Procaccio F.,Italian National Institute of Health
Minerva anestesiologica | Year: 2015
BACKGROUND: As the potentiality of deceased organ donation mostly depends on the number of brain deaths (BDs), the aim of this study is to quantify rates and probabilities of BD declaration in Italy.METHODS: Deaths with acute cerebral lesion (ACLDs) in the Italian ICUs have been prospectively collected. A total of 27,490 ACDLs occurred in 5 years. Age, gender, etiology, timing of death and ICU Region have been utilized for multivariate analysis.RESULTS: The global ratio of BD declarations to ACLDs was 39.9%. The rates of ACLDs, BD declarations and actual donors were 93.5, 37.3 and 19.7 pmp respectively. Wide variability resulted among Regions, with 148.2 ACLDs, 77.8 BD declarations and 42 donors pmp as benchmark. The probability of being BD declared was significantly higher in stroke compared with head injury (OR 1.6, P<0.001) and in females (OR 1.5, P<0.001), with half the Regions missing around 50% of BD declarations compared with the benchmark, particularly in elderly patients.CONCLUSION: Predictable factors associated with BD declaration can be identified in ACLD management. Positive factors leading to the identification of potential organ donors, i.e., the capacity of declaring BD in all the patients fulfilling BD criteria irrespective of age and etiology, could be captured in the best performing regions and reproduced throughout the Country. The implementation of simple indicators based on prospective ACLD monitoring, i.e. the declared BDs to ACLDs in ICU ratio, may be helpful in achieving efficiency targets and reliable comparisons of outcomes in the identification of BD potential organ donors.
Pajalunga D.,Italian National Institute of Health
Cell Death and Differentiation | Year: 2017
Terminally differentiated cells are defined by their inability to proliferate. When forced to re-enter the cell cycle, they generally cannot undergo long-term replication. Our previous work with myotubes has shown that these cells fail to proliferate because of their intrinsic inability to complete DNA replication. Moreover, we have reported pronounced modifications of deoxynucleotide metabolism during myogenesis. Here we investigate the causes of incomplete DNA duplication in cell cycle-reactivated myotubes (rMt). We find that rMt possess extremely low levels of thymidine triphosphate (dTTP), resulting in very slow replication fork rates. Exogenous administration of thymidine or forced expression of thymidine kinase increases deoxynucleotide availability, allowing extended and faster DNA replication. Inadequate dTTP levels are caused by selective, differentiation-dependent, cell cycle-resistant suppression of genes encoding critical synthetic enzymes, chief among which is thymidine kinase 1. We conclude that lack of dTTP is at least partially responsible for the inability of myotubes to proliferate and speculate that it constitutes an emergency barrier against unwarranted DNA replication in terminally differentiated cells.Cell Death and Differentiation advance online publication, 10 February 2017; doi:10.1038/cdd.2017.4. © 2017 Macmillan Publishers Limited, part of Springer Nature.
News Article | January 6, 2016
"Never really known as a friendly group, the Italian mafia has been brutally murdering people for hundreds of years. Most of the time, these killings are quick—some henchmen waylay the target, squeeze a trigger a few times and make their getaway. Yet according to a new report released last week by the Italian National Institute of Health, a few local Italian mobs have been slowly killing dozens of innocent people for decades by way of a multibillion dollar toxic waste disposal racket. In 2014, the Italian parliament mandated that the National Institute of Health conduct an investigation into the higher than normal rates of death and cancer in 55 municipalities of the Naples and Caserta regions of southern Italy. This region has garnered the nicknames “the Land of Fires” thanks to the frequency with which toxic waste is burned by the local Camorra mob, a practice which gave rise to the region’s other nickname: the Triangle of Death. The Camorra mob has been running a multi-billion dollar racket in which they dispose of toxic waste for businesses in Italy’s industrial north since at least the early 1990s. By skirting environmental regulations the mob is able to dispose of these hazardous industrial materials for a fraction of the cost of legal disposal, and the industrialists in the north are smart enough to not ask questions about what happens to their garbage once it leaves their hands."
News Article | January 4, 2016
Never really known as a friendly group, the Italian mafia has been brutally murdering people for hundreds of years. Most of the time, these killings are quick—some henchmen waylay the target, squeeze a trigger a few times and make their getaway. Yet according to a new report released last week by the Italian National Institute of Health, a few local Italian mobs have been slowly killing dozens of innocent people for decades by way of a multibillion dollar toxic waste disposal racket. In 2014, the Italian parliament mandated that the National Institute of Health conduct an investigation into the higher than normal rates of death and cancer in 55 municipalities of the Naples and Caserta regions of southern Italy. This region has garnered the nicknames “the Land of Fires” thanks to the frequency with which toxic waste is burned by the local Camorra mob, a practice which gave rise to the region’s other nickname: the Triangle of Death. The Camorra mob has been running a multi-billion dollar racket in which they dispose of toxic waste for businesses in Italy’s industrial north since at least the early 1990s. By skirting environmental regulations the mob is able to dispose of these hazardous industrial materials for a fraction of the cost of legal disposal, and the industrialists in the north are smart enough to not ask questions about what happens to their garbage once it leaves their hands. An estimated 10 million tons of toxic waste has been buried and burned at a number of dump sites throughout Naples in the last 20 years. This has led to the widespread contamination of the underground wells which irrigate the farmland in the Naples region, which provides vegetables for much of Italy’s center and south. In recent years this has led police to sequester dozens of fields because their irrigation wells were found to contain high levels of lead, arsenic and the industrial solvent tetrachloride. The poisoning of the well water has led to what the new NIH report describes as a “critical” health crisis in the region which is characterized by “excessive” rates of tumors in newborn infants, particularly brain tumors. Local residents have long known about the Camorra mob’s racket and have been complaining about the resulting health crisis for years to authorities. This culminated in 2013 with a massive protest numbering well over 30,000 people calling for an end to the mafia’s dumping. The public outrage prompted the Italian parliament to order an NIH investigation into the matter in 2014. Last week’s report was an update to the 2014 report and blames the higher than average rates of cancer and death in the Naples region on "ascertained or suspected exposure to a combination of environmental contaminants that can be emitted or released from illegal dump hazardous waste sites or the uncontrolled burning of both urban and hazardous waste." The report is a step in the right direction, but for many locals it only confirms what they have known and suffered for years, Reverend Maurizio Patriciello, a priest in the area, pointed out. "Can we claim victory? Absolutely not," he wrote in Avvenire, the newspaper of the Italian bishops' conference, on Saturday. "In this shameful, sad and painful story, we have lost everything. The government above all."
D'Alessandro A.,University of Tuscia |
D'Amici G.M.,University of Tuscia |
Vaglio S.,Italian National Institute of Health |
Zolla L.,University of Tuscia
Haematologica | Year: 2012
Background: Results from recent, highly debated, retrospective studies raised concerns and prompted considerations about further testing the quality of long stored red blood cells from a biochemical standpoint. Design and Methods: We performed an integrated mass spectrometry-based metabolomics and proteomics time-course investigation on SAGM-stored red blood cells. In parallel, structural changes during storage were monitored through scanning electron microscopy. Results: We detected increased levels of glycolytic metabolites over the first 2 weeks of storage. From day 14 onwards, we observed a significant consumption of all metabolic species, and diversion towards the oxidative phase of the pentose phosphate pathway. These phenomena coincided with the accumulation of reactive oxygen species and markers of oxidation (protein carbony-lation and malondialdehyde accumulation) up to day 28. Proteomics evidenced changes at the membrane protein level from day 14 onwards. Changes included fragmentation of membrane structural proteins (spectrin, band 3, band 4.1), membrane accumulation of hemoglobin, anti-oxidant enzymes (peroxiredoxin-2) and chaperones. While the integrity of red blood cells did not show major deviations at day 14, at day 21 scanning electron microscope images revealed that 50% of the erythrocytes had severely altered shape. We could correlate the scanning electron microscopy observations with the onset of vesiculation, through a proteomics snapshot of the difference in the membrane proteome at day 0 and day 35. We detected proteins involved in vesicle formation and docking to the membrane, such as SNAP alpha. Conclusions: Biochemical and structural parameters did not show significant alterations in the first 2 weeks of storage, but then declined constantly from day 14 onwards. We highlighted several parallelisms between red blood cells stored for a long time and the red blood cells of patients with hereditary spherocytosis. © 2012 Ferrata Storti Foundation.
Picardi A.,Italian National Institute of Health |
Gaetano P.,Italian Society for Behavioural and Cognitive Therapy
Clinical Practice and Epidemiology in Mental Health | Year: 2014
In the last decades, psychotherapy has gained increasing acceptance as a major treatment option for mood disorders. Empirically supported treatments for major depression include cognitive behavioural therapy (CBT), interpersonal psychotherapy (IPT), behavioural therapy and, to a lesser extent, short-term psychodynamic psychotherapy. Metaanalytic evidence suggests that psychotherapy has a significant and clinically relevant, though not large, effect on chronic forms of depression. Psychotherapy with chronic patients should take into account several important differences between patients with chronic and acute depression (identification with their depressive illness, more severe social skill deficits, persistent sense of hopelessness, need of more time to adapt to better circumstances). Regarding adolescent depression, the effectiveness of IPT and CBT is empirically supported. Adolescents require appropriate modifications of treatment (developmental approach to psychotherapy, involvement of parents in therapy). The combination of psychotherapy and medication has recently attracted substantial interest; the available evidence suggests that combined treatment has small but significant advantages over each treatment modality alone, and may have a protective effect against depression relapse or recurrence. Psychobiological models overcoming a rigid brain-mind dichotomy may help the clinician give patients a clear rationale for the combination of psychological and pharmacological treatment. In recent years, evidence has accumulated regarding the effectiveness of psychological therapies (CBT, family-focused therapy, interpersonal and social rhythm therapy, psychoeducation) as an adjunct to medication in bipolar disorder. These therapies share several common elements and there is considerable overlap in their actual targets. Psychological interventions were found to be useful not only in the treatment of bipolar depressive episodes, but in all phases of the disorder. © Picardi and Gaetano; Licensee Bentham Open.
Petrini C.,Italian National Institute of Health
International Journal of Environmental Research and Public Health | Year: 2010
The article is divided into three sections: (i) an overview of the main ethical models in public health (theoretical foundations); (ii) a summary of several published frameworks for public health ethics (practical frameworks); and (iii) a few general remarks. Rather than maintaining the superiority of one position over the others, the main aim of the article is to summarize the basic approaches proposed thus far concerning the development of public health ethics by describing and comparing the various ideas in the literature. With this in mind, an extensive list of references is provided. © 2010 by the authors; licensee Molecular Diversity Preservation International.
Giovannini C.,Italian National Institute of Health |
Masella R.,Italian National Institute of Health
Nutritional Neuroscience | Year: 2012
Dietary consumption of fruit, vegetables, fish, and olive oil has been demonstrated to exert beneficial effects on human health. This finding may be due to the high content of antioxidant compounds including polyphenols. Current evidence strongly supports a contribution of polyphenols to the prevention of several chronic degenerative diseases such as cancer, atherosclerosis and cardiovascular diseases, central nervous system disorders, as well as aging. Apoptosis is a genetically controlled and evolutionarily conserved form of cell death of critical importance for the maintenance of tissue homeostasis in the adult organism. The malfunction of the death machinery may play a primary role in various pathologic processes, leading to proliferative or degenerative diseases. Polyphenols can interact with specific steps and/or proteins regulating the apoptotic process in different ways depending on their concentration, the cell system, the type or stage of the pathological process. Because of their ability to modulate cell death, polyphenols have been proposed as chemopreventive and therapeutic agents. This paper reviews and discusses the last 3-year findings related to the principal molecular mechanisms involved in the control of the balance between apoptosis and cell proliferation exerted by polyphenols. © W.S. Maney & Son Ltd 2012.
Costa A.N.,Italian National Institute of Health
Euro surveillance : bulletin européen sur les maladies transmissibles = European communicable disease bulletin | Year: 2011
We report four cases of West Nile virus (WNV) transmission following a single multiorgan donation in north-eastern Italy. The transmissions were promptly detected by local transplant centres. The donor had been tested for WNV by nucleic acid amplification test (NAT) prior to transplantation and was negative. There were no detected errors in the nationally implemented WNV safety protocols.
Bochicchio F.,Italian National Institute of Health
Radiation Protection Dosimetry | Year: 2011
On the basis of recent epidemiological findings, many international and national organisations have revised their recommendations and regulations on radon exposure in dwellings and workplaces, or are in the process to do it. In particular, new recommendations and regulations were recently published (or are going to be) by World Health Organization, Nordic Countries, International Commission on Radiological Protection, International, Atomic Energy Agency (and the other international organisations sponsoring the International Basic Safety Standards), European Commission. Although with some differences, these new documents recommend lower radon concentrations in indoor air, especially in dwellings, compared with previous ones. Moreover, preventive measures in all new buildings are more and more considered as one of the most cost-effective way to reduce the radon-related lung cancers, compared with previous approach restricting preventive measures in radon-prone areas only. A comprehensive national action plan, involving several national and local authorities, is generally considered a necessary tool to deal with the many complex actions needed to reduce the risk from radon exposure in an effective way. © The Author 2011. Published by Oxford University Press. All rights reserved.