Fibrosis progression in paired liver biopsies from HIV/HCV co-infected patients

BACKGROUND: Chronic hepatitis C is more aggressive during HIV infection. Available data about risk factors of liver fibrosis in HIV/HCV co-infected patients derive from studies based on a single liver biopsy. OBJECTIVES: To evaluate the risk factors of liver fibrosis progression (LFP) and to investigate the role of antiretroviral therapy (ARV) in HIV/HCV patients who underwent paired liver biopsy. PATIENTS AND METHODS: We retrospectively studied 58 patients followed at two Infectious Diseases Departments in Northern Italy during the period 1988-2005. All specimens were double-blinded and centrally examined by two pathologists. LFP was defined when an increase of at least one stage occurred in the second biopsy, according to the Ishak-Knodell classification. RESULTS: In a univariate analysis, serum levels of alanine aminotransferase (ALT) > 150 IU/L at the first biopsy (P = 0.02), and a > 20% decrease in CD4+ cell count between the two biopsies (P = 0.007), were significantly associated with LFP. In multivariate analysis, a > 20% decrease in CD4+ cell count remained independently associated to LFP (Odds Ratio, 3.99; 95% confidence interval, 1.25-12.76; P < 0.02). Analysis of life survival curves confirmed the correlation between CD4+ cell count and LFP. CONCLUSIONS: Our findings highlight that in HIV/HCV coinfected patients, an effective antiretroviral therapy that assures a good immune-virological profile contributes to reducing the risk of LF

Confini e parole. Identità e alterità nell’epica e nel romanzo

Dove passa la linea che distingue l’Io dall’Altro nell’epica e nel romanzo medievali? Quale aspetto del sé – individuale o collettivo – si può identificare con questa distinzione? Quali parole, nelle varie opere, hanno valore identitario e costituiscono le radici culturali dell’immaginario alle origini della civiltà europea? A queste domande gli autori e le autrici di questo volume hanno risposto, prima in un Convegno e adesso in queste pagine, in una «inquietudine interrogante» che non coinvolge solo la «pratica» dell’identità ma anche lo studio delle sue manifestazioni in opere prodotte in ambiti culturali differenti, dall’epica al romanzo, alle traduzioni bibliche in versi, alla lirica araba medievale

Confini e parole. Identità e alterità nell'epica e nel romanzo

Il volume pubblica gli atti del convegno "Confini e parole. Identità e alterità nell'epica e nel romanzo", Roma, 21-22 settembre 201

IDERITAS. Repertorio di lessico e immagini dell'identità e dell'alterità nella letteratura dell'Europa medievale

La creazione di una base dati su “Identità e alterità nella letteratura europea medievale: lessico, topoi, campi metaforici” è parte del progetto FIR-Futuro in ricerca 2013, coordinato da Federico Saviotti (Università di Pavia), a cui hanno collaborato Annalisa Perrotta (Sapienza-Università di Roma) Giovanni Strinna (Università di Sassari), Lorenzo Mainini (Sapienza-Università di Roma) e Giuseppe Mascherpa (Università di Pavia, poi Università di Sassari). Ognuna delle tre unità di ricerca (Pavia, Sassari, Roma) ha concentrato il proprio lavoro su uno o più generi letterari che si è scelto di prendere in esame, coerentemente con le competenze degli studiosi coinvolti: Pavia si è occupata di poesia lirica e letteratura di viaggio, Sassari di produzione omiletica, Roma di epica e romanzo. Scopo comune è stata la realizzazione di un repertorio liberamente consultabile on-line del lessico e delle immagini topiche e metaforiche che esprimono l’identità e l’alterità all’interno di testi selezionati. Lo strumento informatico così concepito permette all’utente di attraversare, su un arco diacronico di tre secoli circa (XII-XIV), generi e aree linguistiche differenti (lingua d’oc, lingua d’oïl e italiano), e di individuare e distinguere, a partire dallo studio di opere considerate significative, quanto può essere considerato comune al pensiero e al sentire medievale nel suo complesso e quanto, invece, costituisca un tratto specifico di ciascun genere, area o autore

Biomolecular techniques to detect Pneumocystis carinii f. sp. hominis pneumonia in patients with acquired immunodeficiency syndrome

AbstractObjectives: To verify the clinical value of two different polymerase chain reactions (PCBs) for noninvasive diagnosis and follow-up during Pneumocystis carinii f. sp. hominis pneumonia (PCP) and to analyze the P. carinii f. sp. hominis genotypes involved.Methods: Internal transcribed spacers (ITSs) nested PCR was applied to 630 samples (bronchoalveolar lavage, sera, peripheral blood mononuclear cells, and oropharyngeal samples) from 122 patients with acquired immunodeficiency syndrome and pneumonia and 40 control samples from 20 subjects sero-negative for human immunodeficiency virus. One hundred and eighty samples also were examined by mt-rRNA PCR. Bronchoalveolar lavage samples and 33 sera were analyzed by type-specific oligonucleotide hybridization.Results: On bronchoalveolar lavage samples, the two PCRs consistently confirmed the morphologic diagnosis of PCP. The sensitivity of ITSs nested PCR versus mt-rRNA PCR was 57.3% versus 14.3% on sera, 32.3% versus 22.8% on peripheral blood mononuclear cells, and 69.1% versus 48.6% on oropharyngeal samples (garglings). Both PCRs had 100% specificity. Type-specific oligonucleotide hybridization revealed in 72.2% of bronchoalveolar lavage samples a single P. carinii f. sp. hominis genotype, whereas in 27.8% co-infection with more than one strain was detected.Conclusion: On noninvasive samples, ITSs nested PCR was more sensitive than mt-rRNA PCR, and it confirmed the diagnosis in all patients with PCP. For each patient with PCP at least one noninvasive sample was positive for P. carinii. f. sp. hominis DNA

Immigrants\u2019 Pathways to Outpatient Mental Health: Are there Differences with the Native Population?

A poor use of mental health services has been described in immigrants. We compared the sociodemographic, clinical and treatment features of immigrants and natives attending a Community Mental Health Centre (CMHC). 191 immigrants and 191 randomly selected natives applying to the Borgomanero CMHC between 1 January 2003 and 31 August 2013 were compared. Our sample consisted mainly of the so-called “economic” immigrant. Adjustment disorders and reaction to stress were the most frequent diagnoses; in most cases symptoms onset occurred after migration. Although treatment features overlapped in the two groups (duration, number of contacts), immigrants showed a higher frequency of treatment dropout. While it is necessary to improve access to mental health services for immigrants, for the “economic” immigrant it may be more important to focus on establishing a therapeutic relationship that can be experienced as reliable and trustworthy. The finding of similar pathways to access the CMHC in natives and immigrants is encouraging

Germline variants in genes of the subcortical maternal complex and Multilocus Imprinting Disturbance are associated with miscarriage/infertility or Beckwith-Wiedemann progeny

Beckwith-Wiedemann syndrome (BWS, OMIM # 130650) is an imprinting disorder, associated with overgrowth and increased risk of embryonal tumors. Patients carrying hypomethylation in the KCNQ1OT1:TSS DMR (11p15.5) show MLID (Multilocus Imprinting Disturbance) upon epimutations at other imprinted regions. Few cases of BWS MLID's mothers with biallelic pathogenetic variants in maternal effect genes, mainly components of the subcortical maternal complex, are reported. We describe two families, one with a history of conception difficulties with a novel homozygous nonsense NLRP2 variant and another experiencing 8 miscarriages with a compound heterozygous PADI6 variant

A multi-method approach to the molecular diagnosis of overt and borderline 11p15.5 defects underlying Silver-Russell and Beckwith-Wiedemann syndromes

reserved23noBACKGROUND: Multiple (epi)genetic defects affecting the expression of the imprinted genes within the 11p15.5 chromosomal region underlie Silver-Russell (SRS) and Beckwith-Wiedemann (BWS) syndromes. The molecular diagnosis of these opposite growth disorders requires a multi-approach flowchart to disclose known primary and secondary (epi)genetic alterations; however, up to 20 and 30 % of clinically diagnosed BWS and SRS cases remain without molecular diagnosis. The complex structure of the 11p15 region with variable CpG methylation and low-rate mosaicism may account for missed diagnoses. Here, we demonstrate the relevance of complementary techniques for the assessment of different CpGs and the importance of testing multiple tissues to increase the SRS and BWS detection rate. RESULTS: Molecular testing of 147 and 450 clinically diagnosed SRS and BWS cases provided diagnosis in 34 SRS and 185 BWS patients, with 9 SRS and 21 BWS cases remaining undiagnosed and herein referred to as "borderline." A flowchart including complementary techniques and, when applicable, the analysis of buccal swabs, allowed confirmation of the molecular diagnosis in all borderline cases. Comparison of methylation levels by methylation-specific multiplex ligation-dependent probe amplification (MS-MLPA) in borderline and control cases defined an interval of H19/IGF2:IG-DMR loss of methylation that was distinct between "easy to diagnose" and "borderline" cases, which were characterized by values ≤mean -3 standard deviations (SDs) compared to controls. Values ≥mean +1 SD at H19/IGF2: IG-DMR were assigned to borderline hypermethylated BWS cases and those ≤mean -2 SD at KCNQ1OT1: TSS-DMR to hypomethylated BWS cases; these were supported by quantitative pyrosequencing or Southern blot analysis. Six BWS cases suspected to carry mosaic paternal uniparental disomy of chromosome 11 were confirmed by SNP array, which detected mosaicism till 10 %. Regarding the clinical presentation, borderline SRS were representative of the syndromic phenotype, with exception of one patient, whereas BWS cases showed low frequency of the most common features except hemihyperplasia.CONCLUSIONS: A conclusive molecular diagnosis was reached in borderline methylation cases, increasing the detection rate by 6 % for SRS and 5 % for BWS cases. The introduction of complementary techniques and additional tissue analyses into routine diagnostic work-up should facilitate the identification of cases undiagnosed because of mosaicism, a distinctive feature of epigenetic disorders.mixedRusso S, Calzari L, Mussa A, Mainini E, Cassina M, Di Candia S, Clementi M, Guzzetti S, Tabano S, Miozzo M, Sirchia S, Finelli P, Prontera P, Maitz S, Sorge G, Calcagno A, Maghnie M, Divizia MT, Melis D, Manfredini E, Ferrero GB, Pecile V, Larizza L.Russo, S; Calzari, L; Mussa, A; Mainini, E; Cassina, M; Di Candia, S; Clementi, M; Guzzetti, Sara; Tabano, S; Miozzo, M; Sirchia, S; Finelli, P; Prontera, P; Maitz, S; Sorge, G; Calcagno, A; Maghnie, M; Divizia, Mt; Melis, D; Manfredini, E; Ferrero, Gb; Pecile, V; Larizza, L