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The authors present the case of a 61-year-old man found dead in an agricultural plot. The first investigation of the scene revealed the corpse laid face up in a spot of partially dried blood, next to an olive tree. His face, arms, legs, and abdomen showed signs of severe contusion and laceration of dogs' bite wounds. Next to the victim, an olives bin had been found overturned on the ground. A multi-disciplinary approach, including crime scene analysis, autopsy findings, veterinary animals review, odontologist bite mark study, and forensic genetics DNA correlations, was performed. The present case is a documented watchdogs lethal pack attack and provides an example of how to recognize the more active participants thanks to their odontological alterations. It could be considered the first described dog pack attack case solved by dysgnathia alteration. Comparisons between the dental casts obtained from the dogs and the inflicted wounds were made, resulting in positive correlations between the injuries and the dental arches from two of the six involved dogs, thanks to dental abnormalities and DNA founding. The victim's clothes were also compared with the dogs' dental casts, confirming that they were the most active participants during the pack attack. Dogs' DNA was finally matched with saliva traces found on victim's clothes and skin bite marks.
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BACKGROUND: Gestational diabetes mellitus is defined as carbohydrate intolerance that begins or is first recognized during pregnancy. Insulin sensitizing substances such as myo-inositol have been considered for the prevention of gestational diabetes mellitus and related complications. OBJECTIVE: Because previous studies failed to show a clear reduction of gestational diabetes mellitus complications, the aim of this study was to evaluate clinical and metabolic outcomes in women who are at risk for gestational diabetes mellitus supplemented with myo-inositol since the first trimester. STUDY DESIGN: A secondary analysis of databases from 3 randomized, controlled trials (595 women enrolled) in which women who were at risk for gestational diabetes mellitus (a parent with type 2 diabetes mellitus, obese, or overweight) were supplemented with myo-inositol (4 g/d) throughout pregnancy. Main measures were the rate of adverse clinical outcomes: macrosomia (birthweight, ≥4000 g), large-for-gestational-age babies (fetal growth, ≥90 percentile), fetal growth restriction (fetal growth, ≤3 percentile), preterm birth (delivery before week 37 since the last menstruation), gestational hypertension, and gestational diabetes mellitus. RESULTS: A significant reduction was observed for preterm birth (10/291 [3.4%] vs 23/304 [7.6%]; P=.03), macrosomia (6/291 [2.1%] vs 16/304 [5.3%]; P=.04), Large-for-gestational-age babies (14/291 [4.8%] vs 27/304 [8.9%]; P=.04) with only a trend to significance for gestational hypertension (4/291 [1.4%] vs 12/304 [3.9%]; P=.07). Gestational diabetes mellitus diagnosis was also decreased when compared with the control group (32/291 [11.0%] vs 77/304 [25.3%]; P<.001). At univariate logistic regression analysis, myo-inositol treatment reduced the risk for preterm birth (odds ratio, 0.44; 95% confidence interval, 0.20-0.93), macrosomia (odds ratio, 0.38; 95% confidence interval, 0.14-0.98), and gestational diabetes mellitus diagnosis (odds ratio, 0.36; 95% confidence interval, 0.23-0.57). CONCLUSION: Myo-inositol treatment in early pregnancy is associated with a reduction in the rate of gestational diabetes mellitus and in the risk of preterm birth and macrosomia in women who are at risk for gestational diabetes mellitus.
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Diabetes Gestacional/prevención & control , Retardo del Crecimiento Fetal/epidemiología , Macrosomía Fetal/epidemiología , Hipertensión Inducida en el Embarazo/epidemiología , Inositol/uso terapéutico , Nacimiento Prematuro/epidemiología , Complejo Vitamínico B/uso terapéutico , Adulto , Diabetes Mellitus Tipo 2 , Diabetes Gestacional/epidemiología , Diabetes Gestacional/metabolismo , Suplementos Dietéticos , Femenino , Humanos , Modelos Logísticos , Anamnesis , Obesidad/epidemiología , Oportunidad Relativa , Sobrepeso/epidemiología , Embarazo , Ensayos Clínicos Controlados Aleatorios como Asunto , RiesgoRESUMEN
BACKGROUND AND AIMS: Gestational diabetes mellitus (GDM), is characterized by chronic, low-grade subclinical inflammation with altered production of cytokines and mediators. Recently, a new protein acting as a "danger signal", high mobility group box 1 (HMGB1), that migrates quickly during electrophoresis, has been identified. The aim of our study was to analyze serum levels of HMGB1 in pregnant women, with or without GDM, in the third trimester of pregnancy to evaluate correlation with insulin resistance and other risk factors for GDM. METHODS AND RESULTS: Seventy five pregnant women positive to the 75 g oral glucose tolerance test (OGTT) were included in the study group and 48 pregnant women who were negative to the screening test, were randomly selected using a computer-generated randomisation table. A significant positive univariate correlation was observed between serum HMGB1 levels, HOMA-IR index, glycaemia values at OGTT and pre-pregnancy BMI. Moreover, logistic regression analysis showed that serum HMGB1 was independent linked to GDM. CONCLUSION: Our study demonstrated that HMGB1, a marker of chronic inflammation, is associated to GDM and insulin resistance level, in the third trimester of pregnancy.
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Diabetes Gestacional/sangre , Proteína HMGB1/sangre , Mediadores de Inflamación/sangre , Adulto , Área Bajo la Curva , Biomarcadores/sangre , Glucemia/metabolismo , Estudios de Casos y Controles , Distribución de Chi-Cuadrado , Estudios Transversales , Diabetes Gestacional/diagnóstico , Diabetes Gestacional/etiología , Femenino , Prueba de Tolerancia a la Glucosa , Humanos , Insulina/sangre , Resistencia a la Insulina , Modelos Logísticos , Valor Predictivo de las Pruebas , Embarazo , Tercer Trimestre del Embarazo/sangre , Curva ROC , Factores de Riesgo , Adulto JovenRESUMEN
Gestational diabetes mellitus (GDM) is a condition of abnormal maternal glucose tolerance that occurs, or is detected, for the first time during pregnancy. The new diagnostic strategies recommend a 75 g, 2-h glucose tolerance test for all women not already known to be diabetic, in the early 3rd trimester of pregnancy. GDM is diagnosed when one or more values is equal to or exceeds the thresholds suggested (i.e. fasting ≥ 5.1 mmol/l, 1-h ≥ 10.0 mmol/l and 2-h ≥ 8.5 mmol/l). This criteria will determine a significant increase of the prevalence of GDM, primarily because only one abnormal value (OAV), not two, is sufficient to make the diagnosis. We also suppose that the new cases of gestational diabetes diagnosed with the new criteria will have an increased risk for subsequent abnormal glucose tolerance later in life, as it was largely confirmed in the past for the patients with two or more abnormal values.
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Diabetes Gestacional/diagnóstico , Intolerancia a la Glucosa , Femenino , Prueba de Tolerancia a la Glucosa , Humanos , EmbarazoRESUMEN
Congenital cytomegalovirus (cCMV) infection is the most common congenital infection, with an estimated incidence of approximately one in 200 infants in high-income settings. Approximately one in four children may experience life-long consequences, including sensorineural hearing loss and neurodisability. Knowledge regarding prevention, diagnosis, and treatment increased in the recent years, but some challenges remain. In this review, we tried to summarize the current knowledge on both the obstetrical and pediatric areas, while also highlighting controversial aspects and future perspectives. There is a need to enhance awareness among the general population and pregnant women through specific information programs. Further research is needed to better define the classification of individuals at birth and to have a deeper understanding of the long-term outcomes for so defined children. Finally, the availability of valaciclovir medication throughout pregnancy, where appropriate, has prompted the assessment of a universal serological antenatal screening. It is recommended to establish a dedicated unit for better evaluation and management of both mothers and children.
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OBJECTIVE: To evaluate the 12-month effect of myo-inositol treatment on some biochemical parameters of women affected by metabolic syndrome. METHODS: Eighty outpatient postmenopausal women, affected by metabolic syndrome, were enrolled in a 12-month study. All women were treated with a low-energy diet, and then they were randomly assigned to myo-inositol 2 g b.i.d. (n = 40) or placebo (n = 40). All the women were evaluated for serum glucose, insulin, HOMA-IR (Homeostasis Model Assessment-Insulin Resistance), triglycerides, total and high density lipoprotein cholesterol, body mass index (BMI), waist circumference and blood pressure at baseline and after 12 months of treatment. RESULTS: With the exception of BMI and waist circumference, after 12 months of treatment, all the parameters studied showed a significant improvement in the myo-inositol group compared to the control group. At the end of the study, in the myo-inositol group, the number of women without metabolic syndrome was eight (20%) whereas, in the control group, only one woman no longer had the metabolic syndrome after 12 months of diet. CONCLUSIONS: Myo-inositol might be considered one of the insulin-sensitizing substances in the treatment of metabolic syndrome.
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Inositol/uso terapéutico , Síndrome Metabólico/tratamiento farmacológico , Posmenopausia , Glucemia/análisis , Presión Sanguínea , Índice de Masa Corporal , Restricción Calórica , HDL-Colesterol/sangre , Suplementos Dietéticos , Femenino , Humanos , Insulina/sangre , Resistencia a la Insulina , Síndrome Metabólico/sangre , Persona de Mediana Edad , Placebos , Triglicéridos/sangre , Circunferencia de la CinturaRESUMEN
To evaluate retrospectively the prevalence of gestational diabetes (GD) in pregnancies obtained with myo-inositol administration in women with polycystic ovary syndrome. A total of 98 pregnancies in PCOS women obtained in a 3-year period, either with myo-inositol (n. 54), or with metformin (n. 44) were considered. While myo-inositol was assumed through the whole pregnancy, the group of women treated with metformin stopped the drug assumption after pregnancy diagnosis, and was considered as a control group. After having eliminated cases of miscarriages and twin pregnancies, a definitive number of 46 women in the myo-inositol group and 37 in the control group was taken in account to be retrospectively evaluated. The primary outcome measure was GD occurrence in both groups; whereas secondary outcome measures were pregnancy outcomes: hypertensive disorders, pre-term birth, macrosomia and caesarean section occurrence. Prevalence of GD in the myo-inositol group was 17.4% versus 54% in the control group, with a highly significant difference also after adjusting for covariates. Consequently, in the control group the risk of GD occurrence was more than double compared to the myo-inositol group, with an odds ratio 2.4 (confidence interval 95%, 1.3-4.4). There was no difference between the groups in relation to secondary outcome measures. This study suggests a possible effect of myo-inositol in the primary prevention of GD in PCOS women.
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Diabetes Gestacional/prevención & control , Inositol/uso terapéutico , Síndrome del Ovario Poliquístico/tratamiento farmacológico , Adulto , Diabetes Gestacional/epidemiología , Femenino , Humanos , Hipoglucemiantes/uso terapéutico , Inositol/farmacología , Metformina/uso terapéutico , Síndrome del Ovario Poliquístico/complicaciones , Síndrome del Ovario Poliquístico/epidemiología , Embarazo , Complicaciones del Embarazo/tratamiento farmacológico , Complicaciones del Embarazo/epidemiología , Resultado del Embarazo/epidemiología , Prevalencia , Técnicas Reproductivas Asistidas , Estudios RetrospectivosRESUMEN
To determine the institutional pregnancy complications rate associated with genetic amniocentesis and ascertain whether procedural variables or pre-existing factors may determine an increased risk of having a procedural-related fetal loss, we retrospectively evaluated all the consecutive amniocentesis, with known pregnancy outcome (n = 2990), performed between January 2001 and December 2009 by two very experienced clinicians. The patients who had counselling in the same period but declined to undergo amniocentesis represent the control group (n = 487). A total of 30 fetal losses occurred within 24 weeks' gestation (1%), while in the control group, we had four losses (0.8%). Procedural variables (transplacental sample, multiple needle insertions and gestational age) were not found to be predictive of increased fetal loss rate. Previous vaginal bleeding increased the risk of pregnancy loss after amniocentesis with an OR 4.1 (95% CI 2.0-8.7); on the contrary, a history of two or more miscarriages is not associated with a greater fetal loss rate, while the increased percentage (OR 3.4, 95% CI 1.2-9.0) in patients affected by uterine myoma appears connected, after the comparison with the control group, with the presence of fibroids rather than procedure.
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Amniocentesis/efectos adversos , Resultado del Embarazo , Segundo Trimestre del Embarazo , Aborto Espontáneo/etiología , Adulto , Femenino , Rotura Prematura de Membranas Fetales/etiología , Humanos , Embarazo , Nacimiento Prematuro/etiología , Hemorragia Uterina/etiologíaRESUMEN
BACKGROUND: Deep brain stimulation (DBS) is a safe and effective treatment for patients with advanced Parkinson's disease (PD) and many neurosurgical centers in Italy have a DBS program. Considering the prevalence of PD and criteria for DBS implantation, about 3200-10,350 PD patients may benefit from DBS in Italy. The global management of patients underwent DBS is complex and it can be supposed that many differences exist between centers in clinical practice. The Italian Neurosurgery Society (SINch) designed this survey to investigate the state of the art of DBS for PD in Italy. METHODS: A 26-item closed-ended question survey was designed and sanded by email at all Italian Neurosurgery centers. The main topic investigated was DBS teams, anatomical target selection, surgical procedure, neuroimaging, intraoperative target localization, DBS device and patients' follow-up. RESULTS: A total of 23 neurosurgery centers completed the survey. There are mainly low-to medium-volume centers (<20 annual DBS procedures) with dedicated DBS teams. The principal anatomical target used is subthalamic nucleus (STN) and, relative to the surgical technique, it emerges that in Italy DBS are bilaterally implanted in a single-step session with awake anesthesia and with frame-based technique. Final leads positioning is defined by microelectrode recordings (MER) and microstimulation (MS), with limited role of intraoperative neuroimaging (MRI and O-Arm). The stimulation is started at 15 or 30 days from procedure. CONCLUSIONS: Many centers of neurosurgery in Italy have a well-established DBS program for patients with advanced PD and some practical differences in technique between centers exist. Further investigation is needed to investigate specific criteria for selecting one technique over another.
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Estimulación Encefálica Profunda , Neurocirugia , Enfermedad de Parkinson , Cirugía Asistida por Computador , Humanos , Enfermedad de Parkinson/cirugía , Estimulación Encefálica Profunda/métodos , Imagenología Tridimensional , Electrodos Implantados , Tomografía Computarizada por Rayos XRESUMEN
AIM: To test the hypothesis that myoinositol supplementation will improve insulin sensitivity as measured by markers of insulin resistance such as homeostasis model assessment of insulin resistance and adiponectin in women with gestational diabetes. METHODS: The trial was carried out in diet-treated patients with gestational diabetes diagnosed in our department between April 2008 and September 2009. Subjects were randomly assigned to receive either myoinositol supplementation (4 g daily) plus folic acid (400 µg daily)-the study group-or folic acid only (400 µg daily)-the control group. Both groups received the same diet prescription. Homeostasis model assessment of insulin resistance and adiponectin were assayed while fasting at the time of the diagnostic oral glucose tolerance test and after 8 weeks of treatment. RESULTS: There were 69 evaluable patients, 24 in the study group and 45 in the control group. Fasting glucose and insulin, and consequently homeostasis model assessment of insulin resistance, decreased in both groups (50% in the study group vs. 29% in the control group), but the decline in the study group was significantly greater than that in the control group (P = 0.0001). Adiponectin increased in the myoinositol group while it decreased in the control group (P = 0.009). CONCLUSION: Myoinositol improves insulin resistance in patients with gestational diabetes.
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Adiponectina/metabolismo , Glucemia/efectos de los fármacos , Diabetes Gestacional/tratamiento farmacológico , Suplementos Dietéticos , Inositol/uso terapéutico , Insulina/metabolismo , Adulto , Glucemia/metabolismo , Diabetes Gestacional/metabolismo , Femenino , Prueba de Tolerancia a la Glucosa , Humanos , Hipoglucemiantes , Inositol/metabolismo , Resistencia a la Insulina , Embarazo , Resultado del TratamientoRESUMEN
Cystic echinococcosis (CE) is a severe zoonosis, caused by the larval stage of the tapeworm Echinococcus granulosus. This helminth infection is of increasing public health and socio-economic concern due to the considerable morbidity rates that cause economic losses both in the public health sector and in the livestock industry. Control programmes against E. granulosus are considered long-term actions which require an integrated approach and high expenditure of time and financial resources. Since 2010, an integrated approach to control CE has been implemented in a highly endemic area of continental southern Italy (Campania region). Innovative procedures and tools have been developed and exploited during the control programme based on the following strategies: i) active and passive surveillance in livestock (using geospatial tools for georeferencing), ii) diagnosis in dogs (using the FLOTAC techniques and molecular analysis), iii) targeted treatment of farm dogs (using purpose-built confinement cages), iv) early diagnosis in livestock (by ultrasonography), v) surveillance in humans (through hospital discharge records analysis), vi) monitoring the food chain (analysing raw vegetables), vii) outreach activities to the general public (through dissemination material, e.g. brochures, gadgets, videos, virtual reality). Over eight years, the integrated approach and the new strategies developed have resulted in a noteworthy reduction of the parasite infection rates in livestock (e.g. up to 30 % in sheep). The results obtained so far highlight that using a one health multidisciplinary and multi-institution effort is of pivotal importance in preparing CE control programmes at regional level and could be extended to other endemic Mediterranean areas.
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Enfermedades de los Perros/parasitología , Equinococosis/veterinaria , Enfermedades de las Ovejas/parasitología , Animales , Enfermedades de los Perros/epidemiología , Enfermedades de los Perros/prevención & control , Perros , Equinococosis/epidemiología , Equinococosis/prevención & control , Heces/parasitología , Humanos , Italia/epidemiología , Proyectos Piloto , Ovinos , Enfermedades de las Ovejas/epidemiología , Enfermedades de las Ovejas/prevención & control , Zoonosis/epidemiología , Zoonosis/parasitología , Zoonosis/prevención & controlRESUMEN
BACKGROUND AND AIM: Recent evidence suggests that genistein aglycone may act beneficially on surrogate cardiovascular risk markers in postmenopausal women. We assessed the effects of genistein aglycone on some cardiovascular risk factors and homocysteine levels after 3-years of continued therapy in a cohort of osteopenic, postmenopausal women. METHODS AND RESULTS: The parent study was a randomized, double-blind, placebo-controlled trial involving 389 postmenopausal women with low bone mass for 24 months. Subsequently, a subcohort (138 patients) continued therapy for an additional year. Participants received 54mg of genistein aglycone (n=71) or placebo (n=67), daily. Both arms received calcium and vitamin D(3) in therapeutic doses. Moreover, 4 weeks before randomization procedures and during our follow-up study, all patients received dietary instructions in an isocaloric fat-restricted diet. Blood lipid profiles, fasting glucose and insulin, insulin resistance (HOMA-IR), fibrinogen, osteoprotegerin (OPG) and homocysteine at baseline and after 24 and 36 months of treatment were measured. Compared to placebo, genistein significantly decreased fasting glucose and insulin, HOMA-IR, fibrinogen and homocysteine after 24 and 36 months of treatment. By contrast, isoflavone administration did not affect high-density lipoprotein cholesterol and triglycerides though serum OPG was higher in the genistein recipients. There were no differences in adverse events or discomfort between groups. Results on routine biochemical, liver function, and hematologic testing did not change over time in placebo or genistein group. CONCLUSIONS: After 3-years of treatment, genistein aglycone plus calcium, vitamin D(3) and a healthy diet showed positive effects on some cardiovascular risk factors and homocysteine levels in a cohort of postmenopausal women with low bone mass.
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Enfermedades Cardiovasculares/prevención & control , Genisteína/farmacología , Homocisteína/sangre , Carbonato de Calcio/administración & dosificación , Colecalciferol/administración & dosificación , Femenino , Estudios de Seguimiento , Genisteína/efectos adversos , Humanos , Resistencia a la Insulina , Lípidos/sangre , Persona de Mediana Edad , Osteoprotegerina/sangre , Posmenopausia , Proyectos de Investigación , Factores de RiesgoRESUMEN
AIMS: Neutrophil gelatinase-associated lipocalin (NGAL) is highly expressed in damaged epithelia, during inflammation and cardiovascular disease. Soluble NGAL was measured in women who subsequently developed gestational diabetes. METHODS: From a cohort of 908 pregnant outpatients who participated in a screening programme for Down's syndrome at 9-12 weeks of gestation, we considered all 41 women with a singleton pregnancy, who developed gestational diabetes in the previous 12 months, and a control group of 82 normal pregnancies. Circulating NGAL and insulin resistance by homeostasis model assessment ratio (HOMA-IR) were determined in the first trimester. RESULTS: Median serum NGAL concentrations were higher in the gestational diabetes group [51.3 ng/ml (39.8-66.1 ng/ml)] compared with the control group [17.8 ng/ml (15.5-20.9 ng/ml)] (P < 0.001) and positively correlated with HOMA-IR (P < 0.001). CONCLUSIONS: In the first trimester, circulating NGAL was significantly increased in women who subsequently developed gestational diabetes compared with the control group.
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Diabetes Gestacional/sangre , Lipocalinas/sangre , Primer Trimestre del Embarazo/sangre , Adulto , Biomarcadores/sangre , Femenino , Homeostasis/fisiología , Humanos , Modelos Biológicos , EmbarazoRESUMEN
BACKGROUND: One daily dose of tacrolimus (QDT) improves adherence in kidney transplant (KT) recipients. A switch from twice-daily tacrolimus (BDT) to QDT showed similar efficacy and safety. METHODS: The aim of our study was to demonstrate the long-term efficacy and safety of switching from BDT to QDT in KT recipients. Preliminary results have already been published. Forty-one patients (34 men and 7 women), mean age at KT of 43.9 ± 12.7 years, underwent a 1:1 dose switch from BDT to QDT; the mean time from KT to switch was 36.6 ± 16.1 months. In our study population, 4 patients received a living donor KT and 2 received a second allograft. RESULTS: The mean follow-up was 86.8 ± 13 months from the switch and 126.2 ± 22.3 months from KT. Graft and patient survival rates were 90.2% and 95.1%, respectively. All patients maintained stable renal function during follow-up. During the first 3 months after the switch we observed a significant decrease in tacrolimus blood level (P = .0001). No significant differences were observed regarding tacrolimus dose before and after QDT introduction (P = not significant [NS]). Fourteen patients who stopped steroids under BDT treatment and 16 patients who stopped steroids after the switch are currently steroid-free. CONCLUSION: Our study showed safety and efficacy in switching from BDT to QDT. After early (<1 year) dose adjustment, tacrolimus blood levels remained stable throughout follow-up. Moreover, QDT represented a valid alternative for patients showing steroid side effects.
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Rechazo de Injerto/prevención & control , Inmunosupresores/administración & dosificación , Trasplante de Riñón , Tacrolimus/administración & dosificación , Adulto , Esquema de Medicación , Femenino , Humanos , Inmunosupresores/sangre , Trasplante de Riñón/mortalidad , Masculino , Persona de Mediana Edad , Tacrolimus/sangreRESUMEN
OBJECTIVE: Myo-inositol supplementation prevents gestational diabetes (GDM) in women at risk and reduces insulin resistance in women with GDM. No data are available about its effect on glucose variability. The aim of this study was to evaluate the effects of a supplementation of myo-inositol on glucose variability in women with GDM. PATIENTS AND METHODS: Myo-inositol effect on glucose variability was studied in a pilot case-control study involving 12 consecutive pregnant women (median age 34 years, 25.0% insulin-treated) with GDM. Six women received myo-inositol 2 g plus 200 mg folic acid twice a day, the others received only folic acid. Information on side effects was collected. A continuous glucose monitoring system was wore before and at the beginning of the supplementation. Mean amplitude of glucose excursion (MAGE), standard deviation (SD) and variability coefficient were the indexes of glucose variability. RESULTS: Myo-inositol lowered glucose levels in the first days after the treatment was started. However, pre-post supplementation overall mean glucose difference was similar between groups (-4.8 vs. 5.0 mg/dL for controls and treated, respectively; p = 0.79). Pre-post differences in SD (13.7 vs. 6.0; p < 0.001), MAGE (3.5 vs.-1.5; p < 0.001) and variability coefficient (0.14 vs. 0.02; p < 0.001) were improved in myo-inositol group. No side effects were recorded. CONCLUSIONS: Myo-inositol is effective in reducing glucose variability in women with GDM. It could be a useful strategy for treating GDM.
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Glucemia/efectos de los fármacos , Diabetes Gestacional/tratamiento farmacológico , Suplementos Dietéticos , Hipoglucemiantes/uso terapéutico , Inositol/uso terapéutico , Adulto , Biomarcadores/sangre , Glucemia/metabolismo , Estudios de Casos y Controles , Diabetes Gestacional/sangre , Diabetes Gestacional/diagnóstico , Suplementos Dietéticos/efectos adversos , Regulación hacia Abajo , Femenino , Humanos , Hipoglucemiantes/efectos adversos , Inositol/efectos adversos , Proyectos Piloto , Embarazo , Resultado del TratamientoRESUMEN
Blood samples from 65 sheep were tested for the presence of bovine Deltapapillomavirus (δPVs) DNA. The sheep were divided into three groups. Sheep in groups 1 and 2 were from Sardinia and Campania, respectively, and were in contact with cattle and grazed on lands contaminated with bracken fern. Sheep in Group 3 lived in closed pens and had no contact with cattle. These sheep were fed hay that did not contain bracken fern. Bovine δPV E5 DNA was detected in blood from 24 of 27 (89%) sheep in Group 1. A single bovine δPV type was detected in the blood from nine (33%) sheep, including the detection of bovine δPV-1 DNA in four sheep, bovine δPV-2 in four and δPV-13 in one sheep. Two δPV types were detected in 33% of the sheep, and three bovine δPV types were detected in 22% of the sheep. Bovine δPVs were detected in 17 of 20 (85%) sheep from Group 2. The detection rate by a single δPV type was 40% with just δPV-1 DNA amplified from two, just δPV-2 DNA from four, and just δPV-13 DNA from two sheep. Two and three δPVs were detected in 30% and 15%, respectively. All sequenced amplicons showed a 100% identity with papillomaviral E5 DNA deposited in GenBank. Bovine δPV-14 DNA sequences were not detected from any sheep. No bovine δPV DNA was revealed in blood samples from sheep in Group 3. The detection of bovine δPV DNA in the blood of sheep means that sheep may be able to be infected by these PVs. This suggests that bovine δPVs could potentially be a previously unrecognized cause of disease in sheep. Furthermore, it is possible that sheep could act as a reservoir for these viruses.
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Papillomavirus Bovino 1/genética , ADN Viral/sangre , Ovinos/virología , Animales , ItaliaAsunto(s)
Proteínas ADAM/fisiología , Biomarcadores/sangre , Proteínas de la Membrana/fisiología , Preeclampsia/diagnóstico , Primer Trimestre del Embarazo/sangre , Segundo Trimestre del Embarazo/sangre , Proteína Plasmática A Asociada al Embarazo/fisiología , Proteínas ADAM/análisis , Proteínas ADAM/sangre , Proteína ADAM12 , Adulto , Biomarcadores/análisis , Estudios de Casos y Controles , Reacciones Falso Positivas , Femenino , Humanos , Proteínas de la Membrana/análisis , Proteínas de la Membrana/sangre , Preeclampsia/sangre , Embarazo , Proteína Plasmática A Asociada al Embarazo/análisis , PronósticoRESUMEN
Bovine papillomavirus type 13 (BPV-13), a novel Deltapapillomavirus, has been found associated with urothelial tumours of the urinary bladder of cattle grazing on lands infested with bracken fern. BPV-13 was detected in 28 of 39 urothelial tumours. Diagnosis was based on sequencing of L1 and E5 amplicons from tumour samples. The nucleotide sequences generated from these amplicons showed a 100% homology with the sequences of BPV-13 L1 and E5 DNA found in Brazil from a fibropapilloma of the ear in a cow and from equine sarcoids in two horses. GenBank accession number of our representative BPV-13 sequences is JQ798171.1. Furthermore, mRNA encoding BPV-13 E5 oncoprotein was also documented, and its expression was also shown by immunohistochemistry and immunofluorescence in the basal and suprabasal urothelial tumour cells. In twenty-three tumours, BPV-13 was simultaneously found with BPV-2, a Deltapapillomavirus genus, species 4. The latter virus was detected by amplifying and sequencing a 154-bp-sized DNA fragment of BPV-2 E5. In addition, BPV-13 by itself was seen to be expressed in five BPV-2-negative urothelial tumours. This study shows that BPV-13 is present in urothelial tumour cells thus sharing biological properties with BPV-1 and BPV-2. Although further studies are needed, BPV-13 appears to be another worldwide infectious agent responsible for a distressing disease causing severe economic losses in cattle industry.
Asunto(s)
Papillomavirus Bovino 1/aislamiento & purificación , Enfermedades de los Bovinos/virología , Neoplasias de la Vejiga Urinaria/veterinaria , Neoplasias de la Vejiga Urinaria/virología , Animales , Secuencia de Bases , Papillomavirus Bovino 1/genética , Brasil , Bovinos , ADN Viral/genética , Femenino , Técnica del Anticuerpo Fluorescente , Inmunohistoquímica , Papillomaviridae/genética , Infecciones por Papillomavirus/veterinaria , Reacción en Cadena de la Polimerasa/veterinaria , Vejiga Urinaria/virologíaRESUMEN
AIM: Our objective was to compare, in a Caucasian population, the perinatal outcomes of pregnancies complicated by pregestational diabetes diagnosed in the first-trimester of pregnancy with those of pregnancies complicated by gestational diabetes. METHODS: A retrospective evaluation of maternal and neonatal outcomes was performed for all consecutive pregnancies complicated by gestational or pregestational diabetes that happened between 2005 and 2011. Pregestational diabetes was diagnosed for the first time in pregnancy if the first-trimester fasting glycaemia was ≥126 mg/dL. Gestational diabetes was diagnosed according to Carpenter-Coustan criteria until May 2010, and then according to the International Association of Diabetes and Pregnancy Study Groups (IADPSG) panel criteria modified by the American Diabetes Association. A specific diet, self-monitoring of blood glucose and, if required, insulin treatment were prescribed. RESULTS: Overall, 411 pregnant women were considered eligible for the study (379 with gestational diabetes and 32 with pregestational diabetes). Women with pregestational vs. gestational diabetes were diagnosed earlier in pregnancy (11.6±1.0 weeks vs. 25.9±1.7 weeks; P=0.0001), had a higher mean first-trimester fasting glycaemic level (129.5±3.6 mg/dL vs. 81.6±10.5mg/dL; P=0.0001), more often had a family history of diabetes (46.9% vs. 25.9%; P=0.02) and more often needed insulin treatment (78.1% vs. 14.0%; P=0.0001). Furthermore, a higher rate of fetal malformations in women with pregestational diabetes was detected (9.4% vs. 1.6%, P=0.02). No other differences in neonatal outcomes were identified. CONCLUSION: In a Caucasian population, the prevalence of fetal malformations and insulin requirements with pregestational diabetes first diagnosed in pregnancy were significantly higher compared with women with gestational diabetes. In any case, glucose impairment in pregnancy needs to be diagnosed in a timely fashion and appropriately treated to improve both maternal and fetal outcomes.