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Castel Guelfo di Bologna, Italy

Ivaldi G.,Laboratorio Of Genetica Umana | Barberio G.,Uo Medicina Of Laboratorio | Caruso V.,UO Talassemia | Caldini A.,Laboratorio Generale | And 7 more authors.
Biochimica Clinica | Year: 2015

The laboratory plays an important role in the diagnosis of hemoglobin defects at any age. At the time of birth its role is particularly significant, considering that frequently the newborn has not clinical signs, even when he is carrying thalassemia or other structural defects of hemoglobin. The diagnostic precocity in the affected newborn will help to predict risk, determine appropriate prophylaxis and prevent complications. It may also be helpful for programming treatment and parent control, and planning a prevention for a future pregnancy. In Italy, there have been important demographic and social health changes over the past decade that have suggested the implementation of hemoglobinopathy screening at birth. In addition, the need to know the hemoglobin pattern of the cord blood for possible biobank storage should be regarded as another relevant target. Therefore, it seems timely to define pathways, scope and limits of a correct thalassemia diagnosis at birth through specific recommendations. The Italian Society of Thalassemias and Haemoglobinopathies (SITE) had already published recommendations for first level thalassemia diagnosis, which were primarily focused on preconceptional prevention. This new document provides essential guidance about laboratory methods, pre- and post-analytical information flows and about the most appropriate approach to be followed. © 2014 Biochimica Clinica. Source


Fiorino S.,UO di Medicina Interna | Bacchi-Reggiani L.,University of Bologna | Pontoriero L.,UO Materno Infantile | Gallo C.,Medico Specialista in Malattie Infettive | And 17 more authors.
Italian Journal of Medicine | Year: 2013

Pancreatic adenocarcinoma (PAC) is a very aggressive cancer with a poor prognosis. To date, the causes and pathogenetic mechanisms involved in the development of this malignancy remain largely unknown. Therefore, additional studies are required to improve our knowledge of the events that occur during the process of pancreatic carcinogenesis. The purpose of this article is to describe the most recent evidence, concerning the possible risk factors and mechanisms that may contribute to determine the development of PAC, as well as models, such as the tensegrity model, that may explain this complex process. Available studies suggest that approximately 15-20% of human malignancies are somehow associated with chronic infection. Some epidemiological research has shown that some infectious agents represent risk factors for PAC. In particular, several reports showed that the infection caused by some micro-organisms, including helicobacter pylori and some bacterial species of oral microbiota, as well as by viral agents, such as human immunodeficiency virus (HIV), and hepatitis B (HBV) and C (HCV) viruses, is associated with an increased probability of developing PAC. For the first time, observational studies and meta-analyses have suggested that HBV and HCV, two hepatotropic viruses with oncogenic properties, may be also risk factors for PAC. However, the small number of available reports, nearly all performed in Asian populations, limits their validity to these ethnic groups. Therefore, additional studies focusing on populations of different geographical areas and enrolling larger series of patients are required to confirm this association. Furthermore, an accurate description and a better understanding of the events and of the pathogenetic mechanisms involved in the process of pancreatic carcinogenesis, as proposed by the tensegrity model, might be a useful approach to effectively deal with this pathology. © Copyright S. Fiorino et al., 2013. Source


Fiorino S.,Unita Operativa di Medicina Interna | Masetti M.,Unita Operativa di Chirurgia Generale | Deleonardi G.,Laboratorio Centralizzato | Grondona A.G.,Laboratorio Centralizzato | And 6 more authors.
Medical Hypotheses | Year: 2012

Pancreatic adenocarcinoma (PAC) is a very aggressive and lethal cancer, with a very poor prognosis, because of absence of early symptoms, advanced stage at presentation, early metastatic dissemination and lack of both specific tests to detect its growth in the initial phases and effective systemic therapies. To date, the causes of PAC still remain largely unknown, but multiple lines of evidence from epidemiological and laboratory researches suggest that about 15-20% of all cancers are linked in some way to chronic infection, in particular it has been shown that several viruses have a role in human carcinogenesis. The purpose of this report is to discuss the hypothesis that two well-known oncogenic viruses, Human B hepatitis (HBV) and Human C hepatitis (HCV) are a possible risk factor for this cancer. Therefore, with the aim to examine the potential link between these viruses and PAC, we performed a selection of observational studies evaluating this association and we hypothesized that some pathogenetic mechanisms involved in liver carcinogenesis might be in common with pancreatic cancer development in patients with serum markers of present or past HBV and HCV infections. To date the available observational studies performed are few, heterogeneous in design as well as in end-points and with not univocal results, nevertheless they might represent the starting-point for future larger and better designed clinical trials to define this hypothesized relationship. Should these further studies confirm an association between HBV/HCV infection and PAC, screening programs might be justified in patients with active or previous hepatitis B and C viral infection. © 2012 Elsevier Ltd. Source


Fiorino S.,Unita Operativa di Medicina Interna | Chili E.,Unita Operativa di Anestesia e Rianimazione | Bacchi-Reggiani L.,University of Bologna | Masetti M.,Unita Operativa di Chirurgia Generale | And 8 more authors.
Pancreatology | Year: 2013

Background: Pancreatic adenocarcinoma (PAC) is an aggressive cancer with a poor prognosis. To date, PAC causes are still largely unknown. Antigens and replicative sequences of oncogenic hepatitis B (HBV) and hepatitis C (HCV) virus were detected in different extra-hepatic tissues, including pancreas. Objective: a systematic review and meta-analysis of epidemiological studies assessing PAC risk in patients with HBV/HCV chronic infections. Methods: In September 2012, we extracted the articles published in Medline, Embase and the Cochrane Library, using the following search terms: "chronic HBV" and "HCV", "hepatitis", "PAC", "risk factors", "epidemiology". Only case/control (C/C), prospective/retrospective cohort studies (PCS/RCS) written in English were collected. Results: four hospital-based C/C studies and one PCS, in HBV-infected patients and two hospital-based C/C studies and one RCS in HCV-infected subjects met inclusion criteria. In these studies HBsAg positivity enhanced significantly PAC risk (RR = 1.18, 95% CI:1.04-1.33), whereas HBeAg positivity (RR = 1.31, 95% CI:0.85-2.02) as well as HBsAg negative/HBcAb positive/HBsAb positive pattern (RR = 1.12, 95% CI:0.78-1.59) and HBsAg negative/HBcAb positive/HBsAb negative pattern (RR = 1.30, 95% CI:0.93-1.84) did not. Relationship between PAC risk and anti-HCV positivity was not significant, although it reached a borderline value (RR = 1.160, 95% CI:0.99-1.3). Conclusions: HBV/HCV infection may represent a risk factor for PAC, but the small number of available researches, involving mainly populations of Asian ethnicity and the substantial variation between different geographical areas in seroprevalence of HBV/HCV-antigens/antibodies and genotypes are limiting factors to present meta-analysis. Copyright © 2012, IAP and EPC. Source

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