Optical coherence tomography in bioabsorbable stents: mechanism of vascular response and guidance of stent implantation.

Fully biodegradable L-polylactic acid stents (biodegradable vascular scaffold, BVS), the latest breakthrough in the area of coronary implants, entered clinical trials in 2005 and became commercially available in 2011. Optical coherence tomography (OCT) was used from the first implants to study the vessel wall response and the timing of the resorption process in man. Analysis of BVS with OCT has several advantages over that of metallic stents. BVS polymeric struts are transparent to the light so that scaffold integrity, apposition to the underlying wall, presence of thrombus and hyperplasia, and changes in the strut characteristics over time can be easily studied. We present a comprehensive review of the findings OCT provided when used as a research tool in serial examination up to five years for investigation of the mechanism of resorption, neointimal coverage, shrinkage and late lumen enlargement. We also report our experience with OCT in 47 lesions of various complexity as a practical means of percutaneous coronary intervention guidance during BVS implantation.

Molecular analysis of G6PD variants in northern Italy: a study on the population from the Ferrara district.

In the Ferrara district, an area south of the Po delta, four different variants of glucose-6-phosphate dehydrogenase (G6PD;E.C.1.1.49) have been described as a result of biochemical characterization of the enzyme protein: one was G6PD Mediterranean (G6PD Med) and three were local variants named Ferrara I, II, and III. The Ferrara I variant was recently analysed at the DNA level and shown to correspond to G6PD A376G/202A, while the mutations causing the variants II and III, still remain unknown. We analysed the G6PD coding region of 18 apparently unrelated G6PD deficient subjects, whose families have lived in the Ferrara district for at least three generations: 12 subjects had G6PD Med563T/1311T, 3, G6PD Santamaria376G/542T and 2, G6PD A-376G/202A. In one subject we found a new mutation, a G-->A transition at nucleotide 242 causing an Arg-->His amino-acid replacement at position 81. We named this new variant G6PD Lagosanto242 A. Phenotypically the enzyme has nearly normal kinetic properties and appears different from the variants Ferrara II and III.

Thalassaemia trait and myocardial infarction: low infarction incidence in male subjects confirmed.

A total of 4401 subjects admitted to the Medical Division of St Camillo Hospital in Comacchio (Ferrara, Italy) over a period of 7 years were prospectively evaluated in order to determine whether the heterozygous beta-thalassaemic (HBT) could be considered as a protective factor against the occurrence of acute myocardial infarction (AMI). Of the total patient sample, 3954 subjects were non beta-thalasaemics (NBTs), and 447 subjects were heterozygous beta-thalassaemics (HBTs). AMI was diagnosed in 384 patients, of whom 17 individuals were HBTs and 367 subjects were NBTs. The prevalence of HBTs in this group was significantly lower than expected (4.43%, P less than 0.0001). Furthermore, an analysis by sex showed that this lower prevalence could be attributed to male patients. Moreover, only in male subjects was a significant negative correlation observed between AMI and HBT. The mean age at which AMI occurred in male HBTs was significantly higher than in male NBTs (72 +/- 2.69 vs. 63 +/- 0.7 years, P less than 0.05), while no differences were found in the mean age at which AMI occurred between HBT and NBT female subjects. This study demonstrates that the thalassaemic trait may afford some protection against the occurrence of AMI in men.

Analysis of folate and vitamin B12 in beta thalassemia minor.

To evaluate whether anemia of heterozygote beta thalassemic subjects depends on folate or vitamin B12 deficiency, the serum values of these two vitamins were assessed in 176 adult subjects: 81 healthy heterozygote beta thalassemic subjects, 76 healthy normal controls and 15 subjects with microcytic iron deficient anaemia and no thalassemic trait. Mean serum folate and vitamin B12 levels in heterozygote beta thalassemic subjects were not statistically different when compared to control groups. No statistically significant correlation was found between mean serum levels of the two vitamins and hematocrit in beta thalassemic carriers and in normal subjects.

Immunological pattern in heterozygote beta thalassemic subjects.

In heterozygote beta-thalassemic subjects in a higher incidence of infectious diseases and of liver diseases with progression toward chronic hepatitis has been assessed. This predisposition has been suggested as being related to some immunological defects and to an altered immunological reactivity in thalassemia trait carriers. In order to evaluate whether there is a real deficiency of some humoral and cellular parameters in healthy heterozygote beta-thalassemic subjects, 128 symptom-free volunteers have been studied: 40 were heterozygote beta thalassemia carriers and 88 were normal subjects. In both groups there was no difference in: number and percentage of total lymphocytes, gamma globulins, immunoglobulins A and M, number and percentage of CD21, CD3, CD4, CD8, number of OKla*1, CD4/CD8 rations and lymphocytes' ability to respond to phytohemagglutinin. The values of immunoglobulins G and percentages of OKla*1 were found to be higher only in heterozygote beta thalassemic subjects; however, the number of CD2 in these subjects was lower. The result of the present study seems to indicate there is not significant difference between heterozygote beta thalassemic carriers and normal subjects in the more usual humoral and cellular immunological parameters.

[Heterozygote beta-thalassemia and neoplastic pathology]. / Beta-talassemia eterozigote e patologia neoplastica.

To evaluate the possible correlation between heterozygote beta thalassemia (BTE) and neoplastic disease, a 5-year personal experience of clinically followed patients at Comacchio Hospital Internal Medicine and Surgery divisions is presented. The hemoglobin A2 was assayed in all patients whose medial corpuscular volume was lower than 80 fl. 589 consecutive neoplastic patients were evaluated; of these 73 were BTE. In the BTE patients the prevalence of neoplastic disease was 12.39% higher than in healthy people (8.8%, chi 2 = 8.79 and p = 0.03). In thalassaemic carriers the titres of medial annual incidence to 10,000 for neoplastic diseases were proved to be ever higher (46.08 versus 31.49/10,000). The incidence of gastric cancer was found to be greater in BTE than in non-trait carrier population (13 in 63 patients, with a 20.63% prevalence, chi 2 = 9.52 and p = 0.02). A higher prevalence of thalassaemic carriers was observed among subjects with cancer in different organs: larynx, oesophagus, gallbladder and bile ducts, pancreas, breast and kidney, but these differences were not statistically significant. As for various sites of cancer: lung, liver, uterus and ovary, bladder, prostate, skin, lymphomas, leukaemias and gammopathies, no difference in BTE prevalence was found. We conclude that a greater predisposition to neoplastic disease can be present in BTE than in healthy population.

[Cardiovascular diseases in heterozygote beta-thalassemia subjects]. / Malattie cardiovascolari nei soggetti beta-talassemici eterozigoti.

Forty-four months analysis of cardiovascular diseases in a population with a high incidence of beta thalassemia trait is reported. A lower incidence of acute myocardiac infarctions, strokes, and their recurrence was observed in subjects with thalassemic trait; however they present more infarctions in later middle age and a lower incidence of atherogenic risk factors, specially hyperlipoproteinemias.

[Heterozygous beta thalassemia and gastrointestinal pathology]. / Beta talassemia eterozigote e patologia gastroenterica.

A 29 month personal experience with patients clinically followed-up at the divisions of internal medicine and surgery of Comacchio Hospital, located in an area of high incidence of heterozygote Beta thalassemic carrier is presented. A greater predisposition of these heterozygote carriers to manifest duodenal ulcers and gastric neoplasms is noticed.

[Immunological indexes of receptivity and seroconversion for rubella and toxoplasmosis in the province of Ferrara, Italy (author's transl)]. / Indici immunologici di recettivita' e di sieroconversione per la rosolia e la toxoplasmosi nella provincia di Ferrara.

In the province of Ferrara (Italy) a programme for the prophylaxis against some connatal infections has been carried out through a "Service for the epidemiology and prevention of connatal rubella and toxoplasmosis", which has been instituted in 1978. The investigations on two female groups of different age (prepuberal and adult fecund women) have allowed to obtain the following data: 1. rebella infection has a high incidence yet in prepuberal age (10 years) when a percentage of 62.1 women have already acquired a strong immunity; this percentage arises to 85.0 in adult fecund women. The "conversion index" of 22.9 corresponds to the percentage of subjects who have got the infection in postpuberal, "at risk" age; 2. toxoplasmosis has different epidemiological features; its incidence is lower, in prepuberal age (31.7%), while it is higher (63.4%) in adult fecund women. The highest incidence between 15 and 20 years, and the highest "conversion index" (31.7) underline that, notwithstanding its lower infectiousness, the risk of connatal toxoplasmosis is higher than that of connatal rubella, as far as our country is concerned. Such epidemiological investigations are believed to be necessary to carry out a really useful programme for the prevention of connatal rubella and toxoplasmosis.

[Cross infection due to Salmonella Thompson in a pediatric clinical department]. / Infezione crociata da "Salmonella Thompson" in ambiente nosocomiale pediatrico

The Authors have carried out a programmed bacteriological investigation for the detection of Salmonella in 4 Clinical Departments for Children in the Arcispedale S. Anna of Ferrara. The researches, carried out for 7 months on a total of 2161 samples (mainly rectal swabs) have allowed to detect and study, in one Paediatric Department, a "hospital acquired cross-infection" by S. thompson, spreading in the environment and amongst the sanitary assistance staff. The percentage of positivity ranged, in the 4 Departments, from a minimum of 1,05 to a maximum of 5,56 and confirmed the endemic diffusion of Salmonella in the province of Ferrara. The Authors think it highly advisable to carry out systematic researches amongst the patients and the assistance staff in order to avoid "hospital acquired cross-infections" by Salmonella, and the dangerous condition of "chronic carrier".