Studio del ruolo delle cellule ematopoietiche nella replicazione di TTV

Torquetenovirus (TTV) è il prototipo di una vasta gamma di agenti virali con caratteristiche genomiche simili che vengono continuamente isolati nell’uomo e negli animali e attualmente sono classificati nel genere Anellovirus. Questi virus sono caratterizzati dalle piccole dimensioni della particella virale, da un genoma a DNA circolare a polarità negativa di circa 3,8 kb e da un’elevata variabilità genetica. Sebbene siano stati svolti numerosi studi per comprendere il ruolo patogenetico del virus, attualmente non siamo in grado di associare TTV ad una specifica patologia (Bendinelli e Maggi, 2005). Le modalità adottate per la replicazione del genoma dagli anellovirus rimangono al momento da chiarire; il rilevamento di intermedi replicativi e di trascritti virali in molti tessuti evidenzia una probabile capacità del virus di replicarsi in molti dei tessuti e organi che infetta (Okamoto et al., 2001). In particolare, studi in vitro hanno dimostrato che TTV è in grado di replicarsi nei linfo-monociti solo quando questi ultimi sono opportunamente stimolati. (Maggi et al., 2001; Mariscal et al., 2002) ma ad oggi non è stato ancora dimostrato con certezza se esista una sottopopolazione linfocitaria nella quale il virus si replichi e/o persista preferenzialmente. Al fine di approfondire tale aspetto, in questo lavoro di tesi i livelli di TTV sono stati misurati nel plasma di 8 pazienti affetti da varie forme di leucemia e sottoposti a intensi o moderati regimi di condizionamento mieloablativi prima di ricevere il trapianto di midollo osseo. I livelli di TTV plasmatici sono stati inoltre determinati in altri 23 pazienti: 5 erano stati sottoposti a trapianto di midollo osseo dopo aver ricevuto un regime di condizionamento non mieloablativo (gruppo di controllo), gli altri 18 pazienti erano affetti da artrite reumatoide ed erano stati trattati con il farmaco Rituximab, un anticorpo monoclonale chimerico umanizzato che riconosce la molecola CD20 espressa dai linfociti B. I risultati ottenuti in questo studio forniscono una chiara evidenza dell’importante ruolo svolto dalle cellule del sistema ematopoietico nel mantenimento della viremia di TTV

Small Anellovirus in Hepatitis C Patients and Healthy Controls

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New bioelectrical impedance vector references and phase angle centile curves in 4,367 adults: The need for an urgent update after 30 years

Background & aims: The bioelectrical impedance vector analysis (BIVA) represents a qualitative analysis of body composition. The vector, defined by resistance (R) and reactance (Xc) standardized by stature, can be evaluated compared to the 50%,75%, and 95% tolerance ellipses representative of the reference populations. The tolerance ellipses for healthy adults have been provided in 1995 and were developed by mixing underage, adult, and elderly subjects, possibly misrepresenting the actual adult population. The current multicentric, cross-sectional study aimed to provide new tolerance ellipses specific for the general adult population and as a secondary aim to present centile curves for the bioelectrical phase angle. Methods: R, Xc, and phase angle were measured in 2137 and 2230 males and females using phase-sensitive foot-to-hand analyzers at 50 kHz. A minimum of 35 subjects were included for each sex and age category from 18 to 65 years. Results: The new mean vectors showed a leftward shift on the R-Xc graph with respect to the former reference values (males: F = 75.3; p < 0.001; females: F = 36.6, p < 0.001). The results provided new 3rd, 5th, 10th, 25th, 50th, 75th, 90th, 95th, and 97th percentile curves for phase angle, identifying time point phases of decrement (males: -0.03° per year at 33.0-51.0 years and -0.05° per year after 51 years; females: -0.03° per year from 37.2 to 57.9 years). Conclusions: Compared to the original references, the new data are characterized by a different distribution within the R-Xc graph with a higher phase angle. Thirty years after the BIVA invention, the current study presents new tolerance ellipses and phase angle reference values for the adult population

A study protocol for the evaluation of occupational mutagenic/carcinogenic risks in subjects exposed to antineoplastic drugs: a multicentric project

<p>Abstract</p> <p>Background</p> <p>Some industrial hygiene studies have assessed occupational exposure to antineoplastic drugs; other epidemiological investigations have detected various toxicological effects in exposure groups labeled with the job title. In no research has the same population been studied both environmentally and epidemiologically. The protocol of the epidemiological study presented here uses an integrated environmental and biological monitoring approach. The aim is to assess in hospital nurses preparing and/or administering therapy to cancer patients the current level of occupational exposure to antineoplastic drugs, DNA and chromosome damage as cancer predictive effects, and the association between the two.</p> <p>Methods/Design</p> <p>About 80 healthy non-smoking female nurses, who job it is to prepare or handle antineoplastic drugs, and a reference group of about 80 healthy non-smoking female nurses not occupationally exposed to chemicals will be examined simultaneously in a cross-sectional study. All the workers will be recruited from five hospitals in northern and central Italy after their informed consent has been obtained.</p> <p>Evaluation of surface contamination and dermal exposure to antineoplastic drugs will be assessed by determining cyclophosphamide on selected surfaces (wipes) and on the exposed nurses' clothes (pads). The concentration of unmetabolized cyclophosphamide as a biomarker of internal dose will be measured in end-shift urine samples from exposed nurses.</p> <p>Biomarkers of effect and susceptibility will be assessed in exposed and unexposed nurses: urinary concentration of 8-hydroxy-2-deoxyguanosine; DNA damage detected using the single-cell microgel electrophoresis (comet) assay in peripheral white blood cells; micronuclei and chromosome aberrations in peripheral blood lymphocytes. Genetic polymorphisms for enzymes involved in metabolic detoxification (i.e. glutathione <it>S</it>-transferases) will also be analysed.</p> <p>Using standardized questionnaires, occupational exposure will be determined in exposed nurses only, whereas potential confounders (medicine consumption, lifestyle habits, diet and other non-occupational exposures) will be assessed in both groups of hospital workers.</p> <p>Statistical analysis will be performed to ascertain the association between occupational exposure to antineoplastic drugs and biomarkers of DNA and chromosome damage, after taking into account the effects of individual genetic susceptibility, and the presence of confounding exposures.</p> <p>Discussion</p> <p>The findings of the study will be useful in updating prevention procedures for handling antineoplastic drugs.</p

A Pilot Study of Prospective Data Collection by Italian Homeopathic Doctors

\u2003The main purpose of this article is to report the systematic data collection pertaining to the consultations of a group of qualified homeopathic physicians. Studies have been performed concerning: (1) the most frequently treated pathologies; (2) the symptoms reported by patients, with a particular focus on "fear" symptoms; and (3) the evaluation of the outcomes of the treatment, including likelihood ratio (LR) for fear symptoms of mostly prescribed remedies

I bisogni delle mamme di bambini affetti da malattie dermatologiche

L’analisi dei bisogni delle mamme di bambini affetti da malattie dermatologiche è essenziale prima di qualunque intervento infermieristico dermatologico. La patologia dermatologica del figlio può determinare un cambiamento nelle priorità dei bisogni delle mamme. Obiettivo dello studio è l’individuazione dei bisogni prioritari delle mamme. Metodo. La raccolta dei dati è avvenuta presso l’IDI-IRCCS di Roma, maggio-giugno 2007. A 160 mamme di bambini ricoverati è stato somministrato un questionario sui bisogni ed è stata valutata la gravità percepita della malattia (Patient Global Assessement -PGA-) del figlio. Risultati. I bisogni principali delle mamme sono di avere: più informazioni sulla diagnosi del figlio (59%), maggiore continuità assistenziale (48%), maggiori informazioni sui trattamenti (36%), una maggiore capacità nella gestione dei disturbi (36%) e di ricevere materiale informativo (33%). Le mamme che valutano più grave la malattia del figlio, esprimono sia un maggiore bisogno di continuità assistenziale (63%) che di controllo dei disturbi (56%). Anche se la malattia del figlio non viene percepita come grave, l’informazione sulla diagnosi rimane la prima priorità. Conclusioni. Informare ed educare le mamme è fondamentale per non escluderle dal processo di cura. Gli infermieri possono migliorare le aree critiche di assistenza dermatologica mediante l’identificazione dei bisogni

Human bocavirus in Italian patients with respiratory diseases

Background: hBoV, a recently discovered parvovirus, can be present in the respiratory tract of patients with acute respiratory diseases (ARD), but its etiologic involvement in the underlying diseases is still uncertain. Objective: To determine in a retrospective study, the prevalence of hBoV, compared with common respiratory viruses (RV), in respiratory specimens from patients with ARD. Study design: A total of 335 specimens obtained over 7 years were examined. Two hundred were nasal swabs from infants hospitalized for ARD, 84 were nasal swabs or bronchoalveolar lavages from adults with pneumonia, bronchopneumonia or asthma, and 51 were nasal swabs from healthy children. Results: The overall rate of hBoV detection in specimens from infants with ARD, which was 4.5%, varied slightly from year to year, except for the period 2000-2002, when no specimen was positive. Unlike other RV, no seasonal variation in hBoV incidence was noted. Infants with hBoV infection suffered either from bronchiolitis or from bronchopneumonia and 5 out of 9 cases yielded no co-infecting viral pathogen. Only one sample from an adult was hBoV positive. None of the nasal swabs from healthy subjects tested hBoV-positive. Conclusions: The findings indicate that hBoV can cause ARD in infants. \uc2\ua9 2007 Elsevier B.V. All rights reserved

Long-term treatment with tocilizumab in giant cell arteritis: efficacy and safety in a monocentric cohort of patients

Abstract Objective The efficacy of tocilizumab (TCZ) in GCA is supported by two randomized controlled studies, in which TCZ allowed remission to be achieved after 52 weeks of treatment. However, after discontinuation of treatment, half of the patients relapsed. The aim of this study was to analyse the efficacy and safety of long-term treatment with TCZ and the role of fluorodeoxyglucose (FDG)-PET/CT scanning in the follow-up of these patients. Methods We collected the clinical data of a monocentric cohort of GCA patients retrospectively. Results Thirty-two patients were treated with TCZ [25 males and 7 females; age¼74 (59–81) years]. Most of them achieved and maintained clinical remission (1 month: 69%; 3 months: 91%; 6months: 96%; 12 months: 100%), with serological and FDG-PET/CT scan improvement and a reduction of concomitant glucocorticoid therapy. Nineteen patients were treated for >52 weeks, and in 13 of them a dose tapering was performed, whereas in 2 cases TCZ was suspended for disease remission. Only two patients relapsed: one during TCZ tapering and one after TCZ discontinuation. Ten cases of mild infections and a case of urinary sepsis were reported; in patients treated for >1 year there was no increase in the incidence of side effects compared with patients treated for <12 months. Conclusion In our cohort of patients, we confirmed the efficacy of TCZ in the induction and maintenance of remission of GCA, demonstrating an important steroid-sparing effect and a good safety profile. Long-term treatment seems to prevent relapse of the disease, suggesting that TCZ treatment can be continued for >52 weeks with efficacy and safety

Relationships between Total Plasma Load of Torquetenovirus (TTV) and TTV Genogroups Carried

In 239 torquetenovirus-positive people, multiple-genogroup infections were common and associated with higher viral loads than would be expected from simple additive effects. The latter observation was restricted to the infections which included both genogroups 1 and 3, pointing to the possible existence of some kind of infection facilitation between these genogroups