33 research outputs found
La rappresentazione del sé corporeo in condizioni di patologie croniche diversamente trattate
No full textIl contributo presenta uno studio sulla rappresentazione del sé corporeo in bambini con patologie croniche diversamente trattate, al fine di esplorare possibili risorse funzionali alla gestione della condizione di rischio costituita dalla patologia; nello specifico, gli indicatori delle risorse vanno individuati, su un piano qualitativo, nell’adeguatezza dell’immagine del corpo, nell’integrità dell’immagine di sé, nell’integrazione di mappe cognitive e, su un piano quantitativo, nel quoziente di maturità cognitiva. Lo studio ha previsto il coinvolgimento di un gruppo di 52 bambini (età media 10 anni) di cui un 50% con patologie croniche che prevedono trattamenti invasivi, caratterizzati da "pratiche" sul corpo costanti che alterano la serenità del quotidiano (es. trasfusioni, cateteri venosi, iniezioni di insulina, microinfusioni), l’altro 50% con cardiopatie sottoposti a trattamenti solo farmacologici. L’indagine ha previsto l’uso del Disegno della Figura Umana. I risultati, pur mostrando, in generale, livelli medi di adeguatezza e di integrità corporea, sottolineano differenze statisticamente significative in relazione alla tipologia di trattamento, laddove i bambini sottoposti a trattamenti invasivi presentano livelli più elevati sia di adeguatezza che di integrità corporea. Relativamente al quoziente di maturità, invece, non si evidenziano differenze tra i due gruppi, sottolineando la presenza di alcune risorse cognitive funzionali all’adattamento alla patologia
Influence of heterogeneity of myocardial iron overload, myocardial fibrosis and blood oxygenation on T2* values in beta thalassemia major
No full textLate gadolinium-enhanced magnetic resonance imaging in beta thalassemia major: correlation with ECG-changes, biventricular function parameters and myocardial iron overload
No full textEfficacy of oral deferiprone in beta thalassemia major by multislice multiecho T2* and cine dynamic magnetic resonance imaging
No full textSTRAIN RATE ECHOCARDIOGRAPHYTO DETECT EARLY IMPAIRMENT OF LEFT VENTRICULAR SYSTOLIC FUNCTION IN PATIENTS WITH ASYMPTOMATIC CARDIAC AMYLOIDOSIS
No full textDETECTION OF IMPAIRMENT OF LEFT VENTRICULAR DISTOLIC FUNCTION IN PATIENTS WITH CARDIAC AMYLOIDOSIS USING STRAIN RATE ECHOCARDIOGRAPHY.
No full textComparison of right ventricular longitudinal strain imaging, tricuspid annular plane systolic excursion, and cardiac biomarkers for early diagnosis of cardiac involvement and risk stratification in primary systematic (AL) amyloidosis: a 5-year cohort study.
No full textAims To determine the role of assessing right ventricular (RV) function, using standard echocardiography and Doppler myocardial imaging (DMI), in the early diagnosis of cardiac amyloidosis and in the prediction of mortality.
Methods and results Patients with primary systemic (AL) amyloidosis seen at our institution from 1 February 2004 through 31 October 2005 (N = 249) were categorized by left ventricular thickness and E′ velocity and compared with 38 age- and sex-matched controls. Standard echocardiographic and DMI examination were used to measure echocardiographic parameters of RV function: systolic tissue velocity, strain rate, and strain were determined for basal and middle RV free wall segments. Patients were followed up for the endpoint of mortality. RV tricuspid annular plane systolic excursion (TAPSE) and all DMI measurements were lower in patients with AL amyloidosis and normal echocardiography results (AL-normal-echo group) than controls. A bivariate model including strain of the basal segment of the RV free wall and TAPSE was the best for distinguishing AL-normal-echo patients from controls. Male sex [hazard ratio (HR), 2.2; P= 0.005], brain natriuretic peptide levels (HR 1.4; P= 0.003), troponin T levels (HR 1.6; P= 0.01), pleural effusion (HR 3.6; P< 0.001), E/A ratio (HR 1.3; P= 0.006), RV systolic pressure (HR 1.02; P= 0.01), and RV strain rate of the middle segment (HR 1.3; P= 0.02) were independent predictors of death.
Conclusion DMI measures of the RV can identify early impairment of cardiac function or stratify risk of death in patients with AL amyloidosis. Further studies with longer follow-up are warranted to confirm these results
The burden of Candida parapsilosis bloodstream infections: from azole resistance to biofilm production
No full textThe aim of our work was to evaluate the incidence and antibiotype of
Candida parapsilosis strains isolated from blood cultures at our hospital, the possible
correlation between phenotypic and genotypic fluconazole resistance, and their ability
to produce biofilm.
Materials and Methods. C. parapsilosis strains were isolated from blood cultures by
the BACTEC broth culture system and phenotypically identified by mass spectrometry
(MALDI-TOF). Antifungal susceptibility testing (AST) was determined by broth micro-
method (Sensititre YeastOne Colorimetric Broth). AST reading was performed using
Clinical & Laboratory Standards Institute (CLSI) guidelines for the interpretation of
Minimum Inhibitory Concentration (MIC) values. The different strains isolated were
distinguished into three groups: Group 1 which comprised the strains susceptible to
fluconazole (MIC ≤2 mcg/ml) and voriconazole (MIC ≤0.12 mcg/ml), Group 2A including
the strains resistant to fluconazole (MIC ≥8 mcg/ml) and voriconazole (MIC ≥1
mcg/ml) and Group 2B into which isolates were resistant to fluconazole (MIC ≥8 mcg/
ml) and intermediate to voriconazole (MIC 0.25-0.5 mcg/ml). The study of genotypic
resistance was conducted by Sanger sequencing of the ERG11 gene. Biofilm production
was evaluated according to Ramage’s method, and a biofilm score (BS) was assigned
as follows: low (1+,2+), medium (3+,4+) and good (5+,6+) producers.
Results. ERG11 gene sequencing of 46 strains isolated in 2021 (46/100) mostly
showed the presence of the Y132F and I197I (synonymous mutation) while the R398I
and I261M mutations were quite rare with no apparent phenotypic resistance. Of
these 46, 74% belonged to groups 2A and 2B, furthermore these strains showed low
BS biofilm production (1+,2+). Regarding the biofilm analysis, a total of 71 C. parapsilosis
strains were evaluated, of which 73.24 % (52/71) belonged to groups 2A and 2B
and were associated with low BS (1+/2+) while 26.7 % (19/71) belonged to group 1
and expressed various levels of biofilm production (10/19 were medium and good BS
producers).
Discussion and Conclusions. The results obtained show that the strains harboring the
Y132F mutation correlate with the phenotypic resistance to fluconazole whilst the
I197I synonymous mutation does not impact the morphology of the target region and
thus no associated resistance is observed. Additionally, it can be hypothesized that
azoles, not being endowed with anti-biofilm activity, unlike echinocandins and liposomal
amphotericin B, may have reduced efficacy in vivo, even against the phenotypically
susceptible strains with medium and good BS scores. This can be especially true
in cases of catheter-related candidemia
Molecular characterization of emerging Echovirus 11 (E11) shed light on the recombinant origin of a variant associated with severe hepatitis in neonates
No full textEchovirus 11 (E11) has gained attention owing to its association with severe neonatal infections. Due to the limited data available, the World Health Organization (WHO) considers public health risk to the general population to be low. The present study investigated the genetic variation and molecular evolution of E11 genomes collected from May to December 2023. Whole genome sequencing (WGS) was performed for 16 E11 strains. Phylogenetic analysis on WG showed how all Italian strains belonged to genogroup D5, similarly to other E11 strains recently reported in France and Germany all together aggregated into separate clusters. A cluster-specific recombination pattern was also identified using phylogenetic analysis of different genome regions. Echovirus 6 was identified as the major recombinant virus in 3Cpro and 3Dpol regions. The molecular clock analysis revealed that the recombination event probably occurred in June 2018 (95% HPD interval: Jan 2016-Jan 2020). Shannon entropy analyses, within P1 region, showed how 11 amino acids exhibited relatively high entropy. Five of them were exposed on the canyon region which is responsible for receptor binding with the neonatal Fc receptor. The present study showed the recombinant origin of a new lineage of E11 associated with severe neonatal infections
Cardiac Magnetic Resonance characterization of Thalassemia Intermedia patients confronted with Thalassemia Major patients
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