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Forlì del Sannio, Italy

Ridolfi L.,Immunotherapy Unit | Petrini M.,Immunotherapy Unit | Granato A.M.,Immunotherapy Unit | Gentilcore G.,Cancer Immunotherapy and Innovative Therapies Unit | And 13 more authors.
Journal of Translational Medicine | Year: 2013

Background: In cancer immunotherapy, dendritic cells (DCs) play a fundamental role in the dialog between innate and adaptive immune response, but several immunosuppressive mechanisms remain to be overcome. For example, a high number of CD4+CD25++Foxp3+ regulatory T-cells (Foxp3+Tregs) have been observed in the peripheral blood and tumor microenvironment of cancer patients. On the basis of this, we conducted a study on DC-based vaccination in advanced melanoma, adding low-dose temozolomide to obtain lymphodepletion.Methods: Twenty-one patients were entered onto our vaccination protocol using autologous DCs pulsed with autologous tumor lysate and keyhole limpet hemocyanin. Patients received low-dose temozolomide before vaccination and 5 days of low-dose interleukin-2 (IL-2) after vaccination. Circulating Foxp3+Tregs were evaluated before and after temozolomide, and after IL-2.Results: Among the 17 evaluable patients we observed 1 partial response (PR), 6 stable disease (SD) and 10 progressive disease (PD). The disease control rate (PR+SD = DCR) was 41% and median overall survival was 10 months. Temozolomide reduced circulating Foxp3+Treg cells in all patients. A statistically significant reduction of 60% was observed in Foxp3+Tregs after the first cycle, whereas the absolute lymphocyte count decreased by only 14%. Conversely, IL-2 increased Foxp3+Treg cell count by 75.4%. Of note the effect of this cytokine, albeit not statistically significant, on the DCR subgroup led to a further 33.8% reduction in Foxp3+Treg cells.Conclusions: Our results suggest that the combined immunological therapy, at least as far as the DCR subgroup is concerned, effectively reduced the number of Foxp3+Treg cells, which exerted a blunting effect on the growth-stimulating effect of IL-2. However, this regimen, with its current modality, would not seem to be capable of improving clinical outcome. © 2013 Ridolfi et al.; licensee BioMed Central Ltd.

Ruffatti A.,University of Padua | Milanesi O.,University of Padua | Chiandetti L.,University of Padua | Cerutti A.,University of Padua | And 4 more authors.
Lupus | Year: 2012

While mainly based on the use of fluorinated steroids, there is no standard management of anti-Ro/La-related congenital heart block (CHB). This is a report concerning two consecutive cases of anti-Ro/La-related second-degree block treated with betamethasone (4 mg/day), weekly plasmapheresis, and intravenous immunoglobulins (IVIGs; 1 g/kg) administered every 15 days, a therapy that was begun shortly after CHB was detected and continued until delivery. The newborns were also treated with IVIG (1 g/kg) soon after birth and continued fortnightly until the anti-Ro/La antibody levels became undetectable. In both cases second-degree AV block reverted to a stable sinus rhythm with a first-degree atrioventricular (AV) block. Moreover, there was no recurrence of CHB when therapy was suspended, as confirmed by a 29 month and an eight month follow-up, respectively. © The Author(s), 2011.

Noubiap J.J.N.,Internal Medicine Unit | Joko W.Y.A.,Internal Medicine Unit | Nansseu J.R.N.,Hematology Unit | Tene U.G.,Pediatric Unit | Siaka C.,Blood Transfusion Unit
International Journal of Infectious Diseases | Year: 2013

Background: Blood safety remains an issue of major concern in transfusion medicine in sub-Saharan Africa. Blood-borne agents such as the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and Treponema pallidum are among the greatest threats to blood safety for the recipient. This study aimed to determine the seroprevalence and risk factors of HIV, HCV, HBV, and syphilis infections among first-time blood donors at the new hospital-based blood bank in Edéa, Cameroon. Methods: We carried out a retrospective analysis of blood donor data recorded between December 2011 and May 2012 at the blood bank of the Edéa Regional Hospital. Antibodies to HIV types 1 and 2 were screened with the Determine and ImmunoComb tests. Hepatitis B surface antigen and antibodies to HCV were detected using DIASpot test strips. Syphilis was diagnosed using the Venereal Disease Research Laboratory (VDRL) test and the Treponema pallidum hemagglutination assay (TPHA). Results: A total of 543 blood donors were included, among whom 349 (64.3%) were family replacement donors. One hundred and fifteen donors (21.2%) were infected with at least one pathogen. The overall seroprevalence rates of HIV, HBV, HCV, and syphilis were 4.1%, 10.1%, 4.8%, and 5.7%, respectively. We found a total of 26 dual infections. The most common combinations were HBV-HCV and HBV-HIV. There was a significant association between HIV and HBV infections (adjusted odds ratio (aOR) 3.46, 95% CI 1.29-9.39; p=0.014), and between HBV and HCV infections (aOR 2.81, 95% CI 1.02-10.12; p=0.036). Compared to voluntary donors, family replacement donors were significantly more infected by at least one screened pathogen (aOR 1.81, 95% CI 1.14-2.88; p=0.013), and more infected specifically by HIV (aOR 3.66, 95% CI 1.07-12.55; p=0.039) and syphilis (aOR 2.81, 95% CI 1.05-7.46; p=0.039). Conclusions: Our findings indicate that blood safety remains a major problem in Cameroon where hospital-based blood banks and family replacement donors are predominant. There is an urgent need for a national blood transfusion program in Cameroon that will establish a nationally coordinated blood transfusion service based on the principles of voluntary regular non-remunerated blood donation. © 2012 International Society for Infectious Diseases.

Salam A.,National University of Malaysia | Yousuf R.,Blood Transfusion Unit | Yousuf R.,Darul Iman University, Malaysia | Bakar S.M.A.,University of Malaya | Haque M.,Darul Iman University, Malaysia
International Medical Journal | Year: 2013

Introduction: Stress is an external constraint which upsets an individual both mentally and physically. Study showed that medical students suffer from higher stress than other faculty students. Objective: The objective of this study was to explore the reporting of stress as evident among medical students in Malaysia. Design: It was a retrospective systematic review of literatures. Materials and Method: Literature was searched through electronic databases for English articles published on stress and other psychological determinants among Malaysian medical students till September 2012. Searched terms used combinations of the related terms. Total 13 articles were reviewed and data were extracted. Results: Stress among Malaysian medical students was as high as 56% which is alarming. Year of study, financial problem and relationship problem with parents, siblings and lecturers were the significant determinants. Examination and academic related stressors were the most significant source and religion was the mostly used coping strategy. Conclusions: Medical education is highly stressful to students. Teaching processes exerts an unintentional negative effect on students' mental health. Teachers must ensure a supportive learning environment to facilitate students and be more aware of their function as an ideal role model and guide aimed to relieve academic and examination related stress from their students. Further large, prospective studies are encouraged to identify the impact on affected individual. © 2013 Japan International Cultural Exchange Foundation & Japan Health Sciences University.

Tadini G.,Pediatric Dermatology Unit | Tadini G.,Pediatric Highly Intensive Care Unit | Pezzani L.,Pediatric Highly Intensive Care Unit | Ghirardello S.,University of Milan | And 3 more authors.
BMJ Case Reports | Year: 2015

Epidermolysis bullosa (EB) is comprised of a group of hereditary mechanobullous disorders that are characterised by extremely fragile skin and mucous membranes. This results in blister formation and nonhealing wounds. This case report describes the results of an innovative treatment of two large skin lesions in a newborn with dystrophic recessive EB (DEB) who experienced bacterial superinfections and progressive anaemisation. The lesions were treated with platelet gels derived from allogeneic cord blood (cord blood platelet gel, CBPGs). The skin lesions were clinically evaluated and treated with CBPG weekly until they completely healed. The first and second lesion required CBPG applications for 2 and 4 weeks, respectively. Both lesions were monitored weekly for 6 weeks after the last CBPG application, and no significant relapses were observed during the follow-up period. This case indicates that CBPG is an effective and safe therapeutic option for managing newborns with DEB, particularly as treatment and prevention of fluid loss and superinfection. © 2015 BMJ Publishing Group. All rights reserved.

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