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1.
J Matern Fetal Neonatal Med ; 34(6): 952-959, 2021 Mar.
Article in English | MEDLINE | ID: mdl-31113267

ABSTRACT

BACKGROUND: Stillbirths affect more than 2.5 million pregnancies worldwide every year and the progress in reducing stillbirth rates is slower than that required by World Health Organization. The aim of the present study was to investigate which factors were associated with stillbirths in a University Hospital in the North of Italy, over a time span of 30 years. The goal was to identify which factors are potentially modifiable to reduce stillbirth rate. METHODS: Retrospective case-control study (358 stillbirths, 716 livebirths) subdivided into two study periods (1987-2006 and 2007-2017). RESULTS: The prevalence of conception obtained by assisted reproductive technologies, pregnancy at advanced maternal age, and complications of pregnancy such as preeclampsia, fetal growth restriction (FGR), and other fetal diseases (abnormal fetal conditions including fetal anemia, fetal hydrops, TORCH infections) increased through the years of the study. Despite a rising prevalence, the last 10 years showed a significant reduction in stillbirths associated with preeclampsia and FGR. Similarly, the risk of stillbirth related to abnormal fetal conditions decreased in the second study period and a history of previous stillbirth becomes a nonsignificant risk factor. CONCLUSIONS: Altogether these results suggest that in pregnancies perceived as "high risk" (i.e. previous stillbirth, preeclampsia, FGR, abnormal fetal conditions) appropriate care and follow-up can indeed lower stillbirth rates. In conclusion, the road to stillbirth prevention passes inevitably through awareness and recognition of risk factors.


Subject(s)
Stillbirth , Case-Control Studies , Female , Humans , Italy/epidemiology , Pregnancy , Retrospective Studies , Risk Factors , Stillbirth/epidemiology
2.
Ig Sanita Pubbl ; 76(4): 241-255, 2020.
Article in Italian | MEDLINE | ID: mdl-33161421

ABSTRACT

The last few weeks of pregnancy are critical to a baby's health because important organs, including the brain and lungs, are not completely developed until the end of pregnancy. The adverse events during labor and childbirth can have very serious physical, psychological and financial consequences for the child, the family, health professionals and the whole community. These events can be reduced through interventions aimed at improving the safety and quality of care, based on evidence-based knowledge, guidelines and practices that must be widely and effectively applied. This work reports the experience of the Lombardy Region on improvement actions in the obstetric and gynecological procedures for the reduction of adverse events and sentinel events through the monitoring and management of the RCGS trigger tool.


Subject(s)
Gynecologic Surgical Procedures/standards , Patient Safety , Quality Assurance, Health Care/standards , Quality Improvement , Quality of Health Care , Child , Delivery, Obstetric , Female , Humans , Implementation Science , Infant , Practice Guidelines as Topic , Pregnancy
3.
J Affect Disord ; 246: 148-156, 2019 03 01.
Article in English | MEDLINE | ID: mdl-30580200

ABSTRACT

BACKGROUND: Antenatal depressive and anxiety symptoms are common and may persist over time after delivery, with negative consequences on the mothers and their children. Evidence on the efficacy of psychological and pharmacological interventions during pregnancy aimed at preventing post-partum depression is controversial. METHODS: A consecutive sample of 318 women presenting for scheduled obstetric visits during pregnancy was screened for risk factors and anxiety or depressive symptoms. Based on the screening results, women were classified into three groups at increasing risk of post-partum depression (PPD) and were offered different interventions. RESULTS: Depressive or anxiety symptoms were found in 91 (28.6%) women, 89 (28.0%) had low risk of PPD and 138 (43.4%) had no risk of PPD. The multidisciplinary psychosocial interventions offered to women with clinical symptoms were well accepted, with an uptake of 76/91 (83.5%). Thirty-three women who did not improve with psychotherapy were offered sertraline or paroxetine as a second-line treatment: 7 accepted and 26 (78.8%) refused. Eleven women already on medication at baseline continued their treatment along with the MPI. The MPI interventions had some positive effects in terms of post-partum recovery, symptom reduction, and in preventing a new onset of depression. Among the 227 non-symptomatic during pregnancy, only 5 (2.2%) developed symptoms in the post-partum period. At 12 months post-partum, 84.6% of women who were symptomatic at 2 months post-partum recovered. LIMITATIONS: Our results should be interpreted in light of important limitations, including the lack of a control group that was not offered the MPI, the lack of information on the reasons for refusal and discontinuation and on the number of psychotherapy sessions attended. CONCLUSIONS: Our findings underscore the potential usefulness of MPI in recognizing early signs or symptoms during pregnancy and the advantage of building specific interventions for preventing post-natal depression. The MPI has positive effects on women with depressive or anxiety symptoms during pregnancy, that however did not exceed significantly those observed in women who refused the intervention. Thus, in the absence of a control group, our results are preliminary and warrant confirmation and testing in future randomized clinical trials.


Subject(s)
Anxiety/therapy , Depression/therapy , Mothers/psychology , Perinatal Care/methods , Pregnancy Complications/therapy , Adult , Antidepressive Agents/therapeutic use , Anxiety/diagnosis , Anxiety/psychology , Combined Modality Therapy , Depression/diagnosis , Depression/psychology , Depression, Postpartum/diagnosis , Depression, Postpartum/prevention & control , Depression, Postpartum/psychology , Female , Humans , Longitudinal Studies , Paroxetine/therapeutic use , Patient Acceptance of Health Care , Pregnancy , Pregnancy Complications/diagnosis , Pregnancy Complications/psychology , Psychotherapy , Risk Factors , Sertraline/therapeutic use , Treatment Outcome
4.
Nature ; 544(7649): 202-206, 2017 04 13.
Article in English | MEDLINE | ID: mdl-28346938

ABSTRACT

Recent observations have revealed massive galactic molecular outflows that may have the physical conditions (high gas densities) required to form stars. Indeed, several recent models predict that such massive outflows may ignite star formation within the outflow itself. This star-formation mode, in which stars form with high radial velocities, could contribute to the morphological evolution of galaxies, to the evolution in size and velocity dispersion of the spheroidal component of galaxies, and would contribute to the population of high-velocity stars, which could even escape the galaxy. Such star formation could provide in situ chemical enrichment of the circumgalactic and intergalactic medium (through supernova explosions of young stars on large orbits), and some models also predict it to contribute substantially to the star-formation rate observed in distant galaxies. Although there exists observational evidence for star formation triggered by outflows or jets into their host galaxy, as a consequence of gas compression, evidence for star formation occurring within galactic outflows is still missing. Here we report spectroscopic observations that unambiguously reveal star formation occurring in a galactic outflow at a redshift of 0.0448. The inferred star-formation rate in the outflow is larger than 15 solar masses per year. Star formation may also be occurring in other galactic outflows, but may have been missed by previous observations owing to the lack of adequate diagnostics.

5.
Eur J Neurol ; 24(4): 578-586, 2017 04.
Article in English | MEDLINE | ID: mdl-28229508

ABSTRACT

BACKGROUND AND PURPOSE: Studies investigating psychological interventions for the promotion of well-being in people with amyotrophic lateral sclerosis (ALS) are lacking. The purpose of the current study was to examine the use of an ALS-specific mindfulness-based intervention for improving quality of life in this population. METHODS: A randomized, open-label and controlled clinical trial was conducted on the efficacy of an ALS-specific meditation programme in promoting quality of life. Adults who received a diagnosis of ALS within 18 months were randomly assigned either to usual care or to an 8-week meditation training based on the original mindfulness-based stress reduction programme and tailored for people with ALS. Quality of life, assessed with the ALS-Specific Quality of Life Revised scale, represented the primary outcome, whilst secondary outcomes included anxiety and depression, assessed with the Hospital Anxiety and Depression Scale, and specific quality of life domains. Participants were assessed at recruitment and after 2, 6 and 12 months. The efficacy of the treatment was assessed on an intention-to-treat basis of a linear mixed model. RESULTS: A hundred participants were recruited between November 2012 and December 2014. Over time, there was a significant difference between the two groups in terms of quality of life (ß = 0.24, P = 0.015, d = 0.89). Significant differences between groups over time were also found for anxiety, depression, negative emotions, and interaction with people and the environment. CONCLUSIONS: An ALS-specific meditation programme is beneficial for the quality of life and psychological well-being of people with ALS.


Subject(s)
Amyotrophic Lateral Sclerosis/psychology , Meditation/psychology , Quality of Life/psychology , Stress, Psychological/therapy , Aged , Anxiety/psychology , Anxiety/therapy , Depression/psychology , Depression/therapy , Female , Humans , Male , Middle Aged , Stress, Psychological/psychology , Treatment Outcome
6.
Psychol Med ; 46(5): 995-1003, 2016 Apr.
Article in English | MEDLINE | ID: mdl-26670601

ABSTRACT

BACKGROUND: Many studies have reported that cannabis use increases the risk of a first episode of psychosis (FEP). However, only a few studies have investigated the nature of cannabis-related experiences in FEP patients, and none has examined whether these experiences are similar in FEP and general populations. The aim of this study was to explore differences in self-reported cannabis experiences between FEP and non-psychotic populations. METHOD: A total of 252 subjects, who met International Classification of Diseases (ICD)-10 criteria for FEP, and 217 controls who reported cannabis use were selected from the Genetics and Psychosis (GAP) study. The Medical Research Council Social Schedule and the Cannabis Experience Questionnaire were used to collect sociodemographic data and cannabis use information, respectively. RESULTS: Both 'bad' and 'enjoyable' experiences were more commonly reported by FEP subjects than controls. Principal components factor analysis identified four components which explained 62.3% of the variance. Linear regression analysis on the whole sample showed that the type of cannabis used and beliefs about the effect of cannabis on health all contributed to determining the intensity and frequency of experiences. Linear regression analysis on FEP subjects showed that the duration of cannabis use and amount of money spent on cannabis were strongly related to the intensity and frequency of enjoyable experiences in this population. CONCLUSIONS: These results suggest a higher sensitivity to cannabis effects among people who have suffered their first psychotic episode; this hypersensitivity results in them reporting both more 'bad' and 'enjoyable' experiences. The greater enjoyment experienced may provide an explanation of why FEP patients are more likely to use cannabis and to continue to use it despite experiencing an exacerbation of their psychotic symptoms.


Subject(s)
Cannabis/adverse effects , Marijuana Smoking/adverse effects , Marijuana Smoking/epidemiology , Psychotic Disorders/epidemiology , Adult , Female , Humans , Linear Models , Male , Psychiatric Status Rating Scales , Surveys and Questionnaires , Young Adult
8.
Reprod Sci ; 22(8): 1042-8, 2015 Aug.
Article in English | MEDLINE | ID: mdl-25667200

ABSTRACT

In mice, trophoblasts are equipped with a potent anticoagulant mechanism, the protein C pathway. In human placenta, no functional studies of the protein C pathway are available. Human first-trimester trophoblasts (CK(++) HLA-G(+/-) Vim(-)) were isolated and kept in culture for a maximum of 48 hours. Activation of protein C on trophoblasts was at least as efficient as in endothelial cells (4.43 × 10 (-) (7) nmol/L/min/cell). Endothelial protein C receptor (EPCR) was expressed in syncytiotrophoblasts and extravillous trophoblasts. Downregulation of the messenger RNA of trophoblast EPCR occurred when trophoblasts were challenged with tumor necrosis factor α, and it could be prevented by unfractionated heparin but not by low-molecular-weight heparin at therapeutic doses. In conclusion, there is a functional protein C pathway on human first-trimester trophoblasts which can be modulated by inflammation. This finding has implications for the pathogenesis and prevention of placenta-mediated obstetric complications.


Subject(s)
Antigens, CD/drug effects , Blood Coagulation/drug effects , Protein C/metabolism , Receptors, Cell Surface/drug effects , Trophoblasts/drug effects , Tumor Necrosis Factor-alpha/pharmacology , Anticoagulants/pharmacology , Antigens, CD/genetics , Antigens, CD/metabolism , Cell Hypoxia , Cells, Cultured , Down-Regulation , Endothelial Protein C Receptor , Enzyme Activation , Female , Heparin/pharmacology , Humans , Pregnancy , Pregnancy Trimester, First , RNA, Messenger/metabolism , Receptors, Cell Surface/genetics , Receptors, Cell Surface/metabolism , Thrombomodulin/metabolism , Trophoblasts/enzymology
9.
Br J Cancer ; 110(1): 199-207, 2014 Jan 07.
Article in English | MEDLINE | ID: mdl-24196791

ABSTRACT

BACKGROUND: Survivin is detected in few adult normal cells and it is highly expressed in cancer. Nuclear survivin facilitates cell cycle entry, whereas the mitochondrial pool protects cells from apoptosis. Survivin is overexpressed in keratinocyte stem cells (KSCs) and protects them from apoptosis. METHODS: As KSCs are at the origin of squamous cell carcinoma (SCC), we evaluated survivin expression in normal and cancerous skin in vivo by immunohistochemistry and western blotting. HaCaT cells overexpressing survivin and wound-healing assay are used. Analysis of variance and Student's T-tests are used for statistical analysis. RESULTS: Survivin is localised in both the cytoplasm and nucleus of normal adult and young keratinocytes. Nuclear survivin is detected in one every 10 of 11 basal keratinocytes. When present in suprabasal cells, nuclear survivin is coexpressed with K10 but not with K15 or p75-neurotrophin receptor (p75NTR), a transit amplifying cell marker. Nuclear, but not cytoplasmic, survivin expression markedly increases in actinic keratosis and in SCC in situ, as compared with normal epidermis, and it is highest in poorly differentiated SCC. In SCC tumours, nuclear survivin-positive cells are mainly K10/p75NTR-negative and K15-positive. In poorly differentiated tumours, survivin mostly localises in the deep infiltrating areas. When overexpressed in keratinocytes, survivin increases cell migration. CONCLUSION: High survivin expression and the subcellular localisation of survivin correlate with keratinocyte differentiation and are associated with undifferentiated and more invasive SCC phenotype.


Subject(s)
Carcinoma, Squamous Cell/metabolism , Inhibitor of Apoptosis Proteins/biosynthesis , Skin Neoplasms/metabolism , Skin/metabolism , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Carcinoma, Squamous Cell/pathology , Cell Lineage , Cell Nucleus/metabolism , Child , Child, Preschool , Humans , Infant , Infant, Newborn , Keratinocytes/metabolism , Middle Aged , Neoplasm Invasiveness , Neoplasm Proteins/biosynthesis , Skin Neoplasms/pathology , Survivin , Young Adult
10.
BJOG ; 120(12): 1466-75, 2013 Nov.
Article in English | MEDLINE | ID: mdl-23721372

ABSTRACT

OBJECTIVE: We used data from a national study of pregnant women with HIV to evaluate the prevalence of congenital abnormalities in newborns from women with HIV infection. DESIGN: Observational study. SETTING: University and hospital clinics. POPULATION: Pregnant women with HIV exposed to antiretroviral treatment at any time during pregnancy. METHODS: The total prevalence of birth defects was assessed on live births, stillbirths, and elective terminations for fetal anomaly. The associations between potentially predictive variables and the occurrence of birth defects were expressed as odds ratios (ORs) with 95% confidence intervals (95% CIs) for exposed versus unexposed cases, calculated in univariate and multivariate logistic regression analyses. MAIN OUTCOME MEASURES: Birth defects, defined according to the Antiretroviral Pregnancy Registry criteria. RESULTS: A total of 1257 pregnancies with exposure at any time to antiretroviral therapy were evaluated. Forty-two cases with major defects were observed. The total prevalence was 3.2% (95% CI 1.9-4.5) for exposure to any antiretroviral drug during the first trimester (23 cases with defects) and 3.4% (95% CI 1.9-4.9) for no antiretroviral exposure during the first trimester (19 cases). No associations were found between major birth defects and first-trimester exposure to any antiretroviral treatment (OR 0.94, 95% CI 0.51-1.75), main drug classes (nucleoside reverse transcriptase inhibitors, OR 0.95, 95% CI 0.51-1.76; non-nucleoside reverse transcriptase inhibitors, OR 1.20, 95% CI 0.56-2.55; protease inhibitors, OR 0.92, 95% CI 0.43-1.95), and individual drugs, including efavirenz (prevalence for efavirenz, 2.5%). CONCLUSIONS: This study adds further support to the assumption that first-trimester exposure to antiretroviral treatment does not increase the risk of congenital abnormalities.


Subject(s)
Abnormalities, Drug-Induced/epidemiology , Anti-HIV Agents/adverse effects , HIV Infections/drug therapy , Pregnancy Complications, Infectious/drug therapy , Reverse Transcriptase Inhibitors/adverse effects , Abnormalities, Drug-Induced/etiology , Adolescent , Adult , Birth Weight , Cohort Studies , Coinfection/epidemiology , Female , HIV Infections/complications , HIV Infections/epidemiology , Hepatitis B, Chronic/complications , Hepatitis B, Chronic/epidemiology , Hepatitis C, Chronic/complications , Hepatitis C, Chronic/epidemiology , Humans , Infant, Newborn , Infectious Disease Transmission, Vertical/statistics & numerical data , Italy/epidemiology , Male , Maternal Exposure , Middle Aged , Pregnancy , Pregnancy Complications, Infectious/epidemiology , Pregnancy Trimester, First , Prevalence , Young Adult
11.
Rev. bras. cardiol. invasiva ; 20(2): 199-203, abr.-jun. 2012. ilus
Article in English, Portuguese | LILACS | ID: lil-649573

ABSTRACT

Introdução: O ultrassom intracoronário (USIC) é um método capaz de fornecer medida sensível e reprodutível das dimensões da artéria coronária, da placa aterosclerótica e do lúmen arterial. Avanços em sua tecnologia permitem agora a caracterização da composição e da morfologia das placasateroscleróticas. Embora estudos prévios tenham reportado dados utilizando USIC com análise de radiofrequência, o uso de uma nova modalidade (iMap®, Boston Scientific, Santa Clara, Estados Unidos) de caracterização da placa ateroscleróticaé muito pouco conhecida. Nosso objetivo será analisar as características morfológicas, teciduais e fenotípicas das placas ateroscleróticas consideradas angiograficamente “culpadas” e“não-culpadas” em pacientes submetidos a angiografia coronáriadecorrente de infarto agudo do miocárdio (IAM). Métodos: Estudo prospectivo, transversal, em único centro (Hospital São Paulo – Escola Paulista de Medicina – UniversidadeFederal de São Paulo/UNIFESP, São Paulo, SP, Brasil). Serão selecionados50 pacientes para análise ultrassonográfica, de acordo com os seguintes critérios de inclusão: idade < 75 anos, IAM sem supradesnivelamento do segmento ST ou IAM com supradesnivelamento do segmento ST recente, com ou sem uso de fibrinolítico prévio. Conclusões: O presente estudoobjetivará a caracterização morfológica, tecidual e fenotípica da placa aterosclerótica utilizando uma nova modalidade de imagem ainda pouco estudada em pacientes com IAM.


Subject(s)
Humans , Coronary Artery Disease/complications , Coronary Artery Disease/diagnosis , Acute Coronary Syndrome/complications , Acute Coronary Syndrome/diagnosis , Ultrasonography/methods , Ultrasonography , Prospective Studies , Cross-Sectional Studies
12.
Nanotechnology ; 23(12): 125203, 2012 Mar 30.
Article in English | MEDLINE | ID: mdl-22414783

ABSTRACT

The electroluminescence (EL) at 1.54 µm of metal­oxide­semiconductor (MOS) devices withEr3C ions embedded in the silicon-rich silicon oxide (SRSO) layer has been investigated under different polarization conditions and compared with that of erbium doped SiO2 layers. EL time-resolved measurements allowed us to distinguish between two different excitation mechanisms responsible for the Er3C emission under an alternate pulsed voltage signal (APV). Energy transfer from silicon nanoclusters (Si-ncs) to Er3C is clearly observed at low-field APV excitation. We demonstrate that sequential electron and hole injection at the edges of the pulses creates excited states in Si-ncs which upon recombination transfer their energy to Er3C ions. On the contrary, direct impact excitation of Er3C by hot injected carriers starts at the Fowler­Nordheim injection threshold (above 5 MV cm(-1)) and dominates for high-field APV excitation.

13.
Radiol Med ; 117(7): 1152-60, 2012 Oct.
Article in English | MEDLINE | ID: mdl-22327926

ABSTRACT

PURPOSE: The authors sought to evaluate the feasibility, diagnostic accuracy and safety of urological biopsy performed using a flexible alligator forceps. MATERIALS AND METHODS: Twenty-seven patients with suspected urothelial malignancy underwent retrograde biopsy using a 7-F biopsy forceps (Cordis, Miami, FL, USA). Mild sedation was guaranteed by an anaesthesiologist. The final diagnosis was confirmed by cytohistological data and subsequently by pathology findings at surgery. Lesions with benign histopathology were closely monitored for at least 12 months. RESULTS: The technical success rate was 92.6%. The high diagnostic accuracy was related to the positive correspondence between histological outcomes and surgical results or follow-up observations. As regards sample site, the procedure was less successful in calyceal lesions than in lesions located in the upper urinary tract, with a technical success of 71.43%. Twenty patients had asymptomatic haematuria in the early hours after the procedure; ten of them had mild dysuria. No one require medication, and no major complications occurred. CONCLUSIONS: Urological forceps biopsy is a safe and easy procedure. It provides a relatively high level of accuracy in the diagnosis of lesions of the upper urinary tract.


Subject(s)
Biopsy/instrumentation , Surgical Instruments , Urologic Neoplasms/pathology , Adult , Aged , Aged, 80 and over , Contrast Media , Feasibility Studies , Female , Humans , Male , Middle Aged , Radiography, Interventional , Sensitivity and Specificity , Triiodobenzoic Acids
14.
Placenta ; 32(6): 482-5, 2011 Jun.
Article in English | MEDLINE | ID: mdl-21459442

ABSTRACT

Autophagy is an inducible catabolic process that responds to environment and is essential for cell survival during stress, starvation and hypoxia. Its function in the human placenta it is not yet understood. We collected 14 placentas: 7 at vaginal delivery and 7 at elective caesarean section after uneventful term pregnancies. The presence of autophagy was assessed in different placental areas by immunoblotting, immunohistochemistry and electron microscopy. We found that autophagy is significantly higher in placentas obtained from cesarean section than in those from vaginal delivery. Moreover there is a significant inverse relationship between autophagy and umbilical arterial glucose concentration.


Subject(s)
Autophagy/physiology , Cesarean Section , Delivery, Obstetric , Placenta/pathology , Adult , Blotting, Western , Female , Humans , Immunohistochemistry , Pregnancy
15.
Cell Death Differ ; 18(6): 948-58, 2011 Jun.
Article in English | MEDLINE | ID: mdl-21151024

ABSTRACT

p75 neurotrophin receptor (p75NTR) belongs to the TNF-receptor superfamily and signals apoptosis in many cell settings. In human epidermis, p75NTR is mostly confined to the transit-amplifying (TA) sub-population of basal keratinocytes. Brain-derived neurotrophic factor (BDNF) or neurotrophin-4 (NT-4), which signals through p75NTR, induces keratinocyte apoptosis, whereas ß-amyloid, a ligand for p75NTR, triggers caspase-3 activation to a greater extent in p75NTR transfected cells. Moreover, p75NTR co-immunoprecipitates with NRAGE, induces the phosphorylation of c-Jun N-terminal kinase (JNK) and reduces nuclear factor kappa B (NF-κB) DNA-binding activity. p75NTR also mediates pro-NGF-induced keratinocyte apoptosis through its co-receptor sortilin. Furthermore, BDNF or ß-amyloid cause cell death in TA, but not in keratinocyte stem cells (KSCs) or in p75NTR silenced TA cells. p75NTR is absent in lesional psoriatic skin and p75NTR levels are significantly lower in psoriatic than in normal TA keratinocytes. The rate of apoptosis in psoriatic TA cells is significantly lower than in normal TA cells. BDNF or ß-amyloid fail to induce apoptosis in psoriatic TA cells, and p75NTR retroviral infection restores BDNF- or ß-amyloid-induced apoptosis in psoriatic keratinocytes. These results demonstrate that p75NTR has a pro-apoptotic role in keratinocytes and is involved in the maintenance of epidermal homeostasis.


Subject(s)
Apoptosis , Keratinocytes/metabolism , Psoriasis/metabolism , Receptor, Nerve Growth Factor/metabolism , Signal Transduction , Adaptor Proteins, Vesicular Transport/genetics , Adaptor Proteins, Vesicular Transport/metabolism , Amyloid beta-Peptides , Brain-Derived Neurotrophic Factor/genetics , Brain-Derived Neurotrophic Factor/metabolism , Caspase 3/genetics , Caspase 3/metabolism , Cell Line , Enzyme Activation/genetics , Humans , Keratinocytes/pathology , NF-kappa B/genetics , NF-kappa B/metabolism , Psoriasis/genetics , Receptor, Nerve Growth Factor/genetics
16.
Nature ; 467(7317): 811-3, 2010 Oct 14.
Article in English | MEDLINE | ID: mdl-20944741

ABSTRACT

It has recently been suggested that galaxies in the early Universe could have grown through the accretion of cold gas, and that this may have been the main driver of star formation and stellar mass growth. Because the cold gas is essentially primordial, it has a very low abundance of elements heavier than helium (referred to as metallicity). If funnelled to the centre of a galaxy, it will result in the central gas having an overall lower metallicity than gas further from the centre, because the gas further out has been enriched by supernovae and stellar winds, and not diluted by the primordial gas. Here we report chemical abundances across three rotationally supported star-forming galaxies at redshift z ≈ 3, only 2 Gyr after the Big Bang. We find 'inverse' gradients, with the central, star-forming regions having lower metallicities than less active ones, which is opposite to what is seen in local galaxies. We conclude that the central gas has been diluted by the accretion of primordial gas, as predicted by 'cold flow' models.

17.
HIV Med ; 11(9): 593-602, 2010 Oct 01.
Article in English | MEDLINE | ID: mdl-20408891

ABSTRACT

BACKGROUND: HIV-1 non-B subtypes have recently entered Western Europe following immigration from other regions. The distribution of non-B clades and their association with demographic factors, over the entire course of the HIV-1 epidemic, have not been fully investigated in Italy. METHODS: We carried out a phylogenetic analysis of HIV-1 pol sequences derived from 3670 patients followed at 50 Italian clinical centres over nearly three decades. RESULTS: Overall, 417 patients (11.4%) carried non-B subtypes. The prevalence of non-B strains increased from 2.6% in 1980-1992 to 18.9% in 1993-2008 (P<0.0001) in a subset of 2479 subjects with a known year of diagnosis. A multivariate analysis on a subset of 1364 patients for whom relevant demographic data were available indicated that African ethnicity, heterosexual route of infection and year of diagnosis were independently associated with non-B HIV-1 infection (P ≤ 0.0001). All pure subtypes, except for clade K, and seven circulating recombinant forms were detected, accounting for 56.6 and 34.1% of the non-B infections, respectively. The F1 subtype was the most prevalent non-B clade among Europeans and was acquired heterosexually in half of this patient population. Unique recombinant forms accounted for 9.4% of the non-B sequences and showed a B/F1 recombination pattern in one-third of cases. CONCLUSIONS: The circulation of non-B clades has significantly increased in Italy in association with demographic changes. Spread of the F1 subtype and B/F recombinants appears to predominate, which may result in a redistribution of the relative proportions of the different strains, and this could lead to overlapping epidemics. Thus, the HIV-1 landscape in Italy may in future be distinct from that of the rest of Europe.


Subject(s)
Genes, pol/genetics , HIV Infections/epidemiology , HIV-1/classification , HIV-1/genetics , Phylogeny , Adult , Demography , Epidemiologic Methods , Female , Genotype , HIV Infections/virology , Humans , Italy/epidemiology , Male , Molecular Sequence Data , Racial Groups/statistics & numerical data , Recombination, Genetic , Sequence Analysis, DNA , Sex Distribution , Sexual Behavior , Time Factors
18.
Clin Microbiol Infect ; 15(1): 93-7, 2009 Jan.
Article in English | MEDLINE | ID: mdl-19220340

ABSTRACT

The Abbott Real-Time HIV-1 assay was evaluated for its performance in quantification of human immunodeficiency virus type 1 (HIV-1) RNA in dried blood spot (DBS) samples. In total, 169 blood samples with detectable plasma HIV-1 RNA were used to extract RNA from paired DBS and liquid plasma samples, using the automated Abbott m Sample Preparation System (m2000sp). HIV-1 RNA was then quantitated by the m2000rt RealTime analyser. RNA samples suitable for real-time PCR were obtained from all but one (99.4%) of the DBS samples and HIV-1 RNA was detected in 163/168 (97.0%) samples. The correlation between HIV-1 RNA values measured in paired DBS and plasma samples was very high (r = 0.882), with 78.5% and 99.4% of cases differing by <0.5 and 1.0 log, respectively. Retesting of DBS replicates following 6 months of storage at 2-8 degrees C showed no loss of HIV-1 RNA in a subset of 89 samples. The feasibility of DBS testing coupled with automated sample processing, and the use of a latest-generation FDA-approved real-time PCR-based system, represents an encouraging first step for viral load measurement in reference centres in developing countries where access to antiretroviral therapy is expanding.


Subject(s)
HIV Infections/virology , RNA, Viral/analysis , Specimen Handling/methods , Viral Load/methods , Anti-Retroviral Agents/therapeutic use , HIV Infections/drug therapy , HIV-1/genetics , Humans , Linear Models , Reproducibility of Results , Sensitivity and Specificity
19.
Med Lav ; 100(6): 438-47, 2009.
Article in Italian | MEDLINE | ID: mdl-20359136

ABSTRACT

BACKGROUND: Transitional bladder cancer is the most frequent malignant urinary neoplasm. Occupational exposure to aromatic amines and to polycyclic aromatic hydrocarbons are the main risk factors, in addition to cigarette smoking, recurrent inflammatory diseases of the urinary tract, consumption of certain drugs and a positive family history. Nevertheless cases of work-related bladder cancer are poorly identified in Italy. OBJECTIVE: The aim of this study is to assess the screening accuracy of a short structured interview to detect suspected cases of occupational bladder cancer, which may be confirmed in a second step assessment by an occupational physician. METHODS: The study sample consisted of 94 transitional bladder cancer patients, first hospitalised in 2004 and 2005 at the Department of Urology of the Ospedale di Circolo - Fondazione Macchi, in Varese, Italy. Based on data collected through a simple structured interview, it was possible to estimate two occupational exposure indices: one taking into account only the length of employment in industrial settings (DS Index) and the other considering job title in addition (DSM Index). For all cases a second-step assessment by an occupational physician (gold standard) made it possible to establish the occupational origin of cancer and to assess accuracy. RESULTS: Satisfactory values of the area under the ROC curve were found for both indices (AUC 0,81 for DS and 0,87 for DSM). In particular at the same level of sensitivity (90%), the DSM Index showed a better specificity (72%) in comparison to the DS Index (64%). CONCLUSIONS: The short structured interview proposed here proved to be a valuable tool for general practitioners and urologists to detect cases of bladder cancer of suspected occupational aetiology, which can be referred to an occupational physician for further investigations.


Subject(s)
Carcinoma, Transitional Cell/diagnosis , Mass Screening/methods , Occupational Diseases/diagnosis , Urinary Bladder Neoplasms/diagnosis , Aged , Area Under Curve , Carcinogens, Environmental , Carcinoma, Transitional Cell/etiology , Environmental Exposure , Female , Humans , Male , Middle Aged , Occupational Diseases/etiology , Occupational Exposure , Occupations , ROC Curve , Risk Factors , Smoking/epidemiology , Surveys and Questionnaires , Time Factors , Urinary Bladder Neoplasms/etiology
20.
Arq Bras Cardiol ; 88(5): 521-4, 2007 May.
Article in English, Portuguese | MEDLINE | ID: mdl-17589625

ABSTRACT

OBJECTIVE: To assess the clinical outcome of renal transplant patients who developed coronary artery disease and were treated with coronary stenting (TCA-ST). METHODS: A total of 3,334 renal transplants were performed in our service--Hospital do Rim e Hipertensão--HRH (Kidney and Hypertension Hospital) from July, 1998 to November, 2004. During this period, 33 of the renal transplant patients underwent TCA-ST to treat 62 severe stenoses in 54 coronary arteries. A retrospective analysis was performed with renal transplant patients undergoing TCA-ST at HRH. The clinical events were registered using medical charts, medical visits and phone calls. RESULTS: During the 30-month clinical follow-up after TCA-ST, 67% of the patients remained asymptomatic, 18% presented stable angina, 6% presented acute coronary syndrome without ST-segment elevation (ACSWSTE), and 3% presented acute coronary syndrome with ST-segment elevation (ACSSTE). No strokes, CHF or cardiac deaths were observed. Three non-cardiac deaths occurred. A restenosis rate of 9% was observed, which is comparable to those found in studies on drug-eluting stents. CONCLUSION: In conclusion, renal transplant patients who developed CAD and were treated with coronary stenting had a low rate of in-stent restenosis, probably related to the immunosuppressive regimen given to prevent kidney rejection.


Subject(s)
Coronary Artery Disease/therapy , Kidney Failure, Chronic/surgery , Kidney Transplantation , Stents , Coronary Artery Disease/complications , Female , Follow-Up Studies , Humans , Kidney Failure, Chronic/complications , Male , Middle Aged , Retrospective Studies , Treatment Outcome
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