Risk factors for venous thromboembolism and prophylaxis in medical inpatients: Data from the FADOI "GEMINI" study [Fattori di rischio per tromboembolismo venoso e profilassi nei pazienti ricoverati in Medicina Interna: Analisi dallo studio FADOI "GEMINI"]
Gussoni G.,Fondazione FADOI |
Silingardi M.,Medicina Interna i e Stroke Unit |
Scannapieco G.,Direzione Sanitaria |
Buniolo C.,QssGroup SpA |
And 3 more authors.
Italian Journal of Medicine | Year: 2010
Background: Though venous thromboembolism (VTE) frequently occurs in non-surgical setting, epidemiology and risk factors for VTE in unselected medical inpatients have not been extensively studied, and uncertainties remain about the prophylactic strategy in these patients. Materials and methods: In a prospective, observational, multicenter study we aimed to contemporarily assess the epidemiology of symptomatic VTE in consecutive patients hospitalized in Internal Medicine, to evaluate the impact of potential risk factors, and the attitude of internists towards thromboprophylaxis. A total of 4,846 patients were included, during the period March-September 2006. Results: Symptomatic VTE was registered in 177 (3.65%) patients; of these, 26 cases (0.55%) occurred with onset of symptoms > 48 hours after admission ("hospital-acquired" events, primary study end-point). Previous VTE and bed resting were significantly associated with venous. Thromboembolism, while a trend for increased risk was documented in cancer patients. During hospital stay antithrombotic prophylaxis was globally administered in 41.6% of patients, and in 58.4% of those for which prophylaxis was recommended according to 2004 guidelines by the American College of Chest Physicians. The choice of administering tromboprophylaxis appeared qualitatively adherent to indications from randomized trials and international guidelines, and bed rest was the strongest determinant of the use of prophylaxis. Conclusions: Data from our real-world study confirm that VTE is a quite common finding in patients admitted to Internal Medicine departments, and recommended tromboprophylaxis is still underused, in particular in some patients groups. Further efforts are needed to better define the risk profile and to optimize prophylaxis in the heterogeneous setting of medical patients. © 2010 Elsevier Srl. All rights reserved.
Bonaglia M.C.,Scientific Institute E Medea |
Giorda R.,Scientific Institute E Medea |
Beri S.,Scientific Institute E Medea |
de Agostini C.,Scientific Institute E Medea |
And 54 more authors.
PLoS Genetics | Year: 2011
In this study, we used deletions at 22q13, which represent a substantial source of human pathology (Phelan/McDermid syndrome), as a model for investigating the molecular mechanisms of terminal deletions that are currently poorly understood. We characterized at the molecular level the genomic rearrangement in 44 unrelated patients with 22q13 monosomy resulting from simple terminal deletions (72%), ring chromosomes (14%), and unbalanced translocations (7%). We also discovered interstitial deletions between 17-74 kb in 9% of the patients. Haploinsufficiency of the SHANK3 gene, confirmed in all rearrangements, is very likely the cause of the major neurological features associated with PMS. SHANK3 mutations can also result in language and/or social interaction disabilities. We determined the breakpoint junctions in 29 cases, providing a realistic snapshot of the variety of mechanisms driving non-recurrent deletion and repair at chromosome ends. De novo telomere synthesis and telomere capture are used to repair terminal deletions; non-homologous end-joining or microhomology-mediated break-induced replication is probably involved in ring 22 formation and translocations; non-homologous end-joining and fork stalling and template switching prevail in cases with interstitial 22q13.3. For the first time, we also demonstrated that distinct stabilizing events of the same terminal deletion can occur in different early embryonic cells, proving that terminal deletions can be repaired by multistep healing events and supporting the recent hypothesis that rare pathogenic germline rearrangements may have mitotic origin. Finally, the progressive clinical deterioration observed throughout the longitudinal medical history of three subjects over forty years supports the hypothesis of a role for SHANK3 haploinsufficiency in neurological deterioration, in addition to its involvement in the neurobehavioral phenotype of PMS. © 2011 Bonaglia et al.
Laukhina E.,CSIC - Institute of Materials Science |
Laukhina E.,CIBER ISCIII |
Pfattner R.,CSIC - Institute of Materials Science |
Pfattner R.,CIBER ISCIII |
And 13 more authors.
Advanced Materials | Year: 2010
In polymeric composite thin films it is possible to translate elastic elongations of the film into reversible nanoscale deformations of the soft organic-crystal components, leading to films with extreme sensitivity to strain changes with durable, fast, and completely reversible responses. Simple prototypes (see image), demonstrate that these sensors are highly promising for a wide range of applications. (Figure Presented) © 2010 WILEY-VCH Verlag GmbH & Co. KGaA.
Berra A.,University delllnsubria |
Berra A.,National Institute of Nuclear Physics, Italy |
Bolognini D.,University delllnsubria |
Bolognini D.,National Institute of Nuclear Physics, Italy |
And 20 more authors.
Astroparticle, Particle and Space Physics, Detectors and Medical Physics Applications - Proceedings of the 11th Conference | Year: 2010
In recent years Silicon Photomultipliers (SiPMs) have been proposed as a new type of readout system for scintillating detectors in many experiments. SiPMs consist of a matrix of parallel-connected silicon micro-pixels, which are independent photon counters working in limited Geiger mode with very high gain (∼ 106). This contribution presents the use of an array of SiPMs (manufactured by FBK-irst) for the readout of a shashlik calorimeter composed by lead and scintillator tiles for a total of ∼,23 Xo; the scintillator light is carried out by 64 WLS fibers (4 fibers per SiPM). The performances of the calorimeter in terms of linearity and energy resolution have been tested in a beam test with charged particles (e±, muons and pions) with a momentum up to 6 GeV/c at the CERN PS no line. © 2010 by World Scientific Publishing Co. Pte. Ltd.
Andre V.,University of Milan Bicocca |
Longoni D.,University of Milan Bicocca |
Bresolin S.,University of Padua |
Cappuzzello C.,University of Milan Bicocca |
And 14 more authors.
Blood Cancer Journal | Year: 2012
Shwachman-Diamond syndrome (SDS) is a rare inherited disorder characterized by bone marrow (BM) dysfunction and exocrine pancreatic insufficiency. SDS patients have an increased risk for myelodisplastic syndrome and acute myeloid leukemia. Mesenchymal stem cells (MSCs) are the key component of the hematopoietic microenvironment and are relevant in inducing genetic mutations leading to leukemia. However, their role in SDS is still unexplored. We demonstrated that morphology, growth kinetics and expression of surface markers of MSCs from SDS patients (SDS-MSCs) were similar to normal MSCs. Moreover, SDS-MSCs were able to differentiate into mesengenic lineages and to inhibit the proliferation of mitogen-activated lymphocytes. We demonstrated in an in vitro coculture system that SDS-MSCs, significantly inhibited neutrophil apoptosis probably through interleukin-6 production. In a long-term coculture with CD34+-sorted cells, SDS-MSCs were able to sustain CD34+ cells survival and to preserve their stemness. Finally, SDS-MSCs had normal karyotype and did not show any chromosomal abnormality observed in the hematological components of the BM of SDS patients. Despite their pivotal role in the hematopoietic stem cell niche, our data suggest that MSC themselves do not seem to be responsible for the hematological defects typical of SDS patients. © 2012 Macmillan Publishers Limited All rights reserved.
KolumbicLakos A.,PLIVA Inc |
Skerk V.,University of Zagreb |
Malekovic G.,PLIVA Inc |
Dujnic Spoljarevic T.,PLIVA Inc |
And 5 more authors.
Journal of Chemotherapy | Year: 2011
Chronic bacterial prostatitis (CBP) is characterized by intense clinical symptoms, frequent relapse episodes and poor quality of life. Aggressiveantibacterial therapy is warranted to eradicate the causative pathogens and to achieve a permanent cure. We administered a switch-therapy protocol to 30 patients showing severe CBP symptoms and two or more relapse episodes in the previous 12 months. Patients received intravenous azithromycin (500 mg/day) and ciprofloxacin (800 mg/day) for 3 days, followed by oral ciprofloxacin (1 g/day) for 25 days. Twenty-seven (90%) patients showed pathogen eradication at test-of-cure (TOe) visit. Five cases of infection relapse were detected at follow-up. At the TOC visit, 25 patients (83%) showed mild/absent symptoms, measured with the NIH-chronicprostatitis symptom index. These results indicate the efficacyof a switch-therapy protocol, based on combined azithromycin and ciprofloxacin. Comparative studies on larger CBP patient populations are warranted to confirm these encouraging results. © E.S.I.F.T. srl- Rrenze.
Looking for lost occupational cancers: A systematic evaluation of occupational exposure in a case series of cutaneous squamous cell carcinomas in Italy [Alia ricerca dei "tumori professional! perduti": Valutazione sistematica dellesposizione professionale in una serie consecutiva di carcinomi cutanei spinocellulari]
Bonzini M.,University Delllnsubria |
Facchinetti N.,University of Brescia |
Motolese A.,Ospedale di Circolo Fondazione Macchi |
Casa M.,Ospedale di Circolo Fondazione Macchi |
And 5 more authors.
Medicina del Lavoro | Year: 2013
Background: Cutaneous carcinomas are tumors with a potential occupational etiology due to exposure to established carcinogens such as polycyclic aromatic hydrocarbons (PAH), ionizing radiation, ultraviolet (UV) radiation and arsenic. The occupational origin of such neoplasms is hugely underestimated in Italy. Objectives: To asses the proportion of Squamous Cell Carcinomas (SCC) cases with a previous occupational exposure to carcinogens. Methods: We systematically evaluated occupational exposure in a series of consecutive cases, discharged in the period 2010-11 from the Dermatology Unit of Varese Hospital,Italy, with a histological diagnosis of SCC. Through a structured telephone interview we identified patients with a potential exposure to skin carcinogens. As a second-level step, an extensive evaluation by an occupational physician was performed to assess the occupational etiology in those selected cases. Results: 105 patients were identified (65 men). 15 male cases out of a total of 85 patients who did the telephone interview, revealed a potential occupational exposure; 7 cases were confirmed as occupational cancers after second-level evaluation (proportion of male occupational cases=13.2%). UV radiation and PAH were recognized as major causal agents. Applying those results to the national incidence data, we estimated a number of 700 annual occupational cases, 100-fold more than the cases currently evaluated by the Italian National Workers Compensation Authority. Conclusions: Our results revealed that occupational SCC is still at present a substantially "lost disease" in Italy. Greater attention and enhanced collaboration between specialists is thus needed to overcome this tendency.
Marletta C.,University dellLnsubria |
Valli R.,University dellLnsubria |
Pressato B.,University dellLnsubria |
Mare L.,University dellLnsubria |
And 12 more authors.
Molecular Cytogenetics | Year: 2012
Background: Chromosome changes in the bone marrow (BM) of patients with persistent cytopenia are often considered diagnostic for a myelodysplastic syndrome (MDS). Comprehensive cytogenetic evaluations may give evidence of the real pathogenetic role of these changes in cases with cytopenia without morphological signs of MDS. Results: Chromosome anomalies were found in the BM of three patients, without any morphological evidence of MDS: 1) an acquired complex rearrangement of chromosome 21 in a boy with severe aplastic anaemia (SAA); the rearrangement caused the loss of exons 2-8 of the RUNX1 gene with subsequent hypoexpression. 2) a constitutional complex rearrangement of chromosome 21 in a girl with congenital thrombocytopenia; the rearrangement led to RUNX1 disruption and hypoexpression. 3) an acquired paracentric inversion of chromosome 1, in which two regions at the breakpoints were shown to be lost, in a boy with aplastic anaemia; the MPL gene, localized in chromosome 1 short arms was not mutated neither disrupted, but its expression was severely reduced: we postulate that the aplastic anaemia was due to position effects acting both in cis and in trans, and causing Congenital Amegakaryocytic Thrombocytopenia (CAMT). Conclusions: A clonal anomaly in BM does not imply per se a diagnosis of MDS: a subgroup of BM hypoplastic disorders is directly due to chromosome structural anomalies with effects on specific genes, as was the case of RUNX1 and MPL in the patients here reported with diagnosis of SAA, thrombocytopenia, and CAMT. The anomaly may be either acquired or constitutional, and it may act by deletion/disruption of the gene, or by position effects. Full cytogenetic investigations, including a-CGH, should always be part of the diagnostic evaluation of patients with BM aplasia/hypoplasia and peripheral cytopenias. © 2012 Marletta et al.; licensee BioMed Central Ltd.