Di Nicuolo G.,Cotugno Hospital |
Scuderi V.,Hepatobiliary and Liver Transplant Unit |
Scognamiglio M.,Cotugno Hospital |
Di Florio E.,Cardarelli Hospital |
And 2 more authors.
Xenotransplantation | Year: 2010
Background: Clinical use of porcine cell-based bioartificial liver (BAL) support in acute liver failure as bridging therapy for liver transplantation exposes the patient to the risk of transmission of porcine endogenous retroviruses (PERVs) to human. This risk may be enhanced when patients receive liver transplant and are subsequently immunosuppressed. As further follow-up of previously reported patients (Di Nicuolo et al. 2005), an assessment of PERV infection was made in the same patient population pharmacologically immunosuppressed for several years after BAL treatment and in healthcare workers (HCWs) involved in the clinical trial at that time. Methods: Plasma and peripheral blood mononuclear cells (PBMCs) from eight patients treated with the Academic Medical Center-BAL (AMC-BAL), who survived to transplant, and 13 HCWs, who were involved in the trial, were assessed to detect PERV infection. A novel quantitative real-time polymerase chain reaction assay has been used. Results: Eight patients who received a liver transplant after AMC-BAL treatment are still alive under long-term pharmacological immunosuppression. The current clinical follow-up ranges from 5.6 to 8.7 yr after BAL treatment. A new q-real-time PCR assay has been developed and validated to detect PERV infection. The limit of quantification of PERV DNA was ≥5 copies per 1 × 105 PBMCs. The linear dynamic range was from 5 × 100 to 5 × 10 6 copies. In both patients and HCWs, neither PERV DNA in PBMCs nor PERV RNA in plasma and PBMC samples have been found. Conclusion: Up to 8.7 yr after exposure to treatment with porcine liver cell-based BAL, no PERV infection has been found in long-term immunosuppressed patients and in HCWs by a new highly sensitive and specific q-real-time PCR assay. © 2010 John Wiley & Sons A/S.
PubMed | Azienda Ospedaliera Lecco, Santissima Annunziata Hospital, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, University of Bari and 6 more.
Type: Journal Article | Journal: Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases | Year: 2016
Migrant and Italian HIV-infected patients (n = 5773) enrolled in the ICONA cohort in 2004-2014 were compared for disparities in access to an initial antiretroviral regimen and/or risk of virologic failure (VF), and determinants of failure were evaluated. Variables associated with initiating antiretroviral therapy (ART) were analysed. Primary endpoint was time to failure after at least 6 months of ART and was defined as: VF, first of two consecutive virus loads (VL) >200 copies/mL; treatment discontinuation (TD) for any reason; and treatment failure as confirmed VL >200 copies/mL or TD. A Poisson multivariable analysis was performed to control for confounders. Migrants presented significantly lower CD4 counts and more frequent AIDS events at baseline. When adjusting for baseline confounders, migrants presented a lower likelihood to begin ART (odds ratio 0.80, 95% confidence interval (CI) 0.67-0.95, p 0.012). After initiating ART, the incidence VF rate was 6.4 per 100 person-years (95% CI 4.8-8.5) in migrants and 2.7 in natives (95% CI 2.2-3.3). Multivariable analysis confirmed that migrants had a higher risk of VF (incidence rate ratio 1.90, 95% CI 1.25-2.91, p 0.003) and treatment failure (incidence rate ratio 1.16, 95% CI 1.01-1.33, p 0.031), with no differences for TD. Among migrants, variables associated with VF were age, unemployment and use of a boosted protease inhibitor-based regimen versus nonnucleoside reverse transcriptase inhibitors. Despite the use of more potent and safer drugs in the last 10 years, and even in a universal health care setting, migrants living with HIV still present barriers to initiating ART and an increased risk of VF compared to natives.
PubMed | Galliera Hospital, Amedeo Of Savoia Hospital, Marche Polytechnic University, Sacco Hospital and 15 more.
Type: Journal Article | Journal: Journal of chemotherapy (Florence, Italy) | Year: 2016
The impact of infectious diseases (ID) specialist consultation in the management of many types of bacterial infections has been fully demonstrated but not for bone and joint infections (BJIs). Nineteen ID Italian centres collected of data from June 2009 to May 2012. Italian guidelines (2009) were used to determine the appropriateness of the diagnostic and therapeutic process of BJIs before and after consulting an ID specialist. Data on 311 patients were collected: 111 cases of prosthetic joint infection, 99 osteomyelitis, 64 spondylodiscitis and 37 fixation device infection. A significant increase of microbiological investigations, imaging techniques and blood inflammation markers were noted after consulting the ID specialist. Moreover, inappropriateness of treatment duration, dosage, and number of administrations significantly decreased after consultation. Infectious disease specialist intervention in the management of BJIs significantly increases the appropriateness both in performing instrumental and laboratory analysis, but especially in determining the correct therapy.
PubMed | Azienda Ospedaliera Lecco, Santissima Annunziata Hospital, University of Bari, National Institute For Infectious Diseases L Spallanzani Irccs and 5 more.
Type: Journal Article | Journal: Journal of the International AIDS Society | Year: 2014
Aim of the study was to evaluate possible disparities in access and/or risk of virological failure (VF) to the first antiretroviral (ART) regimen for migrants compared to Italian-born patients and to assess determinants of failure for the migrants living with HIV.All native and migrant nave patients enrolled in ICONA in 2004-2014 were included. Firstly, variables associated to ART initiation were analyzed. In a second analysis, the primary endpoint was time to failure after at least six months of ART, defined as: (a) VF (first of two consecutive viral load (VL) >50 and >200 copies/mL); (b) treatment discontinuation (TD) for any reason; and (c) treatment failure (TF: confirmed VL >200 cp/mL or TD). A Poisson multivariable analysis was performed to control for confounders.A total of 5777 HIV-pos ART-nave patients (1179 migrants and 4598 natives) were evaluated. Most migrants were from sub-Saharan Africa (35.3%) and South-Central America/Caribbean (29%). Median duration of residency in Italy was five years (IQR 1-10). Baseline characteristics significantly differed between the two groups (Table 1); in particular, lower CD4 counts and higher frequency of AIDS events were observed in migrants vs natives. When adjusting for baseline confounders, migrants presented a lower chance to initiate ART compared to natives (OR 0.78, 95% CI 0.65-0.93, p=0.006). After ART initiation, the incidence rate of VF >50 cp/mL was 15.5 per 100 person-years (95% CI 12.8-18.8) in migrants and 8.9 in natives (95% CI 7.9-9.9), respectively. By multivariable analysis, migrants had a significantly higher risk of VF, both >50 cp/mL (OR 1.50, 95% CI 1.17-1.193, p=0.001) and >200 cp/mL (OR 1.59, 95% CI 1.23-2.05, p<0.001), and of TF (OR 1.15, 95% CI 1.00-1.32, p=0.045), while no differences were observed in TD risk. Among migrants, variables associated with a higher VF risk were age (for 10-year increase, OR 0.96, 95% CI 0.93-0.98, p=0.002), unemployment (OR 1.96, 95% CI 1.20-3.20, p=0.007) and use of a boosted PI based-regimen (OR 2.04, 95% CI 1.25-3.34, p=0.005 vs NNRTI-based), while pregnancy was associated with TD (OR 3.73, 95% CI 2.36-5.90, p<0.001) and TF (OR 3.13, 95% CI 02.00-4.89, p<0.001).Despite the use of more potent and safer antiretroviral drugs in the last 10 years, and even in a setting of universal access to ART, migrants living with HIV still present barriers to ART initiation and increased risk of VF compared to natives.
News Article | November 8, 2016
NAPLES, ITALY, November 08, 2016-- Dr. Giulio Tarro has been included in Marquis Who's Who. As in all Marquis Who's Who biographical volumes, individuals profiled are selected on the basis of current reference value. Factors such as position, noteworthy accomplishments, visibility, and prominence in a field are all taken into account during the selection process.Beginning in 1966, Dr. Tarro's illustrious 50-year career has been comprised of notable achievements in virology, microbiology, and immunology. After earning an MD from the University of Naples Federico II, Dr. Tarro became an assistant in medical pathology at his alma mater. He then became a research fellow at the National Research Council, and by the fellowship's end, he was an assistant professor of research pediatrics and a research associate in the division of virology and cancer research at the University of Cincinnati College's Medicine and Children's Hospital. Further, he taught oncologic virology and microbiology and immunology at the University of Naples Federico II's College of Medicine and School of Specialization and was the chief of the virology division at D. Cotugno Hospital Infectious Diseases. Dr. Tarro had also obtained a postgraduate degree in nervous diseases and a Ph.D. in virology. He went on to become the research chief for the National Research Council.Dr. Tarro's academic and professional achievements continued to overlap as the decades passed, with each accomplishment earning the virologist more national and international recognition than the last. Following his Ph.D., Dr. Tarro earned a postgraduate degree in medical and biological sciences from Roman Academy, an honorary degree in medicine from Pro-Deo State University, an honorary degree in immunology from St. Theodora Academy, an honorary degree in bioethics from Constantinian University, an honorary Master of Science in biomedical technology from Assam University, and an honorary degree in social sciences from Bonakè University. At the same time, he became the president of the ethic committee and the head of the diagnostic laboratories in the department of infectious diseases at D. Cotugno Hospital. At last, in 2006, he retired.Prior to Dr. Tarro's retirement, he held an abundance of career-related positions. He was on the National Committee on Health and was the science coordinator of extracorporeal hyperthermia in HCV patients at First Circle Medical. To remain abreast of industry advancements, Dr. Tarro maintained affiliations with the International League of Doctors against Vivisection, the Italian Society Immuno-Oncology, and the American Association for Cancer Research.For his remarkable accomplishments, Dr. Tarro has been featured in the 32nd through 37th editions of Who's Who in Finance and Business, the 48th through 70th editions of Who's Who in America, the 1st through 8th editions of Who's Who in Medicine and Healthcare, the 1st through 12th editions of Who's Who in Science and Engineering, and the 10th through 33rd editions of Who's Who in the World.About Marquis Who's Who :Since 1899, when A. N. Marquis printed the First Edition of Who's Who in America , Marquis Who's Who has chronicled the lives of the most accomplished individuals and innovators from every significant field of endeavor, including politics, business, medicine, law, education, art, religion and entertainment. Today, Who's Who in America remains an essential biographical source for thousands of researchers, journalists, librarians and executive search firms around the world. Marquis now publishes many Who's Who titles, including Who's Who in America , Who's Who in the World , Who's Who in American Law , Who's Who in Medicine and Healthcare , Who's Who in Science and Engineering , and Who's Who in Asia . Marquis publications may be visited at the official Marquis Who's Who website at www.marquiswhoswho.com
PubMed | San Gerardo Hospital, National Institute for Infectious Diseases L Spallanzani, San Paolo Hospital, University of Bologna and 3 more.
Type: Journal Article | Journal: Journal of the International AIDS Society | Year: 2014
This descriptive, non-interventional study on HIV-1-infected patients treated with DRV/r in the usual clinical setting, with a single-arm prospective observational design, collected data on utilization of darunavir/ritonavir (DRV/r) under the conditions described in marketing authorization in usual clinical practice in Italy to evaluate efficacy and safety of DRV/r-based antiretroviral (ARV) treatment. This analysis focussed on the safety profile of DRV/r in HIV-1 infected patients.Data were analyzed from four cohorts of HIV-1-infected patients treated with DRV/r in the real-world setting, including an ARV-nave-DRV/r-nave cohort (Cohort 1), an ARV-experienced-DRV/r-nave cohort (Cohort 2) and two ARV-DRV/r-experienced cohorts (Cohorts 3 and 4), one of which (Cohort 3) was from the DRV/r Early Access Program. The objective of this analysis was to examine the safety data obtained in these four cohorts in patients enrolled from June 2009 to November 2011 and observed until December 2012 or DRV/r discontinuation.Safety data from 875 patients were analyzed. DRV/r-based treatment was well tolerated, with 36.2% of patients reporting 1 adverse event (AE) and very few discontinuations due to study drug-related AEs (3.0% overall). The most frequent AEs were diarrhoea (2.7%), reduced bone density (2.6%) and hypercholesterolaemia (2.1%) (Table 1). Regarding metabolic parameters, levels of liver enzymes alanine aminotransferase (ALT) and aspartate aminotransferase (AST) remained stable from baseline to the last study visit (LSV) in DRV-experienced patients and decreased in DRV-nave patients. Blood glucose concentrations remained stable in all cohorts. Serum triglyceride and cholesterol concentrations remained stable in DRV-experienced patients but increased in nave patients, yet were still within normal range.In HIV-1-infected patients treated with DRV/r in these settings, the tolerability profile was favourable and similar to (or better than) that reported in controlled clinical trials. These data confirm DRV/r to be a safe treatment choice in DRV/r-experienced and nave patients.
Di Costanzo G.G.,Cardarelli Hospital |
De Stefano G.,Cotugno Hospital |
Tortora R.,Cardarelli Hospital |
Farella N.,Cotugno Hospital |
And 6 more authors.
Future Oncology | Year: 2015
Aim: Sorafenib is the standard of care in advanced hepatocellular carcinoma. This study was aimed to identify clinical parameters that may predict survival in these patients. Materials & methods: In this observational study, a training (226 patients) and validation cohorts (54 patients) were analyzed for evaluating pretreatment and on-treatment parameters. Results: At multivariate analysis, only on-treatment variables (skin toxicity, diarrhea and arterial hypertension-sorafenib off-target effects), alphafetoprotein and radiological responses predicted survival. Using the occurrence of off-target effects, a prognostic index able to distinguish three groups of patients with different survival was constructed and externally validated. Conclusion: In hepatocellular carcinoma patients, on-treatment variables are the best predictors of survival. Among these, sorafenib off-target effects may be the most useful indicators for prognostication in field practice. © 2015 Future Medicine Ltd.
Gualdieri L.,Ascalesi Hospital |
Rinaldi L.,University of Naples Federico II |
Petrullo L.,Cotugno Hospital |
Morgoglione M.E.,University of Naples Federico II |
And 6 more authors.
Acta Tropica | Year: 2011
The present study was aimed at carrying out a cross-sectional copromicroscopic survey of helminths and intestinal protozoa in immigrants in Naples (southern Italy). Between October 2008 and November 2009, a total of 514 immigrants were tested comparing the FLOTAC dual technique and the ethyl acetate concentration technique. Combined results of the two techniques served as a diagnostic 'gold' standard and revealed an overall prevalence of parasitic infections of 61.9% (318/514). The ethyl acetate concentration technique detected a low number of positive results (49.0%) and this was confirmed for each helminth/protozoa species detected. Among helminths, Trichuris trichiura (3.9%), hookworms (3.7%) and Ascaris lumbricoides (1.4%) were the most prevalent. Strongyloides stercoralis (0.4%), Enterobius vermicularis (0.4%), Schistosoma mansoni (1.0%), Hymenolepis nana (1.6%) and Taenia spp. (0.2%) were also found, as well as zoonotic helminths, as Trichostrongylus spp. (0.8%) and Dicrocoelium dendriticum (0.8%). As regard to pathogenic protozoa, Blastocystis hominis was the most commonly detected (52.7%), followed by Entamoeba histolytica/Entamoeba dispar/Entamoeba moshkovskii (11.9%) and Giardia duodenalis (4.5%). Several issues concerning diagnosis, epidemiology and public health impact of parasitic infections in immigrants are offered for discussion. In conclusion, the present paper pointed out the need of better diagnosis and cure of the immigrants population in order to improve access to health care of this neglected and marginalised population group, for its own protection and care. © 2010 Elsevier B.V.
Fiore M.,University of Trieste |
de Stefano G.,Cotugno Hospital |
Coppola N.,The Second University of Naples |
Giorgio A.,Tortorella Clinical Institute
Gastroenterology and Hepatology from Bed to Bench | Year: 2015
We report two cases of a gastrointestinal stromal tumor (GIST) synchronous and metachronous, respectively, with pancreatic adenocarcinoma. To our knowledge, this is the first report of a GIST involved 3 years after a ductal pancreatic adenocarcinoma. Data from the literature and our cases seem to suggest that incidental GIST may occur synchronously and metachronously with other cancers more frequently than expected. Thus, the patients with a diagnosis of pancreatic adenocarcinoma may have undergone a strict follow up for GIST. © 2015 RIGLD, Research Institute for Gastroenterology and Liver Diseases.
PubMed | The Second University of Naples, Tortorella Clinical Institute, University of Trieste and Cotugno Hospital
Type: Journal Article | Journal: Gastroenterology and hepatology from bed to bench | Year: 2015
We report two cases of a Gastrointestinal Stromal Tumor (GIST) synchronous and metachronous, respectively, with pancreatic adenocarcinoma. To our knowledge, this is the first report of a GIST involved 3 years after a ductal pancreatic adenocarcinoma. Data from the literature and our cases seem to suggest that incidental GIST may occur synchronously and metachronously with other cancers more frequently than expected. Thus, the patients with a diagnosis of pancreatic adenocarcinoma mayhaveundergone a strict follow up for GIST.