Tomato transcriptomic response to Tuta absoluta infestation.

BACKGROUND: The South America pinworm, Tuta absoluta, is a destructive pest of tomato that causes important losses worldwide. Breeding of resistant/tolerant tomato cultivars could be an effective strategy for T. absoluta management but, despite the economic importance of tomato, very limited information is available about its response to this treat. To elucidate the defense mechanisms to herbivore feeding a comparative analysis was performed between a tolerant and susceptible cultivated tomato at both morphological and transcriptome level to highlight constitutive leaf barriers, molecular and biochemical mechanisms to counter the effect of T. absoluta attack. RESULTS: The tolerant genotype showed an enhanced constitutive barrier possibly as result of the higher density of trichomes and increased inducible reactions upon mild infestation thanks to the activation/repression of key transcription factors regulating genes involved in cuticle formation and cell wall strength as well as of antinutritive enzymes, and genes involved in the production of chemical toxins and bioactive secondary metabolites. CONCLUSIONS: Overall, our findings suggest that tomato resilience to the South America pinworm is achieved by a combined strategy between constitutive and induced defense system. A well-orchestrated modulation of plant transcription regulation could ensure a trade-off between defense needs and fitness costs. Our finding can be further exploited for developing T. absoluta tolerant cultivars, acting as important component of integrated pest management strategy for more sustainable production.

Epidemiology and costs of cervical cancer screening and cervical dysplasia in Italy.

BACKGROUND: We estimated the number of women undergoing cervical cancer screening annually in Italy, the rates of cervical abnormalities detected, and the costs of screening and management of abnormalities. METHODS: The annual number of screened women was estimated from National Health Interview data. Data from the Italian Group for Cervical Cancer Screening were used to estimate the number of positive, negative and unsatisfactory Pap smears. The incidence of CIN (cervical intra-epithelial neoplasia) was estimated from the Emilia Romagna Cancer Registry. Patterns of follow-up and treatment costs were estimated using a typical disease management approach based on national guidelines and data from the Italian Group for Cervical Cancer Screening. Treatment unit costs were obtained from Italian National Health Service and Hospital Information System of the Lazio Region. RESULTS: An estimated 6.4 million women aged 25-69 years undergo screening annually in Italy (1.2 million and 5.2 million through organized and opportunistic screening programs, respectively). Approximately 2.4% of tests have positive findings. There are approximately 21,000 cases of CIN1 and 7,000-17,000 cases of CIN2/3. Estimated costs to the healthcare service amount to 158.5 million euro for screening and 22.9 million euro for the management of cervical abnormalities. CONCLUSION: Although some cervical abnormalities might have been underestimated, the total annual cost of cervical cancer prevention in Italy is approximately 181.5 million euro, of which 87% is attributable to screening.

Incidence of invasive cervical cancer and direct costs associated with its management in Italy.

AIM AND BACKGROUND: Cervical cancer is the second most common cancer in European women aged 15-44 years. The aim of this study was to estimate the direct cost of managing invasive cervical cancer in Italy. METHODS: Data from the Italian Network of Cancer Registries were used to estimate the annual number of new cervical cancer cases. To assess the management costs, a typical management pathway for each FIGO (Fédération Internationale de Gynécologie et d'Obstétrique) cervical cancer stage was derived from published guidelines. Data from the Modena Cancer Registry were used to estimate the proportion of patients by FIGO stage. This algorithm was combined with tariffs for outpatient and inpatient procedures to obtain a mean cost for each FIGO stage. RESULTS: An estimated 2,927 new cases of cervical cancer occurred in Italy in 2005 (crude incidence 9.7/100,000; world age-standardized incidence 6.0/100,000). The estimated numbers of new cases by FIGO stage were: FIGO I, 1,927; FIGO II, 556; FIGO III, 259; and FIGO IV, 185. Costs for the most frequent procedures were estimated as: Euro 6,041 for radical hysterectomy or other surgery; Euro 4,901 for radio-chemotherapy; Euro 1,588 for brachytherapy; and Euro 3,795 for palliative chemotherapy. Mean management costs for incident cases (including 10 years of follow-up) were estimated at: FIGO I, Euro 6,024; FIGO II, Euro 10,572; FIGO III, Euro 11,367; FIGO IV, Euro 8707; and Euro 5,854 for the terminal phase (1 month). The total direct management cost was estimated at Euro 28.3 million per year. CONCLUSIONS: This is one of the first studies to estimate the direct cost of treating patients newly diagnosed with invasive cervical cancer in Italy. Although according to current management pathways real treatment costs are likely to be underestimated, this information is necessary to design evidence-based vaccination policies able to harmonize primary and secondary prevention of cervical cancer.

On-site evaluation of percutaneous CT-guided fine needle aspiration of pulmonary lesions. A study of 321 cases.

PURPOSE: The aim of this study was to assess the usefulness of having a cytopathologist present during percutaneous CT-guided fine needle aspiration (FNA) of pulmonary lesions. MATERIALS AND METHODS: Three hundred and twenty-one FNAs of lung lesions were performed in 312 patients (218 males, 94 females; age range: 20-86 years; mean age: 66 yrs). Nodule sizes ranged from 0.5 to 8 cm. The sampling was performed by a radiologist under CT-guidance; the calibre of the needle used was 20-25 G. Smears were prepared in the Radiology Department and stained using a quick method by a cytopathologist: the sample adequacy was assessed and, if possible, a preliminary diagnosis was made. An additional FNA was requested if the first aspirate was considered diagnostically inadequate. The diagnostic accuracy was examined by reviewing the clinical data and by correlating with the histological material and the clinical outcome. RESULTS: Satisfactory diagnostic material was obtained in 275 of the 321 FNA (86%): 231 were malignant (72%), 8 suspicious (3%) and 36 were negative for malignancy (11%). Forty-six of the 321 specimens (14%) were considered inadequate for any diagnostic verification. An additional FNA was performed immediately in 60 cases (19%). Forty-two subjects developed pneumothorax: 21 patients (50%) of these required thoracic drainage. Blood effusion around the lesion site or adjacent to the needle path was observed in 39 patients (12%). Sensitivity was 99%, specificity was 95% and diagnostic accuracy was 99%. CONCLUSIONS: CT guided aspiration cytology can be a safe and fast procedure for lung nodule characterisation. On-site immediate evaluation of FNA specimens can be beneficial in determining the adequacy of the aspirate and in providing accurate preliminary diagnoses of the specimens, thus allowing for rapid clinical decisions.