Padova, Italy
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Parisi S.G.,University of Padua | Scaggiante R.,Padua Hospital | Boldrin C.,University of Padua | Andreis S.,University of Padua | And 6 more authors.
BMC Infectious Diseases | Year: 2011

Background: A study including 166 subjects was performed to investigate the frequency and persistence over a 6-month interval of concurrent oral and anal Human Papillomavirus (HPV) infections in Human Immunodeficiency Virus (HIV)-infected men who have sex with men (MSM).Methods: Patients with no previously documented HPV-related anogenital lesion/disease were recruited to participate in a longitudinal study. Polymerase chain reaction (PCR) was performed to detect HPV from oral and anal swabs and to detect Human Herpes Virus 8 (HHV-8) DNA in saliva on 2 separate specimen series, one collected at baseline and the other collected 6 months later. A multivariate logistic analysis was performed using anal HPV infection as the dependent variable versus a set of covariates: age, HIV plasma viral load, CD4+ count, hepatitis B virus (HBV) serology, hepatitis C virus (HCV) serology, syphilis serology and HHV-8 viral shedding. A stepwise elimination of covariates with a p-value > 0.1 was performed.Results: The overall prevalence of HPV did not vary significantly between the baseline and the follow-up, either in the oral (20.1 and 21.3%, respectively) or the anal specimens (88.6 and 86.3%). The prevalence of high-risk (HR) genotypes among the HPV-positive specimens was similar in the oral and anal infections (mean values 24.3% and 20.9%). Among 68 patients with either a HR, low-risk (LR) or undetermined genotype at baseline, 75% had persistent HPV and the persistence rates were 71.4% in HR infections and 76.7% in LR infections. There was a lack of genotype concordance between oral and anal HPV samples. The prevalence of HR HPV in anus appeared to be higher in the younger patients, peaking (> 25%) in the 43-50 years age group. A decrease of the high level of anal prevalence of all genotypes of HPV in the patients > 50 years was evident. HHV-8 oral shedding was positively related to HPV anal infection (p = 0.0046). A significant correlation was found between the persistence of HHV-8 shedding and HIV viral load by logistic bivariate analysis (Odds Ratio of HHV-8 persistence for 1-log increase of HIV viral load = 1.725 ± 0.397, p = 0.018).Conclusions: A high prevalence of HPV infection was found in our cohort of HIV-infected MSM, with a negative correlation between anal HPV infection and CD4 cell count. © 2011 Parisi et al; licensee BioMed Central Ltd.


Bonetto N.,University of Padua | Bonetto N.,Irccs San Camillo Hospital | Manara R.,Padua Hospital | Citton V.,University of Padua | Cagnin A.,University of Padua
Neurology | Year: 2011

Objective: To explore the efficacy of spinal MRI study with subtraction analysis as a rapid, reliable, and noninvasive procedure to detect epidural CSF collection in spontaneous intracranial hypotension (SIH) syndrome. Methods: Seventeen patients (mean age 42 years, age range 17-65 years; 11 female) with SIH diagnosed using the International Classification of Headache Disorders criteria and 13 agematched control subjects underwent standard sagittal spinal MRI. Postprocessing image analysis with subtraction of T1-weighted from T2-weighted MRI scans was performed and tested for the detection of the CSF leak. Results: The CSF epidural collection was visible in all patients with SIH and was detected at the dorsal (16 of 17), cervical (13 of 17), lumbar (13 of 17), and sacral (12 of 17) levels. None of the control subjects showed a CSF leak. Diverticula were present in 23% of patients, whereas the actual site of the CSF leak was recognized in only one patient. Eight patients were treated conservatively, whereas 9 patients required an epidural blood patch, performed at a fixed L2-L3 or L3-L4 spinal level, with complete recovery. Conclusions: Spinal MRI with dedicated subtraction analysis could represent the first-line diagnostic tool in the management of patients with SIH, thus leaving invasive investigation for selected patients, such those requiring dural surgery. Copyright © 2011 by AAN Enterprises, Inc.


Bressan S.,University of Padua | Berlese P.,University of Padua | Mion T.,University of Padua | Masiero S.,University of Padua | And 2 more authors.
Acta Paediatrica, International Journal of Paediatrics | Year: 2012

Aim: To evaluate the incidence of bacteremia, and the isolated pathogens, in well-appearing children with fever without source (FWS) presenting to the pediatric emergency department (PED), after pneumococcal conjucate vaccine - 7 valent (PCV-7) widespread introduction in the Veneto region of north-eastern Italy, and to review the main literature contributions on the subject. Methods: Blood cultures performed at the PED of Padova from 1 June 2006 to 31 January 2009 in febrile children aged 1-36 months were retrospectively retrieved. Medical records of previously healthy well-appearing children with FWS were identified and reviewed. Results: The study finally included 392 patients. Bacteremia rate was 0.34% (95% CI 0-1) in the age group 3-36 months and 2% (95% CI 0-4.7) in infants 1-3 months. No Streptococcus pneumoniae was isolated. The literature review identified 10 relevant studies carried out in the USA and Spain showing an overall bacteremia rate <1% for feverish children aged 3-36 months, with values <0.5% in settings with high PCV-7 coverage. Conclusion: Overall bacteremia rate is currently <0.5% in well-appearing children aged 3-36 months with FWS attending the PED in areas with PCV-7 widespread vaccination and is sufficiently low to preclude laboratory testing in favour of close follow-up. Further research is needed to evaluate a more conservative approach in infants 2-3 months of age. © 2011 The Author(s)/Acta Pædiatrica © 2011 Foundation Acta Pædiatrica.


Zorzi M.,University of Padua | Bonato M.,University of Padua | Treccani B.,University of Trento | Scalambrin G.,University of Padua | And 2 more authors.
Frontiers in Human Neuroscience | Year: 2012

Converging evidence suggests that visuospatial attention plays a pivotal role in numerical processing, especially when the task involves the manipulation of numerical magnitudes. Visuospatial neglect impairs contralesional attentional orienting not only in perceptual but also in numerical space. Indeed, patients with left neglect show a bias toward larger numbers when mentally bisecting a numerical interval, as if they were neglecting its leftmost part. In contrast, their performance in parity judgments is unbiased, suggesting a dissociation between explicit and implicit processing of numerical magnitude. Here we further investigate the consequences of these visuospatial attention impairments on numerical processing and their interaction with task demands. Patients with right hemisphere damage, with and without left neglect, were administered both a number comparison and a parity judgment task that had identical stimuli and response requirements. Neglect patients' performance was normal in the parity task, when processing of numerical magnitude was implicit, whereas they showed characteristic biases in the number comparison task, when access to numerical magnitude was explicit. Compared to patients without neglect, they showed an asymmetric distance effect, with slowing of the number immediately smaller than (i.e., to the left of) the reference and a stronger SNARC effect, particularly for large numbers. The latter might index an exaggerated effect of number-space compatibility after ipsilesional (i.e., rightward) orienting in number space.Thus, the effect of neglect on the explicit processing of numerical magnitude can be understood in terms of both a failure to orient to smaller (i.e., contralesional) magnitudes and a difficulty to disengage from larger (i.e., ipsilesional) magnitudes on the number line, which resembles the disrupted pattern of attention orienting in visual space. © 2012 Zorzi, Bonato, Trec- cani, Scalambrin, Marenzi and Priftis.


Bartolini A.,Padua Hospital | Frasson I.,University of Padua | Cavallaro A.,Padua Hospital | Richter S.N.,Padua Hospital | And 3 more authors.
Gut Pathogens | Year: 2014

Background: Multidrug resistance and, in particular, carbapenem resistance is spreading worldwide at an alarming rate, comprehending a variety of bacterial species and causing both nosocomial and community acquired outbursts. Early and efficient detection of infected patients or colonized carriers are mandatory steps in infection control and prevention of multidrug resistance diffusion. The latest EUCAST guidelines for detection of carbapenemase-producing Enterobacteriaceae have set low clinical breakpoints to ensure the maximum detection sensitivity of positive samples. Current workflows involve an initial screening step for species and resistance pattern detection, followed by phenotypic and/or genotypic confirmation. The aim of the present study was to assess the efficiency of six widely used and validated phenotypic assays for the detection of carbapenemases/AmpC in Enterobacteriaceae, to estimate the best workflow in the routine characterization of Enterobacteriaceae isolates. Methods. A panel of 108 non-repetitive Enterobacteriaceae isolates with reduced susceptibility to carbapenems was analyzed by means of 1) Modified Hodge Test, 2) Metallo Beta Lactamase Etest, 3) Double disk test with EDTA, 4) Rosco Diagnostica KPC and MBL confirm kit (RDCK™), 5) AmpC Etest and 6) Cloxacillin inhibition test. Confirmation and validation of results was achieved by genotypic analysis. Results: The most accurate identification of resistance determinants was obtained with the combined disc test (Rosco Diagnostica KPC and MBL confirm kit) which had to be coupled with the cloxacillin inhibition test for correct detection of AmpC enzymes. However, in general, phenotypic tests failed to characterize isolates harboring multiple carbapenem resistance determinants, which were successfully assessed only by PCR-based analysis. Conclusions: To detect and control the spread of pathogens with complicated resistance patterns, both optimized phenotypic analysis (i.e. Rosco Diagnostica KPC and MBL confirm kit coupled with the cloxacillin inhibition test) and genotypic assays are recommended in the routine diagnostic of clinical laboratories. © 2014 Bartolini et al.; licensee BioMed Central Ltd.


Cetica V.,Meyer Children Hospital | Sieni E.,Meyer Children Hospital | Pende D.,Instituto Of Ricovero E Cura A Carattere Scientifico | Danesino C.,University of Pavia | And 10 more authors.
Journal of Allergy and Clinical Immunology | Year: 2016

Background Hemophagocytic lymphohistiocytosis (HLH) is a rare life-threatening disease affecting mostly children but also adults and characterized by hyperinflammatory features. A subset of patients, referred to as having familial hemophagocytic lymphohistiocytosis (FHL), have various underlying genetic abnormalities, the frequencies of which have not been systematically determined previously. Objective This work aims to further our understanding of the pathogenic bases of this rare condition based on an analysis of our 25 years of experience. Methods From our registry, we have analyzed a total of 500 unselected patients with HLH. Results Biallelic pathogenic mutations defining FHL were found in 171 (34%) patients; the proportion of FHL was much higher (64%) in patients given a diagnosis during the first year of life. Taken together, mutations of the genes PRF1 (FHL2) and UNC13D (FHL3) accounted for 70% of cases of FHL. Overall, a genetic diagnosis was possible in more than 90% of our patients with FHL. Perforin expression and the extent of degranulation have been more useful for diagnosing FHL than hemophagocytosis and the cytotoxicity assay. Of 281 (56%) patients classified as having "sporadic" HLH, 43 had monoallelic mutations in one of the FHL-defining genes. Given this gene dosage effect, FHL is not strictly recessive. Conclusion We suggest that the clinical syndrome HLH generally results from the combined effects of an exogenous trigger and genetic predisposition. Within this combination, different weights of exogenous and genetic factors account for the wide disease spectrum that ranges from HLH secondary to severe infection to FHL. © 2015 The Authors.


Rita Lo Vasco V.,University of Rome La Sapienza | Cardinale G.,University of Rome La Sapienza | Polonia P.,Padua Hospital
Journal of Cellular and Molecular Medicine | Year: 2012

A prevalence of 1% in the general population and approximately 50% concordance rate in monozygotic twins was reported for schizophrenia, suggesting that genetic predisposition affecting neurodevelopmental processes might combine with environmental risk factors. A multitude of pathways seems to be involved in the aetiology and/or pathogenesis of schizophrenia, including dopaminergic, serotoninergic, muscarinic and glutamatergic signalling. The phosphoinositide signal transduction system and related phosphoinositide-specific phospholipase C (PI-PLC) enzymes seem to represent a point of convergence in these networking pathways during the development of selected brain regions. The existence of a susceptibility locus on the short arm of chromosome 20 moved us to analyse PLCB1, the gene codifying for PI-PLC β1 enzyme, which maps on 20p12. By using interphase fluorescent in situ hybridization methodology, we found deletions of PLCB1 in orbito-frontal cortex samples of schizophrenia-affected patients. © 2011 The Authors Journal of Cellular and Molecular Medicine. © 2011 Foundation for Cellular and Molecular Medicine/Blackwell Publishing Ltd.


Lo Vasco V.R.,University of Rome La Sapienza | Leopizzi M.,University of Rome La Sapienza | Chiappetta C.,University of Rome La Sapienza | Puggioni C.,University of Rome La Sapienza | And 3 more authors.
Inflammation | Year: 2013

The signaling system of phosphoinositides (PI) is involved in a variety of cell and tissue functions, including membrane trafficking, ion channel activity, cell cycle, apoptosis, differentiation, and cell and tissue polarity. Recently, PI and related molecules, such as the phosphoinositide-specific phospholipases C (PI-PLCs), main players in PI signaling were supposed to be involved in inflammation. Besides the control of calcium levels, PI-PLCs contribute to the regulation of phosphatydil-inositol bisphosphate metabolism, crucial in cytoskeletal organization. The expression of PI-PLCs is strictly tissue specific and evidences suggest that it varies under different conditions, such as tumor progression or cell activation. In a previous study, we obtained a complete panel of expression of PI-PLC isoforms in human umbilical vein endothelial cells (HUVEC), a widely used experimental model for endothelial cells. In the present study, we analyzed the mRNA concentration of PI-PLCs in lipopolysaccharide (LPS)-treated HUVEC by using the multiliquid bioanalyzer methodology after 3, 6, 24, 48, and 72 h from LPS administration. Marked differences in the expression of most PI-PLC codifying genes were evident. © 2013 Springer Science+Business Media New York.


Pavesi G.,Padua Hospital | Causin F.,Padua Hospital | Feletti A.,Padua Hospital
Behavioural Neurology | Year: 2014

Psychiatric symptoms may occasionally be related to anatomic alterations of brain structures. Particularly, corpus callosum lesions seem to play a role in the change of patients' behavior. We present a case of a sudden psychotic attack presumably due to a hemorrhagic cavernous angioma of the corpus callosum, which was surgically removed with complete resolution of symptoms. Although a developmental defect like agenesis or lipoma is present in the majority of these cases, a growing lesion of the corpus callosum can rarely be the primary cause. Since it is potentially possible to cure these patients, clinicians should be aware of this association. Copyright © 2014 Giovanni A.


Control of wound bed bioburden is essential for healing of chronic skin ulcers, including leg ulcers, pressure ulcers, and diabetic ulcers. Clinically, bacterial load manifests itself differently depending on its extent and interaction with the host. Bacteria may contaminate and colonize the wound without harm, whereas criticai colonization and infection are abnormal states that require antimicrobial treatment. Locai antimicrobial treatment is indicated especially in criticai colonization. Silver sulfadiazine, the standard topical antibiotic in the control of bacterial load in the prophylaxis and treatment of skin infections, is listed in the World Health Organization Model List of Essential Medicines. Initially used in burn wound care, it was demonstrated effective also in the treatment of venous ulcers, diabetic ulcers, and pressure ulcers in particular. According to the U.S. Agency for Health Care Policy and Research - Clinical Practice Guidelines (AHCPR), Silver sulfadiazine has the highest level of evidence (level of evidence A) for the treatment of infections caused by Gram-positive, Gram-negative, and anaerobic bacteria. In addition to reducing bacterial load thanks to the synergistic action of sulfadiazine and Silver on various sites of the bacterial celi, it provides ideal hydration of the wound surface, creating a favorable environment for rapid epithelial regeneration and preventing the formation of eschar.

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