Kinetics of human cytomegalovirus (HCMV) DNAemia in transplanted patients expressed in international units as determined with the Abbott RealTime CMV assay and an in-house assay.

Background: Consensus human cytomegalovirus (HCMV) DNA cut-off values for preemptive therapy in transplant recipients have not yet been defined, mainly due to the lack of real-time PCR standardization. Objectives: (i) To compare the kinetics of HCMV DNA in transplanted patients using an in-house real-time PCR assay (Pavia assay) and the new Abbott RealTime CMV assay; (ii) to verify assay concordance in the identification of patients eligible for preemptive treatment and (iii) standardize results with international units (IUs) using the WHO International HCMV DNA Standard as a reference. Study design: The kinetics of HCMV disseminated infection was retrospectively evaluated in 513 stored whole blood samples from 37 transplanted patients enrolled in randomized prospective studies designed for the clinical validation of HCMV DNA cut-off values. Conversion factors of HCMV DNA copy number to WHO international units (IUs) were determined. Results: Among the 513 samples, 352 (68.6%) were concordant positive, 42 (8.1%) concordant negative and 119 (23.1%) discordant. All discordant samples resulted positive by the Abbott RealTime CMV assay and negative by the Pavia assay, showing higher sensitivity for the Abbott RealTime CMV assay. A significant correlation was observed between concordant positive samples (r = 0.89). HCMV DNAemia determined by each assay showed overlapping kinetics. Expression of results as IU/ml provided the best results in preemptive treatment simulation. Conclusion: HCMV DNAemia cut-off values determined using our in-house assay and expressed as IU/ml appear valid for use in commercial assays as well as other potential in-house assays

[Primary non-Hodgkin's lymphoma of the breast. Clinico-pathologic study of 2 cases]

The authors describe two cases of malignant non-Hodgkin's lymphoma in a mammary site observed at IRCCS Policlinico San Matteo (Pavia). Histologic, immunohistochemical and clinical features are illustrated. Correct diagnosis is essential so that appropriate multidisciplinary treatment may be applie

Luna tra et\ue0 romana e medioevo. Dati inediti e rivisitazioni

Il volume raccoglie saggi scientifici dedicati alla ricerca archeologica e alla storia di Luni: dagli interventi archeologici condotti da Soprintendenza, Polo Museale e Universit\ue0 di Pisa, alle ricerche promosse dal Centro Studi Lunensi nella Cattedrale di Santa Maria, fino a specifici studi sulla monetazione e sulla scultura. Due saggi specifici sono dedicati a un'iscrizione di VIII secolo da Filattiera e al Comitatus lunense fra XI e XIII secolo

Continuous quality improvement in intensive care medicine. The GiViTI Margherita project - Report 2005

Aim. The assessment of the quality of intensive care medicine is mandatory in the modern healthcare system. In Italy, the GiViTI (Gruppo Italiano per la Valutazione degli Interventi in Terapia Intensiva) network is working in this field since 1991 and it now involves 295 out of the about 450 Italian intensive care units (ICU). In 2002 GiViTI launched a project for the continuous quality assessment and improvement that is now joined by 180 ICUs. Data collected in 2005 are analyzed and presented. Methods. All admitted patients were entered in a validated software, which performs a multitude of validity checks during the data entry. Data were further reviewed by the co-ordinating center; patients admitted in months with more than 10% of incomplete or inconsistent records in each ICU were excluded from the analysis. Each year, a multivariate logistic regression model is fitted to identify predictors of hospital mortality. Starting from the SAPS 2 and the 2004 GiViTI model predictions of hospital mortality, two calibration tables and curves are presented. Results. In 2005, 180 Italian ICUs collected data on 55 246 patients. After excluding those admitted in months with an unjustified lower recruitment rate or with less than 90% of complete and consistent data, we had 52 816 (95.6%) valid cases. Although the rough hospital mortality in 2005 was 1% higher than in 2004 (22.6% vs 21.5%), the adjusted mortality shows a statistically significant 4% reduction (obser-ved-to-expected ratio: 0.96; 95% CI: 0.94-0.97). Conclusion. Italian ICUs in 2005 performed better than in 2004, at a parity of patient severity