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1.
PLoS One ; 19(2): e0298728, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38422015

RESUMO

Over the past few decades, a growing body of evidence has emerged regarding the positive impact of boardgames in promoting life skills and well-being in various settings including health, education, and military schooling. However, the use of boardgames with inmates for cultural and educational purposes is still an unexplored and fragmented area of research. Incorporating boardgames into correctional settings can be a complex challenge for correctional stakeholders who seek to identify innovative tools to enhance inmate education and promote integration into society after incarceration. This article outlines our scoping review protocol designed to map and evaluate published and grey literature on the motivational, psychological, and pedagogical considerations involved in the design and use of boardgames as an innovative approach to promoting life skills and well-being among inmates.


Assuntos
Prisioneiros , Humanos , Prisioneiros/psicologia , Motivação , Escolaridade , Literatura de Revisão como Assunto
2.
Life (Basel) ; 14(1)2024 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-38255736

RESUMO

Several dermal substitutes are available on the market, but there is no precise indication that helps surgeons choose the proper one. Few studies have tried to compare different xenogeneic bioengineered products, but no objective bio-parametric comparison has been made yet. Fifteen patients who underwent skin reconstruction with Integra® or Pelnac® were retrospectively evaluated. After at least 12 months of follow-up, an objective and quantitative assessment of several skin biophysical properties, such as color, texture, elasticity, hydration, glossiness and trans-epidermal water loss, were measured with non-invasive skin measurement devices. The grafted skin showed a reduction of the superficial hydration level and a tendency to lower values of trans-epidermal water loss with both dermal substitutes. Melanic and hemoglobin pigmentation were higher in comparison to the donor site in both groups, while a melanic pigmentation increase versus the surrounding skin was seen just with Integra®. Finally, the skin was found to be more elastic when reconstructed with Integra®. The skin barrier appeared to be intact in both groups. Hence, these substitutes are valuable means of skin regeneration. Integra® seems to be more advantageous for reconstructing areas that need more skin flexibility.

3.
New Microbiol ; 46(4): 395-399, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38252051

RESUMO

Candida auris has emerged globally as a multidrug-resistant health care-associated fungal pathogen. In the literature, nosocomial outbreaks are reported worldwide. In addition, C. auris diffusion occurs in high-dependency settings with infections typically affecting critically ill patients, resulting in life-threatening disease. We describe the first documented case of C. auris in northeastern Italy and the measures applied to contain the transmission that led to zero collateral infections.


Assuntos
Candida auris , Hospitais , Humanos , Surtos de Doenças , Itália/epidemiologia
4.
Healthcare (Basel) ; 11(3)2023 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-36767000

RESUMO

Candida auris is considered to be an emerging fungal pathogen and is related to high mortality rates, persistent candidemia, inconsistencies in susceptibility testing results and misidentification by available commercial identification systems. Multidrug-resistant (MDR) and pandrug-resistant (PDR) strains are increasingly detected. In Europe, hospital outbreaks caused by C. auris have been reported in the United Kingdom (UK), Italy and Spain; however, several cases have been sporadically detected in all European countries. C. auris is difficult to control despite enhanced control measures due to its ability to survive for a long time in environments and colonize patients for prolonged periods. An adequate laboratory diagnostic capacity and national surveillance are fundamental to rapidly detect new C. auris cases and to apply the correct measures to circumscribe them and prevent their spread. Our narrative review aims to highlight the primary C. auris outbreaks and case reports that have occurred in Europe.

5.
Infez Med ; 30(3): 454-458, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36148162

RESUMO

We report the case of successful use of cefiderocol (FDC) in a Carbapenemase Producing K. pneumoniae (CPKP) post-surgical meningitis in a 44-year-old man treated with antimicrobial therapy and external ventricular drainage (EVD). The patient was known for being colonised by CPKP; for this reason, therapy with ceftazidime/avibactam (CZA) plus fosfomycin and linezolid was started. After an initial response a CZA resistant CPKP strain was isolated from CSF culture, so the antibiotic therapy was modified to FDC with trimethoprim/sulfamethoxazole for 14 days, and EVD was replaced. A complete recovery was obtained. This is the first case report describing FDC administration in CPKP meningitis.

6.
J Gerontol A Biol Sci Med Sci ; 77(9): 1750-1759, 2022 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-35172329

RESUMO

Educational inequalities in all-cause mortality have been observed for decades. However, the underlying biological mechanisms are not well known. We aimed to assess the role of DNA methylation changes in blood captured by epigenetic clocks in explaining these inequalities. Data were from 8 prospective population-based cohort studies, representing 13 021 participants. First, educational inequalities and their portion explained by Horvath DNAmAge, Hannum DNAmAge, DNAmPhenoAge, and DNAmGrimAge epigenetic clocks were assessed in each cohort via counterfactual-based mediation models, on both absolute (hazard difference) and relative (hazard ratio) scales, and by sex. Second, estimates from each cohort were pooled through a random effect meta-analysis model. Men with low education had excess mortality from all causes of 57 deaths per 10 000 person-years (95% confidence interval [CI]: 38, 76) compared with their more advantaged counterparts. For women, the excess mortality was 4 deaths per 10 000 person-years (95% CI: -11, 19). On the relative scale, educational inequalities corresponded to hazard ratios of 1.33 (95% CI: 1.12, 1.57) for men and 1.15 (95% CI: 0.96, 1.37) for women. DNAmGrimAge accounted for the largest proportion, approximately 50%, of the educational inequalities for men, while the proportion was negligible for women. Most of this mediation was explained by differential effects of unhealthy lifestyles and morbidities of the World Health Organization (WHO) risk factors for premature mortality. These results support DNA methylation-based epigenetic aging as a signature of educational inequalities in life expectancy emphasizing the need for policies to address the unequal social distribution of these WHO risk factors.


Assuntos
Epigênese Genética , Epigenômica , Escolaridade , Feminino , Humanos , Masculino , Mortalidade , Estudos Prospectivos , Fatores de Risco , Fatores Socioeconômicos
7.
Biomolecules ; 11(8)2021 08 13.
Artigo em Inglês | MEDLINE | ID: mdl-34439872

RESUMO

Individual response to drugs is highly variable and largely influenced by genetic variants and gene-expression profiles. In addition, it has been shown that response to drugs is strongly sex-dependent, both in terms of efficacy and toxicity. To expand current knowledge on sex differences in the expression of genes relevant for drug response, we generated a catalogue of differentially expressed human transcripts encoded by 289 genes in 41 human tissues from 838 adult individuals of the Genotype-Tissue Expression project (GTEx, v8 release) and focused our analysis on relevant transcripts implicated in drug response. We detected significant sex-differentiated expression of 99 transcripts encoded by 59 genes in the tissues most relevant for human pharmacology (liver, lung, kidney, small intestine terminal ileum, skin not sun-exposed, and whole blood). Among them, as expected, we confirmed significant differences in the expression of transcripts encoded by the cytochromes in the liver, CYP2B6, CYP3A7, CYP3A5, and CYP1A1. Our systematic investigation on differences between male and female in the expression of drug response-related genes, reinforce the need to overcome the sex bias of clinical trials.


Assuntos
Sistema Enzimático do Citocromo P-450/metabolismo , Transcriptoma , Feminino , Humanos , Masculino , Fatores Sexuais
8.
Cancers (Basel) ; 12(11)2020 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-33227890

RESUMO

Colorectal cancer (CRC) is the third most frequent cancer worldwide and the second cause of cancer deaths. Increasing evidences supports the idea that the poor prognosis of patients is related to the presence of cancer stem cells (CSCs), a cell population able to drive cancer recurrence and metastasis. The deregulation of microRNAs (miRNAs) plays a role in the formation of CSC. We investigated the role of hsa-miR-486-5p (miR-486-5p) in CRC, CSCs, and metastasis, in order to reach a better understanding of the biomolecular and epigenetic mechanisms mir-486-5p-related. The expression of miR-486-5p was investigated in three different matrices from CRC patients and controls and in CSCs obtained from the CRC cell lines HCT-116, HT-29, and T-84. In the human study, miR-486-5p was up-regulated in serum and stool of CRC patients in comparison with healthy controls but down-regulated in tumor tissue when compared with normal mucosa. miR-486-5p was also down-regulated in the sera of metastatic patients. In vitro, miR-486-5p was down-regulated in CSC models and it induced an inhibitory effect on stem factors and oncogenes in the main pathways of CSCs. Our results provide a step forward in understanding the role of mir-486-5p in CRC and CSC, and suggest that further studies are needed to investigate its diagnostic and prognostic power, possibly in combination with other biomarkers.

9.
Eur J Public Health ; 30(2): 219-223, 2020 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-31688911

RESUMO

BACKGROUND: Organizational aspects in Health Technology Assessment (HTA) reports play a significant role in managing policies and strategies to implement new health technologies. The organizational domain, however, is often under-represented in HTA reports. This study explored how organizational assessment is carried out in HTA reports and designed a new perspective through an empirical approach after the comparison with EUnetHTA's Core Model 3.0. METHODS: Full HTA reports were extracted from the websites of members of International Network of Agencies for HTA and the aspects relating to the organizational assessment were analysed. HTA reports were classified into 4 typologies of technologies (device, diagnosis/screening, intervention and organizational procedures) and organizational aspects described were explored through a framework of 5 domains and 15 subdomains from Core Model. Specific Multiple Correspondence Analyses were carried out to identify technology-related domains for organizational assessment in reports. RESULTS: The analysis showed that domains and subdomains of Core Model were not covered homogeneously by the organizational assessments in the HTA reports. Through Multiple Correspondence Analyses, four new technology-related dimensions were identified and named according to the Core Model's subdomains in the four new clusters. CONCLUSIONS: This study analyzed the significance of organizational assessments in current literature and the challenges of improving this domain in HTA reports. Through an empirical analysis, we proposed a new methodology to cover the most relevant aspects of organizational appraisal according to new domains to promote support to the assessment of organizational issues in reports and fulfil the needs of future HTA research.


Assuntos
Tecnologia Biomédica , Avaliação da Tecnologia Biomédica , Humanos
10.
Epidemiol Prev ; 42(1): 34-39, 2018.
Artigo em Italiano | MEDLINE | ID: mdl-29506359

RESUMO

OBJECTIVES: to explore clinicians vision on hospital discharge records in order to identify useful elements to foster a more accurate compiling. DESIGN: qualitative research with phenomenological approach. SETTING AND PARTICIPANTS: participants were selected through purposive sampling among clinicians of two hospitals located in Sardinia; the sample included 76 people (32 medical directors and 44 doctors in training). MAIN OUTCOME MEASURES: identified codes for themes under investigation: vision of accurate compiling, difficulties, and proposals. RESULTS: collected data highlighted two prevailing visions, respectively focused on the importance of an accurate compiling and on the burden of such activity. The accurate compiling is hindered by the lack of motivation and training, by the limits of the registration system and the information technology, by the distortions induced by the prominent role of the hospital discharge records in the evaluation processes. Training, timely updating of the information system accompanied by a proper cross-cultural validation process, improvement of the computer system, and activation of support services could promote more accurate compiling. CONCLUSIONS: the implementation of services, unconnected with evaluation and control processes, dedicated to training and support in the compiling of the hospital discharge records and in the conduction of related epidemiological studies would facilitate the compliance to the compilation. Such services will make tangible the benefits obtainable from this registration system, increasing skills, motivation, ownership, and facilitating greater accuracy in compiling.


Assuntos
Coleta de Dados/métodos , Registros Hospitalares , Corpo Clínico Hospitalar/psicologia , Alta do Paciente , Diretores Médicos/psicologia , Confiabilidade dos Dados , Registros Eletrônicos de Saúde , Registros Hospitalares/estatística & dados numéricos , Humanos , Itália , Administradores de Registros Médicos/educação , Motivação , Alta do Paciente/estatística & dados numéricos , Pesquisa Qualitativa
11.
New Microbiol ; 37(4): 503-8, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25387287

RESUMO

This study reports the results of antimicrobial susceptibility testing of 10 MDR and 74 XDR Acinetobacter bauman- nii clinical isolates from our hospital routine. We used three different methods: two automated systems (Sensititre and VITEK 2) and one standardized manual method (E-test). Since many published papers refer to in vitro tests performed by E-test, the aim of this study was to test if this method is reliable for testing tigecycline. The results obtained show that E-test significantly overestimates the MIC of the broth microdilution (reference test), thus ob- taining a significant number of major errors (resistant instead of sensitive). VITEK 2 also shows the same problem, but it is less critical. We therefore conclude that these methods do not seem to be very reliable in the performance of susceptibility testing of MDR and XDR Acinetobacter baumannii against tigecycline.


Assuntos
Infecções por Acinetobacter/microbiologia , Acinetobacter baumannii/efeitos dos fármacos , Antibacterianos/farmacologia , Farmacorresistência Bacteriana Múltipla , Testes de Sensibilidade Microbiana/métodos , Minociclina/análogos & derivados , Acinetobacter baumannii/crescimento & desenvolvimento , Acinetobacter baumannii/isolamento & purificação , Humanos , Minociclina/farmacologia , Tigeciclina
12.
New Microbiol ; 35(4): 491-4, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23109018

RESUMO

This study compared the results of antimicrobial susceptibility testing of 77 clinical strains isolated for Pseudomonas aeruginosa to five beta-lactam agents: aztreonam, ceftazidime, imipenem, meropenem and piperacillin+tazobactam. Four different methods were employed: two automated systems (VITEK 2 and Sensititre) and two standardized manual methods (Kirby-Bauer and E-test). The concordances for the susceptibility categories were better for Kirby-Bauer (medium value =89.6%), followed by Sensititre (medium value =87.0%) and VITEK 2 (medium value =82.8%). The disk diffusion method did not present very major errors in comparison to the two automated systems.


Assuntos
Antibacterianos/farmacologia , Testes de Sensibilidade Microbiana/métodos , Pseudomonas aeruginosa/efeitos dos fármacos , beta-Lactamas/farmacologia , Humanos , Infecções por Pseudomonas
13.
Infez Med ; 20(1): 25-30, 2012 Mar.
Artigo em Italiano | MEDLINE | ID: mdl-22475657

RESUMO

In recent years the incidence of bloodstream infections due to Candida species has progressively increased, partly due to the more critical conditions of hospitalized patients. There has been a significant increase in immune-compromised, diabetic and/or elderly patients, also with venous access, with a subsequent increase in Candida species isolated from bloodstream infections. In 2009-2010 in the hospitals of Mestre and Venice we isolated 123 Candida species from bloodstream infections: 59 Candida albicans, 28 Candida parapsilosis, 12 Candida glabrata, 9 Candida tropicalis, and 4 Geotrichum capitatum, while the 11 others belong to 8 different species. We calculated MIC for the following antifungal agents: fluconazole, itraconazole, voriconazole, 5-flucytosine, amphotericin B and caspofungin.


Assuntos
Antifúngicos/farmacologia , Sangue , Candida/efeitos dos fármacos , Testes de Sensibilidade Microbiana , Anfotericina B/farmacologia , Sangue/microbiologia , Candida/classificação , Candida/isolamento & purificação , Candidíase/tratamento farmacológico , Candidíase/microbiologia , Caspofungina , Farmacorresistência Fúngica , Equinocandinas/farmacologia , Fluconazol/farmacologia , Flucitosina/farmacologia , Hospitais , Humanos , Técnicas In Vitro , Itraconazol/farmacologia , Lipopeptídeos , Testes de Sensibilidade Microbiana/métodos , Pirimidinas/farmacologia , Reprodutibilidade dos Testes , Fatores de Risco , Triazóis/farmacologia , Voriconazol
14.
Infez Med ; 18(3): 162-8, 2010 Sep.
Artigo em Italiano | MEDLINE | ID: mdl-20956871

RESUMO

Treatment of infections by beta-lactamase-producing microorganisms is very difficult. Our aim was to determine the in vitro susceptibility of 430 ESBL-positive Escherichia coli strains isolated from urinary tract infections. All the microorganisms were isolated in the Microbiology Unit at the Ospedale dell'Angelo in Mestre (Venice) between May 2008 and September 2009 and were confirmed by the double-disk test. All microorganisms were sensitive to imipenem and meropenem, 98.4% to tigecycline, 95.1% to amikacin, 89.3% to nitrofurantoin, 67.5% to gentamycin and 63.2% to piperacillin/tazobactam. Only 22.6% were sensitive to cotrimoxazole, while fluoroquinolone (norfloxacin and levofloxacin) activity was found to be very low (6%).


Assuntos
Antibacterianos/farmacologia , Bacteriúria/microbiologia , Farmacorresistência Bacteriana Múltipla , Infecções por Escherichia coli/microbiologia , Proteínas de Escherichia coli/análise , Escherichia coli/efeitos dos fármacos , Urina/microbiologia , Resistência beta-Lactâmica , beta-Lactamases/análise , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Infecções Relacionadas a Cateter/microbiologia , Criança , Pré-Escolar , Contaminação de Equipamentos , Escherichia coli/enzimologia , Escherichia coli/isolamento & purificação , Feminino , Departamentos Hospitalares , Humanos , Técnicas In Vitro , Lactente , Recém-Nascido , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Cateterismo Urinário/instrumentação , Adulto Jovem
15.
J Ethnopharmacol ; 130(2): 379-91, 2010 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-20658771

RESUMO

AIM OF THE STUDY: Plant use has been the subject of many codices, documents and books and still is the subject of many scientific articles, trivial books and brochures. These texts, both historical and recent, exert a strong influence on local plant use, a means of knowledge transmission in particular European studies neglect to consider. Therefore, we determine the causal influence of historical texts on present medicinal plant knowledge using the example of Matthioli (1568) and contemporary ethnobotanical literature from Campania. MATERIALS AND METHODS: We used Bayesian statistical inference and in particular the Bayesian Additive Regression Trees (BART) model to determine the causal effect of Matthioli on contemporary medicinal plant use in Campania. RESULTS: The estimation of the average increment of finding a plant species mentioned for a certain use category caused by Matthioli is about 20%, conditionally on the available data. Matthioli's effect is not negligible and lies between 14 and 25% with a high probability. CONCLUSIONS: Studies on contemporary medicinal plant use in Europe over the last two to three decades still include the knowledge of the texts from the Renaissance and the classical writers. To what extent the remaining 80% contain autochthonous knowledge is difficult to assess. Considering the long-lasting effect of Matthioli, more recent books, brochures and newspapers very likely also exerted an influence. As well, television and radio reports on the results of pharmacological and clinical studies and, more recently, the world wide web show an ever-increasing influence.


Assuntos
Etnobotânica , Conhecimentos, Atitudes e Prática em Saúde , Fitoterapia , Preparações de Plantas/uso terapêutico , Teorema de Bayes , Características Culturais , Etnobotânica/história , História da Medicina , História Antiga , História Medieval , Humanos , Disseminação de Informação , Itália , Modelos Estatísticos , Fitoterapia/história , Preparações de Plantas/história , Plantas Medicinais
16.
Nat Prod Commun ; 5(4): 551-4, 2010 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-20433070

RESUMO

Chemical investigation of the stems of Seseli praecox (Gamisans) Gamisans, an endemic Apiaceae from Sardinia, afforded an isopropenylated chromone (5-hydroxy-6-(2-Z-butenyl-3-hydroxymethyl)-7-methoxy-2-methylchromone), along with four known linear furocoumarins and their natural precursor. For biological characterization the new compound was screened against four cancer cell lines in vitro and showed differential microM antiproliferative effects between suspension and adherent cells.


Assuntos
Antineoplásicos/isolamento & purificação , Apiaceae/química , Cromonas/isolamento & purificação , Antineoplásicos/química , Antineoplásicos/farmacologia , Sobrevivência Celular/efeitos dos fármacos , Cromatografia Líquida de Alta Pressão , Cromonas/química , Cromonas/farmacologia , Células HL-60 , Humanos , Concentração Inibidora 50 , Células Jurkat , Ressonância Magnética Nuclear Biomolecular , Caules de Planta/química , Espectrometria de Massas por Ionização por Electrospray
17.
J Nucl Med ; 50(2): 184-90, 2009 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-19164225

RESUMO

UNLABELLED: Planar 131I scintigraphy is routinely used to detect radioiodine-avid metastases of differentiated thyroid carcinoma (DTC). However, the modality has limitations, such as low sensitivity and lack of anatomic landmarks. We investigated whether SPECT with integrated low-dose CT may have additional value over planar imaging in detecting residue and metastases in DTC patients. METHODS: We studied 117 consecutive thyroidectomized DTC patients. On 2 different hybrid dual-head gamma-cameras (55 patients on one camera and 62 on the other), 108 patients underwent 131I diagnostic imaging and SPECT/CT, and 9 underwent posttherapeutic 131I planar imaging and SPECT/CT. We assigned an incremental value to SPECT/CT when it provided better identification and interpretation of the foci of radioiodine uptake, more correct anatomic localization and characterization, and precise differentiation between tumor lesions and physiologic uptake. RESULTS: Planar imaging showed 116 foci of uptake in 52 of 117 patients, and SPECT/CT showed 158 foci in 59 of 117 patients, confirming all foci seen on planar imaging but identifying an additional 28 occult foci in 10 of 52 patients. Fourteen occult foci were shown on SPECT/CT in 7 further patients whose planar imaging findings were negative. SPECT/CT correctly characterized 48 foci unclear on planar imaging, also defining location and extent. SPECT/CT was a determinant in classifying as neoplastic those foci for which planar imaging seemed to exclude malignancy, discriminating between residue and lymph node metastases in the neck, some of which were adjacent to salivary glands and had been missed on planar imaging. SPECT/CT also showed occult lesions in the mediastinum, abdomen, and pelvis and identified small bone metastases unsuspected on planar imaging. Globally, SPECT/CT had an incremental value over planar imaging in 67.8% of patients, modified therapeutic management in 35.6% of positive cases, and avoided unnecessary treatment in 20.3% of patients with only single benign lesions or physiologic uptake. CONCLUSION: 131I SPECT/CT improved planar data interpretation, showing a higher number of DTC lesions, more precisely localizing and characterizing DTC foci, and more correctly differentiating between physiologic uptake and metastases, thus permitting the most appropriate therapeutic approach to be chosen. A wider use of this method is suggested complementary to planar imaging in selected DTC patients.


Assuntos
Radioisótopos do Iodo , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Tomografia Computadorizada de Emissão de Fóton Único/métodos , Tomografia Computadorizada por Raios X/métodos , Adenocarcinoma Folicular/diagnóstico por imagem , Adenocarcinoma Folicular/secundário , Adenocarcinoma Folicular/cirurgia , Adenocarcinoma Papilar/diagnóstico por imagem , Adenocarcinoma Papilar/secundário , Adenocarcinoma Papilar/cirurgia , Adenoma Oxífilo/diagnóstico por imagem , Adenoma Oxífilo/secundário , Adenoma Oxífilo/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia , Adulto Jovem
18.
Oncol Rep ; 16(4): 763-9, 2006 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-16969491

RESUMO

A correct differential diagnosis between benign and malignant lesions is mandatory in patients with solitary pulmonary nodule (SPN). The aim of the present study was to investigate whether 99mTc-tetrofosmin SPECT may play a role in SPN evaluation. A consecutive series of 111 patients with an uncalcified

Assuntos
Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/diagnóstico , Compostos Organofosforados , Compostos de Organotecnécio , Compostos Radiofarmacêuticos , Nódulo Pulmonar Solitário/diagnóstico , Tomografia Computadorizada de Emissão de Fóton Único/métodos , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Interpretação de Imagem Radiográfica Assistida por Computador , Cintilografia , Nódulo Pulmonar Solitário/patologia
19.
FEMS Immunol Med Microbiol ; 43(1): 67-72, 2005 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-15607638

RESUMO

A study was conducted on the circulation of potentially diarrheagenic Escherichia coli in two groups of children, both under the age of seven. The first group (548 children) suffered from mild diarrhea and attended the Xipamanine Health Center of Maputo, in Mozambique. The second group (380 children) included randomly chosen, asymptomatic, children from the same population. A total of 503 E. coli strains were isolated from the two groups of children (n=375 and 128, respectively). All E. coli strains were genotypically and phenotypically screened. The presence of virulence-associated genes was assessed by a set of multiplex PCR specific for st and lt genes of enterotoxic Escherichia coli (ETEC), eae and bfpA genes of enteropathogenic E. coli (EPEC), stx(1) and stx(2) of enterohemorrhagic E. coli (EHEC), ial of enteroinvasive E. coli (EIEC) and the species-specific gene uidA. Adhesion and citotoxicity of isolated E. coli were evaluated in vitro on different cell cultures. A total of 37 isolates harbored virulence-associated genes: 18 were classified as ETEC, (15 from symptomatic, and three from asymptomatic children), 16 as EPEC (respectively, 13 and 3) and three EIEC in the symptomatic group. No stx(1) or stx(2) genes, associated with enterohemorrhagic E. coli were found. On the basis of the adhesion pattern on HeLa cells, 167 E. coli were classified as diffusely adhering, (125 in patients and 42 in controls) and 67 as enteroaggregative, (50 and 17, respectively). To the best of our knowledge, this is the first report in the literature on the circulation of potentially diarrheagenic E. coli in Mozambique.


Assuntos
Diarreia/microbiologia , Infecções por Escherichia coli/microbiologia , Escherichia coli/isolamento & purificação , Animais , Aderência Bacteriana , Células CHO , Células Cultivadas , Criança , Chlorocebus aethiops , Cricetinae , Cricetulus , Escherichia coli/genética , Escherichia coli/patogenicidade , Células HeLa , Humanos , Moçambique , Células Vero
20.
Radiol Med ; 107(1-2): 113-27, 2004.
Artigo em Inglês, Italiano | MEDLINE | ID: mdl-15031703

RESUMO

PURPOSE: The appearance of pulmonary metastases in neoplastic patients previously submitted to radical operation of an extrapulmonary primary tumor and with no recurrences and/or secondary distant localizations can markedly worsen disease prognosis if the lesions are in advanced stages and no longer removable by surgical procedures. In this study, we evaluated the usefulness of 99mTc-tetrofosmin scintigraphy, both planar and SPECT, in the detection of pulmonary metastases from previously treated extrapulmonary primary tumors, comparing the results with those obtained with CT. MATERIALS AND METHODS: We studied 73 patients, 33 M and 40 F, aged 24 to 79 yrs, had who undergone previously surgical resection extrapulmonary primary tumors; 31 patients had mammary, 13 gastrointestinal, 13 genitourinary, 13 thyroid and 3 laryngeal carcinomas. In all patients CT ascertained single (42 cases) or multiple (31 cases) pulmonary lesions. 99mTc-tetrofosmin scintigraphy, always performed within a week of CT, was acquired 10 min after 740 MBq i.v. tracer injection, using a rectangular, large field of view, dual head gamma camera, equipped with low energy, parallel-hole and high resolution collimators. Conventional planar acquisition, with the patient in the supine position, was followed by SPECT over 360 degrees with body contouring system, using a zoom factor of 1-1.3, a 64x64 matrix size, a 3 degrees angular step and an acquisition time of 30 sec/frame; image reconstruction was performed with the Back Projection Filtered Method using a Metz filter. In the coronal slices of SPECT images a semiquantitative analysis of the lesion was also made and the tumor-to-background (T/B) ratio was calculated; the calculation of the latter, considered indicative for tumor when >1.4, was performed in the lesion with the highest radiotracer uptake in patients with multiple lung lesions. The results of SPECT qualitative images were compared with those of planar scintigraphy and both of these with the data obtained with CT, and statistical difference was calculated with McNemar's test. The definitive diagnosis was achieved after scintigraphy by the analysis of cytologic or histologic specimens obtained by thoracotomy, percutaneous thoracic needle biopsy or bronchoscopic biopsy, and in some cases by the confirmation of instrumental exams at 6-8 month follow up. Pulmonary metastases were ascertained in 65/73 cases, while benign lesions were present in the remaining 8 patients. RESULTS: CT was true positive in 60/65 (92.3%) patients with metastases and false negative in the remaining five, four with a single lesion and one with two lesions in the same lung. SPECT detected metastases in 62/65 (95.4%) patients, including the five CT false negative cases, while it was false negative in three cases with single lesions, all positive at CT, with a size of 1.0, 1.0, 2.0 cm, respectively. Planar scintigraphy was only positive in 23/65 (35.4%) patients, with a sensitivity value significantly (p<0.0005) lower than both SPECT and CT. In the patients with multiple metastases, SPECT, positive in all cases and capable of correctly differentiating the patients with metastases only in one lung from those with bilateral involvement, underestimated the number of micronodular lesions in respect of CT in six patients with >6 lesions < or =0.5 cm in size, while it was more sensitive in three other cases; CT and SPECT were concordant in macronodular metastases detection, except in one case in which SPECT depicted more lesions. Planar scintigraphy had 42 false negative results and, when positive, underestimated the number of multiple lesions in respect of both SPECT and CT; it was positive but CT negative in only one case with two lesions. Specificity was higher for both SPECT and planar scan (87.5%) than CT (62.5%) but not significantly; accuracy was higher for SPECT (94.5%) than both planar scan (42%) and CT (89%), but the difference was significant only in respect of planar. The combined use of SPECT and CT achieved 100% sensitivity and accuracy values. The T/B ratio was >1.ratio was >1.4 in all SPECT positive cases (range: 1.6-5.3), indicating a suspected tumor, while it was 1.2 in the only benign case which turned out to be false positive at qualitative SPECT imaging. CONCLUSIONS: 99mTc-tetrofosmin SPECT seems to be a reliable diagnostic tool in the detection of pulmonary metastases from extrapulmonary primary tumors, in particular in the cases in which CT is indeterminate or false positive, and therefore contributes to a more correct patient classification. Moreover, SPECT image semiquantitative analysis can give additional information for a differential diagnosis between malignant and benign lesions as well as offering a more accurate selection of the lesions to be subjected to biopsy in patients with multiple metastases. However, only the combined use of CT and 99mTc-tetrofosmin SPECT can achieve the highest sensitivity and accuracy values and obtain the correct staging in most patients, thus suggesting that these two procedures must be employed together.


Assuntos
Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/secundário , Compostos Organofosforados , Compostos de Organotecnécio , Compostos Radiofarmacêuticos , Tomografia Computadorizada de Emissão de Fóton Único , Tomografia Computadorizada por Raios X , Adulto , Idoso , Biópsia por Agulha , Interpretação Estatística de Dados , Diagnóstico Diferencial , Feminino , Seguimentos , Humanos , Pulmão/patologia , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Fatores de Tempo
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