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Belleudi V.,Rome E Health Authority | Faustini A.,Rome E Health Authority | Stafoggia M.,Rome E Health Authority | Cattani G.,Institute for Environmental Protection and Research | And 3 more authors.
Epidemiology | Year: 2010

BACKGROUND: Little is known about the short-term effects of ultrafine particles. METHODS: We evaluated the effect of particulate matter with an aerodynamic diameter ≤10 μm (PM10), ≤2.5 μm (PM2.5), and ultrafine particles on emergency hospital admissions in Rome 2001-2005. We studied residents aged ≥ 35 years hospitalized for acute coronary syndrome, heart failure, lower respiratory tract infections, and chronic obstructive pulmonary disease (COPD). Information was available for factors indicating vulnerability, such as age and previous admissions for COPD. Particulate matter data were collected daily at one central fixed monitor. A case-crossover analysis was performed using a time-stratified approach. We estimated percent increases in risk per 14 μg/m3 PM10, per 10 μg/m3 PM 2.5, and per 9392 particles/mL. RESULTS: An immediate impact (lag 0) of PM2.5 on hospitalizations for acute coronary syndrome (2.3% [95% confidence interval = 0.5% to 4.2%]) and heart failure (2.4% [0.3% to 4.5%]) was found, whereas the effect on lower respiratory tract infections (2.8% [0.5% to 5.2%]) was delayed (lag 2). Particle number concentration showed an association only with admissions for heart failure (lag 0-5; 2.4% [0.2% to 4.7%]) and COPD (lag 0; 1.6% [0.0% to 3.2%]). The effects were generally stronger in the elderly and during winter. There was no clear effect modification with previous COPD. CONCLUSIONS: We found sizeable acute health effects of fine and ultrafine particles. Although differential reliability in exposure assessment, in particular of ultrafine particles, precludes a firm conclusion, the study indicates that particulate matter of different sizes tends to have diverse outcomes, with dissimilar latency between exposure and health response. © 2010 by Lippincott Williams & Wilkins. Source


Paganini M.,University of Florence | Biggeri A.,University of Florence | Biggeri A.,ISPO Cancer Prevention and Research Institute | Romoli A.M.,University of Florence | And 16 more authors.
Journal of Neurology, Neurosurgery and Psychiatry | Year: 2014

Objective: To assess the clinical effect of caudateputaminal transplantation of fetal striatal tissue in Huntington 's disease (HD). Methods: We carried out a follow-up study on 10 HD transplanted patients and 16 HD not-transplanted patients. All patients were evaluated with the Unified HD Rating Scale (UHDRS) whose change in motor, cognitive, behavioural and functional capacity total scores were considered as outcome measures. Grafted patients also received morphological and molecular neuroimaging. Results: Patients were followed-up from disease onset for a total of 309.3 person-years (minimum 5.3, median 11.2 years, maximum 21.6 years). UHDRS scores have been available since 2004 (median time of 5.7 years since onset, minimum zero, maximum 17.2 years). Median post-transplantation follow-up was 4.3 years, minimum 2.8, maximum 5.1 years. Adjusted posttransplantation motor score deterioration rate was reduced compared to the pretransplantation period, and to that of not-transplanted patients by 0.9 unit/years (95% CI 0.2 to 1.6). Cognitive score deterioration was reduced of 2.7 unit/years (95% CI 0.1 to 5.3). For grafted patients the 2-year post-transplantation [18F] fluorodeoxyglucose positron emission tomography (PET) showed striatal/cortical metabolic increase compared to the presurgical evaluation; 4-year post-transplantation PET values were slightly decreased, but remained higher than preoperatively. [123I]iodobenzamide single photon emission CT demonstrated an increase in striatal D2-receptor density during postgrafting follow-up. Conclusions: Grafted patients experienced a milder clinical course with less pronounced motor/cognitive decline and associated brain metabolism improvement. Life-time follow-up may ultimately clarify whether transplantation permanently modifies the natural course of the disease, allowing longer sojourn time at less severe clinical stage, and improvement of overall survival. Source


Mancuso M.,National Research Council Italy | Caruso G.,National Research Council Italy | Adone R.,Italian National Health Institute | Genovese L.,National Research Council Italy | And 2 more authors.
Journal of Applied Aquaculture | Year: 2013

A fluorescent antibody (FA) technique specific for Photobacterium damselae subsp. piscicida was tested via challenge experiments performed in microcosms. In the challenge tank, the pathogen concentration trended from 1.71 × 106 to 0 cell/100 ml, respectively, on the first and last days of the experiment. In the control tank, the pathogen was never detected. Results showed that the FA protocol could be used as a rapid and specific method allowing the early detection of Photobacterium damselae subsp. piscicida in fish farm waters. FA enables early detection of photobacteriosis in the environment, as bacteria can be detected even in absence of clinical sign of disease. © 2013 Copyright Taylor and Francis Group, LLC. Source


Giani T.,University of Siena | Pini B.,Microbiology and Virology Unit | Arena F.,University of Siena | Conte V.,University of Siena | And 7 more authors.
Eurosurveillance | Year: 2013

Carbapenem-resistant Enterobacteriaceae (CRE) are emerging as a public health problem in various settings. In Italy, a rapid and remarkable increase of carbapenem-non-susceptible Klebsiella pneumoniae has been reported since 2010. Here we report on the results of a countrywide cross-sectional survey, carried out from 15 May to 30June 2011 to investigate the diffusion of CRE in Italy and to characterise the most prevalent resistance mechanisms and their dissemination patterns. CRE were reported from most (23 of 25) participating laboratories, with an overall proportion of 3.5% and 0.3% among consecutive non-duplicate clinical isolates of Enterobacteriaceae from inpatients (n=7,154) and outpatients (n=6,595), respectively. K. pneumoniae was the most frequent species (proportion of carbapenem-non-susceptible isolates: 11.9%), while a minority of CRE of other species were detected. Carbapenemase production was detected in the majority (85%) of CRE. KPC-type enzymes were by far the most common (89.5% of carbapenemase producers), followed by VIM-1 (9.2%) and OXA-48 (1.3%). KPC-producing K. pneumoniae (KPC-KP) were detected in most centres and contributed majorly to the epidemic dissemination of CRE recently observed in our country. Dissemination of KPC-KP was mostly sustained by strains of clonal complex 258 (ST-258 producing KPC-2 or KPC-3, and ST-512 producing KPC-3), while a minority belonged to ST-101. Source


Gallina P.,University of Florence | Paganini M.,University of Florence | Biggeri A.,University of Florence | Biggeri A.,ISPO Cancer Prevention and Research Institute | And 15 more authors.
Stereotactic and Functional Neurosurgery | Year: 2014

Background: Restoration of functions in Huntington's disease (HD) by neurotransplantation stems from the formation of a striatum-like structure capable of establishing host connections as a result of grafted striatal neuroblast maturation. For the first time, we demonstrated some developmental steps accomplished by progenitor cells in the brain of an HD patient and analysed the molecular asset of the human primordium. Case Report: Surgery involved bilateral (two sessions) stereotactic, caudate-putaminal transplantation of whole ganglionic eminence fragments from single legally aborted fetuses. MRI showed that the tissue deposits of the left hemisphere grew and joined to constitute a single tissue mass that remodelled basal ganglia anatomy and remained stable in size over time. No evidence of graft growth was observed contralaterally. PET demonstrated increased striatal and stable cortical metabolism. Unified Huntington's Disease Rating Scale assessments demonstrated improvement of motor performances, which faded over the 36-month follow-up. Cognitive performance tended to decrease at a lower rate than before transplantation. Conclusion: The striatal primordium grew into the host brain and this process was associated with metabolic change and some clinical benefit. The study suggests the plasticity and reparative potential of un-manipulated primordium in an era where promising cell-based therapies are still in their infancy. © 2014 S. Karger AG, Basel. Source

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