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1.
Cell Death Dis ; 14(11): 763, 2023 11 23.
Artigo em Inglês | MEDLINE | ID: mdl-37996430

RESUMO

The transcription factor MYB plays a pivotal role in haematopoietic homoeostasis and its aberrant expression is involved in the genesis and maintenance of acute myeloid leukaemia (AML). We have previously demonstrated that not all AML subtypes display the same dependency on MYB expression and that such variability is dictated by the nature of the driver mutation. However, whether this difference in MYB dependency is a general trend in AML remains to be further elucidated. Here, we investigate the role of MYB in human leukaemia by performing siRNA-mediated knock-down in cell line models of AML with different driver lesions. We show that the characteristic reduction in proliferation and the concomitant induction of myeloid differentiation that is observed in MLL-rearranged and t(8;21) leukaemias upon MYB suppression is not seen in AML cells with a complex karyotype. Transcriptome analyses revealed that MYB ablation produces consensual increase of MAFB expression in MYB-dependent cells and, interestingly, the ectopic expression of MAFB could phenocopy the effect of MYB suppression. Accordingly, in silico stratification analyses of molecular data from AML patients revealed a reciprocal relationship between MYB and MAFB expression, highlighting a novel biological interconnection between these two factors in AML and supporting new rationales of MAFB targeting in MLL-rearranged leukaemias.


Assuntos
Leucemia Mieloide Aguda , Humanos , Linhagem Celular , Leucemia Mieloide Aguda/metabolismo , Fator de Transcrição MafB/genética , Proteína de Leucina Linfoide-Mieloide/genética , Fenótipo , RNA Interferente Pequeno
2.
Ultrasound Obstet Gynecol ; 62(6): 875-881, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37266920

RESUMO

OBJECTIVE: To assess the role of the choroid plexus (CP) of the fourth ventricle (4V) in fetuses with an open 4V and a normal cerebellar vermis. METHODS: Two groups of patients were recruited in two fetal medicine referral centers. The prospectively collected control group included singleton pregnancies with a normal sonographic examination after first-trimester combined screening for chromosomal abnormalities and normal outcome, recruited in the period between 2019 and 2022. The study group was selected retrospectively by searching our databases to identify all cases with an isolated open 4V and normal anatomy and size of the cerebellar vermis. The inclusion criteria of the study group were: (1) gestational age between 20 and 22 weeks; (2) a brainstem-vermis angle ≥ 18° in the midsagittal plane with an otherwise normal cerebellum and vermis; (3) 4V-CP visible and seen separately from the vermis; (4) absence of other intra- and extracranial anomalies; and (5) available prenatal and/or postnatal magnetic resonance imaging (MRI) data. RESULTS: In 169 cases of the control group, the 4V-CP was seen separately from the cerebellar vermis and was noticed to progressively fill the space caudal to the 4V, between the vermis and brainstem. From 12 to 22 weeks, the surface areas of the vermis and medial portion of the 4V-CP increased progressively with advancing gestation (P < 0.0001). Intra- and interobserver correlation analysis showed good reproducibility for the measurements. Among the cases with an open 4V and a normal vermis, it was retrospectively feasible to visualize the 4V-CP separately from the inferior part of the vermis in 41 fetuses. In five of these cases, the open 4V was due to a small CP. In all 41 fetuses, the diagnosis on MRI was isolated upward rotation of the cerebellar vermis, and no additional anomaly was found. CONCLUSIONS: Closure of the 4V is dependent on the 4V-CP and not only the cerebellar vermis. In fact, a small CP may represent another cause of an open 4V. Therefore, separate visualization of the 4V-CP and cerebellar vermis is crucial to improve discrimination between the different causes of an open 4V at the anomaly scan and its clinical implications. © 2023 International Society of Ultrasound in Obstetrics and Gynecology.


Assuntos
Plexo Corióideo , Quarto Ventrículo , Feminino , Gravidez , Humanos , Lactente , Quarto Ventrículo/diagnóstico por imagem , Plexo Corióideo/diagnóstico por imagem , Estudos Retrospectivos , Reprodutibilidade dos Testes , Ultrassonografia Pré-Natal/métodos , Diagnóstico Pré-Natal , Idade Gestacional , Imageamento por Ressonância Magnética/métodos
4.
Ultrasound Obstet Gynecol ; 59(1): 49-54, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34125985

RESUMO

OBJECTIVE: To evaluate whether in fetuses with open spina bifida (OSB) the tentorium can be seen to be displaced downwards and vertically oriented by the time of the 11-13-week scan and whether this is reflected in an alteration of the brainstem-tentorium (BST) angle. METHODS: The study population was recruited between 2015 and 2020 from three fetal medicine referral centers and comprised a control group and a study group of pregnancies with OSB. The control group was recruited prospectively and included singleton pregnancies with a normal sonographic examination after first-trimester combined screening for chromosomal abnormalities and normal outcome. The study group was selected retrospectively and included all cases with OSB between 2015 and 2020. All cases underwent detailed ultrasound assessment at 11 + 0 to 13 + 6 weeks' gestation. The position of the torcular Herophili (TH) was identified in the midsagittal view of the fetal brain with the use of color Doppler and was considered as a proxy for the insertion of the tentorium on the fetal skull. The BST angle was calculated in the same view and was compared between the two groups. RESULTS: Sixty normal fetuses were included in the control group and 22 fetuses with OSB in the study group. In both groups, the BST angle was found to be independent of gestational age or crown-rump length (P = 0.8815, R2 = 0.0003861 in the controls, and P = 0.2665, R2 = 0.00978 in the OSB group). The mean BST angle was 48.7 ± 7.8° in controls and 88.1 ± 1.18°, i.e. close to 90°, in fetuses with OSB. Comparison of BST-angle measurements between the control group and cases with OSB showed a statistically significant difference (P = 0.0153). In all fetuses with OSB, the downward displacement of the TH and tentorium was clearly visible at the 11-13-week scan. CONCLUSIONS: In fetuses with OSB, the BST angle is significantly larger than in normal controls, with the tentorium being almost perpendicular to the brainstem. This sign confirms the inferior displacement of the tentorium cerebelli with respect to its normal insertion on the occipital clivus as early as the first trimester of pregnancy and is useful in the diagnosis of Chiari-II malformation at this early stage. In fetuses with OSB, the low position of the tentorium and TH is clearly visible, even subjectively, at the 11-13-week scan. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.


Assuntos
Feto/diagnóstico por imagem , Espinha Bífida Cística/diagnóstico por imagem , Disrafismo Espinal/diagnóstico por imagem , Ultrassonografia Pré-Natal , Tronco Encefálico/diagnóstico por imagem , Tronco Encefálico/embriologia , Estudos de Casos e Controles , Fossa Craniana Posterior/diagnóstico por imagem , Fossa Craniana Posterior/embriologia , Cavidades Cranianas/diagnóstico por imagem , Cavidades Cranianas/embriologia , Dura-Máter/diagnóstico por imagem , Dura-Máter/embriologia , Feminino , Feto/embriologia , Idade Gestacional , Humanos , Gravidez , Primeiro Trimestre da Gravidez , Estudos Prospectivos , Estudos Retrospectivos , Espinha Bífida Cística/embriologia , Disrafismo Espinal/embriologia
5.
Sci Rep ; 11(1): 9472, 2021 May 04.
Artigo em Inglês | MEDLINE | ID: mdl-33947915

RESUMO

Our knowledge of subsurface structures often derives from seismic velocities that are measured during seismic acquisition surveys. These velocities can greatly change due to lithological, fracture frequencies and/or effective pressure/temperature variations. However, the influence of such intrinsic lithological properties and environmental conditions at the large scale is poorly understood due to the lack of comprehensive datasets. Here, we analyze 43 borehole-derived velocity datasets of 3 end-member tight carbonate sequences from Central Italy, including massive pure limestone (Calcare Massiccio, CM), thick-layered (20-50 cm) pure limestone (Maiolica, MA), and thin-layered (2-20 cm) marly limestone (Calcareous Scaglia, CS). Our results show that the main rock parameters and environmental conditions driving large scale velocity variations are bedding and paleostresses, while mineralogical composition and current tectonic stress also play a role. For each of the 3 end-members, measured VP values vary differently with depth, as the thin-layered CS units show a clear increase in Vp, while velocity slightly increases and remains constant for the thick-layered MA and massive CM units, respectively. Such observations show that velocities are affected by specific characteristics of lithological discontinuities, such as the thickness of bedding. Counterintuitively, larger Vp values were recorded in the deformed mountain range than in the undeformed foreland suggesting that higher paleo-stresses increase velocity values by enhancing diagenesis and healing of discontinuities. Our results thus demonstrate that large scale velocity variations are strictly related to variation of lithological properties and to the geological and tectonic history of an area. We suggest that such lithological and environmental controls should be taken into account when developing velocity and mechanical models for tectonically active regions of the Mediterranean Area, where earthquakes mostly nucleate and propagate through carbonate formations, and for resource exploration in fractured carbonate reservoirs.

6.
Ultrasound Obstet Gynecol ; 58(4): 568-575, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33847428

RESUMO

OBJECTIVE: To describe the sonographic appearance and position of the choroid plexus of the fourth ventricle (4V-CP) between 12 and 21 weeks' gestation in normal fetuses and in fetuses with Dandy-Walker malformation (DWM) or Blake's pouch cyst (BPC). METHODS: The study population comprised 90 prospectively recruited normal singleton pregnancies and 41 pregnancies identified retrospectively from our institutional database that had a suspected posterior fossa anomaly at 12-13 weeks' gestation based on the ultrasound finding of abnormal hindbrain spaces. In all cases the final diagnosis was confirmed by prenatal and/or postnatal magnetic resonance imaging or postmortem examination. All pregnancies underwent a detailed ultrasound assessment, including a dedicated examination of the posterior fossa, at 12-13 weeks, 15-16 weeks and 20-21 weeks of gestation. Two-dimensional ultrasound images of the midsagittal and coronal views of the brain through the posterior fontanelle and three-dimensional volume datasets were obtained. Multiplanar orthogonal image correlation with volume contrast imaging was used as the reference visualization mode. Two independent operators, blinded to the fetal outcome, were asked to classify the 4V-CP as visible or not visible in both normal and abnormal cases, and to assess if the 4V-CP was positioned inside or outside the cyst in fetuses with DWM and BPC. RESULTS: Of the 41 fetuses with apparently isolated cystic posterior fossa anomaly in the first trimester, eight were diagnosed with DWM, 29 were diagnosed with BPC and four were found to be normal in the second trimester. The position of the 4V-CP differed between DWM, BPC and normal cases in the first- and second-trimester ultrasound examinations. In particular, in normal fetuses, no cyst was present and, in the midsagittal and coronal planes of the posterior fossa, the 4V-CP appeared as an echogenic oval-shaped structure located inside the 4V apparently attached to the cerebellar vermis. In fetuses with DWM, the 4V-CP was not visible in the midsagittal view because it was displaced inferolaterally by the cyst. In contrast, in the coronal view of the posterior brain, the 4V-CP was visualized in all cases with DWM at 12-13 weeks, with a moderate decrease in the visualization rate at 15-16 weeks (87.5%) and at 20-21 weeks (75%). In the coronal view, the 4V-CP was classified as being outside the cyst in all DWM cases at 12-13 weeks and in 87.5% and 75% of cases at 15-16 and 20-21 weeks, respectively. In fetuses with BPC, the 4V-CP was visualized in all cases in both the midsagittal and coronal views at 12-13 weeks and in 100% and 96.6% of cases, respectively, at 15-16 weeks. In the coronal view, the 4V-CP was classified as being inside the cyst in 28 (96.6%), 27 (93.1%) and 25 (86.2%) cases at 12-13, 15-16 and 20-21 weeks, respectively. The medial segment of the 4V-CP was visualized near the inferior part of the vermis. CONCLUSIONS: Our study shows that longitudinal ultrasound assessment of the 4V-CP and its temporal changes from 12 to 21 weeks is feasible. The 4V-CP is located inside the cyst, just below the vermis, in BPC and outside the cyst, inferolaterally displaced and distant from the vermian margin, in DWM, consistent with the pathogenesis of the two conditions. The position of the 4V-CP is a useful sonographic marker that can help differentiate between DWM and BPC as early as in the first trimester of pregnancy. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.


Assuntos
Cistos do Sistema Nervoso Central/diagnóstico por imagem , Plexo Corióideo/embriologia , Síndrome de Dandy-Walker/diagnóstico por imagem , Quarto Ventrículo/embriologia , Ultrassonografia Pré-Natal/métodos , Cistos do Sistema Nervoso Central/embriologia , Plexo Corióideo/diagnóstico por imagem , Plexo Corióideo/patologia , Fossa Craniana Posterior/diagnóstico por imagem , Fossa Craniana Posterior/embriologia , Fossa Craniana Posterior/patologia , Síndrome de Dandy-Walker/embriologia , Bases de Dados Factuais , Diagnóstico Diferencial , Diagnóstico Precoce , Estudos de Viabilidade , Feminino , Feto/diagnóstico por imagem , Feto/embriologia , Quarto Ventrículo/diagnóstico por imagem , Quarto Ventrículo/patologia , Humanos , Gravidez , Primeiro Trimestre da Gravidez , Segundo Trimestre da Gravidez , Estudos Retrospectivos
7.
Sci Rep ; 10(1): 13109, 2020 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-32733008

RESUMO

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

8.
Sci Rep ; 10(1): 3505, 2020 02 26.
Artigo em Inglês | MEDLINE | ID: mdl-32103106

RESUMO

WW domain binding protein 5 (WBP5), also known as Transcriptional Elongation Factor A like 9 (TCEAL9) has been proposed as a candidate oncogene for human colorectal cancers with microsatellite instability and as a predictive indicator of small cell lung cancers. Furthermore, several independent studies have proposed WBP5, and its association with Wilms Tumor-1 (WT1) expression, as part of a gene expression-based risk score for predicting survival and clinical outcome in patients with Acute Myeloid Leukaemia (AML). To date, the prognostic significance of the sole WBP5 expression and its impact on the survival outcome in AML patients remains largely understudied. In the present study, we have made use of publicly available patient expression arrays and have developed an unbiased approach to classify AML patients into low versus high WBP5 expressers and to balance them for known mutations and cytogenetic findings. Interestingly, we found that patients characterized by high WBP5 expression displayed inferior overall and event-free survival rates. Notably, gene expression profiling showed that patients with high WBP5 had elevated expression of several HOX cluster genes, such as HOXA5, HOXA7, HOXA9 and HOXA10, and several of their partner proteins, such as MEIS1 and FOXC1, which have been demonstrated to be causative for AML. Taken together, our data suggest that WBP5 expression level could serve as an indicator for prognosis and survival outcome in patients with AML.


Assuntos
Proteínas de Homeodomínio/metabolismo , Leucemia Mieloide Aguda/patologia , Proteínas Nucleares/metabolismo , Biomarcadores Tumorais/metabolismo , Análise por Conglomerados , Fatores de Transcrição Forkhead/metabolismo , Proteínas de Homeodomínio/genética , Humanos , Estimativa de Kaplan-Meier , Cariótipo , Leucemia Mieloide Aguda/metabolismo , Leucemia Mieloide Aguda/mortalidade , Família Multigênica , Proteína Meis1/metabolismo , Proteínas Nucleares/genética , Prognóstico , Intervalo Livre de Progressão , Transcriptoma , Regulação para Cima
9.
J Matern Fetal Neonatal Med ; 33(3): 421-426, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29950156

RESUMO

Objective: To validate an objective scoring system for middle cerebral artery (MCA) pulsed wave Doppler images.Method: From an image database of routine 36-week scans, a random sample of MCA Doppler images was selected. Two reviewers rated the images subjectively as acceptable or unacceptable. Subsequently they used an objective 6-point image scoring system and awarded one point for each of the following: (1) anatomical site, (2) magnification, (3) angle of insonation, (4) image clarity, (5) sweep speed adjustment, and (6) velocity scale and baseline adjustment. Image scores 4-6 were defined as good quality whereas 0-3 as poor. The subjective and objective agreement between the two reviewers was compared using the adjusted Kappa statistic.Results: A total of 124 images were assessed. Using objective scoring the agreement rate between reviewers increased to 91.9% (κ = 0.839) compared to subjective agreement 75.8% (κ = 0.516). The agreement for each criterion was: anatomical site 91.1% (κ = 0.823), magnification 95.2% (κ = 0.903), clarity 83.9% (κ = 0.677), angle 96.0% (κ = 0.919), sweep speed 98.4% (κ = 0.968), and velocity scale and baseline 94.4% (κ = 0.887).Conclusion: Objective assessment of MCA Doppler images using a 6-point scoring system has greater interobserver agreement than subjective assessment and could be used for MCA Doppler quality assurance.


Assuntos
Artéria Cerebral Média/diagnóstico por imagem , Ultrassonografia Pré-Natal/normas , Feminino , Humanos , Gravidez , Ultrassonografia Doppler
10.
Ultrasound Obstet Gynecol ; 54(2): 207-214, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30207001

RESUMO

OBJECTIVE: To assess the differential diagnostic significance of a series of quantitative and qualitative variables of the cerebellar vermis in fetuses with posterior fossa cystic malformation, including Dandy-Walker malformation (DWM), vermian hypoplasia (VH) and Blake's pouch cyst (BPC). METHODS: This was a retrospective study of confirmed cases of DWM, VH and BPC, diagnosed at the Fetal Medicine and Surgery Unit of the Federico II University between January 2005 and June 2013 or the Fetal Medicine and Surgery Unit of G. Gaslini Hospital between July 2013 and September 2017. All included cases had good-quality three-dimensional (3D) volume datasets of the posterior fossa, acquired by transvaginal ultrasound through the posterior fontanelle. The midsagittal view of the posterior fossa was the reference view for the study. We assessed brainstem-tentorium angle and brainstem-vermis angle (BVA), as well as craniocaudal (CCVD) and anteroposterior (APVD) vermian diameters and vermian area (VA), which were normalized by biparietal diameter (BPD) to take into account gestational age (CCVD/BPD × 100, APVD/BPD × 100 and VA/BPD × 100, respectively). Finally, the position of the fourth ventricular choroid plexus (4VCP) was defined as normal ('up') or abnormal ('down'), relative to the roof/cyst inlet of the fourth ventricle. RESULTS: We analyzed 67 fetuses with posterior fossa malformations (24 cases of DWM, 13 of VH and 30 of BPC). The mean gestational age at diagnosis was 23.6 weeks. Regardless of gestational age, the BVA differed significantly between the three groups, and the VA/BPD was able to differentiate between VH and BPC. In differentiating between VH and BPC, the greatest areas under the receiver-operating characteristics curve were those for VA/BPD ratio. The 4VCP position was down in all cases of DWM and VH, while it was up in all cases of BPC. CONCLUSIONS: Our data support the concept that VA/BPD ratio and 4VCP position may be used to differentiate between DWM, VH and BPC in the fetus. In our series, the position of the 4VCP had the highest accuracy, but a larger number of VH cases should be evaluated to confirm that an up position of the 4VCP indicates BPC while a down position indicates DWM or VH. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.


Assuntos
Vermis Cerebelar/diagnóstico por imagem , Vermis Cerebelar/patologia , Plexo Corióideo/diagnóstico por imagem , Fossa Craniana Posterior/anormalidades , Malformações do Sistema Nervoso/diagnóstico por imagem , Vermis Cerebelar/anormalidades , Plexo Corióideo/anatomia & histologia , Fossa Craniana Posterior/diagnóstico por imagem , Fossa Craniana Posterior/patologia , Cistos , Síndrome de Dandy-Walker/diagnóstico por imagem , Síndrome de Dandy-Walker/genética , Síndrome de Dandy-Walker/patologia , Diagnóstico Diferencial , Feminino , Feto/diagnóstico por imagem , Quarto Ventrículo/diagnóstico por imagem , Idade Gestacional , Humanos , Imageamento Tridimensional/métodos , Imageamento por Ressonância Magnética/métodos , Malformações do Sistema Nervoso/embriologia , Gravidez , Diagnóstico Pré-Natal/métodos , Estudos Retrospectivos , Rombencéfalo/anatomia & histologia , Rombencéfalo/embriologia , Ultrassonografia Pré-Natal/métodos
11.
Ultrasound Obstet Gynecol ; 52(4): 494-500, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29266519

RESUMO

OBJECTIVE: To investigate whether abdominal circumference growth velocity (ACGV) improves the prediction of perinatal outcome in small-for-gestational-age (SGA) fetuses beyond that afforded by estimated fetal weight (EFW) and cerebroplacental ratio (CPR). METHODS: A cohort of 235 singleton SGA fetuses at 36-38 weeks' gestation was examined. ACGV, EFW and CPR centiles were calculated. ACGV centile was determined using data from a large database of 19-21- and 36-38-week scans in an unselected population. Binary variables of ACGV < 10th , EFW < 3rd and CPR < 5th centiles were defined as abnormal. Two composite adverse outcomes (CAO) were explored: CAO-1 defined as at least one of umbilical artery pH < 7.10, 5-min Apgar score < 7 or neonatal unit admission, and CAO-2 that included in addition hypoglycemia, intrapartum fetal distress and perinatal death. Univariate and multivariate logistic regression analyses were performed to analyze the relationship between the three risk factors and their predictive value for CAO. The change in screening performance afforded by adding ACGV to EFW and CPR was assessed and receiver-operating characteristics (ROC) curves were calculated. RESULTS: ACGV < 10th centile was an independent risk factor for CAO. The sensitivity, specificity, positive and negative likelihood ratios of a predictive model based on EFW < 3rd centile and CPR < 5th centile were, respectively, 51%, 70%, 1.71 and 0.69 for CAO-1 and 41%, 70%, 1.39 and 0.83 for CAO-2. After addition of ACGV < 10th centile to the model, the respective values were 82%, 46%, 1.54 and 0.38 for CAO-1 and 71%, 47%, 1.34 and 0.62 for CAO-2. Using continuous variables, the areas under the ROC curves improved marginally from 0.669 (95% CI, 0.604-0.729) to 0.741 (95% CI, 0.677-0.798) for CAO-1 and from 0.646 (95% CI, 0.580-0.707) to 0.700 (95% CI, 0.633-0.759) for CAO-2 after addition of ACGV to the model. CONCLUSIONS: ACGV is a risk factor for adverse neonatal outcome that is independent of EFW and of CPR, although any improvement in the prediction of adverse outcome is not statistically significant. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.


Assuntos
Abdome/diagnóstico por imagem , Desenvolvimento Fetal/fisiologia , Retardo do Crescimento Fetal/fisiopatologia , Recém-Nascido Pequeno para a Idade Gestacional/crescimento & desenvolvimento , Ultrassonografia Pré-Natal , Abdome/embriologia , Biometria , Feminino , Retardo do Crescimento Fetal/diagnóstico por imagem , Idade Gestacional , Humanos , Recém-Nascido , Gravidez , Resultado da Gravidez , Estudos Prospectivos , Natimorto
12.
Eur Rev Med Pharmacol Sci ; 21(16): 3680-3689, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28925473

RESUMO

OBJECTIVE: A retrospective cohort study was performed, using administrative database of the Local Health Unit Roma-A (LHU RM-A). The included subjects were residing in one of the four districts and were hospitalized for COPD exacerbation in healthcare facilities of the LHU during years 2010-2012. PATIENTS AND METHODS: The aim of the present study is to evaluate the impact of comorbidities, length and costs of hospital stay in patients with COPD exacerbations. Chronic obstructive pulmonary disease (COPD) is often associated with other diseases (cardiovascular diseases, diabetes, metabolic syndrome, chronic renal failure, depression) that can increase risk of mortality and hospitalization. RESULTS: A total of 1890 COPD patients are included in the study. The mean length of hospitalization is 12.25 days (SD ± 10.91), 11.63 days (SD ± 9.76) and 11.91 days (SD ± 9.69) with a mean cost of hospitalization amounting to euro 3683.48 (SD ± 2037.12), 3356.82 (SD ± 1674.86) and 3706.81 (SD ± 2087.72) in 2010, 2011 and 2012 respectively. The presence and number of comorbidities are positively and significantly associated to the length and cost of hospitalization. In particular, patients with cardiovascular diseases or diabetes mellitus associated with other comorbidities present the highest values of hospital stay and cost. The cost and the length of hospitalization were significantly linked to the number of comorbidities. CONCLUSIONS: Comorbidities play an important role in the hospital management of COPD exacerbation, increasing health care costs related to this disease.


Assuntos
Doença Pulmonar Obstrutiva Crônica/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Feminino , Custos de Cuidados de Saúde , Hospitalização/economia , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Doença Pulmonar Obstrutiva Crônica/economia , Estudos Retrospectivos
13.
Talanta ; 166: 321-327, 2017 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-28213241

RESUMO

The detection of Salmonella according to EC regulation is still primarily based on traditional microbiological culture methods that may take several days to be completed. The purpose of this work is to demonstrate the applicability of an Enzyme-Linked-Immuno-Magnetic-Electrochemical (ELIME) assay, recently developed by our research group for the detection of salmonella in irrigation water, in fresh (raw and ready-to-eat) leafy green vegetables by comparison with Real-Time PCR (RTi-PCR) and ISO culture methods. Since vegetables represent a more complex matrix than irrigation water, preliminary experiments were carried out on two leafy green vegetables that resulted negative for salmonella by the ISO method. 25g of these samples were experimentally inoculated with 1-10 CFU of S. Napoli or S. Thompson and pre-enriched for 20h in two different broths. At this time aliquots were taken, concentrated at different levels by centrifugation, and analyzed by ELIME and RTi-PCR. Once selected the best culture medium for salmonella growth, and the optimal concentration factor suitable to reduce the sample matrix effect, enhancing the out-put signal, several raw and ready-to-eat leafy green vegetables were artificially inoculated and pre-enriched. Aliquots were then taken at different incubation times and analyzed with both techniques. Results obtained showed that 20 and 8h of pre-enrichment were required to allow the target salmonella (1-10 CFU/25g) to multiply until reaching a detectable concentration by ELIME and RTi-PCR assays, respectively. A confirmation with the ISO culture method was carried out. Based on the available literature, this is the first report of the application of an ELISA based method for the detection of Salmonella in vegetables.


Assuntos
Técnicas de Cultura/métodos , Eletroquímica/métodos , Contaminação de Alimentos/análise , Fenômenos Magnéticos , Reação em Cadeia da Polimerase em Tempo Real/métodos , Salmonella/isolamento & purificação , Verduras/microbiologia , Lactuca/microbiologia
14.
Leukemia ; 31(4): 957-966, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-27748374

RESUMO

Myeloproliferative neoplasms (MPN), which overproduce blood cells in the bone marrow, have recently been linked with a genetically determined decrease in expression of the MYB transcription factor. Here, we use a mouse MYB knockdown model with an MPN-like phenotype to show how lower levels of MYB lead to stem cell characteristics in myeloid progenitors. The altered progenitor properties feature elevated cytokine responsiveness, especially to interleukin-3, which results from increased receptor expression and increased MAPK activity leading to enhanced phosphorylation of a key regulator of protein synthesis, ribosomal protein S6. MYB acts on MAPK signaling by directly regulating transcription of the gene encoding the negative modulator SPRY2. This mechanistic insight points to pathways that might be targeted therapeutically in MPN.


Assuntos
Regulação da Expressão Gênica , Interleucina-3/metabolismo , Peptídeos e Proteínas de Sinalização Intracelular/genética , Proteínas de Membrana/genética , Células Mieloides/metabolismo , Células Progenitoras Mieloides/citologia , Células Progenitoras Mieloides/metabolismo , Proteínas Proto-Oncogênicas c-myb/metabolismo , Transcrição Gênica , Animais , Biomarcadores , Linhagem Celular , Proliferação de Células , Sangue Fetal/citologia , Expressão Gênica , Regulação da Expressão Gênica/efeitos dos fármacos , Humanos , Imunofenotipagem , Interleucina-3/farmacologia , Modelos Moleculares , Células Progenitoras Mieloides/efeitos dos fármacos , Fenótipo , Receptores de Interleucina-3/metabolismo , Transdução de Sinais/efeitos dos fármacos
15.
Appl Opt ; 55(30): 8618-8636, 2016 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-27828145

RESUMO

We present a closure experiment between new inherent optical properties (IOPs: absorption a, scattering b, backscattering bb) and apparent optical properties (AOPs: remote-sensing reflectance Rrs, irradiance reflectance R, and anisotropic factor at nadir Qn) data of Ionian and Adriatic seawaters, from very clear to turbid waters, ranging across one order of magnitude in Rrs. The internal consistency of the IOP-AOP matchups was investigated though radiative transfer closure. Using the in situ IOPs, we predicted the AOPs with the commercial radiative transfer solver Hydrolight. Closure was limited by two unresolved issues, one regarding processing of in situ data and the other related to radiative transfer modeling. First, different correction methods of the absorption data measured by the Wetlabs ac-s produced high variations in simulated reflectances, reaching 40% for the highest reflectances in our dataset. Second, the lack of detailed volume scattering function measurements forces us to adopt analytical functions that are consistent with a given particle backscattering ratio. The analytical phase functions named Fournier-Forand and two-term Kopelevich presented reasonable angular shapes with respect to measurements at a few backward angles. Between these phase functions, induced changes were within 4% for Rrs, within 11% for R, and within 10% for Qn. Additionally, closure of Qn was generally not successful considering radiometric uncertainties. Simulated Qn overestimated low values and underestimated high values, especially at 665 nm, where Hydrolight was unable to predict measured Qn values greater than 6 sr. The physical nature of Qn makes this mismatch almost independent of the measured IOPs, thus precluding Qn tuning by varying the former. The non-closure of Qn might be caused by an inaccurate phase function and, to a lesser extent, by the modeling of the incoming radiance. For the future, this remains the task of accurate absorption and phase function measurements, especially at red wavelengths.

16.
Biosens Bioelectron ; 80: 154-160, 2016 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-26827145

RESUMO

The potentiometric E-tongue system was employed for water toxicity estimation in terms of cyanobacterial microcystin toxins (MCs) detection. The data obtained from E-tongue were correlated to the MCs content detected by the standard chromatographic technique UHPLC-DAD (Ultra High Performance Liquid Chromatography with Diode Array Detector), as far as by the colorimetric enzymatic approach. The prediction of MCs released by toxic Microcystis aeruginosa strains was possible with Root Mean Squared Error of Validation (RMSEV) lower or very close to 1µg/L, the provisional guideline value of WHO for MCs content in potable waters. The application of E-tongue system opens up a new perspective offset for fast and inexpensive analysis in the field of environmental monitoring, offering also the possibility to distinguish toxin producing and non-toxic M. aeruginosa strains present in potable water.


Assuntos
Toxinas Bacterianas/isolamento & purificação , Técnicas Biossensoriais , Monitoramento Ambiental , Toxinas Marinhas/isolamento & purificação , Microcistinas/isolamento & purificação , Toxinas de Cianobactérias , Eletrônica , Microcystis/isolamento & purificação , Microcystis/patogenicidade , Microbiologia da Água
17.
Talanta ; 149: 202-210, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26717832

RESUMO

A reliable, low-cost and easy-to-use ELIME (Enzyme-Linked-Immuno-Magnetic-Electrochemical) assay for detection of Salmonella enterica in irrigation water is presented. Magnetic beads (MBs), coupled to a strip of eight-magnetized screen-printed electrodes localized at the bottom of eight wells (8-well/SPE strip), effectively supported a sandwich immunological chain. Enzymatic by-product is quickly measured by chronoamperometry, using a portable instrument. With the goal of developing a method able to detect a wide range of Salmonella serotypes, including S. Napoli and S. Thompson strains responsible for various community alerts, different kinds of MBs, antibodies and blocking agents were tested. The final system employs MBs coated with a broad reactivity monoclonal antibody anti-salmonella and blocked with dry milk. For a simple and rapid assay these two steps were performed in a preliminary phase, while the two sequential incubations for the immuno-recognition events were merged in a single step of 1h. In parallel a Real-Time PCR (RTi-PCR) method, based on a specific locked nucleic acid (LNA) fluorescent probe and an internal amplification control (IAC), was carried out. The selectivity of the ELIME and RTi-PCR assays was proved by inclusivity and exclusivity tests performed analyzing different Salmonella serotypes and non-target microorganisms, most commonly isolated from environmental sources. Furthermore, both methods were applied to experimentally and not experimentally contaminated irrigation water samples. Results confirmed by the ISO culture method, demonstrated the effectiveness of ELIME and RTi-PCR assays to detect a low number of salmonella cells (1-10 CFU/L) reducing drastically the long analysis time usually required to reveal this pathogen.


Assuntos
Salmonella/isolamento & purificação , Poluentes da Água/isolamento & purificação , Anticorpos Monoclonais/imunologia , Bioensaio , Técnicas de Cultura , Técnicas Eletroquímicas , Corantes Fluorescentes , Água Doce/microbiologia , Separação Imunomagnética , Oligonucleotídeos , Reação em Cadeia da Polimerase em Tempo Real , Salmonella/imunologia
18.
Prenat Diagn ; 35(7): 717-23, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25828703

RESUMO

OBJECTIVE: The aim of this retrospective study was to describe the sonographic appearance of the posterior brain anatomy in normal fetuses at 11 to 14 weeks of pregnancy and to determine the fetal outcome when one of the posterior brain anatomical space is not recognized. METHODS: Two groups of patients were included in the study: a control group of consecutive 311 healthy fetuses with a normal sonogram and a study group of 21 fetuses with absence of one of the three posterior brain spaces. In each fetus, images of the mid-sagittal view of the fetal face and brain at 11 to 14 weeks of gestation were obtained. RESULTS: In all fetuses with absence of one of the three posterior brain spaces, a severe anomaly, including open spina bifida, cephalocele, Dandy-Walker complex, and chromosomal aberrations, was associated. CONCLUSION: Our study indicates that the sonographic finding characterized by the absence of one of the three posterior brain spaces seems to facilitate not only the detection of open spina bifida, as previously reported, but also of other neural tube defects, such as cephalocele, and is an important risk factor for cystic posterior brain anomalies, and/or chromosomal abnormalities. Thus it seems a poor prognostic finding for major fetal abnormalities.


Assuntos
Tronco Encefálico/diagnóstico por imagem , Transtornos Cromossômicos/diagnóstico por imagem , Cisterna Magna/diagnóstico por imagem , Síndrome de Dandy-Walker/diagnóstico por imagem , Quarto Ventrículo/diagnóstico por imagem , Defeitos do Tubo Neural/diagnóstico por imagem , Ultrassonografia Pré-Natal , Tronco Encefálico/anormalidades , Estudos de Casos e Controles , Cisterna Magna/anormalidades , Encefalocele/diagnóstico por imagem , Feminino , Quarto Ventrículo/anormalidades , Idade Gestacional , Humanos , Gravidez , Resultado da Gravidez , Primeiro Trimestre da Gravidez , Estudos Retrospectivos , Espinha Bífida Cística/diagnóstico por imagem
19.
Phys Rev Lett ; 113(2): 029802, 2014 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-25062249
20.
Anal Bioanal Chem ; 406(9-10): 2399-410, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24573577

RESUMO

An electrochemical sensor for palytoxin (PlTX) detection, based on a strip of eight screen-printed electrodes connected to a cost-effective and portable apparatus, is reported. Sheep erythrocytes were used to test the palytoxin detector and degree of haemolysis was evaluated by measuring release of the cytosolic lactate dehydrogenase (LDH). Percentage haemolysis and, therefore, the amount of LDH measured, by use of NADH/pyruvate and appropriate electrochemical mediators, was correlated with the concentration of the toxin. Two different electrochemical approaches were investigated for evaluation of LDH release, but only one based on the use of a binary redox mediator sequence (phenazine methosulfate in conjugation with hexacyanoferrate(III)) proved useful for our purpose. After analytical and biochemical characterization, the sensor strip was used to measure palytoxin. Sheep blood and standard solutions of PlTX were left to react for two different incubation times (24 h or 4 h), resulting in working ranges of 7 × 10(-3)-0.02 ng mL(-1) and 0.16-1.3 ng mL(-1), respectively. The specificity of the test for palytoxin was evaluated by use of ouabain, which acts in the same way as PlTX on the Na(+)/K(+)-ATPase pump. A cross-reactivity study, using high concentrations of other marine biotoxins was also conducted. Experiments to evaluate the matrix effect and recovery from mussels are discussed.


Assuntos
Acrilamidas/análise , Técnicas Biossensoriais/métodos , Bivalves/química , Ensaios Enzimáticos/métodos , Toxinas Marinhas/análise , Frutos do Mar/análise , Acrilamidas/toxicidade , Animais , Técnicas Biossensoriais/instrumentação , Venenos de Cnidários , Eritrócitos/citologia , Eritrócitos/efeitos dos fármacos , Eritrócitos/enzimologia , Hemólise , L-Lactato Desidrogenase/análise , Toxinas Marinhas/toxicidade , Ovinos
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