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Sinagra J.L.M.,Istituto San Gallicano | Kanitz E.E.,Istituto Superiore di Sanita | Cerocchi C.,Azienda Unita Sanitaria Locale Rome C | Cota C.,Istituto San Gallicano | And 6 more authors.
Pediatric Dermatology | Year: 2014

Mycobacterium abscessus is emerging as an important cause of cutaneous infections in sporadic cases and outbreak settings. Although immunosuppressed or elderly patients are most commonly affected, in 2006 an outbreak of clinically distinct cutaneous lesions on the hands and feet caused by M. abscessus in a population of healthy children using a public swimming pool was reported. This article describes an outbreak of skin infection in a population of healthy Italian children attending the same school and using the same swimming pool. In January 2010 we identified three children with multiple, painful nodules on the palms and soles. M. abscessus was isolated from one child's lesions. A public health investigation was conducted and a team of dermatologists and public health officers visited all of the children; 514 children were screened and 29 cases were identified overall. All of the affected children had used the school's swimming pool. These children were treated with oral clarithromycin for 4 to 8 weeks. Because of the long period of time between the presentation and diagnosis of the first cases, the possibility that the number of cases may have been underestimated cannot be excluded. To our knowledge, this is the second largest reported cluster of M. abscessus skin infection suspected to be related to swimming pool exposure in a population of otherwise healthy children. It is unclear whether this disease is rare or should be considered as an emerging clinical entity. © 2014 Wiley Periodicals, Inc. Source


Cavallo F.,University of Turin | Bringhen S.,University of Turin | Milone G.,Ferrarotto Hospital | Ben-Yehuda D.,Hadassah Medical Center | And 20 more authors.
Leukemia | Year: 2011

Lenalidomide has raised concerns regarding its potential impact on the ability to collect stem cells for autologous stem cell transplantation, especially after prolonged exposure. The use of cyclophosphamide plus granulocyte colony-stimulating factor (G-CSF) to mobilize peripheral blood stem cells may overcome this concern. In newly diagnosed multiple myeloma (MM) patients, we investigated the influence of lenalidomide on stem cell collection. In a prospective study, 346 patients received four cycles of lenalidomide-dexamethasone (Rd). Stem cells were mobilized with cyclophosphamide and G-CSF. Patients failing to collect a minimum of 4 × 10 6 CD34 +/kg cells received a second mobilization course. After mobilization, a median yield of 8.7 × 10 6 CD34 +/kg was obtained from patients receiving Rd induction. After first mobilization, inadequate yield was observed in 21% of patients, whereas only 9% of patients failed to collect the target yield after the second mobilization attempt. In conclusion, we confirm that a short induction with lenalidomide allowed sufficient stem cells collection to perform autologous transplantation in 91% of newly diagnosed patients. © 2011 Macmillan Publishers Limited All rights reserved. Source


Carobene A.,Istituto Scientifico Universitario San Raffaele | Graziani M.S.,Clinical Chemistry Laboratory | Lo Cascio C.,Clinical Chemistry Laboratory | Tretti L.,Clinical Chemistry Laboratory | And 4 more authors.
Clinical Chemistry and Laboratory Medicine | Year: 2012

Background: The knowledge of biological variation (BV) data is important for clinical decisions and as a basis for defining analytical quality specifications. However, in generating reliable data of biological variation there are still some unsolved problems, such as age dependence. The aim of our work is to verify this aspect. Methods: Twenty-six subjects divided into three groups by age were studied. Blood samples were collected in lithium heparin tubes for four weeks at one week intervals, on the same day of the week (Tuesday) and at the same time of day (8-9 a.m.) by the same phlebotomist. They were analysed in duplicate for creatinine, urate, calcium, albumin, total cholesterol, high density lipoprotein (HDL) and low density lipoprotein (LDL)-cholesterol, triglycerides and iron. After outlier exclusion by Cochran's test, components of biological variation were calculated by ANOVA. The significance of the differences between results of the classes was also calculated with the Student's test (t-test) and the Fisher's test (F-test). Results: Excluding albumin, the group 3 results (age range from 78 to 98 years) showed significantly lower CV within subjects (CV W) than the other two groups. Conclusions: Our data seem to highlight the relevance of the age when choosing the reference subjects for biological variation studies. The level of within-subject biological variation of the elderly group may have been further reduced by the homogeneity of the group constituted by individuals living together in the same nursing home. © 2012 by Walter de Gruyter • Berlin • Boston. Source


Bignami E.,Vita-Salute San Raffaele University | Frati E.,Vita-Salute San Raffaele University | Ceriotti F.,Istituto Scientifico Universitario San Raffaele | Daverio R.,Istituto Scientifico Universitario San Raffaele | And 4 more authors.
Annals of Cardiac Anaesthesia | Year: 2012

Neutrophil gelatinase-associated lipocalin (NGAL) is a protein of lipocalin family highly expressed in various pathologic states and is an early biomarker of acute kidney injury in cardiac surgery. We performed an observational study to evaluate the role of NGAL in predicting postoperative intensive care stay in high-risk patients undergoing cardiac surgery. We enrolled 27 consecutive patients who underwent high-risk cardiac surgery with cardiopulmonary bypass. Urinary NGAL (uNGAL) was measured before surgery, at intensive care unit (ICU) arrival and 24 h later. Univariate and multivariate predictors of ICU stay were performed. uNGAL was 18.0 (8.7-28.1) ng/mL at baseline, 10.7 (4.35-36.0) ng/mL at ICU arrival and 29.6 (9.65-29.5) 24 h later. The predictors of prolonged ICU stay at the multivariate analysis were body mass index (BMI), uNGAL 24 h after surgery, and aortic cross-clamp time. The predictors of high uNGAL levels 24 h after at a multivariate analysis were preoperative uNGAL and logistic European System for Cardiac Operative Risk Evaluation. At a multivariate analysis the only independent predictors of prolonged ICU stay were BMI, uNGAL 24 h after surgery and aortic cross-clamp time. Source


The measure of the catalytic activity of lipase in serum is a good indicator of acute pancreatitis. Today there is not an accepted reference method. Aim of this work was to optimize a method for measurement of catalytic activity of pancreatic lipase in serum, which could have the necessary characteristics to serve as a candidate reference method. Serum pools with different concentrations of lipase in native and inactivated form (heat inactivation at 56°C for 1 h) and control materials were used as samples. Optimal concentrations in the final reaction mixture were obtained through a series of experiments. Optimization was reached when higher catalytic activity and lower nonspecific signal were obtained. The following conditions were tested: buffer type and concentration, concentration of bile salts (taurodeoxycholate and deoycholate), concentration of calcium chloride, effect of different surfactants, substrate concentration, colipase concentration, and pH. The optimization experiments lead to the following reaction conditions (concentrations in the final reaction mixture): pH, 8.0; taurodeoxycholate, 21,9 mmol/L; deoxycholate, 5,28 mmol/L; calcium chloride, 6,43 mmol/L; colipase, 2,24 mg/L; 1,2-o-dilauryl-rac-glycero-3-glutaric acid (6-methylresorufin) ester, 0,11 mmol/L; Triton X-100, 0,75 g/L. Using the herein described measurement conditions, CV ranging from 1,4% to 2,9% were obtained. A comparison with the assay used in our clinical laboratory using the same substrate gave the following regression equation: y=1.56x + 2,4 U/L, r 2=0.982. Source

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