Azienda Sanitaria Locale ASL

Asti, Italy

Azienda Sanitaria Locale ASL

Asti, Italy
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Pelagotti A.,CNR Institute of Neuroscience | Ferrara P.,CNR Institute of Neuroscience | Pescitelli L.,CNR Institute of Neuroscience | Gerlini G.,Azienda Sanitaria Locale ASL | And 2 more authors.
Proceedings of SPIE - The International Society for Optical Engineering | Year: 2013

An optical noninvasive inspection tool is presented to, in vivo, better characterize biological tissues such as human skin. The method proposed exploits a multispectral imaging device to acquire a set of images in the visible and NIR range. This kind of information can be very helpful to improve early diagnosis of melanoma, a very aggressive cutaneous neoplasm, incidence and mortality of which continues to rise worldwide. Currently, noninvasive methods (i.e. dermoscopy) have improved melanoma detection, but the definitive diagnosis is still achieved only by invasive method (istopathological observation of the excised lesion). The multispectral system we developed is capable of imaging layers of structures placed at increasing depth, thanks to the fact that light propagates into the skin and reaches different depths depending on its wavelength. This allows to image many features which are less or not visible in the clinical and dermoscopic examination. A new semeiotics is proposed to describe the content of multispectral images. Dermoscopic criteria can be easily applied to describe each image in the set, however inter-images correlations need new suitable descriptors. The first group of new parameters describes how the dermoscopic features, vary across the set of images. More aspects are then introduced. E.g. the longest wavelength where structures can be detected gives an estimate of the maximum depth reached by the pigmented lesion. While the presence of a bright-to-dark transition between the wavebands in the violet to blue range, reveals the presence of blue-whitish veil, which is a further malignancy marker. © 2013 SPIE.


Pelagotti A.,CNR Institute of Neuroscience | Ferrara P.,CNR Institute of Neuroscience | Pescitelli L.,CNR Institute of Neuroscience | Delfino C.,CNR Institute of Neuroscience | And 3 more authors.
Progress in Biomedical Optics and Imaging - Proceedings of SPIE | Year: 2013

Melanoma is a very aggressive cutaneous neoplasm, incidence and mortality of which continues to rise worldwide. Identification of initial melanoma may be difficult because it may be clinically, and sometimes also dermoscopically, indistinguishable from benign lesions. Currently definitive diagnosis is made only by histopathological observation of the excised lesion. Several tools have been developed to help detecting malignant lesions. Dermoscopy highlights numerous characteristic features of the lesion and of the pigmented network. The method we propose exploits a multispectral imaging device to acquire a set of images in the visible and NIR range. Thanks to the fact that light propagates into the skin and reaches different depths depending on its wavelength, such a system is capable of imaging layers of structures placed at increasing depths. Therefore a new semeiotics is proposed to describe the content of such images. Dermoscopic criteria can be easily applied to describe each image in the set, however inter-images correlation needs new suitable descriptors. The first group of new parameters describes how the dermoscopic ones, vary across the set of images. More features are then introduced. E.g. the longest wavelength where structures can be detected gives an estimate of the maximum depth reached by the pigmented lesion. While the presence of a bright-to-dark transition between the wavebands in the violet to blue range, reveals the presence of blue-whitish veil, which is a further malignancy marker. © 2013 SPIE.


Allena M.,C Mondino National Neurological Institute | Steiner T.J.,Norwegian University of Science and Technology | Steiner T.J.,Imperial College London | Sances G.,C Mondino National Neurological Institute | And 6 more authors.
Journal of Headache and Pain | Year: 2015

Background: Migraine, tension-type headache (TTH) and medication-overuse headache (MOH) are disabling lifelong illnesses. The Eurolight project, a partnership activity within the Global Campaign against Headache, assessed the impact of headache disorders in ten countries in Europe using a structured questionnaire coupled with various sampling methods. Here we present the findings from the Italian population. Methods: Questionnaires were distributed to a stratified sample (N = 3500) of the adult (18–65 years) inhabitants of Pavia province (1.05 % of the general population), randomly selected in cooperation with the local health service. Questions included demographic and diagnostic enquries, and assessment of various aspects of impact and health-care utilisation. Results: Altogether 500 questionnaires were returned of which 487 were adequately completed for analysis (58 % female, 42 % male). Among these, gender-adjusted lifetime prevalence of headache was 82.5 %, higher in females than in males (91.2 % vs 72.4 %; p < 0.0001). Gender-adjusted 1-year prevalence was 74.2 % (females 87.7 %, males 61.1 %; p < 0.0001). The most prevalent headache type was migraine (gender-adjusted 1-year prevalence 42.9 %; females 54.6 %, males 32.5 %; p < 0.0001), followed by TTH (28.6 %; no gender-related difference); all causes of headache on ≥15 days/month were reported by 7.0 % of participants (females 10.6 %, males 2.0 %; p = 0.0002), of whom 2.1 %,, all female (p = 0.0064) concomitantly overused acute medications (therefore probable MOH). Only 16.6 % of responders reporting headache had received a diagnosis from a doctor, and very few (2.4 %) were taking preventative medications. Headache had negative impacts on different aspects of life: education, career and earnings, family and social life. Each person with headache had lost, on average, 2.3 days from paid work and 2.4 days from household work, and missed social occasions on 1.2 days, in the preceding 3 months. An increasing gradient for impact was observed from episodic to chronic forms of headache. Conclusions: Our study reveals that in Italy, as in other countries, migraine, TTH and MOH are highly prevalent and are associated with significant personal impact. These findings have important implications for health policy in Italy. © 2015, Allena et al.


PubMed | University of Basel, Azienda Sanitaria Locale ASL, C Mondino National Neurological Institute and Norwegian University of Science and Technology
Type: | Journal: The journal of headache and pain | Year: 2015

Migraine, tension-type headache (TTH) and medication-overuse headache (MOH) are disabling lifelong illnesses. The Eurolight project, a partnership activity within the Global Campaign against Headache, assessed the impact of headache disorders in ten countries in Europe using a structured questionnaire coupled with various sampling methods. Here we present the findings from the Italian population.Questionnaires were distributed to a stratified sample (N=3500) of the adult (18-65 years) inhabitants of Pavia province (1.05% of the general population), randomly selected in cooperation with the local health service. Questions included demographic and diagnostic enquries, and assessment of various aspects of impact and health-care utilisation.Altogether 500 questionnaires were returned of which 487 were adequately completed for analysis (58% female, 42% male). Among these, gender-adjusted lifetime prevalence of headache was 82.5%, higher in females than in males (91.2% vs 72.4%; p<0.0001). Gender-adjusted 1-year prevalence was 74.2% (females 87.7%, males 61.1%; p<0.0001). The most prevalent headache type was migraine (gender-adjusted 1-year prevalence 42.9%; females 54.6%, males 32.5%; p<0.0001), followed by TTH (28.6%; no gender-related difference); all causes of headache on 15days/month were reported by 7.0% of participants (females 10.6%, males 2.0%; p=0.0002), of whom 2.1%,, all female (p=0.0064) concomitantly overused acute medications (therefore probable MOH). Only 16.6% of responders reporting headache had received a diagnosis from a doctor, and very few (2.4%) were taking preventative medications. Headache had negative impacts on different aspects of life: education, career and earnings, family and social life. Each person with headache had lost, on average, 2.3days from paid work and 2.4days from household work, and missed social occasions on 1.2days, in the preceding 3months. An increasing gradient for impact was observed from episodic to chronic forms of headache.Our study reveals that in Italy, as in other countries, migraine, TTH and MOH are highly prevalent and are associated with significant personal impact. These findings have important implications for health policy in Italy.


Villa A.,Polytechnic University of Turin | Antonelli D.,Polytechnic University of Turin | Bellomo D.,Azienda Sanitaria Locale ASL
21st International Conference on Production Research: Innovation in Product and Production, ICPR 2011 - Conference Proceedings | Year: 2011

In European countries healthcare systems are organized as territorial networks of services, managed by a hierarchical organization either central or regional. In any country, incidence of healthcare system cost on GNP is going to be explosive. So, new techniques for performance evaluation of services and for cost control must be applied. However, a careful management of both the offered services and the necessary costs must be done, to respect the persons' basic needs and rights. The healthcare service management till now adopted is centred on the service itself, and based first on the desire of doctors to have the most advanced machines, second on the goal of speeding the interventions on patients, to reduce the costs of holding. Thus, wrong effects result. The application of industrial management methods, looking at the specific service and user, allows a more effective impact on the care efficiency and its costs. This paper outlines the results obtained by two projects developed by the authors.


Iannuzzi A.,A Cardarelli Hospital | Verga M.C.,Ambulatory Pediatrician | Renis M.,Azienda Sanitaria Locale ASL | Schiavo A.,Azienda Sanitaria Locale ASL | And 5 more authors.
Cardiology in the Young | Year: 2010

AbstractBackground and purpose Many studies unequivocally indicate that air pollution is directly linked to the adverse cardiovascular outcomes in the general population. No data are currently available on cardiovascular effects of exposure to trafficked roads in healthy children. Distance of the residence to a major road has been shown to be a useful proxy for long-term traffic exposure and seem to be more consistently associated with atherosclerosis than particulate matter2.5. The aim of this study was to investigate a possible association between the distance to a major road and carotid arterial subclinical markers of atherosclerosis in a group of children in Italy.Methods The participants consisted of 52 healthy children living in a small town of the Amalphitan Coast with only one highly trafficked road. All children underwent an ultrasound carotid arterial examination.Results A statistically significant difference was found in carotid arterial stiffness between children living closer to the main street and other children, both those living between 330 and 730 metres from the main street and those living more than 750 metres from the main street. No significant differences were detectable in carotid arterial thickness and arterial blood pressure among the three groups of children.Conclusion This study provides evidence in support of an association of exposure to air pollution with early atherosclerotic markers in healthy children. Impaired vascular health in childhood and adolescence gives further substance to the hypothesis that traffic exhausts are relevant to cardiovascular diseases even early in life. Copyright © Cambridge University Press 2010.


Bongiorno D.,University of Catania | Campanile F.,University of Catania | Mongelli G.,University of Catania | Baldi M.T.,Villa Sofia Hospital | And 5 more authors.
Journal of Antimicrobial Chemotherapy | Year: 2010

Background: Despite 10 years of clinical use, linezolid resistance in Staphylococcus aureus and coagulase-negative staphylococci (CoNS) is still a rare phenomenon. This study reports the mechanisms of resistance and strain types seen in clusters of linezolid-resistant CoNS from two different hospitals in Italy during the period 2008-09. Methods: Genes associated with linezolid resistance were subjected to molecular analysis and isolates were characterized by PFGE macrorestriction analysis using SmaI. Results: Thirty-three linezolid-resistant isolates of methicillin-resistant CoNS comprising Staphylococcus epidermidis (24), Staphylococcus hominis (5) and Staphylococcus simulans (4) were studied. The isolates showed varying levels of linezolid resistance. Almost all isolates for which linezolid MICs were 64 mg/L possessed point mutations in domain V of 23S rRNA, while isolates for which the MICs were 256 mg/L expressed methylase activity at position A2503 mediated by the cfr gene. Overall, the isolates showed reduced susceptibility to vancomycin (MICs 1-2 mg/L) and 11 of the 33 isolates showed no susceptibility to teicoplanin. These strains were also resistant to chloramphenicol (28 of 33), lincomycin (24 of 33), erythromycin (17 of 33) and quinupristin/dalfopristin (13 of 33). S. epidermidis isolates, showing mutations or methylase modifications, belonged to different PFGE profiles and to two different sequence types (ST2 and ST23), in which the cfr gene was carried on a plasmid of ~50 kb. Conclusions: Clinical CoNS strains with resistance to linezolid and other second-line antibiotics, as well as reduced susceptibility to glycopeptides, have emerged in Italy. © The Author 2010. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.


Niegowska M.,University of Sassari | Paccagnini D.,University of Sassari | Burrai C.,Azienda Sanitaria Locale ASL | Palermo M.,Azienda Sanitaria Locale ASL | Sechi L.A.,University of Sassari
PLoS ONE | Year: 2015

Hashimoto's thyroiditis (HT) is the prevailing organ-specific autoimmune disease in Sardinia, often complicated with other autoimmune disorders, most commonly type 1 diabetes (T1D). While numerous studies describe levels of anty-thyroid antibodies (Abs) in T1D patients, few papers evaluate the status of anti-islet autoimmunity in subjects affected by HT. Previously, we portrayed Mycobacterium avium subspecies paratuberculosis (MAP) as an environmental factor strongly associated with both diseases. In this study, we analyzed plasma of Sardinian HT patients (n=177) and healthy controls (HCs; n=175) for the presence of Abs against proinsulin and MAP-derived homologous epitopes: MAP1,4αgbp157-173/PI64-80 were recognized by 5,08% and 18,64% of HT vs 0,57% and 7,43% of HCs (AUC=0,6 for both; p<0,0003 and 0,002, respectively), whereas the prevalence of Abs against MAP2404c70-85/PI46-61 peptides was higher but not significant in patients when compared to HCs. In women (n=152), Abs against MAP1,4αgbp157-173 were detected in 12,50% of HT vs 2,75% of HCs (AUC=0,63; p<0,0002), while positivity to its human homolog PI64-80 was observed in 16,42% of HT vs 6,42% of HCs (AUC=0,61; p<0,001). In men (n=25), a significant anti-PI46-61 Abs levels were detected in 4% of HT vs none of the HCs (AUC=0,7; p<0,003). Age-related analyses revealed the highest prevalence between 31-40 years old (45,83%) in the total study population and among males (33,33%); in contrast, women had a higher seroreactivity between 51-60 years (42,11%). A further follow-up and determination of anti-islet Abs levels is needed to evaluate the association of immune responses directed against the MAP/PI homologous peptides with progression to overt diabetes in HT subjects. Copyright: © 2015 Niegowska et al.


Masala S.,University of Sassari | Cossu D.,University of Sassari | Palermo M.,Azienda Sanitaria Locale ASL | Sechi L.A.,University of Sassari
PLoS ONE | Year: 2014

Mycobacterium avium subspecies paratuberculosis (MAP) asymptomatic infection has been previously linked to Type 1 diabetes (T1D) and Multiple Sclerosis. An association between MAP infection and Hashimoto's thyroiditis (HT) was also proposed only in a case report. This study aimed to investigate the robustness of the latter association, testing a large cohort of HT and healthy control (HCs) subjects, all from Sardinia. Prevalence of anti-MAP3865c Abs was assessed by indirect enzyme-linked immunosorbent assay (ELISA). Moreover, given that human ZnT8 is specifically expressed in the pancreatic β-cells, in the follicle epithelial cells and in the parafollicular cells of the thyroid gland, we also tested ZnT8 epitopes homologues to the MAP3865c immunodominant peptides previously identified. Indeed, Abs targeting MAP3865c and ZnT8 homologous regions display similar frequencies in patients and controls, thus suggesting that Abs recognizing these epitopes could be cross-reactive. A statistically significant difference was found between HT patients and HCs when analyzing the humoral response mounted against MAP3865c/ZnT8 homologues epitopes. To our knowledge, this is the first report, which provides statistically significant evidence sustaining the existence of an association between MAP seroreactivity and HT. Further studies are required to investigate the relevance of MAP to HT, aimed at deciphering if this pathogen can be at play in triggering this autoimmune disease. Likewise, genetic polymorphism of the host, and other environmental factors need to be investigated. © 2014 Masala et al.

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