Atherosclerosis is associated with a higher risk of hepatic steatosis in HIV-infected patients

Introduction. Cardiovascular Diseases (CD) have emerged as a leading cause of morbidity and mortality in HIV population. Some studies have reported higher carotid Intima Media Thickness (c-IMT), a measure of subclinical atherosclerosis (AT), in this cohort of patients.Methods. Here, we evaluate the role of Hepatic Steatosis (HS) as likely marker for AT in 128 HIV-infected patients without  hepatitis C infection. c-IMT has been detected non-invasively by carotid ultrasonography to assess the progression of AT. HS has been evaluated using a process based on vibration-controlled transient elastography (Fibroscan) by a novel ultrasonic controlled attenuation parameter (CAP). The cut-off value for defining the presence of significant HS was CAP > 259 dBm-1. Results. AT has been detected in 26 patients (20.3%), whereas steatosis of grade 2 (S2) in 31 (24.2%). The variables statistically related to AT were age, obesity, diabetes, hypertension and S2. In the multivariate analysis, AT was only associated (p < 0.001) with age and S2. The optimal cut-off value indicated by ROC curve for predicting AT was CAP > 250 dB/m-1.Discussion. Our results highlight the presence of AT in HIV-infected persons and its association with fatty liver disease; therefore, HS assessment in HIV population results crucial to predict AT and CD

In vitro diagnosis of sepsis: a review

Marcello Guido,1 Maria Rosaria Tumolo,2 Antonella De Donno,1 Tiziano Verri,3 Francesca Serio,1 Francesco Bagordo,1 Antonella Zizza2 1Laboratory of Hygiene, Department of Biological and Environmental Sciences and Technologies, Faculty of Sciences, University of Salento, Lecce, Italy; 2National Research Council, Institute of Clinical Physiology, 3Laboratory of Physiology, Department of Biological and Environmental Sciences and Technologies, Faculty of Sciences, University of Salento, Lecce, ItalyAbstract: Sepsis, severe sepsis and septic shock, systemic inflammatory response, and other related manifestations represent a relevant medical problem with high morbidity and mortality, despite the improvements in diagnosis, treatment, and preventive measures over the last few decades. The limited knowledge of the pathophysiology in association with the lack of in vitro diagnostic methods for the certain and quick determination of the causative microbiological agents and their antibiotic resistance means the condition is still critical and of high impact in health care. The current gold standard method to detect the sepsis-causing pathogens, which is based on blood culture, is still insufficiently sensitive and slow. The new culture-independent molecular biology-based techniques can lead to the identification of a broad range of microorganisms and resistance markers within a few hours and with high sensitivity and specificity; nevertheless, limitations of, for example, the polymerase chain reaction-based methods still hamper their application in the clinical routine. This review summarizes the in vitro diagnostic methods and their approach in the clinical diagnosis of the bloodstream infections, and explores their advantages and disadvantages at the current state of the art. A quick analysis of the future prospective in multiplex technologies for microbiological diagnosis of sepsis is also provided. Keywords: PCR, PCR/ESI-MS, microarray, MALDI-TOF, next-generation sequencing, FIS

Using the cytokinesis-block micronucleus cytome assay to evaluate Chromosomal DNA damage in chronic renal patients undergoing Bicarbonate Haemodialysis and Haemodiafiltration

Introduction. Chronic Renal Failure (CRF) patients are considered to show genomic instability and are associated with a high risk of both cardiovascular diseases and cancer. We explored DNA damage due to two dialysis treatments in 20 patients undergoing bicarbonate haemodialysis, 20 undergoing haemodiafiltration and 40 healthy subjects.Methods. The cytokinesis-block micronucleus (MN) assay was performed on peripheral blood lymphocytes to evaluate genetic damage.Results. A higher frequency of MN in the dialysis groups compared with controls was found. The results do not show a relationship between genetic instability and the type, frequency and duration of haemodialysis. The average BD and HDF treatment time was respectively 3.8±6.3 and 3.7±3.9 yrs. CAT and scintigraphy was independently correlated with high levels of MN.Discussion. Overall, the frequency of MN in CRF patients undergoing dialysis therapy was observed to be higher. Further studies need to be performed on a larger number of patients and for a longer period

Simulated versus physical bench tests

none8Pierpaolo Mincarone; Antonella Bodini; Saverio Sabina; Riccardo Colella; Maria Rosaria Tumolo; Martin Fawdry; Dimitrios I. Fotiadis; Carlo Giacomo LeoMincarone, Pierpaolo; Bodini, Antonella; Sabina, Saverio; Colella, Riccardo; Tumolo, MARIA ROSARIA; Fawdry, Martin; Fotiadis, Dimitrios I.; Giacomo Leo, Carl

Health Technology Assessment for In Silico Medicine: Social, Ethical and Legal Aspects

The application of in silico medicine is constantly growing in the prevention, diagnosis, and treatment of diseases. These technologies allow us to support medical decisions and self- management and reduce, refine, and partially replace real studies of medical technologies. In silico medicine may challenge some key principles: transparency and fairness of data usage; data privacy and protection across platforms and systems; data availability and quality; data integration and interoperability; intellectual property; data sharing; equal accessibility for persons and populations. Several social, ethical, and legal issues may consequently arise from its adoption. In this work, we provide an overview of these issues along with some practical suggestions for their assessment from a health technology assessment perspective. We performed a narrative review with a search on MEDLINE/Pubmed, ISI Web of Knowledge, Scopus, and Google Scholar. The following key aspects emerge as general reflections with an impact on the operational level: cultural resistance, level of expertise of users, degree of patient involvement, infrastructural requirements, risks for health, respect of several patients’ rights, potential discriminations for access and use of the technology, and intellectual property of innovations. Our analysis shows that several challenges still need to be debated to allow in silico medicine to express all its potential in healthcare processes

VALUTAZIONE DEL DANNO PRIMARIO ED OSSIDATIVO AL DNA IN LINFOCITI SALIVARI PER IL MONITORAGGIO DEGLI EFFETTI BIOLOGICI PRECOCI CAUSATI DALL’INQUINAMENTO ATMOSFERICO NEI BAMBINI: STUDIO MAPEC

VALUTAZIONE DEL DANNO PRIMARIO ED OSSIDATIVO AL DNA IN LINFOCITI SALIVARI PER IL MONITORAGGIO DEGLI EFFETTI BIOLOGICI PRECOCI CAUSATI DALL’INQUINAMENTO ATMOSFERICO NEI BAMBINI: STUDIO MAPEC Samuele Vannini (1) - Sara Levorato (1) - Elisabetta Ceretti (2) - Milena Villarini (1) - Silvia Bonetta (3) - Cristina Fatigoni(1) - Annalaura Carducci (4) - Tania Salvatori (1) - Maria Rosaria Tumolo (5) - Alessio Perotti (6) - Silvia Bonizzoni (7) - Alberto Bonetti (8) - Massimo Moretti (1) - Umberto Gelatti (2) Dipartimento di Scienze Farmaceutiche, Università degli Studi di Perugia, Perugia, Italia (1) - Dipartimento di Specialità Medico-Chirurgiche, Scienze Radiologiche e Sanità Pubblica, Università degli Studi di Brescia, Brescia, Italia (2) - Dipartimento di Scienze della Sanità Pubblica e Pediatriche, Università degli Studi di Torino, Torino, Italia (3) - Dipartimento di Biologia, Università degli Studi di Pisa, Pisa, Italia (4) - Dipartimento di Scienze e Tecnologie Biologiche ed Ambientali, Università del Salento, Lecce, Italia (5) - Dipartimento di Bioscienze, Università del Studi di Parma, Parma, Italia (6) - Ufficio Minori, Comune di Brescia, Brescia, Italia (7) - Centro Servizi Multisettoriale e Tecnologico, Csmt Gestione S.c.a.r.l., Brescia, Italia (8) Il particolato è l’inquinante atmosferico che provoca i maggiori danni alla salute umana in Europa (Agenzia Europea dell’Ambiente; www.eea.europa.eu). Tra le prime 30 città più inquinate del continente, oltre la metà sono italiane, in particolare quelle situate nella pianura Padana, con concentrazioni di PM10, PM2,5 e NOx ben al di sopra dei valori di riferimento europei. Studi epidemiologici hanno rilevato un’associazione positiva tra esposizione ad inquinamento atmosferico, soprattutto al PM, ed incidenza e mortalità per diverse malattie cronico-degenerative, come cancro al polmone, malattie cardiovascolari e diabete. I bambini, in particolar modo, risultano esposti ad un elevato rischio per quanto riguarda gli effetti a breve e lungo termine dell’inquinamento atmosferico. Dati recenti suggeriscono che alcune alterazioni genetiche che si verificano nella prima infanzia posso incrementare il rischio di malattie cronico-degenerative in età adulta. L’obiettivo dello studio MAPEC (Monitoring Air Pollution Effects on Children for supporting Public Health policy) è quello di valutare l’associazione tra inquinamento atmosferico e biomarcatori di effetti genotossici precoci nei bambini, e di proporre un modello per la stima del rischio globale causato dagli inquinanti atmosferici. Lo studio ha previsto il reclutamento di circa 1.000 bambini, di età compresa tra 6-8 anni, in cinque città italiane (200 bambini per città) caratterizzate da diverse concentrazioni di inquinanti atmosferici: Brescia, Torino, Pisa, Perugia e Lecce. Campioni di saliva sono stati raccolti in due differenti stagioni, inverno e primavera, caratterizzate da differenze qualitative e quantitative degli inquinanti atmosferici (1.000 × 2 = 2.000 campioni). Nei linfociti salivari è stato valutato il danno primario e ossidativo al DNA mediante il test della microgel elettroforesi su singole cellule (comet assay). Alla conferenza verranno presentati i risultati preliminari relativi al campionamento invernale

Improving the reporting quality of intervention trials addressing the inter-individual variability in response to the consumption of plant bioactives: quality index and recommendations

PURPOSE: The quality of the study design and data reporting in human trials dealing with the inter-individual variability in response to the consumption of plant bioactives is, in general, low. There is a lack of recommendations supporting the scientific community on this topic. This study aimed at developing a quality index to assist the assessment of the reporting quality of intervention trials addressing the inter-individual variability in response to plant bioactive consumption. Recommendations for better designing and reporting studies were discussed. METHODS: The selection of the parameters used for the development of the quality index was carried out in agreement with the scientific community through a survey. Parameters were defined, grouped into categories, and scored for different quality levels. The applicability of the scoring system was tested in terms of consistency and effort, and its validity was assessed by comparison with a simultaneous evaluation by experts' criteria. RESULTS: The "POSITIVe quality index" included 11 reporting criteria grouped into four categories (Statistics, Reporting, Data presentation, and Individual data availability). It was supported by detailed definitions and guidance for their scoring. The quality index score was tested, and the index demonstrated to be valid, reliable, and responsive. CONCLUSIONS: The evaluation of the reporting quality of studies addressing inter-individual variability in response to plant bioactives highlighted the aspects requiring major improvements. Specific tools and recommendations favoring a complete and transparent reporting on inter-individual variability have been provided to support the scientific community on this field

Prevalence and spectrum of germline BRCA1 and BRCA2 in a cohort of ovarian cancer patients from the Salento peninsula (Southern Italy): a matter of preventive health

Objectives: The aim of this exploratory, descriptive study was to characterize the deleterious BRCA1 and BRCA2 variants evaluated by genetic testing in a group of Ovarian cancer patients living in the Salento peninsula (Southern Italy). Methods: From June 2014 to July 2023, patients with histologically confirmed high-grade serous carcinoma, fallopian tube, or primary peritoneal cancer who were referred to Lecce Familial Cancer Clinic were considered. BRCA-mutation genetic testing was performed on these patients. Socio-demographic data and cancer epidemiology were assessed, and Next Generation Sequencing and Sanger DNA sequencing were performed. Results: The median age at the diagnosis of 332 ovarian cancer patients collected was 57 years. The pedigree analyses showed that 28.6% had familial cases and 39.7% had sporadic cases. Of the 319 patients submitted to genetic testing, 29.8% were carriers of BRCA1/2 mutation, 75.8% at BRCA1 and 24.2% at BRCA2 gene. Of the 21 BRCA1 mutations, the variant c.5266dupC was the most frequent alteration (28.4%). With respect to BRCA2, 13 mutations were found and the variant c.9676delT was the most frequently recorded (6.3%). Conclusions: This study reveals that the prevalence of germline mutations in the BRCA1 and BRCA2 genes was higher than reported by other studies. A broader understanding of the prevalence and role of BRCA mutations in development, response to treatment, and prognosis represents an exciting and developing area of ovarian cancer treatment and prevention

Economic Evaluations of Magnetic Resonance Image-Guided Radiotherapy (MRIgRT): A Systematic Review

Objectives: This review systematically summarizes the evidence on the economic impact of magnetic resonance image-guided RT (MRIgRT). Methods: We systematically searched INAHTA, MEDLINE, and Scopus up to March 2022 to retrieve health economic studies. Relevant data were extracted on study type, model inputs, modeling methods and economic results. Results: Five studies were included. Two studies performed a full economic assessment to compare the cost-effectiveness of MRIgRT with other forms of image-guided radiation therapy. One study performed a cost minimization analysis and two studies performed an activity-based costing, all comparing MRIgRT with X-ray computed tomography image-guided radiation therapy (CTIgRT). Prostate cancer was the target condition in four studies and hepatocellular carcinoma in one. Considering the studies with a full economic assessment, MR-guided stereotactic body radiation therapy was found to be cost effective with respect to CTIgRT or conventional or moderate hypofractionated RT, even with a low reduction in toxicity. Conversely, a greater reduction in toxicity is required to compete with extreme hypofractionated RT without MR guidance. Conclusions: This review highlights the great potential of MRIgRT but also the need for further evidence, especially for late toxicity, whose reduction is expected to be the real added value of this technology