Laboratory of Clinical Chemistry and Microbiology

Prato, Italy

Laboratory of Clinical Chemistry and Microbiology

Prato, Italy
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Moroni G.,Nephrological Unit | Doria A.,University of Padua | Giglio E.,Nephrological Unit | Tani C.,University of Pisa | And 13 more authors.
Journal of Autoimmunity | Year: 2016

The aim of this multicenter study was to assess the present risk of fetal complications and the inherent risk factors in pregnant women with lupus nephritis. Seventy-one pregnancies in 61women (59 Caucasians and 2 Asians) with lupus nephritis were prospectively followed between October 2006 and December 2013. All patients received a counselling visit within 3 months before the beginning of pregnancy and were followed by a multidisciplinary team. At baseline mild active nephritis was present in 15 cases (21.1%). Six pregnancies (8.4%) resulted in fetal loss. Arterial hypertension at baseline (P = 0.003), positivity for lupus anticoagulant (P = 0.001), anticardiolipin IgG antibodies (P = 0.007), antibeta2 IgG (P = 0.018) and the triple positivity for antiphospholipid antibodies (P = 0.004) predicted fetal loss. Twenty pregnancies (28.2%) ended pre-term and 12 newborns (16.4%) were small for gestational age. Among the characteristics at baseline, high SLE disease activity index (SLEDAI) score (P = 0.027), proteinuria (P = 0.045), history of renal flares (P = 0.004), arterial hypertension (P = 0.009) and active lupus nephritis (P = 0.000) increased the probability of preterm delivery. Odds for preterm delivery increased by 60% for each quarterly unit increase in SLEDAI and by 15% for each quarterly increase in proteinuria by 1 g per day. The probability of having a small for gestational age baby was reduced by 85% in women who received hydroxychloroquine therapy (P = 0.023). In this study, the rate of fetal loss was low and mainly associated with the presence of antiphospholipid antibodies. Preterm delivery remains a frequent complication of pregnancies in lupus. SLE and lupus nephritis activity are the main risk factors for premature birth. Arterial hypertension predicted both fetal loss and preterm delivery. Based on our results the key for a successful pregnancy in lupus nephritis is a multidisciplinary approach with close medical, obstetric and neonatal monitoring. This entails: a) a preconception evaluation to establish and inform women about pregnancy risks; b) planning pregnancy during inactive lupus nephritis, maintained inactive with the lowest possible dosage of allowed drugs; c) adequate treatment of known risk factors (arterial hypertension, antiphospholipid and antibodies); d) close monitoring during and after pregnancy to rapidly identify and treat SLE flares and obstetric complications. © 2016


Novembrino C.,Laboratory of Clinical Chemistry and Microbiology | Aghemo A.,Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico | Ferraris Fusarini C.,Laboratory of Clinical Chemistry and Microbiology | Maiavacca R.,Laboratory of Clinical Chemistry and Microbiology | And 7 more authors.
Journal of Viral Hepatitis | Year: 2014

Summary A cytoplasmic antigen associated to inosine-5'-monophosphatedehydrogenase 2 eliciting specific antibodies (antirods and rings, RR) has been identified in patients with chronic hepatitis C who were exposed to pegylated interferon (PI) and ribavirin (RBV). The significance of anti-RR in these patients merits to be investigated. Sera from 88 chronic hepatitis C virus (HCV)-infected patients undergoing PI-RBV therapy were analysed for the presence of RR pattern by indirect immunofluorescence on HEp-2 substrate (Inova Diagnostics, San Diego, CA, USA). Anti-RR antibodies developed de novo in 32 patients independently of any demographic and virological feature, but with a significant association with cumulative exposure to PI-RBV (P = 0.0089; chi-square test). RR pattern was significantly more frequent in relapsers than in patients achieving sustained virological response (56% vs 30%; P = 0.0282, chi-square test). Anti-RR titre ranged from 1:80 to 1:1280, but significantly declined following treatment cessation. Anti-RR develop de novo in a substantial proportion of patients exposed to PI-RBV in relation to the duration of treatment exposure. Further investigations are necessary to unravel the mechanisms leading to the formation of these autoantibodies. © 2014 John Wiley & Sons Ltd.


PubMed | Laboratory of Clinical Chemistry and Microbiology, University of Padua, University of Calgary, University of Milan and 5 more.
Type: | Journal: Journal of autoimmunity | Year: 2016

The aim of this multicenter study was to assess the present risk of fetal complications and the inherent risk factors in pregnant women with lupus nephritis. Seventy-one pregnancies in 61women (59 Caucasians and 2 Asians) with lupus nephritis were prospectively followed between October 2006 and December 2013. All patients received a counselling visit within 3 months before the beginning of pregnancy and were followed by a multidisciplinary team. At baseline mild active nephritis was present in 15 cases (21.1%). Six pregnancies (8.4%) resulted in fetal loss. Arterial hypertension at baseline (P=0.003), positivity for lupus anticoagulant (P=0.001), anticardiolipin IgG antibodies (P=0.007), antibeta2 IgG (P=0.018) and the triple positivity for antiphospholipid antibodies (P=0.004) predicted fetal loss. Twenty pregnancies (28.2%) ended pre-term and 12 newborns (16.4%) were small for gestational age. Among the characteristics at baseline, high SLE disease activity index (SLEDAI) score (P=0.027), proteinuria (P=0.045), history of renal flares (P=0.004), arterial hypertension (P=0.009) and active lupus nephritis (P=0.000) increased the probability of preterm delivery. Odds for preterm delivery increased by 60% for each quarterly unit increase in SLEDAI and by 15% for each quarterly increase in proteinuria by 1g per day. The probability of having a small for gestational age baby was reduced by 85% in women who received hydroxychloroquine therapy (P=0.023). In this study, the rate of fetal loss was low and mainly associated with the presence of antiphospholipid antibodies. Preterm delivery remains a frequent complication of pregnancies in lupus. SLE and lupus nephritis activity are the main risk factors for premature birth. Arterial hypertension predicted both fetal loss and preterm delivery. Based on our results the key for a successful pregnancy in lupus nephritis is a multidisciplinary approach with close medical, obstetric and neonatal monitoring. This entails: a) a preconception evaluation to establish and inform women about pregnancy risks; b) planning pregnancy during inactive lupus nephritis, maintained inactive with the lowest possible dosage of allowed drugs; c) adequate treatment of known risk factors (arterial hypertension, antiphospholipid and antibodies); d) close monitoring during and after pregnancy to rapidly identify and treat SLE flares and obstetric complications.


PubMed | Laboratory of Clinical Chemistry and Microbiology, University of Pavia, CNR Institute of Clinical Physiology, University of Milan and 2 more.
Type: Journal Article | Journal: BMC pediatrics | Year: 2016

Epidermolysis bullosa (EB) belongs to a family of rare heterogeneous, genetic disorders characterized by blistering of the skin and mucous membranes in response to minor mechanical trauma. The involvement of the oral mucosa and oesophagus stenosis is suggested to be responsible for severe nutritional deficiencies, but few studies have till now considered this aspect. This observational study aimed to evaluate homocysteine status in children and adolescents with EB by assessing total plasma homocysteine (tHcy) and metabolically related vitamins (BTwenty EB patients (12M; age range 0.5-19 years) were evaluated for: plasma tHcy, serum BEB patients showed tHcy levels higher (p=0.04) and BThe assessment of tHcy and metabolically related vitamin levels describes an important aspect of EB patients nutritional status which can result essential for their long term care. Monitoring B


Giufre M.,Instituto Superiore Of Sanita | Cardines R.,Instituto Superiore Of Sanita | Degl'Innocenti R.,Laboratory of Clinical Chemistry and Microbiology | Cerquetti M.,Instituto Superiore Of Sanita
Diagnostic Microbiology and Infectious Disease | Year: 2015

We report the first case of neonatal bacteremia caused by a ". Haemophilus quentini" isolate in Italy. The isolate was differentiated from H. influenzae by 16S rRNA sequencing and was characterized by comparison with the wild-type ". H. quentini" CCUG 36167. Both isolates carried substitutions in penicillin-binding protein 3 but were susceptible to aminopenicillins. © 2015 Elsevier Inc..


PubMed | Laboratory of Clinical Chemistry and Microbiology, G Pini Institute and University of Milan
Type: | Journal: Injury | Year: 2016

The evolution of new prosthetic and osteosynthetic devices has led to more surgical indications, and this is accompanied by an increased incidence of septic complications in orthopaedic and trauma surgery in the general population. The strategy for choosing surgical or therapeutic (conservative) treatment is based on the identification of the pathogen: knowledge of the aetiological agents is an essential element in the decision-making process to ensure the most effective treatment is administered. The pathogen also needs to be considered in the challenging case of doubtful infection, where perhaps the only sign is inflammation, for a more accurate prediction of progression to either sepsis or healing. Biofilm-related infections and low-grade infections may fall into this category. Biofilm slows the metabolism of microorganisms and prolongs their survival, which renders them resistant to antibiotics. Moreover, when microorganisms are embedded in the biofilm they are poorly recognised by the immune system and the infection becomes chronic. As recently demonstrated, isolation and identification of bacteria in biofilm is difficult as the bacteria are concealed. The development of an effective means of sample collection and laboratory methods that can dislodge bacteria from prosthetic surfaces has therefore become necessary. The primary aim of the study was to evaluate the reliability of an innovative technology (MicroDTTect), specifically applied to collect and transport explanted samples (prostheses, osteosynthetic devices, biological tissues), and compare with flocked swabs. The MicroDTTect system is quick and simple to use and, most importantly, is a closed system that is totally sterile and safe for the patient being treated. It contains a specific concentration of dithiotreitol (DTT) that can dislodge bacteria from the biofilm adhering to prosthetic surfaces. The numbers of positive and negative samples were measured to compare the MicroDTTect methodology with swab collection in 30 procedures. The results showed that MicroDTTect had a higher sensitivity compared to swabs (77% and 46%, respectively), and was associated with more positive results than swabs (35% and 20%, respectively). These preliminary results show that MicroDTTect is superior to swab collection for bacterial identification in orthopaedic surgery. The early identification of microorganisms that cause sepsis may help improve treatment strategies and the efficacy of therapy, which will lead to an increased healing rate, reduced severity of sequelae and improved quality of life.


PubMed | Laboratory of Clinical Chemistry and Microbiology
Type: | Journal: BMC infectious diseases | Year: 2014

This study aimed to explore the in vitro antibacterial activity of the bioglass BAG S53P4 against multi-resistant microorganisms commonly involved in osteomyelitis and to evaluate its use in surgical adjunctive treatment of osteomyelitis.In vitro antibacterial activity of BAG-S53P4 against methicillin resistant Staphylococcus aureus and Staphylococcus epidermidis, Pseudomonas aeruginosa and Acinetobacter baumannii isolates was evaluated by means of time kill curves, with colony counts performed after 24, 48 and 72hours of incubation. In vivo evaluation was performed by prospectively studying a cohort of 27 patients with a clinically and radiologically diagnosed osteomyelitis of the long bones in an observational study. Endpoints were the absence of infection recurrence/persistence at follow-up, no need for further surgery whenever during follow-up and absence of local or systemic side effects connected with the BAG use.In vitro tests regarding the antibacterial activity of BAG S53P4 showed a marked bactericidal activity after 24hrs against all the tested species. This activity continued in the subsequent 24hrs and no growth was observed for all strains after 72hrs. Results of the clinical study evidenced no signs of infection in 24 patients (88.9%) at the follow-up, while 2 subjects showed infection recurrence at 6months from index operation and one more needed further surgical procedures. BAG-S53P4 was generally well tolerated.The in vitro and in vivo findings reinforce previous observations on the efficacy of BAG-S53P4 for the treatment of chronic osteomyelitis of the long bones, also in the presence of multi-resistant strains and in immunocompromised hosts, without relevant side effects and without the need for locally adding antibiotics.Deutschen Register Klinischer Studien (DRKS) unique identifier: DRKS00005332.


PubMed | Laboratory of Clinical Chemistry and Microbiology and Instituto Superiore Of Sanita
Type: Case Reports | Journal: Diagnostic microbiology and infectious disease | Year: 2015

We report the first case of neonatal bacteremia caused by a Haemophilus quentini isolate in Italy. The isolate was differentiated from H. influenzae by 16S rRNA sequencing and was characterized by comparison with the wild-type H. quentini CCUG 36167. Both isolates carried substitutions in penicillin-binding protein 3 but were susceptible to aminopenicillins.


PubMed | Unit of Workers Health Protection and Promotion, Laboratory of Clinical Chemistry and Microbiology and University of Milan
Type: Journal Article | Journal: Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology | Year: 2015

Saliva contains a variety of substances and could be functionally equivalent to serum in reflecting the physiological state of the body, including metabolic variations. Salivary samples are non-invasive, safe, and easier to handle than serum. Oxidized LDL cholesterol (oxLDL) is an additional cardiovascular risk factor playing an important role in atheromatous plaque formation; overweight/obese subjects present an increase in oxLDL concentrations. The aims of the study were to assess oxLDL salivary levels, if detectable, and to verify their possible correlation with serum in overweight/obese subjects.Thirty-five consecutive overweight/obese subjects and 10 normal weight controls were enrolled. Serum and salivary oxLDL levels were measured by a commercial enzyme-linked-immunosorbent assay (ELISA method).oxLDL levels were detectable in salivary samples and correlated (P = 0.001) with serum levels. Overweight/obese subjects showed serum and salivary oxLDL levels higher than controls (P = 0.000 and P = 0.022, respectively).Our study showed the presence of oxLDL in salivary samples and highlighted a correlation between salivary oxLDL levels and their counterpart in serum. Moreover, salivary oxLDL levels were higher in overweight/obese subjects than in controls. Therefore, a salivary sample could be functionally equivalent to serum in monitoring cardiovascular risk in overweight/obese subjects.


PubMed | Laboratory of Clinical Chemistry and Microbiology
Type: | Journal: BMC microbiology | Year: 2013

Autologous platelet concentrates (PCs) have been extensively used in a variety of medical fields to promote soft and hard tissue regeneration. The significance behind their use lies in the abundance of growth factors in platelets -granules that promotes wound healing. In addition, antibacterial properties of PCs against various bacteria have been recently pointed out. In this study, the antimicrobial effect of pure platelet-rich plasma (P-PRP) was evaluated against oral cavity microorganisms such as Enterococcus faecalis, Candida albicans, Streptococcus agalactiae, Streptococcus oralis and Pseudomonas aeruginosa. Blood samples were obtained from 17 patients who underwent oral surgery procedures involving the use of P-PRP. The antibacterial activity of P-PRP, evaluated as the minimum inhibitory concentration (MIC), was determined through the microdilution twofold serial method.P-PRP inhibited the growth of Enterococcus faecalis, Candida albicans, Streptococcus agalactiae and Streptococcus oralis, but not of Pseudomonas aeruginosa strains.P-PRP is a potentially useful substance in the fight against postoperative infections. This might represent a valuable property in adjunct to the enhancement of tissue regeneration.

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