Protocollo di valutazione infettivologica pre-trapianto

Lo screening pre-trapianto dei potenziali candidati a un trapianto d\u2019organo \ue8 parte essenziale del trapianto di organi solidi. Obiettivi dello screening pre-trapianto sono: 1. identificazione di condizioni che controindicano il trapianto; 2. identificazione e trattamento di infezioni attive pre-trapianto; 3. definizione del livello di rischio infettivo e impostazione di strategie preventive post-trapianto. Nonostante vi sia un generale accordo sulle indagini di screening da effettuare, vi sono alcune variazioni tra i diversi centri. Allo scopo di armonizzare lo screening infettivologico pre-trapianto, viene schematicamente riportato, alla luce dell\u2019esperienza personale e dei dati di letteratura, lo stato dell\u2019arte inerente lo screening infettivologico pre-trapianto

Inflammatory and Adipose Response in Solid Organ Transplant Recipients After a Marathon Cycling Race

Abstract Background Organ transplant recipients frequently have chronic inflammation, with a weighty impact on cardiovascular risk. These patients can benefit from exercise, although the role of intense training is unclear. We evaluated the effect of a 130-km cycling race on inflammatory cytokines and adiponectin levels in transplant recipients. Methods Circulating interleukin (IL)-6, tumor necrosis factor (TNF)-α, interferon (IFN)-γ, and adiponectin were assayed in 35 healthy subjects vs 19 transplant recipients (10 kidney, 8 liver, 1 heart), matched for sex, age, body mass index, and preparation workout. The determinations were performed before the race, at the end, and after 18 to 24 hours. Baseline values of 32 sedentary transplant recipients also were evaluated to explore the possible chronic impact of lifestyle. Results All cyclists had 6- to 8-fold increased IL-6 levels after the race that decreased, without returning to baseline, the day after. Conversely, serum TNF-α and IFN-γ showed a progressive increase starting during physical performance and enduring for the next 18 to 24 hours in healthy subjects, whereas they were unchanged over time in cyclists with transplants. In transplant recipients who did not perform exercise, all of the analytes were significantly higher in comparison to basal levels of physically active subjects. Conclusions Our data suggest that clinically stable and properly trained transplant recipients can safely perform and progressively benefit from exercise, even at a competitive level. The changes in inflammation parameters were temporary and parallel with those of the healthy subjects. The comparison with sedentary transplant recipients revealed an overall amelioration of inflammatory indexes as a possible effect of regular physical activity on systemic inflammation

West Nile virus: the Italian national transplant network reaction to an alert in the north-eastern region, Italy 2011

We report four cases of West Nile virus (WNV) transmission following a single multiorgan donation in north-eastern Italy. The transmissions were promptly detected by local transplant centres. The donor had been tested for WNV by nucleic acid amplification test (NAT) prior to transplantation and was negative. There were no detected errors in the nationally implemented WNV safety protocols

14 th Conference on Harmonisation within Atmospheric Dispersion Modelling for Regulatory Purposes -2-6

Abstract In regional emission inventories road transport contribution is often evaluated by adopting a top-down methodology, which is based on the choice of large scale variables (for example fuel sold or consumed) then conveyed to smaller scale by using proxy variables (for example resident population or registered fleet). While this approach is the most effective for the compilation of national databases of emissions, since it allows to obtain a geographically complete and methodologically homogeneous set of information, when it comes to the assessment of air quality and to the evaluation of measures in alternative scenarios the bottom-up strategy could prove to be preferable. The amount of pollutants released by traffic networks is in this latter case estimated starting from site-specific data such as traffic flow, vehicles speed, vehicle categories and local fleet technical features (fuel supply, weight, etc.). The bottom-up approach is clearly affected by the amount and quality of information available, but it allows the estimate of emission data with a greater spatial and temporal detail. In this paper, we present a comparison of the results obtained by the application of the two approaches in evaluating road transport emissions in the metropolitan area of Torino, in which 1 350 000 inhabitants on average travel 8.5 km a day. Traffic flow data are available on an hourly basis on a network consisting of 5125 links, part of a larger road monitoring system. On site surveys have been used to differentiate vehicle categories on highway, rural and urban roads. Even if both methodologies are based on Copert IV, the quantitative comparison of estimated traffic emissions enlightens differences which are not negligible for some pollutants. In order to fully assess pros and cons of the two methodologies, emissions have been used to feed an air quality modelling system, based on the Eulerian chemical transport model FARM, on a 1 km horizontal spatial resolution square grid (51 x 51 km 2 ), using a regional simulation on a 4 km grid as one-way boundary conditions. The results emphasize a good description of the pattern distribution of pollution caused by the road network, treated as a linear source in the bottom-up approach, and show the appropriateness of using such an approach when proposed measures for abatement of traffic-related pollution need to be assessed. INTRODUCTION The Directive 2008/50/EC, in accordance with the previous European Directives, requires Member States to develop air quality plans in order to comply with air quality standards in the most effective and timesaving way. A reliable and updated estimation of emission sources is thus a crucial factor in the definition of effective air quality plans and related abatement measures

West Nile virus: the Italian national transplant network reaction to an alert in the north-eastern region, Italy 2011.

We report four cases of West Nile virus (WNV) transmission following a single multiorgan donation in north-eastern Italy. The transmissions were promptly detected by local transplant centres. The donor had been tested for WNV by nucleic acid amplification test (NAT) prior to transplantation and was negative. There were no detected errors in the nationally implemented WNV safety protocols

Relationship between Deck Level, Body Surface Temperature and Carcass Damages in Italian Heavy Pigs after Short Journeys at Different Unloading Environmental Conditions

In order to evaluate the relationships between deck level, body surface temperature and carcass damages after a short journey (30 min), 10 deliveries of Italian heavy pigs, including a total of 1400 animals from one farm, were examined. Within 5 min after the arrival at the abattoir, the vehicles were unloaded. Environmental temperature and relative humidity were recorded and a Temperature Humidity Index (THI) was calculated. After unloading, maximum temperatures of dorsal and ocular regions were measured by a thermal camera on groups of pigs from each of the unloaded decks. After dehairing, quarters and whole carcasses were evaluated subjectively by a trained operator for skin damage using a four-point scale. On the basis of THI at unloading, deliveries were grouped into three classes. Data of body surface temperature and skin damage score were analysed in a model including THI class, deck level and their interaction. Regardless of pig location in the truck, the maximum temperature of the dorsal and ocular regions increased with increasing THI class. Within each THI class, the highest and lowest body surface temperatures were found in pigs located on the middle and upper decks, respectively. Only THI class was found to affect the skin damage score (p < 0.05), which increased on quarters and whole carcasses with increasing THI class. The results of this study on short-distance transport of Italian heavy pigs highlighted the need to control and ameliorate the environmental conditions in the trucks, even at relatively low temperature and THI, in order to improve welfare and reduce loss of carcass value

The 500 ks Chandra observation of the z = 6.31 QSO SDSS J1030+0524

We present the results from a $\sim500$ ks Chandra observation of the $z=6.31$ QSO SDSS J1030+0524. This is the deepest X-ray observation to date of a $z\sim6$ QSO. The QSO is detected with a total of 125 net counts in the full ($0.5-7$ keV) band and its spectrum can be modeled by a single power-law model with photon index of $\Gamma = 1.81 \pm 0.18$ and full band flux of $f=3.95\times 10^{-15}$ erg s$^{-1}$ cm$^{-2}$. When compared with the data obtained by XMM-Newton in 2003, our Chandra observation in 2017 shows a harder ($\Delta \Gamma \approx -0.6$) spectrum and a 2.5 times fainter flux. Such a variation, in a timespan of $\sim2$ yrs rest-frame, is unexpected for such a luminous QSO powered by a $> 10^9 \: M_{\odot}$ black hole. The observed source hardening and weakening could be related to an intrinsic variation in the accretion rate. However, the limited photon statistics does not allow us to discriminate between an intrinsic luminosity and spectral change, and an absorption event produced by an intervening gas cloud along the line of sight. We also report the discovery of diffuse X-ray emission that extends for 30"x20" southward the QSO with a signal-to-noise ratio of $\sim$6, hardness ratio of $HR=0.03_{-0.25}^{+0.20}$, and soft band flux of $f_{0.5-2 \: keV}= 1.1_{-0.3}^{+0.3} \times 10^{-15}$ erg s$^{-1}$ cm$^{-2}$, that is not associated to a group or cluster of galaxies. We discuss two possible explanations for the extended emission, which may be either associated with the radio lobe of a nearby, foreground radio galaxy (at $z \approx 1-2$), or ascribed to the feedback from the QSO itself acting on its surrounding environment, as proposed by simulations of early black hole formation.Comment: 13 pages, 9 figures, A&A accepte

Kidney, kidney-pancreas and liver-kidney transplantation in HIV infected individuals: the Italian experience

Until a few years ago, HIV infection was considered an exclusion criteria for organ transplantation. However, more recently, because of the significant increase in life expectancy of HIV-infected persons with highly active antiretroviral therapy (HAART), kidney, kidney-pancreas, heart, lung and liver transplantation have been introduced in this patients population in several centers around the world. To evaluate the possible extension of the indications of kidney transplantation to HIV-infected individuals, the Italian National Centre for Transplantation has designed a protocol to be applied on a national basis. Inclusion criteria required a CD4 count ≥200/mm3 and undetectable HIV viral load for at least 3 months for patients on HAART.The program was voluntarily adopted by 4 transplant centres. From January 2006 through November 2007 a total of 13 HIV infected patients (9 male and 4 female, mean age 46.4 years, range 35-56) underwent cadaveric kidney transplantation (including two kidney-pancreas and two liver-kidney) after a median waiting time of 142 days (range 58-650). Median CD4 cells count at the time of transplantation was 449 (range 210-782) and the HIV-RNA was undetectable in all recipients. HAART was started in all recipients after transplantation and HIV-RNA remain undetectable in all patients. Five patients (38.4%) experienced an episode of biopsy proven acute rejection (steroid resistant in one). Drug-drug interactions between antiretrovirals and immunosuppressive agents required frequent dosage modifications. Graft and patient survival was 100% at a median follow-up of 161 days after transplantation (range 8-669). Despite the limited number of patients and the shortness of the follow-up, our study confirms excellent short term results of kidney transplantation in HIV-infected individuals