pathology “M.Malpighi” at Bellaria Hospital; University of Bologna; Bologna Italy
| | - C. Baldovini
- Department of Biomedical and Neuro Motor Sciences; Anatomic Pathology “M.Malpighi” at Bellaria Hospital; University of Bologna; Bologna Italy
| | - A. Lanzoni
- Unit of Dermatology; Bellaria Hospital; Bologna Italy
| | - R. Cagarelli
- Public Health Authority; Emilia-Romagna Region Italy
| | - P. Gaibani
- Unit of Microbiology; Regional Reference Center for Microbiological Emergencies (CRREM); St. Orsola Malpighi University Hospital; Bologna Italy
| | - G. Rossini
- Unit of Microbiology; Regional Reference Center for Microbiological Emergencies (CRREM); St. Orsola Malpighi University Hospital; Bologna Italy
| | - C. Vocale
- Unit of Microbiology; Regional Reference Center for Microbiological Emergencies (CRREM); St. Orsola Malpighi University Hospital; Bologna Italy
| | - R. Tigani
- Unit of Microbiology; Regional Reference Center for Microbiological Emergencies (CRREM); St. Orsola Malpighi University Hospital; Bologna Italy
| | - G.A. Gentilomi
- Department of Pharmacy and Biotechnology; University of Bologna; Bologna Italy
| | - C. Misciali
- Unit of Dermatology; Department of Experimental, Diagnostic and Specialty Medicine; University of Bologna; St. Orsola Malpighi University Hospital; Bologna Italy
| | - S. Pesci
- Unit of Dermatology; Department of Experimental, Diagnostic and Specialty Medicine; University of Bologna; St. Orsola Malpighi University Hospital; Bologna Italy
| | - A. Patrizi
- Unit of Dermatology; Department of Experimental, Diagnostic and Specialty Medicine; University of Bologna; St. Orsola Malpighi University Hospital; Bologna Italy
| | - M.P. Landini
- Unit of Microbiology; Department of Experimental, Diagnostic and Specialty Medicine; University of Bologna; Bologna Italy
- Istituto di Ricovero e Cura a carattere scientifico; Istituto Ortopedico Rizzoli; Bologna Italy
| | - S. Varani
- Unit of Microbiology; Department of Experimental, Diagnostic and Specialty Medicine; University of Bologna; Bologna Italy
- Unit of Microbiology; Regional Reference Center for Microbiological Emergencies (CRREM); St. Orsola Malpighi University Hospital; Bologna Italy
| |
Collapse
|
10
|
Pierro A, Ficarelli S, Ayhan N, Morini S, Raumer L, Bartoletti M, Mastroianni A, Prati F, Schivazappa S, Cenni P, Vocale C, Rossini G, Gaibani P, Sambri V, Landini MP, Lewis RE, Charrel RN, Varani S. Characterization of antibody response in neuroinvasive infection caused by Toscana virus. Clin Microbiol Infect 2017; 23:868-873. [PMID: 28344163 DOI: 10.1016/j.cmi.2017.03.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 10/10/2016] [Revised: 03/13/2017] [Accepted: 03/16/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Among sandfly-borne pathogens, Toscana virus (TOSV) is a prominent cause of summer meningitis in Mediterranean Europe. Here, we assessed the kinetics of anti-TOSV antibodies over time in 41 patients diagnosed with TOSV meningitis or meningoencephalitis in northeastern Italy. METHODS Acute and follow-up serum samples were collected up to 20 months after diagnosis of TOSV infection and tested for the presence of specific antibody using immunoenzymatic and indirect immunofluorescence assays. In addition, maturation of anti-TOSV IgG over time was evaluated as well as production of neutralizing antibodies. RESULTS Specific IgM and IgG response was present at diagnosis in 100% of patients; TOSV-specific IgM and IgG were detected in patients' sera up to 6 and 20 months after diagnosis, respectively. The avidity index (AI) increased over the first month after infection in 100% of patients and most cases exceeded 60% by Day 30 post infection. The AI subsequently plateaued then declined at 20 months after diagnosis. Finally, neutralization assay to TOSV was performed in 217 sera collected from 41 patients; 69.6% of tested samples resulted in reactive and moderate levels of neutralizing antibodies observed during all phases of infection despite high titres of total anti-TOSV IgG. CONCLUSIONS Specific antibody response develops rapidly and is long-lasting for neuroinvasive TOSV infection. Serodiagnosis of neuroinvasive TOSV requires simultaneous detection of specific IgM and IgG. Moderate levels of neutralizing antibodies were maintained over the study period, while the protective role of antibodies lacking neutralizing activity is unclear and requires further evaluation.
Collapse
Affiliation(s)
- A Pierro
- Unit of Microbiology, CRREM Laboratory, St. Orsola-Malpighi University Hospital, Bologna, Italy; Unit of Microbiology, The Romagna Hub Laboratory, Pievesestina, Italy.
| | - S Ficarelli
- Unit of Microbiology, CRREM Laboratory, St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - N Ayhan
- UMR "Emergence des Pathologies Virales" (EPV: Aix-Marseille Univ - IRD 190 - Inserm1207 - EHESP) & Fondation IHU Méditerranée Infection, APHM Public Hospitals of Marseille, Marseille, France
| | - S Morini
- Unit of Microbiology, CRREM Laboratory, St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - L Raumer
- Infectious Disease Unit, Department of Medical and Surgical Science, University of Bologna, Bologna, Italy
| | - M Bartoletti
- Infectious Disease Unit, Department of Medical and Surgical Science, University of Bologna, Bologna, Italy
| | - A Mastroianni
- Infectious Disease Unit, G.B. Morgagni-Pierantoni Hospital, Forlì, Italy
| | - F Prati
- Infectious Disease Division, Reggio Emilia Hospital, Reggio Emilia, Italy
| | - S Schivazappa
- Infectious Disease Division, Reggio Emilia Hospital, Reggio Emilia, Italy
| | - P Cenni
- Emergency Department, St. Maria della Scaletta, Imola, Italy
| | - C Vocale
- Unit of Microbiology, CRREM Laboratory, St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - G Rossini
- Unit of Microbiology, CRREM Laboratory, St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - P Gaibani
- Unit of Microbiology, CRREM Laboratory, St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - V Sambri
- Unit of Microbiology, The Romagna Hub Laboratory, Pievesestina, Italy; Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - M P Landini
- Unit of Microbiology, CRREM Laboratory, St. Orsola-Malpighi University Hospital, Bologna, Italy; Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - R E Lewis
- Infectious Disease Unit, Department of Medical and Surgical Science, University of Bologna, Bologna, Italy
| | - R N Charrel
- UMR "Emergence des Pathologies Virales" (EPV: Aix-Marseille Univ - IRD 190 - Inserm1207 - EHESP) & Fondation IHU Méditerranée Infection, APHM Public Hospitals of Marseille, Marseille, France
| | - S Varani
- Unit of Microbiology, CRREM Laboratory, St. Orsola-Malpighi University Hospital, Bologna, Italy; Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| |
Collapse
|
11
|
La Torre G, Rossini G, Saulle R, Mannocci A, Di Thiene D, Mauro V, Barbato E. [Randomized controlled trial on the promotion of healthy lifestyles among adolescents in the orthodontic setting: study protocol]. Clin Ter 2016; 164:e301-4. [PMID: 24045528 DOI: 10.7417/ct.2013.1593] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Many studies have shown that the bad lifestyles are the major factors thought to influence susceptibility to many diseases in our society and often these habits during the adolescence begin. The aim of the study was to evaluate the health promotion intervention effect in an orthodontic adolescent sample, in particular: deterring adolescents from smoking; discourage the use and abuse of alcoholic beverages; encourage the adherence to the Mediterranean style diet. A blinded randomized controlled trial will be performed. The participants will be adolescents aged 10 to 14 years that will receive a medical examination in the Complex Unit of Orthodontics. The sample will be followed for three years. The collected evidence would be a scientific support for decisions in public health, in order to increase the health of the young generations.
Collapse
Affiliation(s)
- G La Torre
- Dipartimenti di Sanità Pubblica e Malattie Infettive, apienza Università di Roma
| | | | | | | | | | | | | |
Collapse
|
12
|
Castroflorio T, Bargellini A, Rossini G, Cugliari G, Deregibus A, Manfredini D. Agreement between clinical and portable EMG/ECG diagnosis of sleep bruxism. J Oral Rehabil 2015; 42:759-64. [DOI: 10.1111/joor.12320] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2015] [Indexed: 11/29/2022]
Affiliation(s)
- T. Castroflorio
- Department of Surgical Sciences; Specialization School of Orthodontics; Dental School; University of Torino; Torino Italy
| | - A. Bargellini
- Department of Surgical Sciences; Specialization School of Orthodontics; Dental School; University of Torino; Torino Italy
- Gnathology Unit; Department of Surgical Sciences; Dental School; University of Torino; Torino Italy
| | - G. Rossini
- Department of Surgical Sciences; Specialization School of Orthodontics; Dental School; University of Torino; Torino Italy
- Gnathology Unit; Department of Surgical Sciences; Dental School; University of Torino; Torino Italy
| | - G. Cugliari
- Unit of Medical and Genomic Statistics; Department of Brain and Behavioural Sciences; University of Pavia; Pavia Italy
| | - A. Deregibus
- Department of Surgical Sciences; Specialization School of Orthodontics; Dental School; University of Torino; Torino Italy
- Gnathology Unit; Department of Surgical Sciences; Dental School; University of Torino; Torino Italy
| | - D. Manfredini
- Department of Maxillofacial Surgery; TMD Clinic; University of Padova; Padova Italy
| |
Collapse
|
13
|
Scalamogna M, Pizzi C, Mercuriali F, Poli F, Lecchi L, Rossini G, Sirchia G. Two years of ciclosporin in the North Italy Transplant Program. Contrib Nephrol 2015; 51:39-44. [PMID: 3552418 DOI: 10.1159/000413092] [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] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
|
14
|
Calzolari M, Angelini P, Finarelli AC, Cagarelli R, Bellini R, Albieri A, Bonilauri P, Cavrini F, Tamba M, Dottori M, Gaibani P, Natalini S, Maioli G, Pinna M, Mattivi A, Sambri V, Pierro A, Landini MP, Rossini G, Squintani G, Cinotti S, Varani S, Vocale C, Bedeschi E. Human and entomological surveillance of Toscana virus in the Emilia-Romagna region, Italy, 2010 to 2012. Euro Surveill 2014; 19:20978. [DOI: 10.2807/1560-7917.es2014.19.48.20978] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Toscana virus (TOSV), transmitted by phlebotomine sandflies, is recognised as one of the most important causes of viral meningitis in summer in Mediterranean countries. A surveillance plan based on both human and entomological surveys was started in 2010 in the Emilia-Romagna region, Italy. Clinical samples from patients with neurological manifestations were collected during 2010 to 2012. The surveillance protocol was improved during these years, allowing the detection of 65 human infections. Most of these infections were recorded in hilly areas, where sandflies reach the highest density. Entomological sampling around the homes of the patients resulted in a low number of captured sandflies, while later sampling in a hilly area with high number of human cases (n=21) resulted in a larger number of captured sandflies. Using this approach, 25,653 sandflies were sampled, of which there were 21,157 females, which were sorted into 287 pools. TOSV RNA was detected by real-time PCR in 33 of the pools. The results highlighted the role of Phlebotomus perfiliewi as the main vector of TOSV and a potential link between vector density and virus circulation. This integrated system shows that an interdisciplinary approach improves the sensitiveness and effectiveness of health surveillance.
Collapse
Affiliation(s)
- M Calzolari
- Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia-Romagna, Brescia, Italy
| | - P Angelini
- Public Health Service, Emilia-Romagna Region, Bologna, Italy
| | - A C Finarelli
- Public Health Service, Emilia-Romagna Region, Bologna, Italy
| | - R Cagarelli
- Public Health Service, Emilia-Romagna Region, Bologna, Italy
| | - R Bellini
- Centro Agricoltura Ambiente ‘G Nicoli’, Crevalcore, Italy
| | - A Albieri
- Centro Agricoltura Ambiente ‘G Nicoli’, Crevalcore, Italy
| | - P Bonilauri
- Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia-Romagna, Brescia, Italy
| | - F Cavrini
- Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies (CRREM), St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - M Tamba
- Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia-Romagna, Brescia, Italy
| | - M Dottori
- Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia-Romagna, Brescia, Italy
| | - P Gaibani
- Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies (CRREM), St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - S Natalini
- Veterinary and Food Hygiene Service, Emilia-Romagna Region, Bologna, Italy
| | - G Maioli
- Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia-Romagna, Brescia, Italy
| | - M Pinna
- Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia-Romagna, Brescia, Italy
| | - A Mattivi
- Public Health Service, Emilia-Romagna Region, Bologna, Italy
| | - V Sambri
- Unit of Microbiology, Greater Romagna Area Hub Laboratory, Pievesestina, Italy
| | - A Pierro
- Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies (CRREM), St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - M P Landini
- Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies (CRREM), St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - G Rossini
- Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies (CRREM), St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - G Squintani
- Veterinary and Food Hygiene Service, Emilia-Romagna Region, Bologna, Italy
| | - S Cinotti
- Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia-Romagna, Brescia, Italy
| | - S Varani
- Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies (CRREM), St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - C Vocale
- Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies (CRREM), St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - E Bedeschi
- Public Health Service, Emilia-Romagna Region, Bologna, Italy
| |
Collapse
|
15
|
Bellini R, Calzolari M, Mattivi A, Tamba M, Angelini P, Bonilauri P, Albieri A, Cagarelli R, Carrieri M, Dottori M, Finarelli AC, Gaibani P, Landini MP, Natalini S, Pascarelli N, Rossini G, Velati C, Vocale C, Bedeschi E. The experience of West Nile virus integrated surveillance system in the Emilia-Romagna region: five years of implementation, Italy, 2009 to 2013. ACTA ACUST UNITED AC 2014; 19. [PMID: 25394257 DOI: 10.2807/1560-7917.es2014.19.44.20953] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Predicting West Nile virus (WNV) circulation and the risk of WNV epidemics is difficult due to complex interactions of multiple factors involved. Surveillance systems that timely detect virus activity in targeted areas, and allow evidence-based risk assessments may therefore be necessary. Since 2009, a system integrating environmental (mosquitoes and birds) and human surveillance has been implemented and progressively improved in the Emilia-Romagna region, Italy. The objective is to increase knowledge of WNV circulation and to reduce the probability of virus transmission via blood, tissue and organ donation. As of 2013, the system has shown highly satisfactory results in terms of early detection capacity (the environmental surveillance component allowed detection of WNV circulation 3–4 weeks before human cases of West Nile neuroinvasive disease (WNND) occurred), sensitivity (capacity to detect virus circulation even at the enzootic level) and area specificity (capacity to indicate the spatial distribution of the risk for WNND). Strong correlations were observed between the vector index values and the number of human WNND cases registered at the province level. Taking into consideration two scenarios of surveillance, the first with environmental surveillance and the second without, the total costs for the period from 2009 to 2013 were reduced when environmental surveillance was considered (EUR 2.093 million for the first scenario vs EUR 2.560 million for the second). Environmental surveillance helped to reduce costs by enabling a more targeted blood unit testing strategy. The inclusion of environmental surveillance also increased the efficiency of detecting infected blood units and further allowed evidence-based adoption of preventative public health measures.
Collapse
Affiliation(s)
- R Bellini
- Centro Agricoltura Ambiente G.Nicoli , Crevalcore, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Mescia F, Piras R, Noris M, Marchetti G, Rossini G, Remuzzi G, Ruggenenti P. Kidney transplantation from a donor with acute kidney injury: an unexpected outcome. Am J Transplant 2014; 14:977-8. [PMID: 24502566 DOI: 10.1111/ajt.12648] [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: 01/25/2023]
Affiliation(s)
- F Mescia
- Unit of Nephrology and Dialysis, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy
| | | | | | | | | | | | | |
Collapse
|
17
|
Pierro A, Landini MP, Gaibani P, Rossini G, Vocale C, Finarelli AC, Cagarelli R, Sambri V, Varani S. A model of laboratory surveillance for neuro-arbovirosis applied during 2012 in the Emilia-Romagna region, Italy. Clin Microbiol Infect 2013; 20:672-7. [PMID: 24329773 DOI: 10.1111/1469-0691.12436] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [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: 07/24/2013] [Revised: 10/03/2013] [Accepted: 10/21/2013] [Indexed: 11/30/2022]
Abstract
Arboviruses with neuroinvasive potential are gaining more attention due to the increased number of cases of autochthonous and imported infections in the human host. Diagnosis of infection caused by these viruses in patients with central nervous system (CNS) diseases is still underestimated and these infections represent an emerging threat to public health. We describe a model suitable for the laboratory surveillance of neuro-arbovirosis that was applied in the Emilia-Romagna region, north-eastern Italy, during the 2012 summer season. One hundred and twenty cases of suspected neuroinvasive infection were tested for arboviral agents on the basis of clinical and laboratory signs and epidemiological data. The most common virus detected was Toscana virus (TOSV): anti-TOSV specific antibodies or viral components were detected in 28.3% of the cases; 79.4% of the TOSV cases were in the acute phase of infection. No cases resulted in acute phase for West Nile (WNV), Usutu (USUV), Chikungunya (CHIKV) or Dengue (DENV) virus infection. Conversely, two patients with a history of staying in a tick-borne encephalitis virus (TBEV) endemic area showed a probable TBEV infection. These results emphasize the importance of a complete and 'ready to act' laboratory diagnostic system to be implemented within the larger frame of a regional integrated surveillance system.
Collapse
Affiliation(s)
- A Pierro
- Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies (CRREM), St Orsola-Malpighi University Hospital, Bologna, Italy
| | | | | | | | | | | | | | | | | |
Collapse
|
18
|
Pierobon ES, Sefora PE, Sandrini S, Silvio S, De Fazio N, Nicola DF, Rossini G, Giuseppe R, Fontana I, Iris F, Boschiero L, Luigino B, Gropuzzo M, Maria G, Gotti E, Eliana G, Donati D, Donato D, Minetti E, Enrico M, Gandolfo MT, Teresa GM, Brunello A, Anna B, Libetta C, Carmelo L, Secchi A, Antonio S, Chiaramonte S, Stefano C, Rigotti P, Paolo R. Optimizing utilization of kidneys from deceased donors over 60 years: five-year outcomes after implementation of a combined clinical and histological allocation algorithm. Transpl Int 2013; 26:833-41. [PMID: 23782175 DOI: 10.1111/tri.12135] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [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: 08/23/2012] [Revised: 11/02/2012] [Accepted: 05/16/2013] [Indexed: 01/16/2023]
Abstract
This 5 year observational multicentre study conducted in the Nord Italian Transplant programme area evaluated outcomes in patients receiving kidneys from donors over 60 years allocated according to a combined clinical and histological algorithm. Low-risk donors 60-69 years without risk factors were allocated to single kidney transplant (LR-SKT) based on clinical criteria. Biopsy was performed in donors over 70 years or 60-69 years with risk factors, allocated to Single (HR-SKT) or Dual kidney transplant (HR-DKT) according to the severity of histological damage. Forty HR-DKTs, 41 HR-SKTs and 234 LR-SKTs were evaluated. Baseline differences generally reflected stratification and allocation criteria. Patient and graft (death censored) survival were 90% and 92% for HR-DKT, 85% and 89% for HR-SKT, 88% and 87% for LR-SKT. The algorithm appeared user-friendly in daily practice and was safe and efficient, as demonstrated by satisfactory outcomes in all groups at 5 years. Clinical criteria performed well in low-risk donors. The excellent outcomes observed in DKTs call for fine-tuning of cut-off scores for allocation to DKT or SKT in high-risk patients.
Collapse
Affiliation(s)
- Elisa Sefora Pierobon
- Kidney - Pancreas Transplant Unit, Department of Surgical, Oncological and Gastroenterological Sciences, University of Padua, Padua, Italy
| | - Pierobon Elisa Sefora
- Kidney - Pancreas Transplant Unit, Department of Surgical, Oncological and Gastroenterological Sciences, University of Padua, Padua, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Pierro A, Gaibani P, Spadafora C, Ruggeri D, Randi V, Parenti S, Finarelli AC, Rossini G, Landini MP, Sambri V. Detection of specific antibodies against West Nile and Usutu viruses in healthy blood donors in northern Italy, 2010-2011. Clin Microbiol Infect 2013; 19:E451-3. [PMID: 23663225 DOI: 10.1111/1469-0691.12241] [Citation(s) in RCA: 48] [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: 02/11/2013] [Revised: 03/21/2013] [Accepted: 04/04/2013] [Indexed: 11/30/2022]
Abstract
Neutralizing antibodies against West Nile (WNV) and Usutu (USUV) viruses were measured in 6000 samples collected, between 1 September 2010 and 30 June 2011, from blood donors living in different districts of Emilia-Romagna, northeastern Italy. On the basis of the microneutralization assay (MNTA), 47 (0.78%) subjects were positive for WNV and 14 (0.23%) for USUV. These results were compared with those obtained 2 years ago and suggest an increased circulation of USUV among humans in Emilia-Romagna.
Collapse
Affiliation(s)
- A Pierro
- Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies (CRREM), St Orsola-Malpighi University Hospital, Bologna, Italy
| | | | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Sambri V, Capobianchi M, Charrel R, Fyodorova M, Gaibani P, Gould E, Niedrig M, Papa A, Pierro A, Rossini G, Varani S, Vocale C, Landini MP. West Nile virus in Europe: emergence, epidemiology, diagnosis, treatment, and prevention. Clin Microbiol Infect 2013; 19:699-704. [PMID: 23594175 DOI: 10.1111/1469-0691.12211] [Citation(s) in RCA: 115] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
West Nile virus (WNV), a mosquito-borne flavivirus in the Japanese encephalitis antigenic group, has caused sporadic outbreaks in humans, horses and birds throughout many of the warmer regions of Europe for at least 20 years. Occasional cases of West Nile encephalitis have also been associated with infected blood transfusions and organ donations. Currently, WNV appears to be expanding its geographical range in Europe and causing increasing numbers of epidemics/outbreaks associated with human morbidity and mortality. This brief review reports on the current epidemic situation regarding WNV in Europe, highlighting the clinical, diagnostic and preventive measures available for controlling this apparently emerging human pathogen.
Collapse
Affiliation(s)
- V Sambri
- Section of Microbiology, DIMES, Alma Mater Studiorum, University of Bologna, Bologna, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Gaibani P, Finarelli AC, Cagarelli R, Pierro A, Rossini G, Calzolari M, Dottori M, Bonilauri P, Landini MP, Sambri V. Retrospective screening of serum and cerebrospinal fluid samples from patients with acute meningo-encephalitis does not reveal past Japanese encephalitis virus infection, Emilia Romagna, Italy, 2011. Euro Surveill 2012; 17:20257. [PMID: 22958609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
|
22
|
Gaibani P, Finarelli AC, Cagarelli R, Pierro A, Rossini G, Calzolari M, Dottori M, Bonilauri P, Landini MP, Sambri V. Retrospective screening of serum and cerebrospinal fluid samples from patients with acute meningo-encephalitis does not reveal past Japanese encephalitis virus infection, Emilia Romagna, Italy, 2011. Euro Surveill 2012. [DOI: 10.2807/ese.17.35.20257-en] [Citation(s) in RCA: 2] [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: 11/20/2022] Open
Affiliation(s)
- P Gaibani
- Operative Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - A C Finarelli
- Public Health Authority, Emilia Romagna Region, Bologna, Italy
| | - R Cagarelli
- Public Health Authority, Emilia Romagna Region, Bologna, Italy
| | - A Pierro
- Operative Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - G Rossini
- Operative Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - M Calzolari
- Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia-Romagna ‘B. Ubertini’ (IZSLER; Experimental veterinary institute of Lombardy and Emilia Romagna), Reggio Emilia, Italy
| | - M Dottori
- Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia-Romagna ‘B. Ubertini’ (IZSLER; Experimental veterinary institute of Lombardy and Emilia Romagna), Reggio Emilia, Italy
| | - P Bonilauri
- Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia-Romagna ‘B. Ubertini’ (IZSLER; Experimental veterinary institute of Lombardy and Emilia Romagna), Reggio Emilia, Italy
| | - M P Landini
- Operative Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - V Sambri
- Operative Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies, S. Orsola-Malpighi University Hospital, Bologna, Italy
| |
Collapse
|
23
|
Pierro A, Varani S, Rossini G, Gaibani P, Cavrini F, Finarelli AC, Macini P, Cagarelli R, Mattivi A, Angelini P, Landini MP, Sambri V. Imported cases of dengue virus infection: Emilia-Romagna, Italy, 2010. Clin Microbiol Infect 2011; 17:1349-52. [PMID: 21745260 DOI: 10.1111/j.1469-0691.2011.03544.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Dengue is a significant mosquito-borne infection in humans, and its worldwide prevalence is rapidly increasing. In 2010, 83 serum samples from febrile travellers returning from dengue-endemic countries to a region in north-eastern Italy, densely infested with Aedes albopictus, were analysed for dengue virus (DENV). DENV RNA was detected in 20.5% of patients. By RT-PCR, DENV serotypes 1 and 3 were the most common. DENV must be identified early in symptomatic travellers returning from high-risk countries, to prevent outbreaks where potential vectors exist.
Collapse
Affiliation(s)
- A Pierro
- Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies (CRREM), St Orsola-Malpighi University Hospital, Bologna, Italy
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Capobianchi MR, Sambri V, Castilletti C, Pierro AM, Rossini G, Gaibani P, Cavrini F, Selleri M, Meschi S, Lapa D, Di Caro A, Grossi P, De Cillia C, Venettoni S, Landini MP, Ippolito G, Nanni Costa A. Retrospective screening of solid organ donors in Italy, 2009, reveals unpredicted circulation of West Nile virus. ACTA ACUST UNITED AC 2010; 15. [PMID: 20807488 DOI: 10.2807/ese.15.34.19648-en] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Since the occurrence of West Nile virus (WNV) infection in humans in 2008 in Italy, concerns have been raised about the potential risks associated with solid organ transplantation (SOT). A nationwide retrospective survey showed that 1.2% of SOT donors in 2009 were WNV-seropositive and demonstrated that human WNV infection is distributed throughout several Italian regions. Transmission of WNV or other arboviruses through SOT is a possibility and risk assessment should be carried out before SOT to avoid infection through transplantation.
Collapse
Affiliation(s)
- M R Capobianchi
- National Institute for Infectious Diseases (INMI) L. Spallanzani , Rome, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Gaibani P, Pierro A, CAVRINI F, Rossini G, Landini M, Manisera C, Sambri V. Serological update of the Chikungunya epidemic outbreak in Italy. Int J Infect Dis 2010. [DOI: 10.1016/j.ijid.2010.02.1951] [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: 11/16/2022] Open
|
26
|
Rossini G, Pierro A, Gaibani P, Cavrini F, Landini M, Sambri V. Analysis and characterization of mouse monoclonal antibodies reactive to Chikungunya virus (CHIKV). Int J Infect Dis 2010. [DOI: 10.1016/j.ijid.2010.02.455] [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
|
27
|
Cavrini F, Gaibani P, Manisera C, Pierro A, Rossini G, Landini M, Sambri V. Imported cases of Chikungunya and Dengue fever in Emilia Romagna region, Italy. Int J Infect Dis 2010. [DOI: 10.1016/j.ijid.2010.02.472] [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: 10/19/2022] Open
|
28
|
Pierro A, Gaibani P, CAVRINI F, Manisera C, Rossini G, Landini M, Sambri V. Sero-prevalence of West Nile virus in north-eastern Italy. Int J Infect Dis 2010. [DOI: 10.1016/j.ijid.2010.02.1952] [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: 10/19/2022] Open
|
29
|
Rossini G, Cavrini F, Gaibani P, Pierro A, Landini M, Sambri V. Chikungunya virus (CHIKV) infection: Analytical performance of real-time NASBA assay. Int J Infect Dis 2010. [DOI: 10.1016/j.ijid.2010.02.1601] [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: 10/19/2022] Open
|
30
|
Cavrini F, Gaibani P, Longo G, Pierro AM, Rossini G, Bonilauri P, Gerunda GE, Di Benedetto F, Pasetto A, Girardis M, Dottori M, Landini MP, Sambri V. Usutu virus infection in a patient who underwent orthotropic liver transplantation, Italy, August-September 2009. Euro Surveill 2009. [DOI: 10.2807/ese.14.50.19448-en] [Citation(s) in RCA: 121] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We report a case of Usutu virus (USUV)-related illness in a patient that underwent an orthotropic liver transplant (OLT). Post transplant, the patient developed clinical signs of a possible neuroinvasive disease with a significant loss of cerebral functions. USUV was isolated in Vero E6 cells from a plasma sample obtained immediately before the surgery, and USUV RNA was demonstrated by RT-PCR and sequencing. This report enlarges the panel of emerging mosquito-borne flavivirus-related disease in humans.
Collapse
Affiliation(s)
- F Cavrini
- These Authors contributed equally to this paper and are listed in alphabetical order
- Clinical Microbiology Unit, Regional Reference Centre for Microbiological Emergencies – CRREM, St. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
| | - P Gaibani
- Clinical Microbiology Unit, Regional Reference Centre for Microbiological Emergencies – CRREM, St. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
- These Authors contributed equally to this paper and are listed in alphabetical order
| | - G Longo
- Oncology and Haematology Unit, Modena University Hospital, Modena, Italy
| | - A M Pierro
- Clinical Microbiology Unit, Regional Reference Centre for Microbiological Emergencies – CRREM, St. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
| | - G Rossini
- Clinical Microbiology Unit, Regional Reference Centre for Microbiological Emergencies – CRREM, St. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
| | - P Bonilauri
- Experimental Institute for Animal Health and Protection of Lombardia and Emilia-Romagna, Brescia, Italy
| | - G E Gerunda
- Liver and Multivisceral Transplant Center, University of Modena and Reggio Emilia, Modena, Italy
| | - F Di Benedetto
- Liver and Multivisceral Transplant Center, University of Modena and Reggio Emilia, Modena, Italy
| | - A Pasetto
- Anaestesiology and Intensive Care Unit 1, Modena University Hospital, Modena, Italy
| | - M Girardis
- Anaestesiology and Intensive Care Unit 1, Modena University Hospital, Modena, Italy
| | - M Dottori
- Experimental Institute for Animal Health and Protection of Lombardia and Emilia-Romagna, Brescia, Italy
| | - M P Landini
- Clinical Microbiology Unit, Regional Reference Centre for Microbiological Emergencies – CRREM, St. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
| | - V Sambri
- Clinical Microbiology Unit, Regional Reference Centre for Microbiological Emergencies – CRREM, St. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
| |
Collapse
|
31
|
Cavrini F, Gaibani P, Longo G, Pierro AM, Rossini G, Bonilauri P, Gerunda GE, Di Benedetto F, Pasetto A, Girardis M, Dottori M, Landini MP, Sambri V. Usutu virus infection in a patient who underwent orthotropic liver transplantation, Italy, August-September 2009. Euro Surveill 2009; 14:19448. [PMID: 20070935] [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] Open
Abstract
We report a case of Usutu virus (USUV)-related illness in a patient that underwent an orthotropic liver transplant (OLT). Post transplant, the patient developed clinical signs of a possible neuroinvasive disease with a significant loss of cerebral functions. USUV was isolated in Vero E6 cells from a plasma sample obtained immediately before the surgery, and USUV RNA was demonstrated by RT-PCR and sequencing. This report enlarges the panel of emerging mosquito-borne flavivirus-related disease in humans.
Collapse
Affiliation(s)
- F Cavrini
- Clinical Microbiology Unit, Regional Reference Centre for Microbiological Emergencies-CRREM, St. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Rizzo C, Vescio F, Declich S, Finarelli AC, Macini P, Mattivi A, Rossini G, Piovesan C, Barzon L, Palù G, Gobbi F, Macchi L, Pavan A, Magurano F, Ciufolini MG, Nicoletti L, Salmaso S, Rezza G. West Nile virus transmission with human cases in Italy, August - September 2009. Euro Surveill 2009. [DOI: 10.2807/ese.14.40.19353-en] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In 2009, to date 16 human cases of West Nile neuroinvasive disease (WNND) have been reported in Italy, in three regions: Veneto, Emilia-Romagna and Lombardia. The number of cases is higher compared with last year when nine cases were identified (eight cases of WNND and one case of West Nile fever) and the geographical distribution indicates spread from east to west.
Collapse
Affiliation(s)
- C Rizzo
- National Centre for Epidemiology, Surveillance and Health Promotion, National Institute of Health (Istituto Superiore di Sanità, ISS), Rome, Italy
| | - F Vescio
- Department of Infectious, Parasitic and Immune-mediated Diseases, National Institute of Health (Istituto Superiore di Sanità, ISS), Rome, Italy
| | - S Declich
- National Centre for Epidemiology, Surveillance and Health Promotion, National Institute of Health (Istituto Superiore di Sanità, ISS), Rome, Italy
| | - A C Finarelli
- Public Health Service, Emilia-Romagna Region, Bologna, Italy
| | - P Macini
- Public Health Service, Emilia-Romagna Region, Bologna, Italy
| | - A Mattivi
- Public Health Service, Emilia-Romagna Region, Bologna, Italy
| | - G Rossini
- Regional Reference Centre for Microbiological Emergencies (CRREM), Microbiology Unit, Azienda Ospedaliero-Universitaria di Bologna, Policlinico S.Orsola-Malpighi, Bologna, Italy
| | - C Piovesan
- Direction of Prevention, Veneto region, Venice, Italy
| | - L Barzon
- Regional Reference Centre for Infectious Diseases, Microbiology and Virology Unit, Azienda Ospedaliera di Padova, Padua, Italy
| | - G Palù
- Regional Reference Centre for Infectious Diseases, Microbiology and Virology Unit, Azienda Ospedaliera di Padova, Padua, Italy
| | - F Gobbi
- Department of Prevention, ULSS 20, Verona, Italy
- Centre for Tropical Diseases, Sacro Cuore Hospital, Negrar (Verona), Italy
| | - L Macchi
- Regional Health Authority of Lombardy, Milan, Italy
| | - A Pavan
- Regional Health Authority of Lombardy, Milan, Italy
| | - F Magurano
- Department of Infectious, Parasitic and Immune-mediated Diseases, National Institute of Health (Istituto Superiore di Sanità, ISS), Rome, Italy
| | - M G Ciufolini
- Department of Infectious, Parasitic and Immune-mediated Diseases, National Institute of Health (Istituto Superiore di Sanità, ISS), Rome, Italy
| | - L Nicoletti
- Department of Infectious, Parasitic and Immune-mediated Diseases, National Institute of Health (Istituto Superiore di Sanità, ISS), Rome, Italy
| | - S Salmaso
- National Centre for Epidemiology, Surveillance and Health Promotion, National Institute of Health (Istituto Superiore di Sanità, ISS), Rome, Italy
| | - G Rezza
- Department of Infectious, Parasitic and Immune-mediated Diseases, National Institute of Health (Istituto Superiore di Sanità, ISS), Rome, Italy
| |
Collapse
|
33
|
Rizzo C, Vescio F, Declich S, Finarelli AC, Macini P, Mattivi A, Rossini G, Piovesan C, Barzon L, Palù G, Gobbi F, Macchi L, Pavan A, Magurano F, Ciufolini MG, Nicoletti L, Salmaso S, Rezza G. West Nile virus transmission with human cases in Italy, August - September 2009. Euro Surveill 2009; 14:19353. [PMID: 19822123] [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] Open
Abstract
In 2009, to date 16 human cases of West Nile neuroinvasive disease (WNND) have been reported in Italy, in three regions: Veneto, Emilia-Romagna and Lombardia. The number of cases is higher compared with last year when nine cases were identified (eight cases of WNND and one case of West Nile fever) and the geographical distribution indicates spread from east to west.
Collapse
Affiliation(s)
- C Rizzo
- National Centre for Epidemiology, Surveillance and Health Promotion, National Institute of Health (Istituto Superiore di Sanita, ISS), Rome, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Rossini G, Cavrini F, Pierro A, Macini P, Finarelli A, Po C, Peroni G, Di Caro A, Capobianchi M, Nicoletti L, Landini M, Sambri V. First human case of West Nile virus neuroinvasive infection in Italy, September 2008 - case report. ACTA ACUST UNITED AC 2008; 13. [PMID: 18926106 DOI: 10.2807/ese.13.41.19002-en] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
On 20 September 2008, the laboratory of the Regional Reference Centre for Microbiological Emergencies (Centro di Riferimento Regionale per le Emergenze Microbiologiche, CRREM) in Bologna, reported the detection of specific IgM and IgG antibodies against West Nile virus (WNV) in the serum of a female patient in her eighties who lived in a rural area between Ferrara and Bologna, Italy.
Collapse
Affiliation(s)
- G Rossini
- Centro di Riferimento Regionale per Emergenze Microbiologiche (Regional Reference Centre for Microbiological Emergencies - CRREM), Microbiology Unit, Azienda Ospedaliero-Universitaria di Bologna, Policlinico S.Orsola-Malpighi, Bologna, Italy
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Abstract
Statins stimulate bone formation in vitro and in vivo and, when given in large doses or by prolonged infusions, stimulate biomechanical strength of murine long bones with healing fractures. However, administration of statins by large oral doses or prolonged infusions to a fracture site is not a feasible therapeutic approach to hasten healing of human fractures. We administered lovastatin in biodegradable polymer nanobeads of poly(lactic-co-glycolide acid) to determine if lovastatin delivered in low doses in nanoparticles of a therapeutically acceptable scaffold could increase rates of healing in a standard preclinical model of femoral fracture. We found that these nanobeads: (1) stimulated bone formation in vitro at 5 ng/mL, (2) increased rates of healing in femoral fractures when administered as a single injection into the fracture site, and (3) decreased cortical fracture gap at 4 weeks as assessed by microcomputed tomography. These preclinical results suggest that lovastatin administered in a nanobead preparation may be therapeutically useful in hastening repair of human fractures.
Collapse
Affiliation(s)
- I R Garrett
- OsteoScreen Ltd., 2040 Babcock Road, San Antonio, Texas 78023, USA
| | | | | | | | | | | | | |
Collapse
|
36
|
Gutierrez GE, Lalka D, Garrett IR, Rossini G, Mundy GR. Transdermal application of lovastatin to rats causes profound increases in bone formation and plasma concentrations. Osteoporos Int 2006; 17:1033-42. [PMID: 16758140 DOI: 10.1007/s00198-006-0079-0] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2005] [Accepted: 01/11/2006] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Statins are drugs that inhibit HMG Co-A reductase and have been shown to enhance bone formation in vitro and in vivo in rodents. However, the statins currently used for cholesterol-lowering have been selected for their capacity to target the liver where their effects on cholesterol synthesis are mediated and they undergo first pass metabolism. When given in lipid-lowering doses, these agents do not likely reach sufficient blood concentrations to reliably cause substantial increases in bone formation in humans. Moreover, statins are inactivated by cytochrome P450 enzymes, resulting in even less peripheral distribution of the biologically active moieties beyond the liver. METHOD To investigate whether an alternate method of administration might produce beneficial effects on bone formation, we administered lovastatin by dermal application to rats to circumvent the first-pass effects of the gut wall and liver. RESULTS We found that the statin blood levels measured by HMG Co-A reductase activity were higher, maintained longer and less variable following transdermal application than those following oral administration. Also the increased circulating statin levels were associated with significantly enhanced biological effects on bone. After only 5 days of administration of transdermal lovastatin to rats, there was a 30-60% increase in trabecular bone volume, and 4 weeks later, we observed more than a 150% increase in bone formation rates. There was also a significant increase in serum osteocalcin, a marker of bone formation. We also found that lovastatin administered transdermally produces these profound effects at doses in the range of 1% of the oral dose, without any evidence of the hepatotoxicity or myotoxicity that can occur following oral statin administration. Several doses (0.01-5 mg kg(-1) day(-1)) and dosage schedules were examined, and collectively the data strongly suggest a powerful anabolic effect but with an unusually flat dose-response curve. CONCLUSION These results show transdermal application of statins produces greater beneficial effects on bone formation than oral administration does.
Collapse
Affiliation(s)
- G E Gutierrez
- OsteoScreen, 2040 Babcock Rd Suite 201, San Antonio, TX 78229, USA.
| | | | | | | | | |
Collapse
|
37
|
Cardillo M, Barraco F, De Fazio N, Rossini G, Pizzi C, Boschiero L, Nocera A, Rigotti P, Marchini F, Sandrini S, Frova G, Chiaramonte S, Maresca C, Caldara R, Messa P, Berardinelli L, Ambrosini A, Montanaro D, Rampino T, Minetti E, Gotti E, Scalamogna M. [Renal transplantation in the North Italy Transplant program (NITp): Organ allocation and results]. G Ital Nefrol 2005; 22 Suppl 31:S30-5. [PMID: 15786399] [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: 05/02/2023]
Abstract
Renal transplantation is an effective therapeutic tool for patients with end-stage renal diseases (ESRDs). Data reported in this article summarize the results obtained from 30 years' activity in the North Italy Transplant program (NITp), the first transplant organization in Italy that implemented a donor procurement and organ transplantation network. In the NITp kidney allocation is governed by a computerized algorithm, NITK3, put in place in 1997, aimed at ensuring equity, transparency and traceability during the stages of the allocation decision-making process. The NITp working group has recognized the NITK3 criteria and they are periodically reviewed following the results of the analysis of patients' transplantation odds. The results obtained with the use of the NITK3 algorithm have been very satisfactory: after 6 yrs, a significantly higher percentage of patients at immunological risk (sensitized or waiting for re-transplant), of patients waiting for >3 yrs and of patients with 0-1 HLA A,B,DR mismatches have been transplanted. Moreover, a higher percentage of kidneys were used locally (in a hospital within the procurement area), and this is known to stimulate donor procurement. Finally, we performed a preliminary statistical analysis of transplants carried out from 1998-2002 in 5/16 centers of the NITp area, demonstrating the quality of the NITp program in terms of patient and graft survival, and that donor and recipient age are the variables significantly impacting on transplant results.
Collapse
Affiliation(s)
- M Cardillo
- Dipartimento Trasfusionale e di Riferimento per il Trapianto di Organi e Tessuti, IRCCS Ospedale Maggiore Policlinico, Milano - Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Cardillo M, Poli F, Barraco F, Fazio ND, Rossini G, Boschiero L, Nocera A, Rigotti P, Marchini F, Zacchello G, Zanon G, Sandrini S, Chiaramonte S, Maresca C, Caldara R, Messa P, Berardinelli L, Ambrosini A, Montanaro D, Rampino T, Minetti E, Gotti E, Ghio L, Ginevri F, Albertario F, Scalamogna M. Renal transplantation. Strategies to prevent organ rejection--the role of an inter-regional reference center. Contrib Nephrol 2004; 146:1-10. [PMID: 15567915 DOI: 10.1159/000082056] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
This paper summarizes the role of the Inter-Regional Reference Center (RC) of the North Italy Transplant program (NITp), in coordinating a donor procurement and organ transplantation network, with a special focus on the strategies to minimize immunological risk and complications after transplantation. In the NITp, patients enrolled on the renal transplantation (RT) waiting list are typed for HLA-A,B,DRB1 antigens with a genomic method. They are periodically screened for the presence of lymphocytotoxic antibodies in their serum by the RC and their suitability to receive the transplant is checked periodically. Cadaver kidney allocation is ruled by a computerized algorithm, named NITK3, established in 1997, which aims at ensuring quality, equity, transparency and traceability during all the phases of the allocation decision-making process. NITK3 has been set up by the NITp Working Group on the basis of biological, medical and administrative criteria and it is periodically reviewed after the analysis of transplant results. In this paper, we show the results of a preliminary analysis of RTs performed from 1998 to 2002 in nine out of sixteen centers of the NITp area, which demonstrates the general quality of the NITp program in terms of patients and graft survival and the special attention to the patients at higher immunological risk.
Collapse
Affiliation(s)
- Massimo Cardillo
- Dipartimento Trasfusionale e di Riferimento per il Trapianto di Organi e Tessuti, RCCS Ospedale Maggiore Policlinico, Milano; Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Pedotti P, Cardillo M, Rossini G, Arcuri V, Boschiero L, Caldara R, Cannella G, Dissegna D, Gotti E, Marchini F, Maresca MC, Montagnino G, Montanaro D, Rigotti P, Sandrini S, Taioli E, Scalamogna M. Incidence of cancer after kidney transplant: results from the North Italy transplant program. Transplantation 2003; 76:1448-51. [PMID: 14657684 DOI: 10.1097/01.tp.0000083897.44391.e8] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Patients undergoing kidney transplantation demonstrate a higher risk of developing cancer as the result of immunosuppressive treatment and concurrent infections. METHODS The incidence of cancer in a cohort of patients who underwent kidney transplantation between 1990 and 2000, and who survived the acute phase (10 days), was analyzed as part of the North Italy Transplant program. RESULTS A total of 3,521 patients underwent transplantation during a 10-year period in 10 of 13 participating centers; the length of follow-up after kidney transplant was 67.7+/-36.0 months. During the follow-up, 172 patients developed cancer (39 with Kaposi sarcoma, 38 with lymphoproliferative diseases, and 95 with carcinomas [17 kidney, 11 non-basal cell carcinoma of the skin, 10 colorectal, 8 breast, 7 gastric, 7 lung, 6 bladder, and 3 mesothelioma]). The average time to cancer development after transplant was 40.1+/-33.4 months (range 0-134 months). Twenty-four patients developed cancer within 6 months from the transplant (10 with carcinomas, 7 with Kaposi sarcoma, and 7 with lymphoproliferative diseases). Three patients demonstrated a second primary cancer. The average cancer incidence was 4.9%. The incidence of cancer was 0.01 per year. Independent determinants of cancer development were age, gender, and immunosuppressive protocol including induction. Ten-year mortality was significantly higher in patients with cancer (33.1%) than among patients without cancer (5.3%). The relative risk of death in subjects with cancer was 5.5 (confidence interval 4.1-7.4). CONCLUSIONS These preliminary data underline the importance of long-term surveillance of transplant recipients, choice of immunosuppressive treatment, and careful donor selection.
Collapse
Affiliation(s)
- Paola Pedotti
- Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Maggiore Policlinico, Milan, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
40
|
Garrett IR, Chen D, Gutierrez G, Zhao M, Escobedo A, Rossini G, Harris SE, Gallwitz W, Kim KB, Hu S, Crews CM, Mundy GR. Selective inhibitors of the osteoblast proteasome stimulate bone formation in vivo and in vitro. J Clin Invest 2003; 111:1771-82. [PMID: 12782679 PMCID: PMC156102 DOI: 10.1172/jci16198] [Citation(s) in RCA: 259] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
We have found that the ubiquitin-proteasome pathway exerts exquisite control of osteoblast differentiation and bone formation in vitro and in vivo in rodents. Structurally different inhibitors that bind to specific catalytic beta subunits of the 20S proteasome stimulated bone formation in bone organ cultures in concentrations as low as 10 nM. When administered systemically to mice, the proteasome inhibitors epoxomicin and proteasome inhibitor-1 increased bone volume and bone formation rates over 70% after only 5 days of treatment. Since the ubiquitin-proteasome pathway has been shown to modulate expression of the Drosophila homologue of the bone morphogenetic protein-2 and -4 (BMP-2 and BMP-4) genes, we examined the effects of noggin, an endogenous inhibitor of BMP-2 and BMP-4 on bone formation stimulated by these compounds and found that it was abrogated. These compounds increased BMP-2 but not BMP-4 or BMP-6 mRNA expression in osteoblastic cells, suggesting that BMP-2 was responsible for the observed bone formation that was inhibited by noggin. We show proteasome inhibitors regulate BMP-2 gene expression at least in part through inhibiting the proteolytic processing of Gli3 protein. Our results suggest that the ubiquitin-proteasome machinery regulates osteoblast differentiation and bone formation and that inhibition of specific components of this system may be useful therapeutically in common diseases of bone loss.
Collapse
Affiliation(s)
- I R Garrett
- OsteoScreen Inc, San Antonio, Texas 78229, USA.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
41
|
Pignatelli S, Dal Monte P, Rossini G, Chou S, Gojobori T, Hanada K, Guo JJ, Rawlinson W, Britt W, Mach M, Landini MP. Human cytomegalovirus glycoprotein N (gpUL73-gN) genomic variants: identification of a novel subgroup, geographical distribution and evidence of positive selective pressure. J Gen Virol 2003; 84:647-655. [PMID: 12604817 DOI: 10.1099/vir.0.18704-0] [Citation(s) in RCA: 82] [Impact Index Per Article: 3.9] [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: 12/13/2022] Open
Abstract
Human cytomegalvirus (HCMV) ORF UL73 is a polymorphic locus, encoding the viral glycoprotein gpUL73-gN, a component of the gC-II envelope complex. The previously identified gN genomic variants, denoted gN-1, gN-2, gN-3 and gN-4, were further investigated in this work by analysing a large panel of HCMV clinical isolates collected from all over the world (223 samples). Sequencing and phylogenetic analysis confirmed the existence of the four gN genotypes, but also allowed the identification of a novel subgroup belonging to the gN-3 genotype, which was designated gN-3b. The number of non-synonymous (d(N)) and synonymous (d(S)) nucleotide substitutions and their ratio (d(N)/d(S)) were estimated among the gN genotypes to evaluate the possibility of positive selection. Results showed that the four variants evolved by neutral (random) selection, but that the gN-3 and gN-4 genotypes are maintained by positive selective pressure. The 223 HCMV clinical isolates were subdivided according to their geographical origin, and four main regions of gN prevalence were identified: Europe, China, Australia and Northern America. The gN variants were found to be widespread and represented within the regions analysed without any significant difference, and no new genotype was detected. Finally, for clinical and epidemiological purposes, a rapid and low-cost method for genetic grouping of the HCMV clinical isolates was developed based on the RFLP revealed by SacI, ScaI and SalI digestion of the PCR-amplified UL73 sequence. This technique enabled us to distinguish all four gN genomic variants and also their subtypes.
Collapse
Affiliation(s)
- S Pignatelli
- Department of Clinical and Experimental Medicine, Division Microbiology - St Orsola General Hospital, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy
| | - P Dal Monte
- Department of Clinical and Experimental Medicine, Division Microbiology - St Orsola General Hospital, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy
| | - G Rossini
- Department of Clinical and Experimental Medicine, Division Microbiology - St Orsola General Hospital, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy
| | - S Chou
- Medical and Research Services, VA Medical Center and Division of Infectious Diseases, Oregon Health Sciences University, Portland, OR, USA
| | - T Gojobori
- Center of Information Biology, National Institute of Genetics, Mishima, Japan
| | - K Hanada
- Center of Information Biology, National Institute of Genetics, Mishima, Japan
| | - J J Guo
- Department of Clinical and Experimental Medicine, Division Microbiology - St Orsola General Hospital, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy
| | - W Rawlinson
- Department of Microbiology, SEALS, Prince of Wales Hospital, Randwick, NSW, Australia
| | - W Britt
- Department of Pediatrics and Microbiology, University of Alabama, Birmingham, AL, USA
| | - M Mach
- Institute of Clinical and Molecular Virology, University of Erlangen-Nurnberg, Germany
| | - M P Landini
- Department of Clinical and Experimental Medicine, Division Microbiology - St Orsola General Hospital, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy
| |
Collapse
|
42
|
Di Gaetano R, Ciofani A, Rossini G, Baldascino G, Taglieri G. The cardiac bradyarrhythmic syncope among the patients of a geriatric division. Arch Gerontol Geriatr 2002; 8:135-8. [PMID: 14764384 DOI: 10.1016/s0167-4943(02)00117-6] [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: 10/27/2022]
Affiliation(s)
- R Di Gaetano
- Unitá Operativa di Geriatria e Lungodegenza, Università degli Studi di L'Aquila, Pescina, Italy
| | | | | | | | | |
Collapse
|
43
|
Campise M, Tarantino A, Berardinelli L, Finazzi S, Montagnino G, Rossini G, Scalamogna M, Cesana B, Ponticelli C. [Living-donor kidney transplantation in the cyclosporine era]. G Ital Nefrol 2002; 19:49-54. [PMID: 12165946] [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: 02/26/2023]
Abstract
BACKGROUND Renal transplantation is the best possibile form of treatment for chronic renal failure. It offers the patient a longer life expectancy when compared to dialysis. Aim of the study was to evaluate our results with live donor transplantation and the variables that influenced the long-term patient and graft survival. METHODS 190 patients received a live donor kidney transplantation in our Hospital between 1984 and 2000. Thirty-eight of them received a graft from an HLA identical donor, 130 from an HLA haploidentical donor, 22 from a living unrelated donor (spouse). Fourteen patients underwent a pre-emptive transplantation. Aim of the study was to evaluate which variables could influence the long-term patient and graft survival. RESULTS The median follow-up of recipients was 69.5 months. The 10-year patient and graft survival were 94.7% and 73.4% respectively. Graft half-life was 29.6 years. Six patients died. Twelve patients lost their graft because of vascular thrombosis and five patients because of rejection within the first six months. After the first year, 11 patients lost their graft because of chronic rejection and 4 after recurrence of the original disease. One hundred and forty-four patients are still under observation, and at the last examination their mean plasma creatinine was 2.0+/-1.1 mg/dl. At univariate statistical analysis the absence of locus DR incompatibility was associated with a trend toward a better long-term survival of both patient and graft (P=0.05), while less than one year of dialysis showed a significantly better survival rate (P < 0.01). CONCLUSIONS Living-donor transplantation offers an excellent long-term patient and graft survival.
Collapse
Affiliation(s)
- M Campise
- Dipartimento di Nefrourologia e Trapianto Renale, Italy.
| | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Cardillo M, Scalamogna M, Pizzi C, Poli F, Piccolo G, Rossini G, Porta E, Malagò D, Sirchia G. [Organ transplantation: results and perspectives]. Ann Ist Super Sanita 2001; 36:151-62. [PMID: 11213646] [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: 02/19/2023]
Abstract
Nowadays organ transplantation is a life-saving procedure, or anyhow it can considerably improve the life quality of patients suffering from irreversible organ impairment. Monitoring transplantation outcome is the last step of a long process that starts with cadaver donor identification, selection and clinical management, and continues with organ allocation, patient evaluation, surgical operation and clinical follow-up. The National Transplantation Committee has been discussing many of these items and, in 1995, it set up two protocols, one on liver exchange for urgent patients and the other on transplantation in the pediatric patient. The protocols application has met many difficulties, mainly due to the uneven behaviours of the different inter-regional organizations. In this paper we comment on the two main aspects to be submitted to the next National Committee: organ allocation and transplantation outcome. As far as the last point is concerned, the enclosed data are based on the experience of the North Italy Transplant program (NITp), and on that of the major international registries. Without any doubt these data demontrate that organ transplantation is to be ascribed among the successes of medicine in the just closed century.
Collapse
Affiliation(s)
- M Cardillo
- Centro Trasfusionale e di Immunologia dei Trapianti, IRCCS Ospedale Maggiore, Milano
| | | | | | | | | | | | | | | | | |
Collapse
|
45
|
Cardillo M, Rossini G, Scalamogna M, Pizzi C, Poli F, Piccolo G, Porta E, Malagò D, Taioli E, Fiocchi R, Sirchia G. Tumor incidence in heart transplant patients: report of the North Italy Transplant Program Registry. Transplant Proc 2001; 33:1840-3. [PMID: 11267536 DOI: 10.1016/s0041-1345(00)02702-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- M Cardillo
- Centro Trasfusionale e di Immunologia dei Trapianti, IRCCS Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122, Milano, Italy
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Abstract
Osteoporosis and other diseases of bone loss are a major public health problem. Here it is shown that the statins, drugs widely used for lowering serum cholesterol, also enhance new bone formation in vitro and in rodents. This effect was associated with increased expression of the bone morphogenetic protein-2 (BMP-2) gene in bone cells. Lovastatin and simvastatin increased bone formation when injected subcutaneously over the calvaria of mice and increased cancellous bone volume when orally administered to rats. Thus, in appropriate doses, statins may have therapeutic applications for the treatment of osteoporosis.
Collapse
Affiliation(s)
- G Mundy
- OsteoScreen, 2040 Babcock Road, San Antonio, TX 78229, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Rossini G. [Adolescents and health services: regional coordination]. Minerva Pediatr 1998; 50:227-9. [PMID: 9859652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
|
48
|
Poli F, Scalamogna M, Crespiatico L, Macchi B, Mistò R, Nocco A, Rossini G, Scarpino C, Sioli V, Sirchia G. Comparison of serological and molecular typing for HLA-A and -B on cord blood lymphocytes. Tissue Antigens 1998; 51:67-71. [PMID: 9459505 DOI: 10.1111/j.1399-0039.1998.tb02948.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
HLA class I typing by standard microcytotoxicity testing has been unsatisfactory for 14.5% of 1644 cord blood samples. In this study, we evaluated the capacity of PCR-SSP in solving problems in HLA-A,B typing with serological methods. With this aim we have compared serology with PCR-SSP in 100 cord blood samples with doubtful or unreliable HLA-A,B typing. PCR-SSP was successful in amplifying HLA-A,B alleles in all 100 cord blood samples. Forty-six typings gave discrepant results with the 2 methods (serology and PCR-SSP). Typings were considered discrepant also in the case of inability to define a split. For 19 specimens, no serological conclusion was drawn due to high mortality of the cell suspension, while PCR-SSP allowed the definition of a clear typing. In 6 cases it was necessary to infer information from serology to define the current typing. Finally, in 3 other cases it was impossible to exclude or attribute the antigen/allele B67 or B4802. PCR-SSP for HLA-A,B can improve the overall reliability of HLA-A,B typing requiring a small amount of blood although, with the set of sequence specific primers adopted, a number of alleles are still poorly defined.
Collapse
Affiliation(s)
- F Poli
- Centro Trasfusionale e di Immunologia dei Trapianti, Ospedale Maggiore Policlinico - Istituto di Ricovero e Cura a Carattere Scientifico, Milano, Italy.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Montagnino G, Tarantino A, Aroldi A, Elli A, Ponticelli C, Cesana B, Milano ID, Rossini G. Prognostic factors of long-term allograft survival in 632 CyA-treated recipients of a primary renal transplant. Transpl Int 1997. [DOI: 10.1111/j.1432-2277.1997.tb00703.x] [Citation(s) in RCA: 15] [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: 11/27/2022]
|
50
|
Del Favero C, Rossini G, Tufarulo L, Ciancio ML, Sopransi M, Martegani A, Borghi C, Campi R, Fugazzola C. [Mammography changes associated with hormone replacement therapy in post-menopausal patients]. Radiol Med 1997; 93:210-3. [PMID: 9221411] [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: 02/04/2023]
Abstract
Hormone replacement therapy (HRT) in post-menopausal or ovariectomized women reduces mortality due to cardiovascular diseases, lowers morbidity due to osteoporosis and improves vasovagal symptoms. Long-term therapy, however, increase the risk of side-effects. HRT may decrease mammographic sensitivity, markedly increasing glandular density. Enlargement of pre-existing cysts and fibroadenomas has also been reported after HRT. The correlation between HRT and breast cancer is highly controversial. We examined 650 women: 550 of them (84.6%) received HRT (157 estrogens and 393 estrogens-progestins) and 100 (15.4%) refused treatment and were thus considered as a control group. All patients underwent mammography and DEXA before HRT and, during treatment, were followed-up yearly with mammography, often combined with US, and DEXA. Fisher's test was used for data analysis (confidence interval: 95%). The statistical analysis showed a significant difference between the HRT group and the control group only for the lumbar spine. Mammographic changes (Tab. II) were shown in 150 of 550 HRT patients. Increased breast density was the most frequent finding. Benign lesions arising de novo or increasing in size and/or number were observed in 41 of 150 patients (27.3%) in the HRT group, where 3 breast carcinomas were detected, versus 1 breast cancer only in the control group. HRT had a marked positive effect on bone mineral content (BMC) at 2 years' follow-up, but it remains debated if it reduces breast cancer risk. In conclusion, our results indicate that a yearly mammography is mandatory in long-term HRT subjects and US may be also needed in particularly dense breasts.
Collapse
|