Incidence, Risk Factors and Outcome of Pre-engraftment Gram-Negative Bacteremia after Allogeneic and Autologous Hematopoietic Stem Cell Transplantation: An Italian Prospective Multicenter Survey

Background Gram-negative bacteremia (GNB) is a major cause of illness and death after hematopoietic stem cell transplantation (HSCT), and updated epidemiological investigation is advisable. Methods We prospectively evaluated the epidemiology of pre-engraftment GNB in 1118 allogeneic HSCTs (allo-HSCTs) and 1625 autologous HSCTs (auto-HSCTs) among 54 transplant centers during 2014 (SIGNB-GITMO-AMCLI study). Using logistic regression methods. we identified risk factors for GNB and evaluated the impact of GNB on the 4-month overall-survival after transplant. Results The cumulative incidence of pre-engraftment GNB was 17.3% in allo-HSCT and 9% in auto-HSCT. Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa were the most common isolates. By multivariate analysis, variables associated with GNB were a diagnosis of acute leukemia, a transplant from a HLA-mismatched donor and from cord blood, older age, and duration of severe neutropenia in allo-HSCT, and a diagnosis of lymphoma, older age, and no antibacterial prophylaxis in auto-HSCT. A pretransplant infection by a resistant pathogen was significantly associated with an increased risk of posttransplant infection by the same microorganism in allo-HSCT. Colonization by resistant gram-negative bacteria was significantly associated with an increased rate of infection by the same pathogen in both transplant procedures. GNB was independently associated with increased mortality at 4 months both in allo-HSCT (hazard ratio, 2.13; 95% confidence interval, 1.45-3.13; P <.001) and auto-HSCT (2.43; 1.22-4.84; P =.01). Conclusions Pre-engraftment GNB is an independent factor associated with increased mortality rate at 4 months after auto-HSCT and allo-HSCT. Previous infectious history and colonization monitoring represent major indicators of GNB. Clinical Trials registration NCT02088840

Mathematica Italia User Group Meeting (UGM 2013), Dipartimento di Matematica, Universita' di Bologna, 30-31 maggio 2013

Annual conference for European and Italian Mathematica Users, mostly devoted but not limited to scientific applications

Bio-inspired benzo[k,l]xanthene lignans: synthesis, DNA-interaction and antiproliferative properties

In this work twelve benzo[k,l]xanthene lignans were synthesized by biomimetic, Mn-mediated oxidative coupling of caffeic esters and amides. These compounds, bearing different flexible pendants at position C1/C2 of the aromatic core, interact with DNA in a dual mode, as confirmed by DF-STD NMR analysis and molecular docking: the planar core acts as a base pair intercalant, whereas the flexible pendants act as minor groove binders. Their antiproliferative activity was evaluated on a panel of six tumor cell lines: HT-29, Caco-2, HCT-116 (human colon carcinoma), H226, A549 (human lung carcinoma), and SH-SY5Y (human neuroblastoma). All compounds under study, except 29, resulted in activity against one or more cell lines, and the markedly lipophilic esters 13 and 28 showed the highest activity. Compound 13 was more active than the anticancer drug 5-fluorouracil (5-FU) towards HCT-116 (colon, GI50 = 3.16 μM) and H226 (lung, GI50 = 4.33 μM) cell lines

Risk of fractures and bone abnormalities in postmenopausal women with type 2 diabetes mellitus

Patients with diabetes mellitus (DM) are at high risk for fractures. However, the relationship between diabetes and osteoporosis is not yet completely understood. Many factors such as type of diabetes, type of population and co-morbidities may influence the type and severity of bone abnormalities in these patients. The aim of this study was to evaluate which factors may explain the risk of fractures in a homogeneous population of postmenopausal women with type 2 DM. Twenty-one consecutive postmenopausal women with type 2 DM were enrolled. Serum and urinary markers of bone metabolism as well as the biochemical markers of glucose homeostasis and diabetes severity were evaluated. Bone mineral density and prevalence of vertebral fractures were evaluated by using MOC DXA and spine radiography, respectively. The measurement of 25-hydroxyvitamin D serum levels revealed a condition of deficiency in 67% and insufficiency in 28% of patients. Vertebral and femoral neck T-scores were -1.1±1.1 and -0.8±1.0, respectively, while Z-scores were 0.1±1.1 and 0.1±0.9, respectively. Twenty-four % of patients showed ≥1 vertebral fractures. There was a direct correlation between occurrence of fractures and PTH levels (p<0.05), and an inverse correlation between fractures and deficiency of 25-hydroxyvitamin D (p<0.05). In conclusion, although bone mineral density is comparable with that of age-matched normal subjects, patients with type 2 DM have an increased risk of fracture which appears to be associated with vitamin D deficiency and secondary increase of PT