Azienda Ospedaliero Universitaria Ospedali Riuniti di Trieste

Trieste, Italy

Azienda Ospedaliero Universitaria Ospedali Riuniti di Trieste

Trieste, Italy
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Kiryluk K.,Columbia University | Li Y.,University of Brescia | Scolari F.,University of Brescia | Sanna-Cherchi S.,Yale University | And 88 more authors.
Nature Genetics | Year: 2014

We performed a genome-wide association study (GWAS) of IgA nephropathy (IgAN), the most common form of glomerulonephritis, with discovery and follow-up in 20,612 individuals of European and East Asian ancestry. We identified six new genome-wide significant associations, four in ITGAM-ITGAX, VAV3 and CARD9 and two new independent signals at HLA-DQB1 and DEFA. We replicated the nine previously reported signals, including known SNPs in the HLA-DQB1 and DEFA loci. The cumulative burden of risk alleles is strongly associated with age at disease onset. Most loci are either directly associated with risk of inflammatory bowel disease (IBD) or maintenance of the intestinal epithelial barrier and response to mucosal pathogens. The geospatial distribution of risk alleles is highly suggestive of multi-locus adaptation, and genetic risk correlates strongly with variation in local pathogens, particularly helminth diversity, suggesting a possible role for host-intestinal pathogen interactions in shaping the genetic landscape of IgAN. © 2014 Nature America, Inc. All rights reserved.


Ruiz-Gonzalez Y.,University "Marta Abreu" of Las Villas | Perez-Diaz M.,University "Marta Abreu" of Las Villas | Martinez-Aguila D.,University "Marta Abreu" of Las Villas | Diaz-Barreto M.,Centro Para El Control Estatal Of Medicamentos | And 5 more authors.
IFMBE Proceedings | Year: 2015

Phase-contrast mammography with synchro-tron radiation is an innovative x-ray imaging technique that improves the identification of breast lesions. Previous studies have proven the superiority of the mammography images taken in the phase contrast modality using synchrotron radia-tion beams as compared with images taken in conventional mammography by subjective analyses. However, to our knowledge, no previous study has compared different acquisi-tion systems in order to quantify this improvement by means of objective robust indicators. In this research, we intend to quantify the superiority of phase contrast imaging by means of objective metrics of image quality. The initial analyses were made using phantom images from two digital equipment for mammography and phase contrast images using synchrotron radiation. The acquisition conditions were varied and three indexes of image quality estimated in order to compare the image quality. The results showed an improvement of the contrast in phase contrast images. This contrast improvements is important in the detection of small lesions and details. © Springer International Publishing Switzerland 2015


Longo R.,University of Trieste | Tonutti M.,Azienda Ospedaliero Universitaria Ospedali Riuniti di Trieste | Rigon L.,University of Trieste | Arfelli F.,University of Trieste | And 6 more authors.
Philosophical Transactions of the Royal Society A: Mathematical, Physical and Engineering Sciences | Year: 2014

The first clinical study of phase-contrast mammography (PCM) with synchrotron radiation was carried out at the Synchrotron Radiation for Medical Physics beamline of the Elettra synchrotron radiation facility in Trieste (Italy) in 20062009. The study involved 71 patients with unresolved breast abnormalities after conventional digital mammography and ultrasonography exams carried out at the Radiology Department of Trieste University Hospital. These cases were referred for mammography at the synchrotron radiation facility, with images acquired using a propagation-based phase-contrast imaging technique. To investigate the contribution of phasecontrast effects to the image quality, two experienced radiologists specialized in mammography assessed the visibility of breast abnormalities and of breast glandular structures. The images acquired at the hospital and at the synchrotron radiation facility were compared and graded according to a relative sevengrade visual scoring system. The statistical analysis highlighted that PCM with synchrotron radiation depicts normal structures and abnormal findings with higher image quality with respect to conventional digital mammography. © 2014 The Author(s) Published by the Royal Society. All rights reserved.


Castelli E.,University of Trieste | Castelli E.,National Institute of Nuclear Physics, Italy | Tonutti M.,University of Trieste | Arfelli F.,University of Trieste | And 22 more authors.
Radiology | Year: 2011

Purpose: To prospectively evaluate the diagnostic contribution of mammography with synchrotron radiation in patients with questionable or suspicious breast abnormalities identified at combined digital mammography (DM) and ultrasonography (US). Materials and Methods: The ethics committee approved this prospective study, and written informed consent was obtained from all patients. Mammography with synchrotron radiation was performed with a phase-detection technique at a synchrotron radiation laboratory. Forty-nine women who met at least one of the inclusion criteria (palpable mass, focal asymmetry, architectural distortion, or equivocal or suspicious mass at DM; none clarified at US) were enrolled. Forty-seven women (mean age, 57.8 years ± 8.8 [standard deviation]; age range, 43-78 years) completed the study protocol, which involved biopsy or follow-up for 1 year as the reference standard. Breast Imaging Reporting and Data System (BI-RADS) scores of 1-3 were considered to indicate a negative result, while scores 4-5 were considered to indicate a positive result. The visibility of breast abnormalities and the glandular parenchymal structure at DM and at mammography with synchrotron radiation was compared by using the Wilcoxon signed rank test. Results: In 29 of the 31 patients with a final diagnosis of benign entity, mammography with synchrotron radiation yielded BI-RADS scores of 1-3. In 13 of the remaining 16 patients with a final diagnosis of malignancy, mammography with synchrotron radiation yielded BI-RADS scores of 4-5. Therefore, a sensitivity of 81% (13 of 16 patients) and a specificity of 94% (29 of 31 patients) were achieved with use of the described BI-RADS dichotomization system. Conclusion: These study results suggest that mammography with synchrotron radiation can be used to clarify cases of questionable or suspicious breast abnormalities identified at DM. © RSNA, 2011.


PubMed | Krysiewicza Childrens Hospital, The Second University of Naples, Carreggi Hospital, Poznan University of Medical Sciences and 42 more.
Type: Journal Article | Journal: Nature genetics | Year: 2014

We performed a genome-wide association study (GWAS) of IgA nephropathy (IgAN), the most common form of glomerulonephritis, with discovery and follow-up in 20,612 individuals of European and East Asian ancestry. We identified six new genome-wide significant associations, four in ITGAM-ITGAX, VAV3 and CARD9 and two new independent signals at HLA-DQB1 and DEFA. We replicated the nine previously reported signals, including known SNPs in the HLA-DQB1 and DEFA loci. The cumulative burden of risk alleles is strongly associated with age at disease onset. Most loci are either directly associated with risk of inflammatory bowel disease (IBD) or maintenance of the intestinal epithelial barrier and response to mucosal pathogens. The geospatial distribution of risk alleles is highly suggestive of multi-locus adaptation, and genetic risk correlates strongly with variation in local pathogens, particularly helminth diversity, suggesting a possible role for host-intestinal pathogen interactions in shaping the genetic landscape of IgAN.


Padovan M.,University of Ferrara | Filippini M.,Spedali Civili di Brescia | Tincani A.,Spedali Civili di Brescia | Lanciano E.,Policlinico Universitario | And 15 more authors.
Arthritis Care and Research | Year: 2016

Objective Rheumatoid arthritis (RA) with concomitant hepatitis B virus (HBV) infection represents a therapeutic challenge due to the risk of HBV reactivation under immunosuppressive treatment. To date there are few data coming from anecdotal case reports that concern HBV reactivation following treatment with abatacept. This observational retrospective study was aimed to assess the safety profile of abatacept in this particular clinical setting. Methods Eleven Italian rheumatologic centers provided data from patients with RA and positive HBV serology treated with intravenous abatacept. HBV markers and clinical and laboratory data were checked at followup visits every 3 months. Results In total, 72 patients were included in the study: 47 inactive carriers, 21 occult carriers, and 4 chronic active carriers for HBV. At baseline all of the patients had normal liver function tests and low or undetectable HBV DNA levels, except for those with chronic active hepatitis. Thirteen patients received prophylaxis with lamivudine, and 4 received treatment with adefovir or tenofovir. At the end of the 24-month followup period, 49 patients were being treated. Data from 316 followup visits showed that abatacept was safe. No patients experienced reactivation of hepatitis B. Treatment withdrawals (23 patients) were due to lack of efficacy, subject decision/lost at followup, or adverse events not related to HBV infection. Conclusion Our study provides reassuring data about the safety profile of abatacept in RA with concomitant HBV infection without universal antiviral prophylaxis. Further prospective studies are needed to confirm these preliminary results. © 2016, American College of Rheumatology.


PubMed | Policlinico Universitario Monserrato, University of Ferrara, Ospedale Civile, Azienda Ospedaliero Universitaria Ospedali Riuniti di Trieste and 6 more.
Type: Journal Article | Journal: Arthritis care & research | Year: 2016

Rheumatoid arthritis (RA) with concomitant hepatitis B virus (HBV) infection represents a therapeutic challenge due to the risk of HBV reactivation under immunosuppressive treatment. To date there are few data coming from anecdotal case reports that concern HBV reactivation following treatment with abatacept. This observational retrospective study was aimed to assess the safety profile of abatacept in this particular clinical setting.Eleven Italian rheumatologic centers provided data from patients with RA and positive HBV serology treated with intravenous abatacept. HBV markers and clinical and laboratory data were checked at followup visits every 3 months.In total, 72 patients were included in the study: 47 inactive carriers, 21 occult carriers, and 4 chronic active carriers for HBV. At baseline all of the patients had normal liver function tests and low or undetectable HBV DNA levels, except for those with chronic active hepatitis. Thirteen patients received prophylaxis with lamivudine, and 4 received treatment with adefovir or tenofovir. At the end of the 24-month followup period, 49 patients were being treated. Data from 316 followup visits showed that abatacept was safe. No patients experienced reactivation of hepatitis B. Treatment withdrawals (23 patients) were due to lack of efficacy, subject decision/lost at followup, or adverse events not related to HBV infection.Our study provides reassuring data about the safety profile of abatacept in RA with concomitant HBV infection without universal antiviral prophylaxis. Further prospective studies are needed to confirm these preliminary results.


Perkan A.,Struttura Complessa di Cardiologia | Vitrella G.,Struttura Complessa di Cardiologia | Barbati G.,University of Turin | De Monte A.,Azienda Ospedaliero Universitaria Ospedali Riuniti di Trieste | And 10 more authors.
Journal of Cardiovascular Medicine | Year: 2013

BACKGROUND: The impact of diabetes in patients with acute myocardial infarction (AMI) treated with primary percutaneous coronary intervention (PCI) is unclear. The benefit of abciximab in this subset of patients remains controversial. METHODS AND RESULTS: Three hundred and twenty-seven consecutive and unselected patients with acute AMI treated with primary PCI were included in our single-center retrospective registry, 103 diabetic (31%) and 224 nondiabetic (69%). Abciximab was given at the physicianÊfrac14;s discretion. Diabetic patients were older (mean age 68. 5 ±â€Š11 vs. 65†Š±â€Š12 years; P =  0.009), had an increased prevalence of hypertension (73 vs. 54%; P = 0.001), a decreased prevalence of smoking (31 vs. 45%; P = 0.02), a longer duration of symptoms before hospital admission (190 vs. 143 min; P = 0.031), and a higher number of stents implanted (1.4 vs. 1.2; P =  0.04). Other clinical and angiographic characteristics were comparable in the two groups. Diabetic patients had a higher incidence of the combined end-point of death and reinfarction rate at 30 days (18 vs. 10%; P = 0.04) compared to nondiabetic patients. Abciximab treatment was associated with a lower in-hospital (23.8 vs. 5%; P = 0.005) and 30-day (23.8 vs. 6.6%; P = 0.012) mortality, and a lower incidence of death and reinfarction at 30 days (33.3 vs. 9.8%; P = 0.003) in diabetic patients. In nondiabetic patients, abciximab was not associated with improved outcome measures. Advanced Killip class (III and IV) and abciximab were found to be independently associated with 30-day death or myocardial infarction [respectively, odds ratio (OR) 6.075, 95% confidence interval (CI) 1.59-23.218, P = 0.008 and OR 0.177, 95% CI 0.034-0.938, P = 0.042] in the propensity score-matched populations of diabetic patients. Advanced Killip class and thrombolysis in myocardial infarction score index were found to be independently associated with 30-day death or myocardial infarction (respectively, OR 6.607, 95% CI 1.5-29.106, P =  0.013 and OR 1.094 95% CI 1.042-1.148, P†Š< 0.001) in the propensity score-matched populations of nondiabetic patients. CONCLUSIONS: In our registry diabetic patients treated with primary PCI for AMI had a worse in-hospital and 30-day outcome than nondiabetic patients. Adjunct pharmacologic treatment with abciximab was associated to a better prognosis only in diabetic patients. © 2013 Italian Federation of Cardiology.


Zennaro C.,University of Trieste | Zennaro C.,Renal Research Laboratory | Mariotti M.,University of Milan | Carraro M.,University of Trieste | And 11 more authors.
PLoS ONE | Year: 2014

The zebrafish pronephros is gaining popularity in the nephrology community, because embryos are easy to cultivate in multiwell plates, allowing large number of experiments to be conducted in an in vivo model. In a few days, glomeruli reach complete development, with a structure that is similar to that of the mammalian counterpart, showing a fenestrated endothelium and a basement membrane covered by the multiple ramifications of mature podocytes. As a further advantage, zebrafish embryos are permeable to low molecular compounds, and this explains their extensive use in drug efficacy and toxicity experiments. Here we show that low concentrations of adriamycin (i.e. 10 and 20 μM), when dissolved in the medium of zebrafish embryos at 9 hours post-fertilization and removed after 48 hours (57 hpf), alter the development of podocytes with subsequent functional impairment, demonstrated by onset of pericardial edema and reduction of expression of the podocyte proteins nephrin and wt1. Podocyte damage is morphologically confirmed by electron microscopy and functionally supported by increased clearance of microinjected 70 kDa fluorescent dextran. Importantly, besides pericardial edema and glomerular damage, which persist and worsen after adriamycin removal from the medium, larvae exposed to adriamycin 10 and 20 μM do not show any myocardiocyte alterations nor vascular changes. The only extra-renal effect is a transient delay of cartilage formation that rapidly recovers once adriamycin is removed. In summary, this low dose adriamycin model can be applied to analyze podocyte developmental defects, such as those observed in congenital nephrotic syndrome, and can be taken in consideration for pharmacological studies of severe early podocyte injury. © 2014 Zennaro et al.

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